Thursday, October 31, 2013 9:30pm

THE MOVE WAS ACCOMPLISHED

Yesterday was a very, very long day.  The paperwork and preparations for the transfer to St. Joseph's Rehab Center seemed to drag on and on - in fact, at 2pm it looked like it would not happen for another day.  Then suddenly everything was cleared and we packed up the room.  John's dressings were changed and the wound vac removed (to be replaced at the new facility).  The wonderful staff just kept coming by to say goodbye.  The surgeon made a final visit until John sees him in two weeks and he was upbeat and positive about the future for John's healing and later prosthesis.  So, the ambulance crew loaded John up and set off across for Phoenix while Elisa and I followed in the car.



It was late before John was settled in his new room and Elisa and I left the rehab center.  Tired and with no supper, we shopped at Walmart at 10:30 buying loose gym shorts for John's therapy sessions.  Not sure he cares about being stylish, but we were good shoppers.

Elisa and I arrived at the center at 7:30am and John's intake had already begun.  The whole day was a parade of doctors, therapists, administrators and nurses.  The gyms and workout room are amazing. What a wonderful place!  They had John working throughout the day.  The only setback was a bit of trouble with his wound dressings.  Several people were surprised and impressed with how much he could do already after the good physical therapy at the Chandler hospital.  There was immediate work on life skills for daily, independent living.  John dressed himself - first time in clothes since 10/21! And he loved the freedom and control of a wheelchair of his own!

More work tomorrow morning starting at 7:30, so it is bedtime for Elisa and me.  John was down at 8pm. The rehab center says that the best time for visiting is between 3-6pm after all the therapy is done for the day and before dinner.  The weekend is more open for visitation.  It is probably better if you give me or John a call before coming.  Thanks for your continuing prayers and all the greetings and cards!  They are bright spots
in John's days!

Wednesday, October 30, 2013 5:30am

MOVING DAY!

Today John will be transported to the Neuro Rehabilitation Center at St. Joseph's Hospital and Medical Center in Phoenix!  It is a red letter day on John's journey to recovery.  St. Joseph's has a national reputation for successful, specific and individualized programs for treatment of brain injury and spinal cord injuries as well as other complex medical conditions including amputations. John is excited and ready to begin the work ahead with an excellent staff that he has seen at work with his parishioners in the past.

Yesterday was the best day yet for John.  The good news of the drop in white blood cells in the morning followed by good reports when his dressings were changed were welcome news.  With the physical therapist assisting, John walked 65 feet to the nurses' station, rested a bit in a chair, then walked back to his room.  What an effort!  Also, the G.I. troubles (hiccupping, coughing, choking) symptoms resulting from the 3 surgeries is beginning to improve which makes eating less difficult.  All attending doctors "signed off" for his transfer and the rehab center accepted John as a patient.  Last night John declared he " felt the best he has felt since this ordeal began.  Certainly, his voice, concentration, and clarity of thought were better.

We will continue to keep you informed.  For people in the valley here, I will let you know when visiting hours are available.  John loves the greetings, but they are best sent to our house.

Our grandson, Josiah (3), in Texas expressed our excitement best:

Tuesday, October 29, 2013 - 8:30am

MAKING PROGRESS!

Coming in late each evening, I do better on these postings in the morning.  Monday was another busy day for John, but there was a lot of good news.  When the "wound care" specialists came to undress both the upper wound and the stump, they did not find infection! Where the stump has been closed neither they nor the infectious disease doctor could not see any necrotizing tissue.  Great news!  John is looking better and stronger.  However, the lab tests don't look as good which is frustrating.  The white blood cell count continued to climb and that will have to turn around before he can move onto to rehabilitation.

Working hard & toting the "wound vac machine"

Elisa stayed with John throughout the day and witnessed his remarkable walks with the physical therapist.  He has passed the physical therapist's required benchmarks for moving on to rehabilitation.



A well-earned nap after therapy!

Paul and I toured two acute care rehab facilities in Phoenix.  We have all agreed on the unit at St. Joseph's Hospital which is just north of the church in central Phoenix.  The doctor supports this and today they may begin the paperwork, etc. that could take 2-3 days.  Our dear brother-in-law, Tom, brought my parents (both in wheelchairs!) to visit and we all had a conference with the surgeon present and rejoiced at his encouragement and optimism.  Paul flew home with a lighter heart.


So...this morning's latest report: John's white blood count dropped from 23,000 to 16,700!  Praise God! There is other lab work they are watching, but we believe John will be on his way to rehab in the next few days. That is where the real work will begin and John is eager to start.  Your prayers and support are working.  John and all his family are very grateful.  Above all, we praise the God who holds John close and has provided just what was needed in this crisis.

Monday, October 28 Update, 7:00am

Sunday was another long day at the hospital.  John looked great when we arrived in the morning - very alert and bright eyed.  He had slept better than the previous night, but still wakes up frequently, both on his own and for numerous nurse checks and starts of new antibiotic drips.  It was very exciting to watch him with the physical therapist as he raised his left leg and worked through the strengthening exercises.  Then he got himself out of the bed with the walker and hop-walked about two feet, turned around and came back - with only one assistant this time!

There were two main concerns: his white blood count slowly is climbing up rather than gradually going down which can mean continuing infection.  Also, his right foot/leg has swollen with fluid, perhaps just from the IV solutions and the inactivity.  The doctor had them remove the dressing and unpack the upper leg wound with Veronica present.  The wound looked good, is draining well and no visible signs of infection, but really is very deep.  An MRI was ordered for that area to search for deeper infection.  An ultrasound scan was done on the right leg to be sure there were no blood clots.  These took up about 3 hours in the middle of the day.  He is on a new pain medication which is working very effectively and makes a real difference.  The wound was re-packed and dressed with John feeling minimal pain, so he was really grateful for the new drug! When we left last evening, we did not have any results, but are hoping this is good news - at least nothing urgent that brought the doctor running.

In so many ways, John looks healthy - he is getting stronger, his color is good, his breathing and heart are good.  There are still issues with hiccuping/belching/coughing/swallowing which interfere with eating.  We continue to think this is a result of the intubation and anesthesia during the surgeries. We're hopeful that's improving, since he spent over an hour talking with visitors without it bothering him.

Veronica and Dillon were with us until they left to catch their plane home.  Little Dillon's voice and happy activity certainly added cheer and thoughts of the future to our day. Of course, Veronica has been an amazing help professionally, but her positive, encouraging words and presence were even more of a blessing.  A real highlight of the day was a visit from Tony and Joy Cook (Tony is Stated Clerk of Grand Canyon Presbytery) and also from Fred and Judy Davis, dear friends from our days in Las Cruces, NM before they were called to Washington.  Fred is a miracle of God's care and faithfulness as well as the power of prayer following a terrible accident when we were all together there.  John and Fred share a special friendship - and they just moved to the Valley from Washington!  All these friends lingered and talked and prayed - for all of us it was a powerful, uplifting time.

We're headed over to the hospital now in hopes of being there when the doctors visit John.  Paul, Elisa and I hope to visit two rehab facilities and then make a decision for a recommendation. Paul will be flying back to California this evening.

Saturday, October 26 Update, 10:00pm

Following the early birthday party with our 3 kids this morning, the rest of John's day started with a warm sponge bath and sprucing up by Elisa.  It has been a pretty good day.  Nurses have worked closely with John to control pain as much as possible.  A good part of the day was spent in the recliner.  All four doctors visited in the late afternoon and seemed pleased with the current situation. Dr. Motzkin, the surgeon, continues to be optimistic as the infection seems contained.  John is doing a great job of using his quads to raise that left leg and work on strengthening.

Veronica, Paul, Elisa and I visited four different acute care rehabilitation centers today.  We probably reduced the selection to two, both at a distance from where we live.  A decision will need to be made next week so advanced preparations can be made.  We appreciate you reading this blog and continuing your prayers.  Feel free to share the link with others who may know John.  He will be in much better shape for company next week.

Bologna (below-the-knee) Amputation October 26, 2013

A good hike at Neskowin Beach in Oregon June 2013

In the early morning hours of Tuesday, October 22, 2013, John's left leg was amputated. It was a fast and shocking turn of events, especially considering that just hours earlier we were driving home from a lovely visit with our daughter, Elisa, and her family in Utah. 

Many people have inquired about his progress, so we have created this blog site to be able to keep you informed of what is happening with John's recovery. I will be updating this periodically. Please feel free to pass on the link.

This first post is intended to cover the events of the last five days.

Monday 10/21/2013: We were wrapping up a great 4-day visit in Layton, Utah with the Hood family. John had mentioned to me briefly that his left foot was bothering him and he had been treating with cream from the drug store for some athlete's foot for 2-3 days, thinking maybe he had some fungus. On Sunday, we began to see some redness and swelling in his foot. Because he has had a previous issue with infection following an injury to the shin, we figured he might need some antibiotics, so we started out on our 12-hour drive back home to Phoenix. During the long drive, John's foot became progressively more red, swollen and painful, and by the time we reached Las Vegas, he was visibly quite ill and the intense  redness and swelling was rapidly spreading upward. We actually considered stopping at that point but figured it was best to push on through and get home. I took over the driving, and John was reclining with his leg elevated. By the time we arrived home in Phoenix at 10pm, it was clear that John was ill enough that we should go directly to the hospital. When we got to the emergency room at Chandler Regional Medical Center, we were rushed back through triage, and it seems that before we knew what was happening, the orthopedic surgeon (Dr. Motzkin) explained that the infection in John's leg was extremely aggressive and needed immediate surgery.  The toes and foot were already beyond saving.  John and the surgeon decided to proceed with amputating his left leg below the knee in order to save his life.  John looked down at his leg and said "Go ahead and do what you have to do."

Tuesday 10/22/2013 Dr. Motzkin took John to the operating room at 3:30am. He performed a below- the-knee amputation but was concerned because there were areas of redness and swelling in John's upper left thigh as well.  Throughout the first several days, he was very clear he was really fighting the beast of an aggressive infection. He and the rest of the doctors on the team were seriously concerned for John's life. My sister and brother-in-law, DeeAnn and Tom, came to the hospital at 2:30am and stayed by our side throughout the night and day.  My brothers also came. Thankfully, Amy was able to come from Texas by Tuesday evening and she has been a wonderful support for her father and me.  

Wednesday 10/23/2013 Though originally Dr. Motzkin had planned to take John back to surgery in 48 hours (which would have been Thursday), in less than 30 hours, precipitated by John's increasingly high white blood count, temperature and atrial fibrillation, he took him again to urgent surgery at noon. In the second surgery, Dr. Motzkin removed a great deal of dead tissue from John's lower leg. He also opened up his upper thigh and drained an infection.  This procedure seemed to correct his atrial fibrillation immediately. The good news was finding strong, healthy muscle at the amputation site. John tolerated both of these surgeries amazingly well and in great spirits. A highlight of this day was finally reaching Paul, Veronica and Dillon on vacation in Colombia.  John was really encouraged to speak with Paul late in the evening.

Thursday 10/24/2013 Nice good, busy, uneventful day. We knew his white blood count was still high and he had lost a lot of blood. We were not out of the woods, by any means. However, John's spirits were high, his fever was down, his pain was well controlled. He was  sitting in a recliner part of the day.  We knew that Dr. Motzkin was planning a repeat surgery on Friday, but for today, John could eat more than strawberry jello and enjoy his visitors.  At one point there were six ordained clergy in the same room!

Friday 10/25/3013 Elisa arrived at mid-day. After a long day of waiting for surgery, John returned for a third time to the operating room.  After a humorous moment in which Dr. Motzkin was talking about below-the-knee amptuation versus bologna amputation (you all know John's humor, which has been amazingly present throughout this insane week). The surgery took twice as long as planned, but Dr. Motzkin returned and for the first time told us he was "cautiously optimistic". He found no evidence of the bacterial infection in his left leg stump and the upper thigh was continuing to drain well with "no evidence of infection continuing to spread upward." In this surgery, they had to take more bone from John's left leg and worked on actually closing the wound. Dr. Motzkin believes he has a good prognosis for a prosthetic and they will be carefully watching the healing process. We are all feeling hopeful. Paul and his family arrived just as John returned to his room.  Certainly, this was the most difficult and painful surgery, and the next few days will likely be challenging as John's pain seems much increased. We expect he will be ready for visitors by the first of the week. He does love mail!

Saturday 8am: Celebrating Amy's and Paul's birthdays before Amy leaves