That said, I would still like to capture the story here. I think the easiest way is to use the updates I have been emailing to family. Why re-invent the wheel? At some point I will add all the stories that are missing but this is a good starting point.
Please be forewarned, there will be bloody graphic pictures included in this post. Do not scroll down if you try to avoid these kind of pictures!
Friday | September 24, 2010 | 4:15 PM
Hard to believe just over 24 hours ago James was on a job site cleaning up for the day and now sits it the orthopedic trauma unit of the best hospital in Seattle. A lot happened in between. But the 2 most important things are skilled surgeons worked into the wee hours of the morning giving James the best chance they could at recovery and hundreds of people across the country were offering up prayers each and every hour. The power of God is phenomenal. The power of man in the hands of God brings awe and wonder.
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| Sept 23 | 4:00 PM. Just about to roll James into the operating room |
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| Just arrived in his room after leaving the recovery room |
The bleeding he is doing is good but it is also a balancing act so they have to draw blood every 6 hours to check the levels of this and that and another thing. If this, that or the other thing get too low they will give him a transfusion. Medicine is amazing. Simply amazing.
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| Immediately post op - before the drip, drip, dripping began |
Emotions get the better of him now and then; a lot of that is more than 12 hours of anesthesia – it does weird things to the brain :/ but for the most part his spirits are high and he is mr-funny-man keeping the nurses and doctors laughing. From the ER staff to the surgical staff we kept hearing what a great guy he is. That he is!
The surgeon described the painstaking task of connecting everything back together and even she was amazed at the stellar results. So far things are going better than they hoped for. The color in all of his digits is good and that is the most excellent news.
All of us can’t thank you enough for your love and prayers. The difference they make is extraordinary. As good as everything is going, we aren’t quite out of the woods so please keep them coming. Back to the hospital – nap time is over!
xoxoxo Kathleen
Sunday | September 26, 2010 | 12:00 AM
Day 2 has been put to bed. James woke up in good spirits, kept us hoping throughout the day and went to sleep exhausted but comfortable.
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| James on day 2 |
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| Still draining but look at those gorgeous fingers; the color just gets better and better! |
However, when his temp climbed to 107.6 by early afternoon (that is not a typo!) they became concerned. Mom (that would be me) however passed right by concerned and moved onto near panic. Our day nurse Joel was awesome and jumped right on it moving at lightning speed. He got the surgeon back down here and they came up with a game plan. Unfortunately, James could not be cooled in the usual way with ice or cold compresses. When you do that all the blood flows away from the extremities and rushes to the core…and that would mean certain death for all of the repaired veins, arteries, nerves and tissue in his hand. It is the thin blood flowing freely to his hand and digits that is feeding the hundreds of newly formed connections back to life. They cooled the room to 80 degrees (can anyone reading this believe Kathleen used the word cool and 80 degrees in the same sentence?). They put light ice packs in his left armpit and groin and increased the Tylenol regimen (apparently Tylenol really is the drug of choice by 9 out of 10 doctors for lowering a fever – who knew?). Slowly but surely it climbed down (at the time of this writing the Tropicana Suite is back to its sauna-like temp of 88 degrees, all ice packs are gone, incoherent ramblings and hallucinations are abating and his temp is 101.1 and descending; I can live with that).
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| Mr. Positive trying to let everyone know he's OK |
Looking forward to day 3…as it is always an adventure in the Tropicana Suite! We feel all of your prayers, love and well-wishes. Thank you from the bottom of our hearts!
-Kathleen
PS – I have received texts and emails from all of you today but it was such a busy day I just couldn’t get back to everyone…and now I’m tired (go figure!) but wanted to let you know how very much we appreciate your connections. Keep them coming! I thought a group email before bed might be the best way to respond to everyone. BTW…we have the best families in the world :)
Monday | September 27, 2010 | 9:57 AM
Sunday was day 3. Surgeons made their morning rounds and once again said they are pleased with the progress. The color of the digits remains constant and the drainage of blood through the wound and into the dressing (and the bed, and his pj’s and the pillow…) is slowing just as it should be, but not stopping which would be bad.
Below are a series of pictures from a dressing change.
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| Time for a dressing change |
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| Joel cutting off the gauze |
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| Only one thin layer of protective dressing left on |
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| Wolverine...for at least another 6 weeks :) |
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| That is an actual hole cut into the tip of his thumb to help pull blood thru and out of the digit easily. Really. |
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| The stitching is a work of art to behold. |
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| All cleaned up for now! |
The best way to describe day 3 is it was like that time in your sleep cycle when you are tossing and turning – not quite asleep, not quite awake - and your mind is churning and twirling and you aren’t getting anywhere – and when you open your eyes you are exhausted and confused and for a brief moment you aren’t quite sure where you are or what day it is. Yup, that is a good description of day 3.
Trying to stop scratching (and not open new wounds in his skin) and trying to keep food down were the big jobs of the day. Can’t say we scored bit points in either category but hey, he tried :/ Some broth at dinnertime and a bit more before bed finally stayed down. Regular doses of Benadryl kept the scratching to a minimum – but it also kept the entertaining waking babble to a maximum…for example did you know he’s not Mel Gibson? Well, apparently he’s not. He told Shannon to save herself because he wasn’t Mel Gibson and he had been bit :) Every time he says something that cracks us up we wish we had a tape recorder – or better yet – a video recorder. He would get a kick out of watching the reruns.
James girlfriend Tess babysat him for a few hours in the afternoon while we all went to my mom and dad’s for Shannon’s going away party (which of course had been planned before this latest Marth adventure started). A party sounded hard to attend. Even Shannon wasn’t much interested. But mom (being the wise woman that she is) said we had to eat sometime so why not do it at her house? Getting out of the hospital was good for the mind – seeing family celebrate Shannon was good for the soul. It was the last time she was going to see her family for a while because she leaves this Thursday for her new home in Palm Desert, California. Even typing those words puts a lump in my throat. I see a lot of Kleenex in my future this week…might be a good time to buy stock in Kimberly-Clark :}
James is still whiling away the hours confined to bed in the Tropicana Suite. I must say, the smell of a 15x15 foot room with no open windows, no fans and hot air constantly blowing through the vents to maintain an 85+ degree temperature for 3 days is quite a unique smell – not one I would recommend bottling and trying to sell - unless your market is street people living under the bridge. Yikes, it is ripe in here. He is looking forward to bath day…we are looking forward to his bath day. Soon, I hope!
Today is day 4…wonder what’s in store?
Love you all. Love the texts and emails. Love the prayers and well wishes. Love all you do - thank you!
-Kathleen
Tuesday | September 28, 2010 | 7:03 PM
Yesterday was day four at Harbor View Hospital. It reminded me of a spring day in Seattle. One minute you need an umbrella and a short while later you’re looking for your sunglasses.
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| Dressing changes are exhausting. The splint his hand rests on is in the left foreground of photo. |
Throughout the day he vacillated between nauseated to eating; sleeping to wide awake; rambling gibberish to thoughtful conversation; insane itching to peaceful resting; cranky to good spirits. He’d anticipated getting off bed rest but surgeons decided at least one more day would be a good idea – along with at least another day in the Tropicana Suite. That pushes the going home date out to Friday at the earliest. His hand was more uncomfortable than previous days but I think that has a lot to do with transitioning to oral pain medication instead of the IV morphine drip. They are trying to find the right dosage to stay ahead of the pain…I like that plan!
They brought us copies of his pre-op x-ray’s and a copy of the operative report. Oh my. Although some words in the report felt like we were reading a foreign language, it was apparent nothing short of a miracle took place on that operating table. Our gratitude was raised to a whole new level for the skilled surgeons and the outpouring of prayers from family and friends.
It is now day five and approaching dinner time. Unfortunately our patient won’t be partaking…again. Much to his complete and absolute frustration nothing will stay down…still. Doc just stopped in. He has a plan.
On the up side he received his first bed bath with soap and water and then got to sit up in a nice big comfy chair – ahhhh, you could take one look at him and see how good those two things felt. But the pièce de résistance was getting his catheter out and his Sponge Bob Square Pants boxers on – he even made me take a picture of him looking like a million bucks sitting up in his own shorts (I have attached it for your viewing pleasure).
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| Sponge Square Bob Pants. Yes, I did say that - not once, but twice - I claim sleep deprivation :) |
Love to all!
Thursday | September 30, 2010 | 9:46
Side note of great importance: today marked the moment that my first born departed on her adventure to California. My heart is leaking buckets of tears but it is equally excited for the excellent choice Shannon has made in this move. I wish her joy, success, purpose, meaning and of course sunshine in her life! More to be posted on her adventure later.
Yesterday was day 6 in the hospital for James. Before this story is over it must be said that the staff at Harborview bring a whole new meaning to excellent patient care. What the hospital lacks in modern electronics, wall murals and stylish furnishings is more than made up for in the area that really matters – excellence in patient care.
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| Our "bedroom". He tried to throw pillows at me to stop the snoring. The nurse offered him ear plugs hahaha. Sort of reminds me of the beach...without the water, the dock, the kitchen and oh ya, the fun. |
A team of surgeons were here after lunch yesterday to get up close and personal with the hand. They liked what they saw and walked over to the thermostat and turned it down to 70 degrees ahhhhhhhh we could feel the cool air moving through the room immediately. That deserves another ahhhhhhhh. As a side note: within an hour James was looking for a blanket and I was hoping I had a sweatshirt in my bag. That cracked us both up.
The doctor who worked on reconnecting his nerves was quite a character and kept us chuckling. James commented on sensations located in the wrong place and she told him that was all on him – not her. Instead of coming to her with nerves neatly lined up and cleanly cut, he arrived with a bowl of spaghetti and she made her best guess as to which two ends belonged together; some she probably got right, some she probably didn’t but no matter as they will relearn their new pathways. We are finding that nerves are one of the most amazing things in the human body.
If they can get him to keep food down, we are going home on Friday – woo hoo! He will spend a week doing absolutely nothing with his hand. He is to protect it from bumps and bangs at all times. I will change the dressing twice a day and otherwise it will remain on its molded splint immobile and protected from the world around it. His job is to get up on his feet, his body moving, eating healthy and ready to tackle whatever they throw at us next. We go back to the hospital the following Friday for the lead surgeon to assess the healing progress and give us our next set of marching orders. We forgot to ask when he could get in a bath or shower but we did remember to ask if he could go to a Jim Gaffigan comedy concert next Friday – priorities baby, priorities! Two of the three surgeons laughed and began tossing Jim Gaffigan one-liners out. James joined in. The third surgeon shook his head and declared them all nut cases. But, he was given the OK to go as long as we wrap it extra well and slip it in a sling. I think their love of Gaffigan tipped the scales in James’ favor :)
Bring on day 7. We are ready.
-Kathleen
Tuesday | October 5, 2010 | 12:54 AM
Friday, October 1 marked day 9 in the hospital and the end of this chapter in James’ story. We were discharged from the trauma unit at 7:30 p.m. My most excellent chauffer (aka Daniel) had us home by 9:00.
My sincere apologies for the delay in my text, email and internet communication. I am THRILLED to be home but I haven’t had a minute to call my own…and when I do, I find myself trying to catch up on sleep – is it possible to catch up ‘cuz it’s not feeling like it so far :) Daniel and John are beyond amazing in doing anything they can to lighten the load; awesomeness is their middle name! Everything is good, just time consuming.
Thursday evening they finally found the right combo of anti-nausea medication to help James keep his food down. He still felt a bit queasy but he knew eating was a prerequisite for going home; consequently lots of motivation to fight through. That evening I received my nancy-nurse lesson and learned how to change the dressing, wash the wound and care for someone who was not allowed to us his right hand for ANYTHING. My teacher said I passed with flying colors. I was highly motivated too :)
Friday morning the surgical team came in for their daily check. This time Dr. Allen (the head honcho) came too. It was our first time meeting the man rumored to be the best of the best in the Pacific Northwest. Once again we heard how stunned they all are that James still has his hand. Apparently no one, including the head honcho himself believed the reattachment of his hand would be as successful as it is to date. Dr. Allen explained that his assistant Dr. Kate Colman was responsible for saving the day. Dr. Allen had run out of ideas after so many hours of surgery but Dr. Kate had an idea. He told he to take the lead and the rest is history. I now understand why he is considered the best of the best; he surrounds himself with excellence and makes great decisions that have everything to do with the patient and nothing to do with ego.
Dr. Allen went on to explain he has seen very few reattachments of this magnitude succeed and it is most impressive that a week later the hand is still doing well. He said there are plenty of things to go wrong still but getting thru a full week is a major accomplishment. He gave us the OK to go home and left James with strict instructions to do nothing, absolutely nothing with his hand other than what OT teaches him (a therapist was due soon). A short while later Dr. Allen popped his head in and said we might stay another day or two (groan). There was a new machine that could passively move James’ fingers and Dr. Allen wanted to take a look at it. He hadn’t used this particular machine before and wanted to see if it would be a good fit for James’ injury. As it turned out, it wasn’t a good fit. We were glad going home was back on the agenda even if we were a bit disappointed the new-fangled machine wouldn’t be helpful.
Melanie from OT came in to teach James how to use his left hand to passively move the fingers on his right hand (same thing the machine would have done only safer this way). She did a good job of explaining the importance of this for his reattached tendons and ligaments – he was motivated by the end of her lesson. She went on to explain he didn’t need to bother doing this with his thumb as they did not reattach the tendon; doing that would have interfered with reattaching the veins and nerves so after everything is healed, they will go back in to reattach the tendon (or was it a ligament (?) ah, it all starts to blur together but thankfully, they know what it is!).
Melanie also clarified that his ability for fine motor movement will not return. A main component that contributes to fine motor movement was damaged beyond repair. He won’t be able to thread a needle (darn, there goes his career as a world renowned seamstress) and buttons might be problematic (no worries, that is why God invented zippers and velcro) but due to the wonders of the brain, his left hand will eventually become his dominant hand. His essential tremor is most pronounced in his left hand so we expect some messy meals between now and left-hand dominance but God’s got a plan for that too – wash cloths, soap and water :)
A lot of physical and occupational therapy, at least one more surgery, skilled medical care and diligent consistent efforts on James’ part will take us down the road to a happy ending; maybe a different ending than James had planned 9 days ago but a good ending all the same…’cuz he’s James - and James has always made lemonade out of the lemons life throws his way!
THANK YOU a thousand times over for your unending prayers, spectacular support and constant connections. They have been the life-blood that our family needed to traverse this challenge. Each and every phone call, text message, Facebook comment and email brought us comfort, smiles and strength. Our family ROCKS!
Love you all!
-Kathleen
PS – Shannon Update: she left Washington late Thursday afternoon to drive to her new home and job in Palm Desert, California. She arrived safe and sound on Saturday and all is going well as she settles in. Her mother cried buckets of tears over her departure while rejoicing over her golden opportunity to live out a dream. I miss her terribly and every moment of every day I am excited for all the possibilities ahead of her.
PPS – Daniel Update: calm, cool and collected. My chauffer and right hand man at a moment’s notice. He remembers being the patient and needing to heal; he provides perspective when I need it. I am extraordinarily grateful for my man, Dan.
PPPS - As I navigate through these last couple of (emotional!) weeks I am reminded of something my mom gave me years ago; it still hangs on my wall (and one of my favorite brother-in-laws sent it to me in a note of encouragement). I suspect many of you have this in your homes too: There are two things we give our children; one is roots, the other is wings. Thank you mom, for giving me a path to follow. Those lessons guide us through weeks such as these.
PPPPS – OK, I’m done waxing philosophical. Must be time for some of that sleep I mentioned needing :) Huuuuugs to all!
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