Update by Ryan

Hi all. This is Ryan. I'm out of the hospital now, and doing quite well. Thank you for all of the support and well wishes. On last Tuesday (the 10th) I was cleared to resume weight bearing and no longer need the wheelchair. At this point I feel like nothing ever happened, and I don't think I should have any long term ill affects. Everyone, from the doctors on down, keeps telling me how lucky I am and are surprised by my speedy recovery. At this point, all I really should have left is a brief rehab. Soon after, Kim and I plan on returning to California so I will see some of you in the flesh soon enough. This should be around the 20th of April if all goes as planned. Once again, thank you for your care and concern.

An update!

Ryan is home & is doing extremely well! He's been spending the past the few days just resting & helping me take care of some things here. He had his first doctor's appointment with his primary care physician yesterday, & she was amazed at how well he's doing considering the injuries he sustained. His next appointment is on the 10th with orthopedics. Hopefully, at that appointment they'll give the okay for him to be able to start the rehab on his left leg & arm. Until this point, they've been pretty much let those extremities rest due to his clavicle (collarbone) & pelvic fractures. Ryan is SO anxious to try to get up & start trying to walk again, so we know that his rehab is going to go very well.

Ryan has a lot of different doctors appointments in the upcoming weeks (trauma surgery, ENT, vascular surgery, neurosurgery etc.) so that the physicians can track his progress. It truly is amazing how well he's doing. If it weren't for the cervical collar (which hopefully ortho will let him take off) & him being in the wheelchair, you would never know that anything had happened to him at all. Hopefully, in the next day or two, Ryan himself should be posting a message here on the blog, so be sure to check back for that! =D

Ryan Says "Hi!"

I'm sorry it's not bigger and the quality's not better, but it was taken on my cell phone. =)

Ryan will be released from the hospital tomorrow & we are so excited! We'll head home to our apartment in Watertown & probably stay there until his doctor's appointment in this (Syracuse) area on Monday. He's doing amazingly well, & we know that he's only going to continue to get better & better everyday!

We will continue to keep everyone updated, & are going to try & get more pictures & videos of him up as well.

¡¿Going home on Wednesday?!

When one of Ryan's doctors came into see him this morning, he told us that they'd be speaking with his therapists & trying to figure out when exactly he'll be discharged. A few hours later, a case worker spoke with us & explained that they're shooting for Wednesday! I'm not sure what all needs to happen in order for that to come through, but we're very hopeful that he'll be released then. I've already made him an appointment with a local primary care doctor for Monday, so that's already in place. It's probably just a matter of making sure that Ryan gets all of the equipment he needs - which may be a little difficult because his Medicaid is still spending. We're both so excited, though, & he can't wait to get out!

Edit: We spoke with his occupational & physical therapist & they said that the little bit of uncertainty as to his release date is because they doctors are trying to decide what medications he needs to stay on. They said that the equipment he needs (wheelchair, shower bench, etc.) can get ordered very quickly. We're just going to be paying out of pocket for everything until Medicaid comes through & then they should take over & reimburse us.

Things are looking good! =D

Discharged soon!

I'm sorry it's taken me so long to update! Ryan is doing amazingly well. So well that they're talking about discharging him within a week! They've yet to give us an exact date (which makes things frustrating), but the word is that he'll be released very, very soon. I'm in the process of getting him an appointment with a primary care doctor, because he will need to have one set in place (or at least an appt. scheduled) with one before he's released. The primary doctor will be the one doing the follow-up maintenance care (such as prescription management). Ryan will be doing outpatient rehab through the hospital, but we're not sure of the frequency of that yet.

We're still trying to find an apartment here in Syracuse, so until that comes through I'm going to try & set it up so Ryan can stay at Sarah House. They have downstairs handicap bedrooms that will be perfect for him until we get everything else settled. Also, I'm still having to run back & forth between Watertown for various appointments, so as long as he doesn't have something scheduled, he can come & stay at home with me in the apartment during those times.

We are so happy that his stay in the hospital is almost over. He couldn't be more excited about getting out of here. I'll update just as soon as I/we have some more info about his exact discharge date. =)

Ryan moved to the rehabilitation center

On Friday they moved Ryan out of his regular floor room & into the rehabilitation center in the hospital. It's really great there & we're excited that he was able to get a room so quickly. He has a private room, spends 3 hours a day (Mon-Fri, & about 2 hours on Sat) doing rehab, & is even allowed to have visitors stay overnight in his room! In addition, there's a great media room there where he/we can watch movies, a washer & dryer available for all to use, & showers for visitors (especially helpful if you stay overnight). He's really comfortable there & seems to like it very much. His rehab is going extremely well: he's really pushing himself with all of the exercises that they have him doing. He is determined to get out of the possible as soon as is humanly possible. If for no other reason, I'm glad that they have them doing 3 hours a day of rehab because it helps break up the monotony of being in the hospital. They also take him out of his room & to a dining area for his meals, which helps give him a change of scenery.

Speaking of his meals, he's eating all of them very well, & his voice is getting stronger everyday. Speech is still working with him & they plan on upping the types of liquids that he can have: nectar thick instead of honey thick (his current allowance). Hopefully he'll soon be off all food consistency restrictions & be able to eat whatever he wants.

I should have more updates by Tuesday or so. I'm currently "stuck" here in Watertown: Chloe has kennel cough so I can't put her back in boarding just yet. She seems to be almost over it, & as soon she's well enough I'm going to have her boarded again. But until then, I'm staying at home with her. We (John, Monique & I) are looking into getting an apartment in Syracuse which would make life easier on all of us. We're going to try & find one with short-term leasing & one that allows pets, so I may not need to ship Chloe out to my dad after all.

We continue to appreciate all your concern & interest in Ryan's progress, & thank you very, very, much for all the well wishes!

Wii physical therapy

Today's been a busy day for Ryan. He declined having the nurses give him a bath, but asked me if I could instead bathe him. It took about twice as long, & twice as much work for him, lifting his arms & rolling from side to side, but we managed to get him all cleaned up. =) After that he went down to the rehab gym (for the first) time for physical therapy. The therapist had him playing some games on a Wii! He did a soccer game where you use your feet to move your character's head to the left & right hit the ball, & then played some bowling. He did really well on both... well, he did about as well on the bowling as he does in real life, anyway. They're saying that hopefully as early as tomorrow they'll be moving him down to a bed in the rehabilitation center here in the hospital. It's really nice down there, so we're super excited about that.

After physical therapy he came back up & had a short nap, but was woken up because they wanted to remove his NG tube. Yay! I know that he was pretty excited to have that taken out. Next Speech came back in & reevalutaed his swallowing & speaking. He's still quite soft spoken, & still having some trouble with really thin liquids (like water), so she wants ENT to come in & take a look at him. She said that because he was intubated for so long that his vocal chords may just be a little askew, which would explain both of the problems that he's having. Even with those issues, she upped the foods that he's allowed: no more baby food mush! He can start having ground types of meats & chopped up vegetable/fruit sides. His dinner tonight should be based off of these new allowances. Ryan's napping now, but OT will be in later to work with him some.

He is literally getting better & better everyday, & we know that in no time he'll be out of here! Tomorrow I have to head back into Watertown to try & get some things taken care of, but I should have another update for all of you the day after that.

Out of the ICU

Ryan was moved out of the ICU & into a regular floor bed this afternoon. Even though he has a roommate now, we're happy that he's out of there. PT & OT are coming by & working with him everyday. OT has him working on some very difficult worksheets (ones that I was even having trouble figuring out), but he's doing great on them.

After here he'll move down to the rehabilitation center (soon we hope!), & they'll be working him 3 hours a day. He's limited on what he can do because he's not supposed to bear any weight on his left arm or leg until some of his fractures heal. Even still, they have him doing some exercises with them.

He ate more of his dinner tonight than I have seen him eat thus far. They've started counting his calories now, so if he can keep them where they need to be on his own, they'll remove his NG tube. He's pretty tired of it, so he really seems to be making a good effort to get most of his food down. Today I brought him up some chocolate pudding with brownie from the cafeteria & he wolfed that down, so I may have to start getting if for him on a regular basis.

He's doing fantastic, playing games on the computer, talking up a storm (he's still very soft-spoken, though), & looking better & better every day.

More of the same good stuff

I haven't been able to be with Ryan today, but Monique (his mom) gave me some updates that I wanted to share with everyone. Ryan started his physical therapy & did very well. Afterwards he was pretty pooped out & when I spoke with Monique he was taking a nice nap. He also passed his swallow test, so they're going to go ahead & allow him to have liquids & soft foods. After a while they'll allow him solids, but until then, his feeding tube will still remain in. Ryan's been practically begging for a drink of water, so I know he must be so excited (and I am, too)!

I will probably be back with Ryan in Syracuse tomorrow. I'm trying to take care of some things here in Watertown - packing up, but mostly trying to figure out what to do with the dog:

She was going to maybe fly home with my mom on Wednesday, but I don't think that we'll be able to manage to get that together. As of now, the plan is that I'll ship her out to my dad in Arizona later on this week. Hopefully that will work out because the cost to have her boarded here is $15/day. If Ryan had a say he'd probably just want to get rid of her, so I'm not letting him have a vote. ☻

The plan is for us to get back out to California as soon as we're able. More than anything, this accident proved to me/us that we're just not cut out for this cold weather & snow business. The settlement we're going to get from the insurance company for the car is going to help enormously. What I think we'll do is get out of this apartment & get our things into storage in Syracuse until we move. I'm able to stay at Sarah House as long as Ryan's in the hospital, & if Ryan needs to be doing some rehabilitation here before we can get out to CA, he can (likely) stay there also. We'll probably be staying with my mom (luckily she & my step-dad have some room to spare at their house) for a few months until we can get things settled (namely a job in place for me so that we can get our own apartment). It's difficult to plan too much ahead since we're not sure how long Ryan will be in the hospital, or where he's need to go/need to be when he's released, but I'm trying to do the best I can to get things sorted out.

Things are slowly falling into place & hopefully very soon Ryan will be back at full health & we'll both be back in sunny Southern California (where we belong)!

Groggy, but good

When I came in this morning Ryan was (basically) strapped to the bed. I could tell by looking at the restraints that he had been trying to get up - which the nurses confirmed. After I left last night he had a bit of a rough night; very restless/anxious, kept wanting to get up to use the bathroom, & he pulled out his NG tube 3 times (I can't believe they didn't strap his arms down after the 1st time! I would have!). They gave him some sedative-type medications which helped calm him, but they also resulted in his being groggy & pretty out of it until just a few hours ago. Now that those are out of his system, he's back to where he was yesterday. The attending physician said that they will start giving him something to help him sleep at night, so that should help enormously.

He's doing great, speaking pretty well, but very softly, so it's a little hard to understand & hear him. He keeps trying to get me to sneak him some water (or whatever it is that I'm drinking), &, of course, I keep refusing. Whenever I, or the nurses, go to suction him he asks to do it himself, & he's manages to fairly well. They've already put the orders in for him to be transferred to a regular floor bed, but it may take a day or 2 for a bed to open up. We had him in a chair for a while today (& he was in one for a while yesterday), but he's not quite ready to walk on his own. Physical & occupational therapy are going to start working with him daily as of Monday, so hopefully he'll be up & about soon.

¡Our boy is still doing fantastic!

So, Ryan had a nice & restful night. His breathing has been great - good rate & even with a measly little nasal cannula he's managing to consistently pull 97-100% oxygen saturation. He tires easily, which isn't surprising, so he's spending a lot of the time just sleeping/resting. He's really trying to speak, but it's very difficult for him to because he had that tube in his throat. In another couple of days he'll probably be able to communicate more easily. He's also not very happy or comfortable with the Foley catheter that he has in place, but he's been made aware of what a bad (and painful!) idea it would be to pull on it. They gave him a breathing treatment this morning & he's have nice productive coughs. The doctors came by & said that they're going to do a little switching around with some of his IVs; taking out his subclavian central line (because they're not really using it) & then adding maybe 1 or 2 new IVs in his arms. They're also going to give him a swallow test to see if maybe he can tolerate eating on his own (now he has an NG tube & is receiving a liquid feed). They don't really think that it's very likely that he'll pass the swallow test because he's still a bit groggy, but they're going to give it a go anyway. It's also very likely that he'll be moved from the ICU & into a regular bed within the next couple days. I couldn't be more thrilled! Ryan's been maintainging when asked that he's not in any pain, so they're giving him low doses of Lortab to make sure it stay at bay. They're saying that there's probably still quite a bit of the sedatives & narcotics in his system. That's probably why he's not really having any pain yet so it's possible in the coming days pain management will be more of an issue. He's doing well, he looks amazing, & he's very comfortable - I couldn't be happier!☻

Doing GREAT!

So, you can ignore pretty much everything in my last post. After they put Ryan back on the sedative the attending doctor came in & Ryan had his eyes wide open & was following commands - while on the sedative. They decided to turn the sedative back off & give it another go. After about 1 hour they decided to extubate him after all & it went perfectly. Ryan is currently breathing very well on his own & is very alert. He's following commands well, shaking his head yes or no to questions, and is even writing notes! I couldn't be happier with his improvement, & I couldn't wait to share this latest development with all of you. =D

No Extubation Today

Ryan was really close to being extubated today, but it doesn't look like it's going to happen. They had him off of his sedatives & on a ventilator setting that was actually making it harder for him to breathe then it would be without the intubation at all (kind of like a stress test). His breathing was fantastic, but they were holding off for a little while because they wanted him to wake up a bit more first. He was following commands pretty well, but we've seen him more alert a few days ago. After a particularly nasty coughing fit, though, they put him back on the sedative & are saying now that the extubation won't happen today. It basically came down to him needing to be sedated again right then, or extubated right then. The head (chief?) resident ordered his sedation back on. That doctor is definitely more cautious then the attending, so I'm left to wonder if the attending would have called for the extubation had he been there. So far, they're not saying much about when they'll try again, but this all happened very recently; only like 30 minutes ago. I just wish they'd get that tube out of him, & if he's unable to tolerate it (I think he could, though) to put in a tracheostomy (which they've listed as a possibility) instead. We'll just have to wait & see where they're going to go from here now. I'll give an update as soon as I have more info. =)

Steady improvement

Ryan's been breathing well on his own since yesterday (on a ventilator setting that only provides continuous positive airway pressure -CPAP-). Everyone's really pleased with his current rate of breathing & oxygen saturation, so the doctors are going to be monitoring him & are thinking that they will try & extubate him again tomorrow. It's also probable that they'll switch his sedative from Propofol to Precedex, which will allow him to be kept more alert but with less agitation.

The cultures that were taken from his lungs aren't showing much growth yet, but based on his chest x-rays they do think that he has pneumonia, so they're keeping him on his IV antibiotics.

His red blood cells were down a little, so they gave him a unit of blood overnight. Amazingly, this was the first & only blood he has had to receive so far.

So, everything is looking good. They're currently keeping him comfortably sedated - they won't start backing him off of his sedative until closer to when they plan to extubate. I'll give an update tomorrow to let you all know how everything went.

Ryan's car accident & current condition

Ryan was in a car accident on Wednesday, January 28, 2009, around 7:00pm. Ryan lost control of the car & was struck by another car. His accident was covered by a few local media outlets, so if you'd like to read see some you can find articles here & here. He was taken to Samaritan Medical Center, located in Watertown, NY, where he was stabilized & then transferred to University Hospital, a level 1 trauma center, in Syracuse, NY. Here is a list of his injuries:

• dissection of the descending aorta (repaired via endovascular stent grafting)
• small subarachnoid hematomas along with other small bleeds in the brain
  
• partially collapsed left lung with bruising (currently re-inflated)
• several small pelvic fractures
• a minor fracture of the sternum
• a small fracture at the base of his skull (left-sided)
  
• lacerated spleen
• bruised kidney
  
• 3 broken ribs
• fractured left clavicle
• fractured left arm
• a small laceration along his left jawline & lacerations on his left ear (they were sutured, but the stitches have already been removed)
• some small cervical soft tissue injuries
  

Ryan/we were very lucky: he didn't have any spinal injuries. Also, amazingly, all of his fractures were (& remain to be) very stable & required no surgery. A monitor & drain were initially placed in his skull to monitor the pressure & drain excess fluid. This monitor & drain has since been removed, & neurology believes that his brain/skull injuries are doing very well.

Ryan is still intubated & remains under fairly heavy sedation. The doctors attempted to remove the intubation, but he was unable to tolerate it. He is able to breathe on his own, & when waked from sedation is able to respond to commands. Yesterday they performed a bronchoscopy & removed a large mucus plug which was inhibiting his breathing somewhat. Ryan's also running a fever so specimens were sent out from his lungs to be cultured. The doctors aren't sure yet, but it's thought that he might have developed a case of pneumonia. They already have him on antibiotics in case the cultures start growing bacteria; if they don't, he'll be taken off of them.

The doctors are allowing him to rest & he's very comfortable. They'll keep him like this for the next few days, reevaluate his condition, see what (if anything) the cultures are showing, & then consider extubating him again.

He's doing amazingly well, as well as anyone can hope for given the severity of his injuries. We, his doctors & nurses included, are all very happy with his progress thus far & his current condition.

I'm going to try & keep this blog updated daily so that everyone will be able to follow Ryan's progress with us. His family & I so greatly appreciate everyone's prayers & concern.