And away we go!

Little did we know one week ago that all of our lives would change. We have been through emotional, physical, spiritual and social ups and downs. We have cried together, prayed together, fasted together, blogged together, hoped together, rejoiced together and mourned together. We have done it together. We have been of one heart and one mind.

There is still much healing to do. It will come. The emotional scars will take longer than the physical ones. I know that not all of you that are following this blog are LDS, but please allow me the leeway to share with you part of our belief in Jesus Christ from the Book of Mormon (Alma 7:11-12):

11 And he shall go forth, suffering pains and afflictions and temptations of every kind; and this that the word might be fulfilled which saith he will take upon him the pains and sicknesses of his people.
12 And he will take upon him death, that he may loose the band of death which bind his people; and he will take upon him their infirmities, that his bowels may be filled with mercy, according to the flesh, that he may know according to the flesh how to succor his people according to their infirmities.

It is this firm belief in the Savior that has allowed all of us to overcome the adversity of Gabe's death and the temporary suffering of so many.

We honor Gabe and our Savior by our daily efforts to be good, to make a difference for good.

This will be my final post, as Lars is leaving the hospital today. Thank you all one more time for your support and wonderful love. On Lars behalf I will say that he loves you all and can't thank you enough. The doctors, nurses and staff at McKay-Dee hospital have been wonderful. We couldn't have asked for a more professional experience.

This is Kurt signing off

The fat lady never did sing

As we were getting all ready to leave, they removed his central line (big IV) from his left chest. He immediately had difficulty breathing and increased pain in his chest. This is not particularly good. He may have had the pneumothorax redevelop. They will re-assess.

I think the discharge home is on hold for now.

Tick, tick, tick

The doctor came in just now. He is waiting for a chest xray. He says that if it looks good that Lars can be discharged home! He's ready. He may need some home oxygen for a little while.

Anticipation

Lars is starting to get tired of being here. He is hoping that he can go home today. So far, that is just his hope. The doctors have not been around yet to see him. He still is on the oxygen.

He wolfed down some Corn Pops this morning. Not the most nutritious breakfast, but we'll take the calories at this point.

He's been in the shower for about 30 minutes. No sign of that ending anytime soon. As long as there still is water...

Repeat chest xray

It was good news on the repeat chest xray. No need to re-insert the chest tube. Now we need to wean off the oxygen altogether. They have started some breathing treatments (kind of like kids with asthma receive) that include Mucomyst, a medicine which will help loosen up the thick mucus in his lungs. He is currently on 2 liters of oxygen per nasal cannula (those nose prong things that stick in your nostrils). That is not much. Some people go home on that amount with a portable oxygen tank. We'll do that if we need to but would prefer not.

He desaturates (loses) the oxygen in his blood stream with activity like walking. However he is quick to recover. You can chalk that up to his youth and incredible cardiovascular conditioning from swimming.

All of this is quite miraculous when you remember the initial prediction that he would be intubated for 7-14 days. I saw the trauma surgeon in the hallway while Lars was walking this evening. He was the one who admitted Lars to the hospital. He was scratching his head at how well Lars has done as he recalled the initial CT scan of his lungs. We know that there was more going on here than traditional medical treatment. Thank you all again for your fasting and prayers.

Incidentally, I never reported the results of Lars study to evaluate if he had a hematoma around the duodenum. He did not. The results were normal.

Enjoying his freedom

Being unattached to the chest tube has made ambulation easier. He has been outside again to take in some fresh air.

He is definitely feeling better. His sense of humor has returned. He is beginning to complain of small things (this unfortunately is a good thing).

We're still working on the appetite. Even Aggie bars could not tempt him. Orange Gatorade is still the number one request.

Houston, we have separation

Lars has grown attached to this chest tube. Sadly we had to let it go. Perhaps this was like Paul's 'thorn in the flesh' (2 Cor 12:7).

Lars just finished physical therapy. He did 10 minutes light exercise on an exercise bike.

He's looking better all the time


Look! No chest tube!

Enjoying new found freedom.

T minus five and counting

They are going to remove the chest tube here in a few minutes. They gave him a pain pill and they are waiting a little while for it to kick in.

The usual procedure is to repeat an xray about 6 hours later to see if the lung collapsed again. If it does then they re-insert the chest tube and we begin again.

He went on a walk this morning and was joined by a few of his Ashby cousins. He wanted to go outside to get some fresh air. He really hasn't been 'Mr. Grumpy-pants' as the photo indicates. I think it was just bad timing by the photographer.

Closely followed colon

It's not pleasant, and its actually kind of weird to cheer and celebrate colonic activity. It sort of reduces us all to the most common of functions as human. It unites us in some strange way. When a child first comes to this earth, we smile and celebrate the first real bowel movement. When we are old and senile, we tend to focus on our daily duty. So, it is with great pride and hubris that I announce that Lars' colon has once again joined the ranks of normalness. He pooped!

On to other mundane issues. The morning chest xray was done. We await the results. He wanted some Frosted Flakes, and scrambled eggs this morning. He ate some.

We're hoping for another good day.

Lap dog

For his fourth and final ambulation effort today Lars made a lap around the hospital floor.

He's requesting food intermittently and the thing that he wanted the most was orange Gatorade. He finished about 3/4ths of that and Tera and Anika are on a mission to find a dinner roll in the cafeteria.

About midnight they are supposed to put his chest tube 'on water seal'. That means it stops bubbling. I don't know how to explain it other than it sounds like a fish aquarium. There are several chambers that measure suction pressure, drain output, etc. One of them connects to the tube in his chest. The other connects to a suction unit on the wall. There are some interconnections.

This is a preliminary step to having the chest tube removed. We were at this stage a couple of days ago. Then in the morning he will get another chest xray.

Tortoise and the hare

The distances are getting farther on the daily constitutional (walks). He at least doubled the distance of his previous walk.

He still is pretty worn out when he is done.

If you notice there is a woman of advanced age that is behind Lars. She is gaining on him.

Being careful

Afternoon rounds by the doctor revealed plans for a new study tomorrow.Lars has been having some fairly consistent nausea, although it is getting better. Apparently it is not getting better fast enough for the doctor and he wants to get a study to make sure he doesn't have a hematoma around his duodenum (bruises around the intestine just below the stomach). I think this is just a precaution. My suspicion is very low for anything serious, but they just want to be thorough.

Healing in His wings

Tera and I just returned from the funeral. Lars asked us to represent him. It was an emotional and spiritual event. Gabe was a special young man. He was loved by all.

As sad as the occasion was, it was necessary for all to have some closure to this event. Many great sermons were delivered. We laughed, we cried, and we left with hope. If a funeral can be great, it was great.

A walk in the park

Halfway through the physical therapy for the day, Lars is feeling much better. He continues to talk more an more and even asked for his cell phone. When it turned on there were about 20+ new messages and phone calls.

Lars's lunch today consists of just water and apple juice, but I'm sure that's a whole lot tastier than the chocolate-looking goop. (I don't have the medical brains or know any technical terms.)

Each hour Lars is improving and we thank each and every one of you for all your prayers.

Squeaky Clean

My parents are currently at Gabe's funeral, so I was given the duty of updating the blog. I can't tell you that I will have the same humor as my dad, those genes all went to Lars.

Having to share a bathroom with Lars growing up, I learned the hard way to let him shower after me because he would take all morning. Well, today was no exception. Lars was in the shower for about 25 minutes, and I'm sure the old lady next door would like some hot water.

Breakfast of champions!

They have advanced his diet. He has chosen chicken broth and apple juice. If that goes well, then he will move on from there.
Such a beautiful smile! You can see he is feeling much better.

Goals

This is on Lars' door this morning. You may notice the 'Ambulate X 4'. He needs to get up and walk four times today.

Oops

Had a little emesis (he threw up) last night. The only thing that came up was the feeding tube. Darn. This does not disappoint Lars at all. The tube has been irritating the back of his throat and making it uncomfortable to talk.
They will re-evaluate if they will put the tube back in. Perhaps they will advance his diet. He still isn't eating yet.
The biggest cause of pain is still his chest tube. He went for a chest xray this morning. Depending on how that looks, he may or may not be able to have the chest tube removed.

Nitey nite

Lars is sleeping. Pleasant dreams to all.

Tomorrow is the funeral here for Lars' friend Gabe. Lars has asked Tera and I to represent him in his absence.

Alert the Press!

Lars ate fruit. You read that right. Lars ate fruit. If any of you know Lars you know that he NEVER eats fruit. He loves fruit juices, but he has this idiosyncrasy about eating fruit. Anyway, as part of the swallow study, they gave him a small cup of pears and peaches (probably covered with barium or gastrograffin -- an xray dye). Delicious. He later told us he only did it because he hoped that they would give him more food if he were cooperative. I guess three days without food could make anything taste good, even fruit.

He continues to generally do well. He has been having more pain from the chest tube and they have increased his pain medication some. He breathes easier when he isn't in pain.

Back from xray

All the movement today has tired him out. He is back from xray. We don't know the results yet. Lars was looking forward to a shower, but has changed his mind. A short nap sounds really good right now. That and a pain pill.

Moving day

Lars has a change of scenery. He has moved to room 2222. The intermediate care nurse welcomed us.

Lars passed his swallow study 'with flying colors.' We are just glad it was not a spit study. I'm not sure I want to know the result of that.

The Foley is out! The Foley is out! Every male rejoices along with Lars.

He has another xray study planned this afternoon. He is studying for it right now.

He feels better all the time.

Another day

The chest xray shows still a little too much air around the lung to take the chest tube out. So they will put suction back on to help reduce that airspace around the lung.

Lars was up with Physical Therapy again today. He made his last stroll around the ICU, as he will be transferred out soon. It gets easier each time, but still it is very tiring.

Lars is looking forward to the new room, because it has a shower! It's not a pool, but we're getting closer.

SportsCenter is next

As Lars waits for things to happen today, he is watching ESPN SportsCenter

Larsapalooza continues

General good news on rounds. He will be transferred out today to the SIMC (Surgical InterMediate Care) No timing on that of course.

They will repeat the chest xray prior to considering the removal of the chest tube.

They will get a swallowing study before advancing his diet. He has had some emesis (vomiting), and they want to make sure that he is swallowing OK. I anticipate that this will be normal. Last night he was hungry. This morning he does not have an appetite.

He hasn't had a bowel movement since he's been here. They will give him something to encourage some action. Sorry we have to talk about stuff like poop and pee. However they are essential to our body's normal function.

They will continue physical therapy. As hard as it is for him, I think he enjoys it.

His oxygenation continues to be very good. He is on a simple mask at this time. I think the plan is to have him stay on BiPAP at night time.

He had a little more pain this morning. He rated it a 6 on a scale of 10. After some pain medications he said it was about a three. I'm okay with that because the parents of teenagers live at about a pain level of four throughout the teenage years...

On the docket

As we wait for morning rounds, we anticipate that a few things will happen today. These are just anticipations. I'll fill you in again after rounds.

The first is that Lars will likely be transferred out of the ICU. They may send him to an intermediate care floor or a regular care floor. My hunch is that it will be an intermediate care room. The timing of his departure depends on the availability of the room to where he is going--kind of like a hotel. They need to clean the room to get it ready. Typically it will be middle of the day or early afternoon.

Next I anticipate that he will be able to have his chest tube removed. It has become more noticeable to him from a pain standpoint. I guess that is reasonable that it would hurt to have a 3/4 inch tube stuck through your chest wall. We lovingly call it his exhaust pipe.

He has had some difficulty with nausea. They may start him slowly on a clear liquid diet. Clear liquids are delicious things like Gatorade, jello and chicken broth. It's not much but it feels like a feast after not having anything cross your taste buds for a few days.

Lastly, I anticipate that they will continue to advance his physical therapy. He gets tired easily for lots of reasons. His red blood count is a little lower than what his body is used to. It will come back quickly in a 17 year old, but in the mean time it means he'll get tired easily.

Bed, Bath & Beyond or Bath & Body Works

First the 'Beyond.' Lars was able to meet with many of his friends tonight that were involved in the accident. Emotions were close to the surface for all. Love was in the air. Lars hasn't had quite as long to process everything as the others, but he is doing very well. He really loves his friends. There was a lot of healing that happened tonight.

Next to 'Body Works.' What an incredible day for Lars. Twice he was able to get out of bed and walk down the hall. The people in the ICU don't usually get to see such feats of physical therapy. (usually standing up and sitting in a chair is the norm). I think some of them started doing the wave as he walked by. (Of course with those hospital gowns, I'm not sure what they were waving at.)

Third, 'Bath.' Yep it's time again. Anika reminds me that Lars doesn't smell as good as either store. Three baths in three days. Lars may break out in a rash.

Lastly, it's time for 'Bed.' We all need our rest to rejuvenate us, Lars included. In order to help his lungs to stay as open as possible while he sleeps, the ICU doctor wants him to wear the BiPAP machine tonight. This is not a step backward in oxygenation. Rather it is a treatment for his lungs to help them get better more quickly.

Good night all. It has been another miraculous day.

What a difference a couple of hours makes

The ICU policy is to close down tight from 5-6:30 both am and pm so the nurses can change shift and exchange information about their patients. No one can get in to see their families. We took the opportunity to rest and rejuvenate, and so did Lars.

We came back to visit him after the 'lock out' and found him to be much more alert, much more comfortable. The new nurse believes he will be out of the ICU tomorrow. Of course it depends on the usual disclaimers. He needs to have a good night and keep progressing. We think he will.

At this point it looks like he won't need BiPAP tonight. As good as it was for Lars, he didn't care for it much. He did say it was 'better than the tube.'

He wanted me to tell you all that he loves you and thank you so much for your prayers. It is an emotional time for him as he begins to process all that has happened.

Round 2

The second physical therapy session went very well. He walked 100 feet. Dr. Stimpson will be happy to know that it included straight leg raises. It still takes great effort for him to accomplish his therapy.

He recovered a lot faster after this session. The first one wiped him out. I think he is making progress.

Nap time

Walking that small amount was very tiring. Lars has re-initiated nap time. He hasn't done that since he was four.

He is next in line for physical therapy in the ICU. We'll see how two marathons in one day turn out.

He is on just a simple oxygen mask at this time and denies having pain. He's off both pain and sedation medicine.

Put one foot in front of the other

Lars got out of bed with physical therapy this morning. He walked down the hall of the ICU and back without any assistance. The therapist and assistant were walking close by to manage the IV pole, oxygen supply and things. Disregard the tall guy in the background.

This little walk pretty much tired him out. There was no flip turn, but we're proud of him anyway.

He also did some shoulder exercises. We think he looks like Rocky.

Round and round we go

General good news. They are going to try to wean the BiPAP this morning and get him up walking in the room. They are going to do the preliminary steps to get the chest tube out. If things go well then that should come out in 24 hours and after the chest xray looks good.

They are going to let him try some ice chips again. He threw up once yesterday and so they will move slowly. He is getting nutrition through the feeding tube, with a nutritionist making sure he gets the appropriate nutrients.

In general, the intensive care doctor was pleased with his progress. If things go well, he may be out of the ICU tomorrow. We are not in any particular hurry as he gets great and personal care in the ICU. However, it will be nice for him to see his friends. I know he wants that as soon as possible.

Day 3 begins

Lars had a good night. He said that he slept well. He remains in the ICU for now. He is on BiPAP, which has really helped him to maintain oxygenation.

Rounds will be about 8:30 or 9:00. That is when and where most of the decisions will be made for the goals of the day. I imagine it will be about decreasing his oxygenation as Lars' lungs allow.

There may be some talk about the chest tube. That is the tube that was placed through the side of his chest to treat his punctured lung (not to be confused with the other 'tube' that was in his throat to help him breathe). It is my guess that it will probably be another day or two before the chest tube is removed. There really is no rush on this other than it is uncomfortable and he has to carry around a little bubbling container with him when he walks.

They will likely encourage him to get out of bed and walk around some. That is very important to open up his lungs, prevent blood clots in his legs, and to prevent pressure sores from too much bedrest (couch potatoes take note). Not to mention it will just feel good to stretch his muscles and joints.

Lars continues to be thirsty. As long as he is on BiPAP they won't give him any fluids by mouth. He gets plenty of fluid through his IV.

I don't anticipate great leaps in progress from here on out. The blog updates will probably not be exciting. We are hoping for a consistent steady progress forward.

Zzz...

Sleeping very well tonight so far...

What goes up...

We are expecting many ups and downs over the recovery period. We had a minor set back this evening. Lars has recovered so rapidly and was doing so well. He has been breathing well on his own most of the day. As the afternoon and evening wore on, it became more and more work to breathe. His respiratory rate ( the number of breaths per minute) was pretty high. It is hard work, even for a swimmer, to keep that up for very long.

As a result, they started him on a BiPAP (Bilevel Positive Airway Pressure) machine. It is like a scuba mask that fits over his mouth with a pretty tight seal. It allows him to have a little constant pressure in his lungs, to help keep them open better. It is kind of the little brother to PEEP, which was used when he had the breathing tube in place. Some of you may know someone with sleep apnea that uses a CPAP machine at night. It is very similar.

He has responded very well so far to the BiPAP. His respiratory rate has slowed significantly. He doesn't have to work as hard to breathe. It should help him get a better restful sleep tonight.

He is doing well, but if he worsens further, they will likely put the breathing tube back in. I want to say a few words about that. I have had you focus on the breathing tube quite a bit the last couple of days. However, if they have to put it back in, it is not a failure or a problem. Now we know that Lars is alright. He has spoken to us. He has told us he doesn't hurt anywhere else. He is our Lars.

If the tube goes back in, this time we'll know all of that and we will consider it just as a form of treatment to help him. Our anxiety level will be very low.

We will continue to have ups and downs over the next many days. It is unreasonable to expect otherwise. Our love goes out to all of you who have shown your concern and love for our son. We would still appreciate your remembering him in your thoughts and prayers.

Pizza party

I hope that many of you were able to enjoy some Papa John's pizza tonight. Our family gathered together and had a pizza party.

I told Lars earlier today that we were going to have a Papa John's pizza party tonight so that all of his friends and family could remember him. He looked at me and said, "... And Gabe." Lars loved his friend. Even though he is sedated and sleeping a lot. He has tender thoughts for all of his friends.

Tuckered out

Lars is doing very well. He sat up in a chair for about an hour. He fades in and out of sleep. He says he's really tired.

We know that everyone wants to come to visit him and see him in person. However, when he talks, even for a short time, his oxygen level drops too low. We love to speak to him, but he really needs to rest right now.

If he continues to improve, he may be able to get out of the ICU tomorrow or Wednesday. When he is in the regular hospital room, we'll have visiting hours where you can visit with him for a few minutes. Until then, we appreciate your understanding that Lars needs to recover and get stronger at this time.

We're all in trouble now...

Lars has his sense of humor back. Amazing with all the drugs, but his particular version of humor is back. We view this as a good thing, I think.

Ice chips never tasted so good

Lars is very thirsty. He keeps asking for water. He was able to have his first ice chips. It still kind of painful to swallow from the recent tube removal. When you have a significant injury, they like to start you very slowly with liquids and then food. Right now he is happy with ice chips.

The tube is out!

Lars made incredible progress this morning. The doctor came out to tell us that he was going to take the tube out. We were just back in the ICU with him and it is great to see him without a tube and talking to us again.
One of the first things Lars wanted to know was about his friends. He learned the sad news about his friend that died. He was tearful. He kept repeating his name. He loved him very much.
He still has a lot of recovering to do. But this is a major hurdle. If all goes well he may be out of the intensive care unit tomorrow.
Thank you all again for your prayers. It has truly been a miraculous recovery so far.

One more thing from rounds

I remembered one more thing from rounds this morning. The intensive care doctor called to speak with the emergency room physician that was on duty when Lars came in. She said Lars was alert, and responding to questions appropriately when he arrived at the ER. This is very good news as we know that Lars' brain was working (at least as good as it ever did...)

Rocky Balboa

The physical therapists were just in with Lars. They stood Lars up at the bedside and had him take a few steps. I think the theme from Rocky started playing in the background. We are so proud of Lars!

Lars is hungry

McKay-Dee ICU is awesome. They include the family in the morning 'rounds' --time that the doctors, nurses, and supportive staff all meet. Lars has made great strides in the last 24 hours. I'll try to remember everything.

His cervical collar has been removed. A cervical collar is always put on as a precaution in severe accidents because of concern about neck injuries. After further review of the CT scan and consultation with the neurosurgeon, the decision was made to remove the collar. This is nice because it is more comfortable for Lars.

They increased his tube feeding rate this morning. Why doesn't it surprise me that Lars can pack away the food.

They are switching some of his sedation medication so that he can be more alert and still not be agitated. He should be able to communicate more with us now.

The most amazing news is that they are already talking about taking the breathing tube out. If you remember the initial guess was for 7-14 days. The fact that they are even talking about it now is amazing. Perhaps this afternoon or tomorrow if things go well.

They are very aggressive here in the ICU. The doctor wants them to stand him up and let him walk a little, even with the breathing tube in. That will be great for his lungs and for his body.

We appreciate all of your prayers and fasting. We know that Lars is loved! We know that your prayers have helped him have such enormous success so far. We're hopeful to speak with him soon.

Papa Lars

One of Lars's favorite meals is a great big pizza from Papa John's. Since there isn't much for anyone do to except wait and pray, we thought that tonight as friends and family we could all share a Papa John's pizza, wherever you are. Order any kind you like, I'm sure Lars would eat every last bite of whatever you ordered, mushrooms and all.

"Slider... you stink!"

That's right. Lars is getting a bath. The nurses are giving Lars a sponge bath right now and changing the bandages on his cuts and scrapes, so we haven't been into see him yet. My wife reminds me that Lars hasn't had many baths in the last 6 weeks because he has been swimming 2-3 times a day. So, he's probably due.

We have always known that Lars has had a big heart, but this morning it is a little bigger. So he will get an echocardiogram (a sound wave test that can view the heart chambers -- kind of like an ultrasound that pregnant women get.) Hemodynamically he remains stable, which is good.