Wednesday-Jeremy had a dental exam today, x-rays & cleaning. OT- He was given adaptive equipment to help put on his shoes; He worked on transferring to a shower chair; & did cardio arm exercises.

Tuesday- Jeremy had his vision tested & it is fine.OT-Worked on desensitizing his left leg, wheel chair push ups on arm rest, & various cardio exercises. PT- He walked forward on parallel bars ( 3 round trips). He also walked sideways on parallel bars ( one round trip). On the mat he worked on stretching & strengthening. He also worked on a cardio machine where he pulls with his arms & pushes with his les to work on his knees & thighs. Physician assistant discussed discharging Jeremy from the hospital on possibly Wednesday or Thursday. His PIC line will be removed before discharge. The food at Walter Reed is very good.
My wife will be moving to a new hotel tonight. The new hotel has a shuttle with wheel chair access.

Monday-Jeremy had a hearing test that was normal. His foot did not come in today but they gave him a temporary foot. He was fitted for a right splint today. They casted his leg & it should be finished in several days. He was fitted with his prosthetic today. In the lab he used the parallel bars & went 1/2 way down & turned around & came back. In PT he tried it again. He went there & back 2 times. They were very impressed with Jeremy's first attempt. It is a very encouraging sign about his strength. He also worked on the mat. They don't want him using it too much right now so they keep the leg locked up in PT. He was tested again for TBI & did fine on the test. They are also working on the hotel. Jeremy did remarkably well. It is only one day but I am very happy for my son.

Friday-More X-rays of right foot & left leg were taken today. Jeremy also had a skin test for TB. He received a new wheel chair which has a good support for his left leg. PT & OT did more evaluations of Jeremy's status.

Weekend-They went tooling around the grounds. PT- Sunday, Jeremy had 45 minutes on the hand bike & exercises on the mat. He had a free pass but getting wheel chair transport was a problem. The hotel does not have wheel chair accessible transport. A cab company that had wheel chair access was backed up over 3 hours. They cancelled their movie plans & stayed on base. Presently the hotel room is not wheel chair friendly & there is only one bed. We are having problems with the current hotel.We were not placed in the hotel they originally promised. We will see if they move us to a different hotel. The other hotel does have a wheel chair accessible transport.Even while we were at Bethesda we had to get a special van ordered to transport Jeremy for his day pass. I hate to complain but it seems to me that if you are handling amputees wouldn't the military be able to make the investment in having a few vans that were wheel chair accessible? The marines have a much smaller staff at Walter Reed. Hopefully we can get this problem cleared up shortly.
Jeremy was weighed and he has gain some weight. He had been down to 142 & is now 155. When he is deployed his weight will start at 180.

Thursday
The chaplain & a bilateral amputee stopped in to visit Jeremy today. Several doctors were up to see Jeremy. OT and PT got a late start in seeing Jeremy today. He was casted for his prosthetic suction cup.
They also ordered Jeremy a foot. Hopefully he will receive these items on Monday. He will still have blood work 3 times a week. Jeremy made it down to the barber shop today. He was getting a little rough around the edges after several months with out a hair cut. PT will be up tomorrow at 1:00pm to see where Jeremy is at physically.

Wednesday
My wife received a call at 7:45 am that Jeremy was going to Walter Reed. Jeremy got over to Walter Reed around 12:30. My wife had some problems getting her luggage brought over. Typical first day problems. She went to a different hotel than anticipated. Convention type hotel-$2.00 for soda from vending machine, unable to make 8:00 call from room unless you gave them a credit card. There is a hotel shuttle from 7 am to 10 pm so that is good. Just a lot of first day headaches for my wife. I guess I picked a good time to come home. Jeremy had doctors make their introductions today. He needs to have a mold of his leg made. Tomorrow we will see how quickly this all unfolds. Thanks to all the medical and support staff at Bethesda Naval Hospital. There have been many ups and downs over the last 6 months. We have finally gotten over the hump to move on to the next phase of Jeremy's medical treatment. It is a big day for Jeremy. He sounded strong and ready to go tonight as I spoke to him.

Good Evening:

Tuesday
We are on standby just waiting for a room to open up at Walter Reed. There is not much new to report.

Hi Everyone. I'm going out of town for a few days this week, so my trustee co-workers will hopefully be updating the website for you the rest of the week. Make sure to give them a hard time if they
mess up... HAHA
Laura
Now onto the update...

Saturday-PT Jeremy went 12 feet on crutches & then 3 feet. He had a new PT person today & was not as confident as he has been. Gayle had to push him back to the Navy Lodge. They were there for about 6 hours. They had some pizza & played some cards. Gayle had laundry day. I guess I timed my departure just right.

Sunday-PT Jeremy went 20 feet on crutches & took it easy all day.

Monday- Jeremy's magnesium levels seem to be stabilizing. My wife had to straighten out some medication issues. Today there were no open beds at Walter Reed. We will see what Tuesday brings. PT-Jeremy did 30 feet on crutches and did mat exercises in the afternoon. He is transferring by himself in & out of the wheel chair better now.

Thursday- 2 doctors from Walter Reed came over & did some assessments for his transfer to Walter Reed. They will do a nerve test when he comes over to Walter Reed. He was able to move his foot down( planter flexion) but was not able to pull the foot up yet. When he gets to Walter Reed he starts off with 3 hours of PT a day. PT-did crutches & went 20 feet. He did 6 feet in the afternoon.

Friday- They pulled out the last drain today. PT- he did 22 steps on crutches.In the afternoon he went 12 feet. He received his last IV of Zyvox for treating the VRE bacteria. He will continue his other antibiotic for now. If things go well over the weekend Jeremy could be going to Walter Reed Monday or Tuesday. He has all restrictions removed
from his back surgery now.

Wednesday-PT more work with crutches. Trip down to ortho for scoliosis x-ray. He had to stand up with his walker to get full length shot of back. The third drain was not pulled today. There was still too much fluid collected. We took Jeremy on a road trip today. We had lunch at Hooters. Jeremy had his picture taken with the girls. They also signed a t-shirt for him. I bought Jeremy a shirt that had the billiard balls racked with a cue stick. ( Hooters the best racks in town). The sacrifices I have to make to keep up my son's morale. We then took in a movie. Strolled around a mall & we bought a few dvds. We went to a Sprint store to try to straighten out his cell phone account. We couldn't get through to customer service so we will try another day. We escaped from the hospital for 6 hours & Jeremy was ready to return. It was an enjoyable day.

Tuesday-The Plastics Team took out a second drain today(1 more to go).
PT-Jeremy used crutches today & took 3 steps & rested. He went another 7 steps. In the afternoon he tried again & went 10 steps. He then went into the hallway & did another 10 steps. I took him down to x-ray & he had more x-rays of foot, femur, & spine. We enjoyed being outside in the evening. Tomorrow we have a van for the day & can escape the hospital. It should be fun.

Monday-Jeremy had one of the 3 back drains pulled today. PT- He used his walker & went 40 feet. He took a brief rest & went another 45 feet.
Tomorrow we are going to try crutches. Jeremy's unit had sent him personal messages & photos of the site. I have periodically asked Jeremy if he wanted to read these messages. For the last 4 months he has declined to read them. Today I brought the subject up again & he said he would read them. He read all the messages & he did see photos of the wreckage. The images did bother him but I was very encouraged that he read the messages form his Marine friends. He even talked about flying down to Hawaii to see them. There are physical issues you have to deal with but sometimes the psychological obstacles take a longer period to heal. Hopefully his Marine friends will remain patient & Jeremy can take the next step & start corresponding with the men that saved his life.
Today was a great day for Jeremy.

Friday-Jeremy had some issues with pain this morning. We took Jeremy in his wheel chair on a shuttle bus & toured Walter Reed Hospital. Between the shuttle ride & tour we were gone 5 hours. A very positive & upbeat environment was observed. We toured the physical therapy room, pool, occupational therapy, inpatient floor, & lodging. Their new amputee facility is scheduled to open October 1st. The information we have on San Antonio is that after Jeremy is no longer an inpatient at the hospital he will be staying in the barracks. I don't think this aspect appealed to my son. It appears that my son has decided on Walter Reed for his amputee rehab. His mother will be staying with him for the amputee rehab. Walter Reed is an Army facility. The marines only have a certain block of rooms for the on base lodging. My wife will be staying at a hotel ,off base, until on base lodging becomes available. It is about 2-3 miles from Walter Reed. She will either take a city bus or there may be a hotel shuttle. We will have to explore this further.
Parking appears to be very limited at Walter Reed. My wife would like a car rental but be we will have to see about the parking issues. Life was easier when you could walk 6 blocks to the hospital.

Saturday-Ultimate fighters Tito Ortiz & Justin McCully stopped in to see Jeremy. They are on their way to Kuwait & Iraq for a tour. PT- Using his walker he made it 30 feet without stopping.

Sunday- The plastics team was in & the back looks good & they hope to start removing the 3 drains this next week. PT- Jeremy used the walker & went 40 feet without resting. After resting he went another 10 feet. The combat veterans of America motorcycle club visited & presented Jeremy with a T-shirt. On the weekend lunches were provided by 2 support groups. We wheeled Jeremy over to our room for about 7 hours.

Thursday-PT-Jeremy used his walker again. He went 5 feet & sat back down in the wheel chair. We coaxed him out to the hallway & he did 15 feet without resting. He wore his tennis shoe & has a metal brace insert & ankle brace. We had him outside for about 45 minutes. Afternoon PT 20 lb weights & leg exercises. Jeremy is feeling more pain in his ankle area while having it rotated. He is still unable to move his toes or feel them. They tell us the nerves regenerate at a rate of 1 mm a day. It may take a long period to see if he regains feeling in the foot.

Tuesday- More magnesium, Jeremy got to the edge of the bed & was hanging his leg over the side. Not much new to report.

Wednesday- Sleepy head slept till 9 am. PT assisted Jeremy getting into the wheel chair today. We went over to the PX & picked out a pair of tennis shoes. He has a brace to put inside the tennis shoe. Tomorrow we will have to wrap the brace in egg crate & see if he can walk with out his big boot. He did 20 lb weights- 3 sets of 10- biceps & triceps. He also did leg exercises in bed. Still researching Walter Reed or San Antonio for amputee rehab. Jeremy has made some calls to San Antonio. In the end Jeremy will make this decision. Summer is winding down & a joint decision will have to be made regarding which parent will be coming back to Wisconsin.

Sat-Monday(330pm)- The cat scan was negative with no fluid build up which was good news. Plastics team is pleased with the way the wound is healing. Jeremy still has all 3 drains in place. When it stops collecting a certain level in a 24 hour period they will pull one drain at a time. The fluid being collected has decreased. His temperature has ranged from 96.7 to 99.9 which is also an improvement. He continues PT with just his legs in bed. He is eating well. He continues to have difficulties with his magnesium levels & continues to receive supplements. A boring report is a good report.

Jeremy is scheduled to get a cat scan later today.
He is receiving 2 units of blood & 2 more bags of magnesium. The plastic surgery team was in again & they are still happy with the way his wound is healing. No lifting, pulling or straining the arms for now. We can lift him into the wheel chair. A kidney doctor was in to speak to us.
The IV contrast for the cat scan can be hard on the kidneys but they will monitor him. His white blood count did not change & still is at 14.6.

Thursday- White blood count has jumped to 14.6 from 7.9. His temperature this evening went up to 101.7. His temperature has ranged from 99.6 to
101.9 over the last 2 days. Plastics has been in many times today. They have removed the dressing & they continue to examine his back. They are satisfied with the way his back is looking. We will continue to wait anxiously until his temperatures decline.

Tuesday evening Jeremy had 2 bouts with vomiting.

Wednesday- He can only do leg exercises in bed. No weights & he is confined to bed. He received 2 bags of magnesium today. Drains from his back continue to be drained. Plastics has been in to examine his back several times & they are pleased with his progress. At 710 pm his fever has reached 101.8. It will be a long night until we can get his temperature under control.

Tuesday- Jeremy went down to preop @9:00 & went to surgery @945am. At
315 pm Anesthesia came back to talk to us. Jeremy received 2 units of blood. Jeremy is connected to a cathether pain pump & has 3 drains from his back. He has had some morphine for his pain. He slept the rest of the afternoon & early evening. He ate a cheeseburger @745pm. He is on PT restrictions for at least a week. It has been a long day.

Monday- Rep John Mertha visited Jeremy today & gave him a Swiss Army jack knife. PT-Jeremy did more arm weights; 2 hours later he did the walker & the therapist had him go farther down the hall with some rests in between. She then had him wheel himself while holding his right boot off the ground. Jeremy tires easily but he is working hard. More PT in the afternoon-leg bike & mat exercises. We tried to coax him into sitting at the edge of the mat & playing catch with a 3 lb ball. Once dad was the target he had a sudden burst of energy & caught & threw quite well. The quantitative bacterial counts had a favorable outcome.
Tomorrow the plastic surgeons will try to close the back wound by doing a latissimus skin flap. The goal is to have some muscle with good blood flow covering the hardware from the back surgery. Please say a few extra prayers. The neurosurgeon would like to keep Jeremy 2-3 weeks after surgery to keep an eye on infection.

Friday-(continued)- Doctor from Walter Reed came over to do some screening for amputee program. We were very impressed with him. There was only one thing wrong with him. He was a Minnesota Viking fan. He wanted to know if we were cheeseheads. The next time you want to take your cheesehead to a game, don't do it. Nothing worse than trying to watch a Packer game when the person in front of you is wearing a cheesehead.

Sat-Jeremy received 2 bags of potassium & 2 bags of magnesium. PT- Jeremy used walker and went 25 feet again. He enjoyed the weather for a short time. Just took it easy the rest of the day.

Sunday-Jeremy had 45 minutes of PT today. He used the parallel bars & walked all the way there, turned around & came all the way back. He worked on the hand bike, stomach & back exercises. He had a 5 hour pass & went back to the Lodge. We ordered pizza & watched the movie Office Space. Jeremy had 6 pieces of pizza & some Oreo cookies. After the movie he played some video games. Jeremy enjoyed the pass out of the hospital.

Thursday- Jeremy received more magnesium today. PT-Weights were the same as yesterday. He used the walker and went 25 feet today. More corridor & sidewalk adventures with the wheel chair. PT in the afternoon again also. The Secretary of the Navy & his wife visited today. Coming back from being outside we ran into Santa Claus( no I have not been drinking)coming out of the elevator. Santa was here to celebrate Xmas in July. He left several DVDs for Jeremy.

Friday( thru 3 pm)-Jeremy was taken down to preop first thing. We did not go into surgery until 145pm. We spent the time in the isolation room. Plastic surgeons will do wash out. They will cut away some tissue for a quantitative bacteria count. They will have to look at the number(Monday or Tuesday) to determine when they can close Jeremy's back. They plan to do a latissimus skin flap to close the wound. Wash out was fine & the wound appears good. We just have to wait for the bacteria count.

Wednesday-Jeremy's calcium has been under control the last 3 days. He continues to receive potassium & magnesium. He worked extremely hard at PT today. He used 20 lb weights for bicep & triceps & did 3 sets of 10.
He has come a long way when he was using only 4 lb weights. He made it outside & wheeled himself on inclines on the sidewalks. Inside he had to make it up a long slope. He used his walker & made it one step outside the door. In mid afternoon he wheeled himself down to PT & worked out on the hand bike. He also worked on the mat on his back & stomach. Dietary wants Jeremy to increase his calories & protein even further. He will take a minimum of 2 liquid protein drinks going forward. He returns to surgery on Friday & the plastic surgeons will be doing the wash outs.

Before the email from Greg: A note to say that the message board is temporarily down. I'm not sure the issue. The place hosting it seems to be having problems. Hopefully it is up very soon.

Good Evening:

Tuesday- Another bag of magnesium today. Jeremy had surgery & back wash out today. He went to surgery first thing today. PT-Jeremy was worn down from surgery. Only made it 1/2 way to door. He spent 45 minutes in PT with mat exercises on back, stomach & sitting.

Monday-Occupational therapy(OT) was in early working on weights for arms(biceps & triceps). PT late am- He used the walker to the door again. PT took him outside & he worked on wheeling up inclines on sidewalks. PT took him into basement & was timing him for speed over certain distances. He ate lunch in the military café & sat at a table instead of eating in bed. The American Legion visited today. He had 1 IV bag of potassium & 1 bag of magnesium today. Afternoon PT went for 20 minutes- leg bike & stomach exercises.

Good Afternoon

Sunday-PT- Jeremy went 18 feet to the door today with his walker. This is the farthest he has gone. He spent 45 minutes in PT today. He received more potassium today. He was out of bed for 4 1/2 hours today.
Today was the first time we wheeled Jeremy over to our hotel room. He got to lay out on the double bed. It was good just to get him out of the hospital. He ate well again today. .

Good Afternoon

Sat-Jeremy had more vomiting around 1 am. The Milwaukee Brewers stopped in to visit Jeremy today. Bob Uecker, Ned Yost, Prince Fielder, Geoff Jenkins, Ben Sheets & Craig Counsell were the Brewers visiting.
Autographed pictures from Jeff Jenkins, Ned Yost & Bob Uecker, a couple of t-shirts, & a invitation to join Bob Uecker in the press box. They were extremely friendly & their visit was greatly appreciated. Thank you to the players, coach, & announcer & the entire Brewer organization. We also were honored to have a retired air force military gentlemen stopped by for a nice visit. He is from Greenfield and served in the air force for over 40 years. He has 3 children in the service now & has 9 children. He is quite the patriot & enjoyed his visit. Jeremy had more potassium & magnesium today. PT- used the walker again for a few steps, wheeled down to PT, hand bike & mat exercises. Out of bed for 2 hours & outside for about an hour. Best day of eating in several days.

Good Afternoon

Tuesday-Jeremy has received potassium & magnesium IV. He had an EKG early this morning. PT working on parallel bars & hopping forward & backwards. PT session cut short by call to surgery. They did not insert the nasal feeding tube today. They will wait to get another cat scan & ultra sound of the gall bladder. We did not talk to the surgeon after the wash out. Jeremy requested spaghetti O's. I had spaghetti & meatballs which he enjoyed. He ate the entire can. However well after we left he vomited his early dinner.

Wednesday- Jeremy ate 1/2 his eggs for breakfast; most of his PB&J sandwich, jello, & ice cream for lunch. At 315 he has been able to keep his food down. PT- worked for an hour today. More standing & hopping forward & backwards at parallel bars. Worked on hand bike, transferred to elevated mat & sat on edge-various exercises. Rolled onto his stomach & did more exercises. More potassium IV bags today. Sat outside for an hour. His kidneys are showing improvement. Endocrinology continues to watch his calcium levels & discussed treatment options.

HAPPY INDEPENDANCE DAY!

.

I want to thank all our servicemen for serving our country. A special thanks to Jeremy and our extended military family I've met through this site.Thanks for making this the safest country to live in. I'm proud to be an AMERICAN and so proud to have you as fellow Americans.

Good morning:
Monday-No appetite again & did not eat breakfast or lunch. Tried to eat a few small things in the evening but had more vomiting. He will be going back to surgery on Tuesday. No general anesthesia will be given.
Local anesthesia & some sedation such as propofol will be tried. They will also be inserting a nasal feeding tube & insert in the small intestines. PT- continues to work on parallel bars & standing on the right leg. Also worked on transferring from the wheel chair to elevated mat. Worked on sitting at the edge of mat & did various exercises. Out of bed for 2 1/2 hours & enjoyed the great weather outside for about 1
1/2 hours. Monday evening they started IV reglan & IV erthromycin. I hope you all have a great 4th of July. My wife & 2 children will be going to the White House to enjoy the fireworks. Originally the plan was to take Jeremy also but he has been too sick to be gone for that length of time. We have out of town visitors coming on the 4th so that should help brighten Jeremy's spirits.

Saturday- After about 19 hours in ICU Jeremy is back in his surgical room on the 5th floor. In ICU we were back to using the alphabet board for communicating. WBC, calcium, & serum phosphorous all declined which is good. Creatin has not increased. Jeremy was clamoring to get out of ICU Saturday morning, it brought back bad memories. He asked to go outside. A nurse came with us while we sat outside for an hour. He was out of bed in total for 1 1/2 hours. We gave him some small portions of steak spread over several hours. Still does not have much of an appetite. He had 3 small bouts of vomiting after 11pm.

Sunday(through 2 pm)-The calcitonin injection continues to decrease his calcium. Endocrinology said the effects of the calcitonin may be effective for only a short period. His serum phosphorous also declined.
His WBC went back up but is less than 13. His creatin also dropped slightly. He did not eat a good breakfast or good lunch. Dry heaves again this morning. PT- worked on standing with parallel bars. Stood on his right leg 3 times in PT. Did leg bending in the wheel chair. He was out of bed for 2 hours & outside for 3/4 of an hour. We have to get this boy eating again.

A Saturday update. These don't happen often, but I thought Jeremy could use some extra prayers this weekend. Hes having a rough time right now. I will post Greg's email below. If i don't post again this weekend that means that he did not get worse. He either stayed the same or got better. Check the messages on the left of the website. I'll post mini updates there today and tomorrow if i get any changes on his condition. Thanks again for all the support for Jeremy. Its much appreciated. -- Laura

Friday-Jeremy had more problems with nausea this morning. PT-Jeremy made it to the wheel chair & rolled himself up & down the hallways both ways on his own power. He went down to preop around noon. We spoke to the neurosurgeon & his back is looking very well. Discussion of the muscle flap & plastic surgeons was explained. His back is healing well & discussed the possibility of some other unidentified problem. We waited in his room & were called back to post surgery area to talk to neurosurgeon & anesthesiologists. Jeremy initially looked like he was responding okay to being removed from the ventilator. He was in some distress & had to be put back on the ventilator. He is now in ICU & we are waiting for things to settle down to see him. Please continue to pray for our son. When I have more information I will send another update.

Continued- Jeremy is in ICU. Jeremy has had a reaction to the anesthesia & being put back on the respirator. He will be in ICU overnight. He now can move his arms. He is responding to commands by shaking his head yes or no. In 4-8 hours he should hopefully regain full use of his muscle abilities. Nothing comes easy for Jeremy.

Good Evening:

Thursday- Jeremy had more vomiting with breakfast. Jeremy received 2 different anti nausea medicines but they were not effective. He has had some jello but has eaten very little today. PT- We did get Jeremy down to parallel bars & did stand on the right leg twice. He was able to last 30 seconds & did a squat & pulled himself up. Jeremy slept most of the afternoon & evening. Nephrology collected urine again today. The colistin will be discontinued & they will switch to Minocycline.
Endocrinology continues to watch Jeremy's elevated calcium. Certain drugs can not be given due to his kidney decline. Tonight they will give a liter IV bolis to maintain hydration & then give him a diuretic(lasix) in an effort to decrease his calcium. Nephrology, Endocrinology & trauma are all in agreement on this. He has also started a nasal spray Micalcin today. Jeremy has surgery tomorrow.

My youngest son has extremely long hair. We went down to the barber shop & we both had immediate seating. One of those magical father son bonding moments. We could see each other getting our hair cut. I have never seen so much red hair on the floor. I thought he still had a decent amount of hair left. We were alone in the elevator & I made the mistake of asking my son if he was mad. He said yes. Foolishly I asked him if he wanted to hit me & of course he said yes. He hit me 3 times in the shoulders. He got off the elevator & he said he felt much better. I repeated the story to Jeremy who started laughing. Jeremy was a little upset that I made him get out of bed & do PT after being sick. He then asked me if he could hit me. I said sure but I only let him hit me once. It was worth it to see him smile.

Good Evening:

Wednesday- PT - Made it back down to the PT room. Jeremy worked on parallel bars & standing on the right leg. We have not been able to do this since the back surgery almost 2 months ago. He did this several times. The first time is the hardest. He was out of bed for 2 hours today. The standing wiped him out for the rest of the day. He had more vomiting mid afternoon. Jeremy thinks it was from his body not being use to standing up & down motion. He did manage to get some sprite, jello & mac & cheese down in the evening. His kidneys have shown some decline.
They will hold the colistin for now & give it to him every 36 hours at a lower dose. They are modifying his drug orders in other areas to watch his kidneys. They have also held off on his elevated calcium issues for a day.

Good Evening:

Tuesday- Jeremy ate well today. He sat in the wheel chair for 2 1/2 hours today. PT in bed & wheel chair. His pre albumin Numbers have improved from the 7 range to almost 14. His Calcium & serum phosphorous levels are too high. Endocrinology has been talking to us over the last few days. Tonight he is starting to take renagel to control his serum phosphorous levels. Tomorrow we will address his calcium issues with Endocrinology. We need to keep Jeremy eating & build up his protein levels. Unfortunately most medicines come along with side effects.

Good Evening:

Monday-There was a 13 year old boy scout from Troop 1257 in Oak Hill, VA that visited Jeremy today. This is a remarkable young man. He raise over $6,000 in funds and designed a Coin of Honor for military people. He had them made & gave Jeremy one this morning. The front has the phrase'
*Coin of Honor* Duty to God, Country, And Others* this is on the outer edge. The middle has a brown heart with an eagle & the 'Be Prepared'
motto. On the back side the phrase '* America Shall Never Forget* Those Who Selflessly Answered The Call OF Duty*. In the middle is a map of the USA colored as a flag with an eagle in the middle. BSA Troop 1257 Oak Hill, VA. Please keep in mind my description does not do this coin justice. It is a beautiful piece of art work. I can not even begin to tell you how impressed I am with this young boy scout. Young men like this don't usually make the front page of the newspaper. He deserves to be on the front page. A special thanks to this fine young man & his troop. Another back washout this afternoon. PT in bed again. Moved up to the 10lb weights for arm exercises.

Another washout today. Jeremy went down to preop close to noon. He is scheduled for another washout on Friday. He was out of it when he returned to the room. Slept into the early evening. Started out very slowly with some drink & food but more vomiting occurred. He slept the rest of the evening. He did not have anything to eat today because of the surgery & vomiting. The good news is he has 3 days to recover now. Trauma team, IFD team & Neurosurgery team will have further discussions on how to proceed.

Good Evening:

Friday-Jeremy went to surgery very early. The surgeon is pleased with the way his back is progressing.The plastic surgeons may be brought in next week. Jeremy refused to have the tube run through his nose to his stomach be inserted. IFD is switching his antibiotics because the acinetobacter has become resistant to the Fortaz. He now will be taking Colistin. The problem with the antibiotics he is taking is that toxicity may be an issue over time. IFD spent some time discussing Jeremy's surgeries with the surgeons. Next week all the IFD doctors and several surgeons will continue to discuss Jeremy's case. Jeremy ate well again today. Getting back to his room late morning from surgery helped his ability to eat the rest of the day. He had several bowls of cold cereal,
2 mac & cheese, 2 Ensure, 1- 6 inch Subway ham & cheese, 1 steak, 1 square of deep pan pizza, & a hot fudge sundae. Complete PT in bed
today. Tomorrow we need to get him out of bed & outside again.

Saturday- IFD continues to evaluate tissue samples from the washouts.
Their analysis has found 3 antibiotics that are effective against the acintobacter. They are colistin, minocycline, & tigecycline. This gives IFD a few more options. They will continue to work with surgeons about what will be the most effective treatment plan. IFD has gone out of their way to keep us informed. Under the best scenario the hardware in the back will not have to be removed. If the hardware has to be removed they will try to delay as long as possible in order for the bones to heal. We will just have to wait & see. Friday nights the hospital puts on a dinner for the patients & families. Contrary to typical stereotypes the hospital food is quite good here. Another support group put on a luncheon for us which was very nice. The Cleveland Indians stopped by to visit today. The USO reps will take a group picture of the visitors & patient. It is okay if the Indians win as long as they lose to the Brewers. They did talk about their opening season & how they had to play games indoors @ Milwaukee. They had very nice things to say about our town. PT- legs in bed, arms in wheel chair. Jeremy spent 3 hours in wheel chair early in the day. Later in the evening Jeremy was outside for about 35 minutes. Jeremy received 2 IV bags of magnesium. Jeremy continues to eat well.

Sunday- 2 more IV bags of magnesium. PT in bed today.

Good Evening:

Thursday-The morning started out slow. It took 3 1/2 hours but he ate a banana & his eggs. He received 2 units of blood & 2 IV bags of magnesium. IFD continues to monitor new cultures & is always exploring new antibiotics that may have to be used. Endocrinology stopped in because his calcium is too high. They are collecting his urine for a 24 hour period to measure his calcium & creatin output. The PPN is being discontinued this evening. They will be switching tactics tomorrow.
Friday another back washout & while down there they will put a tube down his nose into his stomach. They will supplement his diet this way starting post op tomorrow. PT continued leg exercises in bed. Jeremy sat in the wheel chair for 4 hours today. He went outside for 1 hour. Now to show you the boy really does like to eat ,when he is not nauseated, I will tell you what he ate the rest of the day. Macaroni & cheese & cottage cheese for lunch. In the evening he ate pizza, cottage cheese,ice cream, a small steak(Uncle Dennis), & a double cheeseburger(McDonalds).

Good Evening:

Tuesday--More nausea today in the morning, afternoon, & late evening.
They have discontinued his tigecycline and is now on Linezolid. Tomorrow back to OR for more back wash out. No PT Monday or Tuesday.

Wednesday- Jeremy's stomach felt better today. Unfortunately he was scheduled for surgery today. Nothing to eat or drink from midnight until surgery. He did not go down to pre-surgery room until 5 pm. He missed breakfast & lunch due to surgery. PT today again focused on legs.
Surgery went well. They are concerned about his nutritional status. His prealbumin numbers are in the 7 range. His nausea since Saturday has not helped matters. He was vomiting again post op while trying to eat a late dinner. He is now on IV PPN(peripheral parenteral nutrition)& lipid supplements. They are also monitoring his blood sugars due to the PPN.
Thursday early morning he received insulin to adjust his high blood sugar levels from the PPN. Hopefully the anesthesia effects will be gone & we can get some food back into his system. It is a cycle of surgery to clear infection, you can't eat pre surgery; the antibiotics & anesthesia have their side effects. Hopefully the new antibiotic will be tolerated & we can get Jeremy eating again. Wound healing is delayed because nutritional status is not good.

Good Evening:

Monday- Sat & Sunday had PT in bed. Worked primarily on legs. More nausea in the morning. Wash out of back went well. Did not have to cut a great deal of muscle. They are letting the wound heal from the inside out. His WBC was 11.1. He had more vomiting @ 5pm. They will hold his 3am antibiotic & let the primary team reevaluate early Tuesday morning.
He has only been able to get down a chocolate shake & some crackers this evening. IFD would like to try going a few more days before switching his antibiotic. He did develop a rash on the face & the benadryl cleared that up but also knocked him out. There is the 'Equalizer,Enforcer, Terminator,Transporter & Others'. I think I will start calling my son 'The Grinder'.

Good Evening:

Sat- Friday night he received 2 IV bags of magnesium. Later Friday night he had a temperature of 100.6. Saturday morning he had nausea & dry heaves. He has been getting anti nausea medicine with his antibiotics all along. Received 2 different anti nausea medicines & he slept until 4pm. Had peanut butter & jelly sandwich & 2 bowls of mac & cheese in the evening. Late Friday night his WBC was 19.6 but has dropped to 15.6 early Sunday morning.

Sunday- More problems with nausea & vomiting in the morning. Happy fathers day to all. I know it will be a fathers day I will always remember.

Good Evening:

Thursday cont-Jeremy lasted almost 5 1/2 hours in the wheel chair. This was a big jump from going a 1/2 hour previously.

Friday- More irrigating of the wound & cutting dead muscle in the back.
I usually turn Jeremy over & can't see his back too well. Today I looked over his side more & saw the cavity in his back. Hopefully they will not have to cut too much more muscle. A plastic surgeon will be needed & muscle will have to be taken from elsewhere in the body to close the wound. His P.I.C.C line was having troubles pulling back to draw blood.
An x-ray was taken to check the position of the line. They believed a small clot had formed at the tip of the line. They inserted cathflo activase & eventually they were able to draw blood again. So that was good to see. That boy just doesn't like things put into his body. He is scheduled for more wash outs next week on Monday, Wednesday & Friday. We all hope & pray that his back muscle starts to heal soon.

Good Afternoon:

Wednesday- Jeremy returned to surgery for another washout to his back.
His temperature have been fine. His back will require a number of washouts.

Thursday Jeremy has gotten out of bed & is sitting in his wheel chair right now. He is approaching the 3 hour mark of being out of bed. He is scheduled for another washout tomorrow.

Sorry i was out of town the last few days and my trusted workers lost the notes to update this website. You just can't get good help these days..lol. Here are the updates since Friday.

Friday early night- Good session with PT. Sat in the wheel chair for 1/2 hour. His belly pain improved. Nothing to eat or drink after midnight. He may have surgery on Saturday.

Friday night-1030 pm eastern, temperature of 103.7. More blood cultures taken and a second antibiotic has been added.

Saturday- Jeremy had surgery this am. His back had an irrigation & debridement. He has another sponge wound vac that suctions fluids out of the surgery site. He will have to go back to surgery every other day for an unspecified length of time for more back wash outs. He did have a collection of pus & a hematoma in the back area. Jeremy is sleeping comfortably. He will remain on two antibiotics the second one is vancomycin which he was on earlier.

Sat-night-845pm Jeremy's temperature reached 101.1. Since then his temperature has not reached 100 through Monday @345pm. His WBC was 13.4 Sunday morning & 10.1 Monday morning. Jeremy started his 3rd antibiotic this evening( Minocin).

Sunday-PT in bed worked hard at range of motion for legs.

Monday- More surgery & back washout and additional infection drained.
Infectious disease is monitoring cultures from Saturday & Monday to see if new bacteria are present. He is scheduled for another wash out of the back on Wednesday. Limited leg bending of knees in bed today.

Tuesday-IFD-Jeremy has another bacteria-VRE-Vancomycin resistant enterococcus. They will be stopping the vancomycin & minocin. He will now be taking a new antibiotic tigecycline. Jeremy continues to work hard at PT in bed.

Good Afternoon:

Friday- At 4 am Jeremy ran a temperature of 101.2. His WBC is 24.8. He had another CT scan. He received some contrast for the scan through his IV and his belly is in pain. IFD stated there was fluid buildup in the back area. Neuro will stop by later to discuss how to deal with this. Just when you thought he was going to be released...

Good Evening:

Thursday- X-rays of right foot & left femur were taken. Jeremy took his T.B.I. Test this morning & happy days he passed the test. His nausea subsided & was eating better. Since he passed his T.B.I. Test he can skip going to Minneapolis & head right to Walter Reed for physical therapy & prosthetic treatment. He still must be cleared by Neurosurgery but things are heading in the right direction.It has been a very positive day & I couldn't be happier for Jeremy. PT- worked the legs very hard in bed. Moved to the wheel chair for an hour & did arm exercises in wheel chair. They are much tougher to do in wheel chair than in bed. There will be many more grueling physical demands in the days ahead but I can't wait till the day that I hear Jeremy walk through the front door and say dad I am home. It will be a magical day.

Good Evening:

Wednesday-Continued problem with nausea through out the day. He took anti-nausea injection a second time. Jeremy was on IV fluids the entire day. His back drain tube was pulled late in the afternoon. His T.B.I.
Test will be delayed & they will try again on Thursday. He did not take any pills today because of his nausea. He had a good session with the pysch doctor. I have been working with him on the importance of actively interacting with the medical staff. A prosthetic's doctor from Walter Reed stopped by today. Jeremy did keep down about 300ml of coke from 2-8pm & had 3 crackers. Hopefully tomorrow the nausea will subside.

Good Morning:

Tuesday- Jeremy had nausea problems today. PT- Late morning & Late afternoon out of bed & into wheel chair for 1/2 hour each time. The boy was not too happy with this. Psych team was in & discussed medication but Jeremy was resistant to this. They will try to do another T.B.I test & then revisit this topic. They are going to continue testing different antibiotic combinations for the Klebsiella pneumonia strain.
We went down for another cat scan last night of the back. His compact hemovac drain was not putting any fluid out.

Wednesday -am- Problem with vomiting.They have given him something for this. The cat scan was negative. They should pull the drain out of his back today. He is scheduled to take his T.B.I. test shortly.

Good Morning:

Monday-Infectious disease will no longer be stopping in to discuss Jeremy's situation.They have identified their best antibiotic. He will need to be rescanned in 6 weeks. After we leave here they do no monitoring of this situation. It will be up to the next rehab center to monitor. PT in bed again. Left leg is still swollen. Jeremy was in presurgery @1200 & wheeled off to surgery @100pm. He was in surgery 3 hours. Cadaver bone & OP-1( protein to induce new bone formation) were inserted. Washed out back & back closed. Sutures to be removed in 2-3 weeks. Where they will be removed is anyone's guess. Jeremy still has nutritional & immune issues. He did have a double quarterpounder with cheese & a large chocolate shake. He was a little hungry after going 20 hours with out anything to eat. They will have to monitor him closely to see if infection becomes an issue again. Hopefully this issue will be resolved before he is shipped out.

Good Morning:

Friday- The wash out of the back went well & the tissue is looking better. The doctor that performed the surgery today was a doctor that performed surgery on Jeremy in Iraq. We are happy he is back in the states & grateful to all the doctors& medical staff. Infectious disease stopped in & they have identified 2 bacteria in the back- Klebsiella pneumonia & alpha hemolytic streptococcus. For now they will continue with the current antibiotic treatment. They may change the antibiotics next week. The current antibiotics kill a broad spectrum of bacteria & they may narrow the spectrum of bacteria to kill. This issue will not be over after the 6 week treatment. It will be a long term issue. They plan to take Jeremy back to surgery on Monday for another back washout.

Saturday- Heavy vomiting midmorning. No PT today. Neuro & General Surgery teams looked at back & were pleased. On Friday I saw Rick Springfield leaving the lobby area as I was returning from doing my laundry. Saturday the San Diego Padres were on the floor while Jeremy was sick. By late afternoon he was finally feeling better & ate lunch.
He had no problems with dinner either.

Sunday- Infectious Disease told us he has one more bacteria present called acinetobacter. They have been experimenting with different antibiotics to see what will work the best on the 4 bacteria. They have switched his antibiotics to just one for now. The antibiotic being used is ceftazidime(fortaz). Lunches were provided both Saturday & Sunday by support groups for the families. Thanks to all the support groups.
Jeremy will return to surgery on Monday for another wash out of the back.

Good Morning:

Thursday- Jeremy's temperature was stable for the day. He received another unit of blood. PT in bed again. The pain catheter for the left leg was turned off today. It should be removed on Friday. Providencia rettgeri is the bacteria that was cultured off the left femur bone. We are still waiting on the culture from the back. One of the two antibiotics Jeremy is receiving is effective in destroying the bacteria found on the left femur. Jeremy 's spleen was removed. He needs to receive 3 vaccines to cover 3 encapsulated microorganisms-HIB vaccine,pneumovax vaccine & meningitis vaccine. He needs to get this before he leaves.

Friday-Up to now we have been fortunate to have a private room. Today that has ended. We now get a space 7 1/2 feet by 11-12 feet. The room has no shelving for medical supplies. I have placed various supplies in small plastic wash basins & put them on the window sill. The bed takes up most of the room. It is 3 1/2 feet by 8 feet. Jeremy is going down to surgery today for another wash out of his infected back. To get out of the room the computer has to be disconnected & wheeled out of the room.
His room mates bed has to be moved to a 90 degree sitting angle in order to get Jeremy's bed out of the room. Every morning I go through the main entrance & they still have the heat blasting when it is 90 degrees outside. I don't ever want to hear another sarcastic comment about being from the Midwest. All right I will stop with all my whining now.

Good Evening:

Wednesday- Late morning Jeremy went down to Interventional Radiology to have his P.I.C.C( peripherally inserted central catheter). This line can last 6-8 weeks. He will be undergoing at least 6 weeks of antibiotic IV's & his veins can no longer hold up to regular IV's. They can give antibiotics & also draw blood from this line. We both were exhausted from the late night surgery & slept most of the afternoon. There was a microorganism from the femur culture & we will have to wait & see what microorganism grows out of the back cultures. This should help narrow the selection of the proper antibiotics. It could take 4-5 days for these results. This evening Jeremy is running another fever which is not unexpected after surgery. He usually runs a fever the day after surgery.
Thursday night we return to OR for more washouts of the back.

Good Evening:

Tuesday- PT more of the same in bed. Jeremy sat in the wheel chair for 2 hours & 15 minutes. He had a slight blood loss in the lower back area.
His blood pressure also showed a slight drop but has come back since then. Infectious disease was in when he started shivering. They swabbed his back site & ordered more blood cultures. The neurosurgeon stopped in & is calling the operating room(OR) to see if Jeremy can get in tonight. He is suspicious of infection & wants to do a wash out of the area. It could be a late night depending upon the status of the OR.

Wed-Left the presurgery area at 115am & the doctor spoke to me at 315 am. Jeremy has a bad infection in the back. He had to open up the whole wound. When the corpsmen brought down a pressurized wound VAC during the surgery I knew that was a bad sign. He had to cut away some of the dead tissue & remove the necrotic hematoma. The dead tissue & necrotic hematoma were sent for cultures. Jeremy will have to return to surgery on Thursday night for another wash out. The hardware will not be removed. He feels he can treat the infection & still close the wound. Another setback, keep praying for Jeremy.

Good Evening:

Sunday- Jeremy did not sleep well Saturday night. PT in bed again. We treated Jeremy to an A&W root beer float which he enjoyed. He also enjoyed some ice cream cake late last night.

Monday- Anesthesia is starting to wean Jeremy off his left leg pain pump. Ortho took the wrapping off the left leg & the wounds are looking good from surgery. Jeremy is starting to eat better. We need to get some weight back on this boy. We got Jeremy out of bed & outside today. He lasted an hour in the wheel chair before his back acted up. It was a nice extended Memorial Day Weekend. Thanks for all your concern & support. I won't even begin to guess at when we will go to Minneapolis.
When we land at their airport I'll let you know. Every time I give you a date something happens.

Good Evening:

Friday (cont)- The gunnery sergeant from Mail Call stopped by to visit Jeremy. We did get down to nuclear medicine to do another bone scan. In the evening we went down & had an ultra sound of liver, gall bladder, kidneys, pancreas, & legs.

Saturday-PT in bed again. The ultra sound showed no problems just as the trauma doctors anticipated. Infectious disease is still looking at the
T9 & back portion of the abdomen as a possible infection site. Right now they are looking at a 6 week program of antibiotics. His last elevated temperature was 101.00 on Friday @730 am. He is having problems with his veins & IV's not lasting. He will probably need a P.I.C.C. line to be inserted by the radiology department. They have switched his oral pain medication around to methadone & celebrex.

Good Evening:

Thursday- Jeremy had a cat scan of his left leg. He did have a hematoma along the outer left thigh. This should be reabsorbed by the body. He received 2 units of blood. After 300pm they drew more blood & his levels returned to 7.6 for hemoglobin & 24.1 for hematocrit. The plan is to wait till morning to see if his levels hold. Jeremy had some steak that his Uncle Dennis dropped off for dinner. Uncle Dennis is a great cook.
Limited PT in bed.

Friday- His blood levels were 8.6 & 27.2. It must have been the steak.
Infectious disease wants to sit down & have a meeting with Neuro, Ortho, & Trauma. IF said that because his spleen is removed WBC counts in the 10-20 range is not uncommon. Jeremy could not eat his breakfast today & became nauseous. Nuclear medicine dropped by to inject him again & they want him to have another bone scan this afternoon. The nuclear medicine tests & the MRI tests are not in agreement. The big news in the hospital today was the President of the United States visited us. We had our pictures taken & he spoke to both of us for a few minutes & signed a Marine poster we had. Hopefully we can get Jeremy eating this afternoon.
I hope you all have a wonderful Memorial day weekend. It is a good time to reflect on all the sacrifices our military people have made for our great country. Take care.

Good Evening:

Wednesday- At this time the trauma team does not feel an ultra sound is needed of the liver & gall bladder. The MRI of the back revealed no bone infection. They concluded the area showed post operative changes that appear normal. Presently the plan is to do a 6 week regiment of antibiotics. It appears that when ever a surgery is done doctors orders are completely reentered. Originally Jeremy was receiving 4 mg of muscle relaxant but the order was changed to 2 mg because he was sleeping too much. I will have to get this clarified tomorrow to see if it was changed back to 4 mg or if this was entered in error. For the rest of the night Jeremy can refuse the muscle relaxant or ask the nurse to only receive 2mg until this is straightened out. The epidural catheter has been very effective in controlling the left leg pain.

Good Morning:

Tuesday- They put a catheter in his left leg to run a nerve block before surgery. After surgery on his left femur he now has 8 screws & a plate. Some material was cultured from the bone. He has an anesthesia pump for his left leg. The pain control is much better so far. In the evening he had an MRI done. The team had to examine all his x-rays & verify they could see no shrapnel before going under the magnetic pull of the MRI. Vomiting & a fever of 102.8 didn't surprise me. He then enjoyed macaroni & cheese, milk, brownie & ice cream.

Wednesday am-This boy is hard to wake up. Infectious disease was in early & is waiting for final MRI results. More alkaline phosphatase tests ordered. These enzymes are found in the liver & bone. The flow of bile through the bile ducts seems to be moving at a slower rate. More blood work is needed & a possible ultra sound to look for duct obstruction may be ordered. Infectious disease can not order these tests
but must convince his trauma team to order the tests.

Good Evening:

Sunday- Another fever early in the morning. More PT in bed. We had to turn him on his side. The left femur is extremely painful. Ortho came in to open immobilizer on left leg & look at the back. Morphine boost before could not touch the pain.

Monday- White blood cell count jumped up 4 & platelets also increased roughly 250. More PT in bed. More turning to clean & inspect back area.
Open & inspect immobilizer again. Surgery is scheduled for Tuesday mid morning of the left femur. Plate & screws are required. Infectious disease would like a fluid sample from back to see what if anything is present. This would be done in radiology, a date has not been set yet.

Good Afternoon:

Friday-Two more trips to nuclear medicine today. The right foot bone scan showed that there has been improvement to this area. We are waiting to hear from neurosurgery team, hopefully on Monday. No pt today with trips down to nuclear medicine.

Saturday- PT- done in bed because they do not want to move the left leg until after surgery. Even though they have cut the muscles relaxant dose in half Jeremy is out cold. They left weights for me to have him use. We will have him start using them later today when he wakes up. We have to build him back up to where he was before back surgery. We met a family when were in ICU whose son was involved in a helicopter crash. He has been in a coma for a few months now. He is in the room next to Jeremy.
He is back from the Tampa trauma center for some brain surgery. I met him for the first time today. They are from the Oregon area & they are the nicest family. He is married & I pray for his recovery. I have seen many families with many degrees of injuries over the last 3 1/2 months.
I try to keep things in perspective as best I can.

Email from Greg:

Hello Everyone:

Wednesday-Morning surgery by ortho. They remove the external fixator.
The bone did not separate but there was too much wobble in the left femur. They also cleaned out right leg & cultured a ligament from this leg. The left femur will require a plate & up to 6 screws. This was not done earlier because of the all the trauma Jeremy had endured & his high risk of rejection of foreign items introduced into the body while he was still in ICU. Surgery could be next week. The current fever & source of infection still needs to be addressed. Jeremy had another CT scan of his back & right foot. Thursday & Friday we will be visiting nuclear medicine again. Jeremy is being put back on 2 antibiotics. Minneapolis will be delayed indefinitely.

Thursday- Fever spike of 102.7 at 4 am. Nuclear medicine visited early morning. Injected gadolinium & tagged white blood cells. Returned to nuclear medicine in early afternoon & had a bone scan. We will return Friday morning to do another MRI scan to see where the white blood cells are moving to. Ortho stopped by & discussed femur problems & additional surgery. They took wound covering off the right leg. Jeremy still can not feel the toes on his right foot. The ortho doctor then discussed with Jeremy that the right leg may not be a functional leg. He discussed the potential for amputation of the right leg. The doctor was not trying to wheel him into surgery but is trying to prepare Jeremy for this possibility. The feeling in the foot may return. Jeremy has earned the right to work hard at rehabbing the right leg. Jeremy has to exhaust all possibilities before he makes that decision.The cat scan is back but we have to wait for neuro department to comment on the back. As of now they are still tied up in surgery. A young marine from Illinois who was in Jeremy's division stopped by to visit. He was kind enough to leave Jeremy a gift while Jeremy was still in ICU. This young man has made tremendous progress since the last time we saw him in ICU. I know we will see the same from Jeremy.

Email from Greg:

Hello Everyone:

Tuesday-Jeremy was easier to wake up this morning. The head trauma doctor was not concerned about the drainage reappearing from his old peg site( I know I worry too much). PT-wheeled down to PT room & he was being timed. He had the arms pumping today. He had to transfer himself from wheel chair to PT mat. He had to lay flat with his arms back to stretch out that back. Then had to do some curls. Pushed himself to a sitting position. Did several more mat exercises & had to move himself back into the chair. Not a happy camper. They wanted him to sit in the chair 4 hours but made it 3 hours. A Colonel from the 1st Marine division stopped by. Jeremy needed to receive a morphine boost. Ortho- wants to take him back to OR tomorrow to reevaluate the external fixator that is holding his left femur in place. They may remove it all together, add or subtract pins, or possibly put a plate in depending upon what they find. Jeremy vomited in the evening during 2 different times. They should stop the new drug they gave him today. At 8:30 pm he had another fever of over 103 & had an elevated heart rate. So maybe surgery will be postponed. We will have to start calling him fever boy.

Email from Greg:

Hello Everyone:

Monday-Jeremy slept through his morning vitals. PT- more of the same increased weights by 2 lbs. Beautiful day & we did get outside. Spent most of the afternoon in ortho getting more x-rays of left leg & right foot. He had to get in many awkward positions & pain was an issue. After we returned to the room more X-rays were needed & wheeled his bed down to the x-ray department for more shots. Friday when he showered the scab from his peg tube area come off. Monday night he started leaking more what appeared to be the stomach acid that was leaking when he had the peg tube in. I asked to have a doctor look at this & will have to see if he was examined after I left for the night. He had the peg tube pulled back on 4/29 so I will have more questions tomorrow for the doctors. He still needs to be eating better. Psych was in & will start him on some new medication for his T.B.I tomorrow.

Email from Greg:

Hello Everyone:

Friday- Jeremy was in a great deal of pain & receive a morphine boost.
PT-leg exercises in bed; rolled himself to PT room 150 feet; biceps & triceps. First time outside since surgery and it was great to get him outside. Rigged up a shower chair a took a long shower with PT's help.
Cat scan was negative. Infectious disease wants to do 2 more tests.
Ortho had dermatology do a scraping of ulcer & this turned out negative.
Stats looked good today. I thought we were going to finish on a good note but he spiked a fever again this evening.

Saturday-Jeremy slept in late today. PT- leg exercises, biceps & triceps again @ 4lbs.He wheeled himself 150 feet again. We went outside & enjoyed the nice weather. He sat in the wheel chair again for 2 hours.
His appetite has decreased & I am guessing it is from the medication.
Fevers lessoned & that was great news.

Sunday-Changed muscle relaxants today. Did not get out of bed today & took it easy. The medications make him tired. Please hold off on any more cards. The head trauma doctor will push to have Jeremy leave late in the week. Air transportation has to be arranged with the air force & other administrative items need to be handled. This is as always subject to change. His temperature stayed below 100 through 11pm.

Email from Greg:

Hello Everyone:

Country singer visited yesterday. Jeremy was very tired & slept most of the morning after his medications. PT- did leg exercises in bed. Later back in the wheel chair. Couldn't see who the visitor was today. He was in the room next to Jeremy when we were out wheeling in the hallway. I turned around & Mark Harmon was leaving. I guess Jeremy should have stayed in bed 5 more minutes. Jeremy wheeled himself about 50 feet to the lounge & was in quite a bit of pain. Sat in the lounge for half an hour. I wheeled him to PT & he did bicep curls again. Sat in the wheel chair about 1 & 1/2 hours. We had been up to 7 hours pre back surgery.
Pain is more bearable in bed. Corpsmen wheeled his bed down to get CAT scan. When he came out his nurse entered radiology. He got a morphine boost & felt much better. No fevers tonight through 10pm ( happy days).

Email from Greg:

Hello Everyone:

Wed- They have stopped Jeremy's antibiotics for now. Infectious disease is back on the case. PT-4 lb bicep curls. We have to start all over again to build back to the pre surgery levels we were at. Extreme pain in moving to and sitting in the wheel chair. Sat in the wheel chair for
2 hours. Tuesday night very late ran high fevers again. Wednesday night more fevers. They are drawing more blood cultures tonight and they want to send him down for another cat scan late Wednesday night or early Thursday morning

Email from Greg:

Hello Everyone:

Tuesday- Jeremy ran high fevers again early this morning. More blood cultures etc. More blood cultures ordered late morning. They took him off the morphine pain pump today. PT- more leg exercises in bed. Sat in a wheel chair for 2 hours 15 minutes. Miserable day trying to find right pain medications. Had to run an IV when blood pressure dropped. Ortho head doctor had them open up cotton (mummy)dressing. The calf has healed up but he wants the leg in a boot for an area he has some concern for.
The semi open boot has a lining & we have put a thin egg crate inside the boot. Things change by the hour. His leg is so sensitive. Hopefully Jeremy's body will adjust to the new pain plan & tomorrow will be better.

Email from Greg:

Hello Everyone:

Saturday- Miss Pennsylvania stopped by today. She was a member of the Penn State Dance Team & is a huge football fan. Ortho changed the leg dressing & let the leg air out for a few hours. So far so good with the leg. My wife was so kind as to run Jeremy's lap top to a computer store & they gave him a new password. He can access his music, tv shows, & some video games now. The back pain is a little better today.

Sunday-PT stopped in & did leg exercises from the bed. Each day the back pain improves a little.

Monday-PT had to lift Jeremy into his wheel chair. First day out of bed since surgery. He sat in his wheel chair for 1 1/2 hours today.Quite a bit of pain. On the left leg he had some stitches removed. Ortho was in and surgeon looked at both legs. The x-rays of broken left femur are not fully healed & the fixator can not come off just yet.He still has hardware sticking out of his left leg with pins going into the bone. It is difficult to turn him. Ortho will return Tuesday to change wrap of right leg. Neuro stopped by in the evening & removed a stitch & pulled the drain tube from his back. We want to speak to the Neuro surgeon again hopefully will connect with him tomorrow.

Email from Greg:

Hello Everyone:

Friday:The neuro resident was in early morning & said the cat scan looked fine. He examined the back & said it also looked good. Some heating packs were used on his back. We worked most of the day on using a deep breathing exerciser. He was moved out of ICU around noon. They increased the concentration of morphine & his frequency on the pump. He ran some low grade fevers which is no surprise. A marine from his division stopped by to speak to Jeremy. He has similar injuries & is near the end of his rehab. The last time we saw him we were in ICU & can see he has made great progress. The president of Dartmouth College( a former marine) stopped by also. They have many support groups that want to help the troops. Everyone here at Bethesda Naval Hospital has worked very hard on our son's care. We will keep plugging away until he is healthy again.
.

Email from Greg:

Hello Everyone:

Thursday-Jeremy had a slight fever this morning. While in pre-op area he developed some headaches. The neurosurgeon discussed possibly postponing the surgery but the head trauma doctor felt we should proceed. We left Jeremy roughly about 9am & the neurosurgeon stopped by roughly at 430 pm to tells us how the surgery went. Jeremy had 12 titanium screws & some titanium rods placed into his spine. He will be staying in ICU overnight. They wish to monitor him closely overnight. He has a back drain in. The neurosurgeon was pleased with how the surgery went & will have to watch Jeremy over the next 2 weeks. We got to revisit ICU about 515 & he was in extreme pain. They gave him some morphine and a morphine pain pump. We had to leave at 600 & returned at 8pm. He was still very uncomfortable & was not happy to hear that a cat scan was required tonight. Attempts to delay this proved futile. Because of the degree of correction they want to verify immediately how the spine is lining up.
The nurse mixed up some valium in some pudding. I gave him some ice cream & water. The valium has helped take the edge off. I hope it holds through his cat scan which will need to be done before midnight. NO ventilator, hopefully the cat scan will confirm good results & he can return to the 5th floor shortly.

Email from Greg:

Hello Everyone:

Wednesday-The Marine Corp League had several members stop by. They shared several stories & kept the pace very upbeat. Early evening they drew blood to match for surgery & started an IV. One of the samples had to be drawn a second time. Then he spiked another fever. The doctor had to come in and examine him. Since he spiked a fever more blood work to be cultured, sterile urine sample. At midnight no food or drink orally.
We have 45 minutes left to push as much fluids orally before the restriction takes place. At 4 am they will be back in for more pre surgery blood work. If the blood cultures do not show an immediate reaction surgery will proceed. He is scheduled for early morning surgery. The surgery can take anywhere from 4-8 hours. Unfortunately we have been told that he will return to ICU for several hours of constant monitoring after surgery. Hopefully he will not have complications during this period & can return to the 5th floor ASAP.

Email from Greg:

Hello Everyone:

Tuesday- Ortho stopped by & I was able to see them change his right leg dressing. It has been wrapped up since Saturday. The ortho doctor held the leg up for me to look at. She said it looks very good. She changed the dressing & wrapped again with heavy layer of cotton & ace bandage.
We teased Jeremy and say he looks like the stay puff marshmallow from Ghostbusters. PT had another good session & on the way back I forgot something in PT. I went back & as I came back in the hallway I heard my son was racing me back to the room. Results of the race are hotly contested by Jeremy. Sat in the wheel chair for 7 hours today. The hospital food has been good but they did not get the order right & Jeremy is a fussy eater. So he had Subway & McDonalds today.

Email from Greg:

Good Evening:

Monday-Jeremy sat in his wheel chair for over 6 1/2 hours. Increased weights for arm exercises. A colonel from his division visited today.
Later in the day his lieutenant visited also. The unit is back from Iraq now. Jeremy is slated for back surgery this Thursday. More fevers later tonight.

Email from Greg:

Thursday the 26th- I arrived at 7:30am & Jeremy was already in pre-op. He had taken some pills but took too much fluid. They had to delay surgery until early afternoon. No food or oral fluids is allowed. He was back to the room by 5:00pm. He was starving & ate immediately. He was laughing with the staff, whatever he had in pre-op sedation wise I think I could use some. It was good to see the old Jeremy. He spiked another fever but that is typical for him after surgery. The surgery went fine & his leg is wrapped up again. NO PT today-happy days for Jeremy.

Friday- A neurosurgeon stopped by today. Previously we had been told that his L1 fracture(in his back)was healing. Today we were told he requires back surgery due to a problem with his spinal angulation. We did not have any idea that his spine was still an issue. Needless to say it has been a very discouraging day for Jeremy. He is scheduled for surgery next week.
That is all the information I have presently. PT -light day of exercising arms. Jeremy & I went to the PX & he picked out 7 movies. I hope to keep him distracted as much as possible. It has been a very tough day on everyone.

Saturday- Jeremy's spirits were much better today. Ortho team was in & changed his right leg dressing & removed drain tube. Rewrapped wound & said it looked fine. We had Saturday PT- No leg PT, biceps, triceps & worked on a bike pedal you used with your hands. Jeremy was still in the wheel chair & had a pillow under the leg. We put a sheet on him & started to go outside. We were outside about 10 minutes when I looked down & saw a puddle of blood. Didn't see the wound dripping in blood because it was covered by a sheet. Ran like heck dripping blood on the hospital floor & got back to the 5th floor. The nurses, corpswoman, & ortho intern applied a pressure dressing. A ortho resident & the intern wrapped his right leg in heavy cotton & ace wrap. They said we could go back out side but I was more than a little gun shy after seeing all that blood. Another support group gave us a very nice Marine Corp blanket. A counselor stopped by & talked to Jeremy. Watched 2 movies with Jeremy.
By 10:45 he was ready to sleep. It was good to see him bounce back strong mentally today.

Sunday- Jeremy slept in till 945 when he had to take his meds. We went outside this afternoon for about 35 minutes. Cooler & windy than the last few days. Got Jeremy back to bed & took a 2 hour nap. I looked at his face when he woke up & knew he was running another fever. More blood cultures, sterile urine sample & chest x-ray. They had reduced the number of times vitals are taken. However since the fever came he will be checked more often. Hopefully he will get some sleep tonight.

Email from Greg:

Hello everyone:

Wednesday-Jeremy was very tired this morning. Jeremy has a small ulcer on the back of his right calf. He has to return to surgery on Thursday.
He should not have to go through general anesthesia & they tell me it will be a minor procedure to close this small opening back up. PT was scaled back today. They decreased the weights on biceps & triceps by one pound. Worked on bending the legs from the wheel chair. He receive a haircut in his room today so he is no longer a hairy beast. An ICU nurse nicknamed him the beast when he pulled out his respiratory tubes 2 1/2 months ago. He is taking a well deserved nap right now. Friday the plan is to have a teleconference with Minneapolis & try to firm up a date to transfer Jeremy for the next phase of his recovery.

Email from Greg:

Hello Everyone:

Tuesday-Jeremy had a long PT session today. He stood on the right leg 3 different times- 20, 30 & 45 seconds. He had to get out of the wheel chair & back into the wheel chair using his arms to get onto an exercise mat.(no more being lifted). He worked on triceps, crunches, twisting crunches, swinging his left leg back & forth, & bending his right leg up. Rewarded him with Subway for lunch. At 1:00pm he had his stomach feeding tube removed. Pt made him sit in his wheel chair for 4 & 1/2 hours today. For dinner a happy event-a cheeseburger & fries from the hospital kitchen. He was very happy & I enjoyed watching him eat it.

Email from Greg:

Hello Everyone:

Friday: Jeremy was worn down from his Thursday PT. We had to ease up on him today. We did get him outside.

Saturday- Jeremy had PT & bounced back well. He worked with a bar & had
13 lbs on curls & 9 lbs on triceps. He worked very hard. He had a small McDonald's fries in the evening. They are tracking his calories & soon hope to be able to pull his stomach tube.

Sunday- No PT today. Jeremy continues to eat softer foods.

Monday- PT was a big day today. It has taken 11 weeks but Jeremy stood on his right leg. His first attempt he could not make it. He lasted 5 seconds on his right leg on the second attempt. On his third try he lasted 10 seconds. This was extremely painful but each day we will try to go longer. He continued to work well on his arm exercises. Jeremy had Subway today & we ate outside. Two young soldiers who are undergoing the amputee program stopped by & talked to Jeremy. It was good for him to speak to some fellow soldiers that were going through the program. The Master Chief Petty Officer of the Navy & his wife stopped by to see Jeremy today. They were very nice. Today a second person from the respiratory department came up to see Jeremy & went & got him a shake.
Several ICU staff & Respiratory ICU staff have stopped by to check on his progress. The staff on the 5th floor have been very kind & upbeat also. It was a good productive day.

Email from Greg

Hello Everyone:

Tuesday- Jeremy was able to wheel himself all the way to Physical therapy for the first time. He is up to 4 pound weights now. Trach was removed early morning. He is doing fine with his breathing. We went for a wheel chair road trip down to X-ray. He ate most of his scrambled eggs for breakfast.

Wednesday- The doctors feel Jeremy is dealing with some post traumatic stress disorder (P.T.S.D). We went back down to X-ray for another swallow test. He passed this and can now go to a softer diet. His fluid restriction is modified to no water so he can drink as much as he wants now. He is off the pain pump now. He had x-ray return to bedside for more x-rays of femur. Extremely painful moving him into proper position. Two visits by portable x-ray during day. We were having a good day till then. He let Psych doctors have an earful. For dinner he ate all his macaroni and cheese.

Thursday- Morning x-rays of back at bedside-again terribly painful. He started his T.B.I. Test and answered the first question. They will state 15 words and you have to repeat back as many as you can. He did fine with that, however he asked him to do it again. Things went downhill after that. He started arguing with him telling him he already answered the question. The test ended there. We know he needs T.B.I. Therapy but they like to have a baseline from this test. Maybe tomorrow will be better for this. I asked the doctor to increase his nerve pain and they were able to do this. He has to go back with Ortho on Friday and have his external fixator repositioned and they will downsize it also. We wanted to make sure he was not going to be put under general anesthesia again. They said that could be arranged. PT-wheeled himself there and back and is up to 5 pound weights. Another support group dropped off a suitcase care package and blanket. An indoor football team stopped by to visit also. In the evening they told me they needed more back x-rays. I asked the nurse to make sure he was given an extra pain boost which she gave just before x-ray came into the room. They also removed his sutures from his right foot and right leg. He is working on strengthening his hands Jeremy ate 1/2 his eggs, 3/4 of a small McDonalds chocolate shake and 1/2 his pot roast during the day.

Jeremy will require T.B.I. Therapy 4-6 weeks in length. We have selected Minneapolis as the site closest to home. It will focus on speech, physical, occupational and& recreational therapy. After this is completed the one leg amputee rehab period can be 6 months long at Walter Reed. If both legs are amputated the rehab stay at Walter Reed may be 1 year long. I don't have firm dates because they have to contact the air force to fly Jeremy to Minneapolis. Some family and friends may want to come and visit Jeremy in Minneapolis. I would only ask that you do not show up unannounced. I will have to get back to you on this.

Hello everyone:

Monday- They are looking to remove Jeremy's trach early Tuesday morning.
Speech stopped by to tell me a few things once the trach is removed.
Ortho will take x-rays tomorrow of his femur & right foot. Jeremy is experiencing nerve pain when his right leg was being rubbed with lotion.
Hopefully the nerve pain will subside during the next few months.
Infectious disease is signing off again & they will be discontinuing his last antibiotic. Psych who runs the TBI side had 3 visits with 4 different doctors today. A doctor from the amputee program from Walter Reed also came by today. Physical therapy put a fitting stocking on Jeremy's left leg to shape it for his artificial leg below the knee.
Pudding, ice cream & some potatoes(with catsup of course), along with orange juice & milk were eaten today. The pain team is looking at taking Jeremy off the pain pump & giving him an oral medicine for his pain. He hasn't used the pump for pain that often, except when we move him to the wheel chair. It has been a busy day.

Hello everyone:

Saturday & Sunday- Fluid restrictions continue. I am measuring every fluid he receives & water is limited. His sodium level has increased from 128 to 132 on Saturday & Sunday. Normal levels are 135-145. Jeremy will be sitting up & awake when suddenly he will lurch forward & not know where he is. At times he will argue with the nurses. The nurses say they see this with many soldiers. I hope this passes shortly. A lady from the room next to ours stopped at our door and offered us her boom box because they were moving on to the next rehab site. She said her soldier experienced similar problems. Apparently Jeremy's voice carries.
We will pass the boom box on to the next family when we are ready to move on. An extremely nice gentlemen who has been in the air force for quite a few years stopped by with some letters from a grade school class for Jeremy. He lived in Greenfield growing up. It is a small world & I continue to be amazed at how wonderful people have been to us. It is a very humbling experience. Jeremy is enjoying his 4 oz serving size of ice cream. Sunday morning was the best he did with eating the food. He had some eggs & he wanted catsup so I poured it on & he ate 1/3 of them.
He ate 100% of his pudding & 1/4 of his applesauce & all his milk. Some of that pureed food is nasty so it was good to see him eat. It is too bad the kitchen doesn't offer quart size ice cream as a part of their regular diet.

Hello Everyone:

Thursday-A medal of honor winner stopped by. He presented Jeremy with a book listing all the medal of honor recipients & their stories & background. The Navy-Marines wives liaison group stopped by & left Jeremy several nice items. Jeremy refused to take his TBI test. He has been a little withdrawn lately. He did not want to do his physical therapy because he was too tired. Probably the worst thing from his point of view is they put him on a 1,500 ml fluid restriction. He was quite upset about this. His sodium is low & they want him to reduce the water he is drinking. So we push the gatorade & other fluids.

Friday-We are doing better today on fluid restriction. He did physical
therapy(PT) twice today. We graduated from the band to free weights. He is lifting 1 1/2 pounds. He sat in the wheel chair twice today. He even wheeled himself for a short while. They are working on trying to get the bend back in his knees. He enjoyed some ice cream today. Stevie Nicks with the USO stopped in to visit. They presented Jeremy with An I-pod that holds about 900 songs. Stevie Nicks' musical selection that she listens to when she is on tour. Jeremy had asked us to bring his I-pod but we were unable to locate it so this gift will come in handy. He also had his picture taken with her. A very nice gesture on her part. No I did not break into verse & start singing on the edge of seventeen.

Hello Everyone:

Tuesday Senator Feingold stopped by to see Jeremy. Sometime this week Jeremy will take a Traumatic Brain Injury Testing (TBI). He sat in a wheel chair for 2 hours. Jeremy had his catheter removed late in the day.

Wednesday- Jeremy got outside for about 2 minutes. It was brisk outside upper 40's to low 50's. Although much nicer than a snow storm in Wisconsin. He spiked a fever & more cultures were taken. I didn't want to talk about fevers anymore, oh well.

Great news everyone!! Late Monday evening Jeremy was finally moved out of ICU. It has been a long time coming. To finally be on the 5th floor surgical ward is fantastic for Jeremy and the family. One of the trauma doctors stopped by before he left. He talked about what a long way Jeremy has come. From just trying to keep him alive to this great day. They have to do some behavioral & thought process testing. Bomb blast victims will usually require therapy for this. This is done before rehab on the amputated leg. Many more obstacles ahead but Greg and Gayle are going to enjoy the moment.

Jeremy being out of ICU is just awesome. But please still respect the family's wishes of no packages sent and no one flying out there yet either. Once the family gives the OK on anything I will let everyone know. Please keep the cards and letters to Jeremy coming though. Its much appreciated. The address to send the cards is still the same, as they are going to greg and gayles room at the hotel.

Sat & Sunday- Jeremy was off the ventilator the entire weekend. Sunday morning he had 2 double popsicles. He is drinking ice water out of a straw. Sunday night he worked on his exercises in between a few naps.Sunday night he wanted to try some gatorade & was feeling a little sick to his stomach afterwards. They gave him something for that & it was time for Greg and the family to leave. I am sure it will take a little while for his stomach to adjust. Greg hopes to have more good news later in the day

Email from Greg

Hello everyone:

Friday- Jeremy was off the ventilator the entire day. They took the ventilator out of the room today. Hopefully he will not need it.
Physical therapy had him sit in a chair today. He passed his swallow test. He had a small amount of soda & later some ice water. They want to keep it to a minimum for now. Neurosurgery signed off on his L1 fracture. It appears that it is calcifying & will heal up on its own. He may need a brace. He was awake most of the day & watched a movie. He received the Purple Heart from the Assistant Commandant of the Marines. Some fellow Marines were out side the room & they had a nice ceremony. Mom & Michelle were moved to tears.

Email from Greg

Hello Everyone:
Between Wednesday & Thursday am Jeremy went almost 24 hours of being off the ventilator. On Thursday between 7:30 am & 5:30 pm he spent about 8 hours off the vent. His Cat scan showed his lungs are still not normal. They are not completely clear but they are improved. Speech therapy stopped in and put a speaking valve over the trach. He has to be off the ventilator to use this. His first noise was aah. His first words were"hi mom". Of course mom teared up. The second thing was "can I have some ice water now?" Of course the answer was no but maybe in a few days. He did want to "tell dad he is giving it his best shot". Sure as soon as dad goes back to Waterford he starts talking. Jeremy I know you were giving it your best shot. There is one thing I do know, is my son has grit and determination. He is exhausted but he keeps going just like the energizer bunny. His batteries may be a little low but he keeps on swinging.

Wednesday-Jeremy got a late start on being off the ventilator. He was off the ventilator for 8hours & was still off it when we had to leave
(6-8 pm no visitors). He slept a great majority of the day. Tuesday night after Greg left he had a restless night. He had to go down for more
cat scans of abdomen,chest & head. They are also doing a scan to see if he has a sinus infection.

Email from Greg:

Hello Everyone: Monday night- Jeremy did do some exercises.
Tuesday- Early morning Jeremy trach size was lowered from a size 8 to a size 6. Eventually he will not need a trach. He did exercising with PT & did meet his reps of 30. New exercises were introduced & they worked on both legs. In the afternoon PT returned with a more resistant band & did some more exercises. Jeremy stayed off the ventilator for 11 hours today. I will no longer talk about his fevers anymore . He continues to have them. When he stops having fevers I will update you. Jeremy slept deeply in the evening hours.I did not wake him up to do more exercises. He earned the rest & he should develop longer & better sleeping patterns now.

On Monday Ortho came in to change & clean his leg dressings. Infectious disease wanted to see the bare legs & also observed. Both parties were happy with the leg wounds. Jeremy still has no feeling in the heel. He can not feel his big toe. Other toes he has some feeling in. The ortho doctor wanted to make it clear to Greg and Gayle that this is still an area of concern. Physical therapy was in & was working on right leg extensions.
X-ray was in & took images of the right foot & left femur. It was a busy day in his little room. At 9:35am Jeremy went off the vent and stayed off the vent until 4:27 pm-almost 7 hours. They took blood to evaluate his blood gases. The gas results were good. Jeremy was exhausted. Those are muscles he has not used in some time & he worked very hard. Tomorrow he starts all over again. Tonight Greg will be trying to convince him he needs more physical therapy. Resistance bands reps of 30 instead of 10. Greg is hoping he can even wake him up tomorrow since he is so tired.

Saturday evening saw some more fevers & sweating. Sunday morning Jeremy had an obstruction to his airway. He had 3 nurses & 2 respiratory therapists working on him. They ordered an x-ray of his chest to see if he had passed a clot. The x-ray appeared fine & he probably had a mucus plugging of his airway. It was a little unsettling. Jeremy did not even ask for any ice chips until the evening. He continues to sweat with his fevers. On a positive note they do feel that his lungs are improving.
This marks 8 weeks that Jeremy has been in the ICU. He did his exercises in the evening & talked about getting off the ventilator. Hopefully this will be the week to make progress on that front.

Saturday-Jeremy had a good day through 6:00 pm. A little before noon they turned his ventilator settings down to the lowest settings. They did not take him off the ventilator but it was good that his settings were minimal. During the week Jeremy was fighting his fevers & being moved for scans. They did not attempt to get him off the ventilator. Hopefully we can get back on track now to get him off the ventilator. The chaplain told Greg and Gayle that Jeremy was trying to get him to bring in a soda. He almost got it but the nurse told the chaplain it was forbidden. Jeremy broke into the sweats quite a bit today but his fevers were mild.

Email from Greg:

Hello Everyone:

Friday-In the afternoon Jeremy's lungs were scoped & a small biopsy was taken. It may take up to week to grow a culture.They believe that Jeremy has a fungus in his lungs. They started an anti fungal treatment (6weeks). He had 2 periods of fever today but still is off the vest. The radioactive scans showed nothing in the lungs but did show activity in the right heel. He did have surgery in that area & it is still healing.
Ortho changed his leg wounds in the room. His left leg is healing well.
His right leg & heel look healthy but will continue to be monitored closely. Thanks for all the cards.

Thursday-Jeremy slept the entire morning. He needed the rest. Most of the afternoon was spent getting another radioactive scan. They also did a cat scan of his lungs & his L1 fracture of his back. Hopefully we will have the results today. Jeremy went the entire day without any cooling vest. His temperature was controlled by Tylenol & cold packs.
His fevers were not as high as they have been over the last few days.
They set Jeremy up with a pain pump that he can control. It receives a slow drip but if he is experiencing pain he can trigger extra relief.
They keep it locked up & they have other controls in place. He did not need to press for extra pain relief today.

Yesterday physical therapy & occupational therapy were in. Greg and Gayle have a resistance band & sponge to work on some exercises with Jeremy. He had his scan this afternoon & will have another one tomorrow. They have not gotten the results yet. He had fevers again late afternoon & late evening.

On Tuesday Jeremy spiked fevers in the morning, afternoon & evening.
Physical therapy stopped by & is starting to work with Jeremy. On Wednesday Jeremy will get the first radioactive white blood cell scan.
We hope it sheds some light on his elevated white blood count & fevers.

They drew some blood from Jeremy today & nuclear medicine is tagging his white blood cells with Indium. On Wednesday they will scan his body from head to toe. They will continue to scan him over the next few days.
Hopefully they will find the source of the elevated white blood count.

Email from Greg.

Hello everyone:

Monday night things were proceeding nicely until about 10:00pm when Jeremy spiked another fever. He had just received his Tylenol a little earlier. So they used ice bags to bring his fever down & he was still wearing the smaller cooling vest that lay on his chest & arms. He complained of right leg pain. The nurse called the trauma doctor about both items. His right leg was heavily wrapped. An ortho doctor was called in & they opened up the wrapping to make sure his leg still looked good. His leg looked fine so they could then address his increased pain. I thought all 3 phases of the medical team did a nice job with my son last night. They could have just given him more pain medicine but they took the time to look at the wound & rewrapped the leg.
Respiratory stopped by to give him his vibrating treatment & jay hawk elixir. It is tough to sleep sometimes. I thought I could leave but Jeremy is able to point to the electronic alphabet board & wanted to talk to me about a few more items. He then told me he wanted pants to wear while in bed. I thought I explained why we wouldn't want to do that right now however he had his own rebuttal. He said he wanted breakaway pants. He is getting feisty which is good. It was a long night but a good night too.

Email from Greg.

Monday morning when we came in Jeremy had the artic sun vest off. Jeremy had surgery on his legs again on Monday. The left leg wound is healing well. The right leg had a small skin graft & more cleaning of the wounds. However by mid afternoon Jeremy began to spike a high fever again. Cultures on everything were collected again. This time they used a smaller vest that just lay on his chest. Jeremy has developed a blood clot in his left collarbone area. He is on extra blood thinner. Jeremy really appreciates all the cards & emails on the message board & so do his parents. He remains in good spirits.

First I want to congratulate Jason and Jenny Stengel. Jenny gave birth Friday to a beautiful baby girl, Elizabeth Marie.

On Saturday Jeremy was off the ventilator for 11 minutes. They dropped another antibiotic & he now is only on 2 antibiotics.
On Sunday they had to give Jeremy a little more pressure support on the ventilator. When they took him off the ventilator today he went 28 minutes. Jeremy continues to have problems with the fevers. They periodically stop the artic sun vest but his fever will jump 3 degrees.
They have to turn the vest back on & give him tylenol. They have not identified the source of the fevers. He does not like that 42 degree water. I know I wouldn't either.

They continue to reduce Jeremy's ventilator support settings. Friday for 10 minutes they had Jeremy off the ventilator. It was just before surgery & he was a little anxious. Each day they will be trying this. Gradually he will get use to this & get him off the ventilator. In surgery he had the left leg closed & that looks very good.
He had some more wound cleanings on the right leg & next week will require more work. He received 2 more units of blood. After surgery the ventilator controlled his breathing again. Saturday morning Jeremy is doing his own breathing again with slight pressure support from the ventilator. Saturday morning he has received another unit of blood.
He really hates this artic cooling vest but it is still needed. The water temperature can fluctuate between 41-70 F.

On Thursday they continue to decrease some of the respiratory support of the ventilator. They lowered the oxygen concentration & they lowered the pressure support slightly. They tried to wean Jeremy off the artic vest but he spiked more fevers today. His white blood cell count dropped below 30 for the first time since last Friday. His platelet levels have also dropped to a more acceptable level for the first time in 6 weeks.
We will have to wait till Friday to see what effect the temperature problems have on some of these indicators.

Wednesday Jeremy was in a great deal of pain early in the morning. He is off the nerve block because they are worried about infection. He went back to surgery & the remaining tissue looks healthy. It will take 1-2 more surgeries to close the wound on his left leg. They did more cleaning of his right leg. The Dr's hope to close the wounds on his right leg soon. Jeremy bounced back quicker from surgery. He was on the pressure assisted ventilator settings much sooner this time. They want to start weaning him off the ventilator. Jeremy's lungs are about the same. The doctors are going to have him do more breathing on his own to help get rid of the mucus in his lungs. 

Jeremy does not like the cooling vest. He told Gayle to get the "expletive" vest off.  Gayle could easily read his lips on that one...HAHA.
The doctors are not to concerned with Jeremy's fevers because the cooling vest is taking care of the fevers.  After surgery, the drs. let Jeremy breath on his own, he did well.  He hates the ventilator, he even fights it for surgery.  The nurses are amazed how strong he is, they can give him pain medicine or sedation that would knock out everyone on the ICU floor, but Jeremy is still awake.  Of course we already know how strong he is. 

Monday Jeremy's heart rate & respirations were elevated after surgery.
He always struggles after surgery. He received nerve blocks on his left leg to help with the pain. He received 2 units of blood after surgery.
His ventilator settings required breathing assistance. His spirits were pretty good considering everything.

Tuesday his ventilator settings were changed & Jeremy is doing his own breathing. The ventilator still supplies some pressure to his breathing. His heart rate & respirations dropped. The doctors had to make modifications to his pain medication during the day. The pain medications knocked him out most of the day.

Jeremy's surgery went fine. There were no complications. He's a fighter! If i hear more, i will post it.

An Email from Greg:

Our family would greatly appreciate it if you could mail Jeremy a get well card. The comments on the web site have been great. Just cards
please- no donations, no packages, just cards to keep Jeremy's spirits up. The address is :

Navy Lodge
Jeremy Stengel room 311
8901 Wisconsin Ave. Bldg 52
Bethesda, MD 20889

Thank you for all the support.

Jeremy had surgery Saturday morning. The ortho doctor stopped by & unfortunately Jeremy will have his left leg amputated today below the knee.

On Thursday Jeremy went into surgery for more wound cleanings. The doctors came up to discuss some bad news regarding Jeremy's left calf.
They showed Greg and Gayle some photos of the calf. Further muscle had to be cut. A skin graft is no longer an option. Too much tissue has been lost. He is going back to surgery on Saturday. His solius muscle is compromised. If no further decline is observed they have one more option to save the leg. However if further necrosis develops then Jeremy will have to his left leg amputated below the knee. The physical trauma of the blast has caused many injuries to his liver, kidneys,& legs. His liver & kidney indicators have returned to the normal range. However his albumin level has not recovered yet. His albumin levels have stayed at 2.1. The normal range is 3.4 to 5.4. I am told his metabolic state is catabolic which means his metabolic state is breaking down rather than building up body tissue. The trauma doctor feels Jeremy will recover & has showed many positive signs. It will be a long road to recovery.

Tuesday Jeremy went to surgery. They fused the few pieces of bone left & inserted a screw into his right heel. More surgery may be required on this. They were suppose to do a skin graft on his left calf but they had to remove some more dead muscle & tissue in this area. No skin graft was done. Jeremy ran more fevers after surgery. The artic sun cooling vest is till being used. We had a discussion with the ortho doctors on Wednesday. These heel injuries are chronically painful. They still feel they can do the skin graft but they will clean the wound & wait for now.

On Wednesday Jeremy had his central line taken out. They are trying to run the majority of his meds through his feeding tube. He is now down to three antibiotics. He was off the sedation medicine for most of the day.
He looked stronger today. He no longer gets a nebulizer treatment.
Instead respiratory is giving a fluid treatment directly through the trach. Later this afternoon he was going down for another cat scan. They have also changed his pain medication. His lungs have shown no improvement yet.

Jeremy had surgery on his right foot. Hes still able to communicate with Gayle and Greg by mouthing words. Hes holding his own.
Sorry that is all i know at this time.

Gayle and Greg spoke