It's been a while since we've done an update so I will do my best to fit everything in a post. 

Overall, mom is doing well. After transferring to Encompass Rehab in April, mom was there for about 6 weeks. We really liked Encompass and she did well there. It was evident that the left foot drop was not something that could be resolved through PT, and she still had the internal fixator in her pelvis which inhibited a lot of physical progress. She also was healing from the large abdominal surgery and adjusting to life with an ileostomy. The mid-line incision is just about fully healed with one very small area left. The ileostomy has proven to be a bit challenging. It is working well, which we are thankful for, but the placement of it is tricky and it leaks quite often. Wound and skin care teams meet with her frequently to replace the bag and try and prevent leaking. This works sometimes 😊 That is set to be reversed in October, but we are hoping there is potential it could be reversed earlier. 

While at Encompass mom did continue to have some issues with UTIs. She was transported to Sanford in May and spent a few days in the ICU and then the regular hospital as the bacteria is now VRE which means it is resistant to most antibiotics. The infection impacts her body quite a bit and makes her very nauseous, so she wasn't really able to eat or drink anything and ended up really dehydrated and with a low blood pressure that needed some IV pressers to support. While in the ICU they placed an arterial line to check and see if her blood pressure was truly as low as the arm cuff was reading, and we learned that it was actually almost 20 points higher when measured with the arterial line, which was great news! They think the reason it runs low in the first place is because she was low on iron from not eating enough.She got an iron infusion and was moved out of ICU and doing well. We met with the Urologists and they replaced the stent and set a date to get those kidney stones blasted. We finally blasted the kidney stones which were causing the recurring UTIs. This procedure went well, though there are still some pieces of the stones left. For now they're not in a spot where they are causing issues, but we do have to be extra cautious when there is an infection because the ridges on those kidney stones can hold onto infection. 

We then transferred to Vermillion to the Care Center here. She had gotten off the feeding tube while at Encompass, which was great. They tried a few different combinations of medicine to increase her appetite, which worked well for that, but in turn made her very tired and a bit confused and we ultimately decided  the dosing was too high. While at Vermillion she was doing well at the beginning, but I don't think she had fully cleared her UTI and ended up sick again. They transferred her from the Care Center back up to Sanford in Sioux Falls which is where she is currently. We know the signs to look for (not eating, nauseous , not feeling well) and so were adamant that they do blood work etc and so we caught it early enough that she didn't need any time in the ICU, but did need some IV antibiotics. They got that under control, and decided that it was best to go back to the feeding tube, which we agreed. Each time she gets sick and isn't eating, her stomach seems to contract itself again and we start all over with increasing appetite and ability to eat larger quantities. They started off with continual tube feeds and water bolus' to expand the stomach, and have slowed to tube feeds after meals to allow her the opportunity to eat, which she does! For now she just has the NG feeding tube, as the surgery team doesn't want to place a peg tube just yet. They also adjusted some of the medication that she is on to try and decrease the amount of nausea that she has which has really helped. 

As for surgeries- she had a procedure yesterday to finally remove the internal fixator in the pelvis. It was definitely time for it to come out, as it caused a lot of discomfort for her and was almost to the point of poking out through the skin (likely due to the large amount of weight loss she has had). That was a quick and easy procedure with only two small incisions. During that procedure Dr. Van Demark also surgically bent her left knee, as so long in bed had caused a build up of scar tissue and the inability to bend it. For the foot drop, we met with Van Demark in early June and he referred us to an orthopedic surgeon who specializes in foot and ankle procedures. We were expecting a fusion surgery that would surgically place the foot in a position to be able to walk, and fuse the bone. Instead, he thinks she would do well with an external fixator placed on the ankle for a maximum of 6 months. He said the likelihood of walking again with this procedure is 90%. While on one hand it seems exhausting to add that much more time to the recovery, we also want her to have the best quality of life possible. Because the external fixation has such a high risk of infection, the surgeon doesn't want to do it until the ostomy is reversed. We will see what her surgery team says, but maybe we can speed up that ostomy reversal a bit! So if we're keeping track of surgeries remaining, that leaves 3! The reversal, the foot/ankle, and the eventual total hip. Slowly but surely we are making progress.

We're looking at getting mom transferred back to Vermillion, hopefully to the swing bed. Of course this is all dependent on insurance. It feels nice to be back in the Sanford hospital system. We saw one of the trauma surgeons that was part of mom's care in the beginning and he recognized me in the hallway and I gave him the full run down on the last 8 months and he came in to talk with her, and has stopped in to see her quite a few times since. It is so hard being in multiple different hospital systems to have one team keep track of you throughout. It was nice to get on the same page with the surgery team, and we look forward to coming up with the best plan moving forward. 

I know it's been a while since we've updated here, and I appreciate everyone's patience and people reaching out individually. Mom has been pretty good at keeping people updated and we're always happy to answer questions when asked. If we're being honest, we're on day 268 of the hospital and this journey has been exhausting. While we haven't posted in a while, we still live this reality daily. After the longest few months in Omaha, it has been nice to slow down a little bit. We couldn't get through this season of life without our friends and families. Thank you so much for the continued prayers, and please keep them coming! My mom has been such a trooper throughout this whole process. She keeps a positive attitude and always has us laughing. We love her so much, and we are so thankful she's getting better. Returning to a new normal after the accident has taken a much different course than any of us could have thought, and there is still so much unknown about the future. Please continue to pray for guidance for both our family and her team of doctors as we move forward. Pray for continued resilience for my mom and pray that we, as a family, continue to support her in the best way we can.