#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