April 5th 3:06PM
Hey everyone. I'm sure you're all
anxious for an update. Sorry I've been a little slow. My ability to help Phil picked
up quite a bit yesterday and today I'm working on writing up everything that
has happened since his accident. So bear with me as I try to write down all the
experiences and emotions that have been a part of Phil's journey. I need to
write about it while everything is still fresh in my mind.
For now Phil is doing better. If
we look at his condition each day it's hard to see the progress. But our
brother in law, Clark, told us to look for the progress in a cluster of days.
If I look at Phil today compared to how Phil was a few days ago, he's doing
much better. Yeah, each day is very challenging with a new set of goals and
issues, but we're progressing, slowly.
Yesterday was mostly working on a
new pain regimen and getting the Bowles moving. They found a drug, Ultram, that
seems to be working better but we're still having trouble with the
gastrointestinal tract. Well keep working on that today. Today they took Phillip to IR and placed a filter in his
inferior vena cava to catch the blood clot he has in his leg in case it decides
to come loose during surgery. He's been on heparin for the clot but the
surgeons won't do the surgery while he's on that. So now that he has the filter
they will be able to stop the heparin for 12 before surgery. We are hoping that
Phil's swelling in his right leg will have gone down enough that they can do
surgery tomorrow. They won't decide until tomorrow morning.
April 5th 4:17PM
Thought Easter would be a good
day to share our exciting news.
April 5th 7:05 PM
Ugh, why are insta videos so
short. The whole thing is pretty cute. On St. Patrick's Day some silly
leprechauns left a box of lucky charms for the kids with this surprise in it.
The boys both want a girl and Phil and I just want a healthy babe. Thanks for
sharing in our excitement. We're excited but I'm also very grateful that we
have some time to get Phil better before then. Some time I'll have to put a
blog post together just on the timing of this pregnancy...feels sorta crazy. I
have also loved watching this over the last few days because it was the most
recent video of @phillipmoulton filled with lots of love and joy.
April 5th 8:31 PM
Phillip got through some hard stuff today and did great. He says the
worst pain he's having is in his stomach, most likely due to the
gastrointestinal issues. He's already had his meds for sleep tonight so we're
praying for good sleep tonight and that the swelling in his right leg will have
gone down enough to operate tomorrow. I'm staying with him tonight to hopefully
help relieve some of his anxiety about surgery. Thank you for the continued
prayers, support and love. It means everything to us as it is helping to ease
this burden.
April 6th 7:56 AM
Phil is in surgery now for the
repairs on his right leg. They'll be able to take off the stabilizers and then
put a bunch of plates and screws in. It should take about 3 to 6 hours of total
time for this one.
It was no small miracle that he
was taken first case. He was put on the schedule at about 1 am as an add-on
meaning they would get to Phillip
when they finished all their other cases. They thought that would be around 2
pm. Through the night Phil became disoriented. It was hard to see him
frustrated when he wanted something and the answer was no after no. He wanted
to wear clothes, sit in a chair, get off the bed, go home, eat, drink,have me
lay in bed with him and other random requests. He managed it though and finally
got some sleep from about 3:30 to 5. It would have been a VERY long day of
having to explain to him over and over the things his body wasn't capable of
doing. So I am very very grateful that they took him first case.
I'll post updates when I get them
from the OR. Thanks for sticking with us through this. It's the prayers that
are sustaining our family, all in different ways that make all of this doable.
Thank you so much!
April 6th 1:57 PM
Out of surgery. It went well
especially good reconstructing the joint, which they thought would be the most
difficult. There was a small problem with the membrane around the bone just
above the break. Basically there isn't any. In the meantime they have put a
plate on the bone and filled it with bone cement. Because of that he will have
to have one more small surgery in 6 weeks to remove the plate and cement and
use a bone graft from his femer. The biggest risk right now for Phil is infection
because of the compound fracture. Thanks for the prayers!
April 6th 4:49 PM
Hey everyone. I've got another
little update. since last night Phil has been disoriented and not thinking
clearly. Since surgery it has gotten worse. I'm sure it will get better with
time and that its just another hurdle he'll have to overcome. Thankfully the
hallucinations seem to have subsided quite a bit, now it's just disorientation.
Thinking about this new challenge
and the past few days I have come to the realization, which feels heavy, that
the days going forward are going to continue to be very difficult and demanding
of Phil's strength. So while we are very grateful for everyone's thoughtfulness
and eagerness to wish Phil well, we will not be having any more visitors other
than his family. He needs his strength to keep fighting. There will be time in
the future when he will need visitors, just not yet. If you feel like you have
something you'd like to drop off you can leave it at the information desk.
Otherwise we'll let you know when we think he's ready for friendly faces.
We appreciate all the love and
support that we have felt and are overwhelmed by the following that Phillip now has. Now let's pray for his
mind to clear, for no infection and the recovering to begin! Possibly if he
does well this week, best case scenario, he could transfer to a rehabilitation
hospital by Friday. Although it's probably more likely that it will be next
week. It all depends on the progress that is made.
April 7th 10:25 PM
The last 24 hours have been a
nightmare whirlwind combined with some good progress. Starting in the night
Phil was in pretty bad shape. Very delusional and confused. I had gone home a
few hours after surgery be jade he wa still very tired. I felt like I needed
some time to take care of myself. I really needed sleep. But he called me
confused and was not trusting his nurses. We talked for a while and I was able
to convince him to let the nurses give him his pain medication. Then I asked if
we could just both try to get some sleep and that he could call me a couple
times in the night. Two hours later he called me again. So I dragged myself out
of my restless sleep and headed to the hospital. Thankfully Jenna was up with
her baby and was able to talk to me on the phone to help me stay awake while i
drove. Being there helped but he was very confused still. But at least he had
someone that he trained. Then the pain set in. It was the most excruciating
pain that he's had during this experience. The drugs weren't touching it and
after what felt like forever and the ortho team coming to check for compartment
syndrome the charge nurse finally called the trauma physician. He came in and checked
Phil over and gave him something strong through an IV. Of course they first had
to place a new one. That gave Phil some relief and we both slept from about
4:30 to 5:45 when the ortho team came back in. Any time they touched or moved
his toes it was horrible. Plus he was still delusional. And then the
excruciating pain came back. It went on again for what seemed like forever and
Phil just had to bear it for a time. The whole trauma team came in and assessed
Phil and Chris with ortho came in once again. Chris was finally at some point
able to diagnose Phil as having nerve pain. With everyone working together they
changed Phil's pain meds and prescribed gabapentin which is specifically used
for nerve pain. That helped him have relief after a time. Thank goodness!!!
Further into the afternoon Phil
seemed to have turned a corner. His delirium seems fine and he's been fairly
comfortable considering what he's been through. They are still working on
getting his gastrointestinal tract going which has been more frustrating than I
think anyone would have anticipated.
As the evening wore on Phil was
in a pretty good place with his pain managed pretty well and his mind clear.
However just as soon as he was ready for bed the nerve pain has returned he is
frustrated because he thought he would FINALLY get good rest. I'm hoping and
praying it's not another torturous night.
I think I can compare Phillip's journey so far to Dante's
Inferno and the many different circles of hell. I want to say it's horrible for
me to watch him go through all of this but I kind of feel selfish because
compared to what he is going through I shouldn't feel like anything is hard. I
won't know what "hard" really means until I've been in Phil's shoes.
I wish I could have updated more
often but it's been a busy last 24 hours helping Phil. Still hoping ad praying
for his first good sleep to happen tonight!!
April 8th 8:59 PM
The night was not ideal for Phil
last night. The pain that he felt coming on at bedtime seemed to last for most
of the night. It was difficult for him to get comfortable and now has been
suffering from back and hamstring pains. Plus the nerve pain and bloating were
still very intense. During the night they decided to give Phil and IV because
of his urine color was so dark. Unfortunately the IV that was placed earlier
was right in his elbow so if he ever bent his arm the alarm would blare so
loud. That basically happened all night long. But I'm happy to report that we
made it through another night and now as I type another day.
Today Phil made progress. That
doesn't mean it wasn't hard or felt really long, but some good things happened.
Phil finally had a bowel movement, a couple actually. Between that and the fact
that he's no longer dehydrated his gut is finally feeling better and he's been
able to eat a little bit. Hopefully that will all continue to improve and he'll
be able to build some strength back up.
Speaking of strength, Phil is
starting to be able to use the trapeze over his bed even more and move his hip
and pelvis completely off the bed. Physical therapy came in twice today and
worked with Phil. The second time they raised his bed into a sitting position
to start to build pain tolerance to be able to sit in a wheelchair. Isn't that
brutal? He doesn't need to build strength or muscle or skill...just pain
tolerance. Ugh. I was actually really surprised that Phil was able to do so
well in the sitting position. It didn't last too terribly long, but I was so
proud that he would be able to do it at all!
With all the movement and effort
his body has been putting into just healing and moving around the tiniest bit
in his bed he is feeling the affects. He said that today was the first day that
his body really just hurt all over. And that he was weak and exhausted. Part of
that was because he hasn't really had much to eat and yesterday he was NPO
meaning to food or drink because they were so worried about the pain in his leg
and thought maybe they would have to take him to the OR.
One frustration that Phil has
been facing has been urinating. He really loves the catheter because he more
comfortable with his bladder being empty. When they take the cath out, urine
builds out and he's never really able to empty his bladder fully. Over time it
builds up so severely that it causes a lot of pressure and pain. Today they did
two straight cats and then they put the catheter back in. Now urology is on
board Phil's team and they have created a new plan for Phil where he will be
able to do something similar to a straight cath 4 times a day and he'll either
be able to do it himself oand someone else, like me, will be trained on how to
do it too. He will do that for a couple weeks and then he'll be seen at the
urology clinic to reevaluate.
At about 6:30 tonight, same time
as yesterday, Phil's anxiety started to grow and the pain in his right foot
returned. A little while after that the ortho team came in, rewrapped his left
leg and put a new clean brace on. That was okay for Phil, that leg is feeling
pretty good for him. Then they cut off his splint on the right leg, cleaned it
up, bandaged it and put it in a huge boot. Because of all the pain that was
Phil was in two nights ago and into yesterday that had cut his spilt all the
way apart over the top. They did this to figure out where the pain was coming
from and to make sure it wasn't signs of compartment syndrome. But because of
that is pushed Phil's foot forward, instead of keeping a nice bend in it.
Having to flex Phil foot and ankle back tonight was really uncomfortable on top
of all the nerve pain he had. They explained that if they left Phil's foot too
long pressed forward and not in a split it would be extremely difficult to get
flexion back. So it was a must. It didn't help either that his leg was just
being man-handled (by my two favorite on the ortho team, they really are so
nice) just to get everything wrapped up and so he was in a lot of pain. They
were able to give something extra through his IV to cope and it seems to be
helping.
Sadly I do not have a very good
attitude about how the night will go. But I just have to remember that last
night was still better than even the night before. Still hard, but better. Talk
has started about getting Phil out of the hospital and into either a
Rehabilitation hospital or a skilled nursing facility. I'm not going to lie,
that is all stressing me out about making sure we're making the right decision
and working with our insurance to make sure it's all covered.
My brother flew in yesterday and
I was able to get some dinner with him and get out of the hospital. That was
really nice! And then he made a Kneaders run for all of us and came to the
hospital in the morning. Since then he has been taking care of the kids and
being a super fun uncle. He's teaching them magic tricks, getting them out, he
took them to the dinosaur museum and they watched a movie. It's been really
wonderful that all the help that we have had from both our families has caused
me to never have any concern for my kids and their well-being. They have been
so happy, well taken care and very loved. I am very grateful for that. Again,
sorry for the typos...definitely not going to read through this to check for
them...hope it all made sense.
April 9th 6:20 PM
The chest x-ray didn't show
anything concerning which was great news. They took his blood what seems like
every hour but eventually his fever went down and with some Tylenol he started
to perk up a bit. They put him on flexeril, a muscle relaxer last night, and we
noticed today that it made him super loopy and tired.
By late morning Phil's mom and
both sisters came for a visit. It was such a treat to have them there, for both
of us! It was during this time that the flexeril wore off and Phil started to
perk up. Since then he's been feeling pretty good.
We're still working on getting a
facility approved that is in Provo but it's been very complicated. Today we
felt like we had a little success in the right direction but we are still
prepared to fight and appeal a rejection if we get one.
Phil had another successful day
with physical therapy. I forgot to mention the huge accomplishment he had
yesterday! They moved his bed to sitting position and he was able to tolerate it
for THREE minutes!! I was so proud of him. And today he tolerated it for
five!!! He's tough as nails and super determined.
I'm hoping tonight is full of
more sleep for Phil and more improvements. We are also REALLY hoping that by
tomorrow evening we'll be able to have him discharged from the U and onto the
next phase of recovery and rehabilitation. Thanks for sticking with us and
supporting Phil and our family!
April 9th 6:24 PM
WHAT?! This was such a huge
moment to witness (from yesterday). Today he did even better plus he had the
splint replaced with a boot!! One step closer to a wheelchair. #toughasnails
@phillipmoulton
April 10th 10:35 PM
After last night we feel like
there has been some steps back. While that is "normal" it can be
discouraging. The issues that cause concern are the cold sweats/fevers and the
intense bloating, which seem like there is no relief either other than just
waiting it out. Super sucky for Phil. The bloating could be due to the fact
that Phil isn't moving a lot, or that his bowels still aren't digesting food
correctly yet, or it could also be caused from some sort of internal issue that
hasn't been identified yet. That issue could be what is causing the fevers.
That is kind of what they are looking in to. Last night and this morning he was
pretty miserable, but I think he managed to get a couple hours of sleep. They
are considering doing a CT scan to check things out internally.
This morning occupational therapy
came and helped Phil sit up and move to and sit at the edge of the bed. I was
shocked that was even a possibility right now! I may have gotten a tad
emotional watching the progress and watching Phil work hard to earn it. It was
a battle of managing pain in his hips and keeping him from passing out. The
therapist explained that since he's been laying in a hospital bed for 2 weeks
now his blood pressures have changed to be accustomed to always laying down.
That means when he sits up it's harder for his body to get enough blood to his
head. It will take some time for that to all adjust back. But Phil did great
and in another hour or so they will be back to see if they can get Phil into a
wheelchair.
This morning they took out Phil
catheter and so that may be a new challenge for today too. We will have to
learn how to do the straight caths (there's a different name when you do them
yourself) and begin that process. Hopefully it won't take too long before
everything relearns how to work, but a couple of weeks sounds pretty standard.
We are still working on the
facility in Provo. I'm very anxious to get an answer. The rehabilitation
hospital has already said that they will accept Phil and we know they are in
network, it's just a matter of the insurance company approving it. We were told
that since it's Friday that it might still take a day or two to get an answer.
We don't want Phil to be discharged before we know if Provo is an option. We do
know that we won't be having him go to a skilled nursing facility and we know
that the rehabilitation center at the U is an option for him as well. We will
keep working on making sure we have as many options are possible for Phil and
that he can end up at the one which will be the very best for him, physically,
mentally and emotionally. All those factors are very important in healing. And
where he goes has a big impact and how much longer he will have to be in a
hospital before he can start managing things on his own and in the care of our
little family.
April 10 9:39 PM
Phil had some serious progress
today! Sat up to the edge of the bed then later moved to a wheel chair and took
a stroll around the floor. It was so good to see him out of his bed and out of
his room!! Watching him work through the pain and difficulty of moving his body
was humbling and impressive. He fought hard to get through the critical phase
and through the surgeries. Now he's fighting to get home. #toughasnails
@phillipmoulton
April 10th 10:04 PM
Quick update and then I'm going
to bed.
Phil made awesome strides today
in the phsyical therapy department. Sitting up the edge of his bed once.
Getting into and tolerating the wheelchair for as long as possible. And
practicing on his own with the chair setting in his bed.
It looks like he will get
transferred to the University of Utah's Acute Rehabilitation Center for the
next phase, maybe this weekend if we can get written approval or Monday at the
latest if there are no new complications with his health.
He's still retaining urine in the
bladder and today we began the process of re-teaching the bladder and nerves
how to work. Every 6 hours he does a bladder scan and then he does a straight
cath himself. We have seen a little improvement but much for progress ahead.
Still working on GI issues.
Still having occasional fevers
and cold sweats.
Goodnight everyone!!!
April 11th 11:01 AM
Made it outside today! Phil was a
little discouraged during therapy today wondering how it was ever going to get
any better. But as an outsider watching him, and not experiencing the pain,
he's already made huge improvements! He's anxious to get the requirements done
so he can get home. #toughasnails
@phillipmoulton
April 13th 7:51 AM
So I guess it's time for an
update.
The weekend was pretty good.
Saturday and Sunday Phil turned a bit of a corner. He's more alert, has more of
an appetite and has really enjoyed the visits from family. There were even a
couple times when he was bored.
Pain is still something that is
being figured out and managed. The majority of his pain now is from nerve pain
in his right foot, from his broken right ribs, lower back pain from his back
fractures, and in his pelvis. The swelling in his right foot has gone down
dramatically and the ortho team is happy to see that. But it's kind of a catch
22 because the swelling just moved to the lowest point in his body, his pelvis.
They are now again, mostly on the right side, very swollen and painful.
Yesterday morning it was pretty severe and it was impossible for him to find a
position that was comfortable or gave him relief. We changed the bed, stuffed
pillows and iced his side to try to promote some change in the swelling. After
several hours it started to work a little. But unfortunately the swelling won't
be going anywhere until he starts being more mobile. I think he'll be able to
use that as motivation to keep working hard with PT.
Nights remain difficult. Although
last night was maybe his best, getting two stretches of about 3 hours. It's
still not ideal and the medication they're using, muscle relaxers, seems to
help but it also causes some disorientation.
His GI tract seems to be working
better, which has mean that he now has a bit of an appetite. It's small, but
it's a step forward. Urination isn't as bad as it was but still needs to come a
long way. He's still doing a straight cath 2 to 4 times in 24 hours.
Today he should gets discharged
from the OTSS and ortho told him he would likely get the stitches out in his
abdomen and hips today as well.
The plan is to transfer Phil to
the inpatient acute rehabilitation center here at the U. While we feel like it
isn't the best location but it will be the best for Phil and the type of rehab
he will need. It will mean that he's in rehab for the shortest amount of time
and that he has the best therapists.
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