As we wrap up week 8, it seems like a good time to recap.
We may never know how this happened. On January 4th Derek was admitted to Sacred Heart with flu-like symptoms and extremely intense pain in his left thigh. The soundest theory we have is Derek developed an infection of a common form, Strep A. He pulled a muscle in his left thigh and the necrotizing fasciitis (flesh eating bacteria) found the internal torn tissue and spread.
Derek did go into septic shock and his kidneys shut down. After being transported to Harborview in Seattle on January 15th, Derek contracted yet another complication (after a few more bacteria had arrived complicating matters) – a fungus, mucor. This is aggressive, invasive and invisible and led to further skin and tissue removal as well as some muscle in his left leg, groin area and left flank.
On January 21st, Derek’s left leg was amputated as a life-saving measure. On February 3rd, an unrelated issue transpired – a perforated bowel – and 2 feet of his small intestines were removed. Pathology reports indicated matting of the small intestines and inflammation. This surgery set back recovery by about 2 weeks.
Derek has been intubated numerous times, on continuous dialysis as well as intermittent, and taken to the Operating Room more than 20 times in this time period. After 6 weeks in the ICU, Derek was transferred to an acute care floor on February 15th. On Monday, February 25th, his dialysis port was removed from his chest as his kidneys “woke up” after 2 months of dialysis treatment. This was a huge win and a banner day!
At the onset, Harborview dedicated 5 teams to Derek – Infectious Disease, Nephrology, General Surgery, Plastic Surgery and Intensivists on the Intensive Care Unit. He continues to work with Rehabilitation, Occupational Therapy, Physical Therapy and Speech Therapy (which includes cognitive and memory).
All things considered, Derek’s outlook is positive and we talk about adjustments to be made to continue an active, vibrant lifestyle. The challenges as anyone can imagine, are the mountain of side effects (including nutrition and stretching the stomach out and getting recalibrated from the motherlode of medication) and enduring the long hospital stay.
Next Steps? Continue to build endurance each day and re-learning daily movements and tasks including as a starting point, how to walk using a walker. Once Derek meets hospital discharge requirements, he will either be transferred to a skilled nursing facility or an intensive rehabilitation facility. When and which facility is to be determined based on daily changing factors and his care team recommendations. Derek will use a wheel chair some and eventually, mostly crutches - and as a last phase a prosthetic from the left hip.
Words can not express our profound gratitude for the outpouring of love, support and prayers. All of it has kept us strong and moving forward and we can not thank each and every one of you enough. We continue to receive offers of “whatever you need . . .” Believe it or not, we still don’t know and may not until we get home.
There have been donations made to the Caring Bridge site, which fully go toward the operation of the web site (which is a wonderful central communication forum).
If you feel compelled to donate to the family a benefit fund has been set up, details below. Again, exact needs are still to be determined.
With much love and gratitude, Kaarin and Family
Donations may be made at any STCU branch or location to the "Derek Appel Benefit Fund". Donations may also be mailed to: Derek Appel Benefit Fund, C/O STCU, 106 W Nora Ave, Spokane, WA 99205.
-------------------------------------------------------------------------------------------------------------------------------------------------------------- Initial Post:As many have heard, Derek has been in the ICU at Sacred Heart. In an effort to keep succinct updates and put growing phone trees to rest, this page has been created. Please out of respect for privacy, we ask that this Not be shared on social media.
Derek developed an infection of a common form of Strep A, except that the infection was in the tissue of his leg where it can cause a lot of issues. This is very rare (roughly 1 in 250,000 in the US) and is most prevalent in obese/diabetic individuals, which Derek is not. The condition is necrotizing fasciitis (I strongly encourage you to not look this up, unless you are tolerant of graphic medical images).
Essentially, the bacteria kills the skin tissue and stays in the fat between the skin and muscle tissue. It is difficult to kill the bacteria, as antibiotics are poorly delivered and distributed in the fat tissue due to being lipophobic, as well as poor blood contact with the fat tissue.
The infection spread quickly, and he had to be intubated and sedated in the very early hours of Saturday morning, January 5th. He went into septic shock. The only real way to get rid of the bacteria and infected tissue is to surgically remove the infected skin and fat tissue while continuing antibiotics to keep the bacteria out of the rest of the body.
Derek had 5 surgeries in as many days on his left leg and a few neighboring smaller patches on the side. His fifth time to the operating room proved more promising with no bacteria found and they only did a bit of clean up and wound care. As of Wednesday, January 9th Derek began breathing on his own. Continuous dialysis was in place until Friday, January 11th when they moved him to regular dialysis. As of the 11th, Derek continues to receive the best care in the ICU at Sacred Heart Medical Center and is progressing each day.
The road to recovery will be long. Derek will need extensive skin grafts and plastic surgery at Harborview Medical Center in Seattle. This is the best trauma center in 8 states where they perform these procedures routinely. If all continues to move in a positive direction, his time at Harborview will likely be more than 4 weeks (to be determined by surgical team). He is scheduled to be flown there the week of January 14th.
We’ve received an outpouring of amazing support and each day everything that needed to be addressed has fallen into place. It is a bit early to know what is needed and when. We have a solid plan in place for Derek’s time at Harborview with the kiddos staying in their schools and participating in routine activities thanks to our incredible family and neighbors, including managing household chores.
The offers for naps at homes, meals, rides, groceries, on and on, continue to come in and are much appreciated. The power of prayer has provided strength in so many different ways and we ask that prayer continues for Derek’s healing and everyone’s strength as we move forward.
We have been accepting offers of support and will continue to do so as the ‘need of the day’ arises. I have a queue going and will be following up! Potentially, an online platform that offers a coordinated support function may be put in place, it is just too early for that at this time.
Again, the outpouring of love and support has been phenomenal, and is getting us through each day.
With much love and gratitude and prayers for Derek’s healing, Kaarin and his entire family
PS - Please note the donation requested from Caring Bridge is solely for their operations and does not go to the family.
Today was Derek’s second return to the ski slopes. So Proud!! He’s figuring the mechanics of it all and says it feels more like it will be fun again instead of just doable.
We’re seeing our ski hill family again little by little. Greeted with “There’s the miracle man,” and “Amazing.” I couldn’t agree more and it’s pretty great to be on the mountain this February instead of the ICU and Harborview. Thank you to everyone there, at Sacred Heart and St Luke’s as well as our families, friends, and those we don’t even know internationally who prayed and kept us moving forward.
With endless gratitude, Derek, Kaarin & Girls
PS - Apparently can no longer attach a video that is not via YouTube here. Sorry ‘bout that. The video’s rather impressive. 😊
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On the Hoks by the cabin.
Our first time back was complete with the power going out and ...
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