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Dr. Frank Tupper, Our Dad
2/17/2017 Latest post:
Dr. E. Frank Tupper, our sweet dad and beloved professor and friend to so many, suffered a fall sometime overnight Sunday that caused a catastrophic spinal injury with paralysis. He is in ICU at University Hospital.
Some time during the night on Sunday, February 12, our dad fell in his bedroom and found himself unable to move. About 12-14 hours later, around 2 pm Monday, our dear housekeeper Lety found him face down on his bedroom floor with a bloody face. She called 911 and then me. By the grace of the universe, I had just left a conference and was heading home to work the rest of the afternoon. At the time that she called, I was right outside of the neighborhood where both Dad and my family live. I was to his side in three minutes.
He was paralyzed but conscious. He said he tripped in the night and "went down like a stone," but then he could not get up. He asked me to first bend down so he could see my face and then asked me to stay with him so he would not be alone after being alone all night. The ambulance arrived and quickly assessed that he needed to go to University of Louisvile Hospital, the city's only trauma center, instead of our preferred Baptist East. Dad could not move and complained of shoulder pain, but he was conscious and alert throughout transport. The EMTs told me he did not present as a stroke victim but as someone with a spinal or neck injury. My brother Elgin beat the ambulance to the hospital and together we waited for the trauma team to assess him.
Early x-rays indicated no major breaks, but an MRI revealed damage to the bone ligaments around the C3 to C5 vertebrae in the neck, putting pressure on the spinal cord, and the C6 vertebrae had herniated. Apparently in his fall, Dad landed face first, hyperextending the neck and shattering the material that held his spine together and protected the spinal cord. The pressure on the cord caused the paralysis. The one bit of hope as we heard this devastating news is that the injury is "incomplete," meaning the cord was not severed, so no one can anticipate the extent of the damage until emergency surgery removes the pressure from his cord and the swelling decreases around the cord. The danger primarily involved the location of injury -- that particular area of the spinal cord controls breathing and swallowing, so we were warned of the prospect that he may not come off of the ventilator after surgery.
The night was long and the grief and shock were overwhelming. We waited overnight for the neurosurgeons to operate. Dad came out of surgery well on Tuesday morning around three and was moved to ICU at University Hospital on a ventilator. Tuesday was focused entirely on watching his diaphragm to determine if he would be able to breathe on his own. With great celebration the doctors were able to extubate him late Tuesday. This enabled him to begin to communicate, albeit minimally and sporadically and largely to communicate pain.
Since then, the days have been a hazy whirlwind. Dad is being treated on multiple levels in ICU. He is considered a neurology patient because of the nature of his injury. His neurosurgeon, Dr. Mansfield, is top notch and extremely attentive both to Dad and to me and Elgin. Dad is very susceptible to pneumonia (has had it four times since May) and has had trouble with secretions in his lungs, so he is closely monitored by respiratory doctors. He constantly requests suction of material in his throat. At one low point, the doctors were concerned he would need to be placed back on the ventilator. So far that has not happened and his lungs and breathing continue to improve. His blood pressure is intentionally elevated to increase blood flow around the spinal injury to aid in healing. Dad needed a PICC line for one particular medication related to his heart, which ultimately will be useful to limit the number of IVs going into his arms. He had one bad reaction to a different heart medicine at one point and entered a-fib, but the doctors were able to get that under control with other medicine. He also is receiving early therapies -- speech therapy, occupational therapy, physical therapy. He has not yet passed the swallow test, meaning he does not have enough control over the muscles in his neck to ensure he swallows into his throat instead of his lungs. For that reason, he needs a feeding tube through his nose directly to his stomach to receive nutrition. Several attempts to insert the tube failed (you can imagine how unpleasant that was for him), so he is now awaiting a tube insertion with a camera and mild sedation.
As of today, which is Friday -- five days post-accident and four days since discovery -- his vitals are strong but he is at risk on many levels. He must have a feeding tube for nutrition. His lungs must remain clear or he risks return to the ventilator. His blood pressure must remain steady. And through it all, we need his attitude to be positive, even though he is confused and terrified and frustrated. We have zero prognosis yet as to the extent of his spinal cord injury, but we do not expect any return to his prior full activity. We will not know the full extent of the damage until the swelling is down and he is stable and communicating. For now, he is mostly alert -- though insanely exhausted -- and able to speak a few words at a time very softly, though it is a struggle. He is very aware of his surroundings and knows what happened to him. Elgin and I are splitting shifts so that one of us is with him almost around the clock. He needs constant attention, reassurance, hand holding and dabbing with a cool cloth, plus all of the various breathing and muscle exercises.
Dad is expected to remain in ICU for at least a week, then we anticipate another week on the hospital floor, and approximately six weeks at Frazier Rehab Center. Frazier is one of the finest spinal cord rehab facilities in the country, so we are lucky that it is literally across the street. And already Frazier is preparing to receive him.
I started this page because I know my dad has touched so many lives across the country and many, many people care about him. I thank you so much for being his community and including him in your prayers. I will update this site as I am able, and please forgive me for being unable to respond to all of your calls and messages. To be honest, I am still in shock. This is incredibly overwhelming and terribly sad. We love our dad fiercely -- he gave us his very all after my mom died and raised us with unquantifiable strength, and now we are trying to return that dedication and strength to him. We hope to show him in coming days what a fighter he is -- after all, this is the gift he has given us -- because he has a long hard fight ahead.