Tim Schmanski's blog

Afternoon update, 6:44pm:

Hello everyone,

I am so sorry and disappointed to report that Tori is once again in an ICU... This time it is in the UVRMC ICU and we unfortunately had another sprint down the hospital hallways experience as Tori's vital statistics plummeted due to another, quick acting and damaging Pneumonia. We were able to restore most of her vital statistics once we arrived at the ICU but now she under close observation for Septic Shock symptoms. I will provide a detailed update later tonight on today's adventure...

Please offer your prayers for Tori to conquer yet another unfortunate challenge.

Thank you all,

-Tim, Maria, Tori, Whitney and Brendan

Final update, 10:45pm

Well, Saturday night started very calmly as Tori had a great evening bath, was comfortably in bed and humming at
me as I reported in Saturday's update. She had her usual melatonin, bennedryl and valium doses to help her sleep. The only problem is she didn't... She did not seem agitated at all and her only difficulties were swallowing the saliva she was generating and an occasional cough. At 2:30am I decided to unplug her button trach and place the humidified air mask over her trach so she could breath a little easier and hopefully begin to sleep. I also gave her another valium. Her heart rate was a little higher than normal at 130-140 beats per minute, her blood oxygen level was fine at 98% and her respiratory rate was at 30-40 breathes per minute which was a little high as well. She had NO temperature and her phelgm was white and saliva like which is good as well.

She still didn't sleep however and at 5:30am I noticed her blood oxygen level was stuck between 88%-92% and it wouldn't come up even with suctioning or giving her 6 liters of oxygen input. This was very unusual so I had a respiratory technician come over to investigate. We gave her 100% oxygen and saw minimal blood oxygen improvement to 94% and if we turned it off Tori would quickly drop to 84%. We called the pulmonary doctor in and he was somewhat stumped as well but determined we should replace her button trach with a standard one just in case we needed to ventilate her. This proved to be a great decision. Tori's phlegm and blood cultures from two days ago were still fine so we took a chest x-ray at 6:30am and it also seemed void of any pneumonia. We all felt very uncomfortable with the unknowns of the situation and since Tori's temperature then jumped to 40 degrees Celsius it was time to move her to the ICU unit. One of the theories was that since we were fighting serious dehydration she might have taken on too much water... That proved not to be the case later.

Between 6:30am and 7:00am I saw her temperature spike and her respiratory rate go to 60 breathes per minute and I knew it was time to move. Prior to going into the elevator just outside of Tori's room her blood oxygen level was still 94%. By the time we went one floor down it had dropped drastically to 80% and it was time to SPRINT to the ICU which was all the way across the hospital!! I was pushing the bed myself as fast as I could with one nurse trying to guide the front and the other attempting to bag Tori. Her blood oxygen level continued to crash and her heart rate raced to 170 beats per minute. By the time we entered the new room in the ICU her blood oxygen was at 49%, heart rate at 180 beats per minute and her respiratory rate between 70-80 beats per minute. Yes, we have been in this position before...

The UVRMC ICU team moved very quickly and her ventilator was on and controlling her breathing within a couple minutes. They tried Ativan to calm her even though I told them it wouldn't touch her... So after a few minutes they administered Propolol instead which sedated her almost immediately. Unlike the last time at PCMC when Septic Shock immediately set in, Tori's vital statistics began to THANKFULLY improve!! I was honestly expecting and preparing for another repeat of the PCMC Septic Shock incident but it didn't seem to happen. So now Tori is in a close watch mode in case Septic Shock symptoms begin to appear.

After a while in the ICU unit the pulmonary doctor entered and informed us that she indeed has another pneumonia... We aren't sure which family of bacteria yet but Tori is getting 3 different types of the strongest antibiotics to battle it. We should find out much more tomorrow and they will keep Tori sedated throughout tonight so she can rest more comfortably. Her fever was also diminished just before we left the hospital tonight and it was at 38 degrees Celsius. The rest of her vital statistics were also in more normal ranges.

This is yet another case of why Tori CANNOT be anywhere else except for a hospital with ICU services. I'm sure the results would not have been positve if we would have had to move her any great distance...

Alright, I'm exhausted and I won't need any sedation tonight to sleep for sure...

Thank you everyone for your love, prayers and support,

-Tim, Maria, Tori, Whitney and Brendan

Hello again,

Tori was very tired for Maria Friday night and they both actually did get some good sleeping in. The troubling symptoms observed in previous nights were non existent. Tori's dehydration appears to be almost gone and we discontinued giving her any more water through her IV this afternoon. Now we are giving her 100 milliliters of water per hour through her J-Tube plus 30% of Tori's daily bilious output. Now if we can just stay on top of this and keep her hydrated at all times... The double calorie Jevity is still being used as well and I haven't reported Tori's weight yet because I don't believe their scales work very well here... The first time we weighed her the result was 81lbs and I KNOW that isn't correct!! The last time we tried 91lbs was reported and we don't believe it is correct either. We can visibly see she is heavier than the 94lb weight reported at PCMC. I'll now ask for a different scale or at least a calibration on the one in the unit.

The OT and PT team spent about 1.5 hours total with Tori today since it is Saturday and Tori only gets half of her therapies and NO speech therapy. Tori spent some more time in her wheelchair today and afterward she pretty much just rested and relaxed the remainder of the afternoon.

Tori is still experiencing some additional myoclonus or even 'flopping' when you attempt to reposition or move her. We raised Tori's Keppra back to the original 800 milligrams but it might take a couple days to catch up in her system. If the symptoms remain we will have to look at some of the new medications we are giving her. Tori also had a seizure today when we were changing her. It lasted about 10 seconds but her whole body was trembling and her eyes were rapidly moving from side to side. Another behavior we will have to watch for very closely... effect's on Tori.

We have kept Tori's button trach plugged for most of the day and I will keep it plugged tonight as well. We did here differently pitched 'hums' and sounds today. She is actually watching and humming at me while I am typing this update and that is definitely something new. We all pray and hope that words will be following those sounds sometime in the future.

Thanks again everyone!!

-Tim

Hi there!!

Tori's great start of sound sleeping Thursday night didn't last too long as she woke up at 1:00am and several times afterward. Valium was needed to calm her as she was visibly experiencing some pain. She had some cold sweats on her legs and she ended up biting her lip just a little as well. It was enough to use the bite guard once again though... The source of her pain wasn't realized until 7:00am or so when the blood test results taken yesterday were reviewed. Tori is still very dehydrated even with the additional water added to her feeds. We immediately had to place an IV in Tori's hand and begin administering water in this fashion. We are placing 150 milliliters of water per hour through the IV and we are also replacing 30% of Tori's bilious drainage with water as well.

Tori was looking much better by noon today with all of that water being used. Her occupational and physical therapists added some leg stretching to their usual arm routines. They also sat her in bed and had her reaching down past her knees towards her toes to stretch her entire back. The speech therapists continued to try and get a 'yes' and 'no' response and they felt they had some success today with the eye blinking approach. Tori is still inconsistent and delayed in her responses so it is hard to tell. Tori also had some taste testing with lemon juice which caused her to swallow quite quickly.

Tori had a stomach x-ray taken today to study her stomach and her GJ-Tube opening was looking much better today. The stomach x-ray did show some J-Tube looping in Tori's stomach but the end of the tube is still exactly where it needs to be. Since we couldn't stay for the last GJ-Tube placement we don't know if they looped the J-Tube or not. This is obviously an issue we will watch very closely moving forward.

We tried to lower Tori's Keppra dosage today but we don't believed it worked since Tori had her myoclonic jerks appearing again... So we will bump up the Keppra dosage back to the original amounts. We are going to be reducing the amounts of various medications to study the effect's on Tori. We are currently on about 9 basic medications which is FAR better than the 20 we used to be on...

There were alot of visitors today which was great!! I won't even try to list them all... We are expecting a large turnout during this first weekend at UVRMC.

How about a short report for tonight as I am really tired and Tori should be as well for Maria... Good night once again and thank you all!!

-Tim

Hello again,

Tori's sleeping pattern during Wednesday night was very intermittent and she probably ended up with only a few hours of total sleep... There was also a medication error on the charts so she was given a dose of melatonin in the morning just prior to her therapy sessions. This of course caused her to sleep pretty much through a couple of them...

Tori did wake up for the therapy sessions later in the day and once again we placed her in the wheelchair and went outside for a while. She had her arm and hand stretching completed while outside and she was able to track autos and look at the flowers. The fire truck and ambulance that went by with sirens and horns blaring did cause her to jump a bit as well. The speech therapists also completed their session outside and they are trying to get a consistent yes\no type response out of Tori. Whether it is a head shake for 'no' or a blink for 'yes', we must eventually get some consistency of response type. They also watched as Tori tracked various objects being moved in front of her face. When we returned to the room Maria gave Tori a great tooth brushing and mouth cleaning session and we placed her back in bed once we were done. Tori then watched and tracked on Whitney quite a bit.

Tori was visibly dehydrated today so we had to back off the Jevity 2.0 feeds and go back to the 1.0 feeds with more water added. The bilious amounts removed from her stomach is still quite large and all of that fluid must be replaced thought Tori's GJ-Tube. We also removed her trach plug and placed the heated and humidified air mask over her trach again. This will also provide much needed water to Tori's system. This unfortunately seems to be a constant battle for Tori and us...

Tori also had another GI doctor analyze her GJ-Tube opening and the stomach x-ray taken this afternoon. It has been looking rather red and sore lately and there has been some Bilious leakage around it. As a precaution, some antibiotics were ordered for Tori as well as some additional stomach care medications.

The most disconcerting news of the day was based on the results of Tori's MRI taken yesterday. We sat down with the rehabilitation doctor David and a neurologist and Tori's overall brain has definitely shrunken in size since the previous MRI's. It is somewhat expected after an injury like Tori's but it is still a negative finding and further analysis will be needed and the neuropsychological tests will need to take place. Researching the findings on the internet hasn't turned up much information either... We will more than likely take the new MRI results back up to all of the PCMC neurologists who analyzed Tori originally and ask for their input.

I would like to thank all of those people who turned up at the Timpanogos High School event tonight. It was definitely a tough day for us all but it was very nice to personally meet many of you who are following Tori's ever changing story. I think I teared up only a few times during the event which isn't too bad with all things considered. Thank you once again for all of the outstanding support!!

Good night and at least Tori is sleeping soundly as I am finishing this,

-Tim

Hello everyone,

Tori ended up sleeping absolutely great Tuesday night as predicted!! After 38 hours straight of being up she slept right up to her first OT session at 9:30am.

They actually began the therapy while Tori was still sleeping but she woke up quickly when the stretching began... After about 20 minutes of therapy on her arms we put her in her wheelchair and proceeded to go outside for a while. Tori hadn't been outside for quite some time and seemed to enjoy herself by watching all of the auto traffic and people entering the hospital. The OT therapists did some stretching on her outside and left me with her after a while. I eventually decided to give Tori a tour of some of the UVRMC. We went to the large gift store they have inside and Tori had the chance to look at many different items. After that we headed back to the room and she fell asleep on the way. She remained in her wheelchair sleeping for an additional 1.5 hours.

I met with Tori's respiratory technician today and we discussed the goal of getting Tori's button trach removed as soon as possible. So we plugged her first thing this morning and she will remain that way as long for as she can which hopefully is forever. Remember that a trach is an open entry to infections. It was very hard to watch her struggle swallowing her phlegm during the first few times she coughed but she finally learned to swallow it. She has now been plugged all day and seems much more accustomed to swallowing after coughing. She does tend to wait as long as she possibly can before initiating a cough though. Tonight she will remained plugged as well.

After Tori's ride in the wheelchair she took another quick nap until her 2:45pm MRI. She was given some Valium beforehand and the MRI went smoothly. The results are now being analyzed and compared to her her previous two MRI's. We should find more information on the results tomorrow.

Tori will be starting with another medication called Dantrium. Dantruim is designed to work directly within the muscle and should help with her muscle tone and spasticity. Baclofen is designed to accomplish almost the same thing but from a neurological standpoint.

We ended up weighing Tori today on her 'Blue Bath Boat' but it proved unsuccessful since the large device did not fit correctly on the scale. So we will have to try once again tomorrow... We forgot to weigh her earlier in the wheelchair as well. Tori ended up having a bath tonight!! She loved it as usual though it was a little bit different than her previous baths. She was placed in a big, blue bath device that had sides which folded up to give her a 8"-10" depth. We used two shower heads on her which filled the tub up quickly. We washed then drained and rinsed then drained. It actually works quite well.

Tori's Ross Jevity 2.0 arrived today and she was switched over to it immediately. One other item I should mention is that Maria and I are now being trained on getting all of Tori's medications put together and administered. We need the hands on experience so we can be ready for the eventual day Tori returns home. No better time than now we guess.

One of the therapists mentioned today he witnessed for the first time Tori tracking while she was outside and placed it in his report. We thought that comment was rather interesting given she tracks ALL the time. I guess when you are around Tori pretty much 24X7 you see more of this but this was concerning to us and I will now ask to view the progress reports each day. After Tori's bath Maria and I did a little tracking exercise on Tori of our own to make sure we aren't just crazy. Maria held the Teddy Bear about two feet in front of Tori's face and asked her to look at it. Maria then moved it all the way to the right as Tori's eyes and finally head followed then all the way to the left where Tori's eyes and head followed once again. So we are still pretty sure she can track at will. I guess we need to do this demonstration tomorrow for all of the therapists to make sure.

Thank you all once again and good night!!

-Tim

Hello,

Well, our official day 1 at UVRMC is almost over and Tori has been so excited to be here that she hasn't slept for about 38 hours straight... I'm watching her now as I'm typing this and she is on the very verge of sleeping and I'm sure she will need another one of her typical, total recovery days of pure sleep. We will gauge that after tonight and early tomorrow morning when it is therapy time. We might not just let her sleep it off like before..

All of Tori's new occupational, physical and speech therapists gave her initial examinations and baseline workouts today. Her left arm has improved dramatically since the Botox injection on Sunday!! She actually can rest it now in a natural position and she was minimally moving around on her again after her completing her arm stretching routine. The ST's did various taste tests and also monitored swallowing and the gag reflex. They are planning to do a Barium based study on her using yogurt and some scopes to see how she can handle food in her mouth. That should be an intersting one and the schedule for it is not yet determined. The PT's had her sitting up in bed and standing again today as they did their baseline workouts.

We will also be taking another MRI on Tori in the very near future. She hasn't any since the two MRI's which were taken just after the accident. I also had an interesting phone call today with the secretary of a renowned Neuropsychologist who happens to live nearby. He knows of Tori and has kindly offered his expertise and services to help her. I will provide much more details on this as it becomes defined.

Tori also showed NO signs of being tired during today even though she didn't sleep last night. She was very aware, alert and bright eyed throughout the entire day. Kara and couple of her other friends visited for a while this afternoon and told her all about the latest high school gossip and parties. Tori seemed to pay direct attention to them once again which was nice to see. Grandpa and Grandma Schmanski as well as Grandma Harris also spent some time with Tori today.

They didn't get a weight yet on Tori but tomorrow it will happen for sure. We need to get her in her wheelchair for at least a couple of hours and that will provide the opportunity to weigh her. She was really too busy today for this to take place. Her Nutren 2.0 or equivalent should also arrive so we can get those double calories into her once again. We will also try to give her a shower tomorrow as there isn't a large tub at this facility. Maria gave her a sponge bath tonight instead.

In closing tonight, Tori is sleeping quite soundly now!! :-) And I bet Maria is at home doing the same...

Thanks again everyone for your continued love, prayers and support.

-Tim

Good evening everyone,

I just completed my very long, 10 minute drive home tonight... Yes!! You did read that correctly because Tori is now at the UVRMC (Utah Valley Regional Medical Center) just down the street from our home in Provo Utah!! HURRAY!! I didn't want to publicize this at all until it actually happened because there were so many variables involved in this move. Please believe me, this was NOT easy to do... But we are here now!!

So, since Tori is now back into her home town, I'll start the update with some 'visiting Tori rules' for everyone out there who is close. Tori is now back into her full therapy and rehabilitation sessions and will be a getting a minimum of 3 hours of work each day by the therapists plus work from Maria or myself. The sessions are also spread throughout the day to give her adequate recovery time in between. So during the work week, we want to limit her visits for the next few weeks to the time between 4:00pm and 9:00pm. That will leave plenty of time for visits and we are definitely still encouraging them because they ARE an important part of Tori's therapy and recovery as well. Tori also gets therapy during Saturday morning but the rest of the weekend is open. A call in advance to Tori's inpatient rehabilitation room or to Tim or Maria's cell phones is still a good idea as well. As Tori progresses, the rules may of course be changed.

Alright, now on to Tori!! Tori slept very, very well Sunday night while Maria and I didn't sleep much at all... It was the last wonderful night of sharing a chair to sleep on together... We also had the wonderful thoughts of a new bed next to Tori's in her room at the UVRMC on our minds :-) Lastly, and most discomforting, Tori's nurse came into our room after speaking with the resident doctor at 11:00pm and told us NOT to move Tori's left arm at all due to the blood clot detected in her ultrasound!! Of course this was a couple of hours after we moved her left arm in every direction possible when we were told the ultrasound on her arm was just fine!! Yeah, that will make you sleep real well... It turns out the radiologist who ran the ultrasound didn't finish entering all of his notes on the procedure and Tori's arm was indeed just fine but we had to wait until the morning to find this out... So our last night at the PCMC will not be forgotten any time soon.

Tori seemed to recognize changes were coming again as she watched us pack up her room once more. She received her physical therapy and afterward we decided to give her a Valium prior to leaving which ended up relaxing her for the entire, one hour long ambulance journey. She was awake for the ride but didn't fuss hardly at all. She has a new room at the UVRMC with TWO beds inside!! :-) Maria and I were introduced to several of nurses and technicians and finally David, who is the rehabilitation lead physician. We are all in agreement that time will be needed for all of us to familiarize ourselves and adjust to each other and Tori. Tori's needs are obviously first and leave NO doubt that all of her great care will continue. This facility greatly encourages a 'hands on' approach for patient caring and therapy so we feel right at home already. The nurses had a quick introduction to Tori when they had to gather all of the medications she typically gets. When I explained there used to be double that amount they were thankful for all of the medication weaning that has taken place thus far :-)

Tomorrow Tori will be weighed prior to a hopefully rigorous first day of therapy!! Give us a 100lbs Tori!! We will then meet with her new physical, occupational and speech therapists who will perform baseline tests once again on Tori. Afterward, therapy plans will be created and we should be off and going again strong!!

I will close tonight with another GREAT BIG THANK YOU to everyone at the PCMC who cared for Tori once again!! All of you are truly incredible and will be greatly missed!!

Good night,

-Tim

Hi again,

Tori cooperated very well with Grandpa and Grandma Schmanski Saturday night. She woke up only once at around 1:30am after a repositioning and the corresponding Valium dose kept her sleeping until 8:30am in the morning.

A physical therapist arrived after Tori was up and did some therapy on her arms, hands and shoulders once again. Tori's left arm and hand seem to be a little bit better but her hand remains swollen. Both arms and wrists were placed into the inflatable splints after the therapy was over. A couple hours later Tori was taken downstairs to have the ultrasound completed on her arm. The ultrasound highlighted NO blood clots in her entire arm. So we now believe the swelling is just water retention from her constant wrist pressure. To eliminate it we must keep massaging her hand and try to push the water back up Tori's arm. Dr. Gooch, the rehabilitation doctor, visited Tori again today and brought some much needed help for Tori's left arm. More Botox!! :-) She injected more Botox into the back of Tori's left shoulder and into her left forearm which should cause much less wrist tension. When we previously injected Botox into her calves, biceps, lower back and neck it ended up doing wonders for Tori's muscle tone and spasticity.

Tori had many visitors today including our neighbors Chris, Sheryl and their daughter Jacki who taught Tori in dance - Mark, Marilyn, McKenzie and Brady - and finally Julie, Shaid, Serin and Julie's sister Josie, who happens to be a massage therapist!! :-) Josie gave Tori's shoulder, hands and arms a total massage for over 30 minutes and Tori responded very well. Through massage you can just ease into the stretching and Tori tends to relax much more quickly. We are planning on incorporating Josie's massage routine into Tori's routine much, much more moving forward.

Tori's feeds of Nutren 2.0 are continuing at 80 milliliters per hour. Her digestive system also seems to be doing much better today as her Bilious output was lower and she has had normal bowel movements during the past week. Tomorrow we are going to weigh her once more and we hope to see progress!! A 100lbs would be nice Tori!!

Sunday's are pretty slow around the PCMC and today was no exception. It was nice to see Tori interact with all of her visitors today. She mainly tracked and focused with her eyes and she was also easily drawn to sound. She was hardly agitated and her behavior seems to finally be back to how it was two weeks ago. Now it is time to get back to full time therapy and rehabilitation and I will provide details surrounding this when I know exactly where and when it begins.

Thank you all so much,
-Tim

Hello everyone,

Tori's sleep pattern Friday night took a bit of detour as she woke up again around 3:00am but couldn't get back to sleep until 6:00am or so... There were several factors to this one being that Maria opted to see if Tori could return to sleeping without a Valium. Tori tried sleeping during that span but just couldn't get into the deep sleep mode she needs and then the nurses had to take blood samples and place a new IV around 5:00am... She was given a Valium after all of that which helped her sleep from 6:00am until 8:30am.

Much of Tori's pain now seems to be coming from her left arm, hand and shoulder. The twisted inward position of her arm just looks like it hurts and I can't imagine having my arm twisted like that. Since she begins to tremble greatly and becomes seriously agitated if you try to move it, we decided to run x-rays today to check and see if any bones were broken. Tori's hand is very swollen as well so checking for any broken bones was definitely needed. The x-rays indicated that there are NO broken bones so the next test involves an ultrasound to check for possible blood clots. This test will take place tomorrow. In the meantime, Maria and I just had to straighten her arm out onto a correct position and place an inflatable splint over it and her hand. This completely straightens her forearm and hand out. We also did this right before we both left the hospital tonight and we informed the nurse that it should remain on all night if Tori can tolerate it. Grandpa and Grandma Schmanski are taking a turn tonight and watching Tori while Maria and I try to spend a night at home with Whitney and Brendan.

Outside of that left arm, I would say that Tori is looking pretty well. She is tracking nicely once again and seems interested in any activity in her room. Her painful wincing and grimacing has also greatly decreased. She is very alert once again but now we have some ground to make up in her occupational, physical and speech therapies. We will determine Tori's next steps and location on Monday. Tomorrow we are going to get her into her wheelchair for as long as we possibly can.

I learned today that working with the nutritionist to get Tori on the Nutren 2.0 feed was challenging. She apparently was against it because she thought Tori could quickly get too fat!! Boy, don't we wish!! :-) We, as well at the lead attending physician Sara, were adamant she needed the feed so she gave in. Again, getting some weight and fat on Tori to help in solving her SMA Syndrome is our top priority right now.

Tori's Bilious output from her stomach ramped up to over 750 milliliters again... The bile color is also a light green as it should be but the amounts seem to fluctuate every day. We still really don't know why... As long as we are tracking it and replacing it with fluid through her IV line we will be fine. But at some point this will need to be resolved and who knows, maybe it is weight related as well.

Alright, I just called Grandma Schmanski and Tori is calmly sleeping. I'm hoping that Tori cooperates and gives them a quiet and uneventful night.

Thanks again everyone!!

-Tim

Good evening,

During Thursday night Tori once again woke up at 3:00am which seems to be her middle of the night wake up time lately... She was given another Valium and afterward she slept until 7:30am this morning.

The physical therapists came into her room just after 9:00am because of her scheduled GJ-Tube placement at 10:00am. She went through the usual routine of arm and hand stretching. Tori's left arm has greatly digressed since arriving at the PCMC. At HSH, Tori was able to move her left arm in many directions at will and would often extend it for you to hold. Now it remains locked at her side and moving it is extremely difficult at best... She just trembles when you attempt to move it and it is presumably related to her SMA Syndrome. She also turns her wrist completely inward which causes additional stress to her shoulder. Her right arm remains about the same as it was at HSH. It is very frustrating to witness some of Tori's backward progress in some areas. It just takes so much effort to get minimal advancement and you hate to see that leave... We will get it back though!!

Tori's GJ-Tube placement slipped out until about 11:30am when I left the radiology room just prior to the procedure. The new GJ-Tube was a different style than the previous versions. It is more rigid and will hug the walls of Tori's stomach to prevent it from being pulled up again from her small intestine. The J-Tube portion also includes a weighted end so gravity and the pulling nature of Tori's bowels should help to keep it in place. Peter the radiologist was pretty confident it will remain in place. We are hoping he is right. He also removed Tori's NJ-Tube so her face is cleared once again.

Tori was immediately started at 40 milliliters per hour of the Nutren 2.0 feed after the procedure. This quickly moved up to 85 milliliters per hour as Tori handled the input well. We are on our way once again to fatten Tori up a bit!!

Tori's Bilious output from her stomach was half of yesterdays so there is progress on that front as well. The bile color is also a light green as it should be. Now we just need Tori to maintain this.

We basically let Tori recover for most of the day after her GJ-Tube procedure. We didn't push anymore therapy on her and let her visit with Gary and Toni, then Michelle and Kourtney who came in during the late afternoon. Tori also remained relatively calm throughout the day following the procedure.

Maria and I also wanted to provide a special thank you to Tori's technician Gabrielle who has watched her over the past few nights. All of Tori's CMU nurses and technicians have been absolutely great but both Maria and I frequently wake up while at the hospital during the night and Gabrielle is often alone and helping Tori by massaging and comforting her. Some of the nurses and technicians have daughters Tori's age and there definitely is a special connection. Gabrielle is one of them. Thank you so much again Gabrielle and the rest of Tori's nurses and technicians as well!!

Until tomorrow,

-Tim