Updates

The good news is that Zach had two instances of spontaneous eye opening. He opened his eyes around 2:00pm and then again around 4:00pm when the nurse was working on him.

Also, they clamped his catheter again this morning at 9:00am and Anna left today at 8 pm, his pressure was still at a good level. So, he is doing VERY well with his Intracranial Pressure today. He has to do well for 48 hours so that the doctors can begin to take the catheter out. Last night, Thursday June 14, they tried to clamp his catheter but he only lasted for 4 hours so he's doing SO much better than yesterday.

The infection in his Cerebral Spinal Fluid has also gotten a lot better and they hope it clears up very soon so they can take him off the antibiotics for the CSF. He may have developed something called C. Diff, which is some sort of bacterial spore in the intestinal tract. All the antibiotics (he's taking two for his CSF infection and two for his pneumonia - one overlaps for both so it's really only 3 antibiotics now - and 1 for his C. Diff for a total of 4 antibiotics) ruin the natural environment of his intestinal tract. He tested positive for the antigen of C. Diff but we still need to wait another 24 hours or so to see if he actually has the toxin for C. Diff. Let's cross our fingers and all hope that he doesn't.

His pneumonia is the same and they gave him stronger antibiotics (one of the two I mentioned) for his pneumonia since they tested him a few days ago and found out the exact strain of his pneumonia.

So, that's about all. He's keeping his food down well today. He looks better and better every day :) Today was SUCH a good day after yesterday, when his pressure got too high and they kicked us out during visiting hours to leave him alone.

Another great day! Zach's cerebral spinal fluid (CSF) is now flowing back into his spinal cord instead of out of the catheter and his cranial pressure remained very low. So low, the neurosurgeon decided to remove the catheter today, instead of waiting 48 hours.

His pneumonia is still the same and he did test positive for C. Diff so he's on another antibiotic for that. They will give him another CT scan tomorrow to make sure the pressure in his head is still good without the catheter.

The nurse told Anna that he opened his eyes for about 10 minutes in the morning. When Anna went in the room she called his name and touched his leg and he opened his eyes again. He kept them open for quite a while. Later after the neurosurgeon removed the catheter, Anna called his name and massaged his arm and he opened his eyes again! He kept doing this and blink a lot, and then decide to shut them again.

Doctors say this is the first step to coming out of the coma. He needs to start opening his eyes on his own, keep them open, and start tracking movement. But his is a HUGE step in the right direction. By the end of visiting hours he was asleep again and would not open his eyes again. After a CT scan, catheter removal, and people yelling at him to open his eyes, he was exhausted.

Let's hope tomorrow will be filled with more good news!

Doctors were going to put a central line into Zach because he wasn't absorbing the food though his stomach plug, but just before they went to surgery, he started absorbing. Zach is now getting about double the nutrition through the new food doctors are giving him.

Blood pressure and heart rate are OK. He's only on two antibiotics instead of four. One for his pneumonia and the other antibiotic is for meningitis prevention.

He did NOT test positive for the C. Diff toxin (as reported the other day). Anna said they must have either heard wrong from the nurses or they had the wrong info. I can imaging that there's so much info that info can easily get jumbled. They will continue to check him for C. Diff since he did test positive for the antigen.

His breathing is OK. He's still at 50% with the ventilator. One of his lungs is slightly better and the other is slightly worse so he still needs to keep fighting the pneumonia.

They are going to do an ultrasound on him later today to make sure he doesn't have any blood clots in his arms or legs. We have to keep praying, hoping and staying positive!!

A Baltimore Crime Blog website posted that all four teens involved in Zach's attack were indicted by Baltimore City Grand Jury. The blog states that 'An arraignment is scheduled for July 18, 2007 before Judge John M. Glynn, Room 236 Mitchell Courthouse. Assistant State’s Attorney Jennifer Sites will prosecute this case.'

I know I said it before, but thank you, thank you, THANK YOU to the swift and dedicated Baltimore Police detectives who caught these guys.

They did another CAT scan today and everything looks good. There's no swelling and the vessels all look good. They will continue monitoring his pressure throughout Zach's stay. His chest x-ray today showed that his lungs were still 'fluffy' which means the pneumonia is still there but his nurse said that she did not have to perform as many secretions and his secretions have looked better -- another positive sign. We'll just keep waiting for those chest x-rays to show nice, healthy lungs!

He's only on one antibiotic now for his pneumonia. His white blood cells (which increase whenever there is an infection) have gone down gradually over the last few days. Zach will be getting a hearing and sensory test tomorrow. We just have to keep hoping and staying positive that his pneumonia gets better, he passes all his tests and that he wakes up ASAP! Anna is getting impatient and her house is in shambles. Junk food everywhere and I think there may even be some dust on the floor! Gasp!

Yesterday was Zach and Anna's 8 month wedding anniversary. Although they don't celebrate monthly anniversaries, Anna said she would never expect another present for any other anniversary if he woke up. I think Zach decided not to wake up because he knew he couldn't hold that promise to Anna (she needs to be spoiled, just like Mia).

The nurse said the X-Ray shows both of Zach's lungs looking much better and they barely have to suction them anymore. His white blood cell count has gone down from 17 to 15, indicating his pneumonia is getting better. Also the culture to test for infection in his bloodstream came back negative. So now he's still on just one antibiotic for the pneumonia. They are also going to give him some Metamucil to help with the intestinal tract.

Doctors will start to wean him off the ventilator and get him a trach collar. The trach collar will help to keep the air nicely humidified, but he will basically be breathing on his own. He's also absorbing his food very well, so he's off the medication to help him absorb food. One less drug is a good thing. He was also given an EEG a few days ago and it showed he's not having any seizures.

The other day Zach was given a hearing test, which he passed, which means he can definitely hear us** when we're in the room with him. They tried to give him a sensory test, too, but that required acupuncture-like needles in his head. Apparently Zach did not like that very much and kept moving his head around whenever they tried to stick him with the needles so they couldn't do the test. That's a good sign because he's agitated with the needles being poked into his head.

** Zach: Listen; don't tell anyone about that thing I told you. And the other thing, well I was just kidding...yeah...kidding...

So some great progress over the past few days! He kind of reminded me of Magnum P.I. the other day, because he's now growing a pretty thick 'stache. Zach I think we found a new look for you buddy. As soon as you wake up I'll get you some aviators and you'll be set!

Zach is doing great! With only two more days of pneumonia antibiotics, nurses say they barely have to suction his lungs because of his improvement. They are no longer concerned with the pneumonia but will continue to culture him every other day to make sure he doesn't develop any other infections. Also tests for blood infection came back negative and his vital signs have been good all day.

On Thursday his heart rate was above normal because he hadn't been cooled all day with the cooling blanket so his temperature increased. Doctors say this is a neurological reaction and want to take him off the cooling system so his body can adjust to being in a normal condition. They are trying to show the fever is from his brain injury and not from any sort of infection.

Friday his vital signs were great and his cooling blanket was set at the medium setting. He's breathing so well on his own that the ventilator is turned off during the day and only turned on at night to help him rest. The neurological reflex tests from his exam yesterday also showed better results than before.

So the really great news is Zach is doing so well, soon he will no longer be considered in critical condition. Amazing news! This has been a very stressful few weeks, but he's really pulled through the toughest and most critical part of his recovery. The next step is for Zach to be admitted in a coma stimulation program at a rehab hospital in Baltimore. Hopefully this next step will happen very soon. Let's keep praying for him to wake up ASAP!

Even the Orioles are pulling for Zach. They sent him an awesome authentic jersey with Zach's name and Cal Ripken Jr's number. I may have to borrow that for my work softball games, where I've been trying to hit a homerun for Zach. Unfortunately I'm awful at softball, so it may be a while. Thank you Orioles!

Anna, family and friends all want to send a HUGE THANK YOU to Johns Hopkins and the wonderful nurses & doctors who have taken such good care of Zach. Your help and patience have really helped everyone through this very difficult time, and your expertise and attention have meant the world to everyone who cares for Zach. Thank you!

Yesterday when Anna went to visit Zach she was greeted with a bright red notice over his door that read 'Maximum Precaution,' which was a little disturbing. Nurses told Anna that Zach tested positive for bacteria in his sputum (spit) that is super resistant to antibiotics. To prevent it from possibly spreading to other patients in the ICU, visitors had to wear gloves, gowns, face masks and shoe covers. Early tests from the cultures taken yesterday morning showed he may not have the bacteria, but they are still taking precautions. For now, no visitors besides family can see Zach.

His lungs are looking slightly better and he's no longer on antibiotics for the pneumonia. If the culture tests come back negative today, he will be off all antibiotics. If the test does come back negative, this will be the third time Zach's tested positive for something and then it turns out he doesn't have it -- proving Zach is the ultimate stubborn fighter and refuses to let sickness get in the way of his recovery. Keep fighting Zach!

Anna is meeting with a social working today about where Zach's next move once he's stabilized, since soon he should no longer need critical care. There are a lot of great coma rehabilitation hospitals in Baltimore.

As far as his surroundings, I've never seen a hospital room filled with more cards, pictures, banners and music. Anna found a remixed Sarah McLaughlin CD that Zach bought for her a few years ago that was composed by a bunch of progressive house DJs, which she assures me is 'less girly' than the real CD.

So things are starting to level out for Zach and he's remaining pretty stable. His lungs continue to improve with each chest x-ray, and he's finished with his pneumonia antibiotics. He does have the bacteria in his sputum, but it's not the one that's super resistant to antibiotics. However, they have decided to let his body take care of the infection on its own. Doctors will be closely monitoring the infection and taking cultures daily to make sure he is ok.

Zach still needs medicine to regulate his heart rate, blood pressure, and other vital signs. Nurses gave him Tylenol for his fever only once yesterday and have been using a cooling blanket the rest of the time. Hopefully his temperature will stabilize on its own and not need the cooling blanket very soon. He's got a little ways to go, but improving every day.

An ultrasound on his arms and legs showed the small clot in his left arm is still present, but it's in a deep vein thrombosis so they will let his body take care of the clot on its own. Visitors should NOT massage his left arm because of the clot, but it's ok to move his arm to keep his joints fluid. It's important to message and do range of motion to his fingers, wrists, elbows, shoulders, ankles, toes, knees, etc. This helps his muscles stay limber and not stiffen. Stiff muscles take much longer to get movement back once he starts physically therapy.

Remember if you're visiting Zach to wash hands thoroughly before and after entering the room. And if you feel sick, don't visit! He's so close to being removed from critical condition and needs to be germ free to get there. We really want him to show us this week that he's starting to wake up by tracking movement with his eyes. He's opening them a lot whenever nurses turn him or suction his lungs. I think once he's in the coma rehab center he will make much better progress.

Momma Mia will be a happy pug this weekend; Anna is going to Frederick for a visit with her little girl. I'm sure Mia misses both Anna and Zach very much. Don't worry Mia, your dad will be there soon, too.

Neighbors' Night Out is a bold statement against crime. On Sunday, August 5, 2007 from 2 - 8 p.m., in honor of Zach, neighbors across Baltimore will meet at select bars and restaurants to drink, dine and send the message that we stand together against violence. (Participating locations are currently being decided upon). 20% of that evening’s profits will go toward the cost of Zach's lengthy hospitalization. Learn more »