Utah Valley Specialty Hospital, Provo Utah

Utah Valley Specialty Hospital, Provo Utah

Jim and I received a call yesterday from Ron's case worker at IMC that Ron had been accepted and was medically cleared to be moved to a specialty hospital. There are four of these types of hospitals in Utah which is great because most states do not have more than a few. The specialty hospital is designed to care for patients who were once in ICU or trauma and need further care for wounds and physical therapy. They will mostly focus on Ron's wounds with a little physical therapy on his limbs. He won't be able to put pressure on his pelvis for 3 months per his orthopedic surgeon at IMC (I mentioned this earlier). This will also allow time for his brain to heal.

Ron's New Hairdo:

Burr Hole and incision to drain the fluid surrounding Ron's brain.

Brain Injuries

Ron's decor in his room, thanks Stacie for the cute teddy bear!

I found some great information today while searching the topic on brain injuries. It gives me comfort to know that other people have endured the same experiences. Our trials make us stronger and more compassionate towards others who go through what we do. (This is what I have heard and believe, however when I am in the middle of a trial, I don't think like that. I am too busy feeling sorry for myself). Advice from others is common too, "don't worry, God is in charge", "stay strong", "time will heal". Those are all true statements, they don't really make me feel better at that very moment. I have to wrestle with God in prayer. That makes me feel peace. I can't ask "why" or go through the "what if's?" That makes me feel worse. I have to trust fully in God and His plan. Everything happens for a reason. Not everyone agrees with that statement. I truly believe it and that gives me hope and strength to endure.

Talk to them, play the music they like, and let younger children help, too. You never know what may trigger a response. Show them your love and your smiles, not your tears. Stay positive.”

– Mother of a 17-year-old who survived an eight-week coma when the van he was riding in was hit broadside by a drunk driver.

“ I learned more about brain injuries by talking to the doctors and especially the nurses who cared for my son. Most tried to be as honest as possible about the prognosis. The truth is, it’s a waiting game.”

– Mother of a 16- year-old who survived a two-week coma and a five-month hospital stay after a car accident.

Not a Craniotomy - A Burr Hole

Ron was in surgery from 5:15pm tonight until around 8pm. The nurse was too busy to talk to me when I called twice. The nurse I spoke with earlier today said that he would be having the Craniotomy, but really wasn't sure. I didn't know the difference between that and a Burr Hole. The Craniotomy is where a bone flap is removed temporarily to access the brain. (big difference). The Burr Hole is a small hole drilled on one side of the skull to drain the fluid from around the brain. His surgery was successful and he was wide awake, watching t.v., he responded to commands and told the nurse his full name (he knew it). I spoke to the nurse around 10:15 p.m. He will be in trauma ICU overnight and hopefully released to the 11th floor again tomorrow. This is great news!

Craniotomy - Brain procedure to drain fluid around Ron's brain

 I don't like the word Brain Surgery, it sounds too intense. I will call this next surgery a "procedure" that Ron is having to drain the fluids surrounding his brain. A small hole will be made in his skull for this procedure.

I wasn't able to talk to the neurologist today to get more details. His nurse told me about the Craniotomy the doc. decided to perform just yesterday. It was scheduled for today. I was visiting him earlier today and there was no scheduled time for the operation. He was an "add-on" and the nurse said I could call to find out what time he went to surgery.

Ron was not responding again today, at all. Other than a few movements of his right arm and leg, a few sniffles and moans. As I mentioned in a prior post, he can only move the right arm and right leg. I have also seen him lift his head a few times. His regular visitors (myself, Kerri my sister, brother Jim and cousin Stacey, aunt Joyce etc.) have all concurred that this week Ron has not been very responsive. This may be the reason the Dr. decided it was time for this procedure. I will ask that question when I see the neurologist again..

The orthopedic surgeon has been wonderful. I had the privilege of visiting with him today and had the chance to ask a few questions:
How long before Ron will stand and attempt to walk due to his pelvis injuries?
Because of the fractured appendicular bones at the top of the pelvis (I could be wrong about the name of those bones), he won't be able to put any pressure on the pelvis or try to stand for 3 months.
By then the fractures in his left knee and left tibia will be healed.
What about his knee injury, will that heal on its own?
He showed me a few of the x-rays of his knee again. He has a piece of bone that chipped off and a crack in his left knee. Because of the multiple surgeries and other more serious injuries, he decided to leave the knee for now.
A few of the issues Ron will have to deal with down the road is the left hip (hip replacement) and the knee if that is bothering him later, (the doctor said he would go in and remove the chipped bone).

I was in the room when the occupational therapist came to see Ron. He removed the wrap from his left arm and hand and examined his injuries putting pressure hoping for movement. Ron hasn't moved that left arm or hand at all. I was able to see his left hand injury for the first time. It isn't pretty. I am going to share the photo at the end of this post (beware: it is a little gruesome).

First photo is of the staples that the plastic surgeon replaced the stitches with on the top right arm from the fasciotomy (one of the three fasciotomies):

Right arm staples to repair the faciotomy


This is his left hand, shattered a bone and fractured a finger:

 

Ron is cussing - (He is definitely in there somewhere)

Top of left arm, part of fasciotomy they were able to close, surgery was scheduled today to close the rest of the wound

I went to visit Ron on Wed. 8/13 and yesterday 8/17.
On Wed. he was cussing, singing and chatting. He comes and goes, mumbling, saying full sentences and then back to sleep. (I saw signs of the Ron I know!).
I asked Ron if he knew who I was, he said "yes" but didn't know my name. I told him "Jodi, your sister" he then repeated my name. He then said, "Jodi, I don't want us to have any controversy" I told him that was a big word! I asked him if he knew what that meant. "Yes, it means when people have differences". He remembers that we had some issues/differences before his accident. I was cleaning his mouth and scabs caused from his breathing tube. He then spit and said "where do I spit?" and then told me he wanted some cheerios to eat. I kept telling him that I loved him and that he needs to fight this battle, and that he could do it. He also said several sentences that I couldn't understand. However, much progress with the sentences I did understand! Just before he went to sleep, he said "Jodi, tell me everything you know?" I said, "about what?", he said "about this" referring to his accident. I then proceeded to tell him what I knew about it and he had a very puzzled look trying to understand and comprehend. He then went to sleep as I told him that I loved him. "I will see you next time Ron".

My visit yesterday was quite opposite. He was asleep the entire time, sweating, moving around as if so very uncomfortable. My cousin Stacie was there (very consistent with visits from the beginning) and our Aunt Joyce Cottrell (also comes on a regular basis). I don't know what I would do without them checking in on Ron. They told me of their weekly experience with Ron, same thing, up and down. Chatty one day, asleep another and not responding at all. We were told by the nurses that Ron only slept two hours the previous night as he had a difficult night. Jim and Noelle Cottrell (Jim's oldest daughter) also showed up with a guitar. Jim has been playing for Ron and Ron would sing along on a prior visit. Last night nothing would wake him, we were hoping the guitar and Jim singing to him would get him to respond. He was exhausted and slept the whole time we were there. I talked to the nurse today about it, concerned that he isn't getting enough medication for pain. The nurse said that the trauma Doc. said he does this every 3-4 days. He will not respond to commands or really wake up much on certain days. I hope he is back when I visit next. It makes me nervous when he doesn't respond. I was assured by the nurses that they were not concerned.

He went in for surgery again today to close the wound on the left arm from the fasciotomy (already closed the other two in a prior surgery). He was scheduled to go in at 10 a.m., however he didn't go down to surgery until 5pm. They took precaution due to making sure Ron was stable enough. SIGH. "Ron, you are killing me" were my last words to him as I left his room last night.

Ron is coming back, slowly...

IMC - Intermountain Medical Center, Murray Utah

I haven't posted for 10 days. I didn't want to sound negative and sad, so I waited until I could sound more hopeful, and positive. It has been a hard 10 days. However, Ron is progressing slowly. We were told that in the beginning. Last Sunday 8/10/14 was an exciting and depressing day at the same time. The exciting part was that he chatted with me, mostly mimicking me. The first words out of his mouth were "Hi Parker", because my son Parker came with me to see Ron and I told Ron to say hi to him. I went through each of the families names (siblings) and he copied each one. I finally was able to hear him sing and I could understand some if it (an occasional sentence). He also smiled at me, however he showed signs of a stroke because one eye droops and only the right side of the face shows expression. When he spoke, it was very simple and child-like. The only expressions he came up with on his own (without copying) were "yes ma'am" and when I asked him what he wanted to drink he said "fruit punch".  I called our brother Jim and I told Ron to say hi to Jim, and he said "Hi Jimmie". I was so happy to hear him speaking. At the end of my visit the neurologist came in to talk to me. She said that he was going in for a CT Scan because they found fluid around his brain. They were also worried about blood clots near the brain. I was told that there is no way to tell right now if he will be living on his own or in a long-term care facility the rest of his life.  Only time will tell. This was hard news. I went through all the "what if's" I could think of. What if he never moves again, because his brain is not functioning fully. He has been out of ICU for 11 days and has not moved anything but his right arm and right leg. He can't get up to go to the bathroom on his own (I'm not sure of the expectations on that due to the pelvis injuries, that may be normal). What if he does get partial brain function and is nothing but honery and unpleaseant. What if he gives up and has no hope to fight to live and function (I wasn't supposed to be negative).
The Doc's were expecting him to be talking by now. That doesn't mean he won't. I have to have hope.
During Sacrament meeting that morning, I thought about the Atonement. It meant so much more to me than it has in a while. This is because I truly need it right now. Christ knows the pain Ron feels and my family is feeling as we watch Ron go through this rough time in his life. I am trying desperately to hand this over to Him to carry the burden. It is too heavy.
Ron is progressing, he has bad days like we all do. He has days when he is so uncomfortable and doesn't want to be awake and responsive. He has other days when he is singing and chatting. I have to have hope....
Elder James E. Faust said the following "Everybody in this life has their challenges and difficulties. That is part of our mortal test. The reason for some of these trials cannot be readily understood except on the basis of faith and hope because there is often a larger purpose which we do not always understand. Peace comes through hope."
He also quoted Samuel Smiles: “Hope is like the sun, which, as we journey towards it, casts the shadow of our burden behind us.’ … Hope sweetens the memory of experiences well loved. It tempers our troubles to our growth and our strength. It befriends us in dark hours, excites us in bright ones. It lends promise to the future and purpose to the past. It turns discouragement to determination.”  (James E. Faust, General Conference Oct 1999, "Hope, an Anchor to the Soul")

Two weeks ago tonight....

Today has been a hard day. I cried more today than I have since the accident. I am realizing just how long the road back may be, reality hit me today.

Ron was moved from ICU yesterday, which is great news. He is opening his eyes regularly and trying to talk (still mumbling). The leg braces have been removed and his bruising and scrapes are more visible. He was looking around the room and staring at me with blank looks. Jim explained it like this.. "the lights are on but nobody is home."

Left knee and leg where tibia/knee is fractured

View of left foot, two broken toes and stitches on baby toe

Occasionally he would look like Ron, but mostly his looks are blank and confused. Casts and wraps cover each arm and legs. He looks so very thin in the chest, however he has always been on the thin side like my dad. He looks a lot like my dad. We have heard that comment several times from visitors or family who knew my dad. His new room is on the 11th floor and he had two male nurses who were so great. He is getting great care and that is very comforting. His nurses said he sings quite a bit, I tried to get him to sing for me. He wouldn't, I guess he was done singing for the day. We just stared at each other as I tried to make conversation. This is hard, a different hard than losing a loved one. Right now it feels like we have lost him, but not completely. We are hoping he will be back mentally within weeks to a few months. It is hard to say what the time frame will be. Maybe it is good that he isn't mentally aware because of the pain. Does his body need the time to heal a little more before he becomes aware? I expected that because he is awake now we would be able to have some conversation. I have thought about what he might say when he snaps out of this. I have so much hope that he will want to look at this experience as a second chance. It is too early to even know if he will have normal brain function. I am trying to be positive, it is one of those days and I just want to feel sad. I will feel better tomorrow.

Baby Steps.....

I visited Ron again today, his breathing tubes were removed 40 minutes before I arrived. He can only mumble due to all the tubing down his throat. The nurse and I couldn't understand his jabbering. His wonderful nurse Michelle at IMC has worked several 12 hour shifts with Ron. She is so sweet and really great at what she does, all the nurses and staff have been so wonderful. She kindly explains Ron's changes and progress. She told me today that it is quite normal for him to try and talk and he may say some silly things because he is still very confused. The heavy drugs needed to keep him sedated through the multiple surgeries as well as the pain from his accident (impact) will take some time to clear his body and mind.

Ron looked at me several times and tried to talk to me. I put my ear up to his mouth several times and kept talking back to him even though I couldn't understand what he was trying to tell me. He makes lots of facial expressions, mostly squinting as if he is in pain or confused. I brought two of my sons with me to see Ron. Preston and Payton, they had a really hard time seeing Ron in his condition. They didn't really want to stay by his bed for too long. When I told Ron they were with me, he lifted his head to try and see them and made a puzzled look at them like "I can't believe how big you guys are!" The nurse did say that he may recognize people and the next minute be confused. Jim stopped in for his daily visit and to check in, and he told Ron not to move very much because of the pain. Ron nodded his head up and down as if to say "okay". These are all "baby steps," he went a week and a half with barely responding to commands by the nurses, and not much going on with his eyes and face. These small steps he is making are progressive and very exciting to watch as he comes out of the "coma-like state" he has been in.

Yesterday he had one last surgery (8/05/14) to add another screw to the left side of the pelvis where the doctor felt he needed more support. I will add that x-ray at the end of this posting. Jim witnessed the first real progress of Ron opening his eyes yesterday morning. He got it on video and I wanted to go visit to see if he would look at me. Yesterday he got out of surgery at noon. This one was shorter, 2 1/2 - 3 hours. The nurse really didn't think he would wake up for me. He did wake up at about 7pm and looked at me. I told him he had been in an accident, he made a really confused look on his face. Kerri and Brad came while I was there and when I went to leave I told him I loved him and that I would see him tomorrow, He nodded as if to tell me okay.

Second surgery on pelvis to add additional screw on left side

 

Visitors - family and friends

Ron, you have had several visitors and many prayers said in your

behalf. You have a rally of friends in spirit through face book and

other means. Here are some of the visitors that I know have been by

your bedside this past week and 1/2. 



 -  Your brother Jim, the first to hear the news and the first to be by your side. He stops in daily, morn
    night and afternoon, whenever he can to check on you. Katherine has visited you too!
 -  Sister Jodi (myself) I stayed at the hospital during your first surgery on arm and hip (long day)
    I come as often as I can, I asked Tim to come sit in the waiting room last Thurs. during your pelvis
    surgery in order to meet the Doc. afterward and sat in your room until I arrived
 -  Sister Kerri and Brad Ernstsen have been by your side almost every single night
 -  Sister Jen, came from Arizona to see you for a few days (she will be back)
 -  Uncle Phil Fabry, he came to visit that first Tues. in surgery and came to keep us company
 -  Aunt Kerri Fabry, she asked how she could help, we asked her to visit when we could not be there.
    She has been by your side several times and brought us some treats
 -  Uncle Kem and aunt Pat Nixon. They came to visit you while they were in town for a few days
    They visited several times and you responded to Kem when he spoke by lifting your eyebrow.
    Up to that point you had only responded to Kem and Jim
 -  Our cousin Stacey Cottrell has been your angel, and our angel. She stayed all night with you in
    the beginning, you would get irritated and she bugged the nurse all night telling them you were
    uncomfortable. Stacey has been by your side almost every day too. She comes after work or
    whenever she can. This has been so great because we can't always be there, and she doesn't
    like it when you are alone
 -  Our cousin Scott Cottrell came by with Stacey, he was so great and made us laugh. He is quite
    funny. We had a great conversation that night in your room, laughed a little too!
 -  And our cousin Danny Cottrell came by too, I wasn't there but Brad and Kerri were I think
 -  Aunt Joyce Cottrell came by after her trip to Milwaukee, it was so great to see her. It has been
    so many years since we have seen or talked to her, she really wanted to see you. I'm sure she
    will be back!
 -  Victor and his friend/business partner came by and sat in the surgery waiting room on Tues. 8/29
 -  Others have asked to come by, this will happen when you are out of ICU trauma!
 -  You have many others who are concerned and call for updates. Grandma Willie likes updates on
    a daily basis. She gets them from Pat, Phil and Kerri and myself

The X-rays - before and after

 

Left forearm injury (punctured through the skin)

  The left arm was one of the more serious injuries along with the pelvis

Reconstructive surgery - left arm

View #2 of left arm

Pelvis injuries 

Pelvis repair (reconstructive surgery)

I will only post the two major injuries and x-ray for each. There are several other injuries, as listed in my previous post (these are the most critical)

Ron's Injuries -

The injuries:
-  two broken toes (left foot)
-  stitches in left toe
-  fractured tibia
-  fracture in left knee
-  left hip dislocation (possible hip replacement)
-  left forearm multiple fractures (reconstructive surgery was Tues. 7/29 on arm and hip eight hours)
-  pelvis, multiple fractures (reconstructive surgery was Thurs. 7/31 about eight hours)
-  hand fractures, including a crushed bone in hand and fractured finger (in surgery today Mon. 8/04)
-  nose fracture (same surgery today 8/04)
-  stitches in left eye lid area
-  muscle swelling over much of his body
     - due to high impact he has fasciotomies on both arms and left leg, these will need plastic surgery        /skin grafts

The positives:
-  breathing on his own
-  brain activity, responds to simple commands such as squeezing fingers, wiggling toes and gives  a      thumbs up! He responds to my uncle Kem and my brother Jim's voice by lifting an eyebrow
-  no internal injuries up to this point, all organs seem to be functioning normal
-  no noticeable brain damage as far as we can tell, we will know more when he wakes up
-  we feel prayers and support from our friends and loved ones

SUV vs Bike accident

My dear brother Ron, I love you more than you know. The sorrow I feel right now watching you in this state is more than I can handle. Your accident happened just a little over a week ago. You were riding a bike (bicycle) with no helmet, no identification, in the middle of the night down a mountain road near our brother Jim's home on South Mountain in Draper, Utah. There are no lights on that road, no lights on the bike, when the SUV turned in front of you.

This happened early Saturday morning July 26, 2014. The authorities finally identified your body on Monday and called my brother Jim. I got a phone call in the middle of trying to cook dinner, my basement was flooding due to heavy rain and I had someone trying to find my house to pick up a few items, all at the same time. "Ron has been in an accident and is in critical condition in ICU," was the message on my voicemail from my brother Jim. I jumped in the car leaving the basement issue with my husband and kids.

When I arrived at the hospital in Murray, Utah, I walked in to see my sweet brother Jim by Ron's side. I had already started sobbing just as I pulled around the corner of 4500 south and State Street, near the hospital. I continued for a few minutes crying over the horrible state my brother was in. He was alive, breathing on his own, however his orthopedic injuries were critical and invasive.

This is so different than death. We have already witnessed death by experiencing both of our parents dying and seeing their bodies with no breath, no movement, no spirit. This is so different. He lays in bed, sweating, and looking so uncomfortable. He moves his right arm and both feet when he is awake. He isn't fully awake, he is sedated until he gets through the surgeries that are needed. Because of the movements and responses to commands (squeezing fingers, wiggling toes, giving a thumbs up) the doctors believe his brain was not damaged. There are no obvious signs of brain damage. However, because of an injury of an artery near the brain, we will not know until he is fully conscious if his brain is fully functioning.