Adjusting to the Maze

Some milestones so far this week:

• Seth has cut his use of painkillers in half once again
• the new date for removing his pelvic external fixator is Sept 13 (we were told Oct 1)
• he's been cleared to shower (but the new room doesn't have hot water, so we're holding off)
• all the wraps have been removed from his leg--meaning all the skin grafts have taken
• he got to lie on his stomach for the first time in two months

Seth enjoying being on his tummy

One thing that is sure to make Seth smile are the therapy dogs. We have pondered ways to hide a dog in our room some how . . . I guess for now we'll have to be satisfied with just petting them once in a while.

There are still rough times and setbacks; the body is complex and getting it back "online" takes time, but the trend is forward.

Hurricane Follow-Up: One of Seth's therapists kindly ventured back to Walter Reed to retrieve the charger for Seth's wheelchair battery that was left in his room. He said it's a good thing we got out on Saturday because the hurricane (or is it now a tropical storm?) had caused water damage to Seth's room. 

Melancholy Move

 

I would never have believed I could be so nostalgic for a place I never wanted to be. On Friday, I wandered around the hospital and took photos of special places and cried--I have included only three here: 

first, the tree we could see from Seth's window;

second, the now famous Ward 57;

 and, finally, the hospital itself. I never thought I would consider Walter Reed a beautiful building--until we moved to the National Naval Medical Center in Bethesda.

The main entrance of the old Walter Reed Medical Center

The big move took place Saturday. It was supposed to be today but was moved up in anticipation of Hurricane Irene. The move was flawlessly executed, and Seth was in his new digs in about 30 minutes.

Seth gets into the ambulance--before the rain starts.

The new facility is really an addition on a much larger building that already has several additions, so it is not only massive--it is labrythian! Seth's new room is beautiful, but I will withhold my opinions about the rest of the place. Let's just say, my nostalgia for Walter Reed was not misplaced.

Seth's new room and new bed

The National Naval Medical Center is now officially renamed the Walter Reed National Military Medical Center--or WRNMMC. How's that for an acronym?

We slept through the hurricane. The power was out at my hotel when I woke up (as it was for 1.1 million other people), and there was one large branch among many small ones on the ground at WRNMMC. Not bad for our first hurricane. 

Most of our Ward 57 nurses have gone to new places, which is heartbreaking, and the Navy does things differently than the Army, but we hope the move accomplishes all the good it was intended to.

In the Eye of the Storm

We're in D.C. because of Seth's horrific injuries. D.C. has its largest earthquake in a century and now we are looking at Hurricane Irene. I think we must be bad luck . . .

BBF

Today, after Seth knocked out his physical therapy like a champ, the rehab team was working on removing sutures from the wound on Seth's rear end. At one point, the doctor asked if she could take a photograph of his tush to pass on to the wound care team. Seth said, "Sure."

I said, "I bet you never thought you'd be a butt model!"

After looking at the photo, he responded, "This isn't a model butt--it looks terrible!"

I said, "But if people saw it, it might make them feel better about their butts."

To which he replied as if doing the voice-over for a public service announcement: "Now don't you feel better about your butt? Brought to you by the Better Butt Foundation. Better butts for a better life . . . "

It was a good day.

Monday Milestone

and Tuesday triumph.

Seth and his dad after PT

On Monday morning, Seth rocked his PT (100 crunches) and had enough energy left over for lunch out on the Heaton Pavillion and to check his Facebook--for a record outing of three hours.

Seth and Sully having fun in the family room

Today Seth took another big step forward--his PCA was shut down, so no more IV and no more middle-of-the-night vitals checks. He made a two-hour outing with no IRs (instant-release pain meds)
--also a first.



We continue to be part of history here. We felt the earthquake that shook the East Coast today, and now we have warnings about Hurricane Irene this weekend--just as we move over to the new hospital.

Random Reflections
A good friend once gave me some perspective about some problems I was having by helping me identify data points vs. trends. These past two days have also had some very difficult moments, but they were manageable when I could see that they were single data points rather than trends.

Measuring Minutia

Tom, the double amputee from the Korean War, told us that we might want to start measuring Seth's progress every three weeks vs. every day or every week so we're not discouraged. I think we're still able to see big leaps from week to week, but his advice is good, and I'm sure in a couple of weeks, looking back every three weeks will be advisable.

In the meantime, we deal with the minutia of healing. Seth has yet to regain his appetite, so every meal is a chore, but since Friday it's been even more difficult for him to eat. Today breakfast and lunch brought tears, but he choked the food down anyway. Halfway through choking down dinner, he threw it all up. I've never cried when one of my kids has thrown up before, but I did today because I knew all the work it took to get that food down--and I know Seth worries after listening to all the lectures from the orthopedists about how nutrition is vital to his healing.

We believe the culprit is an iron supplement he's been given since Friday. The doctors added it to his vitamin regimen in hopes they wouldn't have to give him more blood. Unfortunately, the nurses just added it to his regular medication regimen and didn't pay attention to whether he took it on an empty stomach. Everything has side effects, and it's difficult to balance it all.

On Friday as I walked into the hospital, I was feeling so grateful that the big surgeries are over for now--and then I walked in on Seth's physical therapy. PT will be every bit as difficult and painful as the surgeries. It kills me to watch him fight the pain to comply with the therapist's instructions, and it makes me burst with pride all at the same time.

Moving a Hospital

Walter Reed Army Medical Center had its official closing ceremonies earlier this month. Since then, the process of moving has begun. The hospital is getting quieter and quieter. Seth is scheduled to move to the new facility in Bethesda next Sunday, August 28th. It is hoped that there will be less traffic on the weekend. The new address will be

Walter Reed National Military Medical Center

WTB Battle Company HHC

PFC Seth Pack

8901 Wisconsin Avenue

Bethesda MD 20880

On another note, here is a recent article in the Washington Post that is of interest. 

Dog Days of August

Now that Seth is under the care of the rehab team, physical therapy begins in earnest--and so it was today. Seth worked very hard even though he didn't feel like it--his last surgery was only three days ago--and his butt wound hurt. I was a proud mom--and posts like this embarrass Seth a lot.

In physical therapy at the same time were two other guys--both with their left legs missing and Taylor spatial frames on their right legs. According to our rehab doctor, this is a very common configuration of injuries because most guys are right-handed, so they lead with their left foot and the left hand as it holds the rifle. So the IED takes the left leg and often left hand and injures the right leg--usually breaking it right where the top of the boot is.

The physical therapist told us that Seth's pelvic external fixator will come off in 12 to 20 weeks--a long time but a bit better than six months, which was the original estimate we were given. Here it is in all its glory. (Thanks to Sew Much Comfort for the adaptive shorts.)


Fluff and Mumbo Jumbo
One of the many touching things that has happened because of Seth's injuries is that people--known and unknown to us--have shared their stories of loss, tragedy and grief--and overcoming them. A friend of mine lost her brother to suicide 18 years ago. After it happened, she wanted to have a T-shirt made that told everyone about her fantastic brother and that he had died. I have sometimes wished for such a T-shirt about Seth as I have walked through the crowds in downtown Silver Spring.

Another friend lost her son when he was only two years old. She wrote, "I was told that many feel during those tragic times that they are living in a dream world while reality swirls around them. For me, it was opposite, I was living reality, stone cold, in-your-face reality and all that swirled around me was a dreamlike state. Going to the bank, shopping for groceries--many of the people I came in contact knew nothing of what I was experiencing. We don't wear signs warning people, 'Treat me gently, I am in the midst of a life-altering set of circumstances.' They were the dream world, they knew not of my reality. Everyone has their own perception of reality and all we can do is treat each other kindly, with love and respect, never knowing when we may be the one to life another soul to a higher place."

This is why when the cafeteria cashier says, "God bless you, Gorgeous" or the guy behind the counter offers to grab my to-go box because I forgot it, saying, "Let me get it. You've got enough to worry about," or the guy who brings Seth's meals greets him with "Hey, Hero," I easily cry.

I sometimes look forward to when I don't cry so easily, but then again, I hope I never cease to be touched by the kindness of friends and strangers.

The Unveiling (warning: graphic photos)

 The rehab team came in on Wednesday to remove the wrap around the Taylor spatial frame so they could do pin care--that means cleaning the sites where the frame enters the leg.

It's a heavy, ugly thing that right now is difficult for Seth to lift--but that will change as he continues his physical therapy every day.

In the second photo, a bit of the skin graft is visible on the right leg and a bit of the donor site is visible on the left. Also on his left leg is what is called a shrinker--it's basically support hose that will keep the leg from swelling and help it take the shape necessary for a prosthetic. As the urologist said when he made his daily rounds, "A shrinker is good news." Funny what becomes good news around here.

More good news: earlier we were told only one of three arteries was functioning in his right leg. Today we were told there are two.

Bones, Babies and Bombay Grill

We have not yet had the great unveiling of Seth's right leg and the Taylor spatial frame, but here is a peek. When his skin grafts have healed more completely, the rest of his leg will be unwrapped.

The biggest milestone of the day was that he was officially moved from the care of the trauma team to the rehabilitation team. (Sigh of relief).

It is very difficult for Seth or me to feel sorry for ourselves here because we are surrounded by so many people going through the same things--or worse, unfortunately. Today a buddy from Seth's company stopped by--Griffin Fitzgerald, with his wife, Tracy, and their three-week-old baby, Brooklyn. Griffin was injured April 12. He lost his right leg above the knee and had a finger reattached on his right hand. Tracy went through what I have for the past two months while pregnant and then, of course, with a new baby. I am constantly amazed by people.

Griffin gave Seth all sorts of advice. We discussed which is preferable--to have people ask about the prosthetic or ignore it. He said both take getting used to, but he probably prefers being asked and has a list of great stories to tell how he lost it, including having it bit off by a shark--which really did happen to a Marine here, so I it's OK to borrow it.

Many people have asked what they could do for us. Seth gave me an answer today. He said, "Keep Bombay Grill in business! If it's gone when I get back, I'm going to be so bummed!" So there you have it. You can consider going out to dinner at an excellent locally owned restaurant an act of service for a wounded soldier. It doesn't get much better than that.

And then there were none . . .

The last wound VAC is gone. The old external fixator on his right leg is gone. Seth now has a Taylor spatial frame on his right leg. I was hoping to have a picture, but the surgeons left it wrapped. 

It was a short (comparatively) surgery, but post-op was two hours because realigning one's bones is a painful thing. Seth's right leg hasn't bothered him the whole time we've been here; today was the first time he said it felt like it was broken. The nurses told him to expect two or three days of decent pain from this change. Interestingly, Tylenol (acetaminophen) seemed to be the medication that helped his pain most today.

This is possibly Seth's last major surgery until he is mobile, and then the surgery to put all his plumbing back online will be done.

One More Day . . .

*Quick note: We no longer have internet access at the hospital. Seth has wanted to reply to his friends' e-mails and Facebook posts, but now he can't--so please know it's not because he doesn't want to! He should have access again some time after August 28th, which is when we move to the new facility at Bethesda.*

I have teased Seth almost since we got here with the comment, "Hey, maybe we could have a sing-a-long!" when there is a lull in the action. Sometimes when his nurses ask what he needs or what he would like, I tell them, "Seth loves to have a sing-a-long." At first he didn't see the humor, which, of course, made it all the funnier to me. Now he rolls his eyes and just puts up with it. Tomorrow is a pretty exciting surgery--removing the final wound VAC, unveiling of his right leg and changing his current external fixator for a Taylor spatial frame (pictures tomorrow). So as we have contemplated this surgery, the song "One More Day" from Les Miserables has been on my mind, and it's been all I could do not to break into song--"another day, another destiny . . ." Seth is grateful, I think, that I have mostly succeeded.

Another thanks for, and another link to, Charlie's column today. Seth and I come from an amazing place full of amazing and generous people.

Last week, Seth was reading the blog, and he noted a couple of errors I had made. He wasn't in a great mood anyway, so this caused him to say, "This blog is nothing but fluff and mumbo jumbo." He has since recanted (mostly), but I think it's a great way to signal when I am about to indulge in my personal reflections rather than Seth's experiences. So . . .

Fluff and Mumbo Jumbo
A favorite scripture of mine since I was a teen is "For God hath not given us the spirit of fear, but of power and of love and of a sound mind" (2 Timothy 1:7). I shared it with Seth before a couple of his early surgeries--before he was the pro at it that he is now. I don't know if it helped him, but it has helped me. In My Grandfather's Blessing, author Rachel Remen says, "Fear is the friction in all transitions" and discusses how experts' best use of their expertise is to ease others' fears. I'm thankful for those around us who have eased our fears--either with their expertise, their own experiences, or just love and hugs--in person or in the form of notes, letters and gifts.

Finally Friday

Saying goodbye to the Van Gogh look

 I'm not sure why I'm so glad it's Friday when the weekends are pretty much just like the weekdays for us--maybe it's because it's just a little quieter and there's more chance of visits.
Today Seth got off the ketamine, and his use of his regular painkillers is decreasing substantially. Pretty good considering his skin grafts are just three days old.

Lookin' good for a guy in a hospital

Other good news is he got the stitches out of his left hand, and his mobility is very good considering. We also learned he has surgery on Monday to remove the final wound VAC and put on the Taylor spatial frame--we thought we had another week to wait for this. The best news, however, was concerning his pelvic external fixator. We had been told it would be on six months; today we learned that's an "outside" projection. The range is generally 12 to 20 weeks. Yay.







These last two pictures are not very good, but I wanted to post them because this is what I see every Friday night when I leave the hospital: volunteers gathered to say "thank you" to our troops. They stand on all four corners of the intersection with signs. They wave and yell--and they make me cry every time I leave.

The Day That Shall Not Be Named

Seth is amazing. The ketamine that he is on makes him forget a lot. However, yesterday when the anesthesiologist came to discuss whether it was time to lower the dose, Seth remembered exactly what dose he was receiving. The doctor was very impressed--most patients who are fully aware don't have any idea what their dosage is. When the doctor came this morning, we commented on this amazing feat--and Seth didn't remember any of it.

The doctor did reduce the dosage yesterday, and that really made a difference. Seth is himself again--not forgetful and loony (although that was kind of fun. Ask me sometime about his interpretative dance). Today the anesthesiologist lowered the dose again, and the plan is to take him off it altogether tomorrow.

Seth will be pretty immobile while the grafts and the donor sites heal, but the surgeons plan to replace the external fixator on his right leg with a Taylor spatial frame next Friday. Then Seth can put weight on that leg and begin physical therapy.

As I have mentioned, not much has tasted good to Seth, with the exception of fresh peaches (brought by friends) and crab legs from Red Lobster. This morning, a mom and her daughters brought fresh peaches for all the guys on the ward. Nice.

Back in the Scrambler

Today is a day we are all glad is over. When I arrived this morning just before 9:00, the doctors had just taken down the dressings on Seth's skin graft donor sites. He was in a great deal of pain, and both his legs from his knees to his groin were covered in fresh blood. It was normal seepage and to be expected, but it was a horrific sight. I will never have to wonder what it means to bleed at every pore again. Seth was already exhausted because he didn't sleep well, so this didn't help the situation.While the ketamine did help with the pain, it also made him very loopy and forgetful, which was really frustrating to him. He couldn't remember eating his breakfast, ordering his lunch and some of the things different doctors told him during the day.

After much discussion about the best options for his donor sites, it was decided to leave them open to the air; we ran a fan over them for an hour of so and shined a sun lamp on them for 15 minutes--twice in six hours. The sooner the sites and seepage dry up, the better. The difficulty in keeping them open to the air all the time is that Seth was always cold.

When I finally left at 9 p.m., he was doing much better. We had the dose of ketamine lowered in the afternoon, so he felt more in control and more himself. He is excited to start doing physical therapy with his left hand now that the pins are out, so he got out his Nintendo DS at the suggestion of the physical therapist (probably the first time anybody has ever told him playing video games is a good thing). We are hoping tomorrow is a better day--it would be difficult to get much worse.

Charlie Trentleman asked me via Facebook to consider writing a column about the doctors and nurses at Walter Reed. I'm not sure I'm up to that challenge, but I thought I'd include a couple examples of our experiences here. Today, after the shocking and upsetting sight of the skin graft donor sites and Seth being in such agony, I was further challenged by what appeared to be uncertainty on the attending doctor's part on how best to treat the sites. After he left, the nurses asked if I had any questions. I asked is we could go out in the hall. I told them that the discussion between them and the doctor had not inspired confidence. Lt. Deane explained that he is a doctor, but an intern and this is a learning hospital. Because she has been here two years, that is why she was advising him on the treatment rather than vice versa. The other nurse, Major Pulido, added a few insights and then said, "Can I give you a hug?" I said, "Sure," and she threw her stethoscope over her shoulder, hugged me and let me cry it all out.

Later, the attending doctor who had not inspired my confidence returned with the orthopedic doctor who leads Seth's ortho team. He checked the donor sites and gave his recommendations, and then explained why there are several options rather than one best option. After he left, the attending doctor apologized for the earlier deliberation over treatment and said, "I thought I owed it to you to get the lead doctor in here to clear things up." I was very grateful. There was no show of ego--no wanting to be right or appear to know everything. He was more concerned with doing the right thing and making me feel confident about my son's treatment that being right.

These are only two experiences out of hundreds of interactions, but they exemplify the way we have been served and treated here.

Wonder of Wonders . . .

Miracle of miracles . . .

I hate to use hyberbole much any more since my perspective on what a bad day vs. a good day has changed so much in the last month, but I'll risk it today.

This morning Seth had surgery number ten--four and a half hours. The surgeons planned to remove the pins from his left hand, clean the wounds (debridement is the official term), exchange the wound VAC, and begin the skin grafts.

Initially, the surgeons told us the grafts would be done over two to three surgeries because of the large area to cover. So that's the good news--the surgeons were able to complete all the skin grafts today! They covered all the area on the back of his right thigh and right calf--37x12 centimeters and 16x10 1/2 centimeters respectively. The donor sites were his left and right thighs and his right flank. It was also good news that they did not have to go to his stomach or back.

After the surgeon told me this, I went into the post-op to see Seth. He was in a great deal of pain but managing it well. He was also freezing, as is normal, but the six heated blankets and plastic sheet with warm air blowing through it still didn't cut it. Still, he was calm and patient. As we talked about things, all of a sudden he got worried and said, "I don't want to do any more skin grafts." I was thrilled to tell him, "Well, guess what? You don't have to. They got it all done today." He gave me the biggest smile and then we both started to cry.

Later in his room, he said, "I want everyone to know that I really feel that this is a blessing from Heavenly Father and an answer to all their prayers." So there it is for you all to know.

The pain specialists offered him an epidural or nerve block again because of the pain at the donor sites; he just doesn't like the idea of either of those, so he opted for a new medication called ketamine. It makes him a little loony, so unlike our last post-op experience, we were having a good time, and he kept me laughing.

My favorite of all his goofiness was when we were discussing one more time the option of having an epidural. I told him if he didn't like the loony feeling, an epidural would be good because it would take away the pain without making him goofy. I told him that I had three epidurals--one with each birth of him and his brothers, and I'm fine. He replied, "Yeah, you had an epidural and look at me. I only have one leg!"

To celebrate, we got Seth crab legs from Red Lobster. It was really good to hear him say, "Mmmm" about something he was eating.

Other good news is that Jarom arrived last night, and did and will do the night shift. Amazingly, he found the "bed" in Seth's room so comfortable, he slept in until noon (OK, so it was only 10 a.m. Utah time . . . ) It's good to have him here.

Some Days Are Diamonds . . .

some days are stones.

A mostly quiet weekend. I've been doing the night shift. Eleanor comes in the day, so I go to the hotel, shower, maybe nap and go back. Nights are getting better and better--but still not sure why the doctors do their rounds at 5:30 a.m.

On the way to the Mologne House

 On Sunday, Bryan talked Seth into going to a barbecue put on by a local HOG chapter. It's quite a trek over to the Mologne House where it was held, and the weather was so hot and muggy, it was quite miserable. The food was great, and the leather-clad Harley dudes were so kind to us and especially the Wounded Warriors. Seth ate one chicken wing and then hit his misery limit, so we headed back--Eleanor and I running to keep up with all the food in our hands. Later in the day, the LDS missionaries dropped by to feed our souls.

By dinner time, Seth felt pretty crappy, and we found that he had a fever of 102. This sent the nurses into high gear, and they had to draw blood from two places and do probably seven cultures. The worry, of course, is that he has pneumonia or one of the many infections that guys can bring back from Afghanistan or develop just by being in the hospital.

This morning, the doctor told us his work-ups showed a urinary tract infection--a big relief because that is easily handled.

The highlight for the weekend was a visit from my old college roommate and her husband who live nearby in Virginia. When she called, she said, "We have an extra car--would you be able to use that?" She received her answer when I immediately broke into tears. So now I have wheels! Thank you, Bill and Sally!

Charlie had another good column, with help from Rebecca. Check it out here.

Random (or not so random) Concurrence:

• My nephew and his wife have a new baby girl who has had some complications that have caused her, among other things, to lose weight and become dehydrated,  requiring IVs and a feeding tube with the accompanying misery of trying to find a vein in the body of tiny, dehydrated baby. I shared their story with Seth, and it made him so sad. He felt grateful that, even with all that he is going through, he at least knows what is happening and why, and that everything that is being done--even when it hurts and is miserable--is to help him get better. How difficult to watch a baby without such understanding go through these things.

Oh, My Heck!

So today Seth had surgery number nine. He has had a very easy time coming out of the last three surgeries--he knows if he's patient, the pain will be soon be controlled, he'll be able to drink some water and the nurses will bring him warm blankets. (After earlier surgeries, he was very disoriented, agitated, upset--and cold).

When he came out of surgery today, however, his left leg was giving him extreme pain. The nurse gave him pain medication in addition to his PCA medication, but the pain would not be controlled. It would lessen for a moment and then return. Seth was very upset, not just because of the pain but because his left leg hasn't bothered him for weeks, so he was worried that something new was wrong or that the surgeons had messed something up.

The nurse paged the orthopedists (affectionately referred to as orthopods here), but they were still in the OR. After three hours, the pain specialist showed up. She offered him an epidural, a nerve block, morphine or another drug I can't remember the name of. Seth didn't want to do any of those. Finally, an orthopod showed up and promptly unwrapped the leg. That was it. That was all it took for the pain to disappear.The doctor re-wrapped the leg, less tightly this time, and all was well. We were relieved that the solution was so simple, but four hours of excruciating pain was hard on both of us.

Even in the midst of pain, Seth still made me laugh. At one point, he said, "Look, Mom." I looked to see him flaring his nostrils at me.

Since Seth had been given so much pain medication, he was in a pretty good mood when we returned to the room and kept the nurses laughing.

Our friend Eleanor arrived today. She'll take the day shift until Jarom arrives on Monday. Tomorrow Seth plans to get out in his wheelchair just for the heck of it. Looking forward to it.

There is No Finish Line

Today marks five weeks from the day that Seth was injured, four weeks since we arrived in D.C. to be with him, and surgery number nine, where he is as I write.


Yesterday was overall a good day. The highlight was Seth getting up in his wheelchair. He handled it like a pro, even in reverse. It is electric and controlled by a joystick, so I told him all those video games are finally paying off. Because of his butt wound, he only lasted an hour, but he was able to do some physical therapy including lifting some weights, and he got outside the building for the first time.

Yesterday's bad news was that Ethan left. We really enjoyed having him here. Seth is also still struggling to eat sufficiently. It has become a real chore.

Seth's surgery today should be another short one--just cleaning, closing, exchanging wound VACS and removing sutures. More skin grafts will probably begin next week.

Finally, Seth's buddy Bryan Dilberian made it on the local news yesterday. Check it out here!

Two Steps Forward . . .

and one step back.

Tuesday was a difficult day. In Monday's surgery, the surgeons discovered some tissue deterioration in Seth's sacral wound, so they opened it and are going to let it heal from the inside out rather than try to close it. This means it will take longer to heal, and there is renewed vigilance to keep him off his butt--difficult to do when he can't be on his front because of the eternal fixators on his pelvis. Also, important to his healing is sitting up and getting out in his chair--both very difficult to do with this wound.

It was also a busy day with all kinds of visitors from a few team members from the Atlanta Braves to Secretary of the Interior Ken Salazar. He was warm and gracious, and after he'd had a good talk with Seth, he talked to me. We both rued the loss of Bob Bennett.

We also had representatives of the Military Order of the Purple Heart who, we learned, have a service (among many others) that will allow Seth to get through airport security without a problem (remember, he's full of metal now). Another group came by with T-shirts that say "Veterans>Movie Stars." I like that sentiment.

When I arrived this morning, I heard from Ethan that they'd had a terrible night. In the doctors' quest to help the sacral wound, they ordered a very special bed that has silicone beads and air and water running through it. To switch the beds and then Seth was quite the ordeal and, at one point in moving him, the nurses dragged his butt across the rail, which, of course, put Seth in a great deal of pain. Once moved, he tried to sleep for two hours and finally, he, Ethan and the nurse decided it was a no-go, and so the whole ordeal was repeated--except this time, they didn't hurt Seth. I was so grateful Ethan was there; I think this might have put me right over the edge.

Seth and I discussed today that we didn't realize that healing was such hard work. For us, healing usually consisted of lots of sleeping and eating of warm things.

Random Reflections
I thought I'd list things we miss about Utah and home, but that's too obvious. We miss everything.

Rainy days and Mondays always get me down . . .

That's not really true. I like rainy days and even Mondays are OK, but I'm not too fond of surgery days. However, they are getting better. Today's surgery was only two hours--a record. Seth came back with only one wound VAC--a sign of progress. He only has three teams of surgeons working on him now. The only ones we've talked to after today's surgery are the urologists, and they were positive but noncommittal about final outcomes.

The anesthesiologists offered Seth additional pain relief via an epidural and were surprised to find he doesn't need it. When they checked his pain medication record, they were astonished to see how little he is using considering his wounds. As I said, whenever the doctors are surprised by positive developments, I see small miracles taking place.

We were sad to see Jerrica leave today. She took the night shifts with Ethan and, rumor has it, Ethan slept through some of Seth's requests for assistance, and Jerrica handled them. Thanks, Jerrica! We miss you already!

Before Seth was wounded, I was planning to go to Guatemala with a WSU study abroad program for most of July. To prepare for that, I was enrolled in a Spanish class. Even though I didn't get to go to Guatemala, my studies were not in vain. I met Maria Louisa in our first days in the SICU. She is the mother-in-law of one of the guys who came in the same day as Seth. She is from Mexico City and does not speak English. She is gracious enough to speak slowly for me, and we have become friends. Her son-in-law Justin spent three weeks in the SICU and just recently made it up to Ward 57. Maria leaves for home on Friday. I will be so sad to see her go. She was a bright spot through a dismal time.