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last updated 9:05pm Central Time, 2/12/2001 Week Four Journal In week four, we started to see David actually get out of bed! More and more tubes came out and the prospect of leaving the ICU became a very real possibility. Early in the week, David showed more signs of being alert, and he made early attempts to vocalize. Wednesday, though, we had some setbacks. The amount of fluid in David's head increased and he needed emergency surgery. Thursday and Friday were very difficult days for him, but he started to progress by Saturday. |
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12:00PM Eastern Time, 2/4/2001 Mornin', as we Southerners like to say. Reports from the west pretty much fit in with what we expected, and that is good. Phycially, David is doing pretty well, although he seems to be a little uncomfortable. Emotionally, he seems to be frustrated. Now, first of all let's stop a moment and recognize the importance of this shift - we can finally talk about David's emotions and feelings, and not just his physical condition. This is a giant leap in progress, but it also brings with it a host of other implications, some of which I discussed yesterday. Thank you to all of the visitors at the hospital yesterday. You demonstrated tremendous patience and love, and your tone with David seemed to strike a better chord with him. If we do not ask to much of him, if we do not ask him to necessarily respond to us, then he seems to feel better about interactions with people. He did make some eye contact and squeeze a few hands, but he spent most of the day looking away from people or shutting his eyes. We set up a TV beside his bed with a golf tournament on, and he looked at that for awhile. What I want to stress to you, especially to the people visiting, is that while David appears to be awake, he is actually closer to a state of sleepwalking. Now, some of you in the past have experienced David sleepwalking (the wallpaper in the Rehoboth beach house will never be the same), and it is frequently a confusing experience for both David and for the witnesses. David will look at you, talk with you, appear to have a rational conversation with you, and then remember none of it in the morning. According to the "Head Injury: The Facts" book, this is close to what David is experiencing right now. [A note about the book - the first couple of chapters are quite helpful and informative, but the purpose and tone of the book is to prepare a family member for the "worst". I highly recommend NOT reading the last three or four chapters.] Anyway, there are a couple of good passages from the book that I would like to share: "Do not expect a patient to open his eyes, stretch out his arms and say "Where am I?" as patients often do in movies or books. People rarely move abruptly from being in a coma to being properly awake." There are several ways in which a patient's memory can be affected by an accident like this, and this is because the memory is a fairly complex critter. Roughly, we must first notice what is happening around us, then we must store the information (there are different places and methods for storing short-term vs. long-term information) and then we must remember the information (and again, there is a different process involved for remembering information without any hints than when we are given clues). Different kinds of injuries and different levels of swelling can impact different parts of this system for different periods of time. Around the period of the accident, there are two kinds of memory loss that is common - "retrograde amnesia" in which the patient cannot recall either the accident or the hours, days or months leading up to it, and post-traumatic amnesia, in which the patient cannot remember the days/weeks/months following an accident, even though they might have appeared to be fully awake and conversational. "Retrograde Amnesia "As he gets better he may remember a few more of the things that happened before the injury, but he is unlikely to remember everything... The moment of impact interrupted the mechanism where the brain changes things that are experienced into a form which makes it possible for them to be remembered later. The things that happened immediately before and at the time of the impact did not have time to be changed into memories, so they can never be remembered." (p.57) "Post Traumatic Amnesia
The point is to remember that David is basically sleepwalking. He may make gestures or looks that appear to be quite intentional or even hurtful or angry, but they are generally not really directed at the person who receives them. The book also mentions that many patients feel that they have to behave themselves in front of nurses, doctors and therapists, but let out their frustration when they are around people they love and trust - because they feel safe. So while it may not always be joyful to be in the room with David, know that he is frustrated, that he gets tired very quickly, that his short-term memory may only last a few seconds or minutes, and that his is not angry AT anybody. He is exhibiting very normal reactions for someone who is in his situation. With time, he will become slowly more and more "awake". On the plus side, while Mom was rubbing part of David's back yesterday, he made appreciative moaning sounds, and he appears more and more willing to allow his tongue to move around in his mouth. These are good signs. The next step up on his Glasgow Coma rating scale will be when he starts making unintelligible word sounds. I hope you all are well. Please keep fighting with us! All our love, 8:00PM Eastern Time, 2/5/2001 Good evening, folks! Constant improvement for David, and we are very excited! Before we get there, though, a couple of other notes. First, yesterday Dr. Manley told us that it is finally time to start thinking seriously about rehabilitation centers! (I think he's as excited as we are.) I know that many of you have had experiences all over the country with rehab centers, and now is the perfect time to let us know about your experiences. Because of David's insurance, we are probably limited to Kaiser Centers, but we are interested in any and all information at this point - from good programs, to things to watch out for, to alternative and complementary therapies. Come on! Hit us with it! We love this stuff! On a similar note, many of you have sent us messages about either yourself or your loved ones who have gone through similar experiences. These stories have been such a source of strength for us that we would like to share them on the web site. Because they are so personal, though, I am aware that some of you may not want those stories on the Internet. As an interim solution, I plan to post the stories to the web site anonymously. If you do not mind sharing your name, then I will add it. If you would like me to remove the story, then I will remove it. Is that fair? If you have shared such a story with us, and I have not discussed this issue with you, please contact me as soon as possible. Ok, so what has David been up to today? Over the weekend, David demonstrated increasing frustration and discomfort. We suspect that the bed is a bit small for him, and he has had back problems at least since he had to sleep in the arctic cubicles in the attic of the Beta House at Denison. Having his hand tied down (to prevent him from grabbing at tubes) was certainly a source of frustration and possibly of discomfort as well. Well, Kathy suggested that we put a TV by his bed and allow him to watch golf, and this seemed to help some. More importantly, Mom and Dad learned a few techniques from the physical therapist who had been coming to visit David every other day or so. David's left side has been pretty active, so the joints are in relatively good shape. But his right side has stayed pretty still, and the joints and tendons are starting to tighten up a little bit. Mom and Dad have been practicing some stretching and movement techniques on David's right side, and even teaching those techniques to some of Dave's friends. This has been great because it feels great for David, helps him retain flexibility, reminds him to focus on his right hand and leg, and gives visitors something to do while they are in the room with David! (He's not really up for conversation at this point.) The lovely Joan was David's nurse again today and decided to push David a little bit to see how he reacted. With the help of the physical therapist, they got David to sit upright on the edge of the bed, with his feet on the floor! Then with the help of a flotilla of folks to watch the various tubes and cords that are still attached to David, they moved David to a chair! This exercise wiped him out and for a while he appeared to be exhausted, but soon the upright position seemed to make him a bit more alert. They have taken the oxygen mask off of David's mouth, and he is now receiving oxygen through a nose tube. He is still also being fed through a tube in the nose. They have removed his neck brace, and it took some effort for him to hold his head up in the chair. His eyes are more and more alert while he is awake, and he is able to track people around the room a bit better. He still cannot show two fingers on command, but he seems to show one (no, not THAT one!), and he is pretty good at showing "thumbs up" when asked to. After the adventure of moving to the chair, he was actually too tired to respond to much of anything. When they asked David to look at his mom, however, he peered over towards her. They asked him to speak to her and he said nothing. When Mom asked him to say "Ah", though, he made a small "aahhh" sound! He seems to respond better to Mom than to the staff - I think he's tired of being poked and prodded so much. The last real issue seems to be the fluid in his head. He has been on a constant drain for almost the last week, and in the last two days, the flow of excess spinal fluid has slowed dramatically. This is pretty exciting because it might demonstrate that we have vented a good portion of the fluid. Of course, it may represent a number of other things as well. We are still not sure whether or not to insert another shunt in his head to drain off more fluid, but that decision will probably be made in the next few days. If we do not insert another shunt, David will probably be ready to leave the Intensive Care Unit in the next week to ten days. If we do insert another shunt, he may be ready to leave the ICU in the next ten days to two weeks. David is very close to being physically stabilized. The next step will probably be the "step-down" unit in SF General Hospital. This is a ward for people leaving the ICU who do not need nearly the level of supervision that they needed before. This would give David much more opportunity to rest unmolested, and just this change is frequently enough to accelerate the healing and recovery process. It is possible that his insurance company will insist that he be moved to a Kaiser facility nearby that has a very good reputation. We are very excited that David will soon be ready to make this transition. We are disappointed, however, that we will not be able to take the wonderful nursing staff with us. Thank you guys! (I mean "you guys" in the sense of "y'all" - totally gender-neutral.) All of you! Without you, for so many things you did for David and for us, we would not have had a prayer of getting where we are today. Thank you so very very much! And thank you to all of you readers out there. Your voices and visits and messages and stories have kept the Smethurst family going. And your prayers and thoughts and warm wishes and love have supported David through the first stage of the toughest trial he has faced. We thank you and we love you. Johanna, Bob, Kathy and Jay 10:00PM Eastern Time, 2/6/2001 Oh, the exciting news! Where to begin...? How about with a logistical note? David is improving very well. It looks like he might leave the ICU within the next week. So, those of you making travel plans to see David on the weekend of February 24th or beyond... you might want to hold off until we get a better sense of the schedule. He will probably leave the ICU the end of this week or early next week. When he leaves here, he will probably be transferred to another hospital, probably a Kaiser Center somewhere in the San Francisco area. He might stay there one or two weeks. After that he will probably move to a rehabilitation center... somewhere in the contiguous United States. So you see, there is very little set in stone right now. So, the big news. Most of it is positive and WAY positive. David was sitting once again in his chair. Recognize that ever since the accident, David has been fed using a tube threaded through his nose and down into his stomach. Today, Mom tried to feed him a half-spoonful of water. He took it and swallowed it! This is huge. Swallowing is a very complex procedure that demonstrates muscle control, an ability to protect the airway, and awareness of the feeding process. So, Mom then offered a full spoonful of water... which he took. Apple juice. Half spoonfull down the hatch, with a full spoonfull as a chaser. Next, the apple sauce. Half-spoonfull down. Full spoonfull down. This is the first food he has "eaten" in almost a month! Mom placed the bowl in David's lap, and the spoon in his left hand. He seemed puzzled by it for a moment, but then dipped the spoon down to the bowl, scooped up some apple sauce, guided the spoon to his mouth, and neatly swallowed the mouthfull! He tried again... but this one was a little messier. (Mother asserts that he looked a little sheepish about the mess, but we are not sure if the muscles in his face are physically capable of registering emotions yet.) He finished the entire bowl and looked around the room "beaming"! I cannot begin to tell you all of the things this signifies - but certainly a level of understanding and thought processing that David has not demonstrated since... 1983, I think. We are blown away, and the nurses and docs are pretty excited, too. Mom and Dad worked with the speech therapist today to learn some techniques and drills to use with David. (Dave worked extra hard, we are told, because the therapist was pretty cute.) They are going to learn even more techniques from the physical therapist tomorrow. This should help David tremendously. Now for the bump. We are honestly convinced that this is much less serious than it sounds. Any time you breach the surface of the skin, you dramatically increase the risk of infection. The tube being used to drain David's head has been a point of concern for this reason for several days, but it has been providing a desperately needed service of draining off excess spinal fluid. Two days ago, David spiked a little fever, demonstrating that he did indeed have some kind of infection. They started him on antibiotics and cultured the fluid drained from the head. The culture came back today as meningitis. This is normally a very dangerous disease, but in David they have caught it extremely early. At the first onset of the fever, they noticed that his white blood cell count had increased as well. The antibiotics seem to already be having an effect, though, because even before the culture came back from the labs, David's white blood cell count had begun to drop. Because he had already been started on antibiotics, because they caught it so early, and because David is Superman, we think that we can control this disease pretty rapidly. So that's the news from Cali. Those of you that have sent us and David e-mail messages, cards and gifts, please remember to send a picture of yourself and David (or just yourself) to Kathy for the photo album that she is creating with Anne DeVries of "Creative Memories" (this is Anne's business). Kathy has received three photos so far. Please include the names of the people in the photo, the year and location of the photo. This album will serve as a great tool to help Dave work on his memory when and if he needs it. Send this stuff to Kathy's address: Kathy Bell Thank you all so much! All of our love,
3:15PM Eastern Time, 2/7/2001 Good afternoon, gang. I forgot to mention the web site yesterday, and yes, someone asked for
it. So, isn't it funny how gently the universe reminds us not to get ahead of ourselves? David might not shake this meningitis quite as quickly as we had thought. His fever spiked overnight to 39.4 degrees celcius (normal is 37). It had come down to 39.3 when Mom called this morning. His white blood cell count has not increased, which is puzzling (to us, at least). Overnight, his use of his right arm and leg decreased dramatically, and as of this morning, he was only moving them a little bit. He is obviously fighting hard to overcome something. Instead of taking out the drainage tube in his head altogether (or putting in a different shunt), they have decided to replace it with a fresh one. Because of the meningitis, and because of the new tube, David will remain in the ICU longer than we were anticipating yesterday. That's pretty much all of the news for now. You continue to send us tremendous stories and now some very valuable information on rehabilitation facilities and resources. Thank you for everything you have sent and will send! Hang in there with us. This is just one of the "bumps in the road" that they promised us. All our love, Johanna, Bob, Kathy and Jay
COLOR COMMENTARY - Brian O'Callaghan February 6, 2001 I promised myself I was not going to use sports metaphors to describe Smot's courage and the massive support exhibited by his family and friends. I promised, but last night Suzanne and I watched the story of the 1980 Olympic Men's Hockey team's overcoming astronomical odds in winning the gold medal. According to most sports experts, we will not see anything like this again in sports. While comparing a life and death situation with winning a medal is not fair, it does provide insight. What inspired me was the players' ability to evolve into a team that was so incredibly close. You see it often in life, people become closer when dealing with adversity or a more talented opponent. Togetherness leads to resolve. In the case of the American team, it tripled their chance of beating a clearly superior Soviet team. Their journey and subsequent success was miraculous. As I watched them hugging and jumping around the ice as the game ended, I thought of Smot. People selflessly praying, `stepping-up', supporting, encouraging and creating positive energy are omnipotent. If you have ever doubted your ability to achieve something in life, this experience must make you reconsider. Think about the way you have felt throughout the defining moments of this experience, and know that you are able to experience this in other aspects of your life with family, spouses, children and friends, but only if you are able to actively fuel the fire that ignites a group's power. Smot has overcome obstacles that were deemed impossible by renowned doctors. Johanna and I agree that Smot has chosen to live. God offered him two choices, and he chose to fight a brutal battle. Throughout this painful ordeal, he has not accepted pain or daunting challenges as a reason to quit. Together, as one mass focused on one outcome, we have created something special which we will never experience again, much like those Olympic hockey players. They have not been together since, and that is sad. We, however, will always be together because our on-going support is not only physical, but spiritual. That is powerful. If we remain a selfless team feeding off of each other's strength and compassion, focused on Smot's full recovery, creating positive energy, we will continue to inspire him to beat the odds. OAKIE 5:00PM Eastern Time, 2/7/2001 Good afternoon again, folks. Please pass this message onwards. David has encountered a more serious setback. Now is a moment when he could really use some focused support. Could you take a minute or so and really send him your love and positive thoughts? As I mentioned earlier, the doctors were deciding today whether to replace or remove the tube that drains spinal fluid from David's left ventricle. Well they want to remove more fluid, and the old drain didn't seem to be cutting the mustard, so they decided to replace it with a drain in a new part of the brain. This required some drilling, so they put David under sedation again, and started the procedure in the ICU. Well the drilling caused David's head to bleed, and bleed quite a bit more than anticipated. They quickly rushed David downstairs to the OR. He was intubated and put back on the respirator for the procedure. Happily, the blood came from the drilling itself, not from any additional brain or tissue damage. The brain itself is not bleeding. The blood was cleared out of the brain, and a new drain or shunt was placed into the right ventrical of David's brain. If you recall, this is where they wanted to have the drain a couple of weeks ago, but the brain was so swollen at that point that they could not reach it. During the procedure, blood did escape into David's head. It was quite fortunate that David's skull plate had not been replaced after his craniotomy (yes, that's what they call it), because it allowed David's head to expand a little bit to make room for the excess blood without increasing the pressure on the brain. The new drain will help because we think it was increasing pressure on the brain that restricted his right-arm movements overnight. The drain should help reduce pressure further. David is still under sedation, and will not wake up for at least another hour. Mom and Dad have not yet been in to see him. We are actually most concerned about how David will react when he wakes up. He has made so much progress in the last couple of days, and he will wake up to find himself back on the ventilator, hands tied down, groggy from sedation. I cannot begin to imagine the frustration and confusion he is about to feel. The doctors have told us, however, that this whole thing is probably just a two-day setback. Once they make sure that everything is ok, they will take him back off the ventilator, and he should quickly be back close to where he was on Monday and Tuesday. They do not appear to be at all concerned about the meningitis - they feel that that is under control. Actually, this whole day seems to have been most difficult and painful for Mom and Dad. They were so excited about David's progress. This setback, even if they know it is only a matter of a couple of days, has been heartwrenching for them. Please send your positive and soothing thoughts and prayers to them as well. So, fire off a quick prayer to David. He is going to need your support over the next couple of days, especially. Thanks! All our love, 10:20AM Eastern Time, 2/8/2001 Good morning all. I have not received the early morning update from out west, but I did speak to Mom late last night. They decided to keep David asleep for the rest of yesterday, and they anticipate extubating him today (taking the breathing tube out). His throat will be sore again for a coupla days, but after Mom got a massage and Dad played some squash and David slept all day, I think that the Smethursts in SF General were feeling much better and brighter about things. On a superficial note, David's head will now be symmetrical. In order to remove the blood that was pooling on his brain during the "incident" yesterday, they did another craniotomy to the right side of David's head. (The last craniotomy was to the left side.) This time they drained off the blood and replaced the skull, so it should heal nicely. But he now has another long, curling set of staples on the right side of his head, as well as the left side. They look almost like mirrored question marks with his ears serving as the dots. That's the update so far. More as I hear it. Thank you for the flood of messages and support. We needed it! All our love, Kathy, Johanna, Bob and Jay 9:10PM Eastern Time, 2/8/2001 Hi, everyone! Please pass this message out quickly. We need your prayer help NOW. David has gone in for emergency surgery. There is more fluid on the right side of his brain, they don't know why, and they're going to clean it up and insert a different kind of shunt. David was behaving strangely all day - not nearly as responsive as before. They discovered increased swelling on the right side of his brain along with increased fluid. They are operating now. Please start your prayers. Please send your support. Please send your love. This is not trivial, and we do not know how serious it is. Hopefully they will tell us that it was nothing major and that we just panicked (yes, even we panic from time to time... ok, rather frequently). But it is your strength that we need to help our own. We can get through this when we know you are out there with us and with David. Thank you. The surgery will last for at least a couple of hours. I will let you know more when I hear it. Johanna, Bob, Kathy and Jay 12:30AM Eastern Time, 2/9/2001 David is now through the surgery, and everything went well. We now just have to see how well it works. During the operation, doctors inserted two new drains in David's head - the goal is to reduce the amount of fluid in David's head in order to reduce the pressure (yes, we're back to measuring ICP). I don't know all of the details, but David now has three drains running, and we will watch his ICP's very carefully overnight. The second area of concern is the skin underneath the first set of stiches that David received. There is some infection here, and the skin appears to be somewhat thin right around the staples. If pressure were to increase in David's head, we would have to watch these staples very closely. If we chose to staple together thicker skin (by pulling the two sides together tighter), we would lose some of the "give" that the skin affords us - as pressure increases, we would not have as much room for the brain to expand. They are treating this area with antibiotics and watching it very closely as well. We are happy with the results of the operation so far - the medical team was able to accomplish quite a lot in a single fell swoop, and there were no major complications. Now it is up to David - with the help of your love and prayers - to fight the fight. Almost four weeks ago to the day, he battled his way through two much more serious operations in less than twelve hours. He has since had four weeks to recuperate, and his vital signs have been very strong this week. We think he's in great shape to recover from this setback as well. Thank you all for staying up with us and sending your healing power David's way. There will be no more news until morning, so please get some sleep. We want David's armies to be rested... Our love to you. Your strength carries us.
8:20AM Eastern Time, 2/9/2001 Good morning, everyone. Well it's been an adventurous evening. For those of you who only have e-mail at work, I imagine you might have closed your office doors already. If you haven't, then you might want to - this morning's update comes from Mom. Also, because some of you asked, Mirna is doing very well - she has left the hospital for a rehabilitation facility. They were not sure that she would ever walk again, but she is healing much faster than anticipated, and they feel confident now that she will indeed walk. Her parents thank you profusely for your prayers. Now, the rest of the message is from Mom. "3AM Update" Dear Jay love, I will confess that my own prayer for him was more a mother's prayer, When we saw him back in his bed in ICU, we felt like dancing. He was I feel grateful and humbled. Does everyone in the world understand We look forward to what today brings, but I think right now, I'll go
back 11:45PM Eastern Time, 2/9/2001 Good evening again, friends! Please pass this message along to other people you think would be interested in David's story, and feel free to sent them to the web site. www.smotty.com So that you know, I am heading to Milwaukee for work early Saturday morning, and will not return until very late on Tuesday. Be aware that the updates will be less frequent over the next few days, but I will keep you informed as best as I can. Friday was a very mellow day for David, which is exactly what we wanted. All of his vital signs looked pretty good, except that he is running a fever still. He is now on three antibiotics, however, and the doctors haven't seemed terribly concerned about his temperature. He is also on three drains in his head, and most of them stopped producing fluid at some point during the day. This is a good sign that they seem to be doing their job. I believe that they will take David in for another CT scan tomorrow (or else they did one this evening and we didn't see the results yet) to see how things are going in there. We kept visitors out of David's room today to remove almost all stimulation for him. He slept most of the day, opening his eyes occasionally, and Dad reports that they seemed to have a clarity to them that he hadn't seen before. He did a little tracking of people around the room. Dad saw no movement on the David's right side, but the nurse reported some flexing of the right hand. His left side is still pretty active, but when they did remove his restraint (under careful supervision), David gently felt his face and head, and made no move to remove the ventilator tube from his mouth. This demonstrates a good level of consciousness and awareness. It is possible that they will take David off of the ventilator Saturday. It is also possible that they will remove at least one or two of the drains from David's head on Saturday. Dr. Smot estimates that this little episode on Thursday and Friday probably set us back about a week, but from what we can tell so far, there is no reason to think that any additional damage has been done. Thanks to all of you for your flood of support during this last little crisis. Mom and Dad in San Francisco, Kathy in Colorado, and I in Florida all read your messages avidly last night and today. Your strength and confidence supported us when we needed it. I cannot express how much it means to us, how absolutely overwhelming it is, to have each of you fighting for David just as much as we are. David is in good hands, even when ours tire from time to time. David's family is in good hands - all the time. Thank you. All our love, 10:00PM Central Time, 2/10/2001 Good evening, everyone, from a dismal and frigid Milwaukee, Wisconsin. It is trips like this that make someone appreaciate living in Florida... Please pass this message on to other people who care about David Smethurst, and send them to the David Smethurst Complete Recovery Web Site - www.smotty.com David had a good day today. He was extubated again this morning - meaning that he was taken off of the ventilator. His throat will be sore again for a couple of days because of the tube. They placed an oxygen mask over his nose and mouth today to provide good oxygen. Tomorrow they will remove this mask and place an oxygen tube in his nose. The doctors told us today that they are once again very pleasantly surprised how well David has rebounded after his surgeries. His recovery powers are very strong. They do not think that the adventures of the last couple of days has caused any additional damage, and while David has been set back a few days in his recovery process, the setback is not nearly as far as we had feared. David has tremendous control over the left side of his body. He moves his left hand with tremendous confidence to scratch his nose or his leg. This is a good sign for the right side of the brain. So far, however, he does not move his right side very much at all. The left side of his head still looks rather swollen, however, so it may not be surprising that he's having right side trouble. There was some very exciting news today about his eyesight. Ever since David has started opening his eyes, he has only done any tracking of people on the left side of his body. Once anything passes the midpoint of his vision from left to right, he appears to lose sight of it altogether. This is due to the damage on the left side of his brain. In vision, like many other parts of his body, he seems to have forgotten that his right side actually belongs to him. Because he is not aware of it, he does not think to use it. This is one of the reasons that physical therapists (and now many of David's visitors) stretch and massage David's right arm, hand, leg and foot - reminding him that these limbs exist will help him remember to use them. Well, back to his vision. Today for the first time, David tracked several people and objects from his left side, across the mid-point, and over to the right side. The first few times took place during specific excercises that Mom and Dad were doing. Later in the day, David tracked several objects to the right side on his own. This shows an activation of his right eye, and a new connection between the left side of his brain and the right side of his body. Dr. Smot feels that this might open up other pathways to other parts of his right side. We are very excited about this progress. There are still three drains in David's head. One of them has stopped draining, and we suspect that it has drained off everything that we wanted it to. The other two drains are still draining, and there is still some swelling in David's head, so we'll keep them pumping for a while yet. We'll take another CT scan tomorrow to see how well the swelling is going down. That's pretty much the news for today. Kathy is out in San Fran for the next couple of days, and is very excited to be back with Dave and with Mom and Dad. Finally, it looks like David will be in San Francisco (if not necessarily SF General) for at least another two weeks. If you're making travel plans, he will probably be in the area through the weekend of Feb 24. I cannot guarantee anything, of course, but that's the best idea we have right now. Thank you all so very much. All of our love, |