Wednesday, September 30, 2009

Update #15 on Peter

I can’t post fast enough to keep up with Peter’s progress.

One story I forgot to tell you from yesterday… sometime in the evening, Dr. Zeng came in to see Peter. He stood at the end of Peter’s bed and told Peter something like “Peter! Wake up! There are pretty girls all around your bed!” Peter opened his eyes… looked around the bed… and although there were some pretty girls around him, it was far from surrounded. Peter scanned the room… and closed his eyes again. Was that a bit of a smirk some saw on Peter’s face?

This morning, Peter’s mom, Claudia, came in for the 7 – 11 shift with a bag from McDonalds. She sat beside Peter’s bed and opened her McMuffin (or something similar). After a couple minutes, Peter looked right at her and said, “You’re eating a McDonald’s hamburger!”

Before I continue, I should mention that just 24 hours before this, most of Peter’s words were unintelligible and he said very few sentences at all and didn’t verbally respond to much that he saw (or smelled) around him. Back to the story…

Claudia picked off a small piece of bread and gave it to Peter to eat. He wanted more and more. She gave him some ice cubes which he immediately crunched and swallowed the water and small bits of ice. Then, she gave Peter a bit of egg from the sandwich. BUT PETER HATES EGGS! I expected him to just eat the egg… but as soon as it touched his lips, Peter said, “That is eggs!” and then “I hate eggs!” He might have said a bit more, but I was hiding beside the bed so he wouldn’t see me laughing. When I stood up again, Peter said, “You are trying to trick me!” and then, “I can’t trust you any more.” Then he said, “I like chicken. Even if it costs one million dollars, I want some chicken.” Isn’t that awesome? He closed his lips to more bread at first, but opened them eventually and started to trust his mom again. We were so happy to see this reaction to people and food and his likes and dislikes. Later, he got his chicken, of course!

A few minutes after “The Egg Incident”, I had to grab Peter’s right hand because he was grabbing at his feeding tube or something… I was holding it tight and I was looking right at him telling him why I stopped him. He looked right back and said, “I’m mad. I’m mad at you. I’m so angry with you!” I told him that was OK and that I loved him anyway. Then he furrowed his brow a little and said to me, “I’m giving you ‘angry eyes’! I’m filled with rage at you! I’m filled with outrage!” I was really glad to see this little outburst and his new ability to communicate his emotions and feelings. On a related note, it was good to hear Peter talk about his pain today. We’ve *known* he was in pain, but it is important for Peter to be able to communicate it to us and he’s started doing that.

Peter’s catheter was tied off this morning to test if Peter would feel the pressure on his bladder and maybe try to communicate a need to urinate. I don’t know the details of this test (and I most likely wouldn’t write them here if I did) but I do know that Peter’s catheter is out.

With the addition of food and liquids in Peter’s mouth today, it was a possibility that the feeding tube would be removed. It was! The catheter and feeding tube caused Peter MUCH distress and those are both gone. I do believe that he was able to understand what we were telling him the last couple days about why those tubes were present and what he could do to speed their removal.

Before I left Peter at about noon, we were tossing one of the balls I mentioned in the previous update back and forth. I was at the foot of his bed and we were gently tossing the ball. He caught most of my throws. After I gave Peter a goodbye hug, high five, and fist bump… Dr. Peter’s wife, Sarah, took over playing catch with Peter.

Peter identified many of his visitors today and was engaged in conversations and answered some questions.

Oh… almost forgot! Peter stood up today! I don’t know the details and I can’t wait to hear the story from those who were there at the time, but apparently Peter just all of a sudden swung his legs over the side of the bed and stood up! Today was the day to try that anyway, but apparently it happened very suddenly and surprised everyone. I don’t know how long he stood, but is another big sign of progress even if it was just for a second. I think he got up at least one other time later.

What a day! Although we have a great deal of good news to share… please remember to keep praying for recovery and healing as you give God praise and glory for what he has already allowed us to see him do in Peter. Bless you all.

Tuesday, September 29, 2009

Update #14 on Peter

It has been one full week since the accident.

I’m finishing up 8 hours with Peter and I’ve seen much improvement during my time with him.

Probably the most fun today was when the Yankees and Royals were finishing up their game. The Yankees are *HUGE* here in Taiwan because Wang Chien-ming is from Taiwan. Peter’s dad, Rick, and I decided to turn on the TV for Peter this morning and I found the baseball game. Peter isn’t a big baseball fan, but he often looked at the TV. Right as the game was ending, Peter started talking about Pete Rose and sliding into 2nd base. He talked about the importance of sliding naturally and not forcing it too much. We had a somewhat disjointed conversation that was focused on sports. Peter has said a lot of other things today… some have made sense… some not so much. At one point, he said “Leonardo” a few times… maybe talking about Ninja Turtles? We weren’t sure. He also said, “Daddy’s boy” when looking at his dad. The ball game is being replayed on TV now so maybe he’ll talk more baseball later.

Last night, on a suggestion from Bev Skiles, I put a pen in Peter’s hand and gave him a pad of paper. He was immediately interested and knew what to do. He wrote his name phonetically in Chinese and wrote at least the “Pe” in his name. He later added the Chinese characters to the page along with a lot of marks that we can’t decipher.

I brought in 2 balls for Peter to play with today. One is smaller and fits in his hand. It is covered with little spikes. I hoped he would use it to exercise his left hand as it shows less strength than the right. He has used it in this way occasionally. The larger ball is also textured and we’ve kept it at his feet most of the time and he likes to kick it, roll it, and squeeze it at the end of the bed.

Peter has sat up on a few occasions today. He sometimes tries to do this himself without prompting, but he has allowed us to sit him up each time we’ve told him what we want and start lifting him. We need to sit him up to start learning if he gets dizzy. As long as he isn’t too dizzy, we may be able to stand him up. So far he has sat for almost 10 minutes at the longest, but gets pretty dizzy so he isn’t ready to stand yet.

The ear, nose and throat doctor stopped by earlier and gave him a few tests. She can’t tell a whole lot until Peter is more able to respond with precision about what he hears and doesn’t hear, but she took a large piece of dried blood out of Peter’s left ear and a smaller piece out of the right. That had to help his hearing.

When Christy left a couple hours ago, Peter waved. Craig stopped by for a short time and when Craig left, Peter gave a high five and a fist bump when Craig asked for them.

He gave a BIG smile once when he saw Jen-Jen’s camera.

I’ve been trying to think of a way to explain this new phase we are in… and I wonder if this will work: for the first week, Peter was taking slow but large steps on the road to recovery. Now we seem to be in a part of the journey where the steps are much smaller, but also are faster. These steps are all in the right direction at the moment.

Monday, September 28, 2009

Update #13 on Peter

At about 1:30PM on Monday, September 28, Peter was moved from the ICU to a regular ward in the same hospital. It is a double room but Peter is the only patient in this room so it is nice to have the large room to put our stuff down and we can also move around a bit.

I haven't seen Peter for a couple days, but was here during the transfer and am typing this in his room although I'll need to go out of the hospital to find good internet access to post it. My impression? He's looking good and doing well so far. If you just walked into his room and saw him for the first time after the accident, you might think he is not doing so well. But to those of us who have been here since the first hour... the progress is clear and hope reigns.

He is down to the following tubes: a catheter, an IV in his femoral artery, a feeding tube in his nose, and oxygen in his nose as well. The bandages on his head look good. The wounds on the back of his head (the impact with the car windshield) and the front of his head where the ICPM was implanted are stapled and look as good as is possible. Just to Peter's left of the place where the ICPM was implanted is a wound with a few stitches where a shunt was used. Peter's fever went down last night so it seems that the infection is gone as well.

It is still VITAL that we protect Peter from infection, so the family and his immediate caregivers have decided to not allow any visitors for at least the next 48 hours with very few exceptions depending on Peter's condition. If you come to the hospital, it may be possible to get updates and chat with others, but please don't expect to see Peter until his condition improves.

As long as someone is holding his hand, it is possible for Peter's hand to be free. It is best for Peter if his hand is free to exercise except that he desperately wants to touch his wounds, take bandages off, and mess with the IV or other tubes. Someone needs to be in charge of that hand 100% of the time. To have both hands free, 2 people are needed... one for each hand.

Peter's foot is ticklish. There are many other small improvements or assurances like this.

Peter has some fluid coming out of his right ear and Dr. Zeng said that he would ask for another doctor to come and try to check his hearing.

Since the news is mostly very small increments these days and probably will remain so, I may have time to share a few pictures or other things about Peter on here, including a timeline of the day of the accident. I can’t promise, but I’ll try.

PETER HOLDING HIS MOTHER’S HAND

Peter holding hands with his mother

 

PETER’S MOM AND DAD WITH (FROM L-R) RENEE, JEN-JEN, A-WEI, AND JOANNA

Peter's mom and dad with some of Peter's friends

 

DURING THE PRAYER TIME COMMUNION

At the prayer time during communion

 

PETER’S MOM TALKING WITH DR. PETER IN THE CHAPEL

Peter's mom with Dr. Peter

Sunday, September 27, 2009

Update #12 on Peter

The praise and prayer time was great. There were about 50 people in and out between 2PM and 5PM with probably about 30 people present in the small Catholic chapel on the 12th floor where we took communion together and sang some impromptu songs in English and in Chinese. There were prayers of thanksgiving for the healing Peter has already experienced and prayers of petition for continued healing. People prayed for the driver of the car (Mr. Lin), for Dr. Zeng, for Peter’s nurses, for other patients in the ICU, for far away family and friends, and for Peter’s mom and dad. This was a special time for calling attention to the things God has already allowed us to see him do and a plea for strength and courage to walk in faith when and if he chooses not to reveal his ways or his reasons.

Some people at the prayer time took photos. If you send those to me, I can put some of them up here on the blog.

We are all riding the roller coaster now. You know Peter was to move out of ICU on Saturday but because of the small bleeding discovered that morning, he remained in ICU. We were told he would be in the ICU 1 or 2 more days. Later, Peter eased our disappointment about the bleeding by giving more signs of recovery. At the close of the prayer time today, we heard that Peter would move out of ICU on Monday morning. A couple hours later, we found out that Peter has a low grade fever indicating an infection of some kind. This may or may not affect him moving out of ICU. We don’t know any more about the infection at this time.

The infection could be from many things. Some are remedied more easily than others. We do know for sure that Peter still has abundant phlegm in his airways and needs to get that out. He is coughing a lot but probably needs to cough more. Have you ever had a headache and then coughed? You hated it, right? Imagine Peter’s headache and realize that he is coughing regularly and is being asked to cough more frequently. To aid the breakup of this phlegm, Peter is being turned side to side every hour and undergoing percussion on his back either from the nurses or a machine. Percussion involves repeatedly striking the back with a cupped hand in order to break up phlegm. Percussion is often used for this purpose (most parents probably have done it with sick kids) so it isn’t related to Peter’s injury, just the effects of being stationary and the tubes in his throat.

As a result of the infection, Peter is only allowed minimal visitors. His parents are able to visit almost anytime, but no other visitors are allowed except on rare occasions and only by doctor or nurses orders. Peter has to beat this infection.

Peter’s mom and dad are thankful for the love expressed by all of Peter’s friends (and friends of friends) around the world. Please remember to pray for Claudia and Rick because they are dealing with a wide range of emotions and experiences. They are holding up well, but Dr. Peter did take time to remind them that they are not as helpful to Peter if they are too tired or become sick. Once again… Dr. Peter comes through with perfect advice, right?

Bless you all!

Praise and Prayer Time

This is not going to be a formal event… there is no order of service… actually, there is no service.

It is more like and open house type event. Please feel free to stop by for a while, sign the guestbook, encourage one another, pray together, etc.

TIME: 2PM to 5PM

PLACE: Cardinal Tien Hospital Yonghe Branch 耕莘醫院永和分院

The hospital has 2 buildings. We will meet on the 12th floor of the building that is back off the main road.

ADDRESS: 台北縣永和市中興街80號 Yonghe City, Zhongxing Street, #80.

Saturday, September 26, 2009

Update #11 on Peter

In the last update we shared what might be a step back for Peter. The latest CT scan revealed some bleeding at the front of Peter’s brain. We now know that this bleeding is not a cause for great alarm, but it is disappointing and kept Peter from moving to a regular room which would have been a big (although mostly symbolic) step towards recovery. This discovery of new bleeding today is the only step back that I can think of during Peter’s recovery so far.

The bleeding was disappointing news, but Peter is providing other forms of encouragement: He has begun talking, saying some things that don't make sense but some things that do: “I can't hear you” (in English) and (in Chinese to his mother)「我在講中文。你聽不動。」 which means “I'm speaking Chinese. You don't understand.” He also smiled at his mom and dad, and hugged his mother.

So… we continue to be reminded that Peter is still in serious condition, but we also take heart as a result of obvious and rapid improvement in Peter, too.

Today, Peter was given some water on a q-tip to drink. He seemed to really enjoy this.

Dr. Peter gave a good summary of the issues Peter is facing and has already faced.

  1. During the first 24 hours, the brain pressure and risk of hematomas were the most important issues to control. These were taken care of and are no longer a concern.
  2. The blood discovered by the new CT image today is from an abrasion on the brain caused by impact and scraping of the brain on the rough surface on the inside of the skull. It is about 1 cm in size. It is not cause for alarm at this time. If the amount of blood continues to increase, there will be a surgery like the one Peter had on Tuesday night to remove the blood. For now we wait and see if it increases or is absorbed.
  3. The accident caused bleeding from both of Peter’s ears. This bleeding could perhaps indicate linear fractures on the side of Peter’s skull. It is possible (perhaps likely) that one eardrum was ruptured. These are not small issues, but they are trumped by #2 above – the new bleeding. These are really not a concern at this time.
  4. Sputum in Peter’s lungs. He is working hard to get this up and out. It’s presence raises the risk of infection. Although we hoped Peter would move out of ICU today, the truth is that the ICU is a better place for Peter to deal with this sputum.

Peter’s Intracranial Pressure Monitor has been removed. It is another risk of infection and now that Peter is awake, his activity will be enough of an indication as to any problems with pressure in his brain. That little device played a big role in saving Peter’s life on the day of the accident. Lord bless the hands of people who can make those things!

I’ll post about the Praise/Prayer time in a separate update in just a few minutes.

Update #10 on Peter

This morning, we received word that Peter would have another CT scan and would await the results before going ahead with the plan to move Peter out of ICU and to a regular room.

This decision was proven to be made with wisdom as the scan did reveal some intracranial bleeding. This bleeding is different from the bleeding Peter experienced in the first couple days. The earlier bleeding was *outside* the brain. This bleeding is *inside* the brain. I wish I could tell you exactly what this means, but I just got the news and thought it best to get the news to you now than to wait for the exact details.

Obviously, the bleeding is not good news. But, this does not change all of the good news we were able to report in the last update EXCEPT that Peter will remain in ICU for 1 or 2 more days. It is good news that the doctor decided to take another CT scan and found this new bleeding. We definitely wouldn’t want Peter moved out of ICU but not know about this bleeding.

I’m headed to the hospital soon and if I find out anything relatively quickly, I’ll update this post. If it takes a while to learn anything new, I’ll post it in the next update.

Friday, September 25, 2009

Update #9 on Peter

Big news today so I'll get right to it.

Peter will move out of ICU in the morning. We don't know what time. His condition has improved to the point where he needs out of the ICU in order to recover. The ICU is 24 hours a day of bright lights and activity. This is a great place to be when you are sedated and your life depends on the observations of nurses moving throughout the room. But when you are awake and alert and trying to regain your normal life, you need sunlight and daytime and nighttime.

We praise God that he has willed that Peter make rapid progress up to this point! Can I get an "Amen"?

This morning when Claudia and Rick visited Peter, they came out very discouraged because Peter was sedated and there was no opportunity to see any progress from yesterday. At lunchtime, the person now known as the "American Angel" showed up and took Peter's parents to lunch at Subway. The "American Angel " is named Alicia and she doesn't know Peter, but heard of his situation and is in Taipei so came by to lighten the load. After lunch, Peter's friend Roming took Peter's parents to Peter's apartment in Banqiao which was a tough thing for them to experience. Roming was hoping to take them out to see a little bit of the city to take their minds off of heavier things, but I never heard if this happened or where they went. They arrived back at the hospital this evening with discouraged spirits...

Those spirits would soon change!

At 7PM they went in to see Peter. Jen-Jen accompanied them as a translator. When 15 minutes passed, we all suspected something good was happening in there. Shortly Jen-Jen came out with eyes, face, and body *full* of JOY!
  • Peter's eyes were open.
  • Peter was looking around.
  • Peter was moving (and also controlling) his arms and legs.
  • Peter was trying to speak, but had a tube in his throat so there were no intelligible words.
  • Peter was blinking.
  • Peter's eyes were moving together and seemed to focus on and track faces.
  • Peter was responding to requests to cough.
  • Peter was annoyed by the tubes and seemed glad when we tried to explain what they were for.
During the visiting time, Peter had a tube in his throat. The tube somehow helps rid phlegm from Peter's airways. Before Claudia left his side, the nurses removed this tube. By this time, Peter was very tired and his throat was probably very sore from the tube so he didn't speak. We think he will tomorrow.

I previously mentioned that the nurses would give him liquids today. I saw this while I visited Peter's bedside tonight. They gave him milk in a syringe through a tube in his nose.

Peter's score on the coma scale is now 14. Remember that this scale is for people who have experienced head trauma. A perfect score is 15, but that doesn't mean that Peter is fully recovered... it just means that his trauma has been managed to a point where we can begin to learn the degree and extent of brain damage. Obviously, we hope and pray there is zero.

We will know more in the coming hours and days.

With Peter's improvement and moving to a regular room, I've been asked to share the following about visitation:
  • Please do - come to the hospital to gather with friends and family, show your support, share information, sign the guiestbook, and more.
  • Please do not - go directly to Peter's room. It is important that the number of visitors to Peter's bedside remain low for the time being. It is possible you might get to see Peter, but you should visit with the understanding that seeing him is unlikely at best. We must do what is best for Peter.
  • With Peter in the ICU, the gathering point has been an area to the left when you get off the elevator on the 8th floor. At least for Saturday, this will remain the gathering point. If you visit. Go to the 8th floor gathering point.
We are planning a praise and prayer time for friends in the Taipei area on Sunday from 2PM - 5PM. Although at the time of this posting, we don't really know what we mean by this! I'll give more details tomorrow when we know more. Keep the time in mind, though, if you are in the area.

There is a picture that Peter's mom wants me to share here on the blog. She posted it to her Facebook profile so it is possible that some of you have already seen it. It is a picture of Peter from the day she arrived. It is of Peter in his bed and you can clearly see the various tubes he is hooked up to. Personally, I support her decision to share the picture. I think it can help people process and understand. However, it occurred to me that some readers may not wish to see Peter like this. So I decided to post the picture at another website and link to it. You make the call. If you want to see it, click the link below. If you don't want to see it, you don't have to. The photo is not graphic in any way. It is sad to see Peter like this, but remember that he is *much* better tonight and most of the tubes you see are either already removed or will be removed in the morning.

click here to view the picture in a new window


Peter has been helping me coach soccer to kids 4 to 12 years old on Saturday mornings. We will all miss him tomorrow, kids included. Perhaps he'll be back on the pitch sooner, rather than later.

Your prayers are powerful and effective. The family thanks you.

Update #8 on Peter

Peter and his family are so appreciative of your love and concern. The stat tracking for this blog kicked in last night and you won't believe the number of hits and the locations people are reading from. I'll share that in another update, though.

Many of your comments either here on the blog or on Facebook also address me or other of Peter's teammates. Often, your comments are to all of us. On behalf of the mission team here and Peter's mission organization, Team Expansion, we thank you for your concern and prayers and encouragement. We are all fortunate to work with such a stellar group of people with a broad array of spiritual gifts, aptitudes, abilities, and talents. The missionaries are here to help local believers plant churches and in over 15 years of purposeful church planting in Taipei, there are now many Taiwanese who are coming to visit us, meet Peter's parents, bring food, help with translation, etc. The list really goes on forever and there are more people who are willing to help than we have jobs for at this time. Some of these people know Peter, some just know of the loving community he is a part of and want to be close. Although the first 3 days were an adrenaline fueled sprint, we are now transitioning to a long term view and able to rest more and get back to some of our regular work as I personally was able to do this morning. Peter and his family remain our first priority.

I do have some updates about Peter's condition today.

I can't remember if I mentioned this or not, but on Wednesday night, Dr. Peter said he believed he saw a small epidural hematoma (on the CT scan) of the same type the emergency surgery addressed on Tuesday night. It was too small to be a big concern but was worth keeping an eye on. Turns out Dr. Peter was right and it technically is a hematoma because it is blood on Peter's brain. But, we have since found out that it is from a small sponge left inside Peter's skull for the purpose of absorbing small amounts of blood. It is doing its job and will dissolve over time. The sponge looks just like blood without a sponge on the CT scan.

For now, any further CT scans will only be ordered if there is a good reason based on Peter's vitals or behavior. It is better for Peter to be in one place than to be moved to get scans done. If there is some reason (vitals changing, brain pressure rising, etc), they will not hesitate to order scans.

The nurses will start (or perhaps have already begun) giving Peter liquids today. I'm going to try to find out more about how this works and the significance when I visit the hospital later. It could be as simple as putting water in his mouth... but I'm curious as to how it actually works.

The doctor and/or nurses have allowed Claudia and Rick to bring in some music to play near Peter.

Peter has so many friends and is part of so many communities here. In fact, he has so many visitors that we have decided (along with doctor's orders) that we will limit the visiting hours to his mom and dad--with others going in only as we evaluate the situation from visit to visit. This is to limit the chance of infection, and because if Peter is overstimulated, he needs to be sedated and then his parents can't have their time with him.

Thanks again for praying. As well as for Peter, please continue to pray for his mom and dad here and his family back in the States. You can pray, too, for Mr. Lin, who was driving the car that hit Peter. We told him that Peter loves Jesus and that he will someday want to tell him how much Jesus loves him, too. Mr. Lin has been very concerned and has come by to see Peter each day.

I am happy to serve Peter, his family, and our Lord Jesus by posting these updates, but I want to mention that I don't consider this "my" blog. I am merely compiling all the reports (from doctors, nurses, other visitors, teammates, internet research, etc) and putting them here. The previous 2 paragraphs are a direct cut/paste from Craig Thompson's latest email about Peter. Peter is standing alone on the front line of this battle, but all of us who care about him equally share the responsibility and privilege of encouraging him as he bravely fights.

Thursday, September 24, 2009

Update #7 on Peter

Thanks for your continued support and prayer. The family wants me to pass on their sincere thanks to all of you in this outpouring of concern and love for Peter.

I'm not going to make you wait. Peter is improving. This is fantastic news. I do need to stress that Peter's situation is still very critical. We are, however, cautiously optimistic that his life no longer hangs in the balance of each passing minute.

At tonight's visiting time, Peter was moving a bit, but not responding to visitors. At one point, the nurse asked the visitors to tell Peter to try to do various things. He was told to open his eyes, but he could not do this. He was told to grasp another person's hand with his right hand and he did. He did not do it a second time when asked. The nurse put her hand in Peter's right hand and he was told to squeeze and he squeezed hard and the nurse said "good!" She then moved to the left hand and he squeezed her hand with his left hand too. This is great to know that he can respond bilaterally and independently with each hand. The nurse asked Peter to try to nod his head or shake it (indicate yes or no) to several questions related to his pain and how he was feeling. This was very difficult for Peter, but he was able to try to respond and in some cases we feel like we understood his answer. He was told to cooperate with the nurses' requests. For example, he is still moving his legs too much. When they tell him to stop moving his legs, he needs to stop. He did stop moving his legs on command 2 times during this visit. We told Peter about some of the tubes around his face and explained that one tube was to help extract phlegm from his lungs but that he would get rid of that tube faster if he could cough on his own to bring it up.

I can't say for certain what he understood and didn't understand, but he is very much trying to respond to stimulus. This is absolutely great news.

Peter received too many visitors tonight. His vitals started rising and he needed to rest. More on this in a moment (below).

Dr. Peter told me that Dr. Zeng raised the score on the coma scale from 9 to 12 because Peter was verbal today. Personally, I felt more like it was 11 instead of 12, but I'm an accountant working as a missionary and Dr. Zeng is a neurosurgeon so I'll revise my score up to 12, too. Even small improvements can change this score dramatically.

Peter is breathing on his own. He could have done this before, but the machine was helping his body relax and focus on restoration of health.

Dr. Peter told me tonight that if Peter had significant brain damage, we would have remained in a coma even after stopping the sedative this morning. He did wake up and worked hard to show us what he can and can't do today. At this time it is impossible to know to what degree Peter will recover but Dr. Peter's observation is good news.

Although Peter's mom said she might sleep at the hospital, this is the first night no one from the mission team is there. Although now that I typed that I realized that it has only been 2 nights. Remember I mentioned the time warping in an earlier post? The important thing though, is that Peter's condition is stable enough that we probably won't have to make major decisions at night and can get rest at home.

I bit of logistics now...
I mentioned earlier that Peter had too many visitors today. I've been asked to share the following:
  • Now that Peter is out of a coma and is responding to visitors, too many visitors makes him much too tired. He is trying to communicate with people. But it is not in his best interest to do so with each visitor. In fact, tonight, Claudia and Rick graciously let others go visit Peter first and were saving their visit for last, but they didn't get to go in because Peter's blood pressure went up too much as a result of the stream of visitors. Obviously, this is a problem.
  • From this point forward, Peter's parents will go in first at visiting time. We hope they will take the entire 30 minute visiting time. If they come out before the 30 minutes is up, it is possible that others may have the opportunity to enter and see Peter. Other than family, those who visit Peter are asked to not touch him and to speak quietly unless instructed by a nurse to do otherwise.
  • Although it is now possible for just a few visitors to go in and see Peter, everyone is welcome to come to the hospital and join the constant fellowship, prayer, and sharing outside the ICU where we are always hanging out.
  • Dr. Peter's orders here. Please do not come if you are sick or are recently recovering from illness. Peter and all the ICU patients are at extremely high risk of infection. Even if you are feeling better, it just means that your body has successfully fought infection, you could still be carrying that infection with you. We should have been watching this more closely.
Peter is at Cardinal Tien Hospital Yonghe Branch 耕莘醫院永和分院
The address is: 台北縣永和市中興街80號
The hospital has 2 buildings. Peter is in the one off of the main road. In Chinese it is called 住院大樓. Peter is on the 8th floor - ICU.
The hospital website is http://www.cthyh.org.tw and there is some English available, but I have to warn you that the web designer likes the blink tag. If you don't know what the blink tag is... click that link and you'll learn quickly.

Update #6 on Peter

I just got a call from my wife, Angie, who is at the hospital. Many were able to go see Peter during visiting time. He made some grunting noises with some visitors. The grunting alone is good news...

When Rick and Claudia went in a little later, Peter tried to speak! He tried to say something with an "L" sound. And then he said, "thanks".

I'm passing his message on to you. If you are praying, you are helping and Peter says, "thanks".

There is a long road ahead. This is another step. We celebrate it!

Update #5 on Peter

Casey Bell and I met Peter's dad, Rick Bennett, at the airport this morning and took him to the hospital. We arrived at the same time as Jennifer Reynolds brought Claudia after she slept a little last night. We all went in together, but Rick and Claudia could not see Peter right away as the staff was changing shifts and then they were changing Peter's medicine.

I left the hospital about an hour ago. When I left, Rick and Claudia were both in at Peter's bedside. I'm so glad we live in a time where they could be here so quickly.

Speaking of time... those of us here with Peter are experiencing a very strange warping of time. The accident only happened about 50 hours ago, but we feel like it was at least several days ago. We routinely find ourselves trying to recall something or some event and we strain to remember it and then realize that it was only 8 or 12 hours ago. I don't share this to gain your sympathy, but just as a matter of information about what it is like to be a part of this.

Here's the latest that I know.
At 8:30AM Dr. Zeng stopped the sedative that was keeping Peter in a coma. He now has a chance to wake up. They don't do anything to help him wake up... they just stop the sedative and wait to see what happens. Obviously, this is very important. The best thing that could happen is that Peter will wake up, look around, and maybe want to talk. All of these things increase his coma score. The worst thing would probably be that he doesn't wake up. If he doesn't wake up, he'll get another CT scan and will try to figure out why he doesn't wake up. If he does wake up and is alert and maybe tries to speak... we enter a new phase of recovery where we can start to learn how badly damaged his brain is and how that damage affects Peter. Up to this point, all efforts have gone towards the first phase of head trauma treatment: to keep Peter alive, manage the trauma, and stabilize him enough to let him try to wake up.

As I mentioned above, when I left the hospital, Rick and Claudia were in with Peter. I have not heard any more about their time with Peter. It is possible that the sedative was wearing off while they were in there and maybe Peter started to wake up. Wouldn't that be awesome?! It is possible that Peter didn't move at all. I'm sorry that I don't know and I won't take time to find out now as any calls I make right now will interrupt visiting time, which is from 11:00AM to 11:30AM. Peter will entertain many guests during this 30 minute visiting time and perhaps he will be awake.

There is always more I could say... but I'll send this now so some of you who get a chance to read it can have time to pray during this visiting time as that could prove to be greatly stimulating to Peter and help him to wake up. I'm not even going to proofread so sorry if something is unclear.

Update #4 on Peter

Thanks again to everyone for your encouraging words for Peter and those of us here who are trying to help him somehow.

Peter's mom, Claudia, arrived tonight from LA. We took her straight to the hospital. Before she went in to see Peter, she patiently hugged each person who was there in the waiting room and then listened to Dr. Peter (from update #2) explain Peter's condition for her. When she and Dr. Peter went into the ICU to see Peter, many of us left for home because we didn't know how long she would be there and there was nothing we could do. Jennifer Reynolds waited so she could take Claudia back to Chad & Alicia Edwards' apartment to get some sleep tonight. I don't know if they are there yet, but this was the plan when I left the hospital. Craig was going to sleep at the hospital in case he was needed. We try to have people there around the clock.

I only have 3 things to share about Peter's status.
  1. Tonight I heard Dr. Peter say that Peter's skull fracture was 10cm long. This is a very large fracture and it sounds awful. It actually can be a blessing because such a large fracture means that the energy from the impact was largely absorbed and dissipated by the skull instead of by the brain. It also means that the impact was extremely harsh. We hope that the skull absorbed enough of the impact that the damage to Peter's brain is zero.
  2. They took a routine CT scan this afternoon and the image shows that there is no blood on Peter's brain. This doesn't mean that there won't be in the future, but when the CT image is combined with the fact that Peter's brain pressure has remained low, it is a good indication that the doctor has successfully dealt with the initial trauma and that Peter is stable.
  3. In part because of this positive CT scan, the doctor plans to go ahead with the original plan to stop (or lessen - I can't remember for sure) the sedative at 7:30AM on Thursday and allow Peter a chance to "wake up" on his own. Peter's response could tell us many things... or it could tell us almost nothing.
We'll keep you posted as best we can.

In the comments from the last update, someone asked for more info about Peter. It makes sense to share some because many people who have never met Peter or don't even know of him have found this blog and are now following his story and praying for him. Someone please correct me in the comments if I have any of this wrong.
  • Peter is from California, USA.
  • He is 28 years old.
  • He is not married, but as you can see in the picture, he is 100% hunk.
  • He loves mountain biking (or any biking actually).
  • He's like the energizer bunny... keeps going and going.
  • His mom and stepdad and his dad are all in California. Peter has 2 sisters and they are in New York.
  • He is a picky eater and has somehow turned this fact into an endearing character trait.
  • I'm not sure of the timing, but I want to say that Peter has lived in Taiwan for about 3 years. He knows so many people and works so well with everyone that it seems like it should be longer than that, but I think it is only about 3 years.
  • He is a hard worker and this has paid off already in learning Mandarin.
  • He is in a time of transition from language acquisition ministry to other ministries and seeking God's direction for the future.
  • I suppose Peter only has one "best" friend... but many would say that Peter is their "best" friend.
  • He lives in Banqiao.
  • He has the spiritual gift of encouragement (among others).
  • He is currently helping as a soccer coach for kids 4-12 years old on Saturday mornings.
Now I've lost control of my emotions again because I had not yet thought of how "Coach Peter" won't be on the pitch with us this Saturday. I'll end here as I need to go get some rest. Bless you all. Hug your kids. Hug your parents. Hug your friends.

Wednesday, September 23, 2009

Update #3 on Peter

Thank you for praying for Peter. Thank you for your comments on the blog and on Facebook and via email letting us know that you are praying and that you find the updates helpful.

We are rapidly learning more than we ever wanted to learn about head trauma. We are learning most of the terms and protocols in English and Chinese at the same time since most of us have not dealt with a situation like Peter’s before. We will keep passing on to you as much of what we are learning as possible in order to help you pray for Peter.

In this update, I want to share about the Glasgow Coma Scale. This was a scale that I did not know about before yesterday afternoon. It has become important to us as one way to objectively evaluate Peter’s status and I’ll share with you how it works and where Peter is on the scale.

The scale runs from a low of 3 to a high of 15. It is comprised of 3 different categories with a score for each category and the sum of the 3 categories make up the score on the coma scale. The lower the score, the deeper the coma. The 3 categories are:
  • Eyes – this category score can range from 1 to 4
  • Verbal – this category score can range from 1 to 5
  • Motor – this category score can range from 1 to 6
Yesterday afternoon, we were told that Peter was at a 7. The category scores were as follows.
  • Eyes = 1 because Peter did not open his eyes
  • Verbal = 1 because Peter was not making any sounds
  • Motor = 5 because Peter showed purposeful movement to painful stimulus
In the previous update, I mentioned that Dr. Zeng told us that Peter had opened his eyes. He did not give us more information about this action at the time. He only said that he would lessen the sedative in hopes that Peter might respond to us during visiting time from 11:00AM to 11:30AM. At least 12 people went into the ICU to see Peter in shifts of 2 at a time. Those in first saw no response, but by the end of the visitation period, Peter was moving his legs and his eyes were partially open. He is still heavily sedated so keep that in mind, too. We were all a little disappointed that Peter’s eyes didn’t pop open when we starting sharing all of your names and comments you are leaving for him.

But just after visiting time was over, Dr. Zeng came with some very good news.

He told us more about Peter’s eyes opening that morning. He said that they asked him to open his eyes and he did. He was definitely responding to stimulus. Perhaps this seems like a small thing, but in fact, it is significant enough to vault Peter from 7 to 9 on the Glasgow Coma Scale! We celebrate this change!

We also celebrate that Peter’s brain pressure has remained at around 10 mmHg for over 14 hours now.

These 2 objective measurements are important to note and encourage us greatly. And yet, Peter’s condition is still very serious. We must rejoice when and where we can, but the big picture is still very cloudy at this time.

The latest info from Doctor Zeng is that they will take him off the sedatives at 7:30AM on September 24 and see if he wakes up on his own and how he responds.

We have a small group to go meet Peter’s mom at the airport tonight. I plan to see if we can go in and meet her at the plane and help her through immigration, baggage claim, and customs. It is an unusual request, but please pray we will be able to do this for her.

Most of the readers here are not in Taiwan. To keep it simple, I’m putting all the times as local times here in Taipei. I’ve added some clocks to the sidebar to help you convert if needed.

Update #2 on Peter

Approximately 24 hours have passed since the accident.

Last night, I took a walk over to the intersection where it occurred. I did this to help me gain a better understanding of what happened. I also saw a picture that Craig Thompson took of the windshield of the car that struck Peter. We are gaining understanding of the timing of the actual accident. It is clear that Peter’s head impacted the windshield and the damage to the windshield is massive. These were sobering moments: to see the accident site and to see the picture of the windshield.

Peter’s mom is on a flight from California at the time of this posting. Her flight is scheduled to arrive on Wednesday night. Peter’s dad was able to get a passport and will, Lord willing, arrive in Taipei early Thursday morning. We plan to bring each of them directly from the airport to the hospital to see Peter.

Today we know a lot more about Peter’s situation than we did yesterday. Longtime friend Dr. Peter Ruan came to the hospital and he was able to speak with Peter’s doctor on a doctor-to-doctor level. Dr. Peter is a radiologist and was able to see Peter’s CT scans and other images first hand. Then Dr. Peter took a great deal of time to explain things to all of us. Actually, we were given so much information during that time, that I know I can’t reproduce all of it for you here. I will try to give you what I feel are the most helpful things for you to know as you pray.

Peter’s situation is still critical, although there have been some reasons for encouragement. He is still in the ICU.

When someone sustains a head injury, it is our understanding that bleeding is the most important issue to be aware of. The severity of the bleeding will display itself by a raise in pressure on the brain. We have learned that normal brain pressure is anywhere from 0 to 20 (measured in millimeters of mercury - mmHg). When standing, brain pressure is often negative (below zero). Although none of us realized it at the time, the decision to implant the Intra-cranial monitor (ICM) was the best first step that could have been taken. Just after implanting the monitor and throughout the afternoon and into the evening, Peter’s brain pressure was between 15 and 25. These numbers were OK. At about 7PM the pressure increased significantly. This increase in pressure indicated a large amount of blood on Peter’s brain. This was a very critical time. He was quickly taken for a CT scan, which revealed a large hematoma on the brain at the area of the skull fracture. Peter was given emergency surgery to deal with this hematoma. The neurosurgeon removed the fractured skull piece which gave access to the hematoma. They collected 70cc of blood which is a significant amount. The skull piece was replaced. There are more details but they won’t fit in this update. The important thing is that as a result of this procedure, Peter’s brain pressure was relieved from 50 to 60 mmHg all the way down to around 10 mmHg. This does not mean that Peter is fine, but if it stays this low (normal) it is a strong indication that the bleeding problem may be taken care of. It has remained near 10 mmHg for about 9 hours now.

Peter is stable and the doctor told us that his eyes are open. It is impossible to know at this time the significance of his eyes opening. It may not indicate improvement, but it certainly is not a bad thing. We will be able to go see Peter in a couple hours and at that time we can speak with him and try to stimulate a response with his eyes or maybe a verbal response.

To summarize key prayer points:

  • Brain pressure indicates bleeding. Pray for no more bleeding. The procedure last night might have resolved the bleeding. Time will tell. We probably won’t know much for 2 or 3 days.
  • Decisions made on Peter’s behalf. This weight is heavy. Craig Thompson is Peter’s team leader and bears much of the responsibility.
  • Peter’s parents’ travel to Taiwan.
  • Peter’s main doctor and surgeon is Dr. Zeng (曾醫師).
  • Praise for Dr. Peter Ruan being able to come over and help us last night.

Tuesday, September 22, 2009

Update #1 on Peter

On September 22, 2009 at approximately 9AM Taiwan time, our teammate and friend, Peter Bennett, sustained a head injury when struck by a car as he was crossing the street in Yonghe, a suburb of the capital city of Taipei.

I'm sure each person learning of Peter's accident would like to know more about Peter, his condition, and the accident. Those of us who are here in Taipei still don't have a full understanding of what happened. At first, we thought he was on his bike... later we found out he was on foot. My point is that even our perspective is cloudy, but we will do the best we can to make this a place for people who care about Peter to come and learn what to pray about and encourage Peter, his family, friends, and co-workers. Please leave comments and we will make sure Peter's family sees each word.

First... the difficult basic facts of Peter's condition:
  • The injury is at the back of the head.
  • Peter's skull is fractured just to the right of center.
  • Peter's injury is serious.
  • He is in the Intensive Care Unit.
  • The next few days are very critical.
  • The biggest danger seems to be hemorrhaging (bleeding) of the brain.
Second... some of the positive things and encouraging signs:
  • Peter is moving his feet, legs, arms, and hands.
  • Peter could breathe on his own if needed but is on a machine to help him breathe for now just to give a little help.
  • Peter's circulatory system seems OK.
  • Although the car must have hit Peter's legs, his legs are not broken.
  • For now, the best news is that the pressure on his brain is under 20. 20 what? I don't know yet. When I know more, I'll share it here. But the important thing to know for now is that anything in the teens is good and over 20 can indicate brain hemorrhaging. This afternoon the monitor was usually between 16 and 18.
  • Although we can't be physically beside his bed at all times as we would prefer... we have a plan for someone to be at the hospital at all times (in shifts) to continue to serve, pray, learn, and be Peter's advocate.
  • I'm debating if this belongs in the positive news section, but I'm putting it here... At one point this afternoon, Peter broke the restraints on his wrists and tore the breathing tube out of his mouth. It is impossible to know how purposeful of an action that was, but I appreciate the fight in Peter! There will be times he needs to rest, but I was glad to see that fighting spirit and strong will.
Third... some other information of interest:
  • Peter had a procedure around noon to implant the intra-cranial pressure monitor. This procedure went normally and he was stable.
  • Peter's mother is scheduled to arrive in Taipei on Wednesday, September 23 at 8:30PM. His dad is trying to get a passport and make a trip soon.
  • Peter is an Ozark Christian College graduate. I spoke with Chris Dewelt at Ozark Christian College on Tuesday morning before his first class to ask the OCC family to pray for Peter during classes and chapel today.
  • We were quickly in touch with the Team Expansion home office and encouraged by their support and prayers.
I'm sorry I can't write more now. We will do our best to pass on relevant details of Peter's situation and progress here in the coming hours and days. We'll share more of the timeline in another post.