Spoke to mom - he's very agitated and thrashing his good arm and leg all over the place - even kicked the old lady one shot ! They removed the wire from his arm - it was a temporary repair - I think they just put a piece of bloudraad in for the time being - nurses say he is just withdrawing from the morphine and needs to go through it - being a smoker (hopefully an ex smoker after all this) apparently makes it worse (is anyone listening ?)- maybe he just wants to get to the re-union next weekend and the buggers wont let him go...he is still on the respirator but they are reducing oxygen levels and he is starting to breathe more and more by himself. Sounds like business as usual and all on track from a clinical point of view but all quite troubling for mom.
Will be going down either tomorrow or monday to see for myself.
Friday, September 28, 2007
Wednesday, September 26, 2007
26 Sept
Good news - he had a bowel movement and everyone is happy - I also enjoy having one but never thought I'd tell the world how happy we are that Colin had one ! Specialist was at the hospital at visiting time this afternoon and saw mom and was quite upbeat - they've taken him off morphine - from 10mg every hour to nothing seems to me like a very positive thing as well - they are still struggling to take him off the respirator but it looks like bringing him off morphine is part of the process - he's still very bloated and has a bad rash which apparently may have something to do with the cortisone they are giving him - what a cocktail of drugs he is getting ! mom sounded really positive - she's my barometer and she was sounding very upbeat this evening.
Had a good suggestion from Bruce Rothman:
Very Tongue in Cheak (sic), I'm wont to ask whether you'll arrange a day when the 30 year crowd (Yeah - I'm almost amazed at how many of us are still around), could come in and do Colin's sedating ourselves! What with the natural diuretic value of that wonderful distilled product of the Scottish Hig'lands, we'd have his kidneys working right-as-rain!
Sounds like a good idea!
Had a good suggestion from Bruce Rothman:
Very Tongue in Cheak (sic), I'm wont to ask whether you'll arrange a day when the 30 year crowd (Yeah - I'm almost amazed at how many of us are still around), could come in and do Colin's sedating ourselves! What with the natural diuretic value of that wonderful distilled product of the Scottish Hig'lands, we'd have his kidneys working right-as-rain!
Sounds like a good idea!
Tuesday, September 25, 2007
25 Sept
Doctor spoke to Colin this morning and told him to stick his tongue out - he cant speak with the respirator in place - and he stuck his tongue out - he's still very heavily sedated as they cant take him off the ventilator yet - they are trying, by reducing the oxygen content, but apparently he started struggling, indicating that he's not coping yet, so they will monitor and continue with the weaning process, which is encouraging, as they wouldn't be trying to wean him if the lung infection was still in place. Kidneys are functioning but there is apparently a concern because there has been no bowel movement since the accident so they'll be calling in a specialist to look at that if no change (if you'll excuse the half hearted pun) tomorrow. Its a long road and I think the indications are mostly good, I think he's on track but there are still all sorts of dangers and complications that are possible. He's still very swollen and like I said, heavily sedated like in unconscious 99% of the time, but intentionally unconscious. If they wanted to bring him out of it they could but they keep him there because its the best for him at this stage.
More when available. Good wishes still coming in from around the globe. Keep up those positive thoughts, prayers and meditations. As a lawyer I became quite cynical about human nature but this incident has reminded me what goodness people have in them and what makes us the most successfull animals on the planet - our genuine interest in others and desire to help them. Your good wishes are a constant source of strength to us all ! Colin has touched many of your lives and will continue to do so. Aluta continua !
More when available. Good wishes still coming in from around the globe. Keep up those positive thoughts, prayers and meditations. As a lawyer I became quite cynical about human nature but this incident has reminded me what goodness people have in them and what makes us the most successfull animals on the planet - our genuine interest in others and desire to help them. Your good wishes are a constant source of strength to us all ! Colin has touched many of your lives and will continue to do so. Aluta continua !
Monday, September 24, 2007
24 Sept
We last saw Colin yesterday at 11 and mom says when she saw him today his position was pretty unchanged. Still quite swollen and giving him medication to keep the urine production going and very heavily sedated. Its important to get him off the respirator asap but today being a public holiday he'll have to wait until tomorrow before the specialist sees him and makes an assessment. Thanks for your good wishes "middle child", Alison, Francois and Sunette - yes ARDS is a monster - I'd never heard of it before but it seems to actually be quite common, especially with multiple injuries and especially when the lungs are involved. I wonder whether Colins lungs were not involved initially - when you see the break in his upper arm, right in the shoulder joint it's not difficult to imagine a huge shock to the lungs,but I'm just speculating, it doesn't appear to have to start with trauma to the lungs. At this stage it's one day at a time and back to reporting second hand via mom in PE.
Although I'm certainly not qualified to comment, it seems to me strange that the hospital rotates nursing staff in the ICU, so that each day a different person will nurse diferent patients. I would have thought that it would be important to have first hand knowledge of a long term patients history - for instance the swelling doesn't necessarily look shocking to someone who doesn't know Colin, because it takes on his body's proportions, but to someone who had seen him previously it would be immediatelly noticeable. (he looks like he could weigh 95 kg, instead of his normal 75) I understand that in some hospitals they try to keep nurses with patients because they become familiar with the patient's history. I suppose there must be very good reasons why this hospital has adopted this regime. I suppose that one benefit of many nurses attending to one patient over a period of time is that you have many eyes and minds considering the same patient - there are probably benefits to both systems.
Will report more tomorrow. Keep up those good vibes and if any of you have some room for improvement, give some thought to looking after your lungs better - they are our primary interface with the world.
Although I'm certainly not qualified to comment, it seems to me strange that the hospital rotates nursing staff in the ICU, so that each day a different person will nurse diferent patients. I would have thought that it would be important to have first hand knowledge of a long term patients history - for instance the swelling doesn't necessarily look shocking to someone who doesn't know Colin, because it takes on his body's proportions, but to someone who had seen him previously it would be immediatelly noticeable. (he looks like he could weigh 95 kg, instead of his normal 75) I understand that in some hospitals they try to keep nurses with patients because they become familiar with the patient's history. I suppose there must be very good reasons why this hospital has adopted this regime. I suppose that one benefit of many nurses attending to one patient over a period of time is that you have many eyes and minds considering the same patient - there are probably benefits to both systems.
Will report more tomorrow. Keep up those good vibes and if any of you have some room for improvement, give some thought to looking after your lungs better - they are our primary interface with the world.
Saturday, September 22, 2007
22 Sep
Colin seems to be stable, temperature 36.6, heartrate 80 - 90 ish, heavily sedated but opened his eyes briefly and definitelly recognised us, but only fleetingly, then back into the mists. It's an interesting situation - they give him a drug to suppress his normaly respiration, so that he doesn't fight the respirator, and then when they wean him off the respirator they have to decrease that drug so that his natural breathing takes over - they are very wary of weaning him too early because if he's not ready for it then he has to go back on the respirator. They also have to bring him back to consciousness so that he works with them. At the moment he is too restless when he surfaces so they sedate him heavily, so its quite a fine balancing act they have to perform. Weaning will only start on Monday, if the indications are all good, as the nursing staff have to wait for the go ahead from the specialists. Obviously the longer under constant anasthesia the greater the risks of other problems cropping up. His urine output dropped yesterday and that could mean kidney's showing signs of stress, but they gave him something to encourage urine production and it worked, so we're hoping for the go ahead on Monday, as his body will function better when he's conscious.
Ilse did some more research on "lung shock" or ARDS (Acute Respiratory Distress Syndrome), which appears to be what affected Colin as a result of the breaks to the bones in his body - bone marrow and fat get released into the blood supply and find their way into the capillaries supplying the lungs and cause damage to the "extremely thin membrane (alveolar- capillary membrane) that prevents fluids from passing into the alveolar space. ... damage to the alveolar-capillary membrane causes it to become permeable. This allows fluid from the blood vessels to flood the air sacs, making it difficult, and sometimes impossible, for oxygen to enter the capillaries." (See the ohiohealth link below.)
Thereafter, he developed some infection, which has by now hopefully cleared up.
The difficulty which he had excreting urine has resulted in his body becoming quite bloated - but as indicated above they gave him something which sorted that out, although his urine production tonight wasn't that good.
Links to ARDS can be found on
http://www.ohiohealth.com/bodymayo.cfm?xyzpdqabc=0&id=6&action=detail&ref=3795
http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_All.html
http://www.ards.org/learnaboutards/whatisards/harborview/
You will see that the reported mortality rate is pretty high - 30 - 40 % - I am sure that Colin has left those sort of odds behind him. Thanks to all for your thoughts and prayers. Ilse chatted to a guy in the waiting room whose 10 year old son was involved in a motor accident today and is in a coma - Eeesch... what a heartbreaking place a hospital can be - I was watching cricket while this poor guy was sitting there all on his own.
More tomorrow or monday.
Ilse did some more research on "lung shock" or ARDS (Acute Respiratory Distress Syndrome), which appears to be what affected Colin as a result of the breaks to the bones in his body - bone marrow and fat get released into the blood supply and find their way into the capillaries supplying the lungs and cause damage to the "extremely thin membrane (alveolar- capillary membrane) that prevents fluids from passing into the alveolar space. ... damage to the alveolar-capillary membrane causes it to become permeable. This allows fluid from the blood vessels to flood the air sacs, making it difficult, and sometimes impossible, for oxygen to enter the capillaries." (See the ohiohealth link below.)
Thereafter, he developed some infection, which has by now hopefully cleared up.
The difficulty which he had excreting urine has resulted in his body becoming quite bloated - but as indicated above they gave him something which sorted that out, although his urine production tonight wasn't that good.
Links to ARDS can be found on
http://www.ohiohealth.com/bodymayo.cfm?xyzpdqabc=0&id=6&action=detail&ref=3795
http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_All.html
http://www.ards.org/learnaboutards/whatisards/harborview/
You will see that the reported mortality rate is pretty high - 30 - 40 % - I am sure that Colin has left those sort of odds behind him. Thanks to all for your thoughts and prayers. Ilse chatted to a guy in the waiting room whose 10 year old son was involved in a motor accident today and is in a coma - Eeesch... what a heartbreaking place a hospital can be - I was watching cricket while this poor guy was sitting there all on his own.
More tomorrow or monday.
Thursday, September 20, 2007
20 Sept
This morning mom phoned and was a bit despondent - the infection in the lungs is still evident so they cant take him off the respirator yet and he's still fully sedated although opens his eyes from time to time - I'm just so grateful I saw him compos mentis for a few seconds so know that he's still inside there somewhere - amazing what the soul is or the individual - where does it hide or go to when unconscious or is it just a mass of cells that somehow function together and create this personality when awake - as some people believe - Colin used to be very interested in astral projection - hope he's making full use of the opportunity now, although I dont think so because if it's possible I think one needs to be able to focus ones concentration and I dont think the drugs allow him to do that - I think he's just adrift in this interminable sea somewhere with who knows what sounds, colours and sensations - just hope the visions are benign.
anyway mom said she would be seeing a man about a shaking matress - apparently Aubrey Klinkradt had one after his horror encounter with flesh eating bugs kept him on his back for I think 8 months - well lo and behold, this afternoon the matress was installed at the hospital - apparently it shakes electronically and prevents bedsores - doctors and everyone fully agrees that it is a fantastic aid but the hospitals dont supply them because of the cost factor.
Looking forward to going down on Saturday and seeing for myself what progress after a week. I'm based in East London next week and then finish my current contract and will be more flexible time wise and able to go down to PE if necessary during the week, possibly to relieve the old lady a bit. Keep up the positive energy, prayers and good wishes!
anyway mom said she would be seeing a man about a shaking matress - apparently Aubrey Klinkradt had one after his horror encounter with flesh eating bugs kept him on his back for I think 8 months - well lo and behold, this afternoon the matress was installed at the hospital - apparently it shakes electronically and prevents bedsores - doctors and everyone fully agrees that it is a fantastic aid but the hospitals dont supply them because of the cost factor.
Looking forward to going down on Saturday and seeing for myself what progress after a week. I'm based in East London next week and then finish my current contract and will be more flexible time wise and able to go down to PE if necessary during the week, possibly to relieve the old lady a bit. Keep up the positive energy, prayers and good wishes!
Wednesday, September 19, 2007
19 Sept
haven't heard anything from mom and havent wanted to bother her (and I think she hasn't wanted to bother me) - I'm sure no news is good news - will report again tomorrow.
19 Sept
Not much more to say - mom says she was quite upset when she saw him yesterday afternoon as he was fighting his restraints and still isn't conscious - probably 10 - 20 % conscious - last night he was more relaxed, his heart rate was up to 118 but probably because of the stress caused by fighting to get up - apparently he tries to lift his head and I know when I was there he was continually trying to scratch an itch on his face but couldn't because of the restraints - temperature normal - must be torture but at least everything seems to be looking good - me and Ilse going down this weekend to see for ourselves - hold thumbs for the removal of the respirator today / tomorrow.
Tuesday, September 18, 2007
18 Sept (2)
Still heavily sedated and fighting restraints when surfacing but looking good and starting weaning process (off respirator).
18 Sept
The Blog sub title has changed
No longer "updates on Colins condition"
Now - "updates on Colins progress" !
No longer "updates on Colins condition"
Now - "updates on Colins progress" !
Monday, September 17, 2007
17 Sept
Just spoke to mom, she visited Colin and reports that he is resting well, although heavily sedated as he was quite restless before that.
She also saw the orthopaedic surgeon who reports that it will be at least 2 weeks before we can move him. The shoulder fracture was just temporarily repaired as they didn't want to do too much to him in one op and concentrated on the femur, which was fractured in three places. There is no fracture to the knee - there are drains coming out of the knee because a lot of fluids build up in there due to the trauma and being flat on his back - but colour coming out is clear and thats good. Fracture to pelvis will take at least 8 weeks of flat on back rest.(not sure if 8 weeks from accident or 8 weeks from now)
Xrays and ultra sound examinations of his chest were performed and as soon as those are available, if positive, and I think they expect them to be, they will start weaning him off the ventilator and keeping him less sedated.
More as I hear it.
She also saw the orthopaedic surgeon who reports that it will be at least 2 weeks before we can move him. The shoulder fracture was just temporarily repaired as they didn't want to do too much to him in one op and concentrated on the femur, which was fractured in three places. There is no fracture to the knee - there are drains coming out of the knee because a lot of fluids build up in there due to the trauma and being flat on his back - but colour coming out is clear and thats good. Fracture to pelvis will take at least 8 weeks of flat on back rest.(not sure if 8 weeks from accident or 8 weeks from now)
Xrays and ultra sound examinations of his chest were performed and as soon as those are available, if positive, and I think they expect them to be, they will start weaning him off the ventilator and keeping him less sedated.
More as I hear it.
Now that I have a soap box
Please excuse me for indulging but these thoughts kept going through my head whle sitting in the hospital and I thought I'd put them down in writing:
The Genesis and The Exodus
The cold clinical corridors
Scented by coffee and detergents
Brightened fleetingly by flowers carried by
warm caring people
Strangers at first, seemingly
unaffected by the coming and the going
of new born babies born proudly out the front
and corpses discreetly removed out the back
They speak to me of resignation and defiance
Of pain and joy
A pit stop and an end stop
A beginning and a fresh start
Of humanity and suffering
Of dignity and shame
Of defiance and tolerance
Of suffering and pain
Humbled and grateful
Enriched by their experience
Not at their expense
But vicariously
Be tolerant and ever grateful
And watch your bloody diet !
Theres a sign on the wall setting out the hospital's responsibilities and next to it, the patients responsibilities. No 1 on the list of patient responsibilities is something to the effect of "Look after your body" - how true - when you see some of the patients walking around (and the people visiting them) you cant help thinking that if they had looked after themselves better they wouldn't be there.
I take my hat off to all nursing staff (and doctors) because they are on an emotional roller coaster ride every minute of every day. I once read a book by Isac Asimov and one of the story's was about this Martian who would respond to peoples emotions somehow - eventually he got torn apart or went mad because he started tuning into too many people's emotions - I think of him at the hospital - you look at peoples faces and very seldom see what they are going through, only when you talk to them sometimes. We dont talk enough.
Its trite but its true - crisis bring out the best in the human race !
The Genesis and The Exodus
The cold clinical corridors
Scented by coffee and detergents
Brightened fleetingly by flowers carried by
warm caring people
Strangers at first, seemingly
unaffected by the coming and the going
of new born babies born proudly out the front
and corpses discreetly removed out the back
They speak to me of resignation and defiance
Of pain and joy
A pit stop and an end stop
A beginning and a fresh start
Of humanity and suffering
Of dignity and shame
Of defiance and tolerance
Of suffering and pain
Humbled and grateful
Enriched by their experience
Not at their expense
But vicariously
Be tolerant and ever grateful
And watch your bloody diet !
Theres a sign on the wall setting out the hospital's responsibilities and next to it, the patients responsibilities. No 1 on the list of patient responsibilities is something to the effect of "Look after your body" - how true - when you see some of the patients walking around (and the people visiting them) you cant help thinking that if they had looked after themselves better they wouldn't be there.
I take my hat off to all nursing staff (and doctors) because they are on an emotional roller coaster ride every minute of every day. I once read a book by Isac Asimov and one of the story's was about this Martian who would respond to peoples emotions somehow - eventually he got torn apart or went mad because he started tuning into too many people's emotions - I think of him at the hospital - you look at peoples faces and very seldom see what they are going through, only when you talk to them sometimes. We dont talk enough.
Its trite but its true - crisis bring out the best in the human race !
Sunday, September 16, 2007
16 sept
More improvement this morning - when I came into the isolation room, which is situated in ICU, Lynette said look Colin here's Leon and he looked at me and nodded, quite clearly compos mentis, and a bit later the nurse made a comment which made him smile - first time I've seen him smile since the accident, but he's still very heavily sedated and drifting in and out of consciousness and haziness - I mention names of people and he kind of registers - sister says they will be doing an x ray of his lungs tomorrow but she can see that there are no secretions and the fluid coming out is clear, instead of yellow as it was last week, and theres much less - he's breathing easier, heart rate down to 61 but fluctuates when he wakes to around 80 - 90. Once they take him off the respirator they put him on oxygen for three days but with a metal valve in his throat in case they need to plug him in again - When they take him off respirator depends on outcome of x rays and whether he can breathe on is own, which seems to depend on the infection. He is also being fed through a pipe and his stomach and intestines are retaining nutrients. His lip is healing well and skin colour is good, swelling going down all over , neck nearly back to normal dimensions, The operation wounds are still weeping at the shoulder and leg but he is on day three of the new antibiotic and responding very well.
He has been through the valley of the shadow of death and come out on the other side but still has a moer of a long way to go - mom has an appointment with the orthopod tomorrow and will find out when we can start thinking of transporting him back to EL - probably not for a week or two or at least until he's off the ventillator and breathing comfortably on his own. I'm off to Queenstown tomorrow for a week but will post second hand reports ex mom.
He has been through the valley of the shadow of death and come out on the other side but still has a moer of a long way to go - mom has an appointment with the orthopod tomorrow and will find out when we can start thinking of transporting him back to EL - probably not for a week or two or at least until he's off the ventillator and breathing comfortably on his own. I'm off to Queenstown tomorrow for a week but will post second hand reports ex mom.
Saturday, September 15, 2007
15 sep (2)
Well not much to report - situation very similar this afternoon and this evening - they are keeping him heavily sedated, but occasionally he kind of surfaces for a minute or so at a time. Eyes open and reality intrudes with a shock into his dazed, drugged consciousness, you can almost see him asking the question - what the HELL is going on here - he sees us standing around and recognition focuses his eyes and then he's gone - but its controlled, he tries to scrach himself but his arms are tethered at the wrists because of the danger of pulling pipes out, and you can see the frustration, anger, pain, and then it goes away and he slips back into the mists. It's going to be a long time, but he's clearly a hell of a lot better than last week. Me and Lyn going back to EL tomorrow and leaving mom behind.
Cheers for now.
Cheers for now.
15 Sept
Quite heavily sedated, opening eyes briefly, but pretty unfocussed and glazed (just like normal on a Saturday morning around 3am after a heavy night out !), temperature normal, heart rate around 68, clearly uncomfortable with all the pipes, metal rods and stuff inside him and feeling pain, but definitely much better. Will report further later today.
Friday, September 14, 2007
14 sept
MUCH better - they did the tracheotomy at 6 pm and when we saw him at 7 he was opening his eyes - still very blurry and disoriented but recognised our voices and even nodded his head. Colin is back. As I said earlier very disoriented and wanting to move his arms and legs, the monitor on his finger keeps falling off, causing the machine to beep. He even has his own tv, not that he can see anything yet but maybe tomorrow. He cant talk yet, mouth very dry but much more comfortable with the pipe out of his mouth.
Temperature 36.5 Heartrate 84 Sore on lip clearly busy healing and will leave a small scar. Growing a moustache as they probably dont want to shave upper lip and looking quite handsome ! Night staff caring and friendly. Everything just started going right today. Comms with the doctors and the hospital started happening, got some documentation from the Medical Aid, still a lot of things that are not clear re the medical aid but things are happening and a huge improvement in Colin's status. Keep those prayers and positive vibes coming and thanks everyone. Will report some more tomorrow morning.
Temperature 36.5 Heartrate 84 Sore on lip clearly busy healing and will leave a small scar. Growing a moustache as they probably dont want to shave upper lip and looking quite handsome ! Night staff caring and friendly. Everything just started going right today. Comms with the doctors and the hospital started happening, got some documentation from the Medical Aid, still a lot of things that are not clear re the medical aid but things are happening and a huge improvement in Colin's status. Keep those prayers and positive vibes coming and thanks everyone. Will report some more tomorrow morning.
14 sept
I have managed to break through the red tape and speak to people at the hospital. Thanks to Tyrone for putting me on to a very caring lady in management. She called up the details and got back to me within minutes. I am waiting for a call from his case manager but have also received a call from the credit control manager who will be faxing me accounts and a fax from the medical insurance scheme concerned. It is apparently quite a complicated story, with codes and stuff, but it does appear that he'll be covered for a substantial portion of the expenses, which was a concern of his before he went under.
They are apparently operating on him at 2pm for the tracheotomy and I suspect that when we see him tonight that information will be a little more forthcoming and will be shared with you all as soon as it is available.
Thanks for the thoughts and prayers - also from all the Old Boys who will be gathering for the 30th re-union next month who are contacting us also thanks very much we will pass on all the good wishes when the bugger wakes up eventually - he always was a hard one to get out of bed !
They are apparently operating on him at 2pm for the tracheotomy and I suspect that when we see him tonight that information will be a little more forthcoming and will be shared with you all as soon as it is available.
Thanks for the thoughts and prayers - also from all the Old Boys who will be gathering for the 30th re-union next month who are contacting us also thanks very much we will pass on all the good wishes when the bugger wakes up eventually - he always was a hard one to get out of bed !
Thursday, September 13, 2007
13 sep (2)
Mom saw the specialist this afternoon - she had to raise hell to get to him and once she got through he was very apologetic about the infection on his mouth - I'm no expert but the few people I have spoken to feel that with proper attention it wouldn't have happened - they are now putting him on a new course of antibiotics and his body is obviously very compromised so any small infection has the potential of causing major problems. I'll be going down tomorrow with Lyn to lend a bit of moral support to mom and to see for ourselves. Will return on Sunday and Mads will probably be flying up from CT on Monday. Will report more tomorrow.
With all the good wishes prayers and positive thinking going on those germs dont stand a chance ! Keep it up and thanks.
With all the good wishes prayers and positive thinking going on those germs dont stand a chance ! Keep it up and thanks.
13 September
First the good news:
Temperature slightly down, pulse stable at 86.
Now the neutral news:
tracheotomy not performed today, will be done tomorrow.
Now the other news:
Turns out his knee is broken as well and the pelvis is broken right through, not just cracked as we thought.
and the bad news:
They moved the tube in his mouth to the other side of the mouth this morning, while my mom was there, and found that there was a massive infection under the tube, with some of the lip gone and pus oozing out of the wound. This is ICU at Netcare Greenacres Hospital in PE. How long it takes before it gets to that condition is unknown to me but it probably doesn't happen overnight which makes me wonder about the supervision Colin is getting. They say they are going to move him to isolation, which is in ICU, in a tent, in order to reduce chances of infection. They say he will probably be there for a long time - How long we dont know.
The problem with getting no information, or limited information from the hospital, is that we tend to jump to conclusions - either negative or positive, which could be completely unwarranted. These guys could use some P.r.o! It may be unfair for me to conclude that the lip infection is evidence of negligence on their part but in the absence of any information to the contrary what else can we think? I'm mindful of the fact that his vitals seem to be stable and thankful for that.
More anon.
Temperature slightly down, pulse stable at 86.
Now the neutral news:
tracheotomy not performed today, will be done tomorrow.
Now the other news:
Turns out his knee is broken as well and the pelvis is broken right through, not just cracked as we thought.
and the bad news:
They moved the tube in his mouth to the other side of the mouth this morning, while my mom was there, and found that there was a massive infection under the tube, with some of the lip gone and pus oozing out of the wound. This is ICU at Netcare Greenacres Hospital in PE. How long it takes before it gets to that condition is unknown to me but it probably doesn't happen overnight which makes me wonder about the supervision Colin is getting. They say they are going to move him to isolation, which is in ICU, in a tent, in order to reduce chances of infection. They say he will probably be there for a long time - How long we dont know.
The problem with getting no information, or limited information from the hospital, is that we tend to jump to conclusions - either negative or positive, which could be completely unwarranted. These guys could use some P.r.o! It may be unfair for me to conclude that the lip infection is evidence of negligence on their part but in the absence of any information to the contrary what else can we think? I'm mindful of the fact that his vitals seem to be stable and thankful for that.
More anon.
Wednesday, September 12, 2007
12 sept
Colin's temperature rose slightly again today but not as bad as before - his eyes are opening quite often but not registering anything - they seem to be reducing the anesthesia in the weaning process. He grimaces with pain and seems to want to cough. They will be performing the tracheotomy tomorrow. The specialist actually spoke to my mom this morning and was quite pleasant. Another nurse from hell was on duty - told mom that she shouldn't look at the machines or ask questions about the relevance of oxygen volumes, temperature, heart rate etc, mom's tired after nearly two weeks down there. The waking up process is apparently always quite difficult. They have quite severe withdrawal symptoms from the anesthesia, but positive in the sense that there seems to be some light at the end of the tunnel.
More tomorrow.
More tomorrow.
12 sept
Spoke to mom last night - his temperature has dropped - not sure exactly what it is and his heart rate is below 90. They are performing a minor op on him today where they take pipes out of his nose and mouth and stick them straight through his throat - standard procedure after 7 days. Mom sounded postitive last night and we could be over the worst. They reduced the sedative slightly yesteday as they want to start weaning him off it, reduced oxygen as well, so things are looking up. Its posible that he could be conscious this weekend some time.
Tuesday, September 11, 2007
11 Sept
Just heard that his temperature has dropped a bit and heart rate is under 100 so that sounds good. I'd like to quote from an email received from Bruce Rothman which probably sums it up and casts a more positive spin on it. Bruce says he's not a doctor but appears to be quite knowledgeable. I think what he says is probably spot on except for the temperature which I think is caused by an infection. I'm not sure how the mechanics of the embolism works. Does it stop the blood supply to the whole lung or to parts of the lung or what and if so how does providing oxygen help?
"Wow! Horror of horrors that bone marrow has caused an embolism in his lungs (from what's been said, nobody uses the word but that's what it's got to be), as it can cause suffocation, so good that the boy is on oxygen to limit the possibility of damage to the brain. Hopefully he'll suffer no more than the consequences of a transcient ascemic attack. In a way I'm relieved that his body temperature is so high as this would appear to reflect the effort of his body to get oxygen to his lungs. The heart is obviously working furiously which I think means that his brain is saying "give me oxygen!" and is not going to give up! Hopefully his liver and other organs are working as furiously to filter out any marrow material and that he'll soon wake up with that "pop" feeling (akin to surfacing from a day long hangover), and that all will be OK!"
"Wow! Horror of horrors that bone marrow has caused an embolism in his lungs (from what's been said, nobody uses the word but that's what it's got to be), as it can cause suffocation, so good that the boy is on oxygen to limit the possibility of damage to the brain. Hopefully he'll suffer no more than the consequences of a transcient ascemic attack. In a way I'm relieved that his body temperature is so high as this would appear to reflect the effort of his body to get oxygen to his lungs. The heart is obviously working furiously which I think means that his brain is saying "give me oxygen!" and is not going to give up! Hopefully his liver and other organs are working as furiously to filter out any marrow material and that he'll soon wake up with that "pop" feeling (akin to surfacing from a day long hangover), and that all will be OK!"
Monday, September 10, 2007
10 Sept (2)
Just heard from Lyn who heard from mom - temperature is still raging - mom says it feels like putting her hand under a hot water tap when she feels his head. Perspiration running down forehead and arms. Sister says she thinks the fever is breaking and that his temperature is "a little down" - maybe she's right. Will update more tomorrow.
10 September 2007
Mom spoke to the specialist this afternoon. He says that the cultures have come back clear but that they have taken more specimens for culturing. He says Colin has not contracted Pneumonia but has "lung shock". He was quite blunt and unsympathetic, from what I can gather and just repeated himself when mom asked him what "lung shock" is - you can find out more on
http://www.medterms.com/script/main/art.asp?articlekey=7817
The mortality rate for lung shock seems to be better than for pneumonia whilst on a ventilator 30% as opposed to 40%, but can be causd by pneumonia.
The specialist says that it was probably caused by bone marrow and that it could also have got into his brain and caused some damage there. Only time will tell.
I think the biggest danger is the temperature. How this specialst can say there is no pneumonia and almost imply that there is no infection because the cultures are negative seems to me to be an attempt to mislead us intentionally. There is clearly a serious infection as he has a serious temperature and they haven't been able to identify the specific bacteria yet. Why not just say it?
Well keep up the good wishes and thanks to all the Old Selbornians who are phoning in - I dont think Colin is going to be running around too much at the reunion but Deus Dixit, he will be back in East London.
http://www.medterms.com/script/main/art.asp?articlekey=7817
The mortality rate for lung shock seems to be better than for pneumonia whilst on a ventilator 30% as opposed to 40%, but can be causd by pneumonia.
The specialist says that it was probably caused by bone marrow and that it could also have got into his brain and caused some damage there. Only time will tell.
I think the biggest danger is the temperature. How this specialst can say there is no pneumonia and almost imply that there is no infection because the cultures are negative seems to me to be an attempt to mislead us intentionally. There is clearly a serious infection as he has a serious temperature and they haven't been able to identify the specific bacteria yet. Why not just say it?
Well keep up the good wishes and thanks to all the Old Selbornians who are phoning in - I dont think Colin is going to be running around too much at the reunion but Deus Dixit, he will be back in East London.
9 September 2007
Well this morning his temperature was still high at 38.4 although he actually felt hotter. His hands are very swollen as is his neck. His breathing was however more relaxed and not like he was running a marathon. Probably because his heart rate was down a bit to 118. The nurse from hell was on duty again – not really from hell but as officious as hell. Spoke to Oom Johnny Rautenbach, Ilse's uncle in PE, who is a doctor, who confirms that they can keep people like that for a long time, (unconscious and on a ventilator) so it appears that everyone who knows confirms that although it looks pretty scary, its quite normal if you're used to that sort of thing.
We drove back this afternoon and haven't heard from mom and Lynette so won't be worrying them. The hospital has mom's cell number and will phone him if anything goes wrong, so everytime her cell phone rings our hearts skip a beat. So I haven’t phoned her and she hasn't phoned me – no news is good news at this stage. I'll be going down again next weekend, maybe bringing mom back depending on progress. Lyn is coming back tomorrow with Colin's work bakkie.
We have ICU's phone number and will phone tomorrow night to speak to our friendly sister who should be on duty then.
To sum up his status. He is totally under sedation and unconscious. It is unlikely that he has more than fleeting seconds of very confused consciousness in a day. He grimaces with pain when they turn him onto his left side every four hours and you can see that he is trying to cough every few minutes. He has slime and mucous building up in his lungs which needs to be drained periodically and this causes him discomfort so he is not so far under that he doesn't feel some pain and discomfort but he's pretty far down. Although it all looks quite scary and there is still danger until he starts breathing on his own, that's not going to happen until the lung infection clears up substantially. At the moment there's a third world war raging in his body and theres no doubt that the good guys will win, but it may still take a few more days. One of the friendly male sisters described his situation as "critical but relatively stable", which pretty much sums it up.
Keep up the good thoughts, prayers and positive thinking and thanks to all.
We drove back this afternoon and haven't heard from mom and Lynette so won't be worrying them. The hospital has mom's cell number and will phone him if anything goes wrong, so everytime her cell phone rings our hearts skip a beat. So I haven’t phoned her and she hasn't phoned me – no news is good news at this stage. I'll be going down again next weekend, maybe bringing mom back depending on progress. Lyn is coming back tomorrow with Colin's work bakkie.
We have ICU's phone number and will phone tomorrow night to speak to our friendly sister who should be on duty then.
To sum up his status. He is totally under sedation and unconscious. It is unlikely that he has more than fleeting seconds of very confused consciousness in a day. He grimaces with pain when they turn him onto his left side every four hours and you can see that he is trying to cough every few minutes. He has slime and mucous building up in his lungs which needs to be drained periodically and this causes him discomfort so he is not so far under that he doesn't feel some pain and discomfort but he's pretty far down. Although it all looks quite scary and there is still danger until he starts breathing on his own, that's not going to happen until the lung infection clears up substantially. At the moment there's a third world war raging in his body and theres no doubt that the good guys will win, but it may still take a few more days. One of the friendly male sisters described his situation as "critical but relatively stable", which pretty much sums it up.
Keep up the good thoughts, prayers and positive thinking and thanks to all.
8 September 2007
Me and Ilse drove down from East London today. Mom has been here exactly a week and Lynette flew down yesterday morning. We saw Colin this afternoon and this evening. He is still in ICU and will apparently be here for a lengthy period of time. This afternoon we spoke to two sisters – both started off aggressively. The one because there were three of us at his bedside instead of two and the other because I was reading the charts at Colins bed. My mom tried to reason with the first one but to no avail, and although my first reaction was to be sarcastic or equally officious with the other one, I suppressed the emotion and ended up trying to draw whatever information I could out of her. It turned out that she actually didn’t know much, and in retrospect, probably knew nothing about Colin, and was probably guessing about what she told us.
This evening visit was like a breath of fresh air by comparison. The sister was sent straight from nursing heaven. Friendly, compassionate, caring, a real lady of the lamp. She explained to us that although they were not permitted to express opinions to family members, she was of the view that Colin had definitely contracted pneumonia and that he would be in ICU for a long time. How long is a long time is anyone’s guess, it seems. Even our angel wasn’t prepared to commit herself on that one. She didn’t seem to be overly concerned about Colin’s appearance and indicated to the patient next to us who was seeing visitors and looking quite good, who she said had been flat lining a few days before.
This morning his heart rate was 68, but this afternoon it had shot up to 128 and his temperature was 38.5. This evening his heart rate was down to 122 but I didn’t check his temperature although it felt hotter. They are taking regular cultures of lung fluid, blood, urine and testing to see what the best antibiotics are to give him. His lungs have obviously been compromised by years of abuse and it will obviously take longer than normal before they heal. Hopefully he will be able to leave the smokes behind him. We asked the sister whether his body and his heart in particular could sustain such a high heart rate. She assured us that it would be no problem for someone “as young as Colin”.
Being on such heavy sedation, and being artificially ventilated has a number of unpleasant but unavoidable consequences. One of them is that when they wean the patients off the sedatives that they suffer from withdrawal symptoms. The patient in the bed next to Colin was going through such a process and was moaning and growling into his oxygen mask. They also have to wean them off the ventilator and this they have to do whilst the patients are conscious, and this is apparently quite difficult, and if he remains on the ventilator for a few more days, might have to perform a tracheotomy, which sounds scary, but is quite a routine procedure, which makes breathing and draining the lungs a lot easier.
His status remains critical but relatively stable. His hands and neck are swollen but this is apparently a normal consequence of the ventilation. He opened his eyes a few time this afternoon, but there was clearly nobody home. Pupils were rolled back in the sockets and he reminded me of the patient in the movie “Jacobs Ladder” which some of you might be familiar with. I am sure he is going through similar journeys and battles. It is quite scary to think that as we speak and go about our daily routine, that he is there, lying on his back, panting through a small hole in his mouth, with oxygen being forced down tubes into his lungs. On the positive side, the oxygen supply being given to him is set at the minimum setting. The original plan was to take him off the ventilator today, but it seems like it might still be a few days before that happens.
Obviously there is no interaction between us – it is possible but unlikely that he can actually hear what we are saying, if he can hear anything at all. He was apparently fighting against the tubes this afternoon and they had to sedate him a bit more but apparently that is quite normal.
There is some confusion and conflicting reports about whether Colin’s hospital plan pays for all of this as it is obviously an expensive exercise. I have got all the relevant phone numbers and will be writing letters and sending faxes on Monday, to find out exactly what the position is. Colin was quite concerned about the financial implications after the accident, and so are we, and will be quite relieved once we know what the position is. The conflicting reports range from yes we cover three days in hospital to yes we cover 100 days in hospital so there’s quite a difference. If its only three days at least we know that we’ve got to start making contingency plans. As far as the hospital is concerned we are all really impressed with it. It imparts confidence, although sometimes some of the staff seem a bit detached and uncaring, as if the patients are just on a production line. I also get the feeling that because we are in another town, and don’t know the doctors personally, that we are treated a little as “outsiders”. Thank heavens for that caring sister this evening – I told her that she is an angel.
Me and Ilse are returning to East London tomorrow after visiting hour, and Lynetter either later or on Monday. Mom will probably remain here till he gets out of ICU or comes off the critical list. I will probably come back next weekend by which time I am sure things will be looking up a lot.
I don’t think heaven is ready for Colin yet. He’ll cause too much disruption. Will report again asap.
This evening visit was like a breath of fresh air by comparison. The sister was sent straight from nursing heaven. Friendly, compassionate, caring, a real lady of the lamp. She explained to us that although they were not permitted to express opinions to family members, she was of the view that Colin had definitely contracted pneumonia and that he would be in ICU for a long time. How long is a long time is anyone’s guess, it seems. Even our angel wasn’t prepared to commit herself on that one. She didn’t seem to be overly concerned about Colin’s appearance and indicated to the patient next to us who was seeing visitors and looking quite good, who she said had been flat lining a few days before.
This morning his heart rate was 68, but this afternoon it had shot up to 128 and his temperature was 38.5. This evening his heart rate was down to 122 but I didn’t check his temperature although it felt hotter. They are taking regular cultures of lung fluid, blood, urine and testing to see what the best antibiotics are to give him. His lungs have obviously been compromised by years of abuse and it will obviously take longer than normal before they heal. Hopefully he will be able to leave the smokes behind him. We asked the sister whether his body and his heart in particular could sustain such a high heart rate. She assured us that it would be no problem for someone “as young as Colin”.
Being on such heavy sedation, and being artificially ventilated has a number of unpleasant but unavoidable consequences. One of them is that when they wean the patients off the sedatives that they suffer from withdrawal symptoms. The patient in the bed next to Colin was going through such a process and was moaning and growling into his oxygen mask. They also have to wean them off the ventilator and this they have to do whilst the patients are conscious, and this is apparently quite difficult, and if he remains on the ventilator for a few more days, might have to perform a tracheotomy, which sounds scary, but is quite a routine procedure, which makes breathing and draining the lungs a lot easier.
His status remains critical but relatively stable. His hands and neck are swollen but this is apparently a normal consequence of the ventilation. He opened his eyes a few time this afternoon, but there was clearly nobody home. Pupils were rolled back in the sockets and he reminded me of the patient in the movie “Jacobs Ladder” which some of you might be familiar with. I am sure he is going through similar journeys and battles. It is quite scary to think that as we speak and go about our daily routine, that he is there, lying on his back, panting through a small hole in his mouth, with oxygen being forced down tubes into his lungs. On the positive side, the oxygen supply being given to him is set at the minimum setting. The original plan was to take him off the ventilator today, but it seems like it might still be a few days before that happens.
Obviously there is no interaction between us – it is possible but unlikely that he can actually hear what we are saying, if he can hear anything at all. He was apparently fighting against the tubes this afternoon and they had to sedate him a bit more but apparently that is quite normal.
There is some confusion and conflicting reports about whether Colin’s hospital plan pays for all of this as it is obviously an expensive exercise. I have got all the relevant phone numbers and will be writing letters and sending faxes on Monday, to find out exactly what the position is. Colin was quite concerned about the financial implications after the accident, and so are we, and will be quite relieved once we know what the position is. The conflicting reports range from yes we cover three days in hospital to yes we cover 100 days in hospital so there’s quite a difference. If its only three days at least we know that we’ve got to start making contingency plans. As far as the hospital is concerned we are all really impressed with it. It imparts confidence, although sometimes some of the staff seem a bit detached and uncaring, as if the patients are just on a production line. I also get the feeling that because we are in another town, and don’t know the doctors personally, that we are treated a little as “outsiders”. Thank heavens for that caring sister this evening – I told her that she is an angel.
Me and Ilse are returning to East London tomorrow after visiting hour, and Lynetter either later or on Monday. Mom will probably remain here till he gets out of ICU or comes off the critical list. I will probably come back next weekend by which time I am sure things will be looking up a lot.
I don’t think heaven is ready for Colin yet. He’ll cause too much disruption. Will report again asap.
6 September 2007
Colin was following his passion, paragliding, in Bedford on Saturday 1 September 2007, when just after take-off a gust of wind caused a full frontal collapse of his canopy. He was about 30m in the air and too low to recover. The canopy apparently partially filled but according to Colin, this seemed to aggravate the situation and accelerated his downward flight onto the rocks below. In time we will able to joke with him about his accident on Spring day. It has always been a favourite day of his.
Fortunately the other members of the Hawkwind Hangliding and Paragliding Club (www.hawkwind.co.za) were on hand and this is the report from them per Cal Dyker, Colin’s instructor:
“Just to fill you all in about Colin Kemp's crash in Bedford
Just after take off on thr NW side he had a full frontal\90 % collapse. He was probably 20-30 meters high and just off the first step of the launch.
He was to low to recover and was facing the mountain when he hit.
He suffered a broken Femur, broken pelvis (front and back) and broken upper arm, all on the left hand side.
We got to him in less than a minute and ran through basic first aid. Thank goodness for Jackie’s first aid kit, I gave Colin a Voltarin shot and Pierre (Doc) was luckily on hand to administer a drip and was a huge help in keeping Colin stable.
Thanks to Karen and Theo for organising a army chopper to evacuate Colin.
Thanks also to all present for helping and supporting.”
I saw Colin the day after his accident and was pleasantly surprised at what I saw. He was obviously in a lot of pain and discomfort but fully compos mentis and in relatively good spirits. He was a bit grumpy about not being able to smoke but quite philosophical about it. We bought him some Nicorettes.
Mom managed to book into accommodation right across the road from the Greenacres hospital and has been there for a week. According to her Colin was in a lot of pain before the op on Monday night, which was exacerbated by spasms which he was getting, causing the broken bones to move around but by Tuesday he asked the nurses to take him off the morphine and things were looking good, although he was still getting the spasms which were still causing him to cry out with pain.
On Tuesday night he started struggling to breathe and eventually apparently stopped breathing and was rushed to ICU where they stuck tubes in his lungs and put him on a ventilator. He also developed an infection and they have taken blood samples to try and identify which nasty little bugs they have to try and eradicate but at the time of writing he seems to be coping with the infection.
Lynette flew down to PE this morning, and was very pleased with what she saw – his colour is good, his kidneys and heart are all functioning and his eyes opened momentarily a few times.
They plan to keep him under heavy sedation for a day or two longer, until they can safely stop ventilating him artificially. Apparently the blood marrow can escape into the blood stream when a person suffers from bad fractures and that can create clots and when they get into the lungs, as apparently happened with Colin, can cause the person to stop breathing completely.
Evey day that passes brings him closer to the day when his bones will have completely healed. He fractured his left upper femur, a few inches under the hip joint, so there was fortunately no particular involvement, but it was badly fractured, with about three pieces displaced, and the pelvis was apparently not a bad fracture but even a slight fracture can be extremely debilitating and he will have to be flat on his back for at least six weeks. He then also had a fractured left arm right at the top inside the shoulder joint, from what I could make out on the x-rays. They have wired up both the leg and the arm but the pelvis has to heal on it’s own.
When I spoke to him Colin was very thankful of the fact that he had survived and that he had not broken his back or his neck. He is not allowed to have a cell phone in the High Care unit where he will be transferred to once he leaves ICU but within a week or so will have his cell phone with him. It is not clear at this stage when he will be permitted to come back to East London, but it looks like it will be in an ambulance when it happens, probably in about two weeks time, and then into a hospital here for a few weeks.
We are all very thankful for all the calls we have been getting from friends and family from here, from other parts of South Africa and from across the world. I must also mention that our cousin Esmé is on a long road to recovery after undergoing a relatively routine procedure in Cape Town and unfortunately contracting septicaemia. She underwent six operations in the space of a few days and it was touch and go for most of the time. She is at home but still very frail and with long term complications that still need to be resolved. Please also spare a thought for her and her family.
I will keep you all posted as things develop and am confident that in a few days will be able to post some photographs of Colin together with some good news about his recovery.
Special thanks to all at Kemp Estates for keeping the flag flying and to all Colin’s colleagues for your support and good wishes.
Leon Kemp
Fortunately the other members of the Hawkwind Hangliding and Paragliding Club (www.hawkwind.co.za) were on hand and this is the report from them per Cal Dyker, Colin’s instructor:
“Just to fill you all in about Colin Kemp's crash in Bedford
Just after take off on thr NW side he had a full frontal\90 % collapse. He was probably 20-30 meters high and just off the first step of the launch.
He was to low to recover and was facing the mountain when he hit.
He suffered a broken Femur, broken pelvis (front and back) and broken upper arm, all on the left hand side.
We got to him in less than a minute and ran through basic first aid. Thank goodness for Jackie’s first aid kit, I gave Colin a Voltarin shot and Pierre (Doc) was luckily on hand to administer a drip and was a huge help in keeping Colin stable.
Thanks to Karen and Theo for organising a army chopper to evacuate Colin.
Thanks also to all present for helping and supporting.”
I saw Colin the day after his accident and was pleasantly surprised at what I saw. He was obviously in a lot of pain and discomfort but fully compos mentis and in relatively good spirits. He was a bit grumpy about not being able to smoke but quite philosophical about it. We bought him some Nicorettes.
Mom managed to book into accommodation right across the road from the Greenacres hospital and has been there for a week. According to her Colin was in a lot of pain before the op on Monday night, which was exacerbated by spasms which he was getting, causing the broken bones to move around but by Tuesday he asked the nurses to take him off the morphine and things were looking good, although he was still getting the spasms which were still causing him to cry out with pain.
On Tuesday night he started struggling to breathe and eventually apparently stopped breathing and was rushed to ICU where they stuck tubes in his lungs and put him on a ventilator. He also developed an infection and they have taken blood samples to try and identify which nasty little bugs they have to try and eradicate but at the time of writing he seems to be coping with the infection.
Lynette flew down to PE this morning, and was very pleased with what she saw – his colour is good, his kidneys and heart are all functioning and his eyes opened momentarily a few times.
They plan to keep him under heavy sedation for a day or two longer, until they can safely stop ventilating him artificially. Apparently the blood marrow can escape into the blood stream when a person suffers from bad fractures and that can create clots and when they get into the lungs, as apparently happened with Colin, can cause the person to stop breathing completely.
Evey day that passes brings him closer to the day when his bones will have completely healed. He fractured his left upper femur, a few inches under the hip joint, so there was fortunately no particular involvement, but it was badly fractured, with about three pieces displaced, and the pelvis was apparently not a bad fracture but even a slight fracture can be extremely debilitating and he will have to be flat on his back for at least six weeks. He then also had a fractured left arm right at the top inside the shoulder joint, from what I could make out on the x-rays. They have wired up both the leg and the arm but the pelvis has to heal on it’s own.
When I spoke to him Colin was very thankful of the fact that he had survived and that he had not broken his back or his neck. He is not allowed to have a cell phone in the High Care unit where he will be transferred to once he leaves ICU but within a week or so will have his cell phone with him. It is not clear at this stage when he will be permitted to come back to East London, but it looks like it will be in an ambulance when it happens, probably in about two weeks time, and then into a hospital here for a few weeks.
We are all very thankful for all the calls we have been getting from friends and family from here, from other parts of South Africa and from across the world. I must also mention that our cousin Esmé is on a long road to recovery after undergoing a relatively routine procedure in Cape Town and unfortunately contracting septicaemia. She underwent six operations in the space of a few days and it was touch and go for most of the time. She is at home but still very frail and with long term complications that still need to be resolved. Please also spare a thought for her and her family.
I will keep you all posted as things develop and am confident that in a few days will be able to post some photographs of Colin together with some good news about his recovery.
Special thanks to all at Kemp Estates for keeping the flag flying and to all Colin’s colleagues for your support and good wishes.
Leon Kemp
Subscribe to:
Posts (Atom)
