Goodbye ex-fix, hello nothing-by-mouth

What was supposed to be a very exciting week for Dan turned pretty quickly around - and he's now right in the middle of one of those setback periods that everybody always tells us are sure to come. As always though, Dan will come out of this one stronger and better than ever.

We got our week off to a really great start. He had an appointment with his head trauma surgeon at NNMC on Monday, and she was thrilled with how all of his wounds look now. I should say, how the areas where his wounds WERE look now. The skin graft that takes up most of his left inner thigh - took 100% and actually feels like real skin now. The area where the blast took some of his right thigh - healed completely. The tailbone and butt area which used to be just a huge gaping hole - healed completely. It really is amazing. One thing his doctor was definitely not pleased about, however, is his GI tract. He was admitted back into NNMC about two weeks ago with some intestines that decided to quit. After a few days there, some bowel rest, and some new medication he seemed to be on the right track back to the Dan that we all know could eat twelve Thanksgiving meals in one day.

After his appointment with his trauma surgeon, we headed to Walter Reed for another appointment with John, his prosthetist. John is actually an amputee himself. He did an initial plaster casting of Dan's residual limbs (I don't know why I'm even trying to be politically correct here - Dan gets such a kick out of calling them stumps). We got a lot of questions answered about what this process will be like - getting up on short legs and standing for the first time, then advancing to legs with knees, etc. Dan could have been up on prosthetics several weeks ago, but the external fixator on his pelvis prevented him from bearing weight on his legs. So he was in a little bit of a dead area for most of November as far as physical therapy is concerned - but this has given him plenty of time to really work on his core strength and balance, which he will definitely need once he goes vertical.

That was Monday. Tuesday it was back to the am PT/pm OT routine, and that evening is when Dan started throwing up. Ever since he was discharged from NNMC two weeks ago his GI issues were definitely improved from the point where they caused him to be hospitalized, but he just hadn't quite gotten back to full digestive speed since then. Every day his stomach would get little bigger, and he'd be able to eat a little less. After he wasn't able to keep his dinner down on Tuesday, and then again on Wednesday, we knew it was time to do something about it. Wednesday was a circus - we were running all over the place back and forth between Walter Reed and NNMC to get him ready for the surgery he was scheduled to have the next day. Yes, surgery - Dec. 3 has been the much-anticipated external fixator removal date, and damned if Dan was going to let a little barfing stop that from happening!

But he was so sick this morning - I took him to the hospital at 4:45 am for surgery and he had been throwing up all night. His stomach was the size of a beach ball. He even asked me to push his wheelchair for him, which is something he absolutely refuses to let anyone do, ever. Once we got to the procedure unit, we asked immediately that he be seen by the team monitoring his GI issues before any orthopedic people even touched him. After much discussion between the general surgery, orthopedics, and anesthesia teams everybody ultimately decided to go ahead with the ex-fix removal, and then admit Dan after surgery back on 5-East for several days to solve this problem.

So on the plus side, the hated ex-fix is off! On the minus, Dan is back in the hospital with a tube down his nose and is understandably frustrated. They are running a bunch of tests right now to figure out what the underlying cause is here. We don't know if it's a small bowel obstruction, an accumulation of narcotics with side effects that slow intestinal motility, or something else entirely. Although he's frustrated about being an inpatient again, he understands that this is a necessary step in getting him back to normal and he's handling it like a champ. He was supposed to have another appointment with John the prosthetist tomorrow to actually get some sockets put on, but we'll have to postpone that, which is okay.

I suppose we had to expect setbacks like this - but it's very difficult to grasp the fact that Dan can have both of his legs amputated and pelvis fractured, and these injuries will not cause nearly the challenges and frustrations that Dan's bowels and bladder have caused him. I look at him in complete amazement every day as he deals with these difficult and very painful complications - of course he complains, how can he not? But does he let it get him down? No way. He just wants to get better and get on so he can get back to learning how to walk.

Please keep him in your thoughts over these next few days. This will pass - after all, this is Dan we're talking about.

Thanks everybody, and have a great weekend!