A busy day today for Cosima. Her staples were removed and most of the stitches on her right arm were removed as well. So far the skin graft on her elbow looks good and it is being accepted. In about 5 - 7 days they will remove the sutures.
She received new dressings and bandages. To complete her new accessories a new half cast was put on her wrist and her broken thumb was splinted. After all the activity she got a well deserved rest throughout the rest of the morning and into the early afternoon.
Her temperature remained normal throughout the day. She will continue on the antibiotics for another week. Again there was quite a bit of drainage from her lungs which is a result of her pneumonia.
In order to increase her overall awareness the medical team is working on reducing her level of morphine and the sedatives she has been receiving.
One of the next steps is to see if they can get the neck brace off. This seems to be a source of discomfort and having seen it I would definitely agree as it is quite bulky and looks very uncomfortable especially on her small frame. Zach suggested a large pediatric neck brace as it may improve the position her neck is in and would reduce the pressure on her C7 fractures in her neck. An MRI needs to be done first before this can happen so we will wait for that to be scheduled.
Her physical therapy should start tomorrow as well for her legs and arm.
Haily has been her nurse now for a couple of days and it is wonderful to have the consistency. She was there during the first few days as well and has an amazing bed side manner.
oxygen assistance
Cosima is still breathing on her own during the day. We were hoping this would continue as she was just removed from the ventilator yesterday. During the evening she is still on the ventilator. She is getting 40% oxygen through her trach which is down from 50% as of yesterday. It is just giving her an extra bit of assistance right now.
She is still pretty out of it and not very responsive which is most likely due to the pneumonia. Her temperature has come down to normal ranges so that is a good step.
Preliminary reports on her skin graft show it seems to be taking. We should continue to get further updates on this but so far so good. Her staples are still in her legs and we hope these can be removed soon.
As you can imagine it has been difficult to keep up with all of the communication. We apologize to anyone who has left us a message we haven't returned yet or contacted as quickly as we would have liked too. Contacting us by email is probably the best way to get a quicker response since we are balancing all of this with our busy work schedules. Thanks for your patience.
She is still pretty out of it and not very responsive which is most likely due to the pneumonia. Her temperature has come down to normal ranges so that is a good step.
Preliminary reports on her skin graft show it seems to be taking. We should continue to get further updates on this but so far so good. Her staples are still in her legs and we hope these can be removed soon.
As you can imagine it has been difficult to keep up with all of the communication. We apologize to anyone who has left us a message we haven't returned yet or contacted as quickly as we would have liked too. Contacting us by email is probably the best way to get a quicker response since we are balancing all of this with our busy work schedules. Thanks for your patience.
kicking the vent to the curb
They have removed the ventilator and Cosima is doing well with out! This is very exciting and a huge step. She will still be hooked up to the ventilator again in the evening to help her breathe while she is sleeping. This is a very common way to wean patients off the ventilator so it may be an on again off again process.
Her temperature is still elevated and has come down just a little bit. She is still being given antibiotics for her pneumonia so we aren't out of the woods yet. Yesterday she felt hot and was perspiring. This is still a sign of infection so they are monitoring her very closely right now.
A new central line was installed yesterday afternoon since the doctors felt the auxiliary lines weren't quite sufficient.
Thelma was able to take a break as she has been at the hospital for so much of the time. She was going to church today and I am sure they are looking forward to hearing her in the choir.
Her temperature is still elevated and has come down just a little bit. She is still being given antibiotics for her pneumonia so we aren't out of the woods yet. Yesterday she felt hot and was perspiring. This is still a sign of infection so they are monitoring her very closely right now.
A new central line was installed yesterday afternoon since the doctors felt the auxiliary lines weren't quite sufficient.
Thelma was able to take a break as she has been at the hospital for so much of the time. She was going to church today and I am sure they are looking forward to hearing her in the choir.
Friday's news
Friday morning Cosima had her surgery for the tracheotomy. They weren't able to remove the staples in her leg at this time but they are able to do this procedure in her room at a later time. For most of the morning and early afternoon she was asleep and groggy when she did start to wake up from the anesthesia.
She is now not breathing through her mouth anymore but through a breathing tube attached to her throat. This can take a bit of time to adjust to but after a short while Cosima seemed to adjust to it and become more comfortable.
There is a single tube attached to a "plug" in her neck, just below her esophagus. This bypasses her esophagus and delivers oxygen directly to her air passage way (to her lungs) through the trachea. This device blocks the 'flap' we normally use to control the flow of air into our lungs or fluids/solids into our stomach - it is controlled manually like a switch. She still has a feeding tube through her nose and saliva tube in her mouth to help, but the air is direct now through the trachea. The Doctor was quick to remind us that this is not a permanent operation. She will likely have a scar from the operation, but it will be removed as she becomes more capable to breath on her own. Overall it is supposed to much easier to breath this way and her lungs should not have to work as hard.
When asked if she would be able to breathe on her own without the ventilator the doctor indicated maybe as soon as this weekend they would start to look at this. Initially they will try for shorter intervals of time off the ventilator, since the risk is far lower now and if she is having difficultly she can be immediately be give assistance back with the ventilator without complications since she now has a trach.
Cosima will not be able to talk while connected to the respirator, as this blocks the air passage way and "air pressure" from reaching her throat and therefore there is no air to move or make sound with. This makes sense if you think about it. Our ability to speak and make sounds is heavily dependent upon air pressure. Without air, there is no sound.
It was confirmed yesterday that Cosima has pneumonia. They had tested for it and the tests showed she did have it. She was starting to run a bit of a fever and she is on antibiotics to treat it. Already her fever has come down so the antibiotics seem be working.
She is now not breathing through her mouth anymore but through a breathing tube attached to her throat. This can take a bit of time to adjust to but after a short while Cosima seemed to adjust to it and become more comfortable.
There is a single tube attached to a "plug" in her neck, just below her esophagus. This bypasses her esophagus and delivers oxygen directly to her air passage way (to her lungs) through the trachea. This device blocks the 'flap' we normally use to control the flow of air into our lungs or fluids/solids into our stomach - it is controlled manually like a switch. She still has a feeding tube through her nose and saliva tube in her mouth to help, but the air is direct now through the trachea. The Doctor was quick to remind us that this is not a permanent operation. She will likely have a scar from the operation, but it will be removed as she becomes more capable to breath on her own. Overall it is supposed to much easier to breath this way and her lungs should not have to work as hard.
When asked if she would be able to breathe on her own without the ventilator the doctor indicated maybe as soon as this weekend they would start to look at this. Initially they will try for shorter intervals of time off the ventilator, since the risk is far lower now and if she is having difficultly she can be immediately be give assistance back with the ventilator without complications since she now has a trach.
Cosima will not be able to talk while connected to the respirator, as this blocks the air passage way and "air pressure" from reaching her throat and therefore there is no air to move or make sound with. This makes sense if you think about it. Our ability to speak and make sounds is heavily dependent upon air pressure. Without air, there is no sound.
It was confirmed yesterday that Cosima has pneumonia. They had tested for it and the tests showed she did have it. She was starting to run a bit of a fever and she is on antibiotics to treat it. Already her fever has come down so the antibiotics seem be working.
3rd benevolent fund
There has been another benevolent fund set up for those in the Los Alamos area - please check on the left hand side for details on how to donate at the branch there or the locations in Santa Fe and White Rock.
Gracia, one of Cosima's friends, has generously commited to donating all class fees she collects from teaching Hatha Yoga in Los Alamos and White Rock to Cosima's Medical Fund. If you are in the area please join her for a class.
Gracia, one of Cosima's friends, has generously commited to donating all class fees she collects from teaching Hatha Yoga in Los Alamos and White Rock to Cosima's Medical Fund. If you are in the area please join her for a class.
tracking well
Cosima is schedule for the tracheotomy this morning. They will also remove the staples on her legs during the surgery as well.
Yesterday Zach said there were quite a few doctors in her room and all said that she was doing well which is good to hear.
Right now they are changing up her pain medications as she is building up a tolerance to some of the ones she has been on. The new ones are longer lasting and she won't have to receive such frequent doses. This will allow her to sleep more and let her body heal naturally.
She has also had her central line in her chest removed since it was primarily being used for a saline drip. A new peripheral line was placed in her left wrist.
All these things may seem small but they do indication she is on the right track and her progress is moving in the right direction.
Yesterday Zach said there were quite a few doctors in her room and all said that she was doing well which is good to hear.
Right now they are changing up her pain medications as she is building up a tolerance to some of the ones she has been on. The new ones are longer lasting and she won't have to receive such frequent doses. This will allow her to sleep more and let her body heal naturally.
She has also had her central line in her chest removed since it was primarily being used for a saline drip. A new peripheral line was placed in her left wrist.
All these things may seem small but they do indication she is on the right track and her progress is moving in the right direction.
future care
Yesterday the social worker sat down with Jan, Thelma, and myself to go over potential steps for Cosima's care after being in the Intensive Care Unit. All time frames are very rough estimates and this is just the initial outline for her next steps in her care after the ICU.
UNMH is for trauma patients and once they are stable they are downgraded to another floor of the hospital or moved to another facility. It is currently anticipated she will be at UNMH for another couple of weeks.
Step 2 is Long Term Acute Care, or LTAC, as I will refer to it going forward. This is for patients who still need a very high level of care but are stable and have their scheduled surgeries completed. They handle patients who require extended hospitalization to meet their medical needs. Anticipated time is about 2-3 weeks here.
Step 3 is a Skilled Nursing Facility, called SNF, and this is for non weight bearing patients. At this stage she would need to be breathing on her own and no longer on the ventilator. They would provide range of motion therapy. Estimated time here is about 4-6 weeks.
Step 4 is a Rehabilitative Center. Cosima would go here when she is no longer non-weight bearing. They would provide up to 3 hours a day of Physical Therapy, Occupational Therapy, and Speech Therapy. I do not have an estimate for the time she would spend here. The goal here is for her to be able to be as independent as possible and provide basic care for herself.
After this there would be ongoing physical therapy but we don't have many more details on this yet.
Yesterday we looked at LTAC facilities and chose one we feel would best suit her needs. It is located in Albuquerque a short distance from where she is now. We all felt it was an easy decision to choose the one we did.
Please keep in mind this is a very rough outline and there are many variables but right now this is the initial plan. There will be more to come but wanted to give a brief summary of anticipated next steps.
UNMH is for trauma patients and once they are stable they are downgraded to another floor of the hospital or moved to another facility. It is currently anticipated she will be at UNMH for another couple of weeks.
Step 2 is Long Term Acute Care, or LTAC, as I will refer to it going forward. This is for patients who still need a very high level of care but are stable and have their scheduled surgeries completed. They handle patients who require extended hospitalization to meet their medical needs. Anticipated time is about 2-3 weeks here.
Step 3 is a Skilled Nursing Facility, called SNF, and this is for non weight bearing patients. At this stage she would need to be breathing on her own and no longer on the ventilator. They would provide range of motion therapy. Estimated time here is about 4-6 weeks.
Step 4 is a Rehabilitative Center. Cosima would go here when she is no longer non-weight bearing. They would provide up to 3 hours a day of Physical Therapy, Occupational Therapy, and Speech Therapy. I do not have an estimate for the time she would spend here. The goal here is for her to be able to be as independent as possible and provide basic care for herself.
After this there would be ongoing physical therapy but we don't have many more details on this yet.
Yesterday we looked at LTAC facilities and chose one we feel would best suit her needs. It is located in Albuquerque a short distance from where she is now. We all felt it was an easy decision to choose the one we did.
Please keep in mind this is a very rough outline and there are many variables but right now this is the initial plan. There will be more to come but wanted to give a brief summary of anticipated next steps.
change of the guards
Zach, Cosima's younger son, arrived yesterday evening. In the ICU visiting hours end at 6 but they also have visitation from 9-11 at night so he was able to see his mom. Cosima was awake when we arrived and was very happy to see him. Much of the time we were there she did sleep after being given some more pain killers but it is always good to see her relaxed. It was nice we had an opportunity to go through some things and chat before I leave this morning.
It is a bit hard to leave her - know it was extremely difficult for Sam to do so but Zach will take excellent care of her as will Thelma and Jan and all of her friends. The internet and email becomes an even better invention right now so we can all be in touch frequently. Oh and did I mention those cell phones - those seem to work out pretty well too.
She is continuing to trend in the right direction. Right now the tracheotomy looks like it will take place on Friday.
It is a bit hard to leave her - know it was extremely difficult for Sam to do so but Zach will take excellent care of her as will Thelma and Jan and all of her friends. The internet and email becomes an even better invention right now so we can all be in touch frequently. Oh and did I mention those cell phones - those seem to work out pretty well too.
She is continuing to trend in the right direction. Right now the tracheotomy looks like it will take place on Friday.
post surgery
Sorry for the late post - know several of you were wondering on the outcome but this is the first chance I have had to give an update.
Cosima's surgery took about 2 hours. They just operated on her elbow but did not do the tracheotomy yet. This will be done on Friday as the surgeon wasn't available during her surgery to do it.
We have been told the surgery went well but don't have a ton of information yet as we haven't spoken directly to the hand surgeon. They did a split-thickness skin graft which contains the epidermis with only a portion of the dermis. They didn't have to take a portion of her muscle which is a better outcome. We won't know until Monday if it was successful and it has taken. The skin was taken from her upper thigh.
I have been told she will have to be sure to wear sunscreen diligently on her arm for the next year or so as it will be very sensitive to the sun. I am putting anyone with her while she is outside in charge of making sure she does this.
She was resting for much of the afternoon. The lights were off which was a refreshing change, nothing like florescent lighting shining down on you constantly. The head of the ICU likes the lights on as he thinks the it stimulates the patients so some nurses shut them off and he walks by and turns them on. It is actually a bit amusing. I was almost thinking about buying lamps but somehow don't think they would let those in.
Later on in the day we went to look at long term acute care facilities which is the next step in her recovery. I will post more on this later and go through the next steps. At this time the projection is for her to be at UNM in the ICU for about 1 to 1 1/2 weeks.
Cosima's surgery took about 2 hours. They just operated on her elbow but did not do the tracheotomy yet. This will be done on Friday as the surgeon wasn't available during her surgery to do it.
We have been told the surgery went well but don't have a ton of information yet as we haven't spoken directly to the hand surgeon. They did a split-thickness skin graft which contains the epidermis with only a portion of the dermis. They didn't have to take a portion of her muscle which is a better outcome. We won't know until Monday if it was successful and it has taken. The skin was taken from her upper thigh.
I have been told she will have to be sure to wear sunscreen diligently on her arm for the next year or so as it will be very sensitive to the sun. I am putting anyone with her while she is outside in charge of making sure she does this.
She was resting for much of the afternoon. The lights were off which was a refreshing change, nothing like florescent lighting shining down on you constantly. The head of the ICU likes the lights on as he thinks the it stimulates the patients so some nurses shut them off and he walks by and turns them on. It is actually a bit amusing. I was almost thinking about buying lamps but somehow don't think they would let those in.
Later on in the day we went to look at long term acute care facilities which is the next step in her recovery. I will post more on this later and go through the next steps. At this time the projection is for her to be at UNM in the ICU for about 1 to 1 1/2 weeks.
in surgery currently
Cosima was taken off to surgery about 10 today. I have now been told the surgery will be about 2 hours and another 1/2 hour if they do the tracheotomy. They would like to do the tracheotomy at the same time so she doesn't have to go back into the operating room again.
The tracheotomy is so they can take the breathing tube out of her mouth. If they leave it in too long it can cause scarring and damage the vocal cords. This will mean Cosima can begin to talk with us when she is ready since she won't have the tube in her mouth. It will also make it easier for her to breath since the tube is shorter. Right now she still needs oxygen. When they take out the tube out of her neck the scarring should be minimal and it will heal quickly.
The doctors and nurses were quick to reassure us it is nothing like what is shown on tv and is a relatively quick procedure.
I will give another update after her surgery.
The tracheotomy is so they can take the breathing tube out of her mouth. If they leave it in too long it can cause scarring and damage the vocal cords. This will mean Cosima can begin to talk with us when she is ready since she won't have the tube in her mouth. It will also make it easier for her to breath since the tube is shorter. Right now she still needs oxygen. When they take out the tube out of her neck the scarring should be minimal and it will heal quickly.
The doctors and nurses were quick to reassure us it is nothing like what is shown on tv and is a relatively quick procedure.
I will give another update after her surgery.
surgery scheduled
It was a somewhat busy day - busier than we had anticipated. They reinserted an A line into her arm for the hospital staff to receive constant blood pressure readings as the other one failed yesterday evening.
She had several visitors today - Michael Silverdragon, Berta, and Angel (hope I am spelling the names correctly). They were able to spend a bit of time with her. Thelma's pastor from Jemez also came by as well but wasn't able to see her as the doctors were with her at that time.
Another piece of good news is that Thelma was able to get her hearing aids adjusted today though everything suddenly seemed a bit loud afterwards.
Cosima also got a bath (well as close as you can receive while in bed) and am sure that has got to feel better for her. Hey this is a big event while you are in ICU and it takes a bit of time. Hopefully anyone reading this won't have to have this done but if so be happy to know they kick everyone out of the room. All the things you take for granted on a daily basis - will be sure to really enjoy my shower tomorrow morning.
Surgery is scheduled for tomorrow - though I don't have an exact time. This surgery is to repair the wound on her elbow. They will take some skin and muscle from her back area to repair the elbow. The surgeon is very positive about the operation and it is a critical piece to her healing. The estimated time for the surgery is 7 hours. It will take about 5 days to know if the skin graft has been successful or if it is rejected.
I read her some of the journal entries, emails, and comments and she seemed very appreciative of all the thoughts. We have several more to read to her as well when she is ready.
Zach, her younger son, arrives tomorrow evening and am sure it will be very good for Cosima to see him. Have a safe flight!
She had several visitors today - Michael Silverdragon, Berta, and Angel (hope I am spelling the names correctly). They were able to spend a bit of time with her. Thelma's pastor from Jemez also came by as well but wasn't able to see her as the doctors were with her at that time.
Another piece of good news is that Thelma was able to get her hearing aids adjusted today though everything suddenly seemed a bit loud afterwards.
Cosima also got a bath (well as close as you can receive while in bed) and am sure that has got to feel better for her. Hey this is a big event while you are in ICU and it takes a bit of time. Hopefully anyone reading this won't have to have this done but if so be happy to know they kick everyone out of the room. All the things you take for granted on a daily basis - will be sure to really enjoy my shower tomorrow morning.
Surgery is scheduled for tomorrow - though I don't have an exact time. This surgery is to repair the wound on her elbow. They will take some skin and muscle from her back area to repair the elbow. The surgeon is very positive about the operation and it is a critical piece to her healing. The estimated time for the surgery is 7 hours. It will take about 5 days to know if the skin graft has been successful or if it is rejected.
I read her some of the journal entries, emails, and comments and she seemed very appreciative of all the thoughts. We have several more to read to her as well when she is ready.
Zach, her younger son, arrives tomorrow evening and am sure it will be very good for Cosima to see him. Have a safe flight!
a good evening
Last evening Cosima had a good night. She was still responsive during the evening visiting hours and was able to nod when I asked her questions. This means she is able to let us know more how she is doing which is good.
I asked her about receiving some visitors today who wanted to stop by and she let me know she wanted them to come. I think this is a very good sign as she is making decisions on what she wants and it will give her a bit of control back. It has to be very difficult for her to be laying here unable to move and not in control of much so making some decisions I believe is good for her.
I also asked about reading her the journal entries, emails, and comments and she wanted to hear those as well so keep them coming. I know the comment section is a bit difficult to figure out so feel free to email and I will read them to her.
My thoughts are that yesterday was a very good calm day and it looks so far today should be the same, especially as she doesn't have to have much done other than replacing her blood pressure line (an A line) in her wrist. She also wants me to touch her forehead and this seems to be reassuring for her right now.
Right now she is listening to her Tibetan music and seems relaxed.
I asked her about receiving some visitors today who wanted to stop by and she let me know she wanted them to come. I think this is a very good sign as she is making decisions on what she wants and it will give her a bit of control back. It has to be very difficult for her to be laying here unable to move and not in control of much so making some decisions I believe is good for her.
I also asked about reading her the journal entries, emails, and comments and she wanted to hear those as well so keep them coming. I know the comment section is a bit difficult to figure out so feel free to email and I will read them to her.
My thoughts are that yesterday was a very good calm day and it looks so far today should be the same, especially as she doesn't have to have much done other than replacing her blood pressure line (an A line) in her wrist. She also wants me to touch her forehead and this seems to be reassuring for her right now.
Right now she is listening to her Tibetan music and seems relaxed.
progress on track
The doctors and nurses feel Cosima's progress is on track in relationship to her injuries. We would all like it to much quicker of course but good to hear she on track so far.
They took out the central line yesterday but have reinserted one back in her chest again today. This is so she can continue to receive fluids and pain medication and the lines in her arms can't quite handle all that she needs to receive at this point.
She also has a blood pressure line in her wrist now so they can continually monitor her blood pressure. Her bruised lung is affecting her breathing a bit and is part of the reason she is still on the ventilator. Most of the day she has been pretty sedated so her blood pressure and pulse have been good.
It has been a calm day even with all the activity of line changes, dressing changes, and xrays. The wound on her right arm where the wound vac is has been healing well. Cosima has nodded in response to some of our questions and has said nodded yes when asked if she was comfortable.
They took out the central line yesterday but have reinserted one back in her chest again today. This is so she can continue to receive fluids and pain medication and the lines in her arms can't quite handle all that she needs to receive at this point.
She also has a blood pressure line in her wrist now so they can continually monitor her blood pressure. Her bruised lung is affecting her breathing a bit and is part of the reason she is still on the ventilator. Most of the day she has been pretty sedated so her blood pressure and pulse have been good.
It has been a calm day even with all the activity of line changes, dressing changes, and xrays. The wound on her right arm where the wound vac is has been healing well. Cosima has nodded in response to some of our questions and has said nodded yes when asked if she was comfortable.
Monday morning
Cosima is sedated this morning. Early this morning they tried to remove her ventilator but after about 20 minutes they had to intubate her again. She wasn't able to breathe without the ventilator without difficulty. They will evaluate again tomorrow to see where she is at.
She was a bit anxious last evening as she is becoming more aware but this morning they have her on some different pain medications and she is resting comfortably since she is sedated.
All the emails are appreciated and we enjoy hearing from everyone who is thinking of her.
She was a bit anxious last evening as she is becoming more aware but this morning they have her on some different pain medications and she is resting comfortably since she is sedated.
All the emails are appreciated and we enjoy hearing from everyone who is thinking of her.
good friends
This afternoon Cosima's friend Gracia (who was riding with her during the accident) and her mom stopped by for a visit. It was a very welcome visit as Gracia is obviously very close to her. With Gracia's presence and some additional pain medication and a sedative it made a big difference to Cosima and brought a sense of calm that had not been felt for most of the day up until that point.
Cosima is very lucky to have such good friends who are so thoughtful and share her beliefs. Thanks Gracia as your visit helped both Sam and I as well.
If anyone else visits please be sure to sign the journal we got for Cosima. We want to read her the entries when she is awake and then it will also be something for her to have when she leaves the hospital.
Cosima is very lucky to have such good friends who are so thoughtful and share her beliefs. Thanks Gracia as your visit helped both Sam and I as well.
If anyone else visits please be sure to sign the journal we got for Cosima. We want to read her the entries when she is awake and then it will also be something for her to have when she leaves the hospital.
starting to move around a bit now
As of right now Cosima is still on the ventilator. They are still working on getting her pain medication at the right dose but still keep her awake. She is now getting oral medication in addition to her IV drip which lasts longer and can be more effective for pain.
Lots of arm movement now and she seems to be more awake. Her wounds continue to heal and her forehead lacerations are almost completely healed.
I am at the hospital now with Sam and will be here for a few days until Zach comes. She seems to be aware when you speak with her and does nod and blink her eyes.
Lots of arm movement now and she seems to be more awake. Her wounds continue to heal and her forehead lacerations are almost completely healed.
I am at the hospital now with Sam and will be here for a few days until Zach comes. She seems to be aware when you speak with her and does nod and blink her eyes.
comments welcome
At the bottom of each post is a comments option. If you have anything you would like to share or say to Cosima please add a comment. We will read these comments to her.
still on the ventilator
Quick update on the ventilator. Oxygen helps the healing process and they don't want her to be short on oxygen at all during this time so she is still on the ventilator at least for today. With her ribs being broken it isn't surprising that she is still on the ventilator.
This morning they did a breath test and it needs to measure at least 25 on her inhale for the ventilator to be removed. Her breaths measured 10-15 so she is on the ventilator at least through today. They will do the breath test again tomorrow.
This morning they did a breath test and it needs to measure at least 25 on her inhale for the ventilator to be removed. Her breaths measured 10-15 so she is on the ventilator at least through today. They will do the breath test again tomorrow.
Saturday morning update
Cosima is still on the ventilator right now as she is not fully breathing on her own. They are working on decreasing her dependence and trying to remove it soon. When the pain medication starts to wear off she is definitely more alert.
She had a pretty good sized cut on her forehead and Sam said the nurses pointed out how quickly it has healed and that it is a very good sign. They said she would be healing just as rapidly internally as well.
For those interested I wanted to give more information on what a wound vac is. VAC stands for Vacuum Assisted Closure and is a device is used to facilitate wound healing by converting an open wound to a closed wound. It consists of an evacuation tube embedded in a polyurethane foam dressing. After the foam dressing is placed in the wound bed and sealed by an occlusive dressing, the tube is attached to a vacuum unit. The device removes fluid from the wound. This procedure reduces bacteria in the wound, draws out stagnant toxins and stimulates new blood flow, decreasing the wound healing time dramatically.
This is what was placed on the open wound of her arm and it has been shown to greatly increase healing time and decrease the possibility of infection. The dressings need to be changed much less frequently as well with the wound vac. Medical technology is amazing.
She had a pretty good sized cut on her forehead and Sam said the nurses pointed out how quickly it has healed and that it is a very good sign. They said she would be healing just as rapidly internally as well.
For those interested I wanted to give more information on what a wound vac is. VAC stands for Vacuum Assisted Closure and is a device is used to facilitate wound healing by converting an open wound to a closed wound. It consists of an evacuation tube embedded in a polyurethane foam dressing. After the foam dressing is placed in the wound bed and sealed by an occlusive dressing, the tube is attached to a vacuum unit. The device removes fluid from the wound. This procedure reduces bacteria in the wound, draws out stagnant toxins and stimulates new blood flow, decreasing the wound healing time dramatically.
This is what was placed on the open wound of her arm and it has been shown to greatly increase healing time and decrease the possibility of infection. The dressings need to be changed much less frequently as well with the wound vac. Medical technology is amazing.
Thanks!
This will have to serve as a thank you card to all the hospital staff until I can sit down and send out proper written ones (sorry to my mom - I really haven't forgotten all the manners you taught me, but for right now I will use netiquette instead of proper notes). The nurses have been very caring and supportive. Our special thanks go out to Amelia the nurse on the night shift. She has been very supportive and so attentive to Cosima. Connie was the first person Sam spoke to when we found out the news and walked him through what was going on with such patience and caring.
All the day shift nurses are wonderful. Haley (hopefully I have spelled her name correctly) was the nurse there at admitting time and has taken excellent care of Cosima. Her bedside manner is terrific and has given Sam and Thelma a ton of support and reassurance. Lauren was also there at admitting and has been taking of her today - thanks for all she has done. Amanda is another day nurse who has been a very calming presence. Judy was the nurse on Weds and Thursday (I think as the days are starting to run together) and took great care of her.
The doctors have all taken the time to explain things to Sam and Thelma. I can only imagine trying to explain medical terminology and all the details when so much needed to be gone through to someone with very little medical knowledge. I try to look some of it up on google (what did we ever do without the internet?!?) and then run it by my mom for verification (she is a nurse as well) after getting it from Sam so hopefully we are somewhat accurate in relating it all back.
All of these caring people have made such a difference and we are thankful they chose the medical profession.
Thanks again for helping make such a hard time that much easier for the family.
Washington Mutual Benevolent Fund
Several people have asked about a benevolent fund that they could donate to in order to help provide for Cosima during her recovery time. I have set one up at Washington Mutual (I am confident about their ability to survive as our personal accounts are there) since they have locations in New Mexico and in Houston.
The account name is Kayla Schober FBO Cosima Pat Leedom. Account number is 9400436568. Donations can be made at any Washington Mutual Branch. The account is listed under their Benevolent Funds. If you have any questions or difficulties please contact me at kaylaschober@gmail.com.
There is also a credit union account being set up as well in Jemez but I don't have information on that yet. Once I have the information I will post the information on that account as well.
The account name is Kayla Schober FBO Cosima Pat Leedom. Account number is 9400436568. Donations can be made at any Washington Mutual Branch. The account is listed under their Benevolent Funds. If you have any questions or difficulties please contact me at kaylaschober@gmail.com.
There is also a credit union account being set up as well in Jemez but I don't have information on that yet. Once I have the information I will post the information on that account as well.
making progress
Cosima is now sitting up this morning - well the bed is sitting up for her but it is progres - which we are very happy about. She is still on the ventilator right now. She is responding by nodding her head to questions though once she gets a dose of pain medication she is pretty out of it.
There are a few additional injuries to add to the list that the orthopedic doctor told Sam yesterday:
Left Leg torn MCL which is one of four ligaments that are critical to the stability of the knee joint. This may need a repair at a later time.
Broken Left Sacrum which is a triangular bone at the base of the spine. The sacrum is the part of the backbone that connects to the pelvis. No operation is needed for this.
Broken left Pubis - won't require surgery either
Broken Right thumb
They are also planning on putting a wound vac on her right elbow. This is to help speed the recovery and keep it from getting infection as there is no skin to close things up. The specialist is looking to see if a skin graft is a possibility.
Cosima is not as awake today since she is on more pain medication. This is one of those times that having a low tolerance to pain medication is probably a very good thing as she gets a dose and pretty much goes back to sleep.
There are a few additional injuries to add to the list that the orthopedic doctor told Sam yesterday:
Left Leg torn MCL which is one of four ligaments that are critical to the stability of the knee joint. This may need a repair at a later time.
Broken Left Sacrum which is a triangular bone at the base of the spine. The sacrum is the part of the backbone that connects to the pelvis. No operation is needed for this.
Broken left Pubis - won't require surgery either
Broken Right thumb
They are also planning on putting a wound vac on her right elbow. This is to help speed the recovery and keep it from getting infection as there is no skin to close things up. The specialist is looking to see if a skin graft is a possibility.
Cosima is not as awake today since she is on more pain medication. This is one of those times that having a low tolerance to pain medication is probably a very good thing as she gets a dose and pretty much goes back to sleep.
a bit more responsive
Later on Thursday afternoon Cosima started to become a bit more responsive. She started to move a bit and turn her head like she was uncomfortable. When asked if she was in pain she indicated she was and was given a bit more pain medication which had an immediate affect. These seem like good signs as she is starting to interact with people.
On another note Thelma (grandma) is doing well. Sam says he can't move 10 feet with her without her chatting with someone and making a new friend. At JB's where they have gone for dinner a few times she knows the server and they already seem like regulars.
On another note Thelma (grandma) is doing well. Sam says he can't move 10 feet with her without her chatting with someone and making a new friend. At JB's where they have gone for dinner a few times she knows the server and they already seem like regulars.
quick Thursday update
Just got an update from Sam and Cosima is starting to show signs of responding. She is actively blinking in response to questions. In order for the feeding tube and oxygen to be removed she will need to become more responsive but this is a step in the right direction.
This sign of progress is making us all feel better about the direction things are heading today.
This sign of progress is making us all feel better about the direction things are heading today.
Thursday morning update
Not much to report this morning. Cosima has still not responded and this is a bit concerning though it could still be the drugs wearing off. She has eye movement but no responsiveness. She is being given minimal pain medication to help increase her responsiveness.
Earlier she had some breathing problems but this was most likely due to a fluid build up and she is breathing fine now.
She had a CT scan and the preliminary results look good, more information should be available later.
The number of friends calling to ask about her has been amazing. The hospital is getting so many calls they have asked if we can help cut down on the number they have been getting. Instead if you could please call Sam Kanner (her oldest son) directly at 206-650-4357 he can give you an update. Some of the time he won't be able to answer as he may be speaking with hospital staff but he will get back to you. I will try and update this blog each time I receive new information as well to help keep everyone in the loop.
Any information you would like posted on the site please email me at kaylaschober@gmail.com.
Thanks again for all the thoughts and prayers for Cosima the support has been incredible.
Earlier she had some breathing problems but this was most likely due to a fluid build up and she is breathing fine now.
She had a CT scan and the preliminary results look good, more information should be available later.
The number of friends calling to ask about her has been amazing. The hospital is getting so many calls they have asked if we can help cut down on the number they have been getting. Instead if you could please call Sam Kanner (her oldest son) directly at 206-650-4357 he can give you an update. Some of the time he won't be able to answer as he may be speaking with hospital staff but he will get back to you. I will try and update this blog each time I receive new information as well to help keep everyone in the loop.
Any information you would like posted on the site please email me at kaylaschober@gmail.com.
Thanks again for all the thoughts and prayers for Cosima the support has been incredible.
Wednesday's surgery was successful
Cosima had another surgery today and the doctor said it was successful, even more so than they had initially hoped which was great news. The surgery was to place pins and screws in her right arm. During the surgery they realized her tricep was not fully torn away - it is about 50% which is much better than was originally thought. Because the tricep wound is open and there isn't enough skin to close it they will have to do skin grafts before the tricep can be repaired.
Today they also reduced her pain medication so they could check her neurological status but so far she is not responding. This could be due to several factors and they are a little concerned but not too worried yet. She could still be working off the drugs from the surgery at this point.
Today they also reduced her pain medication so they could check her neurological status but so far she is not responding. This could be due to several factors and they are a little concerned but not too worried yet. She could still be working off the drugs from the surgery at this point.
Background on Cosima's accident
I wanted to start this blog to update Cosima's friends and family on her recovery. We have many people interested in her condition and this seemed to be an easy way to send updates on her condition. We will post information as we receive it. Since we don't have any medical background we will try and give the information we receive from the doctors and nurses as well as our personal observations. Information may change or we may be inaccurate at times so please bear with us as we try and keep it all straight. Currently my husband Sam and Cosima's mom Thelma are with her at the hospital during visiting hours.
On Saturday September 13th Cosima was hit by a car while riding her bicycle with a group of 20 other riders. She was airlifted by helicopter to the University of New Mexico Hospital in Albuquerque where she remains in intensive care.
Her list of injuries include:
compound fractures to both of her lower legs
broken femur
broken right arm in 2 places - compound fractures
torn tricep
broken scapula
broken pelvis
broken ribs
broken hip
2 small bones in her neck though we have been told these are minor injuries
bruised lung
road rash over her body
Currently Cosima is on a ventilator and has a central line. The doctors have told Sam her biggest risk right now is for infection. She had surgery on Sunday to put pins and screws in her legs and the surgery was successful.
She was conscious when she arrived at the hospital which was a good sign. Currently she is heavily sedated and remains unconscious due to high doses of pain medication.
On Saturday September 13th Cosima was hit by a car while riding her bicycle with a group of 20 other riders. She was airlifted by helicopter to the University of New Mexico Hospital in Albuquerque where she remains in intensive care.
Her list of injuries include:
compound fractures to both of her lower legs
broken femur
broken right arm in 2 places - compound fractures
torn tricep
broken scapula
broken pelvis
broken ribs
broken hip
2 small bones in her neck though we have been told these are minor injuries
bruised lung
road rash over her body
Currently Cosima is on a ventilator and has a central line. The doctors have told Sam her biggest risk right now is for infection. She had surgery on Sunday to put pins and screws in her legs and the surgery was successful.
She was conscious when she arrived at the hospital which was a good sign. Currently she is heavily sedated and remains unconscious due to high doses of pain medication.
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