Dr. Duke's Day of Rest

I don't think Dr. Duke ever really gets a day off (most of the time I don't even think he gets consecutive hours of sleep at night). Today, however, his surgery schedule is slightly shorter - Dad's not on the list. Since he got the new micro-shift yesterday, today he's only having "micro-surgery". I got to see dad (and some of the micro-team) today. Even the newbies are already trying to escape.

Dr. Duke reported yesterday that the maggots are working. The ones he removed yesterday had grown quite large.

"They're about this big (*motions his pointer finger and thumb to signify about half an inch*) and they eat like teenage boys."

So, we asked for hungry maggots and that's what we got. Tomorrow they plan to do a routine wash out, and then on Monday the 3rd string of maggots will get to work their magic.

He's Out

Out of surgery and doing well.

Surgery 18, Day 24

Dad's back in surgery.

Please say prayers for Dad, Dr. Duke, and (as odd as it sounds) even his new little micro-team.

Escapees

We don't know much about the progress our micro-surgeons are making, but we do know they are growing. To me this only means one thing... lots of dead tissue eaten. Now, their bellies are full from the feast, and they are looking to escape to freedom. (possibly to take that post Thanksgiving dinner nap)

Dr. Duke showed off his pager yesterday. There was a frantic message from dad's nurse --

"THE MAGGOTS ARE ESCAPING!"

Without the wound vac the tape stays moist and some try to crawl under it. Yesterday's nurse was given orders to "quickly smush them if they get out".

This is a side of nursing I never knew about, and an experience that some of the nurses seem to want to quickly forget.

Yesterday evening dad was a little more alert. Maybe it was the "maggot itch" that woke him up (because he really wants to scratch). He was quite squirmy, kicking his legs and wiggling to the edge of the bed. Little does he know that he can't escape the maggots. There are MANY, MANY of them and only one of him. Last night they gave him medicine to help him relax and rest up for today's surgery. On today's surgery agenda - out with the old and in with the new. The next shift of hungry micro-surgeons are scrubbing in.

Blood Drive = Free Food

The donor bus will be at the St. Philip parking lot next to the youth house on Friday, Feb. 20 from 3-7 p.m. for a blood drive for Louie. To schedule an appointment, visit www.giveblood.org and click "Digital Donor." Enter sponsor code C047 or contact Janice Kight at 979- 578-2239. The Knights of Columbus Council 2490 will offer each donor a ticket for a fried fish dinner at a later date.

Also if you could please say a little prayer that our "micro surgeons" are able to do their job successfully!

Thanks,
Abby

Not only in the movies.

Since the accident we've been very impressed how the doctors address every issue. They don't make promises to us, but we always know that they are doing anything and everything they can. Chest tube to drain fluid, pacemaker to help out his heart, trach to replace the vent tube, more blood, warming blankets to raise temperature, on pressors, off pressors, more pain medicine, less pain medicine, new pain medicine, surgery, surgery, surgery. When he's very agitated, they trace every tube until they find the one that's causing the problem. With each daily report we know they are doing everything they can. Little did we know that we hadn't heard of EVERYTHING.

Are you sitting down? Dr. Duke wanted to make sure we were before he explained his new course of action. Dr. Duke has told us from the beginning that he doesn't do everything these "young uns" do.

Today Dad became a member of an elite group. You may have seen it before on House or Gladiator. On today's surgical agenda - maggots (we might prefer to call them "micro surgeons"). While I'd heard of this before, I guess I thought it only happened in movies. Nope, not the case. They order these medical micro surgeons from California, and apparently they can do what scapels and lasers cannot by eating and dissolving dead or infected tissue.

Dr. Duke was happy to report that the maggots will be able to remove necrotic tissue without nipping the healthy tissue. Sometimes he goes to remove the infected skin and it makes the healthy tissue bleed. These micro surgeons will only eat the necrotic tissue. At first we were a bit skeptical about this. Obviously we trust whatever Dr. Duke wants us to do, but after a little Internet research we are almost excited.

Here's some information we have found.

Excerpt from National Geographic:
Sherman recalls the case he saw if a woman with perforation of the bowels and an infection that had spread through the abdomen, causing death (gangrene) of her bowel wall and peritoneum. Because it became necessary to remove dead tissue every other day in a risky surgical procedure, the attending physician decided to try the maggots.
"Two thousand of them were sprinkled over her open abdomen, and then covered with a dressing," said Sherman. "Two days later the maggots were washed out, revealing no more gangrene. She healed well, and the abdomen closed, without the need for any further intra-abdominal surgery."

Dr. Ronald Sherman of the University of California, Irvine

While the thought of this might make us squirm a bit, we're very hopeful and we know addressing this issue is the next step we have to take. Plus it means that Dad will only go to surgery every other day while the "micro surgeons" do their work!

In Surgery Now

Please Pray.

Day 21, Surgery 16

Surgery went well. Just a little while ago mom got the report, and there were no set backs today. The doctors said that the daily washouts will continue. Dad had to go back on the pressors (medicine to raise his blood pressure), but they are going to try to wean him off again. His blood pressure is good when he's not in surgery, but he has a harder time maintaining it in during the operations.

They are going to watch him for the next 24 hours and if his heart has no incidents they will remove the pacemaker tomorrow. Part of us just wishes they could leave it in. It's been such a relief to us knowing that it's there and will spring into action if needed. However, the doctors said the line is another risk of infection and could possibly even damage the heart. In that case we're okay with them removing it. (not that anyone even asked our opinions)

Thanks again for all of the prayers. They are working.

Tracy

Headed to surgery...

Uncle Louie is scheduled for surgery this morning. Please keep him in your thoughts and prayers.

Thanks,
Abby

Out of surgery

Uncle Louie is out of surgery and doing well (considering that he is still very sick and all!). They were able to wean him off pressors (blood pressure medicine) so that's good. Apparently it was a routine wash out with no further bowel repair.

Thanks for your prayers.

Abby

In surgery

Please pray.

Abby

No Surgery Today

Dad was scheduled to go to surgery again, but today proved to be another very busy day in ICU (as weekends always are) and he got bumped from the lineup. Dr. Duke gave a report this evening and said they will take him tomorrow. In yesterday's surgery Dr. Duke made a small repair to his bowel, and other than that it was just a routine wash out. Today's labs showed little change from Saturday other than hemoglobin for which they gave him another couple units of blood. Overall dad had a rather uneventful day, and the pacemaker still has not had to help out his heart.

Cayla came for a brief visit this weekend as well. Of course she didn't visit Pawpaw, but Mimi was thrilled to see her little ladybug. When leaving this evening Cayla and I passed Dr. Duke and another Dr. in the hall. They were in deep discussion, but I pointed out to her that that was Pawpaw's doctor. She really wanted to meet him, but he appeared very busy. After we passed, she told me --
"Mom, he really just needs to give Pawpaw a 'walking stick' or 'wheeling chair'. If he did that his tummy wouldn't be wiggly when he walks and he could get better. Next time I see him, I'm going to tell him that."
She really wants me to arrange that meeting for her. I'm not sure how Dr. Duke would respond to her 6 year old wisdom.

Tracy