It’s been a tremendously difficult 6 weeks. Robert was admitted to the hospital on 12 June, and everything has been a roller-coaster since then. He has been fighting very hard and showing an unbelievable amount of strength.  I hope you all keep him in your thoughts…

Rob had gone to work at a theatre festival called Terschellings Oerol Festival. While he doing building work he had a seziure. The following day he was taken to the hospital and told he had bruised his ribs, but was otherwise fine.

After returning home it was clear to me that something more was wrong than brusied ribs. Unfortunately, we were unable to get an appointment with our GP. After a lot of monitoring the situation with him, late in the night of 11 June he finally agreed to go to the hospital (with the help our friend Sjef to convince him to go).

After a few hours of investigations and tests, it was determined that he had some type of an intenstinal obstruction, and that surgery would be needed to clear it. He underwent surgery on Friday, and it was determined that he had “Volvulus Caecum”, which is a twisted intestine — the ascending right lower part of the large intestine. It had rotated so extremely that it had moved to the upper left under his ribs, and he also had a large perforation in the caecum.

They were able to rotate the intestine back and repair the perforation, and overall, the surgery went well. Unfortunately, the perforation caused insidious complications resulting in septic peritonitis and then septic shock.

Because of infections, Rob had 2 more surgeries. The second was a few days after the first, and was mainly to do more cleanup and check for other perforations. Luckily there were none, and it went well. At the end of July he had his third surgery, which was much more extensive. Basically they took everything out to check for more perforations, which luckily there were none, and also re-sutured him and took out some adhesions. Rob now has about a 20 cm incision with 3 sets of staple marks! I think his new name around here will be “Rob ritsbuik” (zipper belly).

All of the conditions have been stablised, with the exception of the pneumonia and general infections, which he still continues to fight.

Due to the Thrombosis (blood clots), it has also been determined that Rob had a cerebral infarction (brain ischemia/stroke) shortly after the surgery. We will not know the extent of this until his general medical situation is better.  We know his left side was affected — he is able to feel, but not yet use his arm/leg. There is good reason to believe that with a lot of rehabilitation, his prognosis is good.

The complications are too many and difficult to explain in detail, but here is an overview:

• Volvulus Caecum (twisted intestine)
• Intestinal Peritonitis / Infarction
• Septic Shock
• Brain Attacks / Ischemic Strokes (2 major / 1 minor)
• Hyponatremia (low serum sodium)
• Hypotension (low blood pressure)
• Thrombosis (blood clots)
• Renal failure (kidney failure)
• Pneumonia (lung infections)
• General infections including staph, strep and c-diff

His mental state is good, and he is quite aware, but not yet able to talk a lot. Much of this has to do with the tracheotomy they did to help him breath with a ventilator.  He was also sedated for about 3 weeks, which caused a lot of muscle loss.  We think this will be a matter of  time and  rehabilitation.

He is able to answer questions, and is aware of all that has happened and seems to have a positive will to keep fighting. He smiles beautifully, and can let it be known if I put bad music on, or heaven forbid, one of the nurses puts football on TV (he hates it!). He also seems very positive and has not become sad about the situation. That is so important, especially with the long and hard rehabilitation that lies ahead.

I hope you all continue to send your healing thoughts to him.  I’ll be able to show him all the well wishes he receives on the blog sometime soon, so please don’t hesitate to comment or e-mail — they do him a lot of good, and really help with his recovery.