DAY 12, LABOR DAY

Apologies, everyone. It has been several days since anyone has blogged. It's amazing how quickly time slips by doing nothing but sitting, watching, waiting and praying. And how one day blends into another without any sense of time. So it is as much for my own benefit as for yours that i noted that today is Labor Day. We are slowly learning from everyone who saw joe when he came in and the day after that they did not expect to see him still here. That is why when people ask me how he is doing, my reply is always "he is still here" and that is a starting point that gives the doctors and nurses something to work with. Every day we can say that, we are grateful and a miracle in itself.
Now for Joe's progress and some updates. Several days ago, it took me several tries and dogging every team that is caring for him before I got someone to be responsible for his right big toe. You may remember back on day 2 or 3 when he had his first sugery, the orthopedic surgeon said the right big toe was broken, but he'd just slapped a bandage on it and wasn't going to worry about it. That's an exact medical quote from the surgeon. So a few days after that, his nurse and I decided that someone should start worrying about the toe since the dressing had not been changed in a few days. So we both started asking everyone and what I have discovered is that Trauma doesn't talk to Plastics and Plastics doesn't talk to Ortho and ortho doesn't talk to anybody. However, we finally got one orthopedic resident to attend to the big toe. It is pretty beat up and open with the nail about to fall off, so it would be prime to develop an infection. It was a huge victory to have someone adopt responsibility for the "Digit", bec. we were not going to have hime go through all of this and then develop an infection in the big toe. That would be pretty silly. So we can all rest easy as the big toe is being cared for.
On Friday, they capped both chest tubes to see how he could manage on his own as far as managing the fluid build up, including the bleeding because of the punctured and collapsed lungs. At first they thought it was going O.K., but soon discovered that he still needed the chest tubes. We were told that they might cap them but would not remove them until they were sure he wouldn't need them again. So we waited patiently and this morning they actually removed the chest tube on the left side, so it's a great day! He still has the one on the right side as it is apparent that the right side of the body sustained the worst of the injuries.
Several days ago they let him come up out of sedation a little bit, but found that he was way too agitated, trying to ask questions and communicate. He, of course, cannot speak because of the trach tube and is way too weak to even mouth words, so after about a day of that they put him way back under sedation to give him a chance to rest. However, on Friday a.m. the head of one of the trauma teams checked his neck and determined that the neck brace could be removed. That made a huge difference in the way he looked and in his comfort level, as it did when they did the tracheostomy. So, last night they took him off the sedation again and by this morning he is full of questions. Up until now, every time he opened his eyes he did not know where he was and we would tell him he was in the hospital and had had an accident, but today he wanted to know how long he had been here and wanted to know what his injuries were. His nurse today, Lia, had given him a suction tube to try to suction his own mouth if he could, but he decided to use it as a pointer. He would weakly try to point to an area and want to know what injury had been sustained. I gave him a brief and simplified version. He managed to communicate that he wanted to know if he had all his toes by trying to point to them and then holding up 5 fingers. So after we'd assured him that he had all his digits, he wanted to know if his back was broken and while he does have some cracks in some of the vertebrae, i told him no, it wasn't broken and he was going to be O.K. While he was trying to get the run-down on the injuries, we were having a hard time trying to understand and so he told us all to Pay Attention. He is still Joe and even a farm tractor could not crush that silly, quirky sense of humor.
All right, so basic update on his situation. Joe is still in very critical condition and will be for a long time, but we, and the doctors and nurses, are encouraged by his progress. His ventilator support is down a bit, so he is doing a little breathing on his own, but he will be hooked up to the respirator for a very long while. And bec. all of the ribs on the right side have multiple fractures and the ribs on the left side are all broken as well, he will have a long healing process as there is nothing to be done for those. it is excruciatingly painful, as anyone who has had a broken rib knows. So compound that by many fractures and we can only guess how much pain Joe will be enduring and everytime the respirator takes a breath for him, it moves the ribs just enough that it will take even longer for them to heal. Unfortunately, the same goes for the vertebrae that are cracked. Very painful and nothing to do but wait for healing. However, the punctured and collapsed lungs have begun to heal, although they will also take a long time. The contusion to the heart seems to be improving and the laceration to the liver seems to be healing. There was fear earlier on that they might have to remove part of the liver and the gallbladder, but so far, things seem to be progressing positively there. Joe has external fixators on both lower legs, as he had very bad compound fractures of both legs below the knee. The left lower leg may need some skin grafting, although they have tried to close it as best they could for now. The right hip is broken and may need to be replaced, or if they can gather enough bone fragments of the hip and pelvis, they will try to wire it all together. The right femur is crushed and will need a rod inserted into it. They tried to do this surgery last week, but the skin and deep tissue on that side of the body from being dragged was nothing but massive, black hematoma and open and weeping and bleeding blisters. They had hoped they might be able to make an incision, but once in the O.R., realized that the chance for massive infection was too great and the chance for any healing too small, so they had to abort that surgery. So, we have waited another week for some healing to take place and for him to become more stable and he is an add-on for tomorrow's orthopedic surgical schedule. They will try to accomplish the hip and pelvis and if they are able and he is still tolerating surgery, they will try to put the rod in the femur. If he is still tolerating the surgery, they will also place a rod in the right tibia. He will also need plastic surgery. The muscle has been pulled off a section of the right tibia and there is, of course, no skin there either, so they will try to move his calf muscle over to cover the bone and then graft some skin over it. There is also another small section where there is a hole that they will need to do a skin graft and and a section on the left tibia that will probably require a skin graft. The plastic surgery will most likely be done later in the week. So my children were wondering with all that surgery if they could take care of their Dad's bunions while they're at it and I've been wondering if they couldn't do something about that snoring!!
So, I know this has gotten a little bit wordy, but i had a lot of catching up to do. I can't tell you what it means to all of us to know how many people are pulling for Joe. It helps all of us to know that so many people are praying for him. As our friends, the Wilkes, blogged - they have the Jews, the Baptists, the Methodists and the Roman Catholics praying for him and my sister added the Mormons and her Buddhist chanting group as well. We like to cover all the bases and you can never have too many prayers. We can never thank everybody enough. It is all so important for Joe's recovery. I will apologize now to people who have been calling. Most of my time is spent in Joe's room, where cell phones have to be turned off. When I do come out, i spend time updating family who are not here (my children have worked out a schedule so that there is always another family member here with me) and then back in Joe's room again. But we do appreciate beyond words everyone thoughts, prayers and good wishes. We have had many requests for the address of the hospital. While Joe is in the Intensive Care Unit, he cannot have anything delivered to his room, but the unit secretary will deliver cards to me. Unfortunately, Joe is not able yet to read or enjoy them, but for those who would like the address, here goes:
Mr. Joe Ferraro
ALBANY MEDICAL CENTER
43 New Scotland Avenue
Albany, New York 12208-3478
SICU - Rm 326
Again, we cannot thank everyone enough and please keep Joe in your thoughts and prayers.
We will try to do better at keeping up to date on the blog. Love, Cindi