4TH PATH - Brian Frank Strong

ICP is good Doctors challenged his “brain drain” today and it went well, and pressure stayed steady  Brian has started localizing to pain, rather than just withdrawing.  PRAYER MAP: Please add where you’re praying from or where you have family praying from: https://docs.google.com/spreadsheets/d/1D51WucTJo_yHokkRw2iLIXw5fv6GwsdmInbtBaVO7Ls/edit Take a look at the map: https://www.google.com/maps/d/u/0/viewer?mid=18Fgd8F5FqRualEPjTUuNGizhpnOkq-tN&ll=-3.81666561775622e-14%2C-28.3131077223834&z=1

  Vent has been off since 6:30am, Brian’s independent breathing is less laborious than his first day off of it Doctors saw a pupil reaction in his right eye, but not left. Doctors feel like a CT scan could give some insight given this change, so he’s headed for one now.  Left arm responded pretty strongly to pain.  ICP has been in the 9-12 range.  4:30pm-ish: Brian’s eyelids are starting to try to open in response to pain stimulation.  Also- get your Brian Beans here: https://detach.coffee/brian-frank-strong-4th-path-blend/?fbclid=IwAR3hswZlIF_tiE38Iliu4hDfjcNT1wl_FJDer3Ql-6I-W4dLNYDJMWJDF1M

  Starting off the morning good! ICP is steady and in range.  Breathing over vent consistently, but they have it on just to support his body and let him work up to being stronger.  His eye lids are doing little blinks and flutters, he has the HICCUPS, and he’s was doing some tapping with his thumb- totally looked like it was to the music.  Still showing responses to physical stimulation.  He’s trying to clear his own saliva and doing a pretty good job of it.  Veins and arteries in the neck looked good on ultrasound, so blood flow to brain is strong. 

BRIAN IS BREATHING ON HIS OWN. I repeat, Brian is breathing without any assistance from the ventilator.  Pupils are less dilated than they have been thus far. He is responding to pain in his right arm, right leg, and most significantly in his left leg.  ICP has stayed below 15 all night!!!  Neurologist wants us to talk and laugh and play music as much as possible!!  Afternoon Update: Doctors turned on the ventilator for a bit to give Brian’s lungs and body a little break. He had been breathing completely unassisted from 10pm last night until about 1:30pm today. Well earned, Brian! BP was a little elevated (probably because Brian is being such an overachiever, and let’s face it- the love of his life was in the room- so he was probably pretty thrilled) so they gave him some meds to bring it down a bit, which worked right away!  Evening Update ICP holding nicely at 14. Little spontaneous movements and body jerks happening! 

  Lauren and several of us had a consult with a U of C doctor last night who agreed to review all of Brian’s notes and scans. He mentioned some dark areas on a CT scan from 2/18 which didn’t sound like information we had heard before. So today we are going to very specifically start praying for the next CT scan to show alleviation of those dark spots. We will continue to pray for ICP under 20 and for Brian’s body to show us a sign of his strength. He still has a good 24-36 hours before the pentobarb is out of his system, but let’s face it, Brian has always been an overachiever. Spread the work, share the focused prayers- let our faith in BRIANFRANKSTRONG not falter now.  ICP is right around 19/20. It went up to 22 at the highest overnight, so they introduced a small amount of propofol back into his system and his sodium was slightly low so they set up via iv which should help bring pressure down. The big news: They got some minor reflexes in his left leg and a slight cough/gag!!  Sever

Please continue praying, your prayers are being heard. Brian’s EEG shows brain activity, so they do not need to do the CT scan to check for blood flow. ICP is also back down a bit. Pentobarbital is the lowest it’s been so far, and he will be fully off of it by 6pm. It will take an additional 1-2 days to clear his system and little by little they will be able to physically assess more. DO NOT STOP YOUR PRAYERS. Today, we continue to pray for ICP to stay below 20. We pray that his EEG continues to show brain activity. We keep praying for Brian’s miracle!  Pentobarb was lowered to .5 at 10am. ICP is holding at 14. (11:30am) ICP is still holding under 20, at about 16/17 currently. (2:00pm) ICP holding under 20, right about 19 currently (3:15pm)  ICP is at 22- so it’s that time again people. Prayers. They were heard last night, let’s do it again tonight. Get on your phone, call your Mom, Grandma, Dad, Brother, friend, grade school teacher. Text every number in your phone. Make the Facebook

Morning Update: Brian had a good night! Medication is at a lower dosage and his ICP is down!!  Evening update: ICP is back up. The doctors feel like the pentobarbital has done as much as it can and will continue to wean regardless of if pressure continues to rise. Tomorrow morning, the trauma surgeon, neurosurgeon, and neurologist will perform several assessments to determine where things are at, if there is brain activity, and what comes next. We need your prayers, we need everyone’s prayers. Call your friends, text your coworkers, ask every single person you know to pray and to pray hard. 

Intracranial pressure (ICP) went up overnight. He’s still only on the one medication, but they did increase it to help bring that pressure back down. The plan today is to watch the pressure and keep him stable.  Late evening update: ICP has gone down, medication is also down a bit too. 

  No major changes overnight! (Like we hoped!)  Blood pressure was previously staying up on the high end, but last night that came down a bit too.  Doctors were successful in significantly lowering Brian’s fentanyl drip and he maintained the lower intracranial pressure with that reduction. Another win!!!  Brian is off fentanyl and Propofol and holding steady. 

  The deep coma medication (P entobarbital) continued to be effective overnight,  with pressure reducing even more and then stabilizing. Right now, the doctors are adjusting his other medications and watching his body’s response. The plan is to get Brian on less medications overall- but to do so very slowly and carefully. 

  Lauren, family and close friends are awaiting to meet with the doctor, today.  Doctors are still looking to perform an MRI to know more fully what is happening and what damage has been done.  There is brain activity, however no involuntary response to stimuli.  As of 2:49pm: Brian’s pressure did increase above expectations, he is being sent for another CAT scan and given additional medication to deepen his comatose state to hopefully bring down the swelling.  As of about 7pm, the medication given to induce a deeper coma has been successful in reducing his intracranial pressure. The goal is that it will remain down or decrease further. 

  Brian is sedated and stable There  has been no involuntary reactions/ responses to stimuli when tested No pupil or pain-test reactions Hoping to perform an MRI today only if the swelling has lowered enough to do so; this is to better understand the injury  As it looks, there has been damage done to the brain stem, but it is hard to say to what extent the damage has been done.  

Brian was airlifted to a local hospital with serious injuries to his brain. There was an immense amount of swelling to the head, which was responded to immediately with an emergency craniectomy. Brian made it successfully out of surgery.