Purple Heart Ceremony and Surgery

It’s official; Josh is a Purple Heart recipient. Tuesday around 5:45 pm, The Commandant of the USMC, Gen. Conway presented Josh with the award. The Commandant was genuine and amicable. But things were not so cheery on Wednesday.

Josh had surgery on Wednesday. It was not a complete success. The surgeons removed the feeding tube from Josh’s stomach, but they were unable to take out the IVC filter. My mom said that the filter attached itself to the wall and there could be risk if they tried to remove it. Post surgery, Josh was sent back to Richmond via ambulance.

Josh's Surgery Postponed

Josh was transferred to Bethesda today. Josh did not have surgery today as expected. His surgery to remove the IVC filter and feeding tube has been rescheduled for Wednesday. Josh is in Bethesda until Thursday. But he is still expecting to receive his purple heart tomorrow.

Weekend Update

Josh is doing ok. He is having intestinal issues and really bad sweats. The doctors are investigating. The surgeons are planning on performing surgery to remove the IVC filter and feeding tube from Josh on Monday. In order for him to have surgery, the doctors plan on moving him to Bethesda until Wednesday.

While Josh is in Bethesda, the orthopedic doctor will assess Josh’s left hand. He will also see neurology. Finally, Josh is “planning” on receiving his purple heart. This is the second time that we have “planned” to receive it, but we are confident that it will take place this time. Today, Josh was presented with a Macbook from the VFW! I know he is ecstatic about that.

Thanksgiving

Hope everyone had a wonderful Thanksgiving. Our Thanksgiving was certainly different, but not bad. The cousins from Georgia and Alabama came up to see us. Josh was able to get in a wheelchair and enjoy a nice meal provided by Wal-Mart that was prepared by the Blue Star Mothers at the Fisher House.

Thanksgiving gave Josh a break from his Physical Therapy which is going well. Josh has experienced muscle atrophy in his legs and his arms. If you know Josh, then you know he likes to work out. Due to his hard work in therapy, his right arm is gaining a lot of muscle and he is frequently looking at his muscles in the mirror (some things never change). His left hand still has the external pins in it. The orthopedic surgeon expects to take the pins out sometime in January. The doctor said that if he didn’t have any cervical spine damage, then his left arm would be fully functional; however the cervical spine damage may affect the functionality in his hand. We are not sure at this point.

We do know that his abdominal muscles are improving. The therapists are impressed with the progress that he has made. Let us pray for continual improvement.

Josh's Clothes

Everyone, thank you for your compassion and generosity. Based on the responses given, we have certainly met our need for Josh's clothes. This will help tremendously.

Josh Has a Wii!!

Contrary to prior information, Josh did not receive his purple heart today. The general that was suppose to give it to him, flew to Florida. There is no re-schedule date at this time.

I went to Richmond to be with Josh as he was suppose to receive his purple heart. So, I was able to spend some time with Josh today and his burning pains in his legs have subsided. The doctor and Justin (a friend of ours) both affirmed that this is normal and that it will be more tolerable in the future. He is also experiencing muscle spasms in his legs. This is because he is now starting to come out of spinal shock.

This was my first experience watching Josh receive therapy. The doctors first stretched out his arms and fingers. Next, another team of doctors worked with Josh to get his body to sit straight up and balance itself. I talked with Josh and he said that getting his neck brace off and being able to sit up straight are the next milestones. He is expected to have his neck brace removed in six weeks. The goal of all therapy is to regain as much functionality as possible

Even with the lack of functionality, he is enjoying the functionality that he does have. Josh wants give a shout out to Chi Zeta and friends who chipped in to buy him a Nintendo Wii, especially Quasi, Iceberg, and Justin who brought him the Wii. One of the practical ways that we can help Josh now is that he needs some clothes. He only has one pair of sweatpants and a t-shirt that my mom has to wash frequently. Because he is still an active duty marine, he needs clothes that identify him as a marine. It would be best to buy him sweatpants and t-shirts because they are easier to change in and out of. If you want to and can give Josh pants or t-shirts please e-mail me at Jakehiman@yahoo.com. We need a few pair of each but please e-mail me if you are going to give Josh clothes, because I don't want anyone to waste money or time on something that we don't need.

Update on Josh

Last night was an incredibly difficult night for Josh. He is experiencing burning pain in his legs. The doctor said that it something that does happen. They are giving him medication to treat his pain so that he can rest and feels good enough for physical therapy.

Earlier in the week Josh appeared to be doing much better. I made sure to let him that so many are thinking about him (with Veteran's Day being on Wednesday). I will be visiting Josh on Sunday and will have more information then.

Josh Passed the Swallow Test

Good news! Josh passed the swallow test today. The doctors are now deciding what he can eat. Josh is frequently dehydrated, so passing swallow test will alleviate that problem. Josh has also been talking about eating McDonalds ever since he was in Afghanistan. We are not sure when he will be able to eat McDonalds, but the time is certainly approaching.

There are a lot of positive things seen throughout the week, but there a couple issues that we can be praying about for Josh. They are his low blood pressure and trouble sleeping at night. The low blood pressure is a recent development.

Many new events have transpired this week. Josh had his first week of therapy. Josh took his first shower since May. He put on clothes for the first time. I even saw a picture of him playing Nintendo Wii in his bed (talk about living the dream). We hope that passing the swallow test is the first of many milestones on his road to recovery.

Update on Joshua

Today, my family met with a team of doctors in Richmond. They setup a rough rehabilitation plan. He will undergo occupational, recreational, and speech therapy. Josh needs to recieve speech therapy to pass the swallow test. They also plan on educating Josh on his injury and administer psychological treatment. He is expected to remain in Richmond for 16 weeks. One the bright side, Josh has been able to go outside in a wheelchair and enjoy fresh air.

Josh is Moving to Richmond Monday

Josh is scheduled to go to Richmond, Va on Monday, October the 26th. The hospital in Richmond specializes in spinal chord injuries. The doctors in Bethesda, Md and Richmond, Va have communicated via teleconferences.

The doctors have also explained to my parents that Joshua's spinal chord injury is incomplete. This means, there are nerves in his body that are sending signals to his brain. Pat said "His nerves need to wake up". Beginning Monday, the level of physcial therapy increases in Richmond.

Also on Monday, Josh has another swallow test. Trust me, Josh really wants to pass this one, it is difficult for him not to eat or drink anything. It is still difficult for him to have visitors. I am sorry for those that want to visit him at this time but it is overwhelming for him at this point. People are in and out of his room every 10 minutes. He has rejected alot of people's request to see him. It will be a long recovery process and he will want to see people in the future.

Quick Update

Josh failed the swallow test yesterday for the third time (this test determines whether he can eat or drink anything). He went into the operation room today to place the feeding tube back in him. The surgery went fine.

Pat communicated to me that his voice and cough are weaker compared to previous days. The Respirator Doctor is assessing the situation.

Josh will be moving to Richmond sometime this week. Richmond has a rehabilitation center. I am not sure on what facility.

Weekend Update

The orthopedic doctor performed surgery on Josh's wrist on Friday. This is the second surgery on Josh's wrist. He spent the night in the PACU (Post anesthesia care unit).

Yesterday, Josh was moved back to the surgical ward. He had a slight fever yesterday that was treated by Tylenol and ice packs. The doctors also took cultures to see if there was any infection from the wrist surgery. The medical staff took x-rays of Josh's chest (I believe it was to check and see the Thoracic spine).

Today, Josh's breathing is strengthening. He is performing breathing "exercises" hourly. His pain level has decreased from previous days.

He has been back and forth on accepting visitors. It is hard for him due to his state of vunerability and difficulty for him to have conversations.

Josh is Moving from the ICU

The doctors have decided that Josh is well enough to be moved from the ICU. They are moving Josh to a room on the 5th floor. Josh has not passed the swallow test for the second time. His lunks are still junky but he is breathing better.

The Latest on Joshua

The doctors have removed the tubes from his mouth. He is breathing on his own. However, he is having a hard time clearing his lungs and it is difficult for him to cough. He is able to talk now.

Josh’s blood pressure is fluctuating. His blood loss situation is getting better. He has some anxiety right now. The doctors are giving him medication to treat the symptoms. He is starting to sleep more. I am not sure whether it is the lack of sleep, medication, or Afghanistan that is causing the anxiety, but it could be a combination of all three. From what I understand, this is normal for someone in his condition. Overall, things do seem like they are improving.

Update on Joshua

The doctors have started weaning Josh off pain medication. They have discontinued giving Josh sedation medication. The doctors plan on taking him off the ventilator tomorrow. His fever is back to normal. The doctors have given him additional blood due to blood loss. The reason for the blood loss is still unknown at this time.

Josh

One of the major concerns at the moment is that Josh is losing blood, and the doctors are unsure what is causing the blood loss. Joshua's blood pressure is artificially high, they are now weening him off of the increased blood pressure medications.

I talked to one Josh's nurses yesterday and he said that he is waiting for some of the swelling to go down in his body before removing the ventilator tubes in his mouth. As far as the Post Traumatic Stress Disorder, the doctors are actually inducing it by giving him certain medications to increase the blood pressure. So, Josh may not have PTSD permanently.

The Latest on Joshua

Josh is still on the ventilator and it looks like it may be a while because his lungs are unable to breathe on their own. The doctors have increased his sedation. His fever is under control, the results of the cultures have not come back. It can take up to five days before the results are in. They have begun giving him antibiotics.

Josh now has a specialized air bed. This should help pressure points. He is experiencing post traumatic stress disorder. He is having bad dreams, the doctors are planning to give him counseling. The trauma doctors communicated that Josh is in stable condition.

Update on Joshua

Joshua had a temperature of 104 degrees last night. The good news is, the fever is starting to go down. He is also complaining about pain in his neck. We are not sure what the cause of the pain is but the doctors are investigating. Right now is not a good time for visitors for many reasons. I will inform you when the time comes, hopefully the time is soon.

Visitors and Phone Calls

Please do not call the ICU. The phone calls are becoming disruptive. As far as visiting Joshua, now is not a good time for visitors. I will let you know when he is available for visitors. Thank you for understanding of the situation.

Update on Josh

Please pray for Josh! He is having issues breathing on his own. They removed the tubes from his mouth. His lungs are not in great in condition. He needs to cough but he is having neck pains and that is affecting his ability to cough. The doctors are going to put the breathing tubes back in his mouth for another day.

Today's Surgeries

Good news! Both the anterior and posterior surgeries on his spine are now complete. The halo has been removed. He now has metal screws and rods from C5 to T7 in the spine. The surgies were succesful.

Update on Joshua

The doctors placed an external fixture on his wrist. They were unable to put the plates in his arm due to the risk of infection. He will have to have another surgery in a week to 10 days to take care of the fractures. The injury was a lot more severe than expected.

Tommorow, Josh will have surgery on his cervical spine. He is first on the schedule for the morning. The doctors will be performing anterior and posterior surgeries. He will also be having an IVC filter put in his to prevent blood clots from traveling into his lungs. Please Pray for succesful surgeries.

Correction on the previous blog: I said cervical "nerve" instead of spine. It should have been spine.

Orthapedic Surgery

Josh is currently undergoing orthatpedic surgery right now. The doctors are cleaning and removing bad tissue in his knee, and forearm. They are either going to try to put external stabilizers on his wrist or internal screws in his wrist, he has a several traumatic fractures in his wrist. No update on the cervatic nerve. The cervatic nerve is the biggest issue concerning Josh's health.

Please also pray for government that it would have wisdom in regards to the War. Our hearts go out to the other troops that are in Afghanistan.

Update on Josh

Josh has arrived in Bethesda, Md. The orthopedic doctor is going to perform surgery on his forearm later today. The neurosurgeon is going to assess his cervical spine damage. His surgery on his cervical spine is TBD. It could be as early as later today.

Joshua is in intestive care, but Do Not call the hospital. Check the blog for the latest updates. This is the prefered method of communication.

Update on Josh

I talked to my mom earlier this morning. My parents are going to come back this Sunday afternoon (most likely on the same flight as Josh). Josh is not going to have any more surgeries until he arrives in Bethesda, Md. His strength is starting to come back! Thank you for your continued support.