Visit with Dr. Gupta, Monday, April 16th

Folks,
We ended up waiting for over two hours but we finally got to see Dr. Gupta. Prior to talking to him Brian got 4 more x-rays of his elbow so we could see the most current status. Dr. Gupta was kind and patient and very empathetic. All of the people we dealt with in his office were exceptionally kind and gentle. Everyone we've talked to have, without our asking, commented about Dr. Gupta being the best there is with orthopedic issues.

Here's what we learned. Brian's elbow is currently out of place. X-rays clearly show the elbow is not sitting in its cradle where it belongs. It also showed the calcification building new bone on top of his ligaments. Dr. Gupta explained that our bodies have an inbuilt preference for stability. Even when a joint is out of place, given enough time, our bodies will try to find a way to stablize it. The new bone growth is also an indication of Brian's brain injury. So Brian's body is attempting to stabilize the eblow joint by building bone to hold it in place. Once the body begins building bone it is difficult to tell the body to stop. Typically this can go on for 6 months. Brian's bone growth has slowed considerably. Brian will go back for another evaluation in 1 month. At that time, we hope, Dr. Gupta will proceed with plans for surgery.

Basically the elbow has to be completely cleaned out of all extra calcium and all ligaments removed. According to Dr. Gupta, in the range of work done to elbows, this is out on the edge. This is extreme. Rarely do injuries require this kind of intensive repair. The new liagments sometimes come from "spares" that we have in our hands and feet. Most likely Brian's will be cadaveric.

Recovery time from this surgery is typically 4-6 weeks. It often requires an exterior, hinged support, held in place with 2 screws in the upper arm and 2 screws in the lower arm. After the 4-6 weeks this is removed. Dr. Gupta stated that his goal is to give Brian a range of motion with his elbow of 30 degrees one way to 130 degrees the other way. This is what Dr. Gupta says will be his goal. Brian may exceed that which would be great. This will give him a range of motion allowing him to do 90% or better of what he was able to do before. Playing a guitar, fishing, feeding himself, scratching his nose, all fall in that range.

Dr. Gupta hopes to be able to do the surgery at the 4 month mark instead of the usual 6 month mark. This would put the surgery somewhere in mid June with a recovery stretching into August if all goes well. Here is where we need to focus our prayers. It seems odd that, given all of the injuries that Brian has dealt with, the one that will linger the longest was never life threatening. His right leg continues to improve as his brain replumbs the nerve connections that control that part of his body. Dr. Gupta checked the progress with Brian's wrist and fingers. It is coming along as well.

In other news, Brian is scheduled to have his "G tube" removed tomorrow morning. This is the feeding tube in his stomach. Brian's not looking forward to it much but it should be a very simple procedure that will be done in his room. He is not to eat or drink anything by mouth after midnight tonight.

Well, that's enough for now. I heard on the radio a little while ago that, while we were in route to Dr. Gupta's office there has been a shooting at Virginia Tech University. 31 people reportedly killed and over 20 injuried. I'm weary of so much pain and senseless suffering. I feel selfish for being able to care for just a small handful of people when there is so much need in the world around us. How much longer, Lord?

Peace, please.
Bob