1/5 - On the twelfth day of Christmas my true love gave to me...

...actually, we're starting to lose some accessories, which is a good thing. Without going into excessive detail, several invasive things have been or will be removed shortly. I sat in on rounds today, and there was lots of good news about multiple systems. His creatinine was up a little, but not terribly high, considering it had been 36 hours since he'd last clotted up the CVVH machine. They are currently seeing whether or not his kidneys can resolve things on their own. If they start to struggle, they will try Lasix or hemodialysis to give him a little help. Right now, his kidneys are enjoying their first solo flight in a while. His pancreas numbers continue to improve. They are still giving him feedings via NJ tube to give it more time to recover. They plan on starting feedings through his G tube (feeding tube in the abdomen) on the 10th to give it more time. They also talked about a plan to see how much support he needs with the ventilator. So far, Sam is tolerating those changes well.  

Post-op changes really aren't super drastic. They've got him on a broad spectrum antibiotic to fight any infections that may arise. I can't remember what it's called exactly, but they described it as penicillin's bigger, angrier brother. I'm good with that. They are managing his pain meds as well. From what I saw, he was in more pain yesterday than he had been in the past, not so surprisingly after brain surgery. Additionally, in a few days, they may start a medication that has the potential to sort of jump start his level of consciousness.  Which leads me to the neuro stuff.

Since we have been here, we have heard from several medical people that say they really wish he'd be more responsive. We know that they took a lot of damaged tissue out yesterday, and while we don't know what functions it controlled, they still believe that some or all of that could be recovered with other parts of the brain. The bigger concern is with the brain stem and any damage that may have occurred there. The only way to see that is with an MRI, which won't work with Sam. His G tube is weighted, and so they can't do an MRI. I had a momentary, crazy vision of Sam being sucked up into the MRI by his belly like a giant car magnet at a junkyard. I'd like to not have that vision fulfill itself, and apparently, neither does anyone else here. As such, they will delay the MRI for 4-5 days until something can be done about the G tube. Until that time, there is no real prognosis on what he may have permanently lost. 

We keep getting the "he may have lost ability to walk, talk, eat," etc. The key word that remains for us is "may." We refuse to dwell in the ambiguity of "maybes" and "what ifs". And, honestly, even if an MRI shows irreversible damage, I'm not sure we'll let that write the rest of the story. God is working for good in this boy and will continue to do so. I know this will make very little sense to anyone with medical training, and I'm at peace with that. Since this has happened, we have heard countless stories of miraculous recoveries from TBIs. If anyone can pull this thing out with a flourish, it's the Sam/God team. And how can you not love that combo?

On a completely unrelated note: if you are planning on visiting, could you please message Jim or me prior to coming? There are some days/times that are better than others, and even that could change in the span of minutes. If we say no, please do not be offended. And because I'm talking about it, we are really trying to keep all visitors to a minimum, and it is especially not a good time for Sam's friends to come yet. We know you're chomping at the bit to see him, and we love you for that. It's still not time. I promise that we'll let you know as soon as that changes. Thanks for respecting that.

Please continue to pray for Sam's recovery, that his numbers continue to trend in the right direction, and that he begins to respond to stimuli. And please add a coworker of mine to the list because of a death in her family. Many thanks.

This is from many many years ago at a big family vacation at Deep Creek Lake in Maryland. I have no reason for picking it, other than it's super cute, and I'm going to need to upload some new pictures, soon!