Friday July 29, 2005

Friday July 29, 2005 When I arrived this morning Zack was chillin’ in his bed with the lights out watching T.V. He had his leg swung over the side rail and looked completely relaxed and at home. As I walked across the room he tracked me all the way to the right. Kendra (night nurse) had left a note on his door for us that he had a great night and nodded yes twice. Dr Skolnick (pulmonary) and Dr Borhan (resident) came at 7:30 to change his Trach. They place a #6 Jackson metal Trach that has a plug. This Trach is smaller, much easier to clean and the plug enables him to speak when he’s ready. After his Trach was changed he was stretching his arm over his head. When I asked him to raise his hand he would. He also put it down when I asked. We were very pleased that he was following commands. At 9:30 AM Amy (PT) and Mary Beth (OT) came in for co-therapy. They took pictures of him in different positions so that I will know how to position him myself when they aren’t around. These positions help with the tone in his right arm and shoulder. Mary Beth cancelled the dynamic arm splint that Dr Mook ordered and said she was going to make him a custom one that was more suitable and less expensive. When they are ready to leave Mary Beth ask him to squeeze her hand if he wants her to leave him alone. He just stares at her. Then she asks him if he wants her to leave him alone and he nods “no”. She almost cried because most patients want her to leave them alone and would nod yes. I think we will get lots of extra attention from OT now. Zack slept for a while and then it was time to get him dressed and ready to go to the gym. We woke him up and set him on the side of the bed. He started to cough and when I looked at him he had a grimace on his face and he looked like he was going to cry. I asked him what was wrong and he said “no”! He spoke!!! There were several visitors around as we moved him to his wheel chair. I asked him if he wanted to go to the gym and again he said “no”! I told him Mary Beth was at the gym and did he want to see her. He said 3 or 4 words that we couldn’t understand but if we would have had a tape recorder to rewind I’m sure we could figure it out (we just weren’t expecting it). When we went to the gym I was telling everyone that Zack spoke. Dr. Miller (physiatrist resident) was in the gym and came to find us. He heard that Zack spoke and wanted to see him. Of course Zack had nothing to say but Dr Miller asked him to “give him five” and Zack held out his hand. He did great in physical therapy. They were using beanbags of different colors and asking him to grab it and give it to me. He reached for the 1st one and released it into my hand. Mary Beth and Amy said that was very good because it is harder to release than to hold something. After the first one he wasn’t ready to give it to me and actually held it in his hand and fingered it like a baseball. When therapy was over and it was time to leave they asked him for a “high five” and he raised his hand. We were all so pleased with him. By the time we got back to his room it was close to 5:00 and he was very tired. He rested peacefully until Julie (who cuts Scott’s hair) came with Scott. She cut Zack’s hair (on the side that wasn’t shaved off for surgery) to clean him up a bit.
I can’t help but think how loving our God is that he would give me such a fantastic day after the emotional one I had yesterday. I would have been happy with one “no” and he gave us two, and a great day in PT. He always sends the right person or posting on the website at the right time. He heard my cries yesterday and I know his heart ached for me so he blessed me with so many things today. When I left here yesterday I commented that I wish I could just go to sleep and wake up months from now when Zack was well. Now I wouldn’t miss these moments for nothing. It is like having your precious child back again and experiencing his 1st words and soon 1st steps. My prayer tonight will be that I will just trust God. That I will know he loves us so much and is waiting for just the right moment to wake Zack up. That’s right…he still is not awake…but he spoke. When my emotions are overwhelming I need to just let go and let God perform miracles. How blessed are we that God will carry us through an experience that not many others can claim? Keep praying for Zack’s complete recovery and the ministry that awaits him.

Thursday July 28, 2005

Thursday July 28, 2005 It was a rough night last night. Zack was doing the river dance with his legs until 2:30 AM. He was all over the place and half the time both feet were hanging off the bed. I had to keep getting up to cover him and put his feet back in bed. I remember at University when he wasn’t moving his legs at all how I would pray for any movement. The nurses use to tell me that there would come a time when I would wish he would just hold still. Well…that was last night. Dr Stevens (physiatrist) and Heidi (resident) came in at 5:30 and woke us both up to evaluate him. It seems comical now that they turned on the lights and asked me questions after 3 hours of sleep when my brain wasn’t functioning, but they have to cover for Dr LaRossa so rounds start early this week. Jennifer is our nurse today and she has worked at Frazier for 5 years so I can feel confident with her care. Dr Skolnick (pulmonary) comes by with his resident and discussed changing his trach to one that can be plugged so he could talk when he is ready. Zack is reaching up and feeling his face. He fingers his eyebrows and feels his ears. I love to watch him but today I am very emotional. I haven’t cried in a few days and now the floodgates are opened. I look at Zack and he seems to handle this with such dignity and grace that I am ashamed of myself. I feel a battle within between Gods will and my fearful conclusions. I try to read my Bible but instead get out a journal and pour my feeling into it. Dr Borhan (pulmonary resident) comes in to check on Zack and sits down to talk with me awhile. The staff here cares so much, not just for Zack but for his family too. A Nutritionist comes by and explains that Zack has been getting 1800 calories and they want to start beefing that up to 2100. We need to build up his strength so he can really participate in therapy. 10:30 I notice some blood on his pillow. He has scratched his head wound and it is bleeding. We will have to pay close attention because stitches itch and his hands are roaming now. I have requested a consult with a wound care nurse so we can review the orders on how to care for it. 11:00 Amy (physical therapist) arrives for some bedside therapy but we spend most of her time getting Zack dressed. It is so good for both of us for him to be in regular clothes. At 1:00 his wheelchair arrives and we go to the gym for the 1st time. It is hard work and Zack at times resist and gets a little mad. Amy tells me that is a good sign. They bring out a full size mirror and for the 1st time he sees himself. He stares intently and I get the impression that he doesn’t believe it is him. Mary Beth (occupational therapy) shows me several moves that I can continue to work on with Zack in his room. He really has a lot of tone in his right arm and shoulder. He is also neglecting his right side. He will not look at anyone to the right (common reaction since his brain injury is on the left side) so we need to stand on that side to encourage him to look that way. It is hard since he will look at you from the other side so everyone wants to be on his left to see those beautiful eyes. We move to speech therapy and meet Kathy Pfeiffer. She turns out the lights and uses a small flashlight and tries to get him to track to the right. This is going to be our biggest battle right now…getting him to recognize the right side. She uses ice cubes on his cheek to stimulate him. She rubs ice on his lips to try and get him to lick them. He salivates but doesn’t swallow. He is very tired after PT (physical therapy) and OT (occupational therapy). When we return to his room there some of his friends were waiting. One of the nurses suggested we take him outside since it was such a pretty day. We are all very excited to spend a 15 minutes with him in the sunshine. It was a bit overwhelming with the bright sun and traffic noises. I could tell after only a few minutes that it was too much stimulation so we came back to the room and put him in bed. Dr. Skolnick came by and ordered a chest x-ray and culture of his sputum (the fluid in the upper respiratory). Larry (the 21 yr old motorcycle accident/brain injury survivor) and his Mom come by to see us. Zack is asleep worn out from his therapy. I need to be asleep. We talk about Larry’s recovery and again I am overcome with emotion. I want so badly to see Zack in the condition that Larry is in. Walking, talking, going to school, having fun with his friends. It takes a good cry to get it out but I am so glad Larry came by. It is encouraging to look into the future and see great possibilities. Dr Miller (physiatrist resident) explains that we really have to be aware of over stimulating Zack at this point or he can become very agitated and stop responding. They put a “quiet zone” note on our door and want to limit how many people are in the room at one time. We have to be careful that there are not several conversations going on at once. I want him to have visitors and the doctors agree as long as we are sensitive to Zack’s responses. As he moves through these phases of recovery we will have to be flexible especially after a big day of therapy when he needs to rest. Scott, Donna and the nurses convince me that I need to go home and get some rest. Sometimes when I am here I can’t see how far he has come with his recovery. Friends that haven’t seen him in a few days are amazed at how good he looks and how much more alert he seems. I realize if I am stressed out and emotional it is not good for Zack. As badly as I want to always be by his side I go home. Scott stays until it is time for his bath, knowing that afterwards he will sleep for the night. I ask for prayers that I will be patient with God’s timing. I ask for wisdom to know when it would be better for Zack for me to leave him in the excellent care of the staff here. I ask everyone to continue to pray that Zack’s recovery will be used to glorify God. Please pray that his friends will visit and leave believing in the power of prayer. That we will send out of Zack’s room many witness for Christ…that they will be encouraged to speak of their faith.
On the lighter side…God took care of my ants. Now I need him to take care of the skunks so that when I am home my dog doesn’t get attached and bring it in the house. It is hard to sleep with your fingers holding your nose.

Wednesday July 27, 2005

Wednesday July 27, 2005 I was late arriving at the hospital today because I had to pack some clothes for Zack to go to Frazier. He had no fever but is white blood count was 12.8 (slightly elevated). Zack had his legs crossed, which was so good to see. He had both hands fingering his Trach. He was really “storming” (profusely sweating) which iscommon with all critically brain injured patients. I watched as he would reach his left hand up to touch his face. It is almost as though he is trying to figure out who he is. Dr Raff with I.D. comes by to check his white count. Again he is not alarmed. He looks at Zack and says, “Go to rehab”. Dr Apfel (Anest.) makes rounds with his residents and says Zack’s lungs sound great. I had told him about this site and he asked again for the address. Don’t be surprised if we see some postings by the doctors and nurses that took care of him at University Hospital. We anxiously wait for the ambulance that will take us to Frazier. Karen (physical therapist) comes to say good-bye and promises to visit. Our chariot arrives at 12:30 for the short ride to Frazier. We get settled into our room, which has a bed for me and it’s own bathroom (just like the Ritz Carlton). I meet Courtney our day nurse and they weigh Zack. He has lost over ten pounds, down to 139 lbs. Dr Miller comes in for a quick evaluation. He is a physiatrist (physical medicine) resident and very nice guy. Remember we also had a Dr. Miller at University (anest. resident) who we really liked. Both of their first names are Jason and they went to medical school together. Dr. Stevens (Attending Physiatrist) comes in to check Zack out for Dr Mook who was off today. He explains that they may use Trazodone, a drug for anxiety or to help him sleep, if he needs it. They do not believe in a lot of medication. At 5:00 his physical therapist, Amy Raque and aid Russell help Zack to sit on the side of his bed. They try to get him to hold his head up while they support his body. This simple task seems like a lot of work for him. When they get him back to bed he is exhausted, but soon that hand goes up to feel his face again. He touches his eyebrows and feels his lips. He is also moving his legs a lot. After lying still for so long we are thrilled to see him moving again. His fine motor skills are intact and he uses to tips of his fingers to find some tube to pull on. He still is handsome and the nurses fuss over him.H Everyone here is so nice. I was afraid to leave the nurses in ICU and had grown fond of many of our doctors at University but this place already feels like home. They know what they are doing but they are gentle and explain everything to me. They brought us dinner and we are encouraged to ask if we need anything. Zack had several visitors, both friends and family. Rita and Louie (Scott’s Mom & Dad) brought Kyle and Logan to see him. Kyle puts the gloves on and holds Zack’s hand. She is not turned off by anything and strokes his arm with compassion. Logan gets overwhelmed, sits on my lap and begins to cry. We take a walk down the hall and I promise her Zack will get well. I am confident that he will. God has a plan that is better than anything I can dream up. Kendal (night nurse) sees Logan crying and offers her ice cream. She also gives her some paper and markers to make Zack a picture for his room. Sometimes I forget how hard this is on Zack’s brother and sisters. Many people have taken them places and sometimes it seems like a big slumber party but….they worry about their brother. When visiting hours are over I am able to settle in with Zack. I will spend the night for a while praying that he wakes up while I am here. Kendal comes in to check his I.V. She asks Zack if he is O.K. He nods his head and mouths yes!!! My back was turned and I was on the phone with Scott. She asked me if he has been nodding when we ask him questions. She tries to get him to do it again but he had already answered that question. She writes it in his chart for the doctor and we are ecstatic. We know it will be tough ahead. He will go through phases of recovery that won’t be pleasant. He won’t seem like the Zack we knew but he will be a new creation that God will use for his glory. It dawns on me that the “storming” he does is the furnace God is using to mold him into His servant. I can’t wait to meet him!

Tuesday July, 26, 2005

Tuesday July 26, 2005 When I arrived this morning Zack had a shave, his hair washed (what is still left) and a bath. He looked so good. He was holding the teddy bear that Dan’s little sister sent him. Stephanie (night nurse) said that although he had slept most of the night at one point he held her hand tightly and didn’t want to let it go. She needed to tend to her other patients so she put the bear in his hand. He held it all night and still had it in his hand when I arrived. He had no fever but his white count was up to 16. Jennifer Gallaway with Frazier came by and said everything was set up for our move except that we had to be sure that this white count didn’t indicate any new infection. She explained that I needed to bring him shorts, t-shirts, socks and tennis shoes because he will be dressed every day. She also told me that Dr. LaRossa couldn’t be his doctor at Frazier because she was just diagnosed with cancer. She is the doctor that works wonders with pediatric brain injury patients and loves her work. We ask for prayers that she will be healed and back giving hope to other children. In the meantime I’m sure that Dr. Mook will take good care of Zack. Dr Raff (I.D.) came with his residents and wasn’t worried at all about the white count. He explained that many things could cause it to fluctuate so they would check out a few possible sites for infection. They pulled his main line and drew blood there. They changed the type of catheter and checked for a urinary infection. They drew blood again. For the next 2 hours he became a human pincushion. They checked his white count and it was back down to 11 so Dr. Raff was right…no problems. Now they had to put a PICC (peripheral inserted central catheter) line back in so they could continue his antibiotics. He has to stay on Linezolid for 28 days and we only started it on July 18^th. At 3:30 Mr. Greener (Christian Academy High School Principal) came by for a visit. Zack was asleep but that’s how Mr. Greener was used to seeing him in study hall. Since they were going to x-ray to be sure his PICC line was in the right place, Donna and I finally find time to eat lunch at 4:30. As we walk down to the cafeteria I think that it would be better to just wait and go to Frazier in the morning. Then we get a phone call from Jennifer saying since it would be 6:00 PM before they could get him to Frazier they decided to wait until tomorrow. I smile knowing that God had already made that decision. I think he needed us here one more night for Nia, the girl in the room next to Zack. She is 20 years old with a brain tumor. She had surgery today and they discovered it was cancer. They are also strong Christians and over the last few days we have been lifting each other up. God decided to keep us together one more night. At 6:00 PM the staples were removed from Zack’s head. Now he doesn’t have such a Frankenstein appearance from that side. It will still be about 2 months before the swelling is down enough to put his bone flap back on. I got to spend a little time with my girls in the 2^nd floor waiting room and Scott got some alone time with Zack. When I came back up to the room at 7:00 he was sitting on the side of the bed. Zack was lifting his head off his pillow about a foot. He moved his own hand to Scott’s chest and was fingering his chest hair. Scott was beside himself joy. Shortly after he left the phone rang in our room. It was Scott and he told me that he was crying as he pulled out of the parking garage. He was so overcome that he pulled over to the side of the street, got out of his truck and fell to his knees on the concrete thanking God for all he has given us. His faith has grown so strong. At 8:30 we move Zack into his chair and put in the C.D. from the Vine that a Southeast volunteer had brought us earlier in the day. We feel so blessed to see Zack intently staring at the steeple outside his window again and listening to rockin’ worship music. At 11:30 Fatima (our nurses aid since we have been here) comes to say good-bye to Zack. She knows tomorrow we will be gone and she is emotional as she talks with Zack. She hugs us and promises to be at Frazier to see his progress. It will be bitter sweet to leave here but we know great things lie ahead. Please pray for all the staff we leave behind that those that don’t know Jesus will see a glimpse of him in our hope for Zack. Yolanda (day nurse) asks for information on Southeast service times. She wants to come to the Vine. Please pray for Nia and Dr LaRossa. And never cease praying for Zack so he will recover quickly and God will be glorified.

Zack will be in room 408 at Frazier by noon. Visiting hours are 5:00 – 9:00 Mon – Fri

12:00 – 9:00 on the weekends. See you there!

Above Pictures

Zack Looking Better.
Nurse Stephanie with Zack
Nurse Tom with Zack.
One of Zack's therapists with Zack
Dr. Mutchnick with Zack
Zack's Anesthesiologist team.
Friends and
Zack's friends in support of his first Thumbs Up Day!

Monday, July 25, 2005

Monday July 25, 2005 Again Zack is fever free but his white count is up to 13. Dr. Raff is not at all concerned so we aren’t either. At 8:00 we get as big thumbs up that encourages all of us. Karen arrives at 9:30 for physical therapy and she gets him to stick out his tongue and wiggle his toes. He is moved to his chair and has to sweat it out in his helmet. We got another thumbs up in the chair. At 11:30 Jennifer Gallaway with Frazier comes by to tell us that the doctor has signed the order to move him. She said that Frazier will take him but she had to get approval from our insurance company. Then comes a new battle. Remember I said I couldn’t wait to see what God had in store for me today. I was expecting something different but God knows just how to make me stronger and today it was learning how to deal with the insurance issues. Traumatic brain injury patients are graded on the Ranchos Cognitive Scale on how they respond. Zack is currently at a 3. Frazier likes for them to be a 4 before they are admitted but because Zack is young and has great potential they agreed to take him now. However, the insurance company wants them to be a 5 before they start rehab. Zack will only have 60 days of Acute Rehab benefits. Basically they don’t want the clock to start ticking and run out before the game is over. Jennifer will continue to talk with the insurance caseworker to get him released. At 1:00 we get a visit from a member of Matt’s church, Westport Road Church of Christ. She talked with Zack and prayed with us. She reminded us of Isaiah 43:10 “You are my witnesses, declares the Lord, and my servant whom I have chosen, so that you may know and believe me and understand that I am he.” She sang some worship songs and we were all uplifted. The Occupational Therapist arrives at 1:30 and works with Zack on his fine motor skills. She tells us that it is critical to his recovery that his brain is stimulated. That happens when he is awake. She explained that now it was important for visitors to talk to him and touch him. He stayed in his chair for 5 hours and we got another thumbs up. At 4:30 Dr Mutchnick tells me I need to call my insurance caseworker. I had to convince her that Zack was a healthy, driven 15 year old and he couldn’t be assessed with subjective numbers. She had to be sure I understood the benefits before she would issue the order to release him to Frazier. We came to a mutual understanding and she made the call (what she doesn’t understand is that God was in control). It was a very difficult 5 hours for me trying to understand what the next best move should be for Zack. Learning the ropes while riding an emotional roller coaster. At 7:00 PM Scott was coaching Zack through leg crunches and I saw first hand how when Scott pushed him Zack tried really hard. He would press his knees together and then release them on command. As Scott counted he would be overcome with emotion. It is exhausting for all three of us. We thank God that when our strength runs out he is there to carry us. Randy Marshall came by and told Zack that she had gone to Honduras on a Mission Trip. She said the church in Honduras is praying for Zack. I also know of a church in India and a Monastery up north that is praying for him. I would love to hear from everyone with the churches that lift him to God in prayer so we can encourage Zack to be strong. As I write this posting Zack is intently looking out the window. He is moving his legs and turning his head. Something outside has had his undivided attention for the last hour. There is a church steeple with a cross on it. I wonder if that is what he sees. I imagine that there are angels they’re guarding over him. He is sooooo close to waking up. I ask for specific prayers that Zack will not need more than 60 days at Frazier. I ask for opportunities for Zack to glorify God through his quick recovery there. I ask for gentle lessons in patience.

Sunday, July 24, 2005

Sunday July 24, 2005 Zack has been fever free for almost 4 days and his white count is back down to 10, which is normal. It looks like we are lickin’ this infection. Dr Han (attending Neuro Surgeon) comes by with Dr Densler and another resident. They discuss the laceration on his head and Dr Han tells me to be sure that Zack has a wound care nurse at Frazier. They decide to leave the staples in his head another week just to be sure that everything is under control with the laceration and no further swelling occurs. It appears as though the swelling is going down so the laceration area seems a bit sunken since there is no scull in that area. We discuss how much longer the bone flap will be off.
They also tell me that his bone flap (scull) that was sent to the blood bank was contaminated. If the cultures they took grow anything his bone flap will be discarded and they will make him a custom-made acrylic bone flap. Dr Apfel (attending Anest) comes with his residents during rounds and discussed that there are no respiratory issues that they are concerned with. We talk about Zack’s accident and the fact that no one in the car was wearing seatbelts. Dr Apfel is from Germany and we have a very interesting discussion. He explains that the U.S. has twice as many car fatalities as Germany and there is only about 2% of the German population that doesn’t wear their seatbelts. He believes that Americans value freedom so much that individual freedom of choice overcomes rational thinking. We choose not to wear our seatbelts as a subconscious assertion of freedom. It is even more prevalent among American teenagers because they are trying to pull away from their parents and have more freedom. Isn’t it sad that the value we hold so dear also causes us such tragedies? At 9:30 Neika (day nurse) moves him to his chair and he supports his head for quite a while. At 10:30 he has physical therapy with the weekend therapist. I leave to go to church and Scott comes to really work him over. He tells me that Zack did 30 crunches with his legs and arms. Don’t get too excited because our idea of crunches has changed in the last 17 days. Zack stayed 5 hours in his chair before they moved him back to bed. He napped for a while and had several visitors. He squeezed Avery and Caroline’s hands. He stuck out his tongue a few times for the staff. He is responding to the verbal commands that he chooses to follow. At 5:30 Dr Miller (Anest resident) removed his Trach stitches. His skin will now hold it in place and the stitches are no longer needed. Zack is at his best (most alert and responsive) at night. Andy and Kelly Raines come by around 10:00 PM. He holds Kelly’s hand tightly and when she tries to pull away he won’t let her. He stares intently into your face. It is almost magical. I am reminded of the thoughts I had driving in early this morning. How God lovingly doles out discipline in perfect amounts. How He knows my greatest fear is that as my children grow up and go off to college they would move away from Him. That they would make choices that lead them to lose their faith. This trial we are going through now will change us. It will make us stronger. It teaches us that when we fear the future God will send us reminders that He is in control. This life is but a whisper in God’s ear. We do not know what he has planned for us only that it will be perfect. My close friend Donna told me tonight that Zack is like a pebble thrown into a lake and you can see the ripples traveling out in all directions. Tonight Zack rest peacefully. We didn’t get our orders to transfer out of ICU in preparation to go to Frazier but it’s O.K. (there wasn’t an empty bed for him to move to any way). God has a reason for keeping us here one extra day and I can’t wait for tomorrow to find out why.

Saturday, July 23, 2005

Saturday July 23, 2005 Zack has been fever-free for 72 hours and his white count has gone down to 12. Dr Raff (I had his name wrong on previous entry) from ID came with his residents and listened to his lungs. He told him to take a deep breathe and Zack did. Dr Raff was very surprised and asked him to do it again. Zack responded and we made the day for the ID staff. Dr. Densler confirmed that the CAT Scan results showed no change and that he would be moved to Frazier on Monday. Zack’s eyes were wide open and he watched TV intently for several hours (he still is not “awake”). At 11:30 he was moved to his chair and he had many visitors. We got thumbs up and he moved his toes. He was in his chair for wiggle from him. He was in his chair for 4 hours, the longest time since they started getting him out of bed. He was very tired when they moved him back to his bed and slept until he heard the voices of some of his friends in the room. He opened his eyes and seemed interested in who was there. He started getting very purposeful with his hands and gently snuck up to his Trach tube. We had to redirect his fingers but a moment later he had his hands on his feeding tube. Again we removed his fingers but right away he grabbed his respiratory monitor line and yanked it off. Neika (day nurse) decided it would be safer to put his hands back in the braces. These are used to keep the hands in rest position so they don’t curl into fist. She also asked him to move his legs. He responded! It looks like we have finally gotten him back to where he was last week before the pneumonia and MRSA set in. He is so close. Wouldn’t it be wonderful if he woke up on Sunday? What a great story for Bob Russell or Dave Stone to work into a sermon about how not everyone sleeps when they are preaching (sorry guys). We keep hearing about how Zack’s story has touch many people and teenagers are starting to think and talk about the consequences of their actions. God has taken something bad and turned it into Zack’s silent ministry. We have not been transferred to the Critical care unit but it will have to happen tomorrow if we are going to Frazier on Monday. Please pray that as we move from the sanctity of our home in ICU that we will have the opportunity to share the comfort of Christ with other hurting people. Please pray that we will have strength through this next phase which could be much more difficult than what has gone on already.

Friday, July 22, 2005

Friday July 22, 2005 Zack was fever free for over 24 hours but his white blood count was up to 15. Dr Van Meter and Dr. Neff (ID) came by and said that they weren’t really worried about his count being up as long as he didn’t run a fever also. They will continue to treat his infection with Linezolid for another 2 weeks to be sure they have gotten it all.

At 8:00 Am Dr. Mutchnick says he wants another CAT scan today to check for fluid on his brain. He wants to be sure that there was no Neurological reason that Zack is not responding to hand commands. I was relieved that the CAT scan was unchanged. He also had a chest x-ray (no change) and an EEG (haven’t gotten the results back yet). At 3:30 Dr Rodriquez places the feeding tube in his stomach. He is sedated and given morphine. The procedure comes off without a hitch and by 6:00 PM the sedative has worn off and Zack opens his eyes. It is so wonderful to see him with no tubes in his nose or mouth and to stare into those big brown eyes with ridiculously long eyelashes. At 7:00 I stepped into the hallway outside the ICU door to talk with some visitors. Then the nurse at the front desk paged me and said that Neika (day nurse) and Stephanie (night nurse) wanted me in his room. I was worried that something was wrong but everyone said it was good. The lights were on in his room and several of the nurses were surrounding his bed. I watched as they told him to close his eyes, keep them closed, now…open them. He followed all of their commands several times. It was very exciting. I have felt that he had been trying to communicate with his eyes and now he was doing it. Dave Stone and Sadie came by soon thereafter and Scott and I were still high off the experience. It seems strange to get such of out of a simple act like closing and opening his eyes. The only way to explain it is to think back to when he was a tiny baby and remember how we delighted in each new talent. I can imagine that’s what it will be like for the next several months. Zack and I shared a very touching moment late tonight. He was very relaxed with no tension in his arms. I took his hand and touched his face with it. He watched me intently and held tightly to my hand. When I would stop he would raise our hands towards his face and I would help him caress his cheek. We were both so content and I felt extremely blessed to be there. Please pray that all goes well during morning rounds and his doctor signs the order to move to the critical care unit. Then after 24 hours it’s off to Frazier. Also pray that in the last few days here I will have opportunities to share with other families here how prayer got us through this tough situation. I can’t wait to see what tomorrow brings and how God will bless us and use this to glorify Him!

Thursday, July 21, 2005

Thursday July 21, 2005 Zack’s white count was down to 11 and he has been fever free all night. I had a tough conversation with Dr. Mutchnick about why Zack couldn’t move to Kosair. I asked for a consult by a Neurologist and although he explained that they did not deal with Traumatic Brain Injury he would request one to see me. After a 20-minute conversation (which is rare with a resident making rounds) I was beginning to see the light. God’s will was for Zack to stay here and I was the one fighting it. Dr. Mutchnick
agrees to keep Zack in ICU for as long as possible, not for him but for me. Dr Schaeffer came for the Neurologist consult and basically confirmed what Dr Mutchnick told me. Dave Kennedy (one of the ministers from Southeast) came at my request to help me be still and listen to God. He reminded me that if it flows its God’s will, if it’s forced it’s from man. At 12:00 Karen comes in to give him physical therapy. She always offers me hope and today was no different. She told us “all kids wake up”. She said she was absolutely certain that Zack would wake up. At 1:00 Dr Mook and his team from Frazier came for his assessment. I felt like a cheerleader telling him all Zack could do before the pneumonia and MRSA set in. I was desperate and hopeful that he would see something in Zack that the Neuro Surgeons didn’t. I gave them the letter to read that Zack had written me about a month before his accident, where he was trying to convince us to change his curfew. They asked a lot of questions about the accident itself and our home situation (how many stairs, siblings, bathrooms). Finally Dr Mook told me that once he got his feeding tube placed tomorrow and went to the floor (Critical Care Unit) for 24 hours, they would accept him at Frazier. I was ecstatic! Only 12 hours earlier I felt hopeless. I drove home crying out to God to help me accept whatever condition Zack would be left in. Now Dr Mook was talking about getting his books from school so they could use them in therapy. He expects Zack to remain at Frazier for 4 – 8 weeks and graduate to the Neuro/Pych outpatient center at Frazier East. He will continue to go through therapy there while he lives at home. The road will be long, very hard and we don’t know where we are going until we get there. But we are traveling forward and I have faith that God will be the light onto our path. Mrs. Thompson and Mrs. Fenwick from Christian Academy come to see Zack while he is in his chair and he squeezes both their hands. He spends 2 hours in the chair a briefly holds his head up several times. This is really hard for him since he is also dealing with his helmet. He sleeps peacefully. I know when it comes to traumatic brain injuries that the surgeons save their lives but Frazier gives them their life back. As I go downstairs to tell everyone the good news a picture keeps running through my mind. It is of God looking down on me last night when I was crying out in despair and saying “Oh Eileen if you only knew what I had in store for you tomorrow”. We will never be the same. We will never be able to sit in church, listen to the word of God and not be impacted. His timing, His grace, His plans for us, His drawing us near to Him. In the last 14 days we have lived through them all.
I only hope and pray that Zack’s many friends who have lived through this with us will learn what tragic consequences can come from decisions that seem harmless at the time.
Zack gets his feeding tube placed in his stomach between 2:00 and 5:00 tomorrow. Please pray that new trauma cases coming in don’t bump his procedure and that a private room will be available when we need it. Please pray that I will have the courage to get home a little earlier so I can get some sleeeeep.

Wednesday, July 20, 2005

Wednesday July 20, 2005 Zack was fever free for almost 24 hours. Throughout the night his heart rate and respiratory were good. His white count was stable at 14. The CAT scan showed no change and even some improvement. Dr. Van Meter (ID) explained that no MRSA was found in his lungs, which means we are only battling it in his upper respiratory. During rounds I discussed with Dr Mutchnick what would make me feel better about Zack moving from ICU to the Critical Care unit here. I was concerned about his care being managed by interns and them cooperating with my busy visiting schedule. Dr Mutchnick agreed to let me check the floors out for myself. He also told me that he was scheduled to have the feeding tube (peg) put into his stomach at 2:00 PM. Christian is Zack’s nurse today and we discuss why Zack is not doing what he was last week by following commands. He says they are taught that the body’s resources are divided…1/3 to fight infection, 1/3 to repair damage and 1/3 to maintain basic functions. Right now Zack has to use more than 1/3 of his energy to fight this infection so he has less to spend on repairing his neurological functions. Whether that is accurate or not it seems logical that once we have cleared him of this infection he will have more energy to repair his brain. He did spike a fever of 101 at about 9:00 AM. At 10:00 AM Karen came to give him physical therapy. She said he was right there on the verge of waking up. I met with the Brain Injury Trust Fund to apply for grant money to help with medical bills not covered by insurance. Zack is still on the Linezolid antibiotic as well as arousal drugs and one to help with the stiffness in his joints. I decided to take a little walk to Kosair Hospital to check out the Pediatric Critical Care Unit. My niece Sherry went with me and they showed us the room where Zack would be should I transfer him there. I came back to several visitors in the waiting room and discussed my options. I had been praying that God would give me clear signs as to my next step for Zack but wasn’t getting an answer. I decided to change what I was praying for and instead I asked him to shut doors at Kosair if Zack was meant to stay here, but I had already made up my mind that I wanted to move him to the nice, warm, fuzzy place that Kosair represented to me.I saw Dr Mutchnick leaving surgery and told him of my decision to transfer Zack. He said he would get the ball rolling so I settled down happily. At 2:00 PM I went upstairs to spend some time with Zack before his procedure. Before long it was 5:00 PM and I was told it was unlikely that he would get his feeding tube tonight. It would be Friday before they could reschedule it. I was so disappointed because others had told me how much better Zack would be with a peg. Zack was stable through the evening but still not responding to any verbal commands. At about 10:00 PM I called Kim Myers (Nurse Practitioner for the Neuro Surgeons) to be sure they got my message about the transfer. She informed me that she had run into a roadblock because Dr Moriority had refused him as a patient at Kosair saying he felt Zack would be better served at University Hospital. We talked at length through my tears as she explained that soon Zack would have no medical issues keeping him in the hospital and if he wasn’t ready for Frazier we would have to consider a transitional home. Zack would have to be able to go 3 hours with no nursing issues before Frazier would accept him and we weren’t there yet. I desperately sought answers for other ways to get him to Kosair thinking that was the answer. Kim told me I was suffering from ICU withdrawl and it wasn’t uncommon, but that did little to comfort me. We have been in ICU for 13 days and the staff here is my medical family. I kept trying to pry the door open that God had slammed shut. It was my worse night since we got the initial phone call from the police that Zack had been in an accident and was Stat Flighted to University Hospital. Scott was extremely depressed because he was feeling guilty about having to go back to work and he couldn’t be at the hospital as much as he wanted. Rita (Scott’s Mom) was crashing. Nothing could console us. I kept thinking about how pitiful it was that God had answered my prayer by closing doors yet I still doubted him. I went up to see Zack one last time before leaving for the night. The staff could see the pain all over my face and tried to reassure me that he would be fine here at University. No one seems to realize the weight of every decision I make feels like life and death. I want so desperately to here God whisper to me yet I fill my ears with my own sobbing. Fear creeps in that Zack will be left in a hospital bed for the rest of his life. I ask for prayer that I will have peace again with whatever the outcome. I ask for healing even if it is only to get his smile back. I want Zack to be able to stand before other teenager and tell them how decisions made now could affect them for the rest of their lives. Please pray! I know God answers prayer and I need help knowing what to ask for. I need to live Psalm 27:14 Wait for the lord, be strong and let your heart take courage

More Hosptial Pics-Zack one week later (with Nana and Eileen) and Dave Stone with Scott

Tuesday, July 18, 2005

Tuesday July 18, 2005 Zack looks really good this morning. He has not run a fever since last night. His respiratory and heart rate are right where they should be. His white count is up to 14 so he is still really fighting this infection. He is really sweating and Stephanie (night nurse) describes it as “storming” (his body trying to decide to fight the infection or just flow with it). She got thumbs up from him last night, which is very encouraging.
Dr Vanmeter from Infectious Decease Control (ID) comes in to check on him about 7:30 AM. She tells me his blood cultures were negative (no MRSA) which is really good news. She also says that his chest x-rays were better than the day before so we are clearing up the pneumonia. She explains that Zack will remain on the new drug Linezolid until all the infection is gone. I didn’t realize how fortunate we were to have ID handling his infection until I discovered that they only come to 5West to see him. Another set of hands and eyes doing Gods work to heal him. The Neuro Team (Dr Densler, Dr Mutchnick and Dr Harpring) comes by to check on him. They tell me not to be concerned but they are ordering another CAT Scan today. They have no reason other than to just check things out. The scan shows no changes which means no additional swelling. They discuss that when Zack has no “nursing issues” for 24 hours they will move him out of ICU. Yesterday I had decided that he would be transferred to Kosair but Dr Mutchnick is trying to convince me to keep him here. They are concerned with “continuity of care” and want the same team of doctors to continue to follow his progress.
He will get his feeding tube placed in his stomach tomorrow afternoon so I have a little more time to decide what to do. I am stressing about it so I ask for prayer that when I wake up tomorrow God will clearly have the decision made. It is strange right now to think he might be moved from bed 4 in the Miracle room. I have come to love the staff here, their excellent care of Zack and compassion for our family. I know that leaving ICU is a positive step but right now I’m experiencing joyous fear. We have developed such a pattern but a glimpse into the future is uncertain and at times unnerving. I am alone with Zack at 6:30 PM. I take the opportunity to read the postings on this site. I don’t get to see them until someone prints them off and brings them to me so I am a week behind. There is God again. As I read I am reminded that Zack is surrounded by prayer. I am touched by how people describe him. I am uplifted by the thought that while Zack sleeps God is talking with him. That he is revealing Himself to Zack and telling him how much He loves him. I look at Zack without that anxious feeling of wanting him to wake up so badly and instead imagine God whispering to him. What a perfect way to be directed back to God’s timing. Thank you Lord for perfect prayers!

Monday, July 18, 2005

Monday July 18, 2005 Zack’s white count is 12, up slightly from yesterday so he continues to fight this infection. His heart rate and respiratory are good. He qualified to be put on a new antibiotic called Linezolid that only Infectious Decease Control can prescribe. We are very fortunate because all of the other patients in Nuero ICU are on Vancomycian to treat their infection. This new drug was developed to aggressively attack MRSA. Dr Lenhardt says it kills everything but the patient. It is also expensive so they are very picky who is allowed in the program. Now we have Dr Vanmeter from ID following Zack’s infection. Zack had a slight fever through the night that was treated with Motrin. Stephanie (night nurse) said he had a panic attack last night where his Heart Rate reached 150 and Respiratory 45. I saw this happen once before and his eyes are wide open and you can see a sense of panic about him. We just hold his hand, talk to him quietly and he settles down. Fevers can trigger these panic attacks. He still isn’t considered awake but he is not in a coma. Yolanda (day nurse) gives me the best description of his condition. It is like he’s daydreaming. I like that better than the medical term for this phase which is “unresponsive”. At 4:00 PM he is moved to his chair and given physical therapy. He is sitting higher and he can see out the window. It is a beautiful sunny day and Zack seems very interested in looking outside. I talk with Karen his physical therapist and she gives me hope with lots of stories of other patients she has seen recover from head trauma. She tells me that Zack is in the “miracle room”. It is called that because of the patients that were there and thought to be hopeless but recovered. There was a 60-year-old teacher that was totally unresponsive for two months. His wife wouldn’t give up even when they discussed turning off life support. One day he just woke up and today he is teaching again. Or the young man who was there just last February and this month is trying out as the place kicker for his high school football team. I should have known that God’s path would lead Zack to bed 4 where miracles happen. After physical therapy he remains in his chair. He gets a visit from 2 of his friends who happen to be female. He seems to appreciate the change in voices and tries hard to respond to verbal commands for thumbs up. His hand shakes and you can tell he is really trying. I have hope that tomorrow we will begin to get him back to where he was last Wednesday. Epiphany church delivers a healing blanket for Zack. It is still apparent than many people who don’t even know him are diligently praying for his recovery. At 6:00 PM Yolanda tries to brush his teeth. He still keeps them tightly clenched. Scott tells him how nasty his teeth will be and demands that he open his mouth. To their surprise he opens up. It figures that his vanity would make him cooperate. Zack is still in there and we pray that God will wake him up soon. Thankfully Scott’s spirit is lifted for his ride home, which is always hard for him. Keep praying. Thursday is Scott’s birthday and he would like nothing more than Zack to wake up. What a gift from God that would be!

Zack Before the Accident

Sunday, July 17, 2005

Sunday July 17, 2005 when I arrive Zack’s respiratory rate is very high 33-38. He is not moving at all. His white count is 11.3 and he is running a fever of 101.5. He won’t cough. Although his chest x-ray looks better today than yesterday he has a lot of fluid in his upper respiratory and it sounds like he has the croup. He struggles to breathe, you can see his rib cage expanding. It is like he is breathing through a straw. His blood gases are good but once they become compromised we worry about the brain swelling. I call Scott and tell him to get in touch with Southeast and get everyone praying. At 10:00 AM they start him back on Vancomycion (antibiotic) to treat his pneumonia. Dr Reed his respiratory therapist decides to try old school methods and he puts an anti-inflamitory in Zack’s oxygon mask to shrink the swollen airway passage. It helps but it’s only temporary. Dr Miller (Anst. Resident) comes to tell me that Zack can’t keep this up so they will re-tube him. I explain that I won’t let that happen I would rather have him Trached. Kelly is my nurse today and although they are not supposed to voice their opinions she tells me to stand my ground. Dr. Parker an ear, nose and throat doctor shows up and I explain how concerned I am about damage to Zack’s vocal cords and trauma to his throat if they re-tube him. He agrees to review the x-rays, discuss it with the team and come up with a plan. At 1:00 they put him on Glycopyrrolate to decrease the secretions in his airway. They decide to re-tube him and perform a Bronchoscopy to suction out all the fluid from his lungs. At that time they will look at his vocal cords and if they are swollen they will Trach him. His procedure is scheduled for 2:00. There are about 15 of us who pray in the 2nd floor waiting room. It is an emotional time. The procedure is successful and he now has a Trach. There was not much swelling in his vocal cords but he has an ulcer on his bronchi. This is why he didn’t want to cough and it would not have healed as long as he had the tube down his throat. We made the right decision on the Trach. We discover that in addition to pneumonia he has MRSA, which is a bacterial infection that is rampant in hospitals. This is causing more problems than the pneumonia. Dr. Let from Infectious Decease Control (ID) is brought in to consult. They will determine the best antibiotic to treat him with. Dr. Reinhardt explains that he is trying to get him approved for a new drug that only ID can prescribe. By 6:00 Zack is breathing on his own again. The night shift nurses fight over who will get Zack. Sandy lets Stephanie win because she has become attached to us (Scott calls her his angel nurse). At 10:30 Stephanie gets him to squeeze her hand. A glimmer of hope that all will be well. This is the roller coaster they have warned us we would be riding through Zack’s recovery. I was prepared for that one but not the roller coaster that the doctors keep throwing us on. We did a lot of praying today. Everyone was praying at church at just the right time and Dr Miller shows up. Zack’s procedure goes smoothly and we seem to be back on track. We ask for prayer now that Zack will recover quickly from pneumonia and MRSA so he will feel up to working on his responses again. God is in control and we must wait for his timing. I’ll probably say that a million times this month.

Saturday, July 16, 2005

Saturday July 16, 2005 When I arrived at 6:30 AM today Scott told me Zack had been unresponsive all night. He had worked with Zack all night trying to get him to follow commands. Scott was very depressed because they would assess him during morning rounds and we hoped to get the tube pulled from his mouth. He had run a fever of 101.5 most of the night and at 1:45 AM they obtained blood, urine and sputum cultures. His white count is back up to 11.8 so he is fighting infection somewhere. They need to identify it to know what type of antibiotic to use. They had done another CAT scan at 3:00 AM and there was no change, which is good. At 7:00 AM Dr Harpring (Neuro Surgeon) arrives to explains that Zack probably has pneumonia and they would keep him on the tube through the weekend and Trach him Monday. The good news is that we have an explanation now for his lack of response. He doesn’t feel well. He doesn’t want to do anything, which is natural considering how bad he feels. Once they Trach him it will be a lot easier to suction him and he will start feeling better and be more responsive. Once we get over the pneumonia and his fever is gone they will remove the tube from his nose and give him a feeding tube into his stomach. They will start giving him 2000 calories a day and he will be more mobile. He also cannot be moved to Frazier Rehab until the feeding tube is out of his nose and that is the ultimate goal…to start rehab. Zack got a bath and a shave before being moved to his chair at 10:00. He was on TP in the chair and for another 2 hours in bed. I had 10 of his friends together for a group visit when Rita told me that Scott wanted to spend time alone with Zack before the kids went in. He is feeling guilty for pressuring Zack throughout the night to follow verbal commands only to find out this morning that he has pneumonia. He wanted to apologize to him alone so we went back downstairs to wait. About 10 minutes Rita comes running downstairs saying they were removing the tube. I ran upstairs very confused because the Neuro Team said they would Trach him on Monday. I told Dr. Lenhardt (Anest.)that I was confused that they were doing it now after what Neuro told me this morning. Kelly is our nurse today and she is also surprised. He reminded me that this was what I had wanted yesterday but Zack wasn’t ready and today he is. At 2:00 he was extibated and Scott and I were both there. Everything went smoothly and he was immediately put on an oxygen mask. Now we need him to cough and swallow. He needs to be able to maintain his airway and move that fluid. Not we have new numbers to focus on and it is his respirtory rate. They want it under 30 with the ideal being 12 but mid twenties is OK. Zack is hanging around 18 – 23. We are elated that there is no longer a tube in his mouth. He looks much more like himself except for his big swollen lip. When they tried to suction some mucus from the back of his throat he clamped down on his teeth. There was no way he was letting anyone put anything back into his mouth. Unfortunately he got his lip in of the way and he bit it until blood was running down his chin. I think we are seeing a little of the old stubborn teenager we knew before. It seems like we’ve been here much longer than 9 days. Our world is so confined to these walls that I don’t watch the news, read any magazines or even listen to the radio in my car. I don’t want to think that the world carries on without him. The time flies when I am at the hospital. We have to live in the day and not think much beyond tomorrow because we don’t know what the future holds. I have faith that God will completely heal Zack but I know it will be in His timing and sometimes that doesn’t seem to move fast enough. Just when I am frustrated the right person shows up. They will pray with us or listen to my never-ending explanations of what has happened during the day. I want to thank all of those who visit us and pray for us. Now we pray that Zack coughs and swallows and he is strong enough to fight pneumonia. I pray for peace for Scott who struggles now with having to leave the hospital in order to work a few hours. We pray for all the kids out there that just haven’t gotten the message yet and hope that their parents aren’t sitting here someday.

Friday, July 15, 2005

Friday July 15, 2005 Zack has a fever this morning of 100.1, which means his body is fighting something. He is less responsive today than yesterday. The Critical Care Team will come around and assess him during rounds to determine whether they can exurbate him (remove the tube in his mouth). At 4:00 AM they put him on T-Piece (TP). This is a smaller tube that gives him humidified oxygen as he breathes. He remains on TP for 2 hours and then returns to Cpap (this provides only pressure to encourage him to take a breath). We are preparing him for his 7:00 AM exam because he has to perform well for the doctors in order for the tube to be pulled. Zack does not do well. He will not give thumbs up or even wiggle his toes and Dr. Lenhardt says he is not ready. I am very disappointed because last night I kept promising Zack we would get that tube out. I get Dr. Lenhardt to agree to come back later in the morning justifying Zack’s lack of responses to his rough night sleeping. After some pitiful pleading the team agrees to reevaluate him later. My spirits are low and I am very emotional. We have been so blessed with how fast he has been recovering that we expect new progress everyday. Zack looks tired but his eyes are open more and he seems to be watching the golf game on TV. At 11:00 the team returns but Zack does no better. Dr Lenhardt is very cautious and doesn’t want to remove the tube yet. He explains that the important thing is that Zack is off the ventilator and breathing on his own. I explain that the important thing to me is that Zack does not like the tube down his throat so we want it out. It is hard to go from Dr Lenhardt’s cautious approach when we have gotten use to Dr Densler’s aggressive one. He agrees to give Zack one more chance today so Kim Myre (the nurse practitioner for the Neuro Team) discusses with Tom and Christy (our day nurses) putting him in a chair. They feel he will be more alert in a chair and they will also put him back on TP. I go in to talk with Zack and for the first time I am frustrated with him. I feel like he is being stubborn and after much coaxing he gives me a small thumbs up. At 2:00 PM they put his helmet on and put him in the chair (this is a special type of stretcher that adjusts into a chair). Dr Densler and Dr Munchnick (Nuero Team) come by as they are moving him to the chair and see how upset I am. They come in and discuss options. They request his blood gases be checked. They will look to see how his body is processing carbon dioxide, which is an indictor of how well he will do off the tube. Dr Densler reminds me that a Trach could be the next step and it is not a bad thing. At 2:30 I bring a group of 11 of Zack’s friends into his room. We close the door and they talk with him. It is so critical to his recovery that he has his friends around. They are able to get a thumb wiggle out of him, which heightens all our spirits. Throughout the day Zack remains inconsistent in following verbal command. He still localizes to pain (brings his hand up to where they pinch him) but he’s just not moving around as much. I am an emotional wreck waiting for miracles that don’t come. God is giving me lessons in patience because it is not one of my virtues. At 6:00 PM coach Woods (one of Zack’s baseball coaches) comes to see him. As he talks to him it appears Zack is listening intently. He keeps giving him baseball signals and Zack responds to the “wipe off” sign.
He moves his arms several times and we are encouraged that he’s still in there. Scott is staying tonight so that I can get a little sleep and take the edge off of my emotions. We have set up Zack to have no visitors after 9:00 PM tonight so that he can get some rest and be ready for his assessment in the morning. We will try to get the tube removed if Zack will start responding again to verbal commands. He looks so tired. I ask for prayers that Zack will be giving the thumbs up again and he will fight off infection. I ask for specific prayers that I will get my peace back and not be so restless. I thank all of those people who faithfully come to the hospital and wait with us, giving encouragement. Our God is so powerful but sometimes he needs to slow things down so we can hear His whispers and feel His healing touch. Keep praying.

More Pictures of Zack's Friends

Thursday, July 14, 2005

Thursday July 14, 2005, I arrived about 6:30 AM anxious for my update from Stephanie (the night nurse). He had a great night. He put his thumb up, so Stephanie was asking for 2 fingers. Since he wouldn’t do it she turned to leave the room and happened to glance back at him. There he was tapping 2 fingers on his chest. We don’t know if he is being stubborn or if his reactions were just a little slow. I look forward to my morning time alone with him. He is alert. He has stopped the shaking and we think he is starting to get used to what they have to do to him. I try to get the thumbs up from him. I was holding his right hand when he started very purposefully rubbing the top of my hand. Since the beginning when I am with him I stroke his hand or arm. Now he is returning that love. He also snapped his fingers twice. I tried to get him to do it for Stephanie but that seemed to be a trick only for Mom. He tapped his upper chest with 2 fingers. I know he’s saying that he doesn’t want that tube down his throat. It brings tears to my eyes and his. They could not have torn me from his room, so again I was allowed to stay with him through rounds. At 9:00 AM Dr. Mutchnick came in to remove Zack’s bolt (the monitor that measures his ICP). He started to prep for surgery. Again I was allowed to be there to hold Zack’s hands and comfort him. Since he seems to be very resistant to pain medication they decided not to fool around, and dosed him heavily with morphine and sedatives. Christy is our nurse today. The plastic surgeon came in to check out the last stitch job on his head laceration. It was sealed tight and looked good, but because of the trauma to that area, Zack will not grow hair on a patch a little bigger than a quarter. Luckily he likes to wear hats. They removed the bolt and took a few stitches. That area will heal fine. They came in and fitted him with a helmet. Once the tube is out of his throat he will wear the helmet unless he is sleeping and until his scull is reattached (probably in 3 months). The occupational therapist came in about 11:00 to work with his arms and hands. We are very lucky that Zack has “full range” which means they can take his arms up over his head. Because he had so much morphine during surgery he was pretty quiet most of the day, not really responding to commands. We decided that God rested on the 7th day and so should Zack. His friends came and I took several in to see him. I discussed with a group of about 12 or 15 the plan for visits in the next several days. It is important to Zack’s recovery that his friends be able to visit him. They need it and so do I. We want to keep him stimulated during the day but resting at night. We’ve started to turn the TV on and opened his blinds. Later that night Andy Raines came to visit and we went up to see Zack. Andy thought that he looked uncomfortable and told him to wiggle his toes if he wanted to sit up. Immediately he moved his toes. Good signs since most of the day he was not consistently following commands. We know he can do it unless he is too tired so I think he is starting to be stubborn (he is a teenager). I don’t think he is going to cooperate much until we remove the tube. My niece Sherry and Mary Rivard went up to see him at 11:00 PM. They were talking to him when very suddenly Zack came off his bed about 3 feet and opened both eyes very wide. He looked directly at Mary and then Sherry before lying back down. Tonight’s nurse Marca said he was trying very hard to “wake up”. They sent for me and the next two hours were very emotional. His eyes are open but he’s not all the way there. He is not in a coma but he is not awake. He keeps squeezing my hand and purposefully pointing to the tube. He is not restrained and at times tears fall from his eyes. My heart aches, I am overcome with emotion and I promise him that the tube will come out tomorrow. I am fortunate to have my good friend Teri and niece Sherry here with me. It is hard on all of us. I make the decision to stay the night in his room to calm him down when the panic sets in. My brother in law Jay arrives and is grief stricken to see Zack in such turmoil. I feel as though I am giving birth to him all over again only this time he is the one experiencing the pain. This has been the hardest time since the 1st day. I know that he is aware and asking me to help him. I beg God for the peace that I had earlier. I turn again to the 23rd Psalm and pray with Zack hoping he can understand me through choked-backed tears. I dwell on the scripture that God only disciplines those he loves. I look up and see the button someone brought for Zack that says, “I am loved”. He is loved…by me, his Dad, his family and so many other people. But most importantly he is loved by God. I don’t know how anyone could make it through this kind of tragedy without faith in Christ. The peace that passes all understanding is a gift of love from God to those who believe and trust in Him. I pray for those who are here hurting and don’t know Jesus. I ask all of you to pray for Zack, for Matt (the driver of the car) and maybe a few more hours of sleep for me.

Wednesday, July 13, 2005

Wednesday July 13, 2005. When I walked in Zack’s room this morning, I knew something was different. His night nurse Stephanie followed me into the room with a big smile on her face. I told her he was breathing differently and she excitedly explained that he had been breathing on his own all night. His ventilator is set at 14 (14 breaths a minute) but his monitor was showing 18, 20, 23 and I even saw 28. Which means that although the ventilator assisted him with breathing, he would then take several breaths on his own. There was an obvious difference in his demeanor. His ICP was 3, then 2 and briefly 1. His heart rate was strong. His white blood count today was 8, as opposed to yesterday’s 7, but anything below 10 is not considered elevated. He looks good. It was time for doctor’s rounds. I expected to be kicked out until 8:30. Stephanie shut the door so that I could stay with him. Zack was sweating a lot and occasionally I would wipe away a tear. His legs shake continuously. I stayed with him until the morphine put him asleep. About 12:00, I took my boss and friend Mel up to see him. They had the lights on in his room, which usually never happens unless something is going on. As we approached the room, I saw Dr. Mutchnick (part of the Neurological team) and he was preparing to rework the stitches of Zack’s laceration. I stopped and he invited us in. He explained that the laceration was “a mess” and he would have to remove all the stitches, clean it out and re-stitch it to eliminate the leaks. I asked him a few questions and he told me to talk to Zack and hold his hand. I stayed with him throughout the surgery, holding his hand and comforting him. He was sedated and loaded with morphine but he felt it. They scrubbed his head like an old boot. I can’t even watch surgery on TV and never thought I could handle it live but I did amazingly well. I was pumped…it was like being on ER. Zack was out for several hours. At 6:00 p.m., they decided to turn the ventilator off since he was breathing on his own. The ventilator is not assisting him at all now but he still has the tube down his mouth and as he breaths he gets additional oxygen. Once he comes around from the sedative he responds to commands. Not quite so quick with the thumb but still responding. He is much farther along than any one expected. Later in the day I see Dr. John Hill, one of the Critical Care Team and ask when they may remove the tube. He says probably in 4 or 5 days but I have learned through this experience that God has broken all the rules with Zack. I am starting to feel honored that God has chosen Zack to glorify Him with daily blessings in the form of healing. God is the great physician and if Zack got up and walked out of here tomorrowh, I would be elated but not surprised. Pray that God uses this to touch the staff here. Pray that Zack continues on this apparent rapid path of recovery. Pray that God will give me the opportunity to share His message with those I meet here.

Tuesday, July 12, 2005

Tuesday July 12, 2005 Today started out a little rough for me. Rushing here in the rain with traffic build up had me worried I wasn’t going to get to see Zack before they started rounds at 7:00 AM. As I was rushing to get stuff out of my car I dropped my keys down the sewer grate. Now I would have to wait until 8:30 to get into the ICU. It was worth the wait to see Zack doing so well. His ICP was 4 and I even saw it drop to 3 and 2. His white blood count has dropped to 7 so still no infection. He is breathing over the ventilator a lot when people talk to him and his blood pressure goes up which indicates he is aware of things going on around him. When he is accessed he opens his eyes and quickly moves his arms to wear they pinch him. At times I am wiping tears away. He is doing very surprising good (well surprising for the doctors but we know that God has been in control of this from the beginning). At 6:30 PM my whole world changed. I was taking Andy Raines and Ann Swope up to see Zack when I saw the lights on in his room. There was a lot of excitement and his nurse Tom called me into the room to tell me he was giving the thumbs up. Before long the room was full with the entire nursing staff and Zack gave us quite a show. His eyes were open; he would show us his thumb, wiggle his toes and stick out his tongue all on command. It was the most exile rating moment and lots of tears. Scott had to run from the room he was so overwhelmed. Rita and other visitors were running in and the staff was gracious to allow many people to share our experience. We wore Zack out. Some prayers have been answered quietly and others God throws at us like thunder! Needless to say my emotional state was entirely different than when I arrived at the hospital early this morning. I was practically running down the halls when we left him. None of this would be possible without the prayers of so many people. The doctors here have been great but God has been in control of this from day one. I have never asked why this happened. I know why it happened…it was an answered prayer. For the last several years every morning in my prayers for my children I ask that they be caught in their disobedience so bad behavior can be corrected. I didn’t expect the discipline to be quite so harsh but only God knows how to get Zack’s attention. And he got not only Zack’s attention but also the attention of all his friends and the many other teenagers who have heard what happened. That is my new prayer. So watch out kids because GOD ANSWERS PRAYER!

Monday July 11th, 2005

Monday July 11, 2005 When I arrived this morning Zack’s ICP was at 6, which is excellent. As I prayed with him it dropped to 3 and even 2. I have clung to the 23rd Psalm and as I pray with him he seems so calm and tears well up in the corner of his eyes. His heart rate is good and his white blood count has dropped to 7 (it was 16 on Sat, 11 on Sun and 8 on Mon), which means there is no infection. All your prayers are working. We were so worried about that laceration on the top of his head and now it appears that God has this taken care of. His physical therapist came in this morning. Zack was calm while she worked his legs however when she started moving his arms around he got very excited. His blood pressure shot up and he started shaking badly. He was moving his legs a lot and ended up with both feet hanging off the side of the bed. The Critical Care Team came in and felt he was having mild seizures. He was given seizure medication and he seemed to calm down. Dr. Lenhardt explained that they would like to keep him on the respirator for 4 or 5 more days before they have to move to a Tracheostomy (where they cut a hole in his throat and insert the respirator). He feels if we wait that Zack might regain consciousness and not need to be trached. Dr. Densler would like to trach him today so they have compromised and will wait 2 days and see how much he is responding.
We are receiving cards at the hospital with words of encouragement from people we have never met. Strangers that were here for other reasons and ran into us or saw all his friends on the 2nd floor waiting room. They are amazed that teenagers would rather spend their time hanging around a hospital rather than out having fun. I love having all his friends here and listening to them tell “Zack stories”. It makes me feel close to him. There is so much love and prayers flowing around Zack I don’t see how he can “sleep” much longer. Pray that God continues to protect him from infection and that the doctors make wise decisions on his respirator.

Sunday July 10th, 2005

Sunday July 9th. Zack looks better this morning. The swelling on the right side of his face has gone down a lot but now the left side has started to swell. His left eye is swollen shut now. He has a tendency to turn his head to that side and the fluid is settling there. His neck is also starting to swell. I don’t have a good side to focus on now like before but it still looks like Zack. His ICP is 16 and at times stays at 11 and 12. He is moving around a lot more. When they access him his hands quickly moves to where they pinch him. The nurse told me he opened his right eye half way to look at who was hurting him. When they stick his toe with a pin he moves his legs. Then when Dr Densler came to check on him and pinched him hard he opened his eye more than half way. It sounds cruel but whatever they have to do to get a reaction is necessary. They are pleased with his progress. He appears to be closer to consciousness even though he is still in a light coma. At 2:00 PM they take him off the sedative. Now he could wake up at any time. We had a lot of visitors today. Many people from church, parents of the kids who are here every day. Dave Stone came by with the youth ministers from Southeast Christian. They prayed with us and we read the letter that Zack had written me about a month earlier. He was presenting his case on why his curfew should be later than 11:00 PM. It is well written and his points are clearly made. It gives those that don’t know Zack well a glimpse at his personality. Of course an 11:00 PM curfew doesn’t mean anything if you are going to sneak back out at 1:00 AM. Even in the midst of the pain we are going through we see God bringing good from it. Several strangers approach us and say they were in the waiting room Friday when Dale Mowery gathered us together to pray. They saw the huge circle of teenagers, friends and family bow their heads and tearfully lift Zack up. There must have been 100 of us silently witnessing to other hurting people who don’t know Zack. Parents call me and say that they are hearing their teenagers talking about the power of prayer. The entries that they are writing in the notebook that we started for Zack talk about how they don’t pray enough but they are now. So there are blessings in the midst of our pain and we didn’t have to wait long to see them.
Praise the Lord!

Saturday, July 9, 2005

Saturday 7-9-05, Zack’s ICP reading is at 18-19. His white blood count is at 16, which is a concern that his body is really fighting infection. He is badly swollen on the right side of his face from the surgery. His right eye is swollen shut. The right side of his head is shaved and you can see the staples holding the scalp over his brain. There is no scull on that side so his brain has swelled making his head oddly shaped. I am noticing the cuts on his face now but am told they are all superficial. He is sedated with a fast acting drug by continuous IV drip. His nurse today is Mary and she explains everything that they have to do. They turn that drip off every hour to access his condition. This involves shining a flashlight in his eyes to see if his pupils dilate. He doesn’t like this and will move his head away. Because his right eye is swollen they have to pry it open but both eyes are responding which is rocking good news. Then they have to pinch him near his armpit to get a reaction. This is done on both sides. They continue to pinch him telling him to come and get them and make them stop. He has consistently reached his hand up to where they are pinching him. This is very good. Although he is not conscious he is responding to pain. His ICP drops to 16 at times. Each little movement is a blessing.
We met Larry today. A 21 year old who was in the same situation Zack is in only 21 months ago from a motorcycle accident. He walked into the hospital. He is back at school at Uof L and doing fine. We also met Mark. He was also in a motorcycle accident with a severe brain injury. Now he is walking and talking and has a great sense of humor. He brought us information from the Brain Injury Association. Mark and Larry give us great encouragement and hope.
The prayers of so many people lift us up. I don’t know how long we will be waiting for Zack to wake up but we are not waiting alone. Always Zack’s friends are here waiting with us, anxious for their 5 minutes with him. Our family and close friends carry us through each hour. Making sure I eat…being there for Scott when he breaks down. God cares for us. Not giving us more than we can bear. The doctor tells us that it is “very strange” that his CAT Scan today showed no change…the bruise has not grown. They can’t explain it. We know the healing power of prayer. He is placed carefully in the hands of God.
On the lighter side, we have been fighting these little ants for weeks in our kitchen at home and can’t get rid of them. This morning when I woke up and went downstairs I saw the food that Scott had left out on the counter and knew the ants would be having a field day. No ants, not one anywhere in sight. God knew that I had enough going on and that I could not bear those ants another day. He took care of them for me. Thank you Lord!

Some Pictures from the Hospital

Friday July 8, 2005

O.K. I have finally found some time to get everyone up to date and I think the best place to start is the beginning. Zack’s accident occurred at 3:50 am Friday 7-8-05. We got the phone call that every parent dreads at 5:00 AM from the Jefferson County police telling us that our son had been in an accident and was air lifted to University Hospital. When we arrived and got to see him he had been given drugs to paralyze him. As they would wear off every hour he would begin to shake. He was moving his arms and legs so we were hopeful early on that he would not be permanently paralyzed. When we met his doctor, Dwayne Densler, he informed us how severely Zack was injured. He had a blood clot on the right side of his brain and a severe bruise on the left side. He also had a laceration on the top of his head that had cut through his scull to the brain. This was full of glass and debris from the accident. His brain was swelling. They put a shunt in his head to drain excess fluid and monitor the pressure building up inside. We were told that his ICP (Inner Cranial Pressure) was at 28 and rising. They were treating him with drugs and had him on a respirator that was breathing for him but they couldn’t get his ICP to an acceptable reading under 20. When his ICP reached 36 Dr. Densler told us that we should prepare for surgery. Many family and friends waited with us including dozens of teenagers. We were amazed at how quickly Zack’s friends found out about his accident and rushed to the hospital. By 2:00 pm his ICP had reached 40 and the bruise on the left side had grown. Although we wanted to wait for a 2nd opinion, we were told surgery had to be performed immediately or he would die. They removed the right side of his scull to allow his brain to swell. At that time, they also removed the blood clot and discovered that he had glass on his brain from the laceration on the top of his head. Everyone prayed with us as we waited for the CAT Scan that would show whether the bruise had grown or begun to bleed. That could result in his left scull being removed, which Dr Densler did not want to do. They had removed the right scull even though the more severe injury was the bruise on the left. The left side of the brain controls speech and motor skills so they did not want to damage any brain cells on that side during surgery. By removing the right scull they would force the brain to swell on that side (which can be more easily retrained). Prayers from our church family at Southeast Christian Church and all those waiting held us up. Others were calling their churches and soon we had thousands of people praying for Zack. Finally, the CAT Scan revealed that his brain had shifted back to the center and there was no bleeding. We learned to live by his IPC readings hour by hour. We prayed that infection would not develope from the laceration and his brain would not continue to swell. We are grateful for all his friends, our friends and family and everyone that faithfully wait with us.

Introduction

This is the first entry for ZackHornback to thank our family, all his friends from school and church and everyone that has been praying for him. We are seeing amazing responces from Zack in answer to these prayers. After I am through these first few days I promise to be faithful to updating his progress every day on this site. Please feel free to visit us at University Hospital 2nd floor waiting room (Zack is on the 5th floor) and pray, pray, pray. Currently we need prayer for no infection to the wound on top of his head and for the swelling of his brain to go down. See you here soon.

Praying for Zack

Praying for Zack