Dave Mackey update 060615

Dave encouraged me to blog about his current state and to share that with people who are interested.  I have been not doing that because I feel that while this story is in the public domain to some degree, this could be a matter that he would want to maintain some privacy on.  But he encouraged me multiple times to share.  So here is a mix of what I understand from Dave, Ellen, Jeff, with some of my own opinions mixed in from my visit today.

JZ was down at the DAC HQ to participate in the NYLT camp orientation (a Scout thing).  As he was finishing up, I got a call from JV that he was going to visit Dave.  I was not expecting Dave to take visitors as he was just in a lengthy surgery yesterday but when I got the word Jeff was over there, and given we were so close, I bolted over.

Dave went a 7 hour surgery yesterday.  He is now in the SICU to best assure good recovery.  This is I think his fifth, maybe sixth surgery he has had since the accident on May 23.  On Wednesday he had a surgery  (that is the surgery before this one yesterday)  that had replaced all the hardware they had put in his leg.  They did this as he was getting feverish and the concern was for infection in/around the hardware, in the leg.  So they went in, took out all the hardware that was in there and replaced it.   They found that some of the bone that they had tried to pin together was not going to make it, and so they took that out.  This left a space in a tibia and so they have put in an interim spacer in there.  Down the road, this will need to be replaced.  That replacement will need to come from bone they harvest from elsewhere in his body – probably his right femur. 

Yes – that is right – they are going to take bone from him healthy right upper leg to heal his lower left leg.  Basically, they are leveraging good parts of him to heal the broken part of him.  When I think about it, that is just an incredible feat of medicine and healing. 

This started with the “gastroc flip” surgery that they did some time ago.  As there is so little musculature / vasculature on the front of the shin there is little blood flow to this area.  In a healthy leg, this not a problem but when trying to heal a traumatic injury like this – you need that blood flowing to that area.  By bringing the muscle to this area, it brings blood flow to help healing.

When I saw him on Thursday, the plan was to take additional muscle from his back to add to the vasculature in this area to further aid this process.  It was decided after that rather than taking muscle from his back would take some from his left quad.  I think they did this because a graft of skin had already been taking from this area and that meant they were taking muscle from an area that had already been acted on rather than creating a new area to manage on the back.  They also took some skin from his right quad to graft onto the wound on the right leg. 

Yeah, it is a lot of stuff.  A lot of stuff.  As you’d expect, there is a lot of pain that comes with these sort of procedures.  And so with that, pain killers.  I can’t even imagine that.  Between the mix of the sea swirl of opiates and the throbbing of pain and heck, just being bed ridden for this long.

So I saw him today after that long day yesterday.  He is in a heated room (88 degrees) as that promotes circulation.  It was good to see him with Jeff because we gave each other some good natured crap, got in some laughs, etc.  While the dressing on his leg was bigger, he had new bandages on his upper thighs from this latest surgery, he looked better to me in the face.  On Thursday, he looked a bit withered to me, and today he looked stronger.  When I shared this with him, he attributed it to that he is now getting a blood transfusion.  His hemoglobin levels were around 7.5 when I saw him on Thursday, and so the transfusion seems to be helping that. 

The biggest risk at this point in my non medical opinion (as is all of this) is that it has been identified there is some infection in the lower left leg. They are looking to aggressively treat this with antibiotics, etc.

And so yes, there has been the question as to whether he will keep the leg.  My take is this: they are going to do what they can to make that happen.  And my take also this:  they should.  Dave recognizes that it may come to a point where keeping the leg is not feasible, and if that happens, he has a perspective on that … as in he is alive and loved.  ALIVE AND LOVED.   He is going to fight to get to be as whole as he was but there are uncountable number of challenges and steps to get to that.  And regardless of what turns this journey throws up at him, he is alive and loved.  And so there is an odd juxtaposition of attacking this thing to heal with everything he has got but somewhere also recognizing the realities of the situations and the gifts you have. 

Similarly seeing Dave creates a swirl of emotions:  sadness for what he is going through, relief that he is alive, hope for what he can do, gratitude for the fact that he lives in a place with such amazing care and technology, concern for those around him, inspiration to see him make a smile for those who visit him, love for the community …

More to come.  Post script – pic from Jeff at the awards of Pikes in 2012.