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Derek is in intensive care suffering from a bleed to his brain (or a AVM), and is expected to be there for the next several weeks. We don't know when he'll be conscious. He is at this time on a ventilator and heavily sedated. His condition is critical.

Thank you for supporting us, we're certainly not giving up. But until we know more his wife, his parents, and I are spending this time with him.

It's very late, and this was very sudden. I'll check back when I can.

- Swoopy

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Originally posted by Kil
Needless to say, our thoughts are with Derek, his wife Susan, friends and family, and of course, Swoopy…

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Originally posted by Kil

Last night I dropped in at Skepticality site to see what was new over in those parts. Turns out all is not well. Along with this there is an update thread here.

Derek was admitted into the hostpital for what Swoopy describes as a #8220;bleed to his brain (or a AVM)#8221;.

From Swoopy#8217;s original post on Derek#8217;s condition:

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Derek is in intensive care suffering from a bleed to his brain (or a AVM), and is expected to be there for the next several weeks. We don't know when he'll be conscious. He is at this time on a ventilator and heavily sedated. His condition is critical.

Thank you for supporting us, we're certainly not giving up. But until we know more his wife, his parents, and I are spending this time with him.

It's very late, and this was very sudden. I'll check back when I can.

- Swoopy

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Swoopy has posted some encouraging updates on Derek#8217;s progress.

I will try to keep you posted on Derek#8217;s recover. Swoopy will be posting updates on how Derek is doing in the Update Thread at the Skepticality site.

Needless to say, our thoughts are with Derek, his wife Susan, friends and family, and of course, Swoopy#8230;

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Has it been a week yet? It's amazing how time plays tricks with your head. Here we are, not yet 48 hours out, and it feels like forever.

People are the power. I've always said faith is part of what a church supports, but the bulk of it is community. The community outreach from so so many people, people we know here at home, people we talk to all the time, people we've never met. That's the greatest power I've ever seen. It reaches out and is a comfort when it's late and I'm not sure how I'm going to keep going. And then I read an email from someone, offering Susan and I anything they can, and it helps. We're a little overwhelmed right now, to say the least, so we're thanking people but not really even knowing what we need. Other than something that turns back time and makes people indestructible.

So..this thing about the stages of grief, there's something in there about unrealistic euphoria I'm sure. I think we had that a bit yesterday. It was good, because we do know that even at the most basic level, Derek has comprehension. The majority of the bleed is on the right side of his brain. This means his left side is physically weak, but speech and comprehension are left brain. Fingers and toes move. And that's all really good.

Last night, no temperature, blood pressure stable, cranial pressure 19. Not far off of normal (up to 13). Overnight, blood pressure skyrocketed. Cranial pressure increased up to 31. They have plans to put a larger catheter in his head for more drainage. The balance of cerebral spinal fluid around the brain is a very delicate balance. So getting the blood out, and allowing the fluid to regenerate and maintain normal pressure is complicated.

And they're leaning more towards calling the "event" that caused this a stroke of sorts. However, they still don't know why it happened. And thus they can't predict if it will happen again. We were told, that if he were to have another hemorrhage at this point, it would probably be fatal. We all in our minds know this, of course. But it's not what you want to hear at 7 in the morning on the phone from a doctor you don't know. The next 48 to 72 hours will be helpful in evaluating which direction he's headed in.

I haven't really slept much, so I didn't go to the early hospital visit today. However, reports from Susan and his parents are that he is still very cognitive. He's moving in response to commands, and is aware of those around him. After the night he had, I'm thrilled. This also though warrants a little care on our parts, because it's important that he not be over stimulated. He needs to remain calm, and so fewer visitors - though it's been amazing how people have been visiting, is for the best right now. There is a very short evening visit, and I'm going to see him then.

An update came (just now on the phone) from a friend who was there reading to Derek, which is awesome but I think we may limit that for now, to let us know that they have put him on a new blood pressure medication, and his blood pressure has returned to safe levels and the intercranial pressure is back to 21. So. Ups and downs.

Again, it's all brand new. 24-72 hours after ANY type of event like this is the most critical, and we're not even there yet. I still have my hopes for the coming week.

My plan is now, is to find out what steps they are going to take in order to further diagnose - and subsequently treat the problem. They have stated because of the BB...I still say it's how the aliens are tracking him...they can't do an MRI. Is it more important to DO one, and take out that silly BB from his sinus? So, this will be what I discuss with the doctor when he makes rounds tomorrow.

So, that's it for now. Possibly more later. And hopefully I'll post up some stuff to the feed as well.

Love,
Swoopy

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Swoopy:

Today began early, we all went to the hospital before 7 so that we could meet the doctor when he came to do rounds. Visiting started at 8, and we went in to see a Derek that was much unchanged from the night before. Which was a good thing to see. Still stable, pressure pretty good. Derek's mom leaned in and told him she loved him, and got a hand squeeze in return. This is the best way to start a day right now, for sure.

We were able to meet the weekend neurologist, who comes well recommended and seems very skilled and also compassionate. Though upfront about the fact that while Derek is as he continually says "holding his own" during this critical period, that sudden changes could be dire and that we were doing well but far from out of the woods. It's important to keep perspective, and I know that's what he was doing, but it's something very hard for all of us to hear. We went home for a little rest.

In the afternoon the phone rang and the Dr. was advising us that Derek's catheter that is draining the blood and fluid out of his head to prevent pressure build up, wasn't doing the job and appeared to be a little clogged. They had flushed it several times without success, and as his pressure was up they wanted to insert a new line.

There was danger that this could disrupt the clot that was preventing a further bleed, but it had to be done. Susan of course consented and asked if we should go to the hospital. We were assured (I listen in on the extension during calls) that we should stay put, and that as soon as he was finished the doctor would call back. After the longest twenty minutes, although truly a short time for such an intricate procedure, the phone rang again and we were told that it went very well. The new line was working excellently and the pressure was decreasing as well. Sigh of relief, yet another scary, but mostly positive step.

We returned for an afternoon visit, and he looked good. His color was still good, his skin is cool and dry to the touch, still no fever. All of his functions, blood pressure, heart rate, sodium levels, glucose levels, urine output..and much much more, were good. But he'd had a hard afternoon, in energy expenditure terms, and was heavily sedated. I did get a squeeze out of both hands, which is what we live for. Susan wiped his face a little, and I confirmed that he was about to start getting some nutritional support, which is key to keeping his digestive system in working order. Pupils are both active and responsive. We left, reassured and hopeful for a good night.

We'll be headed back early tomorrow, again to make sure we see the doctor, which means I'm headed for a few hours of sleep. Derek's parents only just went to do the same, and Susan is resting too. She mentioned she made a post this afternoon, but I haven't gone to see it yet. I think it really helps her to see how many people are including her in their thoughts here. So thank you again.

It's expected he'll have another CT scan tomorrow, which may bring more answers. More updates as we have them, hopefully good ones. Every stable day, brings us closer to our goal. Night.

- Swoopy

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This morning we were ready to go to the hospital when we got another one of those unexpected hospital calls that stops all of our hearts. Derek needed yet another drain installed in his head, his blood pressure was way up, cranial pressure too. Dangerously so.

They had done another CT scan, which I was able to get a look at. The white solids on the scan, showing the clots, were too large and too many. Also, the first notice that I had that his brain itself was being pushed slightly off-center because of the pressure.

We went ahead to the hospital and after the procedure spoke with the doctor. The continued problem is that his brain is making the cerebral fluid it needs and filling his head, but the clots are already in residence taking up space. Thus the pressure, unless the fluid is drained off. The clots are making it hard for fluid to reach the drains properly, so their placement is critical. Derek now has left and right side drains in place.

After a bit of time his cranial pressure decreased some, but not nearly as much as anyone would like. His blood pressure too, dropped a bit, but it is the plan to allow the blood pressure to remain slightly elevated in an attempted to effuse the fluids from his head.

Complicating matters was another bronchoscopy to flush out his lungs due to the aspiration of stomach fluids when he fell unconscious initially. These fluids contained stomach acids and bile and scorched the delicate lung tissues, irritating his lungs. Derek has contracted a form of pneumonia, which was expected to a degree, and is common for patience on a ventilator. He is receiving 100% oxygen to aid in his breathing, and doing no breathing of his own.

The doctors are very concerned about his condition and are monitoring him very closely, continuing to give excellent care. But it was mentioned that his condition as of today was deteriorated slightly, and should the decline continue, Derek's chance of survival would be very low. It's important that we know the reality of the situation, but it's still devastating every time we're reminded of it.

The blessing is that he is still heavily sedated, and feeling no pain. Selfishly, we're hurting the most right now, but it helps knowing he isn't.

At our end of day visit, his condition was relatively unchanged from earlier in the day, which means he's holding steady and that's good. Not much improvement, but not much backsliding either as far as we can tell.

The next five days, we've been told, as the clot breaks down from the thick state it is in now, that is impeding progress, to a liquid that will allow more drainage is the most critical. If Derek can remain stable through this time we'll be a big step closer towards recovery. Five days from now sounds like eternity, as it has only been four days now since it all began.

Thank you again to everyone who has offered meals and support, and anything we could ever need. We're not really taking much right now in the way of food offers, as we're going out usually one meal a day just to be out in the world and breathe some fresh air, and see that normal life is going on around us. As we move further along, and the ability to exhale becomes a possibility, we may very well call on your generosity again.

I'll send more, as I know it. Tomorrow will start off well, if we can skip that morning phone call.

- Swoopy

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Swoopy:

Short Update tonight. Brevity for sake of additional sleep

Remember when I said that it would be a good day if the phone didn't ring this morning?

It was a good day. No phone call. No additional drain required. The existing drains were flushed. The doctor who treated Derek upon his arrival in emergency is back from his out of town time, and was able to evaluate Derek after the weekend and he was in the company of the other two neurologists on his case. He took some time to talk to all of us, and we are as always, reassured by his forthright and informative manner. He puts us all at ease, and we'll take any ease we can get right now.

Derek's drains seem to be well placed around the main clot, in the center. In flushing the drain on either side, flow would be produced to the other drain, so a good space has been created for drainage. Another piece of information we enjoyed was the possible speculation that intracranial pressure readings are not as high as they appear, as the pressure next to the clot where the drains are is higher than in the rest of his head.

The CT shows that he does have some space in his head, and that's good. If we can continue to keep pressures at reasonable levels as the clot absorbs slowly and begins to break down, we'll be on our way toward getting our Derek back. If we can hold steady through the week, his prognosis will be much better in the long run. Though the time it will take for the clot to reabsorb and break down is another couple of weeks or more.

His lungs are being treated, and he has medication being given via the ventilator to mend damage to his lungs and ease his breathing. He's still on 100% oxygen.

He did get another feeding today through a tube, it's a lovely looking concoction called Fibersource. He got a central line so he doesn't have so many IV lines in his arms. His heart rate is a bit higher today, but his pressure is holding (still high) but where they want it to help his brain drain off the fluids. And no fever to speak of, though he gets to lay on this nifty cooling blanket that is set at forty degrees and compression stockings that pulsate to keep the circulation in his legs moving, so prevent any blood clots there.

Derek's parents came in such a hurry they didn't bring much in the way clothes. After the hospital we did a little necessary shopping, and we treated ourselves to new pajamas. Mine have monkeys on them, and Derek's dad has sock monkeys on his pajama pants. It's the little things that are giving us smiles right now.

Susan's best friend Jennifer invited me to dinner at her house with her and her husband, and it was nice to be out of the fray for a bit and play with their cats. Then she took me to the hospital to meet up with everyone for the evening visit.

This evening Derek's condition was relatively unchanged from the morning, and in fact his intracranial pressure was down a bit more. I spoke briefly with Derek's primary doctor, and he said he had flushed the catheters again and had gotten some small bits of clot flushed out in the process.

Susan was speaking to her brother on the phone and summed it up pretty well. "Yesterday was a bad day, because I spent it being afraid he was about to die. Today was a good day, because he hadn't gotten any worse."

Susan just mentioned to me how even though it's nearly the beginning of our fifth day, it feels much like it did on the first day..when we were amazed it had only been 24 hours. We're comparing it to Groundhog Day, (the movie.....not the holiday). Every day begins pretty much the same, continues the same, ends the same. But we know one day it will change.

We had a toast at dinner tonight to hoping for "two good days" in a row. Here's hoping for another phone call free morning. Thanks again for all the care and concern, and also for the offers of food and help. Trust me, we'll be accepting them when we're ready.

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Swoopy:

One of Derek's newest and seemingly fated to be best friends is author Michael A. Stackpole. His books include many Star Wars titles including New York Times bestseller, I Jedi.

As if being an author, an editor, and a designer of computer and role playing games wasn't enough, Mr. Stackpole is also a skeptic and a podcaster with a great show called The Secrets. He is also the driving force behind The Science Fiction Podcasting Network.

Derek spent most of Dragon Con weekend hanging out with Mike, in fact I hardly saw them apart the whole weekend. In the panic following our arrival at the emergency room on a night that seems very far away now, I began dialing numbers on Derek's cell phone, and Mike was the second person I called. He sent this file to me only a couple of days after Derek became ill, and now seems like a good time to share it with all of you.

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Swoopy:

Another call free morning. :)

And all of Derek's numbers were pretty much the same today as yesterday. They did do another CT scan this morning because even with flushing, the catheters in his head were not really producing anything and the doctors wanted to see if there was a new area they could tap into to get more fluid out. The CT showed his drains were placed as well as they could be for now, so they would closely monitor his intracranial pressure and continue to flush.

This evening his nurse was reporting intracranial pressures in the single digits. The obvious reaction to this would be elation. His doctors weren't available when we were there, as it appeared there was an emergency trauma they were responding to in the ER. If these numbers are accurate, and as I reported yesterday his doctor mentioned the high numbers might be reporting higher than actual due to the position of the drains next to the clot, it would be an excellent thing. I'm a skeptic. When I hear it from his doctor, I'll be a believer. :)

Derek is still getting nutrition through a feeding tube, and was running a very low grade fever today that was being kept in check by the cooling blanket. Still under heavy sedation, but his pupils are still reactive and all that. So he's in there, hanging out, until we've healed his brain enough that it's safe for him to wake up.

During the CT scan his oxygen levels dropped some, and he had another bronchoscopy to clear his lungs, which was reported to be productive in clearing them out some more. He was on 60 percent oxygen this evening, down from the 100 percent he had been needing the last couple of days.

So all an all, stability. We're thrilled. Two good days in a row, we're going for three.

-Swoopy

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