THURSDAY NIGHT

What a long day and a big big day for Molly. She did great, of course I, and I am sure all of you have come to expect nothing less from her. The surgery was quite lengthy, they took her to the OR around 10am this morning and did not get back to the room until around 4pm. With all the surgeons did, it took a long time, and was very tedious work. However, the good news is that is was all less invasive procedures and she bounced back very quickly. During surgery they debreeded some of the dead tissue on her wounds (very little, but what was necessary), graphed her thighs, and removed her index finger and part of her thumb on her left hand. The donor tissue for the graphs came from the outside of her thighs. This will feel like a bad rug burn for several days and will take abou 2 weeks to heal completely. she was quite groggy when she returned from the OR but was in good spirits and had only a little pain that her nurse Jay was able to get and keep under control quickly. Now that she has three different types of wounds that need care for, they each need different things to help them heal. She has her stump care, her new skin grafts, and the donor areas. Each requires different care, such as one must be kept dry, one requires soaking, and one requires some scrubbing. However, the Trauma Burn unit and the amazing team that is there deals with these types of things all the time (unfortunately) so they definately know what they are doing. The surgeons feel good about the procedures done today, but we will know for sure how the grafts will do in a day or two. during this critical time for the grafts to heal, she will need to remain in bed and as still as possible. On another note, she also had dialysis today, which she tolerated very well and the dialysis team was very pleased with the results, especially since she had just got back from a 5 hour surgery. Then, if this all was not enough they had to replace her feeding tube in her nose because it had slipped out of her intestines back into her stomach. they are not able to just push it back down (as I suggested) because it is very rubbery and to flexible. When they put it in place initially it has a stiffer guide wire inside the tube to give it some rigidity. She did great with this as well. Even though she should be able to start eating soon (this is another story I will get to in a minute) they will have to keep feeding her through the tube for quite some time to keep her caloric count up. In fact they are giving her over 3,000 calories a day. Of course, like everything else through this journey, they have to walk a fine line between too much of a good thing to "fix" one thing but cause problems in another area, The high calories cause her blood sugar to rise, so they have to give her insulin, because while she need the calories to provide her body to rebuild tissue and heal, the body does not heal well with elevated blood sugar. Now, with all this, they have new orders to only allow a few ice chips until Tuesday. This is because of her vocal cords not working quite right yet. The vocal cords help to protect us from aspirating (letting stuff other than air into the lungs) which can cause pnemonia, which would be a major set back at this point. The reason for letting her have ice cream, popsicles, pepsi, etc, then stopping it is due to now having a clear picture of what is actually going on with her vocal cords. On Tuesday they will do a swallowing evaluation with the "Cookie" test. which means that they actually give her something to eat "a cookie", but trust me it is not an Oreo, it is packed with chalky stuff that they can see on the special x-ray like screen as she eats and swallows. The results of this test will indicate if she can start eating/drinking or not. Two reason to wait until Tuesday, first is that is the first opening in the schedule, second is that with the fresh skin grafts, they do not want her to move to much and this test requires her to go to another department, get out of bed, sit in a very straight and hard chair, etc. So, Tuesday it is, and she understands, obviously disapointed, but ok with it. The chief residents and the attending physicians, interns, med students, therapists, nurses, and the list goes on and on, are amazed at Molly's progress. while they knew she was going to be ok and would make progress they are a little surprised at how quickly she is making that progress. While they are obviously very pleased as they would be with any patient, the whole unit has become like close family and friends and it is just amazing to watch and hear how much they have come to like and admire Molly. Again no surprise to me or anyone that knows Molly, but she has won them all over. Everyone as they pass by her room, even if they have not had her as a direct patient stops by to say "hi" and see how she is doing. Overall, Molly is doing great. We are both also realistic and understand the incredibly long road ahead of us yet to be traveld, but each day of progress, success, and the wonderful feeling of warmth we both feel from all the thoughts and prayers from each of you makes it easier to face each new day. Thank you all! SPECIFIC PRAYER AREAS

• Patience to wait until Tuesday for the swallowing eval, and to start getting out of bed again
• Positive result from Tuesday's swallowing eval so she can start eating/drinking
• Healing of all wounds and grafts
• Continued healing of her entire body
• Quick returned use and function of both hands so she can start doing things for herself (this will be a huge boost to her mental health)
• Clarity and guidance for Molly & I so we are sure what we are being called to do as a result of this experience
• Family and friends as they travel to Wolverine country to visit
• Pray for other trauma and burn patients. Not just at U of M, but all over. We have heard stories from the nurses that so many patients that they care for, including kids, are left in the unit with no visitors for days and even weeks on end. Their spirits are down which makes it harder for them to have a full and quick recovery. Molly and I would like for you to pray for their spirits and for frequent visitors from family and friends, or at least someone who genuinly cares about them.

Pray Hard Daily, it is amazing how powerful prayer is!

God Bless you all,

Love,

Jamey & Molly