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Dr.
Joe Smith Update
Wednesday,
November 3, 2008
It
was a wonderful Thanksgiving..everyone was home even our oldest
daughter from Miami who was not expected! Joe developed severe
edema in both legs on Sunday. After a trip to Upstate's ER Sunday
night he now is going to St Joe's for a procedure to dissolve
the clots. Please keep him in your prayers.......thanks!
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Monday, November 24, 2008
Joe is HOME!
His
goal of getting back to Otisco Lake has been accomplished!!
The trip was uneventful and the arrival amid the snow flurries
quite Syracuse-like. He is very happy to be home and is appreciative
of SU's winning ways of late. He still has a long way to go
in his recovery. While he appreciates everyone's support and
would like to visit, he is going to be busy with in home therapy
- PT, OT, etc. It would be best to hold off for now and let
him get settled in.
Thank
you so much for the continued prayers and good wishes. It will
be an especially wonderful Thanksgiving for the Smith family
and we hope it is for all of you as well.
God bless!
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Tuesday,
November 11
Joe
has been doing his best to get ready to go home but several
infections have thwarted his efforts. His goal is to be home
for Thanksgiving and we pray that this will happen. It will
be 4 months tomorrow since his accident. We are pretty sure
now that he fell because his pulse dropped so low that he blacked
out. He does not remember falling or the week or so after.
In the course of improvement after a spinal cord injury, 4 months
is not a long time... we are gearing up for the long run to
recovery. It will be so good for Joe to be home!
Please keep him in your thoughts and prayers....thanks so much!
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Wednesday, November 5, 2008
Since
the last entry Joe has had a visit from his best buddy, his
dog Theo, orchestrated by daughter Erica and has celebrated
a birthday, another year older and wiser! The rehab dance continues
with small steps of progress accompanied by a few expected missteps
or problems. There are more goals to be met before heading home
but that is what he remains focused on…..it is hard to
find Boeheim’s Orangemen on the NYC/NJ TV channels! Our
many thanks for the continued prayers and good wishes…God
bless!
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Tuesday,
October 21, 2008
Two
steps forward, one step back; one step forward, two steps back….such
is the dance of rehab. On many fronts Joe is doing better! He
has greater use of his right arm and hand, his neck and core
muscles continue to strengthen. His driving ability in the power
chair is so good he is about to trade his learner’s permit
in for a full license. He passed his swallowing test and is
now enjoying nectar and soon fine, chop foods.
Only
the respiratory/trach status has been troublesome. In a mere
6 hours last week he went from thinking the tracheostomy tube
was going to be removed because it was popping out on its own
whenever he swallowed or coughed and he had been off the vent
for three weeks anyway to experiencing a drop in oxygen saturation
necessitating a part-time return to the ventilator. The theory
is that his diaphragm was just tiring out and he would benefit
from going on the vent at night to allow it to rest. This has
been helpful and apparently such setbacks are not unexpected.
Right
now Joe is very focused on doing whatever he needs to do to
get home. Plans are being made and equipment ordered to help
make this happen. We are expecting him to be in his place at
the head of the table for Thanksgiving dinner. Your prayers
and support have helped and will continue to help him achieve
this goal. Heartfelt thanks to all!
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Wednesday, October 8, 2008
And
the beat goes on……..Joe is getting a bit stronger
each day. He can now wash his own face and use the Yankhauer
tube to suction his mouth at times. His head and neck and core
strength are slowly improving. He is tolerating having his trach
tube capped most of the time. This means he is breathing through
his mouth and nose like the rest of us! However the saga of
the trach continues….he had trouble last Thursday and Friday
nights with a shorter tube that kept popping out. The specialist
in NYC assessed him, treated the stoma area but said he would
prefer to do an examination under anesthesia to really be sure
the trachea is clean and healthy. At this point we are praying
for continued progress so the trach tube can be removed altogether.
He won’t be out of the woods with respect to the granuloma
for several more weeks. Please keep the prayers going…God
bless you all and thanks. There is no way we can ever repay
some of you………
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Tuesday, September 30
Everything
has been going quite well for Joe. The biggest thing looming
over his head is the tracheal granuloma. He has been on steroids
and antibiotics to help shrink this bothersome tissue. The plan
is Thursday to examine the area and if it has resolved, replace
the #8 long with a regular length #4 trach tube. He will be
traveling into NYC Friday to see a tracheal specialist at Mt.
Sinai whether the situation is improved or not. This is where
he would have to go for further treatment if it is necessary.
He is very anxious to put this complication behind him so he
can focus on getting stronger. But a patent airway trumps all
else! Again prayers are appreciated for resolution of these
tracheal issues. Thanks so much!
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Wednesday, September 24, 2008
Ah,
the beauty of a quiet uneventful day…..PT, swallowing practice,
OT, spending time on the outside patio enjoying the warmth and
soft fall breezes. That was today. Yesterday was another story.
Recurrence of the tracheal obstruction sent Joe back to the
hospital ER. Another bronchoscopy was done confirming again
the presence of granulomatous tissue blocking the end of his
trach tube. That tube was removed and replaced with a longer
one bypassing the area of obstruction. This ensured a patent
airway and allowed for the removal of secretions. He will be
on steroids and antibiotics for awhile even as the process of
decreasing trach size resumes. Meanwhile he continues to breathe
well off the vent all day and night.
Let’s
pray for quiet uneventful days…….
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Thursday, September 18, 2008
A
long but rewarding day…..Joe’s repeat bronchoscopy
showed that he had responded well to the medical treatment.
The area of granulomatous tissue had shrunk significantly allowing
the removal of the long tracheal tube and replacement with a
shorter smaller one. He tolerated the procedure well and was
back at Kessler by evening. Now hopefully it will be back to
kicking butt in therapy in the morning! Everyone’s prayers,
good thoughts, support, and a tincture of time have helped again…thanks
so much!!
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Thursday, September 11, 2008
Today
Joe had a serious setback. Early in the morning he had difficulty
breathing. When an attempt was made to suction him, the catheter
could not be inserted beyond the end of trach tube due to an
obstruction. He was transferred to the ER where 2 bronchoscopies
confirmed the obstruction. He ended up in the OR for examination
under anesthesia and placement of a longer trach tube whose
opening was below the level of the obstruction allowing for
better air flow. The ENT doctor said his airway was 90% occluded!
Treatment now is with steroids and antibiotics in hopes of shrinking
the tissues. If this does not occur, other treatment options
are difficult.
Please
pray for Joe and for resolution of this airway obstruction.
It is amazing that he had been doing so well breathing on his
own. ……what a difference a day makes.
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Wednesday, September 10, 2008
Dr.
Joe (as they call him around here) slept the whole night breathing
on his own for the first time! He did great!! His only complaint
was a dry mouth and throat from not having the humidifying effects
of the vent. This can be remedied by a trach collar with mist.
The other big news is with lots of SUPPORT he stood upright
for the first time in 8 weeks. He will not be able to do this
independently for many more weeks but at least he has a reminder
of what it’s like to stand 6’4”! Each day he
is more eager to hit the gym and get back in shape. The progress
is excruciatingly slow but each little bit gets him closer to
realizing his potential. Outside of the gym he continues to
work on his swallowing, a much more complex activity than one
would imagine. He has dreams of a Bellevue sundae in his future!
We
have finally been able to share most of the emails on the gmail
site….he was amazed at all the good wishes and expressions
of concern. Once again thanks to all for the tremendous support!
God
bless!
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Wednesday,
September 3, 2008
Finally after being at Kessler for just over a month (not counting
the first time pre-pacemaker) Joe is truly in rehab mode. So
many little problems that had been in the way of really moving
forward now seem gone. He is sleeping well and at night (!),
can tolerate sitting upright for extended periods of time, is
off the ventilator all day until bedtime, and is really able
to focus on the physical strengthening that is so important.
His weight is right where it should be for a spinal cord injury
patient. Amazingly he is finding Jevity 1.5 satisfying and has
not asked for any apple pie ala mode!! Soon he will be set loose
in a motorized wheel chair…..watch out! The swallowing
is still weak so he is receiving electrical stimulation to help
strengthen the appropriate muscles. He is working hard every
day and has regained that sense of focus for which he is so
known! No one can say for sure where this path will take him
but for sure he is on track and going to persevere to the end.
Please keep up the prayers and support!
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Thursday, August 28, 2008
Great news! Joe was breathing on his own for nine hours yesterday!!!
The plan is now for him to be off the ventilator all day including
when he goes to therapy. He will go back on in the evening and
overnight to rest. To be honest he seems more comfortable when
off than on…..this is a HUGE step making the future much
brighter!
He
continues to work on strengthening the control of his head and
neck (some would say this is a big job-one heck of a noggin!)
and his core body strength. He has rejected his special bed
because it was way too short and was swallowing him up! Joe
has gotten a bit too lean and mean and is now in the process
of bulking up for the long haul ahead. At times it all seems
overwhelming but everyone’s words of encouragement and
support are very helpful and keep him going. THANKS AGAIN…I
don’t know how we will ever be able to thank and acknowledge
all the cards, gifts, and prayers etc. God bless everyone!!
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Friday, August 22, 2008
Joe
has been making great progress this week - where he has had
movement, he is getting stronger, where he has had no movement
there is a whisper of activity! Despite numerous efforts to
get a definite timeline and final estimate of outcome from everyone
in sight, Joe has had to resign himself to taking each day as
it comes and being a patient patient!! This may be the hardest
task of all….
He
now has a funky Clinitron bed which is like lying on heated
silicon jumping beans…. This makes sleeping an interesting
and challenging experience! All in all six weeks since his accident,
Joe has come a long way. He is very lucky and hopefully will
continue to improve at more than a snail's pace!
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Tuesday, August 19, 2008
After a quiet weekend Joe was up and eager to get going Monday
morning……..by 1pm he was exhausted! He had his morning
PT session from 9-10:30 then he was off the ventilator for two
and ½ hours. Pushing himself he went to his afternoon
therapy session and then later was off the vent again. Total
time off yesterday was 5 hours! He is still not really comfortable
when breathing on his own but with time this will get easier.
He is sleeping better at night which will help. In between he
met with the speech therapist and worked on his swallowing!
All
of this may sound pretty simple to most but for someone in Joe’s
situation, it is hard work!! The cards and letters from so many
are encouraging and really spur him on. We are so thankful that
he has made so much progress in a relatively short period of
time. And we are grateful for the tremendous support and concern
from so many.
THANK YOU AND GOD BLESS!
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Thursday, August 14 10pm
Tuesday found Joe in the ER of St. Barnabas for investigation
of a very large red swollen area under his left ear. After a
CT scan ruled out anything more ominous it was determined to
be cellulitis cause unknown which is treatable with antibiotics.
He continues to be challenged by his daily therapy sessions.
Each day he is off the ventilator for increasingly longer periods
of time. He is exhausted by 5 pm!! He always was an early-to-bed,
early-to- rise kind of guy but this is ridiculous!!!
We
realize he is very fortunate to be getting back so much sensation
and movement this soon after injury. The bumps on the road aren’t
that bad considering this. God willing he will be back on the
fairways at Bellevue at some point in the future.
Monday,
August 11, 2008
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This past weekend Joe had bedside PT, did isometrics on his
own, and was off the vent for an hour. He now has good control
of his core abdominal muscles as well as slight movement of
his left biceps and left thumb! He has been enjoying visiting
with family and watching the Olympics especially Michael Phelps
and the men’s swimming team’s gold medal victories!
Today
he had PT twice which really zapped him. He met with his team
of doctors and worked out a game plan for physical, occupational,
swallowing/speech therapy, and weaning off the ventilator. This
is a long comprehensive plan which includes the adjustment from
being the good doctor to being the good patient!
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Thursday, August 7, 2008
Inch by inch is the new motto…..progress is measured in
very small increments but progress it is. Joe has been working
hard in therapy. He is also off the ventilator for brief periods
each day. All of this is very tiring for him.
Many
have indicated that they would like to come to visit but it
is too soon. All of Joe’s energy needs to be devoted to
his various therapies. While he and we appreciate it and would
love to see you all, he just is not his usual gregarious self
and would feel badly to have people come and not be able to
visit with them. At some point in the future, hopefully this
will change.
Along
these lines he has been moved back to a private room. It is
quite small without space for a lot of flowers etc. The most
helpful thing that everyone can do is to send prayers and positive
thoughts his way.
Thank
you so much. We continue to be amazed by all the concern and
best wishes for the “good doctor.”
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Tuesday,
August 5 10:15pm
These
past days have been long and tiring but productive. Joe has
been working on being upright more than 45 degrees and exercising
his extremities. There is more strength especially in his legs
and right arm. Today was his first shower since the accident
(albeit in a shower chair!) He also was breathing totally on
his own off the ventilator for 10 minutes. This evening he even
was able to sing happy birthday over the phone to our daughter
Adriane. She was thrilled and said it was her best present by
far!
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Sunday,
August 3 10pm
Friday
afternoon Joe arrived as scheduled back at the Kessler Institute
for Rehabilitation. The doctors there were excited to see him
and were very happy with the progress he had made in the week
he had been away. He spent the weekend settling in… it
is quite an adjustment to go from the level of acuity in the
Coronary Care Unit to that of a rehabilitation unit!! The highlight
was going out on the patio in his wheelchair dressed and wearing
his Bosox hat!!!
Tomorrow
he begins again with Physical therapy in the morning and Occupational
therapy in the afternoon. He is tuned up and ready to go!!!
As
Joe’s condition has stabilized, these updates may not be
daily but several times a week. We have been able to share many
of your cards and words of encouragement with him. They really
are a big help!! Thank you all again!!!
PS-
Joe has changed rooms and may be moved again… so anyone
interested in sending anything by mail may want to “tweek”
the aforementioned address and simply try:
Joseph
Smith, Second Floor
Kessler Institute for Rehabilitation
1199 Pleasant Valley Way
West Orange, NJ 07052
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Thursday, July 31 10:00 PM
It
seems that even though Joe is basically bedbound, he is able
to run the show……most of today was spent preparing
finally for the pacemaker insertion early tomorrow with a transfer
back to the rehab center in the afternoon. Around 4pm he had
another “episode” which brought them all running.
By 4:30pm we got word that he was to go to the Cardiac catheterization
lab ASAP for the pacemaker insertion! Halleulah! All went well
and he was back in the CCU resting comfortably by 8pm. Tomorrow
he will return to Kessler to get on with his rehab program.
It has been a long week but he is in better shape, pneumonia-free
and hard-wired for good! The prayers are surely helping so please
keep ‘em coming. Thanks from all the Smiths!!
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Tuesday, July 29 10:30 PM
A
day of waiting but a good day nevertheless. Joe continues to
be afebrile and his white count is almost normal. He is now
able to move all the fingers of his right hand slightly and
has a weak grip. When the cuff of his trach was deflatedfor
a brief period, he was able to talk. Let’s just say his
words were colorful and there is no doubt he is still the same
Joe Smith we all know and love!!! We are hoping for the pacemaker
insertion on Thursday. Keep the prayers going! Many thanks….Joe
and family
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Monday, July 28 10:30 PM
Last
night brought another glitch that resulted in the postponing
of Joe’s pacemaker placement….he developed a fever,
an elevated white cell count and it was determined he has pneumonia
in the bases of both lungs. Today he is responding well to the
antibiotics, his fever is down and his spirits amazingly good.
He understands the rationale for waiting on the pacemaker placement
and is in agreement. Hopefully it will be done Wednesday or
Thursday. He continues to monitor his situation and contribute
as best he can. Some good news is the continued improved movement
of his right hand and slight movement of his left arm. We will
take any progress however small!
Thank
you for the prayers and good thoughts…..
Sunday,
July 27 9:00 PM
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Following
several “fainting”episodes Joe was transferred Friday
afternoon to an acute care hospital not far from the Kessler
Rehab center. He is most likely going to have a pacemaker inserted
to prevent future episodes and allow his rehab efforts to continue.
If all goes well, he will be back at Kessler by midweek. Please
keep praying that these bumps in the road will smooth out. All
he wants is to get better and return to his home on Otisco Lake.
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Wednesday, July 23 8:00 PM
Joe’s
first full day in New Jersey went considerably well. The night
had been a little hard on him as he is trying to get back on
a more regular schedule and was a bit confused coming down off
of some meds administered for the flight (telling the night
staff repeatedly that he had “the bird flu”). However,
as the day progressed and the meds wore off he became more aware
of his surroundings and made a remarkable recovery from the
bird flu. By 9AM he was dressed in real clothes- his Red Sox
t-shirt and fleece sweats- and sitting in a reclining wheelchair.
He was still pretty tired but had his first OT/PT sessions.
He is in good spirits and felt even better after moving his
right thumb. Minor movement---major improvement! Anyone interested
in Joe’s current mailing address, it is as follows:
Joseph Smith, room 2026
Kessler Institute for Rehabilitation
1199 Pleasant Valley Way
West Orange, NJ 07052
Thank
you, and God Bless.
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July
23, 2008
On
Tuesday morning Joe and Carol were flown to Northern New Jersey
to an acute rehab facility. Joe was eager to go and the facility
is one of the best in the country for his type of injury. The
plane ride was apparently an adventure in itself as they flew
through some rain in a plane that barely was big enough to house
Joe. Carol was wondering if they were going to have to hang
his feet out the back. But all landed safely as Adriane, Kendra
and Erica waited for them at the facility (They had driven ahead).
J was in Syracuse, making sure Joe got on the plane. It made
for a long day but Joe was evaluated upon arrival and the tough
work begins Wednesday the 23rd. His day will begin at 8 AM.
He will have 1 ½ hrs of PT(Physical Therapy) and 1 ½
hrs of OT (Occupational Therapy) at scheduled times every day.
The goals for now are to get him up in a chair and to get him
breathing on his own….
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Monday, July 21 5:00 PM
Joe
had a procedure today in which a screen /filter was placed in
his blood stream to prevent clots from traveling to his heart
or lungs. This procedure combined with a probable trip to New
Jersey tomorrow has led to a long day. He is tired and we are
trying to get him rested up. The plan is for him to be flown
to the acute care facility in Northern New Jersey to truly focus
on rehabilitation from his injuries. His activities will include
speech, physical, and occupational therapy. The goals of his
trip will be to get off the trach and be breathing on his own
and to begin to reclaim the use of his limbs. Joe is on board
and wants to get moving. He is in for a long and grueling battle
but we are all behind him. His will and mental toughness are
second to none. Hopefully by the time you are reading this,
Joe will be in the air or landing in Jersey. Keep the prayers
and good thoughts coming!!
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Sunday, July 20 7:00 PM
Joe
continues to make progress in his recovery. He has begun to
breath a bit more on his own, his fever has receded, and he
continues to mouth some words although that is a frustrating
process. He seems to be using more swear words than we remember
(which we take as a positive sign). The plan is to move him
to a rehab place in New Jersey. It comes highly recommended
and Joe is eager to go. He is working hard to get better as
he battles to regain control of his limbs. Please continue to
keep the good thoughts and prayers coming. They seem to be working!
The Smith family extends its deep gratitude for all the well
wishes.
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Friday, 18 3:00 PM
Joe
has had a busy day today with some positive improvements. He
was up at 4:30 am (a bit late for his normal rise time). The
staff is beginning to work toward preparing him for acute rehabilitation
(perhaps in New Jersey). He has begun to initiate some breaths
on his own as the doctors are lessening his oxygen intake percentage.
This is an attempt to encourage him to breath on his own. He
had some occupational therapy to move his arms and legs and
reduce swelling. He is taking ice chips and making requests.
He seems to be looking forward to having a root beer! But he
is tired and is still battling a low grade fever. Once again,
the volume of thoughts, prayers, and well wishes have been astounding
and have served as a source of comfort for all of us. Please
continue to pray and think good thoughts.
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Thursday, July 17 3:00 PM
Joe
has gotten a trach tube (which replaced the breathing tube through
his mouth) and has a feeding tube directly to his stomach. This
allows him to "mouth" requests. He has become more
expressive in the past few days through winking and smiling.
However he is still reliant upon the machine to breath for him.
This is most probably attributed to the initial spinal cord
trauma. The bruise on the spinal cord may take a long time to
heal and we are all trying to be patient. Joe is requesting
his arms and legs be moved (a classic illustration that he is
preparing and ready to fight and recover). We are exploring
the possibility of getting him to an acute care facility for
spinal rehabilitation towards the middle of next week. Obviously
the situation remains fluid as there are changes every day.
Your support has been an invaluable comfort to us and we hope
to share the flood of emails with him soon. These are unfamiliar
waters for all of us and we appreciate the support that has
been provided for us to navigate them.
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Wednesday,
July 16, 2008 3:00pm
We have made some progress today. Joe is getting his gastric
feeding tube inserted. And later will have his tracheostomy.
He has been able to communicate more easily with us which makes
us all feel better. Otherwise he is stable and is relatively
comfortable. We are beginning to look at the next phase which
will be acute rehab. This will mean a transfer probably some
time next week.
We
truly appreciate the offers of food and flowers but at this
point our schedule is erratic and his room cannot accommodate
anything else.
Thank
you for all the tremendous support, the prayers, calls, and
inspirational emails. We look forward to sharing them with Joe
in the near future. God bless you all.
Love, the Smith family
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The
Smith Family is amazed at and appreciative of the outpouring
of support for the family patriarch Dr. Joseph Smith. The flood
of calls and visits have been heartfelt and moving. In order
to allow everyone who is concerned to be kept up to speed, we
have decided to establish a website link that will be periodically
updated.
The accident occurred on Saturday, July 12th around noon. Joe
lost his balance and fell off a retaining wall onto the ground
below, fracturing his neck. Carol witnessed the fall and immediately
called for Kendra who administered CPR. He was taken to Upstate
Hospital and is currently in the Neuro-Intensive Care Unit.
He had spinal surgery that Saturday night to stabilize a fracture
in the first cervical vertebrae. Screws were put through the
4th vertebrae to the base of the skull, limiting his future
neck motions but protecting the spinal cord from what was determined
to be an unstable fracture.
As of Tuesday, July 15th around 1 pm, Joe has had modest movements
in his legs and only slight movements in his upper extremities.
He has a bruise on his spinal cord that has been problematic.
He is still on a ventilator at this point but has taken some
breaths on his own (not nearly enough to be off the ventilator
however). He recognizes people, tracks them well with his eyes
and is responsive to stimuli. He developed a fever indicating
a possible infection on Monday so we are limiting visitors to
the actual ICU room. His temperature has since come down somewhat.
His response to conversation is appropriate and he is resting
with some comfort. He is awaiting a tracheostomy and a gastric
feeding tube that should make him more comfortable and allow
him to communicate to some degree.
Please keep Joe in your thoughts and prayers as we continue
to hope for a successful recovery.
Please send wishes, notes or regards to the following web address:
dr.joesmithfamily@gmail.com
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