Words of a Fighter

Words of a Fighter

Wednesday, June 30, 2010

Update from Tuesday Night and Wednesday...Another Surgery Today

Let me start by saying Thank you to everybody who made it to the drumming/glowstick vigil last night. It was really amazing when I pulled into the parking lot and heard the thunder of the drums. I had no idea it was going to be so touching. Thank you to those who wanted to come, but couldn't for whatever reason. We know you're still praying for my Dad and the rest of us.
Yesterday ended up being a really good day for my Dad and the rest of the family. He was able to speak very briefly to Linda and Josh while the speech therapist was working with him. Mostly, it was responding to the therapist asking if he can feel this or that, or other yes/no questions.
Then later in the evening when I got to see him he adamantly shook his head when I stated that his mind wasn't listening to his body, was it. It was completely unexpected on my part because up until that point, I had only heard that he was answering by nodding or shaking his head. Josh told me that it was the biggest shake of his head that he had seen all day, which made me feel good.
Probably the most touching moment that I saw yesterday was when my Grandmother, Joyce, came in to say goodnight to him. As soon as he heard her voice near him, he reached up to her with his hand. She took his hand and he squeezed hers back and relaxed. I know that moment was such a sigh of relief for her, and me as well. He still knows who we are.
Today, he wasn't quite as awake as he was last night, but I think we were all ok with that because we knew he had his surgery ahead of him and he needed his rest for that.
They took him into the OR around 1:45 to repair his left humerous (upper arm) and right wrist. It took about five hours, but he tolerated it really well and stayed stable the whole time. Unfortunately, they were unable to take the skin grafts to close the wounds in his leg because the plastic surgeon had other commitments this afternoon, so he will have to go under again for that. We were all hoping that they could get that done as well and it would mean one less trip to the OR.
The good news is that his Orthopedic Surgeon was very confident in his ability to use his arm to support himself on something to try to start walking soon. He said that if he were awake, he would have him up tomorrow trying to start therapy. That was very encouraging.
Another ray of sunshine was that his Trauma Surgeon told Linda to start looking for a really good intensive inpatient rehab/therapy facility because he expects that he should be able to transfer him. He suggested starting with Loma Linda. If anybody has any experience in this area and would like to make a suggestion, we are very open to hearing them.
I apologize for not updating last night, I was having trouble getting a wifi signal.
Thank you for all of your prayers and support...They are working.

Tuesday, June 29, 2010

Healing Drum Circle/Candlelight Vigil Update...TONIGHT

My previous post said that the vigil was tonight at 8 pm, however, I was informed that it was changed to 7:30 pm. It will be held in front of the hospital and as long as it doesn't resemble a picket of any kind, then we will be allowed to continue.
Thank you all for your support and prayers.

A Better Day

He was able to respond by trying to talk today. I didn't get a lot of details, but my brother, Josh, called me from the hospital and said that our Dad was trying to talk earlier. They had to deflate something in his tracheostomy in order to hear him better. It sounded as if he was saying "mmmmm hmmmm" and "Ya". I don't know what questions he was answering because I'm not at the hospital yet.
I am hoping to get to hear him talk later when I can get there. Right now, I have my girls, so I will go down there once my husband gets off of work.

2 Steps Forward, 1 Step Back...

After breathing on his own for 5 hours yesterday, my Dad got tired and the pulmonologist decided that he should be back on ventilation in order to rest. His nurse mentioned that often times it's only overnight and then they let the patients breathe again on their own during the day. However, this particular pulmonologist happens to be somewhat conservative and chose to keep him on it for the daytime as well.
He is still looking better each day. His face us healing slowly but surely. The staples came out of his shoulder today, and they were planning to see if they could get the ones in the back of his head out as well, but his nurse needed a second set of hands to do that.
His chest tube is still in. His blood pressure is a little higher than it was a few days ago, but I believe that's normal since they have reduced his pain medication so he is feeling more pain than he was before. As far as I know, that can cause an elevation in blood pressure.
He has been off sedation completely for 3 days, and yesterday they started lowering the dose of his pain medications. Today, he was no longer on the pain drip, but he did have a patch that administered the medication to him in a lower dose, and they were giving him morphine in between if he seemed to need it.
A Speech Therapist came in today to start working with him in order to wake him up. The do a type of therapy called "Coma Stim". It's a technique that they use for patients in a coma or similar state (like my Dad) that helps to stimulate them and bring them up to consciousness. During the therapy, he was able to move some toes on his right foot when she asked him to.
The Speech Therapist will continue to work with him, not only on the Coma Stim, but once he's awake, he will have to re-learn how to swallow again since he now has a hole in his throat and his face has been rearranged. He will also need to learn to speak through the trach when the time comes. We've been told that it could be 3-4 more weeks before he will be stable enough to add the part of the trach that allows him to speak through it.
My little Brother, Josh, came into town today on the train. It's so good to see him, although we all wish it were under different circumstances. He and I got to visit our Dad for about an hour before they needed us to step out to change his bandages.
On our way out, we were informed that when we came back in, we would need to wear hospital gowns, gloves and possibly masks as well, because my Dad now has an infection. She told me the name, it started with a B from what I recall, but I can't remember it for the life of me. Anyhow, they didn't seem too concerned with how it may effect his recovery, but they did tell us that it was contagious and that we would have to gown up to protect ourselves from being exposed.
Josh and I went to grab a bite to eat and it took about an hour. That seemed like plenty of time to get the bandages changed, especially since it only took 40 minutes yesterday. But when we got back, they asked us to give them another 40 minutes, but didn't really tell us why. When I told Linda, she decided to call and see if everything was ok. We were hopeful that it meant that maybe he was coming around, but that wasn't why. Apparently, while she was changing his dressings, he got "Riled up". We don't know for sure what that means, but it more than likely means that he was in pain and got aggitated. I think Linda said that they gave him more pain meds and were working on finishing his bandaging still.
As of right now, I believe he is scheduled for surgery on his left arm later this week.
Thank you for your prayers.

Sunday, June 27, 2010

He's breathing on his own!

My Dad is off the ventilator now. He has been breathing on his own since about noon today. He is still hooked up to it and it's streaming continuous O2, but the breaths he is taking are all on his own. He huffs and puffs a little from time to time, but after some soothing, he calms down again.
He is moving his head quite a bit more today also. I believe he is slightly more aware of us than he was yesterday. So far, he hasn't come all the way out of his unconscious state yet.

Nothing New to Report

I just wanted to check in and let everybody know that there really hasn't been any change since yesterday. He isn't awake yet. They plan to start backing his pain medication down slowly today to see if that helps him wake up. If he isn't awake by tomorrow, the doctor said that he would have a speech therapist come in and do something called 'coma stim'. Even though he isn't technically in a coma, his state of unconsciousness is very similar to a coma and what ever exercises the therapist will do helps to bring them to consciousness.
Most of us are ok with him still being out because we figure he needs the rest and time to heal. But the doctors want him to wake up, even if it's just for a short time because they want to evaluate his mental state and see if they can get a better idea of the extent to the damage to his brain.
Keep praying for him, pray for him to not have to experience much pain, pray for strength during his recovery and therapy, pray for his mind and that it is still in tact.
Thank you all for your prayers.

Saturday, June 26, 2010

He is off sedation now

They stopped the sedation this morning so that he can slowly come to consciousness. He is still not fully awake, however, he is able to move his head toward the sound of our voices. So far, he hasn't gotten aggitated or too upset.
We continue to remind him when he stirs that he's been in a terrible accident and that he's at RCH and will be ok. We tell him not to try to talk because his jaw is wired closed and not to try to move because of his broken bones. He is trying to breathe on his own but he is still on the respirator.
His most recent CT Scan showed some minor brain damage, mostly to the part of his brain that controls his inhibitions. They have prepared us for the possibility that he will wake up very aggitated or angry and that it is likely that he will just say what he is thinking and will not be able to help himself.
They say that it may take a couple of days for the sedation to completely wear off depending on how quickly his body metabolizes the medication. We all agree that the longer he can sleep, the better, since he still has the trach in and is on the respirator. Not to mention that the longer he sleeps, the less he's aware of his circumstances.
He looks much better today. Most of his swelling has gone down and he has a lot more natral color in his face and body. He isn't so red and puffy.
The lacerations on his face look like they are healing really well and he's had some of his sutures removed.
Now that the swelling has gone down, I can see a horrible goose egg on his forehead. Seriously, it's like what you see in the Tom & Jerry cartoons.
Thank you again for all of your love and support and prayers. Ultimately, they are working. While he is still considered critical, he is stable and responding to treatment.

Friday, June 25, 2010

Pictures and Video of Truck and Accident Site

For those who would like to see, I have added a slideshow of the damage to the truck and a video that I show re-tracing the path of the accident to the bottom of the blog. I put it down there just in case there are some who do not wish to see. I kept a couple of pictures of the truck private because they were hard to look at, even for me and I don't get squeemish. It was a little emotionally overwhelming, so I hope you understand.
To see them you can scroll all the way down to the bottom of the blog.
He spent most of the day today resting and recovering from surgery on his leg. It is likely that they will begin cutting back on the sedative tomorrow and allow him to come to consciousness slowly. I will continue to update as he progresses.

Update on his condition

He is still stable and did well through the night.  He was supposed to have another CAT Scan last night, but they didn't end up doing it because his oxygen levels dropped when they were moving him so they took him back to his room.  His oxygen levels have stabilized and they are giving him a medication now to help increase his O2 sats.
He's on so many medications, it's hard to keep them all straight.  He is on a sedative, pain medicaions, blood pressure medication, insulin for his diabetes, a medication that helps to reduce the swelling in his body, another medication to pump up his red blood cells, antibiotics to reduce the risk of infection, and on and on.  He has so many IV drips that as soon as the nurses replenish one of them, another runs out.  They spend most of their time refilling and managing his IV and then charting what they just gave him.
It is comforting that most of his caregivers, be they Nurses, RT's, Doctors, etc. all know him or know of him.  Something about them knowing him outside of being a patient makes me feel better.

Thursday, June 24, 2010

Dave is out of surgery

It went well and he is stable.  It took about 5 1/2 hours, and he has a large nail supporting his femur (upper leg) and a plate and screws in his tibia (lower leg).  He remained stable through surgery, although he had to have a few units of blood to keep his hemaglobin levels from dropping too low.  Some of the swelling returned so he's a little puffy, but they say that is normal with surgery and blood transfusion.  It seems like everytime he gets blood, his face swells up again.
He is resting now and they plan to give him through the weekend to recover from this surgery before they go in and fix his left arm and right wrist.  So long as he stays stable, they will fix those sometime next week.
We still don't know when they will allow him to wake up, however, at this time we are ok with them letting him sleep for now because we know he is pretty drugged up.  The way I see it, he can sleep for weeks if it means that he won't be in as much pain when he wakes up.  The only downfall to him being so heavily sedated is that we don't know what his mental impairments might be until he is awake and they can evaluate him.
His Neurologist is pretty optimistic regarding any damage to his brain, however, they do warn us that there is a chance that he may suffer from some impairment, but nobody can estimate how much yet.  His Ortho Surgeon, has prepared us for approximately 6 months to a year before he is able to get around without some sort of help, be it from a wheelchair, walker, cane, etc.  It is likely that he may have a limp for quite sometime.
He still has a chest tube and intracranial pressure monitor.  His pressure levels in his brain are still in the safe zone, though, which is good.
More to come....

He is in surgery now...

I was able to accompany him down to the OR a little bit ago.  His doctors decided that they will only be working on his leg today due to the risks and probably blood loss that will occur during surgery.  They will have to fix his arm and wrist at another time.  The estimated time in the OR for this procedure is about 5 hours.  He went in around 3pm, so he should be finished around 8pm and I will update again once he is out.

Candlelight Vigil

There will be a candlelight vigil in front of Riverside Community Hospital on Tuesday, June 29th at 8:00 pm.  If you can come and show your support, we would love to see you there.

Surgery Today

My Dad has been stable enough for them to go in today and repair his leg.  If they have enough time, they will also work on fixing his left arm and possibly his right wrist.  He is still on the ventilator, however he is doing really well at this point.  He will remain under sedation for another day or two at the least before they allow him to regain conciousness.
Some more good news is that he is now able to tolerate being fed through a tube.  They had attempted feeding him on Monday night, however, he didn't tolerate it well.  They tried again on Tuesday night and he did better, so he is now able to 'eat' gruel through a tube.  I know that doesn't sound appetizing, but at least he doesn't have to taste it and he can get more nourishment to help him get stronger and recover.
I will post another update after his surgery today to let everybody know how it goes.

Wednesday, June 23, 2010

Blood Drive in Dave's Name

For those who are asking if there is anything that they can do, we have started a blood drive in his name.  If you want to donate, you can go to your local Life Stream Donation Center and make a donation in his name.  All you have to do is tell them that you want to donate 'replenish blood for David Van Voorhis and that he is at Riverside Community Hospital'.
I should have a code in the next couple of days that you can give them, but for now if you tell them that, they will make a note in the system to give him credit for your donation.
He had to have at least 10 units of blood during his first couple of days in the ICU and he will likely need more blood as he continues to have surgeries down the road.  He may not get your blood specifically, however, he will be given credit for every unit donated in his name.  Every donation means the world to me.  Thank you for helping.
The Life Stream Center in Riverside is located at the corner of Garfield and Van Buren and the one in Victorville is located on Bussiness Center Drive near Charter Communications.
Below is a list of local locations addresses and phone numbers.

San Bernardino Donor Center


384 West Orange Show Road

909.885.6503

Sun - Thu 8:30 a.m. to 6 p.m.

Friday 7:30 a.m. to 7:30 p.m.

Saturday 7:30 a.m to 5 p.m.



Riverside Donor Center

4006 Van Buren Boulevard

Van Buren and Garfield

951.687.2530

Sun - Thu 8:30 a.m. to 6 p.m.

Friday 7:30 a.m. to 7:30 p.m.

Saturday 7:30 a.m to 5 p.m.



Ontario Donor Center

1959 East Fourth Street

Fourth and Vineyard

909.987.3158

Sun - Thu 8:30 a.m. to 6 p.m.

Friday 7:30 a.m. to 7:30 p.m.

Saturday 7:30 a.m to 5 p.m.



High Desert Donor Center

12520 Business Center Drive, Building G, Victorville

760.843.9700

Sun - Thu 8:30 a.m. to 6 p.m.

Friday 7:30 a.m. to 7:30 p.m.

Saturday 7:30 a.m to 5 p.m.

What Happened?

As most everybody knows, my Dad, David Van Voorhis was in a serious car accident very early Sunday (Father's Day) morning on his way to a call at the hospital.  It was a single car accident in which it is suspected that he swerved to miss something in the road and lost control of his truck just around the corner from his destination on Palm north of Bandini.
His vehicle went up the embankment on the right hand side, smashing the drivers side into a palm tree before flipping and rolling back across Palm into oncoming traffic lanes.  There were no witnesses, however, my Grandfather, Dirk, and I were able to locate the scene of the accident and retrace the path of the accident.  Somebody came upon the accident shortly after it occured and called 911.
He was brought to the Emergency Room at Riverside Community Hospital and from what we are told, he was conscious when he arrived and was pretty mad that he had been in an accident.
We had plans for later that morning, my three daughters and I were going to take he and my Grandfather out to breakfast for Fathers Day.  One of his friends and coworkers said he had been very excited about our breakfast date earlier that night when they worked together on another call.
He suffered multiple trauma including a punctured and collapsed lung, a horrible skull fracture that extended to most of the bones on the left side of his face.  His four left lower teeth were knocked out and at least one or two molars were cracked.  His left scapula (shoulder) and left humerous (upper arm) were broken, his left hip is cracked, his left femur (upper leg) had an open fracture, his left tibia and fibia (lower leg bones) were broken in two places.  His right wrist and ankle were broken and his sternum was fractured as well.  He has so many lacerations that we couldn't begin to count them, and most of them seem to be on the left side of his face.
Fortunately, his internal organs didn't suffer any damage.  He was wearing his seatbelt, which most definately saved his life.  His brain has suffered some trauma, but it's limited to a couple of bleeds that are not life threatening at this time, a lot of bruising and some swelling which is normal for the type of trauma he has had.
He is currently in a medically induced coma under very heavy sedation.  He is on a ventilator and had to have a trach inserted through his throat because they can't have a tube through his mouth now that his jaw is wired closed.  They do not plan to allow him to wake up until Friday or Saturday at this point.
He was taken into surgery Sunday morning around 10 am where they were able to reconstruct his facial bones to the best of their ability at the time.  They had to wire his jaw closed so that they could use his mandible (lower jaw bone) as a foundation to support and build the rest of his face upon.  His maxilla (upper jaw) was broken in several places as was his left cheek bone.  They were able to reconstruct the pieces of his cheek bone, but his occipital (eye socket) bone was beyond repair.  His surgeon compared that bone to 'potato chips' and said once it was smashed, there was no putting it back together.  So, a titanium plate was put in to replace his occipital bone. 
His plastic surgeon prepared us for the probability that he will have a couple of more facial surgeries, but that he had to wait for the swelling to go down before he would be able to see where things were sitting and if he was going to have vision problems with his left eye.  Fortunately, even with all of the trauma surrounding his eye, his actual eye ball remained in tact and undamages so far as they can tell right now.
They also put an external immobilizer on his left leg to keep the pressure off of the break and stabilize his leg.  His arm and wrist were also splinted and immobilized during his surgery.  The surgery lasted about four hours and once he was finished, he was taken to the ICU where he will stay for at least two weeks.  They inserted an internal monitor in his brain so that they could monitor the pressure on his brain constantly without having to bring him out of sedation to asses him and take him down for CAT Scans every couple of hours so he is able to remain heavily sedated around the clock.
From what we were told, none of his injuries alone were life threatening, however, the amount of trauma he has suffered combined was life threatening.  The good news is that he has made it through the first 72 hours without infection or blood clots and everyday he seems to look better.  A lot of the swelling has subsided, and for the most part, his vital signs are staying stable.
One of us, either Linda, myself, Joyce (my Grandmother and his Mother), Dirk, or Lindsay (my Aunt and his Sister) are by his bedside during every waking hour.  All of us appreciate all of your love, support, prayers, and positive healing energy.  It means so much to us that everybody is so concerned and being so wonderful.
We will continue to post daily updates and news so that we can all follow his progress.