Well, today there is good news and bad news....
The good news is, he's not any worse. The bad news is he's not any better. His condition is still listed as 'unstable critcal'.
They were able to start the kidney dialysis (or CRT) at his bedside. He had the first "round" started in the middle of last night, and then the machine quit working properly. They thought perhaps he had clotted the catheter off, so they increased his dose of Heparin (a blood thinner) to 3,000 u/hr. They are still not pleased with his clotting times (the blood is clotting too fast). That's the way God designed our bodies to work at times of stress and shock/trauma, so they're essentially asking his body to NOT do what it was designed to do. After the first dialysis treatment, he was anemic, so they had to give him another unit of blood, which they had warned us would probably happen. His mom told me this is the 4th unit he's gotten, although I was not aware of the others.
For the second round of dialysis, they brought a new machine in, and started it up, but within 20 minutes it wasn't working properly. They were concerned he had again clotted it up. They called in the trauma surgery team, and they inserted a larger diameter catheter in the other groin. They checked the first one, and it wasn't clotted off, it had kinked! One piece of good news, at least I thought so. With the dialysis, he is slightly less acidotic, (was 7.17 last night, and is 7.24 tonight... headed in the right direction. Normal pH is 7.35-7.45 and the body can't tolerate it much higher or lower than that range. They expected that rebound from the dialysis. Also, his creatinine (level of toxins that indicate how well the kidneys are functioning) is going down. It was 5.35 last night, and was 4.37 tonight. I said to the trauma doctor (Dr.Juri) that things were looking up, when I heard those values, an d he scowled and said, "Ach, he's on dialysis. Means nothing." Alrighty then.
Also, they are still having so much trouble keeping his lung perfusion adequate. That's the blood flow to the actual lung tissue itself. They explained to me tonight that his lungs are very weak right now, and they need to strengthen. Part of that is the pneumonia, part of it is the PE (blood clot) and part of it is the systemic shock/sepsis. His ventilator settings are very aggressive, and they're having a hard time getting him off 100% oxygen. Even at 95% his oxygen saturation drops. For you medical folks out there, his PCO2 (or did she say PO2) is 65, and they'd like it to be higher. That's a number that shows how much CO2 (Carbon dioxide )is coming off his lungs in relation to the oxygen going in, I think. Perhaps Karen can correct me if I'm remembering that wrong.
They are giving him TPN, which is a systemic form of nutrition, because due to the strength of the pain meds and muscle relaxers he's on, his GI system is not fully able to work. The shock plays into part of that scenario as well. Dr. Juri and his day nurse, Anita, explained that his care right now is a minute to minute balancing act to make decisions to get him to the next minute. They are doing a great job. The only thing that raises our eyebrows, is that it being a teaching hospital, you frequently have students or residents/interns looking in at things, saying "I think this is what's going on.", or "I think this is what should be done next." That phrase, "I think", just drives Sr. crazy. He says, "Don't think, get someone who knows!" The students don't actually change things without the nurses or their instructors present.
He has these booties on to prevent 'foot drop' which is something that can happen as you lay and are unable to move your legs. They took those off for a few hours today to let his skin breathe. He is still breathing somewhat on his own, in addition to what the ventilator is doing, but it's not very productive breaths. His lungs just remain so weak. They are trying to buy time for him with all this other stuff to allow the lungs to strengthen. I'm thinking that right now that needs to be our primary focus and prayer.... for God to strengthen his lungs. Also, pray that the swelling begins to diminish to the point it is no longer affecting his lung function. Pray that his fever stays down. It was 98.5 tonight at 9:00 p.m. when we left, and the cooling blanket was actually set at 105 degrees! It was warming him and his temp was normal. That 5 antibiotic mix for sepsis they have him on must be doing something, althoug h they're still not sure it's getting in to where they need it to get. Once his lungs are stronger, they'll be able to take him for CAT scan and other tests, but until then, they are doing their best guesstimation.
His heart rate today was down to 92 bpm, (also probably from the dialysis). His pupils are equal and reactive to light. He still has a lot of fluid in his lungs, some of it the pneumonia and some of it the extra fluid from the edema (or swelling). His chest cavity drain is working appropriately. They have this really cool suction toothbrush sponge thingy that they use every 4 hours or so, to refresh his mouth. They dip it into mouthwash, and then move it across his teeth, and tongue, to freshen him up. There are no other outer signs of infection at any of his incisions.
I'm sure I missed some things here, but I'll add them tomorrow. This covers the major stuff. Please remember that 'Jr' is fighting for his life. We found out today that Sr's sister, Denise, in Phoenix, AZ, phoned a talk radio program (K-LOVE I believe it's called) and put him on their prayer list! Also, another friend of ours attends church in Leola with the president of the Christian Motocycle Enthusiasts' Club. She spoke to him about 'Jr's' situation, and he's added him to their prayer chain. We are so encouraged, and so blessed. He is still critical, and has not yet survived this severe trauma, but we believe God is at work revealing himself to many in the midst of this trial. We are praying there will be lasting fruit in the lives of those touched by Jerry, Jr.
I'm fairly exhausted, after two long days in Philly, back to back, so I'll head to bed now. The hospital knows to call us and 'Jr's' mom if anything changes for the worse, but hopefully he'll be stable tonight, and we'll rest soundly.
In Christs' love... Linda and Jerry, Sr. Hambleton
Friday, October 24, 2008
Thursday, October 23, 2008
No calls = good news
Well, we received no calls overnight, and that's a good sign. Means he was stable as we left him. We asked that we be notified of any changes for the worse, even if it wasn't life-threatening at the time. Getting ready to head back down now.
Thank you all for the consistent prayers and well-wishes. The messages you're getting to me I'm passing on to him, although I'm not sure how much he can process yet. They'll also go into "the book" for later...
In Christ,
Linda
Thank you all for the consistent prayers and well-wishes. The messages you're getting to me I'm passing on to him, although I'm not sure how much he can process yet. They'll also go into "the book" for later...
In Christ,
Linda
Record time.. post for Wednesday even though its Thrusday morning..EARLY
We made the trip down and the trip back today in record time. Jerry said his speed wasn't excessive but I didn't get a definition from him on what exactly excessive refers to in his mind. We made it home in 1 hour and 10 minutes. Jerry, Jr.came by his heavy foot naturally! :o)
We did get some good news today. 'Jr's' blood pressure has been stable since the middle of last night incident, where his oxygen levels dropped rather suddenly to the 55-60% range. When we arrived today, it was 90-91% Much improved! His temperature, in spite of the fact that he feels warm, was 98.9, but just before we left at 10:00 p.m. it was up to 100.1, and they had turned on the cooling vest and blanket again, at 40 degrees. They are being as aggressive as possible with his ventilator settings, and his oxygen levels are steady, which is good. He has sepsis, and they have a special combination of 5 I.V. antibiotics that they give in this situation. They are Flagyl, Merepenum, Zocyn, Vancomycin, and Amykacin (sp?).
Then there was the rest of the news. His kidneys are showing signs of even more strain (his creatinine is up to 5.35 and yesterday was 2.4), so they put a line into his femoral artery to prepare him for renal dialysis. The hope, and the usual circumstance, is that this dialysis is a temporary thing, but the doctor who gave us information was clear that there is no way to know at this point whether his kidneys will survive the stress they're under. I'm praying that they do. I'm also praying that his fever will break, and that the antibiotics would do their job. He has ARDS (Acute Respiratory Distress Syndrome) which is something that goes along with the sepsis, I think, and is worsened by this pneumonia. The problem with his lungs is not getting oxygen into them to enter the blood stream, it is in getting enough perfusion, or oxygenated blood to the cells of the lungs themselves. Either there are blood clot issues in his lungs, or the pneumonia is not improving, or the fluid around his lungs in the chest cavity is pushing on the tissue, obstructing blood flow in the lungs themselves. This sepsis cocktail should help.
They will begin to evaluate him again after 24 hours on CRRT (continuous renal replacement therapy, or dialysis), to see if there's any improvement. They may have to give blood transfusions along with the dialysis, because the machine that clears the blood of all its toxins also can damage the red blood cells, causing a form of anemia. The trauma Fellow (a nice lady physician named Dr. Lee) said that side effect is common for most dialysis patients. They'll have a machine at his bedside that will do the work. His lungs are still not strong enough to transport anywhere.
They placed a chest tube in his right side during the night, to drain off extra fluid from his chest cavity, to hopefully decrease the pressure that the swelling and fluid is putting on his lungs, hypothetically decreasing their blood supply. They are getting oxygen into him, his levels are 91-94% this evening), but the trouble their having is with the actual blood supply to the lung cells and tissue itself. There's that area blocked by the clot, and the presence of the clot makes it even harder to deliver antibiotics to the area. They did an ultrasound to see if there was any sign of abcess or severe infection that they could go in and take out, but there was none! That's a good thing!!! Praise God! He is hearing our prayers and responding. Dr. Lee also reiterated that we need to be thinking in terms of weeks and months, rather than days and weeks, for his recovery, if he recovers.
She also made it very clear that he is still fighting for his life. He is not out of the woods. Currently, his prognosis is poor, and the picture bleak, but I know we serve a God who answers our prayers and cares deeply about the people we love. Let's continue to ask him for mercy for Jerry, and healing! When I was in the room today praying for him, I kept asking God to heal him. I couldn't find any other words to say, and was in faith, so I went with it!
Today, when we arrived, his heart rate was higher @ 123-129 beats per minute (bpm). Yesterday, when we left it had been in the 90's. His breathing rate was faster, 29-34/minute. The fluid draining from his chest cavity tube is clear yellow, and does not appear to contain infection, which is good. Some of his swelling has gone down, but not all of it yet. They actually have this machine that vacuums the fluid (and potentially any infection) out of the open wounds on his leg from the accident (I'm pretty sure I didn't bother to mention those wounds previously). Really cool! He is attempting to breathe some on his own, although it's not very full or productive breaths. His PO2 on bld gases is 88. He remains slightly acidotic, with a pH of 7.17 this evening, which was actually up from 7.14 earlier in the day. Some of that is from his kidneys shutting down and some of that is from his breathing, as I underst and it. The renal dialysis could help reverse the acidosis, but it will be a waiting game. The renal docs weren't sure they wanted to start dialysis yet, because Jr's still putting out urine, but the amount has decreased significantly since yesterday, and his creatinine has more than doubled. Some of the doctors were thinking that if his kidneys shut down, with his lungs currently so weak, (if not for the ventilator right now, his lungs would collapse) he'll not have much reserve to fight through that combination until the dialysis gets started. They said something about rechecking his creatinine around 2 a.m., and then deciding from there. I'd rather have him on it sooner than later, and was able to voice my opinion to Dr. Lee. She agreed, but apparently the orders will be written by the renal service physicians.... gets confusing!
They are concerned about possible permanent damage to his vocal chords from the ventilator tube, so getting the trach done is high on their priority list, but at his current ventilator settings, a trach wouldn't withstand the pressure. The respiratory therapist told me today that he's just not stable enough for a tracheotomy yet. But, it's been 10 days now on the vent, and I know they don't prefer to go over 10-14 days, if possible. So, we'll see. His CVP, (central venous pressure) was 17 just before we left, and that was down from 23-25 at about 5:00 p.m.
Like I said earlier, his temp was up a bit late this evening, and I asked about Tylenol. The nurse, Erin, said they weren't trying that anymore, because it hasn't helped yet. What has helped is the cooling blanket and vest, so they're utilizing those and they've been working well so far There are no other signs of infection at this point, but they continue to search for them, because he is so sick.
Bob, if you could send this to Tyler, I'd appreciate it, or get his email to me and I'll send it myself. Jerry, Jr's vent settings are: Peak: 37; Pmean: 27; PEEP: 8.9-34; I:E 1:3.9; fTOT: 29; VTE: 426-550; VE TOT: 14.8. I have some questions for him!!!
Also, I asked the nurse if Jr. was unstable enough that his life was in danger tonight. She felt he was stable enough with a steady blood pressure and good oxygen level for us to come home and rest. We'll be going back down tomorrow, or earlier if they call and say he's taken a turn for the worse. Dr. Lee also said that she is working hard to get him through the next 24 hours, but that at this point, anything can happen at any time. He is still fighting! We talked to him about how many of his friends are supporting him with their thoughts and prayers, and all of you who asked me to tell him you said "Hello", I did that today several times, and will again tomorrow.
Thanks for all the meals that have been brought by, and for the prayers for our finances, and other encouragement sent our way. God is faithful and is at work!
Love you all,
Jerry and Linda H.
We did get some good news today. 'Jr's' blood pressure has been stable since the middle of last night incident, where his oxygen levels dropped rather suddenly to the 55-60% range. When we arrived today, it was 90-91% Much improved! His temperature, in spite of the fact that he feels warm, was 98.9, but just before we left at 10:00 p.m. it was up to 100.1, and they had turned on the cooling vest and blanket again, at 40 degrees. They are being as aggressive as possible with his ventilator settings, and his oxygen levels are steady, which is good. He has sepsis, and they have a special combination of 5 I.V. antibiotics that they give in this situation. They are Flagyl, Merepenum, Zocyn, Vancomycin, and Amykacin (sp?).
Then there was the rest of the news. His kidneys are showing signs of even more strain (his creatinine is up to 5.35 and yesterday was 2.4), so they put a line into his femoral artery to prepare him for renal dialysis. The hope, and the usual circumstance, is that this dialysis is a temporary thing, but the doctor who gave us information was clear that there is no way to know at this point whether his kidneys will survive the stress they're under. I'm praying that they do. I'm also praying that his fever will break, and that the antibiotics would do their job. He has ARDS (Acute Respiratory Distress Syndrome) which is something that goes along with the sepsis, I think, and is worsened by this pneumonia. The problem with his lungs is not getting oxygen into them to enter the blood stream, it is in getting enough perfusion, or oxygenated blood to the cells of the lungs themselves. Either there are blood clot issues in his lungs, or the pneumonia is not improving, or the fluid around his lungs in the chest cavity is pushing on the tissue, obstructing blood flow in the lungs themselves. This sepsis cocktail should help.
They will begin to evaluate him again after 24 hours on CRRT (continuous renal replacement therapy, or dialysis), to see if there's any improvement. They may have to give blood transfusions along with the dialysis, because the machine that clears the blood of all its toxins also can damage the red blood cells, causing a form of anemia. The trauma Fellow (a nice lady physician named Dr. Lee) said that side effect is common for most dialysis patients. They'll have a machine at his bedside that will do the work. His lungs are still not strong enough to transport anywhere.
They placed a chest tube in his right side during the night, to drain off extra fluid from his chest cavity, to hopefully decrease the pressure that the swelling and fluid is putting on his lungs, hypothetically decreasing their blood supply. They are getting oxygen into him, his levels are 91-94% this evening), but the trouble their having is with the actual blood supply to the lung cells and tissue itself. There's that area blocked by the clot, and the presence of the clot makes it even harder to deliver antibiotics to the area. They did an ultrasound to see if there was any sign of abcess or severe infection that they could go in and take out, but there was none! That's a good thing!!! Praise God! He is hearing our prayers and responding. Dr. Lee also reiterated that we need to be thinking in terms of weeks and months, rather than days and weeks, for his recovery, if he recovers.
She also made it very clear that he is still fighting for his life. He is not out of the woods. Currently, his prognosis is poor, and the picture bleak, but I know we serve a God who answers our prayers and cares deeply about the people we love. Let's continue to ask him for mercy for Jerry, and healing! When I was in the room today praying for him, I kept asking God to heal him. I couldn't find any other words to say, and was in faith, so I went with it!
Today, when we arrived, his heart rate was higher @ 123-129 beats per minute (bpm). Yesterday, when we left it had been in the 90's. His breathing rate was faster, 29-34/minute. The fluid draining from his chest cavity tube is clear yellow, and does not appear to contain infection, which is good. Some of his swelling has gone down, but not all of it yet. They actually have this machine that vacuums the fluid (and potentially any infection) out of the open wounds on his leg from the accident (I'm pretty sure I didn't bother to mention those wounds previously). Really cool! He is attempting to breathe some on his own, although it's not very full or productive breaths. His PO2 on bld gases is 88. He remains slightly acidotic, with a pH of 7.17 this evening, which was actually up from 7.14 earlier in the day. Some of that is from his kidneys shutting down and some of that is from his breathing, as I underst and it. The renal dialysis could help reverse the acidosis, but it will be a waiting game. The renal docs weren't sure they wanted to start dialysis yet, because Jr's still putting out urine, but the amount has decreased significantly since yesterday, and his creatinine has more than doubled. Some of the doctors were thinking that if his kidneys shut down, with his lungs currently so weak, (if not for the ventilator right now, his lungs would collapse) he'll not have much reserve to fight through that combination until the dialysis gets started. They said something about rechecking his creatinine around 2 a.m., and then deciding from there. I'd rather have him on it sooner than later, and was able to voice my opinion to Dr. Lee. She agreed, but apparently the orders will be written by the renal service physicians.... gets confusing!
They are concerned about possible permanent damage to his vocal chords from the ventilator tube, so getting the trach done is high on their priority list, but at his current ventilator settings, a trach wouldn't withstand the pressure. The respiratory therapist told me today that he's just not stable enough for a tracheotomy yet. But, it's been 10 days now on the vent, and I know they don't prefer to go over 10-14 days, if possible. So, we'll see. His CVP, (central venous pressure) was 17 just before we left, and that was down from 23-25 at about 5:00 p.m.
Like I said earlier, his temp was up a bit late this evening, and I asked about Tylenol. The nurse, Erin, said they weren't trying that anymore, because it hasn't helped yet. What has helped is the cooling blanket and vest, so they're utilizing those and they've been working well so far There are no other signs of infection at this point, but they continue to search for them, because he is so sick.
Bob, if you could send this to Tyler, I'd appreciate it, or get his email to me and I'll send it myself. Jerry, Jr's vent settings are: Peak: 37; Pmean: 27; PEEP: 8.9-34; I:E 1:3.9; fTOT: 29; VTE: 426-550; VE TOT: 14.8. I have some questions for him!!!
Also, I asked the nurse if Jr. was unstable enough that his life was in danger tonight. She felt he was stable enough with a steady blood pressure and good oxygen level for us to come home and rest. We'll be going back down tomorrow, or earlier if they call and say he's taken a turn for the worse. Dr. Lee also said that she is working hard to get him through the next 24 hours, but that at this point, anything can happen at any time. He is still fighting! We talked to him about how many of his friends are supporting him with their thoughts and prayers, and all of you who asked me to tell him you said "Hello", I did that today several times, and will again tomorrow.
Thanks for all the meals that have been brought by, and for the prayers for our finances, and other encouragement sent our way. God is faithful and is at work!
Love you all,
Jerry and Linda H.
Wednesday, October 22, 2008
"peace that passes all understanding".. post #2 for Wednesday
You know the bible talks about Christ supplying a "peace that passes all understanding?" Well, that's definitely what Sr. and I are experiencing. We are at peace, and we see that there is absolutely no reason to be there. We're grateful to our faithful God for supplying it.
We received another update by phone after Vicky and Darryl arrived @ 7:45 a.m. to hospital. They have not yet done the lung drain procedure, but are "putting a drain in his side?" (I'm thinking to drain excess fluid off). That's what Darryl said anyway. They currently feel the risk to move him or turn him (back to that) is dire right now.
Apparently, around 4:00 a.m. or shortly after, his oxygen levels dropped sharply. They attempted to adjust ventilator settings unsuccessfully, and so at that point the risk of turning him was less than the low oxygen level. Apparently then his oxygen levels improved, but I'm only assuming, since they opted to not do the procedure. The big thing they're concerned about is that with the oxygen levels dropping, he may have thrown another clot into his lungs. Wow. We could really use that CAT scan. He is not responding properly to the blood thinners, and he's on a pretty significant (but not real high) dose.
Jerry had a bit of work to do this a.m., and then we are going down to Philly today. We are at peace with waiting, and know each time we leave that he may not survive til the next visit. The staff has made that perfectly clear. But, we pray otherwise! So, please join us in that prayer for Jr's healing, and pray for God's grace for his family and especially his sisters, and please pray for abundant safety for Jerry and I as we drive down today. Thanks so much. In Christ, we are a family of believers. I look so forward to the time when this disintegrating earth is put behind us, and we are in His presence forever! Amen.
In Christs' love, Linda (and Sr.) Hambleton
We received another update by phone after Vicky and Darryl arrived @ 7:45 a.m. to hospital. They have not yet done the lung drain procedure, but are "putting a drain in his side?" (I'm thinking to drain excess fluid off). That's what Darryl said anyway. They currently feel the risk to move him or turn him (back to that) is dire right now.
Apparently, around 4:00 a.m. or shortly after, his oxygen levels dropped sharply. They attempted to adjust ventilator settings unsuccessfully, and so at that point the risk of turning him was less than the low oxygen level. Apparently then his oxygen levels improved, but I'm only assuming, since they opted to not do the procedure. The big thing they're concerned about is that with the oxygen levels dropping, he may have thrown another clot into his lungs. Wow. We could really use that CAT scan. He is not responding properly to the blood thinners, and he's on a pretty significant (but not real high) dose.
Jerry had a bit of work to do this a.m., and then we are going down to Philly today. We are at peace with waiting, and know each time we leave that he may not survive til the next visit. The staff has made that perfectly clear. But, we pray otherwise! So, please join us in that prayer for Jr's healing, and pray for God's grace for his family and especially his sisters, and please pray for abundant safety for Jerry and I as we drive down today. Thanks so much. In Christ, we are a family of believers. I look so forward to the time when this disintegrating earth is put behind us, and we are in His presence forever! Amen.
In Christs' love, Linda (and Sr.) Hambleton
Risky procedure this a.m. ... but the bible commands "do not fear"!
Morning, all. I know most of you are starting your day now, so I wanted to update you a.s.a.p. Jerry, Jr. is undergoing a risky procedure this morning. His Mom just phoned and said the hospital called her to let family know about it. Apparently they will be turning him onto his side to insert a tube to drain his lungs? I didn't speak with the hospital staff, that is just the message we got from Vicky. It is risky to turn him, but they must believe it to be necessary. Something was mentioned to us about the possibility of this the other day.
Vicky and her husband, Darryl are driving down now, instead of taking the train later, in case Jr. doesn't make it. We have turned him over to our loving and faithful God, for his support and care, and God's support and guidance to those performing the procedure. We know God will get us through whatever happens, however difficult, but we ask you to join us in praying for a smooth procedure where benefit would be Jr's.
God tells us 365 times in the Bible "do not fear", so there's one there just for today. Please be strong in your faith right now, for Jerry's sake. To you friends who've only recently learned of Jerry's condition, please feel free to call his dad or I today if you need to talk. We care deeply for each of you hurting during this time, and feel your support as well. We know Jr. is thankful that you're in his life in whatever capacity.
I'll be in touch when we've heard more. Thanks for being there with us through this entire time. It's made a huge difference to us. In Christ, Jerry, Sr. and Linda Hambleton
Vicky and her husband, Darryl are driving down now, instead of taking the train later, in case Jr. doesn't make it. We have turned him over to our loving and faithful God, for his support and care, and God's support and guidance to those performing the procedure. We know God will get us through whatever happens, however difficult, but we ask you to join us in praying for a smooth procedure where benefit would be Jr's.
God tells us 365 times in the Bible "do not fear", so there's one there just for today. Please be strong in your faith right now, for Jerry's sake. To you friends who've only recently learned of Jerry's condition, please feel free to call his dad or I today if you need to talk. We care deeply for each of you hurting during this time, and feel your support as well. We know Jr. is thankful that you're in his life in whatever capacity.
I'll be in touch when we've heard more. Thanks for being there with us through this entire time. It's made a huge difference to us. In Christ, Jerry, Sr. and Linda Hambleton
Tuesday, October 21, 2008
#10 Praise God, his blood pressure is normal..
Hello all. I wrote an update earlier, and when I hit send, got an error message. It was very frustrating and so I walked away from the computer for a bit.
Essentially, there has been no change in 'Jr.' since yesterday evening. The pneumonia is still very bad. They are still anxious to be able to take him for a CAT scan to check the area of his lungs where the clot is lodged. His kidneys are still showing signs of strain, and he is still very swollen. He is still basically 'asleep' from the pain medications. They were able to completely stop the medicine to keep his blood pressure up (Levophed), and, praise God, his blood pressure is stable. His temperature is still normal as of this evening.
His mom was down today, and will be going down to see him again tomorrow on the train. We are planning on going down on Thursday and Friday (well, Sr. will be going down Friday, but I'd like to but it's doubtful).
We are so thankful for all the encouragement you've been faithful to send our way. While Jerry is not out of the woods, we believe God is in control, and are believing for Jerry, Jr. to make it thru this. He is a fighter and is very determined, is young and physically fit, and we know God is on his side... we can feel His presence in the room with him! What a comfort. We are also holding Jerry, Jr's life in an open hand before God, knowing that if it's his time to go, holding on and begging will do no one any good. I was reminded by a very dear sister in the Lord of that today, and I thank her for her words of wisdom.
Please continue to pray against any and all infection. Pray his kidneys continue to work. Pray for no absess to be present in his lungs. Pray that the swelling will go down, and that his arms will work. Pray and believe with us for miracles. Ask God to work in the lives of his friends who don't yet know Him (some of them are reading this).
Be safe, and take care... In Christs' love... Jerry, Sr. and Linda
Essentially, there has been no change in 'Jr.' since yesterday evening. The pneumonia is still very bad. They are still anxious to be able to take him for a CAT scan to check the area of his lungs where the clot is lodged. His kidneys are still showing signs of strain, and he is still very swollen. He is still basically 'asleep' from the pain medications. They were able to completely stop the medicine to keep his blood pressure up (Levophed), and, praise God, his blood pressure is stable. His temperature is still normal as of this evening.
His mom was down today, and will be going down to see him again tomorrow on the train. We are planning on going down on Thursday and Friday (well, Sr. will be going down Friday, but I'd like to but it's doubtful).
We are so thankful for all the encouragement you've been faithful to send our way. While Jerry is not out of the woods, we believe God is in control, and are believing for Jerry, Jr. to make it thru this. He is a fighter and is very determined, is young and physically fit, and we know God is on his side... we can feel His presence in the room with him! What a comfort. We are also holding Jerry, Jr's life in an open hand before God, knowing that if it's his time to go, holding on and begging will do no one any good. I was reminded by a very dear sister in the Lord of that today, and I thank her for her words of wisdom.
Please continue to pray against any and all infection. Pray his kidneys continue to work. Pray for no absess to be present in his lungs. Pray that the swelling will go down, and that his arms will work. Pray and believe with us for miracles. Ask God to work in the lives of his friends who don't yet know Him (some of them are reading this).
Be safe, and take care... In Christs' love... Jerry, Sr. and Linda
#9 we look forward to giving God all the credit and praise He is due!!
Hello again.
I'm sorry for the delay in getting this to you all... I would have preferred to be able to email from down at the hospital, but we just got home about 10 minutes ago (stopped and had dinner on the way home and it's 12:30 a.m. now). Jerry's mom was unable to make it down today so it was Jerry, Sr., myself, and Allie. We were delighted beyond words when we walked in and his temperature was reading 98.7 degrees! I wanted to telephone my sister to ask her to email everyone and encourage you that the prayers are working, and then his nurse walked in to introduce herself. We mentioned the temperature, and she said, "Yes, we're happy about that, but he still has very bad pneumonia and the PE (blood clot in his lungs), and he is not doing as well as we'd like with his breathing." I thought perhaps we still needed the urgent prayers, so I didn't make that call. We sat down as she explained a bit more to us. ***We found out later that to bring his temperature down last night they added a cooling vest to the cooling blanket. That worked. The cooling blanket was set at 45 degrees when we got there today, and they slowly raised it to 58 degrees by 8:00 p.m., (turned the cooling vest off at about 4:00 p.m.) and his temp was still 98.8 when we left at 8:05 p.m.) Thank you heavenly Father!!! In my opinion that means the antibiotic they have him on is helping his body fight the infection (and I believe wholeheartedly that God is assisting in answer to all your prayers!!!)***
* He is still on Levophed, which is to help keep his blood pressure up. They have begun to decrease it slowly with some success. His blood pressure was 96-124/46-62 throughout the day.
* Some of the indicators of his kidney function have elevated from his baseline (for you medical folks his creatinine is 2.4), which could mean his kidneys are struggling. They did an ultrasound on his kidneys this evening, but we don't yet have the results of that.
* He has a lot of edema, (swelling throughout his body), which can decrease circulation to vital organs and his limbs (that could be the issue with his kidneys). The amount of swelling is not unusual for trauma patients. It causes other entry points for infection, however, because wherever they stick him to draw blood, or start an IV, or wherever there was a break in his skin from the accident, he oozes a yellowish fluid. So, we need to continue to pray against infection as well as for his kidneys. I'll mention more about them later. Our bodies are so amazing!
* They have him down to one antibiotic (Zocyn?) which is a broad-spectrum antibiotic. There are no signs of antibiotic-resistant infection, (MRSA) which is very good.
* The trauma doctor told us that although he doesn't have an infection in his blood per se, he essentially is septic (or has sepsis), because of the combination of events going on in his body. Sepsis is very serious. He told us that if this was a regular 60 year old person, there is no way that he would still be alive. We told him there were many people praying for Jerry, Jr., and he told us that is the best medicine at this point! Praise God! We agree.
When we arrived today, they explained to us that the ventilator was doing all the work. Because of his need for the cooling vest, they removed the abdominal 'wrap' that was assisting his diaphragm in breathing, so his oxygen levels were low. They were giving him as much oxygen as they could through the ventilator (using a lot of pressure to really push it in), and keeping his lungs inflated longer than deflated to allow as much oxygen as possible to be absorbed. Apparently, the pneumonia is blocking a lot of his lung area from functioning (does that make sense to you?). His oxygen level was running 85-88% all day, and they were okay with that because it was stable. Like they kept telling us, the pneumonia is very bad. He is not out of the woods yet. I asked the trauma doctor (Dr. Uri - that's his first name, but he is foreign, and told us not to even bother with his last name!), anyway, I asked him what he meant by "very bad". Wh at makes this case of pneumonia worse than others? He explained that Jerry currently has 3 strikes against him, in terms of his breathing: #1 - He has something called ateletasis - which is a decrease in the overall volume or size of the lungs. This can happen when a person has to lie flat for periods of time, but is also occurring because of the amount of pneumonia present. #2 - There is lots of infection from the pneumonia. He has it all throughout both lungs, top and bottom. And, #3 - The pulmonary embolism (blood clot in his lungs) is present, which is blocking part of his lower lung (I'm not sure which side). The trauma doctor told us the blood clot hinders blood flow to that area of his lungs, and since there is pneumonia present, the antibiotic isn't circulated fully, so it's harder to treat.
The doctor also told us that we need to be thinking in terms of weeks, rather than days for Jerry's improvement. That wasn't easy to hear, given the distance to Philly, but, as Jerry, Jr. would say,
"It is what it is."
They are still planning to put in the traecheotomy as soon as possible, but as long as the ventilator settings are so high (as long as they need to force oxygen into his lungs) they are unable to trach him, because the trach won't withstand the pressures. (It would keep popping off and alarming - very annoying). As of today, Jerry is still very sedated, although he is only on pain medicine now (Dilaudid and Morphine) rather than the anesthetic (?Propofyl?) they had him on the last 5 days. The nurse said it's better for him to have his cough reflex, and to be somewhat more alert for them to better assess his status. The neurologist did stop by today, and told us that there is no way that 'Jr.' will remember any of this time on the ventilator. I do pray that is true.
His ABG (arterial blood gas) this afternoon, (for you medical folks out there) was:
7.42
49
131
Also, the nurse wanted to warn us that with any trauma patient, it is not unusual for the patients' kidneys to just "shut down". She said its like they say, "We're not gonna play anymore for now." and just quit working. They put the patient on dialysis (temporarily), and then at some point the kidneys say, "Okay, we're ready to play again!" and they start up and remain functioning. She said in severe trauma, it happens so regularly, they almost expect it. So, we may have to face that. (But God could spare him!) I was soooo grateful to her for the warning, because as she stated, normally, "on the outside", dialysis is a very dire stage for patients, and is usually not reversible. A little knowledge in the right areas is a very good thing. :o)
Also, thanks to all of you for the positive feedback to these updates. It is so much easier and far more accurate than trying to repeat all the information many times on the phone. We know how beneficial specific prayers can be, and we're humbled by your faithfulness to this task on 'Jr's' and our behalf! We thank you all for your prayers for his family as well. Please continue to pray for his sister Jennifer, that she would be upheld in God's hands until and after she is able to see Jerry (she and the baby are still doing well).
The trauma doctor also explained that they had wanted to transfer him to Medical ICU (he's currently in the Surgical/Trauma ICU) because that unit regularly treats more severe cases of pneumonia and cases of pulmonary embolism like 'Jr.' currently has, but instead they did the less risky and more simple thing, and that was to transfer the physician in charge of his treatment from neurology to the trauma service. Apparently, neurology operates out of an entirely different building, and 'Jr.' needed more hands-on attention, so the trauma doctors are in the unit where room 5011 is all the time, so it made more sense for them to take over. It appears they are doing an awesome job, and please continue to pray for wisdom and guidance from God for them as they make decisions regarding 'Jr's' care and treatment. Also, please pray for the nurses to continue the excellent care they are giving him, and that they would have the ability to see the overall picture, and not just focus on a single aspect of his care (like breathing, or blood pressure). When there are so many issues, it can be easy to have tunnel vision, unfortunately.
It is so much easier to be down there with 'Jr.' than to be in Lancaster "waiting and wondering". Dr. Uri made it very clear that Jerry, Jr. hasn't survived this yet, and is still not out of the woods by a long shot, but his youth and fitness going into this are to his benefit. Please pray for God to show mercy. Please pray for God's grace to be with each and every family member who is unable to be in his room on any given day, that they would feel God's presence and comfort, too. God is definitely in that room with Jerry. It is such a comforting presence! His entire family needs to not only pull together, but to remain strong for him, so to pray for sound rest and sleep for all of us would be appreciated, too.
Jerry, Jr. is so blessed by God, not only with his abilities and gifts, but also to have so many faithful and true friends as you all out there. I will be asking LA Fitness (at the Golden Triangle/Lancaster) (sorry, Lori, but you'll read this before I can ask in person) if I can place a notebook at their desk for members and staff to write notes to Jerry, Jr. As soon as we can read them to him, I know he would be blessed by hearing everyone's hopes for a speedy and full-as-possible recovery! And, hopefully, a little humor will be included as well. :o) So, for any of the rest of you who would like to contribute, the book will be there. Or, you can send an email, and we can print it out and we'll include it with the other messages. We have a week or so before we'll be at that point, unless God really wants to glorify His name by healing Jerry sooner! Amen!! We are believing that Jerry, Jr. will pull through this, even though we need to approach it realistically, and we look forward to giving God all the credit and praise He is due!!
May the God of our salvation and the author and perfector of our faith keep you in perfect health until we can see or meet each of you... we are truly blessed.... may we each dedicate every moment to that which matters for eternity.
Jerry, Sr. and Linda Hambleton
I'm sorry for the delay in getting this to you all... I would have preferred to be able to email from down at the hospital, but we just got home about 10 minutes ago (stopped and had dinner on the way home and it's 12:30 a.m. now). Jerry's mom was unable to make it down today so it was Jerry, Sr., myself, and Allie. We were delighted beyond words when we walked in and his temperature was reading 98.7 degrees! I wanted to telephone my sister to ask her to email everyone and encourage you that the prayers are working, and then his nurse walked in to introduce herself. We mentioned the temperature, and she said, "Yes, we're happy about that, but he still has very bad pneumonia and the PE (blood clot in his lungs), and he is not doing as well as we'd like with his breathing." I thought perhaps we still needed the urgent prayers, so I didn't make that call. We sat down as she explained a bit more to us. ***We found out later that to bring his temperature down last night they added a cooling vest to the cooling blanket. That worked. The cooling blanket was set at 45 degrees when we got there today, and they slowly raised it to 58 degrees by 8:00 p.m., (turned the cooling vest off at about 4:00 p.m.) and his temp was still 98.8 when we left at 8:05 p.m.) Thank you heavenly Father!!! In my opinion that means the antibiotic they have him on is helping his body fight the infection (and I believe wholeheartedly that God is assisting in answer to all your prayers!!!)***
* He is still on Levophed, which is to help keep his blood pressure up. They have begun to decrease it slowly with some success. His blood pressure was 96-124/46-62 throughout the day.
* Some of the indicators of his kidney function have elevated from his baseline (for you medical folks his creatinine is 2.4), which could mean his kidneys are struggling. They did an ultrasound on his kidneys this evening, but we don't yet have the results of that.
* He has a lot of edema, (swelling throughout his body), which can decrease circulation to vital organs and his limbs (that could be the issue with his kidneys). The amount of swelling is not unusual for trauma patients. It causes other entry points for infection, however, because wherever they stick him to draw blood, or start an IV, or wherever there was a break in his skin from the accident, he oozes a yellowish fluid. So, we need to continue to pray against infection as well as for his kidneys. I'll mention more about them later. Our bodies are so amazing!
* They have him down to one antibiotic (Zocyn?) which is a broad-spectrum antibiotic. There are no signs of antibiotic-resistant infection, (MRSA) which is very good.
* The trauma doctor told us that although he doesn't have an infection in his blood per se, he essentially is septic (or has sepsis), because of the combination of events going on in his body. Sepsis is very serious. He told us that if this was a regular 60 year old person, there is no way that he would still be alive. We told him there were many people praying for Jerry, Jr., and he told us that is the best medicine at this point! Praise God! We agree.
When we arrived today, they explained to us that the ventilator was doing all the work. Because of his need for the cooling vest, they removed the abdominal 'wrap' that was assisting his diaphragm in breathing, so his oxygen levels were low. They were giving him as much oxygen as they could through the ventilator (using a lot of pressure to really push it in), and keeping his lungs inflated longer than deflated to allow as much oxygen as possible to be absorbed. Apparently, the pneumonia is blocking a lot of his lung area from functioning (does that make sense to you?). His oxygen level was running 85-88% all day, and they were okay with that because it was stable. Like they kept telling us, the pneumonia is very bad. He is not out of the woods yet. I asked the trauma doctor (Dr. Uri - that's his first name, but he is foreign, and told us not to even bother with his last name!), anyway, I asked him what he meant by "very bad". Wh at makes this case of pneumonia worse than others? He explained that Jerry currently has 3 strikes against him, in terms of his breathing: #1 - He has something called ateletasis - which is a decrease in the overall volume or size of the lungs. This can happen when a person has to lie flat for periods of time, but is also occurring because of the amount of pneumonia present. #2 - There is lots of infection from the pneumonia. He has it all throughout both lungs, top and bottom. And, #3 - The pulmonary embolism (blood clot in his lungs) is present, which is blocking part of his lower lung (I'm not sure which side). The trauma doctor told us the blood clot hinders blood flow to that area of his lungs, and since there is pneumonia present, the antibiotic isn't circulated fully, so it's harder to treat.
The doctor also told us that we need to be thinking in terms of weeks, rather than days for Jerry's improvement. That wasn't easy to hear, given the distance to Philly, but, as Jerry, Jr. would say,
"It is what it is."
They are still planning to put in the traecheotomy as soon as possible, but as long as the ventilator settings are so high (as long as they need to force oxygen into his lungs) they are unable to trach him, because the trach won't withstand the pressures. (It would keep popping off and alarming - very annoying). As of today, Jerry is still very sedated, although he is only on pain medicine now (Dilaudid and Morphine) rather than the anesthetic (?Propofyl?) they had him on the last 5 days. The nurse said it's better for him to have his cough reflex, and to be somewhat more alert for them to better assess his status. The neurologist did stop by today, and told us that there is no way that 'Jr.' will remember any of this time on the ventilator. I do pray that is true.
His ABG (arterial blood gas) this afternoon, (for you medical folks out there) was:
7.42
49
131
Also, the nurse wanted to warn us that with any trauma patient, it is not unusual for the patients' kidneys to just "shut down". She said its like they say, "We're not gonna play anymore for now." and just quit working. They put the patient on dialysis (temporarily), and then at some point the kidneys say, "Okay, we're ready to play again!" and they start up and remain functioning. She said in severe trauma, it happens so regularly, they almost expect it. So, we may have to face that. (But God could spare him!) I was soooo grateful to her for the warning, because as she stated, normally, "on the outside", dialysis is a very dire stage for patients, and is usually not reversible. A little knowledge in the right areas is a very good thing. :o)
Also, thanks to all of you for the positive feedback to these updates. It is so much easier and far more accurate than trying to repeat all the information many times on the phone. We know how beneficial specific prayers can be, and we're humbled by your faithfulness to this task on 'Jr's' and our behalf! We thank you all for your prayers for his family as well. Please continue to pray for his sister Jennifer, that she would be upheld in God's hands until and after she is able to see Jerry (she and the baby are still doing well).
The trauma doctor also explained that they had wanted to transfer him to Medical ICU (he's currently in the Surgical/Trauma ICU) because that unit regularly treats more severe cases of pneumonia and cases of pulmonary embolism like 'Jr.' currently has, but instead they did the less risky and more simple thing, and that was to transfer the physician in charge of his treatment from neurology to the trauma service. Apparently, neurology operates out of an entirely different building, and 'Jr.' needed more hands-on attention, so the trauma doctors are in the unit where room 5011 is all the time, so it made more sense for them to take over. It appears they are doing an awesome job, and please continue to pray for wisdom and guidance from God for them as they make decisions regarding 'Jr's' care and treatment. Also, please pray for the nurses to continue the excellent care they are giving him, and that they would have the ability to see the overall picture, and not just focus on a single aspect of his care (like breathing, or blood pressure). When there are so many issues, it can be easy to have tunnel vision, unfortunately.
It is so much easier to be down there with 'Jr.' than to be in Lancaster "waiting and wondering". Dr. Uri made it very clear that Jerry, Jr. hasn't survived this yet, and is still not out of the woods by a long shot, but his youth and fitness going into this are to his benefit. Please pray for God to show mercy. Please pray for God's grace to be with each and every family member who is unable to be in his room on any given day, that they would feel God's presence and comfort, too. God is definitely in that room with Jerry. It is such a comforting presence! His entire family needs to not only pull together, but to remain strong for him, so to pray for sound rest and sleep for all of us would be appreciated, too.
Jerry, Jr. is so blessed by God, not only with his abilities and gifts, but also to have so many faithful and true friends as you all out there. I will be asking LA Fitness (at the Golden Triangle/Lancaster) (sorry, Lori, but you'll read this before I can ask in person) if I can place a notebook at their desk for members and staff to write notes to Jerry, Jr. As soon as we can read them to him, I know he would be blessed by hearing everyone's hopes for a speedy and full-as-possible recovery! And, hopefully, a little humor will be included as well. :o) So, for any of the rest of you who would like to contribute, the book will be there. Or, you can send an email, and we can print it out and we'll include it with the other messages. We have a week or so before we'll be at that point, unless God really wants to glorify His name by healing Jerry sooner! Amen!! We are believing that Jerry, Jr. will pull through this, even though we need to approach it realistically, and we look forward to giving God all the credit and praise He is due!!
May the God of our salvation and the author and perfector of our faith keep you in perfect health until we can see or meet each of you... we are truly blessed.... may we each dedicate every moment to that which matters for eternity.
Jerry, Sr. and Linda Hambleton
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