Friday Noon, December 31st,2010

Hello to All,

Josh has been breathing off the ventilator for over 52 solid hours now! Though still receiving a boost of oxygen from a vapor collar, the oxygen level is now much reduced and he is doing great with mainly the air from the hospital room drawn in through a humidifier. This is one of the positive shifts that have made him ready for rehab consideration. His pneumonia is well under control and his white blood count has returned to a low level.

Josh's sedation continues to be reduced but his storming intervals are still calling for medication to calm his heart rate and respiration. One of his doctors described it as a push-pull between weaning him off the narcotics and sedating him slightly more at certain times to help him through.

A tumultuous night has turned into a sleepy afternoon and though Josh needs the rest the PT ladies will be here later to wake him up and get him working.

Mike is feeling better. Rose and Darling are starting the slow process of moving out of the hotel and home once again, which will be a welcome return to normalcy.

We are looking forward to the new environment of Bryn Mawr Rehab, where routines and schedules will help us all shape our days. But the hardest work will continue to be up to Josh. Please keep sending him the love and hope that will keep him strong for his long course of recovery.

Thank you for the continued flow of prayers and light energy.
We are ever thankful for all the love and support.

The Bonjos

Thursday December 30th

Josh is still moving
between storming and
calm periods. The doctors
have figured out what meds
settle him and have made
changes.












Josh got the stitches taken out of his head today.
Josh stuck out his tongue on command for the
PT doctor this AM. He is still in there fighting.
The doctors said he can be moved to rehab as soon
as the storming passes, hopefully next week.

Meanwhile, Mike got sick and Darling moved to
the night watch. Don't get alarmed if we don't
post for a whole day as things are hectic and
time has little meaning.

Thanks again for all the meals
and for taking care of our home. Thanks to
Gretchen and Taggart, Dylan and Sam for their continuous
support and to Brad and Keith for taking
care of the difficult details, so we don't
have to. Thanks to Tom and Julie for checking in on us.
Thanks for the cards and letters.

The Bonjos

Wednesday, December 29th

Sorry for the late post.

Everything is fine. We
just needed some rest.

Josh continues to shift between
total peacefulness and storming.

He is fighting for himself now.

Get some rest as we will and
pray for Josh to have the storms be productive
and then pass. His brain is trying to
reboot.

Love,

The Bonjos

Tuesday December 28th

Josh had a quiet night and a
busy morning. He is resting
now after another sympathetic
storm about 5 AM after his
morning care. He did recover
from this one with a minor
amount of medication.







His bed is in chair position right now and he
looks very comfortable.

Now he just finished PT a few minutes ago
and managed a small wiggle of his thumb
after sitting, supported on the edge of the bed.

More later.

The Bonjos

Monday December 27th

Josh had a very peaceful night
during the snow storm. From his
warm quiet room, we could see the
snow swirling under the street
lights.

Josh is resting this morning after
a few stormy episodes. He is opening
his eyes wide in response to voices and
noises in his room, then blinking and
closing them. A little too much stimulation
sends his heart rate and respiration up a
bit high, but he recovers in a few minutes.
Maybe he will be allowed a few visitors by
next weekend.



The next goal is to wean Josh completely off
of the breathing assistance and move him to
a rehab center specializing in brain injury.
This could take several weeks.

Our gratitude for your continued prayers, support and
generosity can not be thoroughly expressed.

Love, The Bonjos

Sunday Morning December 26th

Josh had a rough Christmas.
He is resting very comfortably
now.
After the doctors reduced his
sedation over several days with
only positive results, he was in
distress for a good part of the
day yesterday. He had a very
high heart and breathing rate,
sweating, fever, and
surprisingly, an increased
white cell count after it had
dropped significantly
the day before.

This prompted a midnight CT scan that
showed very little.

The doctors increased Josh's sedative again
and he is now resting peacefully. His white
cell counted and fever dropped dramatically over night, leaving
everyone scratching their head. Was it the reduction
of his sedation, a phenomenon called a sympathetic
storm, a fever or a combination of things?

For now, we will be content with another quiet
day while we watch the snow move in.

Thanks again to everyone who is on the Trott's
cooking schedule and to all of you who set up
this blog or are just following along. Thanks to
our friends, neighbors and relatives who are praying
for Josh and supporting us in so many ways. We are
eternally grateful.

Love,
The Bonjos

Merry Christmas Everyone!

Friday December 24th Christmas Eve

Josh had a quiet night. After
reducing his sedatives yesterday,
he is much more reactive to
stimulus. He opens his eyes a bit,
blinks, and flexes with his
arms and legs in response to what
he feels.





We gave Josh a shave and haircut last night. Both were
overdue. He looks like a different guy.

Josh will do some more PT today with the therapists. They
also have given us instructions to involve the family in
routine physical therapy throughout the day. What a great idea!

We would like to continue to thank all the amazing nurses who are
caring for Josh: Terry, Amy, Kerry, Mike, Skate, Jon, Nancy, Karen
Patty, Chris, and also all the doctors. Thanks also to everyone
at Columbia Boiler for their understanding, kindness and support
during this time.

Thank you all for your love and support. Say a prayer, hug your
kids and love ones and enjoy your family on Christmas Eve.

Love,
Mike, Darling and Rose

Thursday December 23rd

Josh had another good night after an eventful day.
The physical therapists had Josh sitting on the
edge of his bed (with their support). Twice
yesterday and once this morning, Josh opened
his eyes half way and blinked several times.




This is a small step on the long road, but a huge leap in terms of a daily gain.

Josh's temperature is down this morning, so he is fighting off the infection.

Josh's sedatives will be reduced again by 25% this morning.

There are some low level clouds tinted pink by the sunrise, floating slowly past Josh's window,and the just full moon is still shining. Hopefully a beautiful start to another good day for Josh.


The Bonjos

Wednesday, December 22nd 2:00 PM

Josh is having a pretty good day. He got his hair

"washed" this afternoon and he has been sitting

up in his bionic bed that can transform into a

chair. Yes Josh, Transformers Bed.

It was determined that Josh does have pneumonia and is on 2 strong antibiotics.

He is taking food through a feeding tube, to regain his strength. Josh was taken off the

respirator for 4 hours today. They will continue with 4 hours on and 2 off if all goes well.

The doctors did reduce his sedatives today. We will watch closely for any changes in his

response to our voices and to stimulation over the next few days.

Thank you to the kind friends who cleaned our home yesterday,

and to those who prepared our dinner and delivered it to our hotel.

We really don't know how we would be doing this without you all.

.

*************Just found out Josh is starting physical therapy today.

The Bonjos

Wednesday, December 22nd

Josh had a quiet night. The MRI cleared his neck

from injury, so they removed the immobilization

collar for the first time since he arrived. We were

able to clean up Josh's face and head, and he is

beginning to look like himself again.

The doctors plan to begin weening Josh off the respirator

going forward. They also plan to have him sit upright in

a special chair periodically.

Josh's MRI seemed to confirm the type of injuries that were suspected.

The doctors are slowly lightening his sedatives so they can evaluate

his true condition. The MRI and the initial "waking up" will be helpful, but they

are still just pieces of the puzzle that make up his long term prognosis.

For now, it is still wait, watch and pray.

The Bonjos

Tuesday, December 21st Solstice Afternoon

Another day of positive progress and we are ever hopeful. The milestone of the MRI was reached this afternoon, but even after the results are analyzed and discussed, it will not change anything in the current day to day care and support Josh is receiving. The information will just continue to enrich the picture we have of Josh's amazing brain and how well it is handling the healing process.

Right now Cindy, our sweet Respiratory Therapist is experimenting, exercising they call it, with Josh's ability to breathe on his own and it is going well with minor support from the ventilator. Later she will give him a rest and turn on the ventilator again. Nurse Mike did a great job helping Josh through a somewhat hectic day full of transitions. He also blushed a little when I told him he was the most famous male nurse in the blogosphere.

Please light a candle, say a prayer, or wish on a wintry star for Josh tonight.

Most importantly, enjoy your own family and let them know how much you love them.

A Happy Solstice to you all.

The Bonjos

Tuesday December 21st

Josh had his breathing and feeding arrangements

changed yesterday. He is much more comfortable

and looks more himself.

The doctors are trying to slowly reduce his sedation.
This will allow him to get closer to a state of

consciousness so they can better evaluate his

neurological condition.

Josh's pressures were stable overnight. If they stay down today,
they can get him into the MRI soon, clear his neck and spine as uninjured,
and get him out of the neck restraint he has had on from day one. It
will be another huge improvement in Josh's comfort and appearance.

At times, Josh is breathing faster than the ventilator, pushing the machine
up to his speed.

These are all beautiful, wonderful signs, but the road ahead is long and steep
with many unknowns. For now, we will take everything positive we can get.
As the doctors keep telling us, "Baby steps."

Thank you for helping Josh get to this point. Thank
you for your prayers and acts of kindness. Your support of our family
has given us the strength to be there for Josh during these past 10 days.

We would also like to begin to thank the Caln police and first responders who
arrived so quickly and got Josh on the way to Paoli in a matter of minutes.
Their speed and expertise may have made all the difference in Josh's recovery.

Please keep Josh in your thoughts and prayers today and we will update as we
are able. The prayer and meditation focus again today is for Josh's lungs to heal.

As today is the Winter Solstice, last night was the longest night of the year.

The days will now grow longer and the nights shorter. Let's hope that is a metaphor for

Josh's recovery. (Thanks Chris)

The Bonjos

Monday Morning December 20th

Josh had a pretty calm night. The doctors are still
working to keep his system in equilibrium on an
regular basis. He has a small issue with his lungs,
which they are treating effectively. If Josh is in
your thoughts today, please think about deep, full
refreshing breaths for him, and lots of smiling.


The doctors will be meeting today to plot a course for the week.
Josh will be having a procedure today that will make him more
comfortable and make breathing easier. We will keep you updated.

We wanted to thank you all for following Josh's progress. Special
thanks to Dr. Bob for adjusting us down at the hotel yesterday,
and to Keith for innumerable acts of kindness.

Nurse Amy hands off to John this morning after a vigilant night of care.
The nurses caring for Josh are amazing.

Thank you for your love and support.

The Bonjos

Sunday Morning December 19th

Josh was pretty stable all night. The doctors are still working
hard to keep his vital signs strong, while minimizing the pressure
in his head. They have many effective tools to accomplish this,
as the body and brain change in response to medication and stimuli
throughout the day and night.

Josh is resting comfortably this morning in a dimmly light room overlooking
the woods, while classical music plays quietly in the background. There are
some who will tell you that it helps to visualize a loved one while you are
praying for their health. So I hope this will help you to see where
Josh is, in your mind.

We want to again thank the Upattinas community, family and friends, and the
incredible staff at Paoli Hospital for your continued support. We could never
endure this experience without you all.

The Bonjos

Saturday Evening, December 18th

Good Evening to All,

I am writing while sitting in Josh's quiet hospital room in the Paoli ICU. Never thought a place of such sadness for so many families could feel as peaceful as it often does. The fantastic staff and the beautiful new facility certainly contribute to this. But deep healing is taking place all around us here and the prayers and hopes of loved ones swirl in every corner.

Many other families here have reached out to us because of Josh's young age in this ward.
Their compassion for us and their prayers for Josh in the midst of their own crisis has been indescribably moving.

I wanted to let everyone know that we are reading and re-reading all the comments within the blog. My family down south is watching and receiving great comfort from the web of support you have all created with your prayers, your comments, the great treats that have been dropped off, and most importantly, the hotel room that we would be scrambling without especially in this cold and sometimes snowy weather. It has all made us feel so loved and cared for. We can never express the gratitude we feel for all the wonderful people in our life.

Please know that even the simplest hope of wholeness or prayer for healing sent Josh's way is a meaningful act. We feel them streaming through us and into him from every direction. Keep them coming!

Monday will bring the big changes that were postponed on Friday and we feel confident he is ready and just waiting for these new challenges. Meanwhile, our beautiful Nurse Amy just put his furry boots on again and we all know how much he must be loving that!

May your night be Peace-filled too,

Darling

Saturday Morning December 18th

Josh had a good night last night under Nancy's care.
His IC pressure is down this morning, which is a good thing.
We hope for a calm, quiet and uneventful day. If we can
finish the weekend in this manner, Monday will bring
some important changes in Josh's care. Nurse SKate
will be caring for Josh on the day shift today.

Thank you again to everyone for everything you have
sent to the hospital and just for keeping up with Josh's progress.
As much as you may be motivated to visit Josh here,
please understand that the doctors are trying to keep
Josh and the other ICU patients calm, quiet and isolated from any
type of colds or viruses. Virtual visiting through this website
is requested. There will be plenty of time for your personal
support in the coming weeks.

Please continue to think about and pray for Josh today
and we will update as possible.

Mike, Darling and Rose

Friday Morning December 17th

Josh had a slightly rocky night. His cranial
pressure was trending up a bit. With some
adjustments to his medication and equipment
he is resting calmly today with good readings.

Based on last night, the doctors have decided
to hold off on some of the procedures
they had planned on today, which they are
just fine with. No need to rush the process.
Mike, one of our favorite nurses here, is in
charge of Josh's care for today.

Thank you to everyone who put us up
in the hotel in Malvern and stocked the fridge. It gives a
close and private place to retreat for short periods,
to shower and change clothes. Thanks to Keith,
Brad and Jim Taylor for your help and support. Thank
you to everyone who has sent prayers, cards and well wishes
to Josh for a complete recovery. Josh has everyone
from you, to Buddhist Monks to Carmelite nuns
praying for his recovery.

We are keeping the home fires burning Josh.
We love you dearly and miss you terribly.

Mike, Darling and Rose

Hello to all hopeful Friends,

Another quiet and stable night thanks to the wisdom and skill of our great Nurse Kerrie.

Josh is resting and maintaining good health. His stability and strength is prompting the doctors to start the next phase. After an early morning CAT scan tomorrow, he will have his breathing and feeding tubes switched around, a great step that will clear his mouth and face of all the equipment.

He will also have the pressure gauge in his head removed, which in itself is a very positive progression, meaning that all here think the worst of the pressure and swelling will be over by then. It's removal will also allow him to have a MRI which will provide valuable info for the doctors as well. It will not be definitive or move anyone towards the positive prognosis we are hoping to hear, but will give an idea of how his treatment should progress.

His will be a long healing process, we are reminded of that everyday, all day, by every doctor and nurse that consults with us. Any miracles that may occur will be slow to develop.
Though it feels like three weeks, it has only been five days, and we are looking at weeks or months of recovery.

With all the love, prayers, and support we are receiving, please keep in mind this drawn-out time frame for Josh's healing. Please keep those prayers and wishes headin his way.

His visitation is still limited to immediate family only. A time for visitors will come and then we look forward to the joy those visits will bring our boy.

First Update

Hello to all! Thanks to Anna Knapp and Keith Clinton for setting up this blog. We are posting updates for all concerned to follow Josh's progress and to give some space for hopes and prayers to be acknowledged.

Today is Wednesday, Dec. 13

Josh is resting peacefully in the Paoli Hospital ICU. Everyone in this new trauma center is a wonder and have made this impossible time manageable because of their obvious care, concern, empathy, and wisdom.

He is currently comatose, but is also heavily sedated to keep him still and his healing brain very quiet. He is getting help with breathing but is currently almost completely off of the extra oxygen. He has a slight infection in his lungs that is being treated.
He may have a fractured rib or two, but miraculously no other injuries beside a few stitches in the back of his head that we know of.

Of most concern is the trauma to his brain. He must have had a major blow to his skull during the accident. We have spent the last three days watching the pressure and swelling build around his brain as the doctors and especially the nurses work hard along with Josh to keep the pressure under control. We are in the downhill stretch with this part of his crisis and we are so hopeful that the peace he is currently experiencing is a boon to his deep level healing.

On the horizon are neurological tests, switches in his breathing apparatus, and an MRI, all which will provide clues to his future progress. But for now, we are happy he is resting, healing, knitting, and mending.

Please hope and pray along with us that Josh and his amazing brain will find the path through this deep period of hibernation and return to us well and whole when the healing is done.

Much love to all,

Mike, Darling, and Rose

Thank You

Thank you for all of your thoughts and prayers for Josh. As of this morning he is still stable.

We deeply appreciate your care and support.