Monday afternoon report finally:
Melanie was very informative this afternoon. She said Aunt Edna was there all day. The take downs on the arms showed good pink adhering grafts with good granulation showing. There was no takedown on the scalp yet. In a couple of days it will happen. His shoulders have biograin (a fine mesh dressing) on them so you can't really see what is going on there. His left foot looks like the skin of a baby foot and there is one small spot on the right that they are watching. It is a little open where there was a second degree burn.

Michael's vent settings are still good. He's been on 40% for over 24 hours and if it keeps going they will try something different (a T piece) ---type of trach tube. His BUN and Creatinine are still elevated but he is adequately filtering (that means producing urine) so they don't have to put him on dialysis.

He has been a little more awake. Following commands and trying to form words. They are trying to wean him to oral pain meds.(oxycodone) There is a small area on his face/forehead that they may graft on what day?(there was an ambulance rolling in at my work...sorry I missed what day....maybe Thursday???)

He is going to get antibiotics for about two more days.

and so the afternoon report is done. It is not quite midnight here but I wish you all safe and sweet dreams.
More later,
and so we go
JaCee

Monday afternoon
There is a report but I have to work right now....will get to you when it slows down or I get off work
More later
and so we go
JaCee

Monday 08/31/09
Luke, the night nurse, said Michael is still doing pretty good. They decreased his vent settings. fiO2 is now 40% and they are still weaning his sedation medicines. He said they took down his grafts (burn lingo for unwrapped the sites where the grafts are) and said they are looking good. Forgot to mention that Bette said he has "isotoner-like " gloves now. Michael got 2 units of blood last night. There is some sort of physiological process with burn patients so that they don't make enough erythropoeitin (sp) so they need blood from time to time. If any of you can explain it to me please feel free... I will try to research it, too.
okay that's the morning report. Luke is a man of few words.
More later,
and so we go
JaCee

Sunday afternoon
The "mom" report: Bette wanted me to let you know that they mostly messed around with Mike's medication today. There will be a new doctor rotating through the burn trauma unit. We aren't exactly sure if they are on a two or four week rotation schedule... as long as the doctor is fabulous...
Aunt Edna will be with Mike tomorrow since Bette had to go to Pocatello to gather some things for her stay. She is with Chris and Karen and hopefully will be able to rest.
To all of you good night and thanks for your prayers for Michael.
More later,
and so we go
JaCee

Sunday 08/30/09
Luke (night nurse) said "he's doing great!" Remember I told you that it really takes a lot to get nurses excited? So this must be good news!! Mike has remained stable throughout the night. They are trying to wean the sedation medicine, propofol and so they have started seroquel, which in small doses, has a tranquilizing effect and is good for weaning. And no, just because it's a bipolar medicine doesn't mean that Mike has that.

I am finding that the course of burns are, in and of themselves, a different breed of injuries and have their own definition of how to treat and heal and seems to follow no other course that I have seen... sure, I have seen and treated first and second degree burns, even referred patients to the burn unit for minor <1%

Continuing; Mike is on pressure support again (yay) His vent settings are 50% fiO2. Renal function is still not pre-renal failure (BUN 52, Cr 3.2) The good news about this is that his urine output has gotten better. His blood gases are good. He has completed the vancomycin protocol, and remains on zosyn as the antibiotic. It looks like there are some preliminary growths on the lung cultures but blood and urine are still pending. Luke RN said that his feet are looking pretty good now. His face is burned from the nose-line up to the top his head and over his scalp. He said that, because the face is so vascular and has a great blood supply, that sometimes the body will heal without grafts. It is going to be a waiting game. Pray for patience! and healing, and good lung function, and....and..... and......
More later,
and so we go
JaCee

Saturday afternoon

The "mom" report: Mike's face is less swollen today. He is able to nod or shake his head when asked questions. He became active/agitated a lot today and waved his arms and legs about. His feet actually look pretty good. The left looks almost perfect and the right has a small area that is questionable but nothing like when he first came in. What a relief that is. Bette got to participate in oral care of Mike. Earlier, when he wasn't quite aware of things, he bit a sponge in half while a nurse was attempting to do oral care. Now, he seems to appreciate his oral care. There is still a lot of suctioning and maintenance that has to happen. His oxygenation and blood pressure seemed adequate today. Bette stepped out with Aunt Edna for lunch when they were doing dressing changes. So into the night they move...going forward as the adventure of suctioning, pain control, blood levels, healing and the challenge of oxygenating continues.

More later,

and so we go

JaCee

Saturday 8/28/09

The night nurse, Luke, said Mike is doing pretty well. They are giving him some blood due to low hematocrit (measures the blood) and his blood pressure was a little low (yeah, I'd say 60 systolic is low too) The burn nurses are really cool because it takes a lot to make them get excited. The doctors reported that the bronchoscopy showed a lot of secretions but under there, somewhere was pink lung tissue. This is encouraging. Better pink than black, eh?

Not much else was said...the usual...."he's holding his own"

More later,

and so we go

JaCee

Friday late afternoon:

The "mom" report:

Mike went to surgeryat 11:45am and didn't get back to the room until 4:30pm. They did grafts on his chest, shoulders and the back of his head with the donor site being his lower back. He was face down for a good portion of the surgery and his face and lips were swollen. He got new lines in place and had a bronchoscopy, which showed extensive lung damage. Bette says that the doctors say that if they can keep on top of the secretions and infection it will help determine the overall outcome.

Mike's urine output has shaped up...(yay) His oxygenation is at 100% but he is also on 100% oxygen. Bette says that there is a really cool sling that they have under Michael and it makes is easy to lift him and position him. Comes in handy for x-rays He is pretty zonked right now so let's wish him a night of rest and recovery.

More later

and so we go

JaCee

Friday afternoon:
Talked with Bette. Mike is currently in surgery (2:30pm SLC time). They are doing his shoulders and chest. He is still febrile (100.4 F) That's 38 C... (the conversion is: Farenheit - 32 divided by 1.8 = Celcius so: Celcius x 1.8 + 32 = Farenheit) In other words, Mike had a 104 degree Farenheit temp this am. (The nurses only talk in Celcius there) His urine output is better but she didn't have any numbers for me.
Bette said that Mike has to be on his stomach for part of the surgery which can make it a challenge for the anesthesiologist, but they somehow manage it. So if you get this promptly, pleas say a little (or preferably BIG) prayer for Mike during surgery right now.
More later,
and so we go
JaCee

Friday 8/28/09
Luke, the night nurse said that Mike has had a lot of lung secretions. He is still running a fever. His vent settings have been raised to 60% fiO2 and his oxygen saturation hovers at around 91% ( 90-100% is normal). They were waiting for the morning lab results. The kidney function tests (BUN and Creatinine) were elevated but when you calculate the ratio it is still pretty good and doesn't indicate pre-renal failure. (yes, I calculated it and the ratio is 16 for those of you who care to know) His urine output was better during the night. His antibiotics were changed to vancomycin and zosyn (bring out the big guns!) Blood, urine and lung secretion cultures have been taken to see if they can determine a source for the fever. Depending on his breathing, they may take him to surgery to change out lines and whatever else. I will talk to Bette (mom) a little later.
His sedation is for comfort now. He is not as snowed as a couple of days ago and can nod his head when asked questions.
More later,
and so we go
JaCee

Thursday afternoon:

The "mom" report: Bette and Aunt Edna stayed with Mike today. He had a fever (40c) and was not producing much urine. They changed his antibiotics (to what? I will tell you later) and they changed his pain meds, as well as the nutrition formula. It sounds like that helped with urine output. The doctor told Bette that they might have to put Mike on dialysis, if he doesn't shape up. I guess they do pretty well on it and the doctor made it to not sound like a huge thing, but still... (freaking out here!)... Tomorrow, Mike will go to surgery to change the arterial line, in case that's a source for infection.

Bette will move to hospital guest housing tomorrow. It will be a closer drive than Bountiful, where she is currently staying with Paul and Christy. Thanks for being such angels during this time!!!

I will inform you of any more changes tonight if mom calls me or stay tuned for the morning report.

More later,

and so we go

JaCee

Thursday 08/27/09

What did we miss yesterday? There was a change in Michael's urine output and the labs indicating his kidney function. (BUN and Creatinine were up, for those of you who have to "know", like me!) Bette stayed with him for the day and said they gave him some fluids. Amelia, the night nurse, gave him some albumin. Dr. Saffle is aware and will probably do something later this morning about the urine/kidney thing.

Amelia woke Michael up earlier and said that he was able to nod "yes and no" this morning. So he's in there somewhere! He has been weaned off of versed again and is just getting propofol for sedation now.

His vent settings were changed a little. Evidently, he was weaned to 40% FiO2 (the mixture of oxygen that is going in: room air is 21% and it goes up to 100% with additional oxygen) That setting did not go so well and now they are back up to 60%. He also got the vent working for him last night so he could rest better. By the way, for those "techno-nerds" like me, he has a Shiley 7.0 trach in place.

More later,

and so we go

JaCee

Wednesday 8/26/09

Amelia said that she has kept Mike pretty snowed all night because he was agitated all day. His sedation holiday went well and he opened his eyes and followed all commands and then she put him back under. He had a "big Bertha" bowel movement last night and again tonight which was fun and special for Amelia...lucky her! No fever. No results from morning labs yet. In other words, "he's holding his own...status quo".

More later

and so we go

JaCee

Tuesday 6:40pm (Utah time)

Michael has been doing pretty good today. He is on a continuous antibiotic for his lung infection. He has not been running a fever and his white count looks great. His blood and urine cultures came back negative, which means the infection is only in his lungs. Mary, the day nurse, said they are getting copious amounts of phlegm from the lungs with good suction. It is good to be able to get the junk out. Better out than in, eh?

He is not on the books for the OR yet but it is anticipated that he will head there next week. He has periods of agitation and they are offering pain medicine and sedation when needed.

Bette was there for the afternoon. Her meeting with the insurance people discovered that she will be displaced from her home for at least a couple of months, not weeks, as she was thinking. That is okay, though, because it will allow a stipend for housing for the time they take to remove everything from the upstairs, clean and replace. Mike's side of the duplex will be gutted and remodeled. Chris will be there to help and make sure that Mike's needs are considered as he approaches a homeward journey...there is still a very long road ahead and it is anticipated that his stay in the Burn Unit will take months to complete. The take home that I got today is that he is stable, gracias a Dios.

More later,

and so we go

JaCee

Tuesday 8/25/09 5am:

Mike is doing good, according to Amelia, the night nurse. He has been feverish all day and night so they have been giving him Tylenol and Motrin. He is on IV antibiotics, nafcillin, now. He has been mostly sleeping with the aid of sedation but is starting to wake up. They don't anticipate any difficulties with his sedation holiday, which will happen in a little while. Amelia said his face is looking better. Also, his feet are looking better. They are waiting to see about his shoulders, as well. They may not need to graft them. yay!

The address for cards and beautiful pictures to put on the wall for when Mike wakes up is:

University of Utah

Burn Unit

for patient: Mike Lochridge

50 North Medical Drive

Salt Lake City, Utah 84132

Just thought you might like that information:)

More later,

and so we go

JaCee

Monday afternoon:

Looking at the new grafts went well. They are looking good, according to the day shift nurse, Shawn. He managed to chew a hole in the oral gastric tube so they put in a nasal gastric tube. The sedation continues to be a challenge but they are still trying to wean one and settle with another. Overall, he's holding his own. Way to go Mike!

Thank you all so much for your continued prayers. We have people all over the world praying for our dear Michael and we are so grateful.

more later,

and so we go

JaCee

Monday 8-24-09 (5am)

Talked to Dan, the night nurse, and he said that they had quite a time getting Mike comfortable last night. He has been weaned off his versed and max-ed out on the pain med, fentanyl, so Dan gave him a little versed to see if that would quiet him a bit. The resident is there and they will talk to the attending a little later to find out what to do. There are a lot of secretions coming from Mike's trach and it is good that they can suction that junk out. He is still on antibiotics by IV every 8 hours. Other than that, his blood gases are good (his oxygenation is doing well). He's "holding his own...status quo".

more later

and so we go

JaCee

Sunday (afternoon continued)

Talked to nurse Sarah and she said Mike was doing pretty good. They did a CT scan of his head and neck bones which both looked good. His lung x-rays look better, compared to yesterday. The antibiotics were changed from vancomycin to ancef. He is still on pressure supported ventilation so he is starting his own breaths. Oxygenation is good.

The sedation medication is being weaned to another, shorter acting drug. (from versed to propofol). His urine output has picked up...go kidneys go!

Chris and Karen and Bette were there most of the day. Chris said his lips are not as swollen as before and there is a little colour in them. They all headed to Pocatello for insurance stuff tomorrow. When done, Bette will return to Utah.

Tomorrow, the doctors will take the first look at the grafted areas. It is called a "take down". I am learning new vocabulary with this experience.

So he is still holding his own...

more later

and so we go

JaCee

Sunday 8/23/09

Nothing eventful happened during the night.

Yesterday, Mike went to the OR again to have auto grafts to his upper arms. An auto graft is when they take the donor skin from the person having the grafts. Mike has a lot of skin that is not burned so they are using his own skin for this, which is the best. He developed a fever yesterday and urine and lung sputum cultures were taken. The results showed an infection in the lungs (staph aureus) He has been placed on a super strong antibiotic, vancomycin. His blood counts remain stable. He got a unit of blood yesterday, as well.

He is now on pressure supported ventilations. Mike is initiating the breaths now. yay! He still is on the ventilator.

Mike is coming around a bit more now. They are trying to wean the sedation medication and say that he doesn't really like it. The nurse, Veronica, was getting ready to do a sedation holiday when she finished our conversation.

"He's holding his own....status quo, for the extent of his injuries"

On Monday, the doctors will check the graft sites to see if they are doing what they are supposed to do.

Chris and Karen came down yesterday to visit. I didn't speak to them but I know that mom Bette really appreciates it. She may have to go to Pocatello tonight through tomorrow morning to meed with the insurance people and then drive back to SLC. She doesn't want to be away but some things have to happen in person. Wish her safe travels.

I tried to post this under my name but it wont send emails to those of you who want them, so I hope you don't mind.

more later

and so we go

JaCee

Saturday 8/22/09

Yesterday Mike went to surgery later in the morning-midday and had skin grafts done on his hands up to mid upper arms. The donor sites were packed and wrapped with ace bandages as part of the procedure. There was some blood loss and he will probably get some blood today, according to the night nurse, Ericka. The doctor, Dr. Saffle (attending) and Dr Mawhinny (resident) think that it went well. Mike also got a trach, as mentioned earlier. They are trying to back off on the paralyzing agent to see if they could wake up Mike. He's not so cooperative with that and so they are waiting to see what happens. Last night they tried a sedation holiday and it sounds like Mike is actually breathing on his own a bit. He is not as awake as they would like so a Cat scan of his head may be done. It was scheduled for yesterday but actually did not get done. The CT machine is located on a different floor than the burn unit and Mike's oxygenation was not cooperating so they cancelled the test. The generic answer for "how's he doing?" is, as usual, "He's holding his own" with the caveat; "for the extent of his injuries". I tend to pry and ask more questions so that is why you get a more medical approach to what's happening. I also want to give a running report so you can focus your thoughts and prayers to those areas in need...."please wake up Mike"...I told the night nurse to tell him to "Press on Tiger" It's something our father used to say and maybe it will trigger something in him to keep moving forward.

more later

and so we go

JaCee

Friday (continued again)

This is partially a test to see if you are getting emails every time there is a posting of this blog. Please let me know if you get this, or if you want to be added to the list, please email me at: jclochridge@cox.net

Another thing I found out about Mike and burn patients in general, is that there is an awful lot of calories that the body requires to heal. Sometimes it is taxing to the balance of sugar in the body so there is an insulin protocol initiated by the burn unit. So that means that Mike is getting insulin based on the protocol while he is in healing mode. It doesn't mean that he will be diabetic when all is said and done.

more later

and so we go

JaCee

Friday (continued):

Talked to Bette this afternoon and she said that Mike went to surgery to get some grafts on his arms. He also got a tracheal tube. That will make it easier to manage his airway and all of the secretions that are coming from the lungs. I talked to a respiratory therapist today that used to work at a local burn unit and he said that the lining of the lungs can get a burn just like the skin an after a few days it starts shedding and there is a lot of mucus production. It is a good thing that there is a trach so they can take care of the breathing. By the way, having a trach doesn't mean that it's going to be there forever. It makes it easier to wean off the ventilator and also easy to be placed back on if Mike gets in trouble. I will check in later.

and so we go

JaCee

Friday, 8/21/09
Mike went to surgery yesterday afternoon. Debridement of hands and arms was done. (that means the parts of the skin that was burned needed to be cleared away so there would be a good nutrient base to graft the new skin to) His lungs have produced more phlegm and the vent oxygen setting was turned up to 70% to keep the SaO2 level up. This morning the "sedation vacation" was forgone to keep him stable because there will be a CT (cat) scan of his head and cervical spine. His kidneys are functioning (yay). There is good urine output. more later
and so we go
JaCee

Thursday morning 8/20
At 6:30am (5:30 in Utah) Mike's status was generically "he is holding his own". Later, I talked to Bette and she said that they were waiting for his lungs to cooperate. They said about day 5 that patients can sometimes experience difficulty and it is true with Mike. There was no surgery. He is being observed as of 10am. I will check on him after work. I guess some people can't get on this site. I have tried it in capital letters, small letters, at home and at work (which is not so easy because there are a lot of sites that are not allowed) I have had no problem. I will try to see if I can figure out a way to automatically send emails when I post new information. Please bear with me because I do not have the "saavy" that others do...I will try.......
and so we go
JaCee

Wednesday 08/19/09
Talked to the nurse, Raygen, this am at 6:30 and he said that they woke Mike up at around 4 or 4:30 am and he was able to open his eyes and wiggle his fingers and toes. His blood pressure started to become elevated so they decided to sedate him once again. No other major changes.
more later,
and so we go
JaCee

Tuesday (5pm):

The central line that Mike had was creeping out and so they replaced it so it has better position. Mike went to wound care at 8am and they had to give extra doses of pain meds. A TEE (trans-esophageal echocardiogram) was done and they seemed pleased with the results. Official results are pending. (that means his heart seems to be doing okay) a dobhoff tube (please excuse the spelling) or feeding tube was placed through the nose and directly into the small bowel so feedings could be started. Promo with fiber (a high calorie formula) has been started within the past hour. Mike will require lots of calories for healing at this time.

According to his nurse, Sarah, he is "holding his own" right now and there have been no big changes.

He will head to the OR on Thursday where donor sites for the grafts to head, face, left shoulder, possibly right shoulder and hands will be initiated. It is typical for patients to have a trach placed at this time as well. We will wait and see.

and so we go

On the family side:

There has been an account set up for the family to use for travel and lodging at POTELCO credit union in Pocatello, ID if anyone cares to contribute. Bette is staying with a cousin right now and is waiting for a small room or apartment to become available since we anticipate Michael's recovery to take months. (Just get us over the rough parts this week please!!!)

Chris met with the insurance guys in Pocatello today. Mike's half of the duplex will be gutted. Bette's side will need to have every single thing removed, cleaned and replaced.

more later...

JaCee

August 18, o2oo hours:

Amelia is taking care of Mike tonight. She was there when he first came in. She said she was sad to cut off his pony tail. (hey, he had a little hair? cool!) They have finished the fluid resuscitation protocol and he is now on maintenance fluids. The ventilator has been weaned to 50% and they had to change his paralytic since the other one didn't seem to be working well. His blood pressure is stable. He is hemodynamically stable (good news). He is still producing urine. Yay! With the extensive pulmonary insult, he manages to keep a good blood gas balance. This is the best news. These next few days are critical. sometimes patients experience a "bump" in the road at about 5-7 days with their lung function. We really appreciate your words of encouragement and your prayers.

and so we go

thanks,

JaCee

PLEASE PRAY FOR HIM !!!!!!!

Monday 8-17-09

Mike was involved in a house fire tonight(Saturday, August 15, 2009). He was air lifted to Salt Lake City University Of Utah burn unit.

Bette, Chris Karen, Ted and Mary have all been at the hospital

He received 2nd and 3rd degree burns over 29% of his body. He is critically stable.

He has significant inhalation damage. Burns are over his face, head, chest arms and shoulders. The sole of his feet are also burned.

We have created this blog for information to passed out to concerned parties. As it is hard for Bette to keep repeating the information and it is emotionally draining her.

If you need more information please email Jacee at jclochridge@cox.net She is corresponding with the unit several time a day.