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Steve Laszko |  |
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Steve Laszko | |
Steve crashed in the straight between T6 and T7 during this morning's 600 Supersport practice. Although details are sketchy about the crash, my best guess is that Steve came up quickly on a slower rider on the race line, tried to take evasive action and either clipped the other bike or locked up the front brake and somersaulted over the front of the bike. He was unconscious when the corner workers reached him and was not breathing. The trackside paramedics were called over and the on-site life-flight helicopter landed nearby. The paramedics intibated him and he was flown to Santa Rosa Memorial Hospital.
Steve regained consciousness when he arrived at the hospital, but was quickly sedated to allow the doctors to investigate the extent of his injuries. He had damaged his spleen and kidney and had a severe neck injury. His spleen was the immediate concern, as it was causing a lot of internal bleeding. It was removed during emergency surgery; the kidney was examined but left to heal on it's own.
The doctor's attention was now on the extent of the neck injury. Steve was suffering from paralysis from the neck down. He had been unable to breath on his own since the time of the accident, and had been placed on a respirator shortly after arriving at the hospital. X-rays showed a significant displacement of the C2 and C3 vertebrae (at the base of the neck) with some collateral damage to the C1 and C4 vertebrae. MRI scans did not reveal any tear / shear damage to the spinal cord. Steve was placed in traction to begin moving the vertebrae back into position.
The neurosurgeon had hoped to see some improvement in the level of Steve paralysis by this morning, but it was unchanged. The doctor placed him in halo to further stabilize his neck. Surgery to fuse his vertebrae together is planned for Monday morning.
Steve went into surgery at 10:00am. The procedure to insert two titanium rods into his neck took four hours to complete. Bone grafts were taken from Steve's right hip and were used in the fusing of the vertebrae. The re-alignment and fusing of the vertebrae relieved a lot of the pressure from his spinal cord. Ultrasound testing during the operation revealed no shear / tear damage to the cord. There are a number of other types of damage that can cause paralysis, but a shear / tear wound is absolute and irreversible - thankfully that isn't the case with Steve.
Steve was returned to the intensive care unit at about 3:00pm. He's floating in and out of consciousness, because of the meds from the operation and the morphine drip. We're able to communicate only through yes/no eye blinks for now, as the respirator is still in place. Hopefully a tracheotomy will be performed soon so he'll be able to speak on his own.
There haven't been any improvement in Steve's paralysis today, but then that is to be expected. The operation yesterday was fairly traumatic on his body and it will be a while before the swelling goes down.
Steve has had moments of lucidity, usually just before the nurses give him a squirt of medication. During those times we're able to talk with him and he communicates by mouthing words and blinking yes / no. Cards, faxes and emails have been coming in steadily and we've been reading them to him. He really, really appreciates the love and support that these bring him. Please keep them coming.
The oral respirator should be replaced by a tracheotomy tomorrow and he should be speaking soon.
Steve had the respirator tube moved from his mouth to his throat today (tracheotomy). A balloon-type seal is still present in his throat to keep him from choking on anything, so he can't use his vocal cords yet. With all the tape and tubes gone from his mouth we're able to read his lips better and he's yacking up a storm when he's awake. He's still on heavy meds, so he drifts in and out of conciousness. I don't think he has too many moments of real awareness, nor is he really sure what's happened to him yet. The bright spots of his day are listening to his favorite songs, to which he mouths the words and percussion rifts, and and when we read the many cards, faxes and emails that are coming in. The support from the racing community has been terrific and I know that he appreciates the get well thoughts (as do the family and friends).
There wasn't much change in Steve's condition today. The doctors did turn off the respirator for a few moments and he took a couple of ragged breaths on his own. Yes, that's a good sign! It's still way too early to hope for much more than that, but it does give us all hope.
Steve will be air-ambulanced back home to San Diego on Monday. He will be cared for at Palomar Hospital in Escondido. Some of the family is flying back Thursday morning to help get things ready back home.
We met with Steve's case worker yesterday and among the things we discussed was his insurance coverage. It looks as though the bulk, if not all, of the immediate intensive care is covered. The hit will come when his rehabilitation starts. It could be a very long process and the insurance coverage for that type of care is historically minimal. We have created a fund at our hometown bank to accept donations on his behalf. If you are interested in helping out with Steve's rehab expenses, please see the information below.
The next phases of Steve's immediate future care came into focus today. He will be transferred to Palomar Hospital's intensive care center, where he'll spend the next few weeks. He still has some issues, like susceptibility to pneumonia, that will require constant vigilance. Once he's discharged from intensive care, he'll transfer to a rehabilitation center; probably Sharps / Scripps in San Diego.
Steve was in pretty good spirits today, enjoying his music, reading the get well cards, faxes and letters. He's been fighting off a fever for the last couple of days, but the docs say that's normal considering the trauma to his system. He had his first workout with a physical therapist this afternoon. She worked his limbs and showed us some things that we can do. Moving the respirator from his mouth has really helped him to communicate with us. He can't talk per se, but manages a low whisper.
We met with the neurosurgeon in the afternoon. He presented the full series of x-rays, cat-scans and MRI images from Steve's first day through the neck surgery. It was a lot easier to understand the extend of the injury when he explained it with the images. There is still no evidence of a tear / shear injury, but the most likely cause of the injury happened when his chin came down to his chest. That stretched the spinal cord quite a bit. The normal pathway for the spinal cord is intact and stable. Steve will have to remain in the halo brace for two to three months to allow the bones to heal.
We found out today that there may be a delay in transporting Steve back home. The receiving hospital has come up with a list of criteria that they want fullfilled, like changing his feed tube from intravenous to either a nose-tube or GI tube. We will be getting together with the tramua surgeon on Monday morning and will know more then.
Steve's condition hasn't changed much since yesterday. He's still under heavy meds, but when he's awake he tries like hell to breath on his own. He doesn't understand yet that he's on a respirator that breathes for him. He's confused by the missing sensation of breathing for himself. The respirator he's on is a pretty smart device. It senses when Steve tries to breath himself and an indicator lights up. It was lighting up quite a bit today.
Some of the side affects of Steve's condition are starting to rear their ugly heads. Steve developed an irregular heart beat during the day and it actually stopped for 15 seconds at one point. The docs say that this usually happens when the different nerves that control the heart get confused, and it's usually a temporary condition. To be on the safe side, they hooked up an external pace-maker / defibrillator that kicks in whenever his heart does that again.
He's also developed an infection in the lining around his lungs - also a normal thing according to the docs. They'll be scoping out his lungs and probably drain the fluid from the lining on Sunday.
Otherwise, Steve had a pretty quiet day.
There really isn't anything new to report today. The docs are keeping Steve sedated so he will sleep as much as possible because too much stimulation kicks off the defibrillator. Steve has reached a plateu of stability for now, so I will add updates on his condition as major changes occur. I hope to report that he's been transferred closer to home in the next day or two.
It's been a few days since the last update, so I thought I'd let everyone know what's up. Steve is still here in Santa Rosa. We're waiting for the details of the transfer to Escondido to work themselves out and take care of a couple of complications that have cropped up. The condition with his heart has stabilized somewhat and they've installed a portable pacemaker. He's still collecting fluid in his lungs, but hourly suctions through his trach are helping to keep that in check. Some kind of enzyme level is running too high today, so they're checking out his gaul-bladder and kidney functions this afternoon. All of these things are expected and the folks at the hospital are doing an excellent job staying on top of his problems.
Steve has been sleeping 20 - 22 hours each day, mostly wiith the help of meds. When his is awake, he really enjoys reading the emails, faxes and cards that are coming in.
Hopefully my next update will be from southern California.
We're still up in Santa Rosa and probably will be for another week or so. The sum of Steve's complications have the docs concerned about the transport down south. We're of the opinion that Steve is receiving excellent care right here and we'd rather be safe than sorry.
The gaul-bladder and kidney function test went fine. Steve's lungs aren't collecting as much fluid as they were a few days ago, and his fever isn't as high as it was. The docs took the staples out of his incisions and they're healing up fine.
The condition that caused Steve to have irregular heart beats seems to have stablized, so the pacemaker was removed today. As of 8:00am, he hasn't required any of the heart meds either. A throat & swallowing therapist checked him out this morning to see if he could start eating and drinking, but his cough reflex isn't up to par yet. She'll keep working with him each day to get that going. When that's working, the nose tube he's 'eating' through will be removed and he'll be able to talk.
On the downside, his body isn't regenerating red blood cells as quickly as it should, so he was given a tranfusion this evening. Like his other complications, this isn't unexpected. The docs are running tests to figure out what's going on.
Steve was moved to a new room this afternoon - W260. This is part of the new ICU wing at the hospital. The old room was pretty good, as ICU units go, but the new room is like a suite at the Waldorf. It's about twice as big, has a big window looking out over the front of the hospital, a recliner chair for visitors and a work desk. The new digs have cheered him up.
We're heading home!
Steve's plane took off at noon today, enroute for southern California. He'll arrive at Palomar airport in Carlsbad around 2:30, then travel by ambulance to Palomar hospital in Escondido. Steve is expected to stay in the ICU unit for another week or two, then will be transferred to a rehab facility, probably Sharps / Scripps, in San Diego.
My father and I will be driving our motorhome back this afternoon and will probably be in Fallbrook sometime tomorrow evening. I'll post an update when we get back.
Steve's flight to Palomar hospital went just fine. The specialists began a re-evaluation of his condition when he arrived and they wrapped that up tonight. They are concerned that the reconstruction of his vertebrae isn't as complete as it should be and recommend a second surgery to add some more support for his neck. The neurosurgeon at Palomar consulted with the original surgeon in Santa Rosa and he concurred. The plan now is to transfer Steve to the UCSD medical center in La Jolla, where the heads of both the American board of neurosurgery and orthopedic surgery have their practices. These are the top surgeons in those fields. Steve will probably remain in the ICU unit at UCSD after the surgery and go from there to the Sharps / Scripps rehab center. We don't know yet when the surgery will be performed, but it should be soon. I'll post an update after we know more.
Steve will be transferred to the UCSD medical center Friday afternoon. Before they perform the second operation on his spine, he'll have a permanent pace maker installed. Although the heart medication has kept his irregular beats under control, the last thing the surgeons want to deal with during the operation is a cardiac problem. Steve was scheduled to have the pace maker installed Friday morning, but his fever spiked tonight and they want to have that under control before putting in the pace maker. If all goes well, he should have the pace maker installed and the spine surgery next week.
Steve was transported Friday afternoon to USCD medical center (in San Diego - Kensington to be more exact - not La Jolla). His good buddy and EMT Rich rode along in the ambulance with him, jamming to AC/DC on the way down. Steve is in the surgical ICU facility on the second floor. The docs began a series of tests, xrays and CAT scans as soon as he arrived and they will lay out the course for his care over the next couple of days. We'll know more about this come Monday.
Monday turned into Wednesday....... The second surgery and the pace maker are on hold for now. The top ortho and neuro surgeons at UCSD put their heads together and decided that reinforcing the repair work done to Steve's neck in Santa Rosa would involve some pretty tricky surgery and might not be necessary. They installed a modified halo yesterday, designed to further imobilize his head and neck. It will be three weeks before the original bone grafts will have a chance to take and they hope that the vertebrae will fuse together by then.
Steve has been off the heart medication, which kept his irregular beats under control, for the past three days and has had no further instances of cardiac distress. He is attached to a backup defibrillator just in case, but so far it hasn't been needed.
The second surgery is now back in the plan. After reviewing daily x-rays this past week, the surgeons don't think that the original work is going to take sufficiently to support Steve's neck over the long haul. They estimate that the total procedure could take up to 12 hours, so to minimize the danger to Steve, they will break it up into three separate procedures. I'm not sure what will be done in each procedure, but the end result will be to remove the titanium rods now wired along the back of his spine, replace them with a plate and add another plate in front. Steve is on a new series of anti-biotics to beat down the pneumonia / chest infection that he's been contending with these past few weeks. Once that's under control, he'll head for surgery.
The speech and respiratory therapists have been working overtime to help Steve use a 'talking trach' two or three times each day. This device utilizes a special respirator and trach attachment that allows Steve to talk. It's been tough for him to use it, as it forces him to actively participate in his own breathing. He's gone from 15 minutes per session to 35 minutes in the past few days. I've always kidded him that he talked too much, but I'm not bitching any more.
He's also started eating 'real food'. He's only allowed to have the puréed variety, not unlike baby food, but at least he can taste his dinner now instead of it taking the direct route into his stomach via a feeding tube.
The REALLY BIG NEWS of the day (the last few actually), is some sensation has returned to his forearms and fingers. Steve is able now to tell when someone is rubbing his forearms and has 100% accuracy telling us which finger on either hand we're squeezing. This is very encouraging, as he had no feeling there whatsoever just a short time ago. It's a small step forward, but the long road to recovery is traveled in small steps.
We spoke at length with one of the ortho surgeons today. The work to get Steve prepared for surgery has paid off, so they'll start this Monday at about noon. They're going to try to push the displaced front half of his C2 vertebrae back into place by pressing on it from inside the back of his throat. They're not sure if this will work, but if it does, it will significantly reduce the work that they need to do and the time that overall surgery process will require. If it slips into place, they'll go in through the inside of his mouth, insert a plate over the front of the C1 - C3 area and tie it together with the rods already in place on the back of his neck.
If the vertebrae doesn't go in easily, Steve is looking at a long process and a lot more work. The surgeons will have to access the area in front by also going through the side of his neck, get the vertebrae into place and install the plate. Then they'll have to go in through the back of his neck and probably replace the rods with another plate, then tie the two plates together. This process will take place over two or three separate surgeries. In either event, Monday's surgery will take a good part of the day to complete. I'll post an update here when we know more.
Steve underwent four hours of surgery this afternoon. The hoped for attempt to push the front of his C2 vertebrae into place, by pressing on it from inside the back of his throat, did not work. The surgeons removed the titanium rods from the back of his neck to prepare Steve for the next operation, which he will probably have towards the end of the week. That next phase will involve accessing the front of his spine through the side of his neck to install a plate bridging the C1 to C3 vertebraes. A likely third operation will be performed to install a plate on the back of his spine, to which the front plate will be wired.
He came through the operation fine and is resting as well as can be expected. We won't be able to see Steve until tomorrow, so I'll post more information then.
If it weren't for some swelling around Steve's neck and a few extra doses of pain meds, you wouldn't know that he had just had surgery. The docs and nurses were very impressed with his ability to bounce back like that. Hell, he even beat his personal best of 40 minutes on the 'talking trach', yacking up a storm for three hours.
Assuming Steve doesn't develop any complications, like a post-op infection, over the next few days, his next surgery will be on Friday or Monday.
Steve's recovery from the first surgery continued to go very well all week. He had his second of three surgeries this morning at 8:30, which lasted about six hours. An orthopedic head and neck specialist was called in to make an incision into the left side of his neck and show the 'regular' ortho surgeons the best way to access the front of his spine without damaging any of the nerves in his neck. The C2 vertebrae was put back into place, a bone graft was taken from his hip and a plate was placed from C2 to C5 to hold it all together. The surgeons said the operation went extremely well and they accomplished everything they wanted to. Steve was back in his room by 3:00 and doing well. I'll be able to see the surgeons handywork tomorrow and I'll post an update then.
Steve's recovery from the second surgery is also going very well. He has developed a lot of mucous in his lungs, but that's an expected complication from being under anethesia for so long. The docs think that this will clear up in the next couple of days and are planning the last of the three surgeries for Thursday. In this last phase, the surgeons will install a plate along the back of his spine from C2 to C5 to compliment and tie into the one they installed in front.
We talked to the rehab doctor last week and he is recommending that we send Steve to the Craig Hospital, a rehab facility in Denver that specializes in spinal injuries and research. Craig is the best facility in the western U.S. and can give Steve the best chance at regaining all the sensation and mobility that he can. The doc is going to work with Steve's insurance company and see if we can make that happen. If we can get him into Craig, he'll be there for at least two months. I mention all this now because a lot of local folks have been waiting for his rehab phase before coming down to see him. Denver is a helluva commute from Southern California, so if you haven't visited yet, sometime in the next two weeks would be a good time.
Some really good news - Steve continues to regain some feeling. It's a very slow process, but it is coming along. He has a lot of sensation now from his jaw-line to his shoulders. This was amply demonstrated tonight when he had his surgery dressings changed. "Ow, that hurts" he said as they pulled dressings off his neck. He probably doesn't want to talk about the next area, but he can feel a good pinch on the gluteus maximus (that's his butt in case you skipped Latin in high school). I didn't ask how he figured out he had feeling there, and I'm not sure I want to know, but it's there.
I knew as soon as I mentioned it, the butt jokes would start rolling in. Steve's getting a good laugh out of them, so keep them coming.
The build-up of mucous in Steve's lungs isn't clearing up as fast as the docs had hoped and he started running a fever today. The surgeons have decided to postpone the last surgery until his lungs are in better shape. This wasn't an unexpected development. Hopefully this will improve by the end of the week and the surgery will happen the first part of next week. I'll post an update when I know more.
Steve's fever is back under control, but his lungs haven't cleared up enough for the surgeons to feel comfortable about operating on Monday. They're hoping for sometime during the week, but we'll have to wait and see.
The possibility of having a pacemaker installed is back under consideration again. Steve's heart stopped for about ten seconds Thursday evening. The nurse got it going again with CPR and they hooked up a external pace-maker / defibrillator to kick in should it happen again. This isn't a new development, as Steve has had this happen before, but it was one we thought had resolved itself. Because of the situation with his nervous system, his heart will receive a signal to slow down ("hey, the blood pressure is too high, slow down for awhile"), but doesn't receive or understand the signal to speed back up ("ok, blood pressure is fine, let's get back to normal beats"). The cardio docs will make a decision on the pacemaker in the next few days.
Otherwise, Steve is doing well. He was moved into a private ICU room on Friday. It's much larger than the shared room he had before and has a skylight to let the sun in.
We're meeting with some more rehab people on Tuesday and will hopefully get more information about the possiblity of getting him into the Craig Hospital in Denver.
Steve was looking pretty good for surgery on Thursday, but late Tuesday night he had a bout of vomiting, some of which was aspirated into his lungs. His fever started to rise again this morning, so surgery is off until probably the first part of next week. The nurses have been having a hard time getting IV's started the last few days and they gave him some medicine to dilate his veins Tuesday night. The medicine is probably what made him nauseous and caused the vomiting. He didn't get much sleep Tuesday night and slept for most of today.
The rehab meeting scheduled for yesterday was cancelled. The docs want to wait until this last surgery is done before they do an evaluation. We won't have a clue about Denver until he's evaluated, so we're in a rehab holding pattern for now.
Today is our father's 62nd birthday and we held a surprise party for him in Steve's room. We jammed about 15 people in there, closed all the doors and curtains, and had a great time. Although Steve was in on the occasion from the start, we also had a surprise for him too. Don and Bobbie Presten have been collecting donations for Steve's rehab fund through a post on their San Diego Motorcyclists web site since May. They stopped by to drop off over $1000 in donations. Steve and our family want to extend a heartfelt thanks to all the folks who donated, and especially to Don and Bobbie for their efforts.
The Presten's are also spearheading a Poker Run in the San Diego area on September 10th to benefit Steve's rehab fund, and are doing a helluva job putting it together. If you ride, or want to get involved in the event, mark that date on your calendars and check out the web site for more information.
Steve's condition for surgery continues to improve, so we hope the that the surgery will be performed next week. Stay tuned and I'll post more information as soon as I know more.
Steve was cleared for surgery by his trauma team yesterday. The surgeons are coordinating their schedules and should be able to perform the surgery in the next few days. I'll post more info as soon as we have a firm date.
Our folks took a tour of the Sharps rehab center in San Diego today and came away impressed with the facility. Sharps is our 'backup' plan if we can't get Steve into the Craig Hospital in Denver. Speaking of Craig, our good friend Rob Berlind paid them a visit yesterday afternoon and was very impressed too. Craig is our first choice for rehab, but it's going to be an uphill fight with the insurance company to get him in there.
The docs decided yesterday morning to schedule Steve's operation for today. Unfortunately, Steve's pneumonia started creeping back in the afternoon and he developed a fever, so the surgery for today was cancelled. This isn't the first time a complication has set in and delayed surgery. He's on an increased dose of antibiotics now, which should get things back under control by the first part of next week.
Steve has been very slow to recover from the pneumonia and fever, so it's been a pretty miserable week for him. The surgery is still on hold, perhaps indefinitely. It has been four weeks since his last surgery and there is the possibility that the vertebrae have already fused well enough on their own to make the last surgery unnecessary. We had hoped to know for sure today, after the docs looked at his x-rays and cat-scans, but they are going to wait until Monday to make a decision.
In the meantime, he has been cleared to use a vibration vest to help clear out all the crap in his lungs. The vest looks like a life jacket with fittings to hook it up to an air pump. The vest is inflated and pulsates for fifteen minutes every four hours.
I had some time this week to update the photo gallery with some pics from this year and a great series of shots that Steve's girlfriend Mo took out at Willow last October.
I'll post an update once we know more about the surgery - hopefully on Monday.
Steve went from miserable last week to sunshine this week - literally. The surgeons decided over the weekend that the final surgery is not necessary since the vertebrae in Steve's neck are healing fine. Being able to sit up now, along with the vibration vest therapy, is helping to clear up his pneumonia. Sunshine? Yep - for the last couple of days the nurses have packed all his gear under the bed and rolled him outside for some vitamin K therapy.
The emphasis of Steve's care now is on getting him ready to go to rehab, which should happen in the next week or two. Everyone is still working hard to get him into the Craig Hospital in Denver. We should have a better idea about this towards the end of this week.
Last week was a relatively good one for Steve. His pneumonia is starting to clear up and his temperature was stable. A representative from the Craig Hospital paid us a visit on Wednesday to evaluate Steve's condition and screen him for admission to their rehab program. She was very encouraging and felt that there was a lot that they could do for him. Now it's up to the insurance company to come through with the authorization to send him there. If everything stays on track, he should be released from USCD for rehab soon. This may develop quickly, so I will post more information as it becomes available.
I guess quickly in normal terms doesn't apply in Steve's case. His pneumonia continues to improve, but it is a slow process. The insurance situation for rehab is now in a state of flux. Workman's comp is reviewing the case and should make a decision on whether they will take it over from his private insurance company by the first of next week. His benefits under work comp are substantially better, but it will still be a tough sell to get him into Craig.
Steve is still in good spirits, due in no small part to the visits and emails from friends and family.
Workman's comp has taken over from Steve's private insurance (this is a very good thing). We had a very productive meeting with his case worker on Friday. She was very up-beat and informative regarding the benefits that Steve is entitled to now that work comp is on the job. Priority #1 is getting him into rehab and although Craig in Denver is still going to be difficult, she laid out the best course of action to get him there. My father has been on the phone to our state representatives, Steve's doctors are all writing letters, and even the San Diego-area rehab centers are recommending Craig. We should know more later in the week.
Yes, Virginia, there is a Santa Claus ...... and her name is Gretchen Bashaw (Steve's case worker at workman's comp). We got the word this morning that Steve will be heading to the Craig Hospital in Denver as early as this Thursday the 10th. I don't know much more than that right now, but I wanted to get the word out ASAP. If you've been planning to stop by and visit Steve before he heads for the hills, make it soon.
It's all set - Steve will fly out for Denver on Monday morning the 14th. Our brother James will accompany him on the jet. Our father and I will start driving east on Saturday morning and will be in Denver to meet the plane. The two of us plan to be with Steve throughout his stay at Craig, which will probably last six months. Yes, we'll be having a white Christmas this year!
The next few days will be pretty hectic around here, so I probably won't post an update until sometime on Monday or Tuesday.
Before we left the hospital tonight, Steve asked me to thank everyone who has been there for him over the past three months. The emails, cards and letters have helped keep his spirits up; the visits from friends, family and more than a few strangers have brightened each day; and the donations to his rehab fund has left him grateful beyond words. I'll also add the thanks of our family and the team. These last three months would have been an absolute hell without everyone's support.