{Karlton Bontrager}

Is it possible that we’ve been at this for over a week? The days all blur together, and we know that Karlton has made progress, but sometimes we forget just how and what steps were involved. The website preserves all of the information for us. It also reminds us of the miracles we’re seeing day after day.

Yesterday Choy and I spent a lot of time at the university, checking and responding to emails. When we got back, the physios (PTs) had Karlton sitting on the side of the bed, dangling his legs. He’d been up in a La-Z-Boy recliner before, but the chair had given him considerable support. This time he was sitting fully on his own. He sat there for about 5 mins., they said, and then he was ready to lie down again.

The exertions of sitting up–plus all the probing and stabbing that the hospital staff do–wore him out. He spent most of the day alternating between sleeping and eyeing us soberly. He was able to open his left eye wider than ever. He’s unable to open the right eyelid, however. Both eyes have only a little redness about them now, though the right eye is still noticeably swollen. The swelling in his face and hands has gone down considerably, and you can see the old Karlton in his face now.

Karlton can be playful with his hands and feet, but his face is nearly expressionless. Occasionally, he gives us an eye-rolling sneer, but he doesn’t smile. Last night I encouraged him to smile, and for the briefest second the corners of his mouth turned up a trifle. He did the same this morning with encouragement. I wonder if it’s hard for him to smile.

Full inflation of the left lung continues to be a concern. Apparently his coughing does not loosen the phlegm as much as is hoped. So the staff is having to suction him often. On the other hand, they’re reducing the amount of oxygen that he gets, since he’s breathing so efficiently.

Alec/Derek, Karlton gets anticoagulant shots twice a day in his stomach. If I understood correctly, they don’t give the shots in the arm because there’s too little fat there, and they want the body to absorb the medication gradually. But Karlton is so lean that I’m wondering if there’s really any gain to giving the injection in his stomach. On the other hand, it goes just under the skin, so maybe that helps.

This morning the physio was back, saying they were going to try transferring him to a La-Z-Boy, and he’d have to stand on the floor to make that transition! How quickly he is moving–sitting without support one day and standing the next! She warned us that he’d probably sleep for the rest of the day after he’d done that.

Last night Earl, Sophie, and Aidan–university students and rugby friends–invited Choy and me over for dinner. As students, they live simply, but they shared with us so generously. Earl was cook, and he prepared a magnificent vegetarian lasagna and a delicious curry. They have a big screen TV, and together we watched “Fear Factor” and something like “Whose Line is it Anyway?” It was so refreshing to get away for a bit.

This may have been communicated, but somehow it slipped past us. The neurosurgeon has replaced the sections of skull that were removed earlier. So Karlton’s head is whole again. He continues to try to write, sometimes more successfully than others, and keeps one eye (the left one) open a lot. He was able to stand with a lot of assistance, and he still sleeps for long stretches at a time. We in the family have been talking to him on the phone; although he is unable to answer, he does seem to hear and understand what we’re talking about. Mom says his blood pressure tends to go down and he seems to get calmer when we talk to him. He wrote that he wants to watch TV, but at this point they are afraid that it might cause seizures, so no TV yet.

Karlton was able to write to us last night. He indicated that he wanted to write, and the RN picked up on that. She put a blank sheet of paper on a clipboard and gave him a felt-tip marker. He was lying down with his head raised, so it must have been awkward writing in the air. We had to adjust positions so that he could see with his left eye what he was writing with his right hand. The RN asked him, “What’s your name?” and he wrote, “Karlton”. Then she asked, “Do you know where you are?” and he wrote “USA.”

Later he tried writing again. His sentence stated with a T and had “you” in it, but we just couldn’t make it out. He became frustrated and gave the pen a toss.

This morning we arrived after the night shift had left, so we missed out on stories of communication attempts. Yet we saw papers by the side of the bed that had

– 2002 Queenstown
– 1982 Dunedin
– 1996 Christchurch

written on them in someone else’s hand, one sheet for each list. So it looked as if someone had been trying to communicate with him.

Besides the excitement of knowing that he’s able to express a few ideas is the knowledge that he can see fairly clearly out of his left eye. That’s such a relief. The swelling in his face has gone down markedly. We noticed it already yesterday, and it’s even better today (Sunday). The purple in the eyelids too is receding. He looks so much better now.

Yesterday (Saturday) he spent most of the day back in the Intensive Care Unit. We feel very comfortable with the staff there, so we were almost glad for his return. They take such good care of him there. A second set of X-rays that day showed marked improvements in his left lung. The doctor told us that they’d gotten a lot of phlegm out of his left lung with their suctioning.

He was so alert and cooperative while in the ICU that his nurse freed his right hand. Ever since he came out of the drug-induced coma his first three fingers of the right hand have been tethered with long strips of tape. Each strip was folded back upon itself so no adhesive was exposed except where it covered a finger. The three strips were then tied to the bed rail so he couldn’t pull at his tubes and wires. But last night he was given more freedom to explore those tubes and wires, and he didn’t pull them out. So the RN cut off the tape and freed his fingers. I think he was really pleased to have his mobility back again. He gave us a thumbs up sign.

Karlton moved back to the High Dependency Unit (HDU) about 6:30p. It was while he was there and his hand was untethered that he wrote to us.

This morning when we returned to his room, his hand was tethered by the wrist to the bed rail. He’d managed to take the TEDS (tight stockings to prevent blood clots) off his right leg. So that’s probably why he had to go back to being restrained.

He’s breathing really well. The surgeon in charge of his case decided to lower his oxygen level. So he continues to make really good progress.

Yesterday we read to him messages that people have sent to the website. Besides messages from individuals, he had a number from OMBAC, the rugby team he played on in San Diego.

That’s it for today. Mom’s here at the library with me today so that she can answer her emails and she can see the website that Jason constructed. Hope you have a great day!

I called the hospital last night, and while I was talking to my dad, he said that Karlton was trying to write something. My mom later told me that the nurse had asked him what his name was, and he had written “Karlton.” She then asked if he knew where he was, and he wrote “USA.” Well, he can’t get *all* the answers right immediately, but I find it really impressive that he is able to write.

Alexa and I just got off the phone with Mom, and she had more encouraging news. Karlton has been moved out of the ICU and into the “High Dependency Unit,” which is a level down in terms of seriousness.

He is continuing to breathe on his own. He spends a lot of time sleeping, which anyone who ever lived with him will know. Because of the tracheotomy (which will be reversed when he recovers more) he no longer keeps the whole building rattling with his snores.

The nurses and my parents make sure to hold the phone up to his ear when we call. We have been doing a little “conference calling,” with Alexa and me, and sometimes Alec, on the phone all at once. Alec updated him on the Red Sox last night.

He will need some surgery to fix the bones around his right eye; that will probably happen some time next week. The swelling around his eye continues to improve.

Today some friends from Queenstown drove over 3 hours each way to come see him. We are so impressed with all of his friends!

Good news! Karlton “graduated” out of the ICU yesterday. His breathing stabilized enough for him to go to the High Dependency Unit (HDU). They moved him about 2:00p in the afternoon.

Yesterday morning, while I was emailing updates, Choy (his mom) and the nurse washed his hair. The staff have been great about shaving him too. He looked really spiffy.

We’ve made friends with another couple whose 40+ year old son is also in the unit . . . for the 2nd time! 20 years ago he was in an accident and fully recovered. But recently he was mugged, and he’s back again. The point of telling you this is that we compare notes from time to time about our sons’ progress. They said that from across the room in ICU they can detect Karlton’s nodding his head as we speak to him. That’s really encouraging!

After the move yesterday afternoon, three friends from Queenstown stopped in and stayed quite a while. Later, Sam, a Dunedin friend, came too. Two of the friends from Queenstown were going to stay at his place for the night. He’d been out shopping for blankets at a thrift shop. When he mentioned that he needed the blankets because of his friend’s snowboarding accident, the people in the shop insisted that he take the blankets without paying for them. They wanted to give him some money too. People over here are so good!

Talked to the people in charge of Karlton’s health insurance. They will pay for our lodging. They will also pay for a round-trip ticket for one of us. Thank goodness he subscribed to a generous health plan!

Things have been a wee bit less comforting this morning. Karlton seemed to have rested well over the night, but he got into breathing distress about 8:00a. Fluid had accumulated in his left lung. Though the nursing staff suction his trach and get him to cough at intervals, they’re less able to clear the left side, and he has less control there too. The machines indicated that he was getting lower percentages of oxygen, and his heart rate kept climbing. The final decision was to return him to ICU for the morning. The nurses assured us that we didn’t have to move all of his things because he’d be returning to HDU in the afternoon. We certainly hope so.

He’s made so many giant strides forward that we shouldn’t be discouraged by a baby step backwards. We’re convinced that he’s in great hands here. We’ll just have to hold on tight. Your continued prayers, positive thoughts, and best wishes are always appreciated. We have also been getting many messages forwarded from the website and promise to read them all to him.

The ICU freely let us use a CD player. The HDU, on the other hand, doesn’t have one. So we plan to buy him a Discman today so that once he returns to HDU he can continue listening to his music.

Karlton did really well yesterday sitting up in the Lay-Z-Boy recliner. The changed posture and the new requirements to support his breath exhausted him. He did a lot of sleeping. He was also successful with the new ventilator. The doctors are encouraged, and we’ve been told repeatedly that he’s likely to be moving to another ward where he’ll be more independent.

In the meantime, the hospital is gearing up today for its annual mock crisis. We’re told that the police and fire brigades will have the hospital cordoned off, and no one will get in–not even hospital administrators or high fallutin doctors–without a valid hospital ID. We’ll grab a bite to eat before noon, when it all starts, and then hunker down to see what happens. It’ll be interesting to see how they balance intensive care for the actual patients with readiness exercises with mock ones.

The woman who was snowboarding with Karlton on Friday stopped by yesterday. It was so good to talk with her and learn more details of the accident. According to her, the snow conditions were good, they stayed on intermediate-level trails, and he was not taking any undue risks. She snowboards with a helmet, and he’d been asking about it, apparently considering the possibility of buying one for himself. She works on the slopes, and he’d often catch up with her over her lunch break. They’d do a couple of runs together until she had to go back to work.

Friday was her day off, and they’d been snowboarding together all day, having done about 8 runs. It was their last run for the day. Toward the bottom of the run, she would always ski toward the right and he toward the left, their vision of each other blocked by some rocks. But they’d meet at the bottom to catch the lift up again together. This time his friend was in the lead and so she wasn’t able to see Karlton as they came down the hill. When she got to the bottom and he didn’t join her, she assumed that he’d stopped to help somebody out.

Somebody from the ski resort asked her to help do the final sweep for the day, ensuring that everybody was down from the mountain. So she got to go up one more time. She rode the life with someone from the ski patrol, and she noticed that he got a call just as they got off the lift. She found out later that the call was about Karlton. But she’d already begun the final sweep.

Towards the bottom, she noticed a collection of people from the Ski Patrol. She caught up with them and saw it was Karlton who had been hurt. That was really surprising to her, she said. Even though he was a rank beginner this year, he had worked really hard at learning to snowboard well. She’s much more experienced than he, but he would often give her tips about improving her form. She thinks it was just a random accident. . . a rock in the wrong place at the wrong time. For us as parents, it was a relief to learn these details and know that Karlton had been taking adequate safety precautions.

The Ski Patrol must have assumed that Karlton was Japanese. They called in a Japanese interpreter for him. His friend told the Ski Patrol that he was American, but in all the confusion, somehow the word didn’t get to the interpreter. That poor person stayed around for the longest time hoping to be helpful.

This morning Karlton got a beautiful bouquet from Heather, his housemate at Hamilton. It had orchids, Dutch iris, and many more beautiful flowers. Ethan, from the rubgy team at Hamilton, sent flowers yesterday. The florist sent up a card, saying we could”cash it in” for real flowers whenever Karlton was ready. The same happened with the bouquet sent from Zentropy (Jennifer’s work).

Hope all is well with you. We’re doing well. It’s always a delight to hear from everyone.

Yesterday afternoon KS had the tracheostomy (Kiwi for tracheotomy, I guess). Before, he had the ventilator tube down his mouth. It had to be tied onto his head, and they tied it so tightly that he looked really uncomfortable, with his lips sqeezed b/w the ties. Also, he’d yawn and use his tongue to try to push the mouthpiece out. But now he doesn’t have to do that. His face looks more relaxed w/out any tubes in it.

The plan is to move him to another unit, one with slightly less intensive care. It’s a neurosugical unit with a dependency ward. That means that instead of a 1:1 RN to patient unit, he’ll be in a 1:3 setting. He’ll still be heavily monitored, but they don’t want to have him on any kind of ventilator. The major obstacle at the moment is his breathing. He is breathing on his own, but he’s not fully inflating (or is it deflating?) the alveoli with each breath. This morning the RN put him on a different ventilor for 30 mins. to encourage him to fill and empty his lungs completely. He did well at that, and later she’ll put him on it again for 60 mins. and then keep increasing the time according to his success.

She also plans to sit him up in a Lay-Z-Boy recliner today. That will encourage his diaphragm to support his breathing more.

He continues to be active in the bed. The RN reported that his sheets were in good order when she arrived at 7:00a, but by 7:20 when we arrived, they were pulled out again. He’s taken to using his right hand to grab the railing on the left side and pull himself over on the left. In fact, Mom started massaging his back, and he did just that to give her more space to work with. He also uses his fingers to play with us, catching our fingers in his or tapping us on the hand. Such activities are alternated with periods of sleep.

Maree, the RN today, said that he tried to move his left leg a bit last night. Wow!

His gang of friends stopped by again last evening. They are such really nice people with lots of good energy. They really keep us going.

When we got back to the hotel room last night, there was a beautiful bouquet of flowers from Bunac, the group that sponsored Karlton’s stay in NZ. Another article appeared in yesterday’s newspaper. Unfortunately, we didn’t bring it with us to the University to send it along to you. They’ve got all the facts right, now, so we feel less urgency to respond to the media’s request for interviews.

We sneaked over to the University while the crew was X-raying KS. They should be done by now, so we’ll head back. Thanks again for being so wonderful.

It sounds as if Karlton is making progress each day.

I called the hospital last night, and my mother seems to think that Karlton is able to see, at least to some degree, through his left eye. She said that as he was sitting in his chair, she was doing something else nearby (not touching him), and he kicked her to get her attention.

Also yesterday, Jennifer called the hospital while my parents were out, but was able to talk to Karlton a bit. The nurse told her that his eyelids were fluttering as he listened to her on the phone. Later, my mother returned and asked him if Jenn had called; he nodded his head a little. Mom claims that while I was talking to him, his heart rate slowed a bit and that he was moving his mouth as if to try to answer me.