OMS Follow-up, Monday, June 29

Happy news, Jake had his follow-up at the Loma Linda Oral & Maxillofacial Surgery Center and had the splints removed from his nose. Below is a picture, immediately post follow-up.

The process of removing the splints was quick and apparently painless, although I am assured that it felt "weird." That's not surprising, because it looked pretty weird. Those who've prepared calamari from scratch will have some perspective on this. Imagine you have a fresh squid and are preparing to remove the spine or "quill." Now, imagine that you are pulling the quill out of someone's nose with a hemostat. That's pretty much it. I was expecting some little tubes and what came out was as long as Denise's index finger, as evidenced by the following photo.
OK, that was pretty gross, but nothing like the rest of what came out, so we'll just drop that subject for now.

The other good news was that the doctor told Jake he no longer needs to elevate his head while sleeping. He's been pretty uncomfortable in bed and always looks like a contortionist by the morning, so I'm sure he'll welcome the option to sleep flat on his back.

We celebrated with lunch at Chili's. Well, Denise, Nick and I celebrated; Jake was not overly thrilled with the liquid options on the menu. He settled for a lemonade and a chocolate malt, which I thought was kind of a strange combination, but whatever works I guess.

Jacob is becoming increasing unhappy about the liquid diet. Not surprising, but unfortunate since he's only a week and a half in to a 6 week stretch.

He has been able to supplement his diet with some somewhat solid food (or at least liquids with a few incorporated solids). He gets to remove his elastics to brush his teeth, so he eats some chunky soup or whatever while the bands are off. Last night he had some red beans and rice (from a box, not my from scratch recipe) - I removed the casing from an Andouille sausage, minced it up in the food processor and added it to the pot to give him a little more protein. He seemed to enjoy that.

Tonight we are trying chili burgers. I thinned out a little canned chili with some beef stock and tomate juice, then pureed it with the stick blender. Grilled and chopped the burger in the food processor and also minced up a half a bun. So, the theory goes that he can take a spoon full of burger and bun, then wash it down with a spoonful of chili. I'm not optimistic.

(Update: The Chili Burgers were a success!?! At least he ate quite a bit and was generally please with the chili burger taste. He insisted that we all try some and it did, in fact, taste like a chili burger, albeit like a chili burger that had been pre-chewed by someone else.)

So, finally, here's a photo of Jake at home this evening, looking more than ever like himself, most likely because of his expression of annoyance at the photographer. He's not very tolerant of the Papa-razzi. (Sorry about that.)

Very Brief Update, Friday June 26

OK, I'm going to try to keep this short.

First of all, my niece ("I" before "E", except after "C"; did you know that the linguistic powers that be are trying to do away with teaching that?) Sara has implored me to fix the links on the photos so that they can be viewed in hi-res. Apparently there is some anomaly that when I move pictures within a post it breaks the associated link. I am working on fixing the previous photos. If you go back to the latest pictures of Jake they can be viewed in hi-res.



Last night I finally agreed to play Boggle and put Jake in his place. I got off to a slow start, but down by about a dozen points I came back on the final round and...lost. I scored 22 points on the final round, which I thought was kind of a coup. Unfortunately Jake also scored 22 points and logged his highest score ever.



Today his Aunt Terry arrived and did, in fact, put him in his Boggle place. She is something of a ringer.



Aside from beating the daylights out of Jacob (and Nick) Terry also provided some very helpful information regarding any issues that might arise with deferred registration at Humboldt State University, should that become necessary.



More on all that later. For now I just wanted to make sure the Sara is happy.

Thursday Follow-Up

One whole week gone since the surgery!

Today Aunt Jackie came up from San Diego and kept an eye on Jacob. She had a somewhat short day, because Jake had his one-week follow up with the surgeons. She was here long enough to lose badly, along with Nick, to Jake playing Boggle. Another step in Jake's word game domination. Yesterday Aunt Kathy was the Boggle-fodder. (I am mostly abstaining from play so as not to add a bruised ego to his injuries.)

After the slaughter, Nick and Jake took off and met up with their mother for the drive up to Loma Linda. I met them at the surgeon's office and we all piled into an examination room to see his checkup.

So, the doc removed his elastics and checked him out. With the bands out he had an opportunity to brush his teeth. I can't imagine how good that must have felt after two weeks and change. Apparently he is to keep the bands on 24/7 except to remove them to brush his teeth. I'm wondering if he can sneak down a spoonful of real food while they're off? He is definitely not supposed to chew, that much is certain.

The doctor removed the last of the sutures and staples from Jake's forehead. He also checked out his ears. Jake had been complaining of some pain in his right ear. Apparently the ear drum is fine, but there's a small laceration inside his ear canal. The doctor speculated that his jaw bone snapping back on impact may have actually torn the skin in his ear. (Nick thought that was so "Bitchin'!" I mean, who else do you know who can say they've torn the skin in their ear with their jaw.)

More good news, he has another followup on Monday at which they will remove all the splints from his nose. Then another appointment on Monday the 6th with the MD who did the surgery. I think at that point they may make a decision about whether he needs additional surgery on the orbit of his left eye.

During the visit they took a panoramic x-ray of Jake's mouth. With all the microplates, bolts and bailing wire it looked a little bit like something out of X-Men, once again prompting admiration from Nick. I hope I can get a copy to add to the family photo album.

(Our neighbor Susan from across the street just delivered dinner. While I was seeing her out I noticed that our friend Laura had dropped off some Muscle Milk for Jake. I cannot believe the incredible support we've gotten from everyone.)

So all good news from the MDs today. On the way home we stopped at a Wienerschnitzel. Jake celebrated with a vanilla shake, Nick with the #7 (2 corn dogs, fries and a Sierra Mist) and iced tea for me.

Jake is pretty wasted after a busy day, so he's catching up on his sleep. Quick before I go, a couple new pictures compliments of Aunt Jean. First on our deck...

And one in the vegetable garden, which is totally out of control.


More later.

Tuesday Night, June 23

Quick update - Denise convinced me that I need to taper off the blogging slowly; don't want people to have to quit cold turkey.

So far so good at home. My sister Jean came over from Newport to spend Monday and Tuesday with Jake while Denise and I try to get back into the swing of things at work.

Jean was a huge help, monitoring, medicating and feeding the patient. She also did the laundry, gardening and miscellaneous other tasks around the house. She did not have to cook dinner for us though, thanks to a gift of a home-made spaghetti dinner from my co-worker Linda and her husband Chris. It was fabulous, complete with Caesar salad and a bottle of Zinfandel (Jean and Denise were not much help with the Zinfandel; I pretty much had to throw myself on that grenade.) Jake, unfortunately nixed the idea of pureed pasta sauce and went with a vanilla shake instead.

One very nice surprise was that when I arrived home on Monday, Jake and Jean were busy playing Boggle. The nice surprise being that he was not wearing his eye patch. I figure his double vision must be clearing up if he is able to focus on the lettered cubes in this word game. His cognition doesn't seem to be impaired at all because he's as competitive as ever. In fact, Jean reported that he "beat the pants off her" (hopefully not literally) when they played today.

In addition to the Boggling, the two had an outing to Albertsons today, primarily so that Jake could cash in his change collection at the CoinStar. (At no charge, because he cashed in for an Amazon gift certificate.) They also took a trip through the soup aisle so that Jake could pick out some new liquid meals to try. Apparently he did pretty well with some canned soup, so he's starting to get a decent amount of calories.

Unfortunately for Jean, her only reward for all her hard work was a viewing of Sean of the Dead, from our extensive collection of classic motion pictures.

Tonight Jean had to head home, so we have to fend for ourselves for the evening. I had a successful attempt at feeding Jake something that he liked; a Pumpkin Pie Shake. He finished that, which puts him at about 1500 calories for the day. He's got quite a few left to go to get to the target of 2000 to 2500, but this has probably been his best day so far. He can't taste stuff really well, which I attribute to the fact that he can't breathe through his nose, so he's not getting any of the olfactory sensations.

Anyway, his Aunt Kathy will be here tomorrow, so Jake will be breaking in a new care giver. Then on Thursday Jake has his first follow-up visit with the surgeon. So, hopefully we'll have more good news to report Thursday night.

Father's Day!

Happy Father's Day! It turned out to be a pretty good Father's Day, since Jacob was able to be home for it.

We are slowly getting a handle on the whole process of caring for Jake without professional medical care. Sleeping arrangements are a little tricky. He's not supposed to sleep flat on his back; the doctor wants him to keep about a 30 degree angle to help with any drainage from the surgery. Last night he tried sleeping in his bed with a bunch of pillows piled up to support his back. Not a rousing success, but he seemed to be sleeping fine when I went in this morning.

Tonight we'll try something different. I bought some sheets of 1-inch foam and I've cut and layered them into a big foam wedge. I think it should be fairly comfortable based on my quick testing.

He had more visitors today. Giovana, her brother Gus and Mom Gina all came over for a bit. Bonus for us, Gina brought some barbacoa with all the fixings. Can't wait for dinner! I'm going to try to puree some of the meat and juices for Jake so that he can at least get a taste.

So far Jake is not eating a whole lot, so we have to keep working on that. He's had some smoothies, protein shakes and Gatorade, but I think he needs to get a few more calories.

We took an outing to The Yard House this afternoon for lunch with our friends Mike, Jane and Michael Griffin. Jake finished most of a rootbeer freeze for his lunch. (I had the Seared Ahi Caesar Salad. ) Not much of a dining experience for Jake, but it was good to get him out of the house and interacting with some friends.

Jacob took a little rest when we got home, as seen below, using a stuffed bear from Grandma as a headrest. Leo has been keeping a close eye (OK, nose) on Jake.


He had some more visitors this afternoon; JD Voechting and his Mom and Dad, Bev and Gary. They brought Jake a nice gift...

That's a plant potted in a bicycle helmet. Note the skull and crossbones on the helmet.

So, starting tomorrow Denise and I have to get back to work. Denise has a very full schedule. I am hoping to play things a little by ear. I have some conference calls and what not that I can take from home, so I can be a little flexible. Fortunately, my sisters have worked out a schedule to help out with Jake for the next week. Jean is coming over tomorrow morning and staying through Tuesday. Kathy will be here on Wednesday, Jackie on Thursday and Terry on Friday. I'll be around in the morning to check them out on the medications, blenderized meals, etc. I think by next week he will probably want to start taking care of himself, but we'll see how it goes.

Going forward I think the frequency of blog updates will taper off a bit. I'll be updating the blog with news as we get it. The next major thing will be his followup appointments with the surgeon, psychologist and maybe orthopedist, sometime later this week.

Until then, thanks to everyone for all the support that we've received. I don't know how we would have handled this without it.

Motherhood and the Middle of the Night

Eighteen-year-olds don't often remind us of the cuddly infants we nurtured all those many years ago. And so it should be.They have new endearing qualities such as language and independence. But last night was one of those nights that just had so many similarities: sleeping near-by, listening for their breathing, counting the hours in a row they sleep, monitoring intake and out-put. I even behaved like the mom whose baby is starting to sleep through the night by lying awake from 4 to 5 am waiting for him to wake up. Overall, it was a good night. He was only up three times from midnight to 6 am. Then he was uncomfortabble in that chair and we moved to the other room. Our fatigue and the "June Gloom" resulted in us sleeping until 8:00 or later. Ahhhhh. At 5 am during a med dosing, Jake complained that the birds outside were singing too loud. OMG! After constant beeping and alarms and hissing and suctioning and lights and talking and snoring at the hospital, he's complaining about the birds! I close the window and went back to sleep... Home Sweet Home
MomDenise

Saturday AM

Made it home by about 11:00PM and more or less settled in by midnight. Denise set Jake up in the family room, Jake in Lazy Boy and Denise on the couch, so that she would be available when/if he needed anything.


I toasted Jake's homecoming with a short Glenfiddich (compliments of my friends and coworkers at Toro) and crashed in bed about 12:02. I slept absolutely uninterrupted for eight straight hours (haven't done that in months) and woke up, still exhausted, to the sounds of Leo crying to get in to the house.

I went out to check on the family and found that they had migrated into the living room during the night. Apparently Jake did not find the Lazy Boy to his liking so he had moved onto a big easy chair and ottoman. Will have to work out some way for him to recline in his own bed.

Took a quick swing through the garden. It's amazing how you can leave a vegetable garden for 3 days and come back to pattipan squash the size of hubcabs and baseball bat zucchinis.

Blended Jake some breakfast of milk, frozen banana, vanilla ice cream and chocolate protein powder. He chased that with some Gatorade. For now I'm tracking his intake on a whiteboard to make sure he's getting a decent amount of calories and nutrients, but I have some software that will make the tracking a little easier. Just need to install it on a PC by the kitchen so it will be a little more convenient.

Medications will be interesting. Since everything needs to be in liquid form we ended up having 2 grocery bags full of bottles, instead of a few pill bottles. The pharmacist pointed out that I had great medical insurance to cover one medication in particular, "This one is normally about $2300." My co-pay for the whole batch was $71 and change.

All the medications come with little stoppers that allow the liquids to be drawn out into a dosing syringe. The gradations on the syringe allow accurate measurements. Once we have the liquid drawn we attach a short piece of tubing. Jake slides the tube back in by his cheek so he doesn't shoot the stuff straight down his throat. We have to keep a water chaser on hand because the taste apparently leaves something to be desired.

He has 2 different pain meds (one narcotic, the other not). Each calls for one dose every 6 hours, so he can overlap, taking one or the other every 3 hours so that he can control spikes in pain a little better. He also has an antibiotic (every 6 hours), eye drops (every 2 hours) and nausea medication to take as needed. And, because he can't brush his teeth, he has a prescription mouthwash that he has to use 2 times daily.

For now, Jake is sitting down playing his Ghostbusters X-box game. (He was disappointed that he could not create an avatar with an eyepatch; had to settle for a monocle.) He seems to be enjoying it, can hardly get a word out of him.

The next big thing on the agenda will probably be a shower.