One more thing

I was thinking about a conversation I had with Bill today and I have to share it with everyone.  He was feeling pretty low about his prognosis and I was trying to get him motivated to go to rehab and finish his engineering degree.  I told him that one of the facilities I spoke to today told me that they get the latest technologies and their patients often get to participate in clinical trials and that the people that get to do this are young, healthy, motivated, and working towards goals.  After I finished talking he looked at me and mouthed "like me."

Yes, Bill.  Exactly like you.

Thank you for the cards!

Bill wanted me to pass along his thanks for the cards that many of you have sent.  It really means a lot to him to know that people care.  If anyone else would like to send a card (nudge, nudge) you should do so.  I would not wait too long, we may be out of here in a week or two.

West Virginia University Hospitals
Andrew W. Beck
Ruby Memorial Hospital
1 Medical Center Drive
Morgantown, WV 26506

Thanks again!

Monday, November 30

Today was a bittersweet day.  Bill found out this morning that he won't walk again and it's been rough.  For those of you with stories about your coworker's uncle's college room mate who was given the same prognosis and then defied everyone and walked again: keep those stories coming.  The doctors are telling us that it is not possible and the scientist side of me understands that when a spinal cord is injured the way his was that it is not possible to walk, but the hopeful, optimistic, loves-a-good story part of me wants to think there is some little chance he will.  And when Bill has had a chance to process all of this and is a little farther along on his road to recovery, he may want to have some of that hope as well.

So, that was the bitter part of the day.  The rest of the day was fairly busy and he should sleep well tonight.  His doctor said he's come a long way on the ventilator and they spent most of the day turning the settings back.  I'm not sure what sort of timeline we are looking at in terms of getting him off the ventilator, but it looks to be just over the horizon.  Yay!  His heart did much better today and I don't think he had a any bradycardic episodes.  Double yay!  He had speech and swallow therapy this afternoon and was able to talk around the trach as well as swallow some thickened cranberry juice.  It went very well and he will have another session tomorrow.

I'm not sure how much longer he will be here in Morgantown.  I don't think he's medically stable yet, and in fact tonight he is having another round of CT scans to look at his GI tract.  However, he's made a lot of progress and it won't be too much longer before he doesn't need to be in the intensive care unit.  He will likely spend a day or two in a regular room and then go on to a rehabilitation facility.  I talked about rehab with him today and he wants to get into a program, work hard, and become as independent as possible.  I'm amazed by his strength and courage and know that he will get through this and blow us all away.  I can't wait to see it!

Sunday, November 29

Today was a better day.  The GI issues of yesterday have largely resolved themselves although it will likely happen again.  Part of how our digestive systems work depends on us moving around regularly, which stimulates things inside to keep moving as well.  For someone like Billy who is not moving, and for whom movement has some negative consequences (see the low heart rate episodes of the past few days) this presents a bit of a problem.

He was bradycardic (the medical term for his low heart rate episodes) this morning, but they were able to bring him back up with drugs.  In the meantime, his body decided to forget how to thermoregulate and his temperature dropped pretty low.  From what we are learning, this is all fairly standard for people with spinal cord injuries.  There is an enormous shock to the body and everything gets thrown out of whack.  His spinal cord is swollen and even though the areas that control his autonomic nervous system (which is responsible for keeping your heart beating, your lungs working, your body temperature at 98.6, etc) were not damaged in the initial injury, they are affected by the swelling. 

He asked me to take his picture today.  I've been secretly snapping grainy pictures with my phone over the last couple of weeks and at some point I will show him those.  I also told him that I was keeping this blog and asked if it was okay with him to post the picture here.  It meant a lot to him to hear that so many people are concerned.

Oops, I forgot to mention this bit: both chest tubes are out!  He was pretty pleased to inform me of that this morning.  I don't know if he knows just how many tubes and holes there are in his body or not, but he's excited to see them go!

Saturday, November 28

Some days are good, some days are crummy.  Today was the latter.  He's having some gastrointestinal issues that are part of the package deal you get with a spinal cord injury.  So most of today he felt nauseous and bloated.  All the pressure in his abdomen seemed to affect his heart rate (this is my totally non-medical opinion here) and he had a couple more episodes.  If things don't improve tomorrow they will probably put him back on dopamine to help regulate his heart rate.

He's asking for Pepsi pretty regularly and has been for a couple days.  Today he also asked about rehab and I'm pleased that he's able to think past this current discomfort (putting it mildly) and thinking about the future.

Here's hoping tomorrow is a better day.

Friday Evening

I can't believe I forgot to mention this earlier- but he's able to shrug both shoulders and move both arms.  It's just a bit and it's all upper arm movement (so, nothing really from his hands) but it's awesome to see this.

Friday, November 27

Today is going really well.  He's awake and more lucid than we've seen him so far.  We are getting better at reading his lips and we are also using an alphabet board to spell out words.  When we tried the board yesterday he would sort of space out before we could get a whole word out, so the fact that we are communicating sentences and ideas today is remarkable.  He remembered that I told him the other day I am borrowing his truck, he wants us to speak with our uncle about him becoming a Mason, and he wants to know how much I pay for my cell phone each month.  It's interesting to learn what his concerns are after the 12-day trip he's been on.  He is also asking about his condition and wanted to know details about the accident, his current state, and how much he will recover.  He's saving these questions for Dad and so far Dad has been honest and straightforward with him but has not used the words "paralyzed" or "quadriplegic".  The truth is that we don't know how much he will recover but we know that it will take a long time and that's what Dad has told him.  I think he grasps the severity of his injuries which is tough.  I expect that he will become very depressed and angry during his recovery and I am afraid of that.  I wish there was some way I could save him from that pain, but I also recognize that it will be part of his recovery and it is important that he work through it himself. 

Thursday, November 26

Today was mostly quiet.  Billy had another "episode" where his heart rate dropped and his breathing became erratic, but we were told he recovered on his own and did not need any medication.  These episodes are not surprising to anyone providing care and seem to be symptomatic of high spinal cord injuries.  Just to be safe they took chest x-rays (which I think might be a near-daily occurrence anyway) and an EKG.  Those all checked out, which I guess again just points to high spinal cord injury and not any other complication.  He also had another bronchiostomy today and it seems like he has an easier time breathing after this procedure.  They gave him some more sedative so he's been sleeping calmly all afternoon and his vitals look good.

I spoke briefly with one of the trauma doctors today and he told me that it could be at least two years before we know the full extent of permanent damage or recovery possible.  Two years seems like a long time, but I am glad to have some sort of time frame to think about.  And two years is a long time- a lot of healing can take place in two years.  In any case, we've started thinking about rehabilitation facilities and have a lot of research to do.

Finally, for those of you who are wondering, we did have a turkey dinner today.  There is a facility adjacent to the hospital called the Family House with affordable (long-term) housing available to the families of patients here.  There are also kitchen and laundry and other useful amenities here.  Anyway, the Family House provided a Thanksgiving dinner today so we got our annual dose of tryptophan and have been dozing off in the waiting room all afternoon.

Giving Thanks

I thought that this year we would have to dig deep to find reasons for being thankful, but when I thought about it more last night I realized that wasn't the case.

• Billy was with someone when the accident happened.  That person ran for help and without that he would certainly not be here now.
• When our township volunteer EMTs saw him, they realized that his injuries were too severe for treatment at the local hospital.  They made the call for a helicopter and saved Bill from an ambulance ride that would have surely done more harm than good.
• Our immediate family was available to be by his side, the whole time.
• We have seen such an outpouring of support, love, prayers, and plain old good thoughts from people all over the country- for Billy as well as the rest of us.
• He has been receiving top-notch medical care from an amazing team of doctors, nurses, therapists, and anyone else.  They have been incredibly responsive to us as well and will answer all of our questions, many of them multiple times.
• He is alive.

This is no one's idea of a good time and right now there is so much uncertainty and so much sadness for what we think he has lost.  It's easy to lose sight of everything we still have and the potential Billy has for healing.  For all of this and so much more we are thankful this year.  Thank you all for your comments, emails, phone calls, and all the other support we've felt.  It means so much to us all.

Wednesday, November 25

He's making small improvements. He has a lot to say but unfortunately we are not very good at reading his lips yet. It's getting better, but I know it is frustrating for him to not be able to communicate with us. This afternoon both a respiratory therapist and a speech therapist worked with him and we hope this means he will get a speaking valve for his ventilator sooner rather than later. 

Apparently his heart rate dropped fairly low during the afternoon session. His heart seems to be doing well but every now and then he has an "episode". Depending on how things go, he may need to take medication or even get a pacemaker to keep things consistent.  Either way, no one will know anything for quite some time.  This is the 10th day following the accident and if we understand this correctly, the swelling in his spine has not really started to go down yet. Someone else told me that it could take a year for the swelling to fully subside. I am sure you are starting to catch my drift here: this is going to take a long time.

Tuesday, November 24

Billy had the tracheostomy and feeding tube relocation (not sure of the correct medical term for this one) this afternoon.  He "tolerated" both well which is a good thing.  If he is not tolerating procedures well his heart rate and blood pressure drop and his breathing gets erratic.  As far as I know he made it through the whole day without needing a shot of dopamine to help regulate heart function.  Yay!

I was reminded today that he may never be weaned off the ventilator and that I should not get so caught up with that idea.  Just passing this nugget along to everyone else.  I, for one, will continue to hope that he does not need it for the rest of his life but I will do my best to not see it is a hindrance if that is not the case.

He is mouthing words but because of the way the trach ventilator works (air is expelled through the tube in his throat instead of past his vocal cords) he can't currently speak.  His trach can be fitted with a valve that would allow him to speak at some point down the road, but I don't think that is anything that will happen soon.  There is also the possibility that because of the location of his spinal cord injury he may not be able to speak again.  The reason, as told to us yesterday, was that he might not have the muscle control to operate his lower jaw.  He bit a doctor yesterday and was able to enunciate words (while mouthing them, it that makes any sense) today, but maybe the concern is whether or not he has the ability to expel air from his lungs to make sounds.  We won't know for sure for some time.  Unfortunately we aren't very good at reading lips yet.  I thought he might have been asking for morphine and when I asked him to confirm that, he nodded his head yes in agreement.  I then asked him if pink elephants were his favorite animal and he agreed to that as well.  His nurse said he also agrees to being a girl.  All of this is clear indication that his cocktail today contained some fun drugs.

In all seriousness, we are excited about the tracheostomy.  This should hopefully reduce the occurrence of future pneumonia infections and will hopefully ease the weaning process.  If nothing else, he's much more comfortable without all the tubes in his mouth and we will learn to read his lips and better communicate with him.  I miss my brother.

Monday, November 23

Bill's sedative is starting to wear off so he woke up some today.  I put it that way because I think he is still foggy from the sedative and will continue to be for a few days.  He would wake up for awhile and then fall back asleep.  He would open his eyes and would answer yes or no questions, although not always in a way that made sense.  The pain medicine has also been greatly reduced and they tell us that is to determine if he has any lung function.  So far we don't see any evidence of that, but these things take time.

I want to state that again- this recovery is going to take a long, long, long time.  We won't know anything about the extent of permanent damage for a long, long, long time.

He had a couple of episodes today where his heart rate dropped and he started gasping.  This was quickly remedied with dopamine (I think) and when I left him tonight he was fine.  There is still (and will continue to be for a couple of weeks) a lot of swelling in his spinal cord in the areas that control his heart.  He is getting better, but this is a long process.  We won't know for some time whether or not he will always need medication or even a pacemaker to control his heart.  That is a possibility, but we don't know yet.

Tomorrow he will have the tracheostomy surgery.  This involves cutting a hole in his throat, through his windpipe, and putting the ventilator tube there rather than in his mouth.  We knew this was coming and he will definitely be more comfortable with this set-up.  This also gives his doctors more flexibility to wean him off the ventilator, which we hope will be the case.  Please remember that until the swelling in his spinal cord goes down we won't know if he will need a ventilator for the rest of his life or not.  They will also move his feeding tube tomorrow so that it goes directly into his stomach rather than through his mouth.  Also, this will be much more comfortable for him.

We talked to a couple different surgeons last night and tonight about his initial injuries.  Cervical vertebrae 1-7 were displaced (meaning that they no longer are neatly and evenly stacked one on the other) and there are major fractures in the facets of the spinous processes of C5 and C6.  There is a transection in the spinal cord at C5 and bruising all the way up to C2 or C3.  The surgeons fused C4 and C6 together with a plate, some rods, and lots of screws.  There is nothing that can be done for the spinal cord except stabilizing the cervical vertebrae and waiting.  This is all a bit ominous.  He was administered methylprednisolone approximately 8 hrs and 48 hrs following the initial injury.  This is a steroid that may or may not reduce damage to nerve cells and decrease inflammation near the site of the injury.  That is as far as I've gone in regards to researching this kind of injury.  You are more than welcome to Google away, but I don't really want to hear about what you've learned.  At least not yet.  The only thing we know for sure about this type of injury is that it takes a lot of time before we will know anything for sure.

Sunday Evening

Today was indeed a good day. When I left this evening he was completely off the dopamine and both the pain medicine and the sedative were greatly reduced. He was breathing comfortably and his eyelids were twitching as though he was dreaming. I hope his dreams are good.

He had the bronchiostomy tonight and his doctor said "he tolerated it well" and then she told us that he bit her during the procedure. I don't think she minded that at all to be honest with you. The really good news is that his pulse did not drop at all while they were doing the test. When he was bronched two days ago they had to stop and give him breaks because his pulse dropped to 60 beats/min (thats low for him right now) and then went down to 40 (frighteningly low) while they waited. Yikes! Tonight it did not go below 80. His body is better able to maintain his heart rate.  See, the small things feel like the biggest accomplishments! They were able to remove quite a bit of fluid from his lungs and his temperature came down during the day. It looks like the pneumonia is under control. I'm not sure how long it takes to clear up completely, but I suspect that because of his condition we will see more infections like this.

Our family from Massachusetts came in Friday and Saturday. It's been so great to have them here, and even better to share some of this. My cousin Bekah spent most of today with him and for that I am incredibly grateful.

Sunday, November 22

Billy had an uneventful night, which you will recall means a good night. He will be on the ventilator for now and quite possibly forever. I'm not going to pay much attention to it or write about it much anymore. The ventilator is his reality and is keeping him alive. At some point down the road they will give him a tracheostomy which means instead of having the vent tube going through his mouth to his lungs it will go through an incision through his throat. This type of ventilator is ultimately more comfortable for patients, won't cause tissue breakdown in his lips (a very real risk he has with tubes laying in his mouth), and allows for more flexibility which makes weaning patients a lot easier. We hope that will be the outcome in Bill's case, but we don't know yet. His doctor seemed pleased and encouraged by his status this morning.  They are going to take him off the dopamine drip (the IV I mentioned last night) because his heart is doing much better. Yay!

He will get another bronchiostomy later today. This is the procedure where they drop a camera down his throat and look at his airway.  Probably the main reason they are doing is that they can remove some of the mucus that's lower in his lungs. He had a much, much easier time breathing a couple days ago after this procedure.

He has developed pneumonia which is not surprising. His doctor told us the other day that it was more a question of when rather than if he would have pneumonia. So, another round of antibiotics and some Tylenol to bring down the fever.

All in all, today is shaping up to be good.

Saturday Evening

This day ended on a much better note than yesterday. He's breathing much more easily, still on the ventilator, but it's much better today. I noticed that the IV drip he's on to control his heart rate and blood pressure has been reduced. I didn't actually talk to anyone about it, but I think it might mean his heart is better able to maintain itself than it was yesterday. I'll find out more about that tomorrow. He also had two blood transfusions between last night and this morning. His color looks much better and his blood tests are good as
well. Whew.

The other big news I have for this evening is that he responds to extreme pain to his feet. I saw his right foot respond last night but I didn't say anything because I'm trying hard not to get my hopes too high. Anyway, they take a big pair of tweezers and pinch his toenail as hard as they can. So, I think that you or I would find this excruciating and so far Billy jerks his foot. Just a little bit, but enough to make me happier than I've been all week. Anyway, I did not see it but tonight both feet responded. It is still much too soon to know what this means so please keep that in mind. Regardless of how this ends, the fact that he is responding to this is very good.

I feel much better than I did at this time last night. He's still not out of the woods yet. He's still in critical condition and who knows how tonight will go for him. But, today there were lots of little improvements. I will take whatever I can get!

Saturday, November 21

I wish I had some better news, but the last day has been pretty awful.  First of all- he is still alive.  His doctor sat down with us yesterday to go over the extent of his injuries.  The MRI indicated that things were not as great as I've been allowing myself to hope.  I don't remember all of the details and I will probably bungle this description, so please bear with me.

The MRI showed that the damage to his spinal cord was more extensive than the CT scan indicated.  This is just the nature of these types of tests.  His spinal cord is damaged, crushed at cervical vertebra 5.  This means that he will be a quadriplegic.  The doctor told us that the best case scenario is that he has some movement in his arm (probably never in his hand) but the ability to move his arm means that he could operate a motorized wheelchair.  If that's not the case then there are voice-controlled wheel chairs or other technology.  However, this is not anything to really think about right now. 

The MRI showed that there is bruising in his forebrain (which controls, among other things, personality, decision-making, compulsions).  This may or may not be permaently affected.  This is the least of the doctor's concerns right now and I am choosing not to dwell on it.

The MRI also showed that there was damage to the spinal cord all the way up to cervical vertebra 2 (C2).  The higher the damage, the worse the prognosis.  C1 is right below your skull, C2 is the next one down, etc.  People with injuries at C3 or higher are ventilator-dependent for life.  Until the swelling in his spine subsides, we won't know the extent of the long-term damage.  The MRI also showed that there was bruising in his midbrain (the part of the brain that controls among other things heart rate and breathing).  Between the damage and swelling in his spinal cord and the midbrain bruising, he's having a really tough time maintaining reasonable heart rate, blood pressure, and breathing.  So, he's on a ventilator for now and until the swelling subsides (that won't be for another week or so) we won't know whether or not he will need to be on a ventilator for the rest of his life.  He's still in critical condition and he's having a lot of trouble breathing despite the ventilator.  Some of this can be explained by midbrain and spinal cord injuries, but some of it is still a mystery.  There is some slim chance that he won't pull through this part of it.

Everything above we found out last night.  We are all in shock and this is still slowly sinking in.  He had a test last night where they slipped a small camera down his windpipe to look at his lungs from the inside.  There was no sign of injury or damage (that's good)  but he did have some mucus in the bottom of his lungs.  They removed that and he went on to have an uneventful night (which is practically a good night considering) and they are spending today tweaking back the ventilator settings.  He got a couple of blood transfusions and I thought he looked much better today.  His breathing is not nearly as labored as it was last night and when I spoke to his doctor this morning she was encouraged by these small steps.  In the meantime, he has developed a dent on his left lung and today had a chest tube inserted on that side.  That surgery went fine and was also "uneventful".  From what we hear, tall, skinny guys are susceptible to developing blebs (small air blisters on the top of the lungs) and given everything else going on these blebs may rupture and cause a pneumothorax (which is the fancy way of saying collapsed lung which is what I'm calling dented lung because it sounds better).  So- this is not a surprise to anyone here and is remedied with the chest tube and is controllable.  It's just one more thing.

The staff here is amazing and I had a long talk with a nurse last night who held my hand and called me sweetie.  She did not give me any false hopes, but she did tell me that there is always hope, and I desperately needed to hear that.  He's young, strong, and healthy and people like that are able to recover better.  If this had happened to someone twice his age then we could be more sure of the prognosis.  There's no way to know how his recovery may go and where he will be in a week, a month, or a year.  Right now he needs rest and we have to wait for the swelling in his spine to subside.  I thank you all for your thoughts, encouragement, and prayers.  Mike (my husband) came out this week and has been an enormous help.  We are all eating, getting outside for walks, and doing our best to stay healthy and cope with this.

Thursday, November 19

Today was a long day.  Bill had a rough night last night and was having difficulty breathing.  They took a chest x-ray and determined that he had a collapsed lung (although, the description I received made it sound more like it was dented) but it was something else to be concerned about.  This was not a result of the initial accident he had, but rather something that developed in a weak spot on his lung from the constant positive pressure exerted by the ventilator.  He had a chest tube inserted this morning to relieve the pressure and allow his lung to fully inflate.  I was told to think of this as a step sideways, not necessarily back.  It was still discouraging given all the progress he made yesterday.  Because of the "dented" lung, he had several CT scans done today to make sure that there were not any other issues with his lungs and those all came back clear.  Tonight's nurse described it to me basically this way: my brain is able to send a message to my lungs telling them to inhale and my lungs receive the message almost instantaneously.  Because of the nature of the injury to Bill's spinal cord, the message his brain sends is taking some time to get to his lungs and might be a bit garbled.  This is not uncommon in this set of circumstances, nor is it necessarily permanent.  They bumped all his ventilator settings back up (O2 tonight was 95% and the machine was doing most of the work).  He also had physical therapy today as well as an MRI.  All the scans and other activity were enough exertion to warrant bumping the ventilator settings back up.  Depending on how he does tonight, tomorrow they may start turning things down.  No way to know until tomorrow.  In brighter news, he is taking food better today.  He's always had a sensitive stomach and had been having trouble with whatever goo they've been putting in his feeding tube but today it appears that things are moving along, if you get my drift.  I suspect that he will be mad at me for sharing that little tidbit, but I am very much looking forward to the day he tells me to get out of his business.

I do not know the results of the MRI yet but should find out tomorrow.  We are also going to schedule a consultation with a neurosurgeon to discuss Bill's initial injury and the surgery he received Monday night.  The only reason for doing this is that we are confused.  I may have misspoken when I told you that 4, 5, and 6 were all broken.   It doesn't really matter much, but I want to be sure that I am passing on the correct information.  The thing that we know for certain is that the spinal cord was not severed.  No guarantee that he will walk again, but it makes it a possibility.  Does anyone have some spare patience they can lend me? 

For those of you that wish to visit I will ask you to wait a little longer.  He is still sedated and not waking up much.  The folks here feel that having people come see him isn't helping him much and is exposing him to more germs and the last thing he needs right now is a cold.  His recovery is going to be long and he will need much support in the weeks and months to come.  I know it's frustrating, but it would be better if we wait a bit.

Wednesday, November 18

Today was a great day!  He's been on the sedative all day but seems a bit more aware than he was earlier.  A few of his coworkers at the power plant came by to see him and he opened his eyes and nodded his head when they asked if he knew who they were.  A physical therapist came by and gave his arms and legs a workout.  The filter surgery was fine and they even are even backing off the ventilator a bit.  He's still on it, but he is initiating the breaths himself and as soon as he starts to inhale the ventilator will push a breath into him.  It's part of the weaning process and it's very encouraging.  He was awake and able to communicate (again- nods and head shakes) with Dad, Nancy, and I this evening.  He's still pretty upset about the vent tube down his throat (try swallowing a garden hose and tell me how you feel) and was fighting and chewing it a bit this evening.  The next option is a bite guard to keep him from chewing through the line and I know that will probably just make him mad.  He hears us but is not really interested in lying back and relaxing and not fighting the tube.  This is absolutely my brother's way so we're pretty happy to see him so mad.  He also had the brain-swelling probe removed tonight.  Yay!  It's really nice to be able to scratch things off the list.  He will probably have the MRI tomorrow.

He was awake and aware of us for a long time this evening.  After he fell asleep I left (I'm worn out) but Dad and Nancy are still at the hospital.  They won't make any major changes to his treatment overnight so he should be able to rest well tonight.  Today was a big day and he will surely need all the rest he can get.

Wednesday, November 18

Thanks so much for the concern and well wishes.

Bill was hit by a limb in a falling tree late Monday morning. Our local (volunteer) EMTs responded very quickly and when they realized the extent of his injuries they called a helicopter in. The nearest and best-equipped trauma center was in Morgantown, WV, at WV University.  Billy broke cervical vertebrae 4, 5, & 6. Two of those three were fused in surgery Monday pm. He came through the surgery pretty well and was responsive to nurses, family, & visitors yesterday. He would wake up, open his eyes, and could nod or shake his head in response to questions. He has some gross movement in his right arm and very little in his left. One of the main concerns is how long his brain went without O2 after the accident. He is not as responsive as they had hoped, but he's also on some powerful pain meds. He's on a ventilator and started fighting it yesterday evening. They put him on a sedative that seems to have knocked him out for now. The O2 in the vent is down to 55 percent which is good. I think they will try to wean him off the vent tomorrow. He has a probe in his head monitoring brain swelling, which there is very little of. However, as long as he has the probe he cannot have an MRI. The MRI will tell us more about the extent of O2 deprivation but will not change his treatment at all. For that reason they are going to monitor the swelling a little longer and worry about the MRI when the probe is removed.

Today he goes in for minor surgery to install a filter in the vein returning blood from his legs to his heart (the  inferior vena cava.) The filter will catch any blood clots that might form in his legs and might break loose and potentially cause an embolism. This is only a precaution and is a very simple procedure.

It is still too soon to know what the long term effects of this accident will be. Some degree of paralysis is certainly possible, but is not certain. He is young, healthy, and strong. It's just too soon to know anything for sure. We are taking things hour at a time and are truly thankful for the progress we have seen so far. Your thoughts, prayers, and calls have meant so much to us. I will do my best to keep you informed.