Dr. Joe Smith Update

Sunday, July 11, 2010

Tomorrow it will be two years since Joe's fall, It doesn't seem possible....so much has happened and life is so different than it used to be.
Joe made it back to outpatient therapy at Upstate from late April to early June even though he had another bout with pneumonia in early May. But then his infections returned with a vengeance in mid June. He was hospitalized for a week so he could be treated with heavy duty antibiotics. That helped and he has been home resting and regaining his strength.
The repeated cycles of infection, weakness and recovery are discouraging, The infections are due to organisms he has acquired as a result of his multiple hospitalizations. They are the drug resistant variety which is making them harder to treat each time. We are doing our best to make the most of each day. God willing Joe will be the proud father of the bride next month. We are thankful for the closeness and love that has grown within our family over the past two years. Also, the help and support we have received from so many people and especially from a few core friends is amazing! We are forever grateful.
With love and God's blessings, the Smiths

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Friday, April 2, 2010

Winter is over..it was a very difficult one on many levels. With spring we have renewed hope for a healthy more fulfilling life for Joe. He continues to regain the level of strength and function he had last fall. He is zipping around the house and outside like Parnelli Jones! Where to go next with his rehab therapies is the current question...there is no rest for the weary. Every day he must work just to maintain what he has. But those who know Joe know that working hard is not a problem for him. It is what he does.
Infections are a recurrent problem. He has just finished another round of IV antibiotics. So far we are winning the battles...our family is so grateful that he is still with us. Our prayers and those of so many have surely helped. Many thanks! We rejoice that it is spring, we rejoice that it is Easter. May God bless you all.

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Sunday, February 21, 2010

It appears Joe has dodged another bullet..his recovery from December's infections has amazed his doctors. His strength is almost what it was in early December and in a few areas even better, his lung capacity greater than ever since his accident, and he is eating again, even a little bit of salami! Only the fine motor movements of his right hand have not returned yet, although he can still operate his chair. Therapy at home continues for now.
There is much to live for... 2 graduations and a wedding this summer, the garden to plan and supervise, and the Orange to cheer for! As always we are grateful for the prayers, cards, and messages. God bless.

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Tuesday, January 5, 2010

A few days in the hospital for tests and tube changes turned into two weeks of fever,pneumonia, and other infections. We brought Joe home on Christmas Eve day still very sick. He has slowly gotten better but is very weak. Every bout with infection sets his rehab efforts back for weeks. It is very discouraging.....but he will continue to work to get stronger and we will continue to support him. We know the thoughts, prayers, and love of so many out are there with us. Thanks to all, especially to those who have sent food, flowers, and cards. God bless and Happy New Year, the Smith family.

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Wednesday, November 25, 2009

It has been a year since Joe returned home from Kessler Institute for Rehabilitation. In many areas he is far from where we expected he would be at this point. In some he has definitely improved. The infections continue to slow his progress, yet in spite of all the negatives, we are grateful this Thanksgiving. He is still with us and at home, the kids are doing well, and there will be a turkey in the oven tomorrow! We are also immensely grateful for the love and support of so many. God bless and have a wonderful Thanksgiving!

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Tuesday, September 29, 2009

No news is not always good news...Joe has been struggling with recurrent infections which have sapped his strength. Finally after two courses of antibiotics, he is starting to feel a little better. He is receiving both physical and occupational therapy at home until he feels strong enough to return to outpatient therapy at University Hospital. There are many who have indicated they would love to come visit but at this point he needs to conserve his energy and concentrate on getting better. We truly appreciate the continued support and pray that one day there will indeed be good news to report.
God bless and go Orange!!

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Friday, July 31, 2009

This was supposed to be an upbeat report saying that Joe was off the vent and on his way to getting rid of his trach tube but the reality is another respiratory infection has knocked him down. This time the infection has spread to his bloodstream. He is receiving IV antibiotics at home and our goal is to keep him here.
There has been progress over the last few weeks...he now can tolerate 80 degrees on the tilt table and has graduated to a stand-aid which positions him at 90 degrees. His left hand and arm continue to show signs of movement and will be electronically stimulated to encourage the nerves and muscles to respond. He now manuevers his power chair very smoothly. Joe passed his second swallowing test and can gradually eat just about anything. His current favorite is Italian meatballs accompanied by ice chips and chased with a mini chocolate sundae. He has tried a little pizza but the beer just doesn't taste the same as it used to.
Your prayers are most welcome as he faces this current challenge. Many thanks - the Smiths

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Tuesday, June 16, 2009

Just returned from a therapy session at University Hospital during which Joe moved his left arm and hand more than ever before! We are now hopeful that it will become a functional limb for him. With help he is able to sit and balance on both arms. He continues to work on his core and neck strength...holding up that noggin is a definite challenge! He still hovers around 70 degrees on the tilt table. Progress has been slow lately because of another bout of pneumonia. We caught it in the early stages and began IV antibiotic treatment so he is improving pretty quickly.
Eating is going very well although in small quantities and only pureed, soft consistencies. All in all as we close in on next month's anniversary of Joe's accident, he is still improving slowly but surely. Dreams of that slice of pizza now include a cold beer!!
Many thanks for the notes and words of encouragement. God bless!

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Tuesday, May 12, 2009

Some good news to report! Each rehab session results in a little more return...Joe is now beginning to move the fingers of his left hand and has some gross movement of his left arm. His right arm and hand are improving in both fine and gross motor movements. He is getting quite adept at maneuvering his chair through the house and outside. The strength of his neck and trunk are improving. He is now able to tolerate 75 degrees of elevation on the tilt table. In terms of weaning from the ventilator, bipap did not work so we are gradually decreasing the amount of time on the vent until he will just go off cold turkey! And the best news to report is that Joe passed his swallowing test!!
He is gradually beginning to eat pureed foods and is now dreaming of a slice of pepperoni pizza!
On Mother's Day I asked Joe what his mom would say to him if she were alive. He said she would say, "You can do it" That is our new mantra....
We thank everyone for the continued support and prayers.
God bless!

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Wednesday, April 8, 2009

It is interesting how time can fly while it is crawling...this update is long overdue!
Joe is significantly better in many respects. He is now going to outpatient therapy at University Hospital several times a week. Getting onto the mat or tilt table, he gains in strength and ability with every visit. His right arm and hand are keys to his recovery so far allowing him to shave, brush his teeth and DRIVE his new power chair. The house is taking a few hits but he gets more adept every day. Areas where there has been less progress are respiratory and swallowing. He has just gotten over another lung infection requiring IV antibiotics. We managed to care for this at home thankfully keeping him out of the hospital. This infection resulted in a delay in progressing to BIPAP at night instead of the ventilator but he is now ready to try this weaning procedure again. The last modified barium swallow test showed eating is still not safe for Joe. We are looking for outpatient help in this area....that salami sandwich is still a goal!
For two acute care oriented people this rehab journey is a real test of patience...but thanks to the love and support of family and friends we are making it.
Best wishes to all for a Happy Easter and a wonderful spring! with love, Joe and Carol

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Tuesday, February 24, 2009

Five weeks home and out of the hospital! Joe is working hard and progress, albeit small, is being made on all fronts. Going to outpatient rehab is on the horizon which will allow the use of machines and mats to further his recovery. One of his exercises as he works toward that salami sandwich, is to use his voice and sing....not to worry Josh and Kenny, no competition here!!
The support of family, friends, and everyone has been amazing. We thank you all! As spring approaches with its promise of new life, we look forward with hope and faith in the future.

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Tuesday, January 27, 2009

Finally some good news to report! Joe has been out of the hospital for a week now. He is feeling better than he has in months. The infections are under control and he is working on getting stronger each day. This seems like a minor miracle after all he has been through.

He has a ways to go before getting to where he was when he returned from Kessler two months ago but we are all encouraged and hopeful that he will continue to improve.

Old goal = getting home to Otisco Lake
New goal = a salami sandwich!

As always your prayers and good wishes are much appreciated!
God bless…..

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Sunday, January 4, 2009

The New Year has arrived, the holidays are over, and the Christmas cards were never sent. The last few weeks have been pretty rough for Joe. He developed bilateral pneumonia in mid-December, another complication following the thrombolysis of clots in his legs. He was home for Christmas but has been hospitalized twice since for difficulty breathing and symptoms of sepsis. We are praying for his return to reasonable health and strength.

With thanks and best wishes to all for a happy, healthy 2009 – the Smith family.

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Tuesday, December 9, 2008

I was hoping the drama was over….the three-day treatment to dissolve the clots in Joe's legs was successful. He is now basically clot-free and should remain so due to anti-coagulant therapy. However the procedure did a number on his total red blood cell count requiring 4 units of blood (packed cells to be exact). The extensive destruction of red cells has also taxed his kidneys and left him with an infection in his bladder. Needless to say he is exhausted. With time and rest he will recover and get back to concentrating on his rehab program. It seems that he has had every complication possible but that probably isn't true so let's not say it. In spite of all this he has regained a very slight grip with his left hand. So this journey to recovery continues. Your prayers have helped him dodge another bullet. Please keep them coming and God bless!

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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.

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Monday, August 11, 2008

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…..

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Sunday, July 27 9:00 PM

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