Merry Christmas

Hello everyone,
Merry Christmas. There haven't been any changes, and not any change in Britney's progress so I haven't put in an update on the blog in a while. Britney is still in a coma with brief periods of awareness where she will blink if we ask if she can here us or when she will look at us. She is more awake. Her progress has been very slow and her neurologist has asked me if he could consult a coma specialist from Cornell. She is six months out and since her progress is slow her doctors are not very hopeful but she is still making progress. We still have a very strong peace that she will come back but her progress is completely unknown at this time. If there are any new updates I promise we will put them on the blog right away.

The best news we have is that the kids finally got to visit Britney on Christmas. They haven't been able to see her for 2 months because Kindred banned visitors under age 18 from November to March because of the H1N1 flu virus. We have asked many people to make an exception but have not been able to get one until Christmas when I ran into the infectuous disease doctor who asked me how the kids were doing. I told him how much they missed Britney and he said since they had their flu shot they could visit her again. Jonas cried and said it was the best Christmas present ever. He has been saving his money so Britney can go to a hospital where they would allow kids to visit. Britney followed us around the room with her eyes. She was very peaceful and relaxed.
We are still going through the process for social security disability and guardianship. We have a court date in January and after that we will hopefully be able to move her to a skilled nursing facility. For now she is still at Kindred in Denver. When she moves we will update the blog right away.
Thank you all for the incredible kindness you have shown our family over the Christmas season. We are overwhelmed at all you do. Thank you. Merry Christmas.
John

Happy Thanksgiving

I got the best Thanksgiving ever. My team told me last minute to go home for the weekend and I was able to spend a few days with Britney and the kids!! I bought one of the last available plane tickets the day before I left. I didn't think I would be able to visit for 3 more weeks with how busy my rotations have been. It was amazing. When I walked into Britney's room She was awake. I asked her if she could hear me to blink her eyes. She did right away. I asked her 4 more times to blink if she could understand me and she did right away each time. I walked around her bed and she followed me with her eyes. She made a sound but didn't move her lips. She was really comfortable. Jonas, Vera, and Anna were a blast. They had so much fun. They have really missed Britney. Because of the H1N1 the aren't allowed to visit Britney for the past 4 weeks. They cry a lot about not being able to see her and missing her. They are very resilient and are still happy. We have a meeting with social security disability tomorrow. Hope and pray it goes well so Britney can continue to get the care she needs. Thank you for all of your comments on the blog and her facebook. I read them to her when I'm able to visit. I am so thankful to all of you for your continued love and support. It means so much to all of us. I was able to meet Elder Scott, an apostle of our church, a few days ago. He was so kind, and was able to give me a blessing. He took time to meet with me even though he was in town visiting his family. He said he will keep Britney's name on the temple prayer roll of the apostles for a long time. I'll never forget it. Britney has a lot of people who are thankful to her for who she is and the amazing mom, wife, daughter, sister, friend she is. It was a very emotional week for many people. Thank you all again.

John

Hi everyone. Just a quick update. There was a little confusion with how I wrote the last post. Unfortunately Britney hasn't talked yet. I said hi to her and she looked at me. She has made sounds but hasn't talked yet. She has been much more responsive though. Her curtains were opened up a few days ago and she opened her eyes and looked all around the room like she was figuring out where she was. When people talk to her she looks at them. Her therapy is going better since she got her baclofen pump.

Britney is waking up more

Hi everyone,
Thanks for your patience between posts. I was able to go to Colorado last week after being up post call and flew home the next day. It was amazing to see Britney, and to be with our kids. Britney woke up when I came in her room and said hi and looked right at me. A few days ago she was stretching her arms and head. She has been more awake and looking at people when they talk to her. She has made some sounds but hasn't said anything yet. She is still at Kindred because we are not able to find a skilled nursing facility that will take her because of insurance issues. We are working with a lawyer to help her qualify for social security disability for nursing home care and to work with our insurance to cover her at Kindred until she can find a skilled nursing place that will accept her. In the mean time she has continued to get great physical therapy and become more responsive the past few weeks. She will be at Kindred until we get this figured out. We will post as soon as she goes to a new hospital with directions for all of you wanting to visit. Thank you for all of your support and prayers and birthday messages for Britney.

Happy Birthday Britney

Britney is 28 today. She was really sleepy this whole last week but has been awake a lot of the morning. I got to tell Her happy birthday and she blinked a lot when I was talking to her. I miss her so bad today. Lots of her friends have been wishing her happy birthday on her facebook account. Vera was sick last night and can't make it to the hospital to tell her mom happy birthday. Jonas is going to come with Casey. We may have to do a cake another day. Even though her recovery is slow she is recovering. Every time I get discouraged I get a really strong peaceful feeling she will make a full recovery, that she wants to come back and will. She isn't suffering in pain anymore because of the baclofen pump which is such a great blessing. A great birthday present to not be in pain, and to be awake to know her family loves her.

I had a great time with Jonas, Vera, and Jessah last weekend. They went back Wednesday morning. Britney is very very comfortable. She has been more sleepy with fentanyl patches for pain after her surgery. I'm not sure if the Baclofen pump is helping her wake up but she has been very relaxed. It is much much better than watching her suffer in pain. She has been lifting her legs off the bed more and more the the last few days and smiled today. I got to tell to her hi on the phone tonight. I really miss her. It was great having the kids here but I miss her really bad. I was really depressed that she hasn't been waking up more since she got her baclofen pump but every time I worry I get a really peaceful feeling like she will come back. I can't describe it but I have always had it everytime I doubt. It's what keeps us all going. Britney's sister Mckenzie got married yesterday and Vera woke her up that morning to tell her it was her day to be a princess. Vera is obsessed with princess movies. She has talked about the wedding non stop for the past two weeks and couldn't stop talking about it tonight. I couldn't make it cause of work. My call schedule got changed around. I will have a hard time getting back to Denver the next 7 weeks because of my hard rotations Trauma and Orthopedics. I get one day off a week and if I get to fly out I can only stay for less than 1 day after being up for 30+ Hours and coming back to work 12 hour days. I have already done 3 weeks like this. After this I will get to go back more. We are trying to have Jonas and Vera come back with someone else in a few weeks so they don't go too long without seeing me. We talk on the web cam a lot and it helps.

very comfortable

Britney has been much more relaxed since she got her pump. They increased her dose 2 days ago. She has much less pain. Her heart rate is much lower and her face looks relaxed and she has been able to sleep much better. Dr. Yager and many of her nurses think that she has progressed a lot since getting the pump and has been a lot more aware. I called a few days ago to have the nurse tell her I love her and she woke up and looked at the phone when she heard my name. Jonas, Vera, and Jessah are coming to Tucson tomorrow for 4 days. I can't wait to see them.

Back at Kindred

Britney did very very well today. She was uncomfortable for a few hours this morning but her pain got under control and she slept most of the day. She came back to Kindred tonight and is breathing very well and has a normal heart rate for the first time in a few weeks. She will be monitored in the ICU at Kindred for a day or two until she gets used to the pump so they are sure the dose she is on is not too much because Baclofen can affect her breathing.

Pump is in

Casey just called and he just finished talking to the NeuroSurgeon who is very happy with the surgery and the pump placement. The catheter that goes in her spine can stay in for a long time and the actual pump lasts for 3 years. It is under the skin in the abdomen, and can be changed out easily. They did extra infection precautions because she is colonized with MRSA and are continuing her antibiotics as a precaution. 30%+ of all people have MRSA in their noses, and it is a common problem for people who have trach's to have their trachea's colonized because of routine trach care by heath care workers who are colonized. It's good they are taking extra precautions. She will stay at Sweedish hospital for 12-23 hours to monitor the function of the pump. After that she may go back to Kindred or stay at Sweedish Rehab floor to be monitored for a few more days after that. Please call the Fosters before you visit so you can be sure to visit the right place. I will put up a post when we know where she will be going. Thank you for all of your thoughts and prayers today.
John

Getting Baclofen Pump Today

This was just sprung on Casey and Jana yesterday afternoon and I was on call for 30 hours and didn't find out until this morning about 1 hour ago. She has been cleared by the Infectous Disease Dr. Fisher to get the baclofen pump. The neurosurgeon with the most experience in Denver with Baclofen pumps at Sweedish hospital who works with Dr. Ripley was able to get her in on short notice today for the pump. She is leaving Kindred Hospital now to have surgery at 3:00 pm Denver time in about 3 1/2 hours. Pray that it goes well and that the pump does not get infected. She is very calm and comfortable now. She has not had a fever since 9/30 and Dr. Fisher said she probably didn't have a pneumonia and was just colonized with MRSA in her trach which is common and she has been treated with a very powerful antibiotic for the past 4 days to decrease colonization. We are going on his word even though she has had very thick sputum and high heart rates, and a high white blood cell count over the weekend. The chest X-rays have been clear and what was thought to be a infiltrate was scarred lung tissue from previous surgeries in the left lung. She will be given a few more days of antibiotics as a precaution. I hope everything goes well. I will post an update after the surgery.

doing better

Britney is doing much better since Sunday. She is a lot more calmed down and still getting better. The official read from the chest x ray isn't done yet but nothing glaring. It's possible she was colonized with MRSA but has had a lot of sputum so maybee it's an early pneumonia. She hasn't had any more fevers since the 30th. I came back to Tucson late Sunday and am doing my OB rotation. Long hours and miss my family but having fun.

Britney has Pneumonia

Britney had a lot of spasms when I got here yesterday and more secretions. She was having a hard time breathing. The sputum they took from the day she had her fever on the 1st grew out MRSA a resistant antibiotic. She was given a very very strong antibiotic linezolid starting last night and has been getting fluids. She has not had any fevers but her heart rate has been very high and she has needed more oxygen overnight. Thank you all for still praying for her and following her blog despite the sparse updates. We love you all and are so so grateful for all the support that has been given in every way. You all have showed us incredible compassion. We are and will always be so grateful. Even though her progress has been slow and she is having set backs she is improving and we still have hope that she will come back to us fully through a long road. Thank you all of you for not giving up on her.
John

Sorry for the delay in posting this week. I had a very busy week at work. Britney had a fever a few nights ago and the Baclofen pump has been delayed. She had a hard day and a half Tuesday through Wednesday. None of her cultures grew out any bacteria and her fever resolved in a day. She has been very comfortable the past few days. I am at the airport getting ready to fly to Denver to see everyone after 2 weeks away. I miss them really bad, especially Britney. I've been able to talk to the kids on the webcam a lot but not Britney. She is still making sounds but has not talked yet. As soon as she can things will be much easier for me. I miss her so bad constantly. Her pump will likely be put in sometime next week if she doesn't get any more fevers. I am taking the kids to the circus tonight after we go to the hospital. Talk to you soon,
John

Baclofen test dose done today

Britney finally got her test dose of Baclofen today and it went really really well. She already is much much looser and in less pain in her neck arms and legs. She is over her infection, and has been very alert the past week looking at people when they talk much of the time. It was hard to find someone to do the test dose because the Craig Dr. who usually does it was on vacation the past 2 weeks and they went through many options of people in interventional radiology and anesthesia at St. Luke's trying to get it set up and by the time they did Dr. Ripley came back in town and did it today. It's probablly better that way so that she would have time to get over her infection. The kids are very happy. We talk on the web cam 1-2X per day. It's much better than talking on the phone. I am flying back next weekend for a day and a half.

Britney doing much better

Britney has been doing much better the past 3 days. I drove back to Arizona the last two days and didn't get to put a post up. She has been very relaxed and more awake. She has been looking at us when we talk more and more. She blinked her eyes tight when her aunt Jan asked if she wanted her to read, and then she blinked tight again when Jan asked her if she wanted her to stop reading about an hour later. Her fevers are gone, and her blood pressures have been very good for the past few days. I spoke with Dr. Fischer, her new infectious disease doctor, and he said she is doing much better. The Baclofen test dose should be in the next few days. It takes a long time to set up because they had to find a Neuro Surgeon and a hospital who would put in the pump (it doesn't pay very well so not many surgeons or hospitals want to put them in). If the test dose works well they will put in the pump. Again they have to document very well to get the insurance to pay for it. There is a spasticity scaling system they do before and after the test dose. She has had her braces off for the past few days to get this done. She also had a blister on one of her elbows that has been healing. I'll put up a post when I know more about the test dose.

Infection causing spasms and pain

Tuesday I came 3X because Britney seemed to be in much more pain despite having the splints on, and even with lots of massage, heat, and pain medicine. She started getting low blood pressures and spiked a fever that night to 101.8. She got lots of fluids and antibiotics. Everything got cultured (sputum, blood and urine). I stayed up with her all night to help her calm down, and make sure she got the treatment she needed. So far we know she has a urinary tract infection. Her doctors said many times that infection and dehydration can cause more spasms and pain. After she got about 3 liters of fluid and some antibiotics her spasms decreased dramatically and she has been progressively more and more relaxed. She had a good night last night and is sleeping really well now. They are still working out where she will get the Baclofen test dose with the neurosurgeon who will be putting the pump in. An infectious disease Doctor is coming to see her today. Over the phone yesterday he said he likes to treat toxic shock syndrome for 6 months with antibiotics to decrease the Strep A colonization so she was started on another antibiotic for that yesterday.

Britney had lots of pain over the weekend. She had a really bad day today. She was crying out loud a lot of the day. She was able to calm down with a lot of massage, heat packs, pain medicine, stretching. She is hopefully going to get the first test dose of baclofen soon. It is done by a lumbar puncture to see how she tolerates it. She has to be closely monitored because it can depress her breathing a lot and if it is bad she may have to go on a ventilator until it wears off. Then she has to get the pump inserted into her spinal canal by a neurosurgeon. I spoke a lot with Dr. Ripley, one of the Neuro Rehab doctors from Craig that has been following her a lot. He said she is really early in her recovery. Brain injuries from lack of oxygen typically take a lot longer to heal from than traumatic brain injuries. He said that it may be many more months or longer than a year for us to know what kind of a recovery she will have. He seemed very optimistic and wanted to give her every chance at recovery. He said that some times they take people to Craig early in their recovery but he thinks it is better to let her come later when she is able to follow commands more so she can use her rehab days from insurance when she can use them more. He said that they can follow her at a skilled nursing home and monitor her baclofen pump until she is ready to do 3 hours of rehab exercise a day (Craig's normal criteria). He is working with Britney's case manager to find a good place after she gets her baclofen pump that would still give her just as much rehab (range of motion) that she is getting now and that can take care of her splints. She is so medically stable that the people at Kindred and Craig think that after she gets her baclofen pump she will be ready to a skilled nursing home with really good therapy. She doesn't need the constant critical care at Kindred anymore because she has been doing so well. She is still on some oxygen but everything else has healed. Hopefully when she gets the baclofen pump she will be able to wake up more and not be in so much pain.

I made it to Denver safely late Monday. The kids were so excited to see me. Vera squealed for 5 minutes and again every time I got out one of her toys from the car. Jonas said about 20 times how much he missed me. Britney was in a lot of pain after the 3 day weekend of no splints and had a lot of stiffness. She did really well today with them and was very comfortable. She has been more sleepy because her Baclofen got increased again. She is having spasms in her neck, both arms and legs now. She looked at me a lot tonight. I talked with Dr. Yager today. He said she is more sleepy but when she has been awake she has been doing more. Her neurologist and Dr. Ripley from Craig have decided she will be able to get a Baclofen pump. It will go into her spinal canal. This way she can get high dose Baclofen without the side effects of being so sleepy. They didn't do it the last 3 weeks because they needed to know that the pump could be taken care of and that she will be going to Craig. The details are being worked out for her to get there. She is not awake enough to participate in exercise or follow commands consistently, but they will manage her Baclofen pump, and hopefully while she is there she will wake up enough to go through the rehab program. Her splints are working very well. Her right arm is all the way straight, and her left arm has been almost straight. She smiled again at Jan a few days ago and her nurse also saw it. Sorry for the delay between posts. I'll update you all soon.
John

Britney's splints are working great. She was up to 7 hours yesterday and her wrists are back straight and her elbow is much straighter. She is tolerating them really well. Her baclofen dose was increased and she has been a lot sleepier. When she is awake she is very interactive. She continues to make sounds and look at people. Her massages are really helping her relax and not have pain. I'll put another more detailed update when I get back to Denver. I am driving up from Tucson on Monday. I work tomorrow night.
John

I just talked to Casey for an update. The MRI showed decreased swelling from the CT scans she had at UMC. The swelling from what I heard from Casey was the only abnormality which is great news. She is progressing will with her splints and frequent massages. She had less spasms with the increased baclofen and she may get a intrathecal baclofen pump (a pump inserted into the spinal column). This is a very common procedure and done earlier may help with preventing permnant contractures better than botox injections and will help with whole body spasticity. She continues to make sounds, and be more and more aware of her surroundings and the people coming to visit her. I'm headed back to Denver on Monday for my 2 week vacation and I'm driving up a bunch of stuff for the kids they weren't able to bring with them. Jonas and Vera are excited to get a lot of their stuff again. Jonas loves school and has made some friends. Britney's sister Carlie came to visit for a few weeks with her son who is Vera's age. I'll post another update soon.
John

Sorry for the long wait between updates. I had tons of help yesterday and completely finished moving. It was exhausting working nights the whole week and trying to pack. Lots of people from church and friends helped me finish packing and moving most of our stuff into storage and the rest to my apartment. Britney has been doing so good. She looks at the TV whenever a movie is put on. We got her the planet earth DVD's and she watches them with Jonas and Vera whenever they come. She looks at people when they are talking to her and continues to make a lot of sounds. Our family friend that has been giving her massages set up a rotation with a bunch of her friends to Britney will have massages almost every day. She has loosened up a lot and has had so so much less pain. Her baclofen dose was also increased a few days ago so she has been more sleepy. She finally got her correct splints on Friday. She did really well with them. Her OT didn't want to leave her in them all weekend without any therapy because she thought it might be too much for Britney to have them on non stop for so long and didn't want her skin to break down. Everyone continues to do lots of range of motion. If the splints and Baclofen increase dont get her arms and hands straight she may get botox injections in her forearm muscles soon. She went to St. Anthony's for a MRI a few days ago. Casey went with her. She turned her head and looked at all the trees and the sky. She was very peaceful during the whole ride Casey said like she enjoyed being outside. The results from the MRI aren't back yet. She will have a EEG soon also. Thank you for all your support.
John

Sorry I haven't posted in a few days. I came back to Tucson Monday morning and I have been working graveyard shifts and trying to pack up my house. I found a 1 bedroom apartment to rent that will let me stay in the same congregation and that is a lot closer to the hospital. Thank you to all of you who have offered to have me stay with you. I figured I would be working and sleeping all hours of the day and it would be better this way. I really appreciate all your help. Britney continues to loosen up and stretch out. She got some wrist braces but they were the wrong size. This continues to be very very frustrating. Hopefully she will get the braces she needs soon to help her keep all of her range of motion. She is still more and more responsive. I'll post again soon. And Britney's sister or parents may post more soon.
John

Lots of progress and a visit from TMC friends

Sorry I didn't post yesterday I had a long busy day spending time with our kids and Britney. Britney made a lot of noises yesterday but no words yet. She had the valve on for about 4 hours the last few days in the afternoons. She did great with it. It makes her work a lot harder to breathe so she has to build up to having it more and more. She has been blinking to communicate with her therapists and nurses the past few days more and more. She has been moving her legs a lot and has a lot of sensation in both feet. We can tell from her face and reactions when we massage them or stretch them. This morning she smiled at a joke her Aunt Jan told her. She smiled for a whole minute after really wide. She has been looking at us a lot and looking at her hands and feet when we stretch her out. She is really comfortable today after a massage from a family friend last night. We had a great surprise this morning one of the nurses from TMC ICU came and brought a card and presents for all the kids and Britney from the whole ICU team there. She was visiting a friend for a wedding and found out where Britney is. It was the nicest surprise and made our day. Thank you to all the people in the ICU at TMC who saved her life in those first few days to give her a chance at recovering, and for following the blog so closely and for all your prayers and support.

Passed swallow eval now has valve to talk

Brintey did great again with her swallow evaluation and has had the cuff down on her trach so I asked if she could have a valve to give her the chance to start speaking and she just got it. She has seemed like she tried to talk many times over the past few weeks. Her speech therapist said it is common to make some sounds first and then maybe one word sentences. She has already made a lot of sounds since getting it in. She has some gauze n her lower lip that makes hit hard for her to move her lips because her lip is still healing. Her vocal muscles need some exercise and it will take lots of brain coordination to speak more complexly. It will be a process, but we are very excited she is progressing so much. She has been looking around a lot, and smiled again today when we were talking about the kids. She closed her eyes when her therapist asked her to. She has therapy 3X per day (speech, occupational, and physical therapy). The rep from the splinting company came today. Her braces in Tucson got sent back to the home office because they didn't have the right address to ship them to so we lost another week and a half and she has lost some more range of motion in her left arm. She will be getting custom braces on Tuesday or Wednesday. Sorry I haven't posted everyday. I just wanted to keep everyone up to date on any changes and didn't want to bore anyone with more of the same. She has been very comfortable with some periods where her spasms are increasing causing bad pain. These periods are getting less frequent and she is comfortable most of the time. Her nurses are very good at controlling her pain, and we are doing a lot of heat packs and massage. The constant stretches in therapy also keeps her pain down. I'll post again with any changes.
John

Listening more

Britney has been showing us she is hearing more and more. Last night on two separate occasions when her nurse told her that she had to poke her finger and give her a heparin shot before the nurse did it she frowned. She has been looking around a lot, and our voices help calm her down. When I told her this morning I brought the baby she opened her eyes wide. Her occupational therapy is going really well and her arms are getting more straight. We are still waiting on splints being shipped from Tucson. Hopefully they will be here soon. Also she is only on 2 liters of oxygen and her lungs sound great.

Very comfortable here

Britney is very comfortable here. I swear she knows she is around family and friends who will be there for her constantly. I have seen a dramatic difference in how calm she is here. She got some IV fluids last night and has been very restful. Her myoclonic jerks are happening less. Her neurologist is pleased with some improvement over the weekend. She will be getting a MRI soon. She had a great session with her speech therapist this morning and was able to swallow some foods. She has to be able to pass a swallow eval before she can get a valve for her trach that will allow her to speak. She has had so many visitors. We are so happy how many family and friends have already come and who have said they would come when we are settled. Thank you all of you for being so kind to us in all the ways you have helped wether it was time with Britney, our kids, talking to us, donating food, money. It has been amazing to see the outpouring of love from everyone around us. Thank you.
John

Britney's care is so incredible here. Her physical therapist got her into a chair and took her into the lobby so she could see and hear the rain. Everyone here is very kind and willing to include us in all of her care. They are very very thorough for every minor detail and have impressed us greatly. We feel very comfortable with her there. She has a big window in her room with a giant tree outside that has squirrels in it. She looks out the window a lot. The kids are adjusting well. We are getting them situated at Britney's parents house and got Jonas registered for school yesterday. Britney has ton's of visitors all the time. Her best friend from High School Becca was planning on coming to Tucson in a week to visit but happened to arrive in Denver the same day as Britney to see family and friends. She spent a few hours the last 2 days with Britney and brought a bunch of pictures and put them on Britney's wall.

Special prayer today

I found out from Mary Lee the the actual prayer with the 12 apostles of our church is today on their regular Thursday meeting day. She found out about it Sunday and thought it was that day but posted a comment a few days ago that it is actually today. Britney had a very comfortable night. This morning Dr. Weintraub one of the directors of Craig Hospital neurorehab came by to see Britney and had a ton of great ideas. He and the speech therapist and occupational therapist at Kindred in Denver rounded together and were very encouraged by her progress and and said that they will change around her medications to keep her less sedated with narcotics and baclofen and will look into getting her some injections. Her OT did some great range of motion and is working on some splints. She said that Britney will likely not have any permnant contractures with agressive treatment. They will get a MRI today. A neurlogist who works closely with Kindred here and Craig hospital will be coming in a few days. He is getting over a sinus infection and didn't want to get anyone sick. Britney's aunt Jan talked to her a lot yesterday when she was telling her how great it would be to have so much family coming and taking care of her and she smiled. She has been very awake this morning and has looked at us when we talk to her a lot. When my mom told her about the apostles of our church praying for her she cried and had a tear roll down her cheek. Her eyes were dry before she heard this.

Trip went smoothly, hospital is incredible

This is the 1st internet I have gotten a chance to post. The trip went very smoothly. Britney was kept very comfortable. We found out we were landing at the airport in Denver where Casey's (Britney's dad) firestation takes care of this morning. Casey talked to the flight coordinator and arranged for his station's paramedics to transport Britney from the airport in Denver to the hospital. It just happened to be the day his team was on. When we landed at the airport there were more than a dozen firefighters and their 2 medics waiting for us. It was like coming home to family. Britney's dad has been at that station over 20 years and she grew up at the fire station and Jonas had his last birthday party there. They have been incredible in raising money to keep family coming to Tucson to help out these past 8 weeks. I can't even describe the emotion I had or the emotion that was on all of their faces when we landed. I will never never forget that moment and I'm sure none of them will either. Thank you thank you.

When we got to the hospital Britney's Aunt Jan and my Mom were waiting there. Just as much emotion as at the airport. Jan has been talking to Britney on speaker phone most nights and posting comments on the blog. Britney has responded to her so much in the past and I'm sure she will continue to help Britney come back. My nephew Dante was climbing in the room and Britney turned her head and eyes and looked at him. Britney's hospital is amazing. We feel like her care is phenomenal. We met with everyone from almost every group already PT, OT, Speech, Dr. Yager the medical director and critical care Dr, and many of the case workers, nurses, etc. There is an outstanding neurologist who has known she is coming who will meet her tomorrow and one of the PM&R Dr.'s from Craig will meet her in the next few days. She will be put on the waiting list for Craig right away and a plan to get her to Craig is in the works. We feel very very peaceful about our decision to bring her here. Talk to everyone soon.
John

Please help if you can with transport costs

We are very happy she is going to get the best care for her situation in Denver. The air transport will leave here tomorrow morning. Unfortunately our insurance will not cover transport costs but the care in Denver is approved. The flight will be $11,700. We have about $5000 now and our family has said they would help get to get Britney the rehab care she deserves. If you can help out even a small amount it would be greatly appreciated. I was able to get out of our lease so I will be moving out by the end of the month and will be able to save some money. Carlie put up a post on July 15th about how to donate to Britney's trust fund. I know it was the right decision. Craig Hospital is the best Neuro rehab anywhere I believe and will all of the family and extended family and friends support in Denver it will be the best place for her and our kids. Thank you again for all of your help in every way. Britney has responded a lot more lately. She has so much emotion on her face. She has smiled (when we have talked about the kids), she has cried (when in pain). When I ask her if I can stretch out her muscles she relaxes and lets me. If I forget to ask she tightens down until I ask. She has opened her mouth when we ask her to. Yesterday she turned her eyes and watched TV when Casey turned it on. Britney has been off the ventilator just on oxygen for about 60 hours now and has had 100% o2 saturations!!!!! She had a really really hard night last night and a very painful day but is finally sleeping for the last few hours. I think she will have a good night and get the rest she needs for tomorrow. I'm sure she will get phenomenal care in Denver and we feel at peace about this decision even though it was the hardest one we have ever made.
John

Britney going to Denver for Rehab

Hi everyone,
This has been in the works since Thursday afternoon. Britney will not get the rehabilitation care she needs in Tucson. We were told this by multiple people, and by the rehabilitation doctor who came Saturday. Dr. Toiber suggested that we should look into Barrows in phoenix which would be harder for our family. After much discussion and looking into places we found an acute care hospital in Denver that has PM&R doctors from Craig hospital who come there everyday. It is a kindred hospital but they have a much higher level of care there than in Tucson. They have 24/7 Critical care on site, intensive rehabilitation. They prepare all of their patients to meet criteria for Craig hospital. My dad visited it on Saturday and was very very impressed with the atmosphere the concern and human touch. They are the best place in the country to get her ready to go to Craig. Their Medical director Eric Yager did his pulmonary critical care fellowship in Tucson and my program director knows him. We feel very very good about this decision. Our insurance has approved for her to come to Denver and there is a good chance the insurance will pay for the transport. All the details are being worked out now. Hopefully she will fly to Denver this week. We will let you know when we find out when she will be going.

How this affects our family.

Everyone has asked this. All of the kids will go to Denver to be with family and Jonas will go to school with the same teacher Britney in Littleton. Britney's parents Casey and Jana will drive the kids up with their stuff. My parents and Britney's parents live 15 minutes away from eachother. Both the kids and Britney will have increadible amount of support and care in denver. We have tons of extended family there and many many friends. I have no doubt it will be better for them. I will go with her to get them settled and be back there for my vacation in 4 weeks from today. I do not qualify for family medical leave because I haven't worked at UMC for a 12 months. I will be able to visit on days off and as needed take elective time. It is a very hard situation but we have prayed about it a lot and feel a huge peace about it. I need to keep up with residency #1 to keep Britney having the insurance she needs to get the best care there is, and #2 to make a future for our family and our future. This situation will be sustainable long term. We are getting out of our lease and I will stay with friends in Tucson until we get a time frame worked out. This way we will be able to save the money we need for me to fly back and forth.

Special prayer today

Britney had a very painful night last night. We just got a call from Mary Lee Call who is in our ward. Her father is Elder Scott who is one of the 12 apostles in our church. She shared with him Britney's story and he was very touched. Mary Lee called us about an hour ago and told us that the quorm of the 12 apostles are having a prayer session right now for Britney and a some other people. We are fasting today for Britney to be able to get all the care especially the rehab care she needs. Thank you for all of your thoughtfulness and prayers.
John

Britney slept pretty good last night. Today we worked with her a lot and got her arms a lot straighter so she was pretty sore by the end of the day. The baclofen she has been getting has made her more sleepy. The PM&R doctor came by today and was very helpful. I'll write more tomorrow and monday. We need to catch up on sleep. Thank you for all of your emails and comments for Britney.

Britney's dad spent last night at the hospital and moved her joints a couple of times every hour. She was much more relaxed this morning and I spent most of the day with Britney and kept heat packs on her and massaged her, and stretched her legs and arms. Her right arm I have got back to normal, and her left arm a lot straighter. She is in less pain. I also stretched her neck. She is sleeping very comfortably tonight. The physical medicine Dr. still didn't show up today which is very frustrating. She is tolerating her G-tube feedings well, and has turned a big corner. Thank you for all of the comments and emails. I read to her all of these today also.
John

more pain today

It's frustrating without good therapy. Britney was in a lot more pain today. I bought her a bunch of heat packs and some icy hot and gave her some good massages. She loosened up during the day but had more pain in the afternoon and was just as contracted as she was when I started this morning. A physical medicine/rehab doctor was going to come today but didn't. Hopefully he will come tomorrow. They have very few in Tucson. Hopefully he can offer something to help her loosen up and be in less pain. In Wisconsin our PM&R docs did a lot of injections to loosen up muscles. She is still having trouble tolerating her G-tube feedings but is making progress. She hasn't had a fever in a few days. The next big thing we have to get her over is to help her get rid of her contractures and pain from her muscles. For all of you who want to write something to britney but haven't been able to post on the blog you can sent me an email at winklerj87@yahoo.com and I will read it to her. Several of her friends and family have done this and she has listened to the letters and looked at us while we read to her. Thanks for your continuing support and love.
John

Britney had a really good day. She was kept very comfortable with heat packs, muscle relaxers and pain meds. She still woke up when we talked to her. DeeDee her cousin spent the night with her and talked to her a lot of the night and did her hair. She calmed down whenever she talked to her, and even cried when DeeDee talked about Britney's kids and DeeDee's kids. Her and DeeDee grew up like sisters. She went home last night back to her family. Thanks for coming. It means the world to us and to her.

More comfortable

Dr. Smith had a brilliant idea yesterday. Britney's pain was still bad and she figured out it was from her tight muscles and put her on muscle relaxers. She has been very peaceful. She is really tight in her arms and neck and has developed some flexion contractures over the last few days. She had heat put on them and I stretched her muscles and gave her a few good massages. It helped a lot but she is still in a lot of pain in her neck and arm. She has a urinary tract infection she is being treated for. The official report of the CT showes that her lungs are better and no pneumonia, or bowel infection. The phyical therapists at UMC don't want to work with her because they say they don't just do range of motion. We are working on it ourselves. It is very frustrating, hopefully we will get some good therapy and she will follow commands more and more so they will be willing to work with her. We have been reading to her a lot and she has been looking at us while we read. We read her all of your comments you post and she is very relaxed while we read them to her.

Doing better but blood counts low

Britney is doing better at UMC. Her pain is easier to control and she doesn't have a fever anymore. The CT scan showed that she had a lot of air in her colon and intestines. No infection they saw in her belly. Her left lung has a lot of scar tissue and collapsed lung. I'm not sure if there was a small pneumonia there also. She was really dehydrated from not having anything to eat for a few days before she was put on TPN (food through and IV), and it took a lot of fluid to catch her up since she got back to UMC. Her kidneys are fine now she has had a lot of fluids to catch up. She is on antibiotics right now. She has been very awake and moving a lot. More when she is in pain.

back at UMC for fevers and belly pain

Britney had more and more abdominal pain yesterday and today and has had a fever since last night so she was transferred back to UMC. She just didn't seem like her pain medication was working more than 15 minutes since early this morning, and I told the Dr. at Kindred that I wanted her back at UMC and he agreed. She came back by ambulance, and is comfortable back in the cardiac ICU at UMC. They are taking blood cultures and doing a CT scan of her chest, abdomen and pelvis soon after they give her contrast. Hopefully we will know soon what is causing her pain and fevers. I'll let you know when I find out.
John

Kindred Hospital is going well

Hi everyone,
Britney had a really good night. She was flexing her arms up to her face again and almost pulled off the ventilator tubing multiple times. The people at Kindred are great. The Dr. who took care of her at TMC in the ICU back when she first got sick came to Kindred to take care of her. His group comes there also. He told everyone in his group that he wanted to come take care of her. It totally made my day. He was instrumental in saving her life has been following along on the blog for the past 6 weeks. Thanks Dr. Toiber. Talk to you soon.
John

Britney is going to the acute rehab hospital in a few hours. We are really excited. She moved so much yesterday she is very tired today. Yesterday also after I posted Britney lifted her head and arms off the pillows and opened her mouth like she was trying to say something but couldn't. Her trach makes all the air go out below her vocal cords so she can't make any noise. When she couldn't get a sound out she started to cry. I talked to her and stroked her hair and she calmed down. This happened about 10X yesterday. She is in there still and coming back to us.

More movements

I just got back from the hospital and wanted to give an additional update for the evening. Britney was getting some gases building up in her stomach, so they took her off the feeding tube tonight. She seemed very awake and full of movement most likely due to the discomfort in her stomach. She was far more active than Jessah or I have ever seen! With a lot of effort she managed to move both her hands from down at her sides to up near her face. She was even pivoting one of her wrists quite a bit. I thought I caught her staring at her hands, but wasn't sure if it was on purpose. A minute or two later I asked her to look at the green grip in her hand to see if she'd do it again. She couldn't seem to, so I asked her to follow my hand to try and lead her eyes back to the grip. She did it perfectly! For the next forty five minutes or so, Britney continued moving her hands around a ton and once accidentally disconnected her ventilator tube. She also stared at her hands again, that time without any coaxing. Eventually, her heart rate rose some and she became shakey and tense from exerting herself too much. She kept trying to lift her head off the pillow and was acting like she still had stomach pains. The nurse gave her some pain medication to calm her back down and within a few minutes she was breathing at a good pace and fell asleep. Have a good night everyone!

-Kenzie

Britney just moved both of her legs. She hasn't moved them since she has been off ECMO. There was a CT scan about that time that had showed a possible stroke in the leg territory of her brain, but now she is moving them!!!. Arielle stayed the night at the hospital last night and also saw her move her toes!!!!!!! Arielle read to her a lot yesterday and she looked at her and stayed awake the whole time she was reading to her. She also saw her smile when Arielle was singing to her last night.

Britney opened her eyes and looked at Anna when Anna smiled and cooed at her. She had another great day. I met with the people from Kindred hospital and went on a tour today with all the kids and Britney's sisters. It seems like a great place. They have a great staff with a lot of experience in critical care. They have lots of physical and occupational therapy. They said they can take Britney even with the chest tubes in. Britney may go there in the next few days.

Britney's feeding tube got put in today. It went really well. They used a camera in the stomach to shine a light on her abdomen so they could do it in her room. With the camera they saw her whole stomach and the beginning of her small intestine and it didn't have any ulcers. Lots of ICU patients commonly have ulcers from being bed ridden and sick for so long. Me and Jonas spent the day at the hospital. We read to her a lot and she opened her eyes every time we read to her. When her nurse was cleaning Britney's mouth Jonas told her it was ok and told her to open her mouth and she did. She was breathing fast in the afternoon and had to go back on the ventilator for a rest.

Britney had another really good day. She has been moving and tracking (following people with her eyes) a lot more. She heard Anna crying today and started moving alot. When I brought Anna to her Britney calmed down. I brought Anna to her and Britney calmed down and layed back down. The doctors and nurses are excited about the progress she is making. She is going to get a feeding tube tomorrow that will be put in her stomach from the outside. She has had a naso gastric (nose stomach) feeding tube for almost 3 weeks now, and needs something more permnant that wont irritate her nose. Medically she is doing very very well. One of her chest tubes got taken out today. Her air leak is almost better and she may get off all of her chest tubes in the next few days and not need any more surgery. She has been breathing great on her own during the day and resting on the ventilator at night. She will likely be going to Kindred hospital an acute rehab hospital that is much closer to our house in a few days.

Vera read Britney a book today and she started moving her arms a lot. Vera was really excited. I told her that she could help wake Britney up if she talked to her and read to her. She has been looking at us a lot more today. She has been doing great without the ventilator during the day and being back on it at night to rest. Vera had a great birthday. We went to a swimming party, and she opened her presents from family in the morning. She put a barbie wig on Anna and Anna liked it.

Britney slept for a lot of the day, but opened her eyes and looked at me when I read to her and when her sister Mckenzie talked to her a lot this afternoon. She had a fever overnight and this morning but was out of it this evening. She will probably go to rehab next week.

Anna Learns Piano

Britney has been breathing on her own for most of the day. She has been really relaxed. I was talking about our kids to one of the RTs and she saw Britney smile. I showed Britney the picture of our family we have in her room and I saw her smile again. She turned her eyes toward the phone when her dad was talking to her on speaker tonight also. When we were talking about her how I asked her to squeeze my hand and I thought she did but wasn't sure she picked her head and arm off the pillow. She put her head down when I told her I believed she could hear me. She didn't squeeze my hand again or close her eyes when I asked her after that. I really don't think it was concindence at all. I'll give you all a update in the morning.
John

Breathing on her own all day

Britney was breathing on her own with just oxygen over her trach for 12 and 1/2 hours today. The more she breathes on her own the faster the air leak in her left lung will heal. She did amazing. Her oxygen saturations stayed near 100% all day. She got really tired near the end and got put back on pressure support ventilator for the night to rest. She fell asleep soon after they put her back on it. She was looking the other way when I said hi to her last night. She moved her eyes and looked at me, and I put my ear phones in one of her ears and she moved her eyes all the way to the side where the ear phone was put in. She moved her hands (mostly her left) all day, and has been opening her mouth for the nurses most of the time.

Kids update.
3 of Britney's sisters are here for the next 2 weeks. Mckenzie, Jessah, and Arielle. The kids are having a blast with them. They have been playing with some friends a few days a week. They went swimming today at our pool and had a great time. Vera is turning 3 on Saturday and is really excited. Anna is 15 weeks old and is growing a ton. She is a really easy baby. Vera was too until she could roll then she rolled around the house following Britney everywhere, and pulling things off shelves. We'll see what Anna does. Jonas has been having a harder time the last few days and has need a lot of one on one time. Yesterday he stayed with me at the hospital and played games with me. Tonight he read me a chapter of one of his books.
T

Surgery went well

Britney's surgery went well. She was very stable during the surgery. There was a lot of scar tissue around her left lung and a lot of blood clot at the top of the left lung also. When the clot was removed an air leak was found. Dr. Smith made a pleural tent (used the lining of the lung to try and cover up the air leak). It may work. She said that they will see how her lung expands and to a functional scan (ventilation and perfusion) to see what parts of her left lung are exchanging oxygen. She didn't end up having a feeding tube put in today and will get one in the next few days. During surgery they also did a bronchoscopy ( a camera in her lungs) and found the pneumonia is resolved, but took samples of the mucus in her lungs anyway. She's back on the ventilator until they wean her off it again because of the anesthetic and paralytics used for the surgery. Thanks for all your extra thoughts, concern, and prayers today.
John

Surgery Tuesday

Britney is going to have surgery tomorrow to have the scar tissue around her left lung taken off so her left lung can expand more. Right now she is breathing on her own without the ventilator and is doing very well with it. She is doing so well they are talking about getting her to a rehab facility in a week or two. Talk to everyone soon.
John

Another good day

Hi everyone. I hope you all have had a good weekend. Britney continues to move her arms a lot. She has lifted her elbow off the bed multiple times. She followed me with her eyes when I talked to her. She has been picking up her head off the pillow a lot also. She does these things intermittently throughout the day and has been more sleepy at night. Her responsiveness comes and goes. We have had amazing nurses. Her nurse today told us that she has had many amazing experiences with patients who have been on ECMO who have recovered. Many have taken months to be ready to go to a rehab hospital. She is most likely having her lung surgery on Tuesday to take off the scaring on the outside of her left lung so it can expand more. Kids update: The kids had a great day playing at a friends house. Vera is having a hard time understanding why Britney isn't up talking to her yet if she is still alive. We have to reexplain things everytime we take her to see Britney. She gets really excited about every little movement Britney makes. Anna is growing like crazy. She kept me up half the night last night. I think she hit a growth spurt because she is eating a ton more and waking up more. She had some rice cereal today and gobbled it down. Hopefully she will sleep more tonight. She is staying the night at a friends house so we can get caught up on sleep. I'll post again tomorrow to let you know when the surgery will be.
John

Britney has had a great day. She has done more and more throughout the day. She was asleep tonight and I had her aunt Jan talk to her on the phone then she opened her eyes a little, held up her head, and L arm off the pillow, turned her head and moved her other arm all the time her aunt talked to her. After she was done Britney went back to sleep. She has picked her head up off the pillow a lot today and her left arm too. She has been following us better with her eyes also. She is still in there trying to wake up all the way. Have a good night.
John

Britney is moving more and more. She has been moving her head in different directions, yawning, moving her hands, and following us more and more with her eyes. I have lots of her family and friends call and talk to her on speaker phone. She has been turning her eyes towards the phone a lot today. Yesterday there was a box dropped down the hallway and her whole body jumped. It happened again when her mom coughed in the room. The nursing staff has been taking amazing care of her. They have been talking to her, moving all of her arms and legs to keep them loose. We have been massaging her hands and feet. Everyone I have talked to says the people they have seen come back from coma's have started doing little movements, and moving eyes more. This happened to my sister in law and to one of Britney's extended family members. I talked to her CT surgeon today and her pneumothorax (air leak) in her right chest is gone. Her pneumonia is healing very well and there is no evidence of clots in her lungs any more. She has a fibrous layer around her left lung that is constricting it. On Monday she will probably have that taken off with a video assisted surgery. She is completely off of dialysis also. Have a great day.
John

More movement

Hi everyone. Britney continues to improve and show us she is still there. She has been opening her mouth for the nurses. She has been tracking (moving her eyes to follow people and objects). She was turned on her side a few days ago and her hand fell off the pillow, she lifted her hand and put it back on the pillow. These episodes don't happen constantly but are increasing in frequency. Her kidney's are almost better and she might not need any more dialysis. Her lungs continue to improve, but she still might need an air leak in her right bronchus (the air pipe in the right lung) patched, and some of the blood clot removed in her left lung. There is a tentative plan to do this Monday. She is still having some fevers. Her doctors think it may be from the fungal UTI she still has because the only antifungal that works against the type of UTI she has doesn't get into the bladder very well. Also she is still fighting her pneumonia. They more blood and urine cultures everythime she gets fevers and so far nothing has grown from her blood cultures. Everytime I lose hope for her to get better I feel an incredible amount of peace that everything will be ok and that she will come back. I wish I could see into the future at least a few weeks or months and see what will happen. It's hard to be patient. Thank you for all of your continuing support, kindness, prayers. Don't lose hope. She continues to get better. I constantly hear stories of impossible situations where people have gotten better and come back to their families and lives. Have a good day.
John

Britney had another really good day. Her kidneys are continuing to get better. She had another CT scan of her chest abdomen and pelvis. Her pneumothorax on her right side is almost gone as they have repositioned the chest tube. Her left lung pneumonia is healing much faster than expected. She may or may not need the clot in her left lungs removed to heal completely. Have a good night everyone.
John

Trust Fund

We have had many requests, by people wanting to donate money, to open a trust fund for Britney and her family. Reluctantly John has agreed to open a fund. We don’t want anyone to feel obligated to donate. We have been helped in so many ways and we could never express how grateful we are to everyone who has helped us during this time. We appreciate EVERYTHING that you have done for us.

 

We would like to thank all of you for your thoughtfulness, prayers, help with the kids, words of comfort, offering your homes to us, meals, and rides to and from the airport. We are grateful to those who have made it possible for us to spend time away from our homes and jobs to be with Britney and to care for her kids. Thank you to those who are assisting John to help him keep up with residency. To the doctors who have used their skills and knowledge to make the best decisions for Britney, and the nurses who tirelessly care for her and are willing to answer all of our questions. To those who have already made donations and all who are simply thinking about us and letting us know you are there for us. We could never list all of the ways you have helped. What a difference each of you have made. You have been the hands of the Lord to bless us and help us through this.

 

For those who wish to donate:

The title of the trust fund is “For The Benefit Of Britney.”

You may donate at any Chase bank.

Bring account number #815195532 with you.

Make all donations to John Winkler. (We are unable to put Britney’s name on the account because she cannot be there in person)

Donations can be made using check or cash.

All donations are anonymous.

Sincere Thanks, 

Carlie

Britney had another very restful day. She tried breathing on her own with only oxygen this morning and did very well with it but is not ready to be off the CPAP assisted ventilator yet. She continues to move her arms a lot, and to track a little with her eyes. Casey went home today. He was very sad to leave. He has been an amazing friend. We have become very close through these past few weeks. Britney's mom is trying to get on another flight tonight because the other one was canceled. Her aunt made it here this morning after 3 days of flying stand by through about 10 cities. The kids are doing really well being at home on a schedule and playing with other kids. It's amazing how resilient they are. Have a great night.
John

Another good day

Britney moved her arms very purposefully today multiple times. She looked at me when I talked to her tonight after I got off my shift. She has been breathing on her own with a CPAP ventilator for almost 2 days now. Her kidneys are starting to work again on their own. Her left lung is still clearing on it's own. Her heart rate has been very normal for the most part. I had a great 1st shift today, and really fun ultrasound training. Talk to you soon.
John

No surgery tomorrow doing better

Britney is having a very good day. Her pain is very well controlled with a small amount of pain medicine. She has been awake sometimes looking around. She followed her sister Arielle's finger around with her eyes. She also was switched to a new ventilator that allows her to breath on her own and give breaths as needed. It also has some pressure support like CPAP to keep her airway open. Her left lung is beginning to clear on its own, and they are readjusting the chest tube on the right side to take care of her pneumothorax. Today was such a amazing day for her. Thank you for all of your prayers and thoughts and support.
John

Hospital Photos

These are a couple photos that I took of the kids at the hospital while I was visiting Britney about two weeks ago. I thought everyone might like to see them.

Carlie

Britney has been much more comfortable since last night when with a lot of help we found a oral surgeon who has hospital privileges. He took out 6 of her teeth, numbed her mouth very well, and took a lot of time cleaning up her mouth and lips. She has been very peaceful since then and has not required much pain medication to stay comfortable. She was calm and peaceful all last night and today. Her eyes have been open and looking around. She looks beautiful. Close to her normal self which is incredible from how in pain and damaged her mouth and teeth looked yesterday. I went to our Intern retreat yesterday on Mt. Lemmon and had an awesome time. I tried to come back last night but we had a giant hail storm right before night fall and I didn't want to drive down it in the dark. I took the kids up there today and they had a blast. Vera has made a great friend. One of the other Interns has a 4 year old daughter and they are almost inseparable when we get together as a class. We still have a lot of peace and hope that everything will be ok. It is incredible the stories people have told me and keep on telling me of family members or friends who were in a similar situation and have made it back to their families. Thanks everyone for your incredible support.
John

Britney had a good night

Britney's pain was controlled the whole night. Her hemoglobin and hematocrit have been stable for 36 hours and she hasn't needed any blood. She has been very peaceful since her pain medication was increased. We pray for her body to heal over the weekend so she can be ready for her surgery monday.

Britney had a very hard night and day today. Her blood counts dropped a lot last night. They thought it was a GI bleed but the GI doctors didn't think so. Luckily with 3 units of blood overnight she was stable and kept her blood counts stable all night and day. She was taken off all sedation and pain medication all night and morning for the neurologist to come. She was in excruciating pain when she tightened her mouth because of her teeth or when they repositioned her. She looked at me many times. We have seen many movements we have put in our blog that seem very purposeful to us. Neurology came by at 9:00am and told me they are signing off because they do not see any purposeful movements. They have only been by 2-3X in the past week for about 5-10 minutes per visit. I told them what they see is only a snapshot in time. They were very abrupt, and stated her chances without any purposeful movements is very close to zero to come back to us. It was very frustrating. I asked her primary team to keep her comfortable because they didn't need to torture her anymore for the sake of the neurologists. It still took about 4 hours to get her pain under control and to help her fall back asleep. They are trying to track down a dentist who will pull out her teeth since the other one went on vacation and didn't do a thing for her. Britney's best friend in Wisconsin's husband is a oral surgery resident and they offered to have him fly down to help her not suffer so much but he can't do anything without hospital privileges. Neither can his dad who is a oral surgeon in a different state who they also offered to fly out. She will have to suffer with her teeth until they get someone to come here. Today she also had a CT scan to look at her lungs, and the fluid collection behind her right kidney and to see if she was having any bleeding anywhere. The left lung is very infected and has a lot of blood clot keeping her from getting better. A surgery is scheduled Monday to clean out the clots in her lung and help her heal. The time until then they will work on getting her well enough for surgery. She is stable and comfortable since they got her pain under control a few hours ago. The primary team is great and said they will go all out to save her. It is way to early for us to give up on her. My sister in law survived a severe head bleed and was written off for dead many times. We don't want her to continue suffering but want to give her the chance she deserves at the same time. We have felt so much peace and hope. Ever since the night she was placed on ECMO and we thought she was gone I have such a strong thought and feeling come to my mind and heart when I start to loose hope. The story of Lazarus has popped into my mind so many times with such peace. If God wants to take her home to him I pray it will be soon and without suffering but if he wants to give her back to us I know he can. Sorry for such an emotional post. So many of you are so emotionally invested in her and our family. Despite the horrible tragedy this is to all of us we are not our tragedey's. We are filled with a peace that is well beyond us and has kept our family going. What ever the outcome of the next few weeks there will be a great life to live. She will be our angel in this life and the next. Keep praying for her to get better, and to be comfortable. Thank you for all of your love.
Have a great night,
John

Britney had a rough day but is doing much better tonight. She had a lot of different arrhythmias today and had to have lots of medication to help her come back into a normal rhythm. She had cardioversion pads on for a lot of the day because her heart rate was fast but never needed to have her heart shocked. Her teeth are very sore. A dentist came yesterday and looked at them. He said she would have to have her three front top teeth pulled. He didn't do it and left on vacation today so the team is trying to find someone to pull them. When we put a movie on for her this afternoon she picked her head off the pillow to look at the TV and stared at the screen for about 1 minute. She was also very awake tonight and looking all around. She looked at me for quite a while but didn't seem to be able to understand me. She is still having fevers also and is being treated for a urinary yeast infection. She had another broncoscope of her left lung today also which got out a lot of mucus. No bacteria has grown from the other two other times they took samples the past two weeks. Tomorrow will be a big day also. They are considering having her go to interventional radiology to drain a fluid collection behind her right kidney to see if it is the source of her fevers. They are also planning on taking her off all of her sedation tomorrow to see how much she wakes up. The last EEG last week showed that she was still in a metabolic coma. That means it could be from infection or her kidneys not working well, or other things. There are many reasons she has to not be fully awake yet. We are still hoping and trying to be patient. Have a good night.
John

Britney was opening her eyes more today. She had a CT a few days ago that showed inflammation of her intestines, and a small amount of bleeding or abscess behind one of her kidneys. She is going to have a drain put in under live X-ray later today. Thank you for all of your support. She is still very sick but overall slowly improving. It will be a bumpy road but she is headed in the right direction. Have a good day.
John

Britney had a trial without the ventilator this morning with only CPAP (she is breathing but the CPAP helps keep her airway open). She did it for about an hour!!! She also opened her eyes wide open a few times this morning and was staring at her dad and my mom before my mom went to the airport. It meant a lot to my mom to see before she left. I successfully passed my advanced pediatric life support this morning also so we are having a good day so far. Thank you all for your prayers and love.
John

John and the kids having fun with surgical masks! Jonas said he was being storm shadow (GI Joe)

Hi everyone,
Britney had a tough day. She has been biting her tongue and lips and had to have a bite block put in. She bit it so hard she broke one of her front teeth. She is still very sleepy. The hardest thing is being patient for her to wake up. We all miss her a lot. The brief moments she opens her eyes and looks at us are wonderful but so small a part of everything we miss about her. The kids are having a great time with their aunt Jessah. My mom is going home tomorrow. She has been incredible to have here. I got through the 1st week of residency (lectures only) and was able to miss my 1st shift in the ED to be with Britney. We have the best intern class in the world. I have to go read a book to Vera now. Have a good night.
John

Anna doing karate


At the request of Grandma Foster or grandma LuLu as our kids love to call her here are some more pictures of anna for everyone. I haven't uploaded the latest and greatest pictures from our digital camera so these are a few months old. We will get some more up soon. Britney had a very good day. She has been awake off and on today. Her dialysis is going well. We had an awesome party for all of the new interns to meet the other residents and faculty. Everyone had a great time. It was really good to get out and have fun. The kids had a blast. Hope everyone had a great 4th.
John

Happy 4th of July.
Britney had a very good night. She was looking around a lot last night and and squeezed my hand. Have a great 4th.
John

Trach done went well.

Britney had her tracheotomy done today and it went very well. She woke up quite a bit after surgery and was pretty responsive. She is getting dialysis now. Over the next few days they will wake her up more by decreasing her sedation. This is another huge step for her because she can heal her mouth, and possible mouth words, and be able to get off the ventilator quicker.
Have a great 4th of July tomorrow everyone.
John

Hi everyone. Britney had a great night. Today she got a dialysis catheter. She didn't start dialysis because her blood pressure was a little low this afternoon. She is doing better now though. She squoze my hand really hard today when she was having her mouth cleaned out. She looks a lot better but has been more sleepy with more pain medicine and sedation. The kids are doing great. I slept at home yesterday and they kept me up until 10:00 playing and laughing. They have been very happy being at home on a schedule. My mom has been amazing with them this past week and a half. Have a good night.
John

Britney had a great night and day. She got her central line changed out, and a new air bed so she doesn't get any bed sores. So far she hasn't had any which is pretty amazing. She doesn't like being moved at all and clenches her jaw and hands. She is still pretty sedated otherwise. She still tries to open her eyes whenever we talk to her. I'll post another update tomorrow.
John

Picture of the day

Hi everyone it's Jonas,
Thank you for helping us with our dinner cause our mom is sick and my dad is helping with mommy. Thank you for praying for my mommy. Thank you for watching me and Vera. We miss you.
love Jonas (Jonas told me what to write)

Britney had another great night. She was off sedation and most pain medication last night to see if she would wake up more. She had her eyes wide open for a long time and looked at us for what seemed like forever. She blinked her eyes when we asked her to multiple times. She didn't seem scared like I thought she would. She calmed down very easily when me and Casey held her hands. She was awake for a few hours then slept most of the night only waking up when she got repositioned and had a very peaceful night. She had a fever this morning (The ECMO had controlled her temperature before this) and was started on another antibiotic. Over all she is doing great considering all she has been through. Now she is scheduled for a tracheotomy on Friday. They are keeping her very comfortable and more sedated today. I don't mind posting her updates cause then I don't tell so many people the same thing so it's a lot less time intensive to keep this up. each post only takes a few minutes. And we are sleeping pretty well. Have a good day.
John

Britney's off ECMO (Bypass)

The heart surgeon just talked to me and Casey. Britney did great and was just fine when they took her off ECMO!!! Her woulds are all closed and she is doing well on the ventilator. She will get a tracheotomy in a few days. Then they can start to cut down on the sedation medications and wake her up more. She will be in the Cardiac ICU in a few minutes. Thank you all for your extra prayers today.
John

Just got word everything is going well and she will come to the Cardiac ICU. Not sure how much longer.
John

Britney just went to the OR

Britney just went into the OR about 15 minutes ago. The transport from the room went ok. We don't know the time table but will put up a post when she is out. If they have any problems they will just put her back on ECMO. We'll let everyone know soon.
John

Family blog site

We just got a request to make our family blog site Britney has been doing for a few years public so I just opened it up. Here is the link. http://www.winklersite.blogspot.com/

Photo of the Day

Jonas and Vera love to "cook" i.e. make a mess. They got a hold of Britney's old cullinary school uniforms and had a blast a few months ago.

I just spoke with Britney's cardiac surgeon. They are planning on getting her off ECMO this afternoon. She has tolerated the weaning well. They just cleaned out her lungs again with a bronschoscope to get her ready to be only on the ventilator. Say extra prayers for her today.
John

Just a few hours ago I was standing by Britney's side holding her hand and asked her to open her eyes. She has been very sleepy with a lot of sedation and pain medicine. She opened her eyes half way and moved her eyes to look at my face. They nurse asked her to close her eyes as tight as she could if she could hear us and she did. We asked her to do it again if she could hear us and she did. About 20 minutes later I was on the other side of her holding her other hand and asked her to open her eyes and look at me. She opened her eyes and looked where I had been 20 minutes before. I said I'm over here and she looked at me for about 30 seconds. They have been giving her more sedation and pain medicine because she has been more aware this evening. She had a very relaxing 2 days. Tomorrow will be a big day for her. Have a good night everyone.
John

Image of the Day,
Here is Anna,
She looks a lot like her mom. She has been a little angel to look at in the middle of the night. She started laughing and cooing last week. Have a great day everyone.
John

Britney had a good day. They continue to wean her from ECMO. They lungs are taking more of the oxygenating on by using the ventilator more, and her heart is doing most of the work now. As she continues to show that her heart and lungs are able to take over she may go to the OR tomorrow to get off ECMO. It will not be today. Her body continues to fight her ventilator pneumonia and is doing well with it. The dialysis is also going well. Her kidneys are still making good urine also. Her vascular surgeon said she might not lose any toes only a few toenails which may grow back completely. She was biting her breathing tube alot this morning and had to get a bite block in. She has been moving a lot today and continues to blink. She has been looking around a little. She has had a lot more pain medicine and sedation these last few days also and has been more sleepy. Thank you all for following the blog so closely. We went to church today and had so many people ask about her. Jonas and Vera got to play and be with their kid classes. It was a good break and rejuvinating to be at church. We love you all.
John

For all of you who have not heard the story of how Britney got sick here is a condensed version. 1 1/2 weeks ago Britney had a sudden onset Toxic Shock Syndrome that came from a infection of her uterus by Strep A. She had sudden onset belly pain. She made it through an appendectomy and a hysterectomy (this saved her life). Last Saturday night she was being transferred to the University Medical Center in Tucson to possibly put an assist device in her heart to help her heart and lungs recover from the sepsis. On the way there her heart stopped multiple times. Luckily a heart surgeon transferred Britney herself and saved her through CPR and placing Britney on a type of heart and lung bypass called ECMO. She had another stable night.
John

Britney's blood type is A+. I asked the hospital staff about donating to britney. They said it takes a week to process. It is better just to donate locally wherever you are to replenish the local blood bank. I know there are many people who go through a lot of blood in every city. For those of you in Tucson they had a blood drive at UMC cafeteria but it was closed today. Sorry for those of you who came by. Try calling the local blood bank and asking for their hours. That is the best way to make sure you don't miss them. I just figured out how to read posts and respond (Britney set up our other blogs). It is a good way to keep in touch. Sorry I didn't get back to all of you sooner. Please if you have any questions or ideas of what you can do to help just post them and I or one of our family will email you back. Have a good night everyone.
John

Britney moved her eyes.

Hi Everyone,
Britney had a great peaceful day. No ECMO removal. Maybee tomorrow or Monday. Her aunt and uncle Debbie and Gordon came just for the morning to say hi. When Debbie and Jana (Britney's mom) were holding both of her hands and I was standing right by them she looked at each one of them and stared at their faces. Then she had a few tears roll down her cheek. She had a lot of pain responses today with repositioning so they increased her pain medication and gave her some sedation so she slept peacefully most of the day. She is in there trying to wake up. Have a great night everyone.
John

Sorry I didn't get a post up last night. I didn't have internet access. We moved out of the sleep room at the hospital so another family from out of town could use it last night. Britney had a great day yesterday. It was a very great day. She had a trial off the ECMO so they could get a echocardiogram. Her heart did wonderful, even better when the ECMO was off briefly yesterday. There is talk of taking her off it completely today or tomorrow. The other big thing that happened yesterday is she developed a ventilator pneumonia in her left lung. She was already empirically covered with the antibiotics she was on. They also put a scope into her lungs and washed a ton of it out and got samples for cultures. Yesterday she also started dialysis. This is a very common thing in ECMO and from what I have been told the kidney's usually return to their normal function. She has moved both sides of her body, and has turned her head. We have seen tears come up in her eyes quickly while talking to her. One of the night nurses last night said that he saw her follow his face with her eyes which is huge improvement. The Neurologist said her CT scan looks amazing. No areas of lack of blood flow he can see. This is not sensitive enough to see smaller brain damage. According to the EEG there was some damage to the cortex of her brain diffusely but he said that it will be a long time before we know her long term function and he is hopeful much will continue to return. She is young and healthy. She was placed on ECMO as fast as possible and her brain was cooled immediately after starting the ECMO. Thank you all for waiting so patiently for this update.

Today she needs many prayers to help her fight this pneumonia, and if they take her off ECMO in the operating room today. Thank you all for your love and support.

For people helping in Tucson.
I am setting up a online calender in a gmail account so people can know what kind of help we have from day to day and so we can sign people up who want to bring food or play with the kids. I tried to copy and paste the calender into the blog last night but it didn't work so we may have to have one or two people sign people up to help and have links to the PDF calender file daily on the blog. Have a great weekend.
John

Thanks From Casey (Britney's Dad)

My outlook on life and the things that matter most have been forever altered. There are no words to describe a father's feelings when word arrives that your daughter is very sick, followed up with word that she is worsening and we may be loosing her. The 2 hour flight from Denver to Tucson was the longest flight I ever have taken. Britney's condition and outlook was not good upon my arrival. Britney was still fighting and We had some hope. Day by day Britney has improved in small ways (huge ways to us). The outpouring of support has been staggering and very appreciated. We have been contacted by family and friends from coast to coast and from Texas to British Columbia. I cannot begin to express my gratitude to everyone for their love and generosity. I will Thank each of you in a more personal way as soon as I can. I want my Fire Department Family to know how much your support has and will help us get through this together. Since it's impossible for me to call 300 people right now, I hope this Thank you will suffice for the moment. Believe me it is small but sincere. Our prayers along with yours have been answered daily. Please keep them up. If anyone wants to help at a personal level, please donate blood in Britney's name. She has used much and will need much more. Last night our youngest daughter, Arielle, called from Galveston TX and talked to Britney over the phone. Britney's eyes welled up more than I've seen yet. She can hear us I am certain and we relay your messages and love to her directly. Last night Britney fully opened her eyes, turned and looked at the attending nurse with a look of (who are you and what are you doing to me?) Thanks to everyone for now. Love Casey Foster

You Make All The Difference

What can I say... but thank you everyone for fasting and praying for Britney & for our family. The fasting, the prayers, the meals, the beds, the rides, the contributions... it makes all of the difference! It has helped me personally so much to get through each day! Please continue the fasting and prayers! Britney still needs them!! I take comfort to know that she is in the Lord's hands, I don't have to worry... he will take care of her in what ever way is his will!
Jana

6/25/09 Update

Britney had a great night and day. Sorry I didn't get this out earlier. I had a lot of calls to see when I would post this. She has so many amazing friends, family, and people she has not met doing everything they can to support her. A sincere thank you.
Today Britney turned her head to the right and moved her left toe. She continues to cough, blink. She opened her eyes all the way today. The neurology resident and attending doctors stopped by today. Her cranial nerves are completely intact. They said her coma at this point could be due to her severe infection, some due to the lack of oxygen during CPR. It will be difficult to tell and is too early for people who have had hypothermia (cooling the brain). We are very hopeful and have a very peaceful feeling.

Kids update
They are doing great today. Kurt Demminghoff (one of my teachers) and his wife Amy took me, Jonas and Vera to the Desert Museum today. They loved it. Jonas especially loves Gila Monsters. It was very nice to get out and get our minds off of everything. Thank you for a great day.
We slept at home last night and feel much better.

I am going to my orientation day tomorrow. We have so much family here to help out that want me to and I know Britney would want me to also. I am very excited to learn and help other people. My program is amazing. If Britney wakes up they will let me take a family medical leave.
Thank you to so many people that offered to pick up a shift for me. I think we are ok for now.

I'll post another post after orientation and Britney's sister may post one before then.
John

Anna Recognizes Mommy

I held Britney's hand and talked to her for a few minutes before lunch today. Right away, she swallowed and then blinked a few times during my short visit! This was the first I had seen a response from her myself! Mom and I brought Anna in with us. She was squirmy and distracted by all the machines in the room at first. Then she noticed Britney in the bed, stopped wiggling, and just stared intensely at Britney's face. Suddenly, her eyes lit up and she got an enormous smile on her face. I think she recognized her mommy!
MacKenzie

6/24/09 Update

Britney has been responding more and more. She was blinking her eyes throughout the night, and has swallowed several times today. John and Mom spend a lot of time talking to her this morning. Mom spend a good ten minutes talking to her, and saw tears well up in the corners of her eyes. The vascular surgeon has asked the family to talk to Britney a lot, because she will remember some of it and it may help her wake up. We and the medical staff talk to her about everything. They kids love to read her stories and talk to her. I put on her favorite movie, pride and prejudice for her today also.

The vascular surgeon is very very pleased with her feet. The left foot will be fine and the right foot may only lose a couple of toes.

We also just want to provide her with as much emotion comfort as we can. Yesterday afternoon, they calmed Britney down with more sedation because she continued breathing against the ventilator. Her heart is working so well, they may need to decrease her blood pressure to make her heart take a rest and allow the ECMO to do the work.

Vera Update
She took a 3 hour nap yesterday, then was able to go swimming with the Jones family and her dad. Vera slept here at the hospital all night, so she could be close to her mommy. She read her stories until 10pm and then watched her barbie movie. She feels much better this morning.

Thank you for all of your incredible support. We love all of you.

Just one more quick update. I just talked to the infectious disease team and they said if her OB had not given her the right antibiotic by chance (she is penicillin allergic) she would not be here today to continue fighting. There are many series of events like this that have kept Britney fighting.

Love you all,
John

A Sincere Thank You

We are overwhelmed with gratitude by all of your prayers, your support, and all the hands being offered to lighten our burden. Our family would sincerely like to thank everyone who is offering up their homes, giving rides from the airport, delivering meals, donating funds, bringing toys for the kids, sending words of love and encouragement...our list goes on. Your generosity is making this whole experience much easier on our family and bringing us a lot of much needed comfort. Thank you again!

Sincerely,
Our whole family

Britney Swallowed

Just a quick update. When I told Britney I loved her about and hour ago she swallowed. A tear rolled down her eye. It could have been coincidence because they have been giving her eye drops. The fluid is coming off her face and she is looking much more like herself.

Photo of the Day

Photo of the Day.
Here is Vera. She is having a hard time today. Please say a prayer for her. She has been reading her mom stories.

6/23/09 Update

6/23/09
Britney had a great night last night. She had a chest wash out which is common for any one with their chest open. Clotting is common if there is not constant drainage from chest tubes. After the clots were removed and a pnemuothorax (air in the chest cavity compressing the lung) was drained with a chest tube her heart began pumping above the ECMO which is an amazing sign. The blood flow to her feet hands and face improved greatly. Her left foot has normal color now and the right foot is looking much better also. She had a pain response during the surgery and blinked her eyes 20x. She was very stable overnight. They continue to give her blood because the heparin from the ECMO is causing some small bleeding from all of her surgical sites but this is controllable.

I have been a blood donor for 4 years since going to medical school. It is an incredible way to give back. So many people ask what they can do. Give blood locally where ever you are.

Kids update
Jonas is doing much better today. One of the childlife specialists helped him get his feelings out over a game of air hockey, and his friend Isaac who moved to Phoenix last year from Milwaukee was able to come down and suprise him. Today Vera is sad and acting out but we are getting through it. She thought that since mommy looked more like herself last night she would be awake and was angry she wasn't.

Thank you everyone for your love and prayers. We have incredible family and friends. The Emergency Medicine program here has quickly become our family and along with people from our church have taken us in and we will love them forever.
I'll post another update later today and a story of what happened for all of the people I have not been able to explain how she got sick and the series of miracles that has kept her alive and with the chance of recovery.
John