Laughed at a Joke

Rehab went well today. Dad was put in this machine type thing so that he can stand and it helps him walk, but more right now to gain strength and balance. He sat on the edge of the PT table to learn to balance for quite awhile and sat and in chair for 1.5 hrs. He tolerated everything well. When put back to bed, he fell right to asleep, I am sure he was exhausted.

Although Dad cannot speak, Joey and Andy told a joke and Dad was laughing at it, silently. Dad gave Anna a big smile and just seemed to be in a better mood about the day. He still has those moments of staring around, and he hasn't responded to anything the doctor ask of him. Please continue to pray for his ability to understand, recognize, and speak through this PT process so that he can move on to the Rehab center at the hospital. He still needs to respond to commands. We are thankful for every little thing that he has done.

Kelli

Good Day!!

Today the Physical Therapist did an assessment on Dad to make his therapy plan. The therapist found dad to be very alert and they feel positive about his treatment. As part of the assessment they had Dad stand.... yes I said STAND! He stood on his own with a person on each side. They said that the left leg is very strong and the right (which was always his bad side) was weaker. Dad smiled at Mom today and lately puckers up for a kiss here or there.

They are putting Dad on a big flat surface that moves him around so that he can get used to motion again, and will begin other PT options as the days come. We are all thrilled and give thanks for his improvement just in one days time.

Kelli

Moving Day

Today Dad moved to the Select Care Facility in St. Joseph Hospital. His new room number is 815. He is on the 8th floor and visiting hours are from 8am to 8pm. We are thankful that he is no longer considered a ICU patient.

The transition went smooth, however it is a big change for all. Dad now shares a room with another patient but is in the bed closest to the door. They have ordered the special bed he had at Parkview that rotates, we are looking forward to him getting that. He will start physical therapy this week for 3 hours a day. This is the good part of the move as the PT is more focused and will help dad to get to the next level.

We believe in miracles, with God all things are possible. Everyday is a new day.

Kelli

Sunday Evening

Again, Dad was sitting up in his bed and awake much of the day. He did not respond much to any one person other then Mom. We brought a DVD that was made on his 63th birthday which had all of the kids, grandkids as well as trips him and mom took together. We played it a couple of times of which Dad would sleep and watch. We would wake him and say "Dad did you see...." and he would open his eyes. I am sure he would say he was watching it all along if he could.

Mom and Kelli went to check out Dads new home at the Select Care Speciality Center inside St. Joseph hospital. There is going to be great changes taking place with this move. Please pray for all of us to have patience, strength and courage to take this next step. Where as Dad had 1 nurse for 2 people, it will now move to 1 nurse for 4 people. There is a rehabilitation area of which Dad will be sent to each day, so here please pray for Dad to have paitence, strength, courage and the will to step it up to the next level. Dad needs to do well enough here to be sent on to the rehabilitation center back at the hospital.

Kelli

Sunday Morning

Dad has had a busy week. Once the halo was on this gave room for new things. Everyday his bed is tilted to a sitting position so that he can now look around the room. however dad has been exhausted from the surgery and just having the halo itself so he sleeps most of the time.

On Friday, dad was moved to a chair for 4 hours. Joey brought Blaze to see dad during this time. Blaze was so excited to see dad that he was literally grinning from ear to ear. It's funny to see a dog smile. Blaze licked dads face but at this time there was no reaction from dad. We will continue to try.

Saturday, Dad was awake for about 4 hours. He was having one of his days where he just looked around but really didn't look at anyone that was in the room. He was in an upright position in his bed for about 4 hours as well. He seemed to be watching TV of which I bored him with What Not to Wear like old times. Andy took a movie up last night and watched with Dad as he snoozed in and out.

Dads vitals are all normal, he has been breathing on his own for 3 days now. They removed the ventilator from his room on Friday night. We are all thankful and praise god for this.

Please continue to keep dad in your prayers. Specifically that he will wake up and have knowledge and mobility to move on to rehabilitation. We all know that there is a long road ahead and are ready to take that next step of the journey with dad for recovery.

Rumor has it that he will be moving to a new facility on Monday. We will keep you posted.

Kelli

baby steps...

we are making baby steps forward towards recovery. since the halo has been put on, the doctor has given the go ahead to be a little more aggressive in rehab/therapy work. this morning when i showed up at the icu, dad was positioned about 1/3 upright in his bed. the goal was to continue to move him towards moving around. this afternoon, around 1 o'clock, the therapist and nurses set dad up on the edge of the bed and had his legs hang over the side on a stool. they were steadying him of course, but nonetheless, this is progress. i'm sure dad liked the view of the room instead of staring at the ceiling like he has for the last 30 days.

as far as we know, we will still be in the icu until monday. after monday, the plan is to move to a specialty hospital for additional aggressive "pre-rehab". once dad is fully able to participate in the rehab, they will increase the amount of time that he gets treated. please pray for patience on dad's part as he starts this process. i have been thinking about the fact that as he continues to become more aware of what is going on, he will likely become frustrated with the slow process (at least i would if it was me). pray that we continue to make steps (even little ones) forward. thanks for you love and support. we will update more as things progress...

surgery complete....

Dads surgery is done. Dr Young said that it went well. Nothing to worry about. We are waiting to go back and see him now. They are going to try to sit him up tomorrow. We will update you more later.

time for the halo...

tomorrow at 12:30, dad will go to surgery to have his fractured neck fixed. they will be putting a halo on him (a device that keeps your neck from moving that gets screwed into your skull).

there have been little improvements each day and we are thankful for them. we all want things to move faster, faster, faster, but we are often reminded that this process is long and slow. we consider ourselves blessed and fortunate to be as far along as we are.

as dad is being weened off the ventilator and his neck is being set by the halo, he will soon no longer be a candidate for the ICU. we will likely be moving to somewhere else soon, so stay tuned.
on another note, there are several families that haven't been as fortunate as we have in this process. please pray for comfort for the other icu families and that we can help them as they go through this hard time. thanks as always for your prayers and encouragement.

not much to tell you today....

I thought i would give you a brief update since one hasnt been given in a few days. Not a whole lot has changed. Dad's vitals are still doing well. They have continued to ween him off of the vent machine. They went for several hours with out the vent on last night...this is a great thing. This means that dad is doing well at breathing on his own for a bit and building those muscles that do this. He still is not that highly responsive. We might get few seconds here and there that we think that he is "with us" but nothing for long periods. The doctor wants to see dad being responsive for 4 hour periods of time. Sometimes it feels as if we are sooo far from seeing this, but i have seen God do miraclous things so far....I know that He could bring dad out of this comma at any time. Please continue to pray that dad will come out of comma quickly. Please also continue to give thanks for all of the things that have already transpired. On a side note...it seems as if it is a really hard day for some folks here in the ICU. Please pray that God will wrap his arms around them and comfort them. Pray that His presence will be made known. Will update you later....

friday update..

well, as you know, the trach was put in successfully last night. they have already started weening dad of the vent. they are guessing that he could be off of it in a few days. in case you didn't know, the trach is just another airway to connect the ventilator to; instead of connecting it to the tube that was in his mouth, they now hook it to a small tube that is in his neck.

it looks pretty likely that they will be putting the halo on dad's head next week to fix his broken neck. once this is done, we will be able to move dad around, try to have him sit up, etc.

please pray for the following: first and foremost that dad will start "moving with purpose" consistently. it is important that he is able to participate in the rehabilitation process, and until he is more responsive, he cannot. second, please pray that as time moves on, God grants us wisdom as we have to make constant decisions.

thanks again for lifting us up in prayer. we have been blessed with the world's best support group.

Waiting for the doc...

We don't have much new to post this morning. I was trying to wait to post until the doctor came in, but he has not been in yet. They dropped the vent machine from 10 to 6. This means that dad is doing a lot of the breathing on his own. They are trying to ween him off of the vent machine. I spent a little time with dad this morning and his eyes are wide open. I don't think he is "always" there....but will look as if he recognizes us for moments. We will take the moments! I told him that his strength was still good in his arm but that i could beat him in arm wrestling now....he disagreed. As i was holding his hand in the air, he pushed my hand down to the bed! Its still dad alright. He still telling me that he will win! I'm OK with that!

Thanks for the continued comments on this blog. We look forward everyday to the support we get from all of you. You all have been such a blessing to us! Thanks again for your friendship and your care. Mom or Jason will update you once the doctors come in.

One last thing, if you scroll down to the middle of all of the posts, you will find one that says "Notes for dad.." , if you haven't had a chance to write dad a note, and want to...this is a great chance to do so. As dad starts to come to more, we will begin to read these to him and hope to give him some encouragement. Thanks for taking the time to do this.

"Couldn't have gone any better..."

"Couldn't have gone any better..." is what Dr. Culp told us. Dad went in at 8:15 and Dr. Culp came out to talk to us at 9:15. ...Dad is now without the tube in his mouth and it is in the trach only. PRAISE GOD! Thank you for your continued prayers!!! They are supposed to call us back here in a bit to see him. We will update you tomorrow as to how dad responds to this new way of breathing.

quick update...

Dad has not gone into surgery yet....there has been a delay due to waiting for a room. We hope that he will be going into surgery in the next 30 mins or so. Its 7:45 right now...will update you as soon as we know more.

I like dads new hair cut...

I know that we said that there was not going to be a new post but i thought i would let you know that dad got a new hair cut! Tom the nurse decided (with the help of mom) that dad didn't look good with a mullet, so Tom got out the clippers and cut his hair; the problem is that the clippers that the hospital use do not have guards. This being said...dad is bald! It looks good though!!

Just a reminder that today is the big day...the day that dad gets his trach. This is supposed to happen at 6pm and last an hour or so. We will likely not have an update until later in the evening. Please pray for Dr. Culp and his team as they do the surgery. Pray that God will give the doctors steady hands and the surgery will go well.

Please also continue to pray for endurance. This has been and will be a very long journey. It has been pretty wearing at times and patience can run a little thin...

Praise God that dad has been more active and moving more each day. Earlier we saw some movement out of his right side. There hasn't been much until now. He is also moving fingers more instead of just his hand. I look forward to the day that he really knows that we are in the room!

Thanks again for your continued thoughts and prayers. We will update you as soon as the surgery is over....

update from the great white north...

things are much the same today in the icu. the doctor said that we are basically in a waiting period until thursday when the trach will be done. dr. young agreed that the trach could be done as long as dad's neck isn't moved. all of dad's vitals are good and he is occasionally awake. the tube seems to be really aggravating dad, causing him to gag and cough quite a bit.

we do not expect to have any news to update you with until after thursday 6:00 p.m. when the trach is done, so don't be concerned if you do not see anything before then. thanks for your continued prayers. stay warm :)

Post overdue.....

I am way overdue on getting a post out for the day. We are trying to get back into some normal life pattern (whatever that might look like) by going home some nights and sleeping. When we do that, we don't have the computers up here at the hospital and it makes it harder to get a post out. We are up here tonight and i have the computer with me so we will have you updated while here. If we get snowed in...then i will be up here giving you the normal updates!

Dad is slowly progressing. Today the therapist came in and worked on bending dads arms and legs. She was asking him to help her bend and he was. She would ask him to relax his arms and he would. It was evident that he was responding to her. Also, I had my kids up tonight and Kade came in and said " hey grandpa, its Kade...I love you"...and dad smiled. It was very evident that it was a smile and not any other movement! This is great progress.

The doctor also took a CT scan again. The CT scan showed that the shift has almost corrected itself. This means that the swelling is almost gone and there are no real signs of more bleeding.

They are also going to attempt to do the trach on dad on Thursday at 6pm. This is not confirmed with Dr. Young but is likely they will do it. Please keep this in your prayers. This can be a slightly risky task but thankfully they figured a way to get around moving dads neck!

This is all for now...i will try to give you some sort of update tomorrow afternoon. Thank you again for your continued prayers and support. If you haven't gotten a chance to yet...scroll down to the post "Notes for dad" and leave dad a note...encouraging him or letting him know how he has touched your life.

Until tomorrow...

-A

nothing really to update...

sorry for the lack of communication, but there hasn't been much to update today. all of dad's "numbers" are doing well. he hasn't been "awake" much today. the doctors are getting together tomorrow to decide on the plan for the week. when we hear what that is, we will update you. thanks for your prayers and encouragement.

A TENTATIVE PLAN AND HEARTFELT THANKS!

The pulmonary Dr. came by yesterday and said he will try to wean Jim off the ventilator. He backed off a little yesterday, but today he said he would leave it as is. The plan is to try to get him off next week. Jim has responded to a couple of commands but has slept most of today. It is so hard to be in the "waiting room". We want everything to speed up and get on with improving....but we have also learned a powerful lesson on how precious it is to have one more hour, one more minute....

I have never studied every breath and every muscle movement, as I have since Jim's fall. So many things I took for granted, so many moments I passed by as insignificant. His eye's move and my heart beats faster...his hand moves and I run for the nurse. Why do we think we will always have that. All the energy I've put into everyday chores that are now gone from my life and I could care less.

I know these are not "new" thoughts for anyone who has experienced a trauma, I have had a few of those in my life, also. We lost our son, Donnie, 4 years ago this past week. The loss was huge. But each tragedy or trauma, leaves its own mark and brings its own unique change forever. This is one I have never known or know how to walk. But I have an alter of God's faithfulness in past events to cling to and family and loved ones praying and being God's servants in our lives. How do people survive without this?

There is no way we will ever be able to express our thanks and love to all of you who have walked thru this with us. I am so humbled by it all. But I am going to try. Just know this, from all the Maley family, we are forever grateful for all the prayers, notes, cards, calls, visits, food, and many, many other signs of support and love.

Keep praying and we will keep you updated.

Sue

some slight encouragement..

when the doctor tells you things like "that movement is just reflexes" it becomes difficult to get excited over movements. that being said, dad has been more and more responsive each and every day. today, andy asked him to wiggle his toes.....and he did --- three different times on command. he also slowly looked at andy and pulled andy's hand towards his chest. we continue to pray that these movements are consistent and on command so the doctor feels that he is responsive enough to get him off the ventilator. more updates later...

waiting...

Just a quick note...we have no new news this morning. We are waiting on the pulmonologist to check dad out this morning/afternoon. We hope to have better answers and be able to update you later this afternoon.

-A

Thanks!

tonight was a sweet time of prayer. the elders of our church (Blackhawk) came in this evening at 5:30 and prayed with our family at dad's side. it was a precious time of lifting up our requests to the creator of the universe. we are so thankful for all of you and the genuine concern and care that you have shown our family. i spoke with mom after this and she said that she felt refreshed. it was nice to see her spirits up as today and yesterday seemed to be a little more tough than others.
we will continue to boldly approach our Father with reverence on our dad's behalf. thank you for joining us.

same story, hard to deal with....

we are in a really strange phase of this tragedy. as mentioned yesterday, dad needs to get off the ventilator, but they cannot do so because of his broken neck. the doctor told us this morning that even if dad by miracle wakes up today, his throat muscles need a week or two to be able to handle breathing and coughing on his own. we are told that the ventilator lasts 3-4 weeks tops until the body rejects the tube and infection becomes an issue. we are at 3 weeks tomorrow. the doctor says that we have nothing else to do.

so, while dad's numbers are as good as they have ever been, the clock is ticking. this is probably the most helpless we have felt in this entire process. we know that God is big, but frankly, this is hard.

while we are all in constant prayer, we are asking everyone to take some time at 5:30 p.m. EST this evening to approach God and ask for a miracle. our prayer is that dad wakes up enough to respond to commands, and is able to breath and cough on his own. reality of where we are is setting in with all of us, so today is a rough day. thanks again for approaching the Father on our and dad's behalf.

Catch 22...

We have a situation that needs specific prayer. We spoke to the doctor this morning and he told us that we have some things working against us. Dad needs to have a "trach" put in to assist with his breathing until he wakes up. This is because the tube for the ventilator cannot stay in too much longer without risk of other major complications. Here is the problem: because of the fact that he has broken his neck, they cannot do a "trach" because his neck would have to be hyperextended. So, basically, we need dad to wake up....enough for him to be able to cough and clear his lungs on his own. Please pray that he will wake up so that we can ween him off of the vent. The doctor has said that dad has already surprised him this far. We know that God can do immeasurably more than we ask or imagine, so that is what we pray for. Thank you for your continued prayers and encouragement.

Updates from the desk of the ICU....

So, I really don't have anything to say, but i know that all of you wait for updates from us each morning and night. Mom just headed to bed and Joe and Kelli just headed over to the house to sleep. I am sitting here listening to a CD that i just made for dad. "Sade"...great music! The nurse said that we can play music in his room for him. "Just no hard rock-n-roll and defiantly no country!" ...that was what Tom the nurse told us.
Dad's numbers are staying stable for the most part. He has a slight fever tonight. His BP is stable. His pulse is a little high (120-125) but the cardiologist seems to think that is due to his brain swelling.
We will see the doctor again tomorrow morning. I will give you more as he gives us more. Continue to write to dad in the post marked "notes for dad".

-A

late morning update...

Sorry this is so late in the morning... ( i started this at 11:00 am...several distractions :) )
We spoke with Dr. Young this morning and he confirmed that the CT scan from yesterday was better. He also made the statement that we are not at "day 1" anymore. This was one of the most positive statements that he has made yet. I know that it sounds strange, but that is a positive thing to be away from "day 1" since we have been at "day 1" for a few weeks now.

We are waiting today on information from the cardiologist and the throat doctor. The cardiologist is going to look at dads heart and tell us why his pulse is so high (110) and if this is hurting him.The throat doctor is going to come up with a way to do the trachiosticpy (sp?) since they cant do the normal. To do it normally, they have to stretch his neck to get it in. Because his neck is broken, they can not do this, so they have to come up with an alternative method. This might bring about some difficulties. So we just wait.

Please take a look at the last post and take some time to jot dad a note of encouragement or let him know how he has impacted your life.

We appreciate your continued prayers and we will keep you posted.

As I was writing this, we had an update from the case manager of the ICU. She was giving us a snapshot of what was to come in the future if dad stays stable. They said that as soon as the stability comes, he will not stay in the ICU...but if he has the ventilator, they can not take him in rehab here at the hospital. That being the case, he would be moved to a facility in the St. Joe hospital that would give him the care until he wakes up and gets off of the vent. Once that happens, then he would be moved back to rehab at the hospital (parkview or Lutheran...our choice)..this could be a long process. I will update you more soon.

-A

Notes for dad...

I wanted to give some a chance to write dad. I figured that you could use the comment section to write dad an encouragement note or if you would like to leave him a note of how he may have touched your life, that would be great too...I would love to overwhelm him with this encouragement when his awakes and is able to listen or read! Please use this section to write to him only and not to us! Thanks for taking the time to do this!

-A

Roller coaster ride...

The neurologist came in this afternoon to see where dads progress might be. He stated that although we see dad's eyes, he is still in comma and that he is not responding right now to us. He told us to continue to talk to him but as of right now, he is pretty much in the same state he was in. He also made a statement that recovery time could be anywhere from a month to longer than a year. Basically, we are still one day at a time. They really don't want to give us answers as to what the future may hold, including the immediate future. We will just keep talking to him, and praying that he will come out of comma soon and have a swift recovery.

One last thing, the CT scan from earlier today was improved. His numbers are staying stable with out any Manittol or Dipravin. The nurse did say that today was dad's best day so far. Thats all for now...more tomorrow.....

-A

More Positive!

Last night the nurse continued to drop the sedation and mom was able to see dad open his eyes again for about 35 mins. I came in this morning to talk with the doctor and they want to take him off of his sedation meds all together if he will tolerate it. I got to see his eyes too this morning. He was blinking a little. He still didn't respond to commands from us or the doctor but this could take time. The doctor ordered a CT scan for this morning. Mom is VERY hopeful. Please continue to pray! The question was asked to the doctor" when can we expect to be hopeful and think positively about dad moving out of the critical state?" and his response was, "when you see him out of the ICU!"
After we get the results back from the CT scan, the doctor would like to see dad stable with his numbers being down for 48 hours. We are not sure what this next step is, just that whatever it will be will happen in 48 hours...or Wednesday morning (hopefully). Please continue to pray...with hope..that dad will be able to respond to commands soon (although dad has never been one to take commands :) ) we will try to have an update for you later this evening.

-A

something positive....

Last night, the nurse decreased the amount of dipravin (sp?) that dad was getting for a bit to see if he would respond at all. Mom was able to get a glimmer of hope. Dad opened his eyes just a flicker. It wasnt much or for long, but it was enough to give mom some more "wind beneath her wings". Once his ICP level and BP went up, they sedated him again. They are going to continue to lower his dipravin this weekend to see if we can get more of a response. His sedation level is at 40 right now. Please continue to pray for my father. Pray that he will begin to wake up. Pray that his levels will continue to stay level while waking him up. Pray that mom will find some rest and that she will have great patience during this time.

-A

saturday update 2......

I was made aware that i need to continue to update you even when things do not change. The last post that Jason gave is pretty much where we still are. We really appreciate your continued prayers and support. Thanks for following us thru this blog and earnestly praying. Jason or I will update you in the morning or later if there is any change.

saturday update...

there isn't much to report this morning. dad has been pretty much doing the same over the past two days. his icp numbers continue to hang around the 19-21 range and his temperature and blood pressure have occasional spikes up and down. we were reminded again today that the longer this goes on, the less favorable the outcome. while we want to say "staying the same is good", the reality is that we need to make some steps forward. please pray that dad's icp numbers steadily go down in the next couple of days. thanks again for all of your constant prayers and encouragement.

friday morning update...

"no significant change.." those were the words of dr. young. dad had a pretty stable night. his icp numbers are staying in the 19-21 range and his blood pressure has been pretty much under control. his temperature has been under control as well. the plastic surgeon did come by last night and said that his hand will heal up just fine and is nothing to be concerned about.

the plan. once again, the goal is to have a stable weekend with lower icp numbers. if this happens, we will do a CT scan on Monday. if there is improvement and numbers stay down, they will start backing off the sedation medication again and see how he responds. pray for continued stability, and pressure numbers to go down. thanks as always for your prayers and encouragement.

update from this morning...

In the past 1.5 hours, dads temp has gone back up to 98.5. This is good...but another issue has arisen. Dads ICP level is back up. They are reducing his Fentinol and giving him morphene instead. This could be the reason for the elivated ICP and blood pressure but unsure.The word "sepsis" was used in the conversation with the doctor this morning, but it was more of a "possibility" of the reason for the temp drop but not an absolute. The chances of sepsis being the reason for the temp drop is slim and more likely due to the medications that he is on. This is one of the reasons they are reducing some of the meds. This ride is such an emotional roller coaster! Please continue to pray, and write! We love all of you! More to come...

-A

more bad news.....

Met with Dr. Young this morning and although dads ICP's are hanging in there where they should be which is a good thing, we have a new problem. Dad's temp. is very low right now. It is around 95. They said this is most likely due to infection or "sepsis". This is very severe. They told us that this is just as severe as his ICP level. They are going to run several tests on him to find out where the infection is coming from. Please continue to lift dad up in your prayers. Pray that the doctors will find answers quickly and be able to get the infection under control. Pray for my moms nerves.

I will update you more later...

-A