Monday, October 26, 2009

Update on Injured Texas Student

Philip Caler was tragically injured in an accident at Circle Centre mall after falling 40 feet. We do not feel that Philip was sitting on the rail as reported in the national media. Philip is in serious condition at Methodist Hospital in Indianapolis. Internal bleeding has been stopped and/or has stopped on its own. Initial CAT scans do not reveal any fractures in his spine as first suspected. He has facial fractures around his right eye that are of concern, a broken right arm, broken scapula and a fracture on the right side of his pelvis. Pressures on the brain are within tolerable levels but are of concern for the first 72 hours. Phillip’s family was provided air transportation to Indianapolis so they were able to arrive within 3 to 4 hours of the accident. The outpouring of prayer and support for Philip, his family and our school has been incredible. The immediate response of the National FFA and their continued support with the sponsors and other five students from Booker has been very much appreciated. We ask that you continue to pray for Philip, his family, our school and the many doctors and nurses who are working with him.Philip continues to be in very critical condition. However, the fact that he is alive and able to continue to fight for his life is indeed a miracle. We certainly hope for a full recovery.

October 24, 2009
Philip had a rough night Friday night. However they have been able to stabilize him again. The family received an optimistic report from one of the doctors Friday evening, but that was before his episode on Friday night. The goal is to get Phil through the first 72 hours and then develop a plan for treatment of his other injuries. The ventilator is still doing most of the breathing. The outpouring of love and concern has been very much appreciated. Your continued prayers are needed.

October 25, 2009
(Morning) Phil has had a good 24 to 36 hours with no major events happening. He is of course still in a coma, but is making improvements. His pastor indicated this morning that we need to pray specifically for his blood count. Apparently he has lost enough blood over the past 30 or more hours to be of some concern. There is blood available if needed. Also, we need to pray for his fever and that it will remain manageable. Pray that Phil does not get an infection. Phil had a spike in pressure on his brain, but it was only up to 18, with 21 being a point of concern.
(Evening report) The probe used to measure the pressure on his brain was removed today. This is a good thing. Also, a nurse indicated that he moved his toes for her during the night when she asked Phil to do so. He has not done this every time he is asked, but has done so a few times. They have also increased his nutrition intake through feeding tubes today. Please continue to pray that the fever goes down and that Phil does not get an infection.
There have been conflicting reports in the media and what we feel happened in this event. Some reports in the media state that Phil was sitting on the rail. We do not feel that Phil was sitting on the rail. We do feel that perhaps Phil was lifted off the ground when his clothing became caught and it could have appeared he was straddling the rail of the escalator for a brief moment.
I have forwarded emails of support and prayers to the Caler family. The concern that continues to be shown is very much appreciated.

October 26, 2009
(Morning) Philip held his own through the night. He did have a blood transfusion and his fever is still a concern. Apparently there is blood seeping from somewhere. We need to pray that it will stop. Also, we need to pray against infection and that his fever will be manageable.
(Evening) Phil has had a good day, but the doctors are finding more problems. This is probably normal. Our initial reports indicated he did not have problems with his spine. However, that is not the case. Phil has fractures in vertebrae c-7; t-1, 2, 3, 4, 5. Also, they found that his left arm has two broken bones above his wrist. They have not heard about his left leg yet. The fever (102) continues to be a problem. The doctors have taken cultures of anything that might be infected. Another 48 hours will show if there is one. Also, they have taken steps to thicken his blood.
Phil has responded to verbal stimulus on occasion. That has been encouraging. They will be cutting back his pain medication to see if it will help him to respond better. Although there are more injuries listed here, we are still optimistic for Phil’s long term recovery.

October 27, 2009
(Morning) The overall condition for Philip is unchanged this morning. They did put a splint on his left arm after finding two breaks yesterday. The left leg does not have any breaks in it. The blood continues to be a balancing act between making it too thin or too thick. He still has a slow bleed and we hope that will stop soon. The tube in his left lung has done its job. The lung is fully inflated. The fever is still an issue. The doctors feel he probably has an infection and are giving him a broad based type of an antibiotic. The doctors are going to start reducing his pain medication today. They will reduce it by 2/3 over the course of the day and hopefully have him off by Wednesday. We hope this will allow the doctors to assess the neurological aspect of the injuries. The doctors indicated they are approaching the stage where everything will stabilize and no major changes will take place. They attentively plan to sit down with the family Wednesday or Thursday to make long range plans for Philip’s recovery. The recovery of course will be determined by Philip’s body as it takes time to heal. I am receiving several emails of encouragement and prayer. Please know that I am forwarding these emails to the Caler family. Also, Mrs. Yauck (principal) is putting the emails out in the hallway for our students to read. We ask for continued prayer and continued support and encouragement.
(Late Morning Update) Philip will need surgery on his left arm. When they do surgery, they will also repair his right arm which is broken above the elbow. The date of surgery will be determined pursuant to clearance by other doctors (neurologist) but will probably be later in the week.October 28, 2009(Morning) There has not been much change in Philip since yesterday. They have reduced pain medication yesterday and last night, but there has not been much of a response yet. Hopefully, Philip will start to respond more as this medication leaves his body. He will probably have surgery Friday on both arms to repair broken bones.
(Mid Morning) The word from Indianapolis is that Philip’s condition and responses are status quo. He has a slight staff infection and maybe a slight case of pneumonia in his right lung. His pain medicine has been reduced from 125 to 25 over the past day or more with no response. His medication will be reduced from 25 to zero tonight and they hope to see a response by Thursday evening. They do have surgery scheduled for 12:30ish on Friday to repair both arms. This will last 3 hours or more.
The emails that are sent to me with encouragement and prayer are being forwarded to the Caler family. We certainly appreciate the support shown this family.
Hospital Address:
Methodist Hospital 1701 N Senate Ave Indianapolis, IN 46202 Room 8327

If anyone is interested in making contributions to help the Caler family with Philips medical expenses, please send them to:
Booker Aid Fund/Philip Caler First Bank Southwest - Booker Branch 115 South Main St. P.O. Box 636 Booker, Texas 79005

October 28, 2009
(Morning) There has not been much change in Philip since yesterday. They have reduced pain medication yesterday and last night, but there has not been much of a response yet. Hopefully, Philip will start to respond more as this medication leaves his body. He will probably have surgery Friday on both arms to repair broken bones.
(Mid Morning) The word from Indianapolis is that Philip’s condition and responses are status quo. He has a slight staph infection and maybe a slight case of pneumonia in his right lung. His pain medicine has been reduced from 125 to 25 over the past day or more with no response. His medication will be reduced from 25 to zero tonight and they hope to see a response by Thursday evening. They do have surgery scheduled for 12:30ish on Friday to repair both arms. This will last 3 hours or more.
(Evening) There has not been much change in Philip’s condition. Please pray that he responds more in the next few hours as the pain medication is reduced.
The emails that are sent to me with encouragement and prayer are being forwarded to the Caler family and Mrs. Yauck is putting them up in the hallways for our students to read. We certainly appreciate the support shown to this family

October 29, 2009
(Morning) The Caler family met with two of the doctors this morning. Apparently, the doctors were pessimistic with what they feel Philip’s probable prognosis might be. Philip has been in a coma since the accident and is not responding, or waking up, like they had hoped he would once the pain medication was removed. The doctors have not been able to remove the respirator.(Evening) The only possible change is that the doctors think what looked like pneumonia might be the lung trying to collapse. His temperature is 102, so they have put him on a mattress that keeps a constant 50 degrees. His fever is cause for concern. I will post the newest information tomorrow when I receive it. The information has been coming to us midmorning or late morning, so I will wait until then to update this site. We certainly need to lift Mr. and Mrs. Caler up as they possibly face hard decisions in the next few hours and days.

October 30, 2009
Our report this morning is less pessimistic. Phil had an MRI done last night. His brain does have damage, but there is no way to tell how far he can recover at this time. He has water on the brain stem; therefore, electrical impulses or responses are not able to make it through all of the time. Once this area clears out and the brain starts to heal, there is a possibility of this improving. They should know something within the next five weeks. They are treating his right lung for pneumonia and partially collapsed and it is responding to both. They are continuing to test to see if he can get off the ventilator. If not, he will have a tracheotomy and possibly a feeding tube put in sometime next week. This will also allow him to be moved closer to home at some point.
The surgery on his arms is still scheduled for this afternoon. This of course will put more trauma back into him as he prepares for surgery, but it is necessary.
So the report today is more optimistic than yesterday. The doctors assured the Caler family that this would continue from day to day as he goes through more surgeries, etc.

(Afternoon) Philip entered surgery for his arms about 1:30 p.m. our time. This will be a four hour surgery. I will try and post again tomorrow morning. We have an away football game tonight, so I will not be able to update tonight.
Philip came through the surgery with no complications.

October 31, 2009
Philip had a good night with no complications from the surgery. Philip seemed to show signs of more pain, so he was put back on a lower dosage of medication. There are still concerns of pneumonia and possible collapsing of the right lung. Therefore, they will not test the ventilator today. They have not seen spontaneous movements or waking up.
The pastor and sisters will be coming home so the girls can get back in school. There are six teams in our football district. Schools hosting the two district games not involving Booker held fund raisers for the Caler family. The response from all across the nation has been very much appreciated.

November 1, 2009
Philip had a good day yesterday, although he is still in his coma. Family members feel that they receive little signs of response when they talk to him. They also acknowledge that it is difficult to tell for sure. Again, your emails of support and prayer are very much appreciated.

November 2, 2009
Philip’s blood pressure shot up. The doctors are concerned about blood clots, so please pray for that to be resolved. The family feels that Philip is showing more signs with his eyes flickering when they try to get a response from him. We know his recovery will certainly be gradual. The respirator has been turned down to 10 and Philip seems to be tolerating that so far. That is also a positive sign. Please remember the Pancake Supper tonight. Please continue to remember Philip and his family in prayer.

November 3, 2009
Philip is doing about the same overall. He still has eye flutter on occasion. His breathing is about the same. Surgeries are scheduled Friday to put in a tracheotomy and feeding tube. If everything goes well with the surgeries he will be moved to the rehabilitation floor where they will work his muscles. Doctors found blood clots in the right artery of his neck and behind his shoulder blades. He has been given blood thinner to hopefully dissolve the clots.
The pancake supper was a success last night. Other organizations all across the nation have also raised money for the family. The outpouring is amazing. Many people continue to send emails of encouragement and we are receiving many, many reports of prayer. Please know they are all appreciated by the family and by the school.
(Evening) The doctors have put Philip on a CPAP machine to help him breath. So far he has tolerated it well and is breathing some on his own. His blood gases were good enough tonight that the doctors are going to take the ventilator tube out tomorrow and see if he can get by with just the CPAP machine. If this works, Philip will not need the tracheotomy on Friday. So pray that this happens. Otherwise things remain the same for Philip.

November 4, 2009
We are hearing positive news from Phillip’s family. He has done well on his breathing, so well that they are hopeful the ventilator tube can be removed today. This would allow the doctors to have Phil wear an oxygen mask and they are hopeful that he will not have to have a tracheotomy. Time will tell. The doctors are hopeful that he can be moved to rehab next week. The goal is to get him closer to home. His fever is very manageable and is lungs are improving.
Today, the doctors were able to take the breathing tube out and Phillip is breathing on his own. The only help he is getting is some oxygen through his nose. The doctors are thinking that they will be able to get him into rehab by Monday, which will bring him one step closer to home. Thanks for your continued thoughts and prayers! .

November 8, 2009

Doctors continue to try and wean Philip off the ventilator. His time off the ventilator is increasing each day. Philip is much the same. However, his parents feel there are some days where he shows more reaction to their stimulation, although he is still in a coma. Mr. Caler has expressed how much they appreciate the emails and prayers for Philip.

November 9, 2009

Philip remains much the same. He is breathing on his own for now. The doctors will see how far he can go before he tires out and they put him back on the respirator. They continue to get responses from him on occasion, but nothing consistent. He does move his limbs.

Philip is about to the point where he needs to go to a rehabilitation facility. We need to lift up this family as they look for a facility closer to home, and hopefully a program that will help defer costs of transporting him.

November 10, 2009

The hospital is still trying to wean Philip off the respirator. He has gone for a few hours at one time, but tires out and has to be put back on the respirator. They have found fluid on the outside of a lung and will drain that off sometime today. The physical therapy people have evaluated Philip and have worked with him to some degree. They hope to transfer Philip to a different floor where physical therapy can work with him on a more regular basis. Philip still moves and still responds on occasion, but not every time he is stimulated or asked to do something for them. He does appear to experience pain, but of course it is hard to determine the source of the pain. He is still being given pain medication for this issue. The family will probably find out more this week about his progress as it relates to his head injury. They certainly appreciate all the emails and prayers sent on Philip’s behalf.

November 11, 2009

Philip would move last night for his father, but would not move for anyone else. However, today he is not moving for anyone, probably because they are working him hard. Philip continues to struggle with breathing on his own for more than a few hours. The place on Philip’s right arm where the bone broke through the skin is an area of concern for possible infection.

The Caler family found out yesterday that Philip will not be moved to another facility until he wakes up. I feel he will be moved to a different location within the current facility. Also, they want him to be off the ventilator before he is moved if possible.

November 12, 2009

The good news is that Philip is breathing on his own! Philip breathed on his own all night last night and all day today and they have taken the respirator out of his room as of this afternoon. Philip’s responses are still unchanged, probably due to fluid on his brain. We need to pray that his body will reabsorb the fluid.

November 13, 2009

Philip is more than 48 hours into breathing on his own. The place on his elbow is of some concern. One doctor thought it was infection, another calls it a deep bruise. Philip may be moved to a rehabilitation part of the hospital soon. He remains in his coma. Responses are still much the same.

Your emails of support and prayers are much appreciated by the family.

November 14, 2009

We are out of town for the weekend. I have not heard of any changes. We will continue updates Monday.

November 16, 2009

Philip’s condition remains much the same. He is still breathing on his own so that appears to be working like it is supposed to work. He is to be moved to the rehab floor sometime today. There was some consideration of doing surgery on his eye, but that has been decided to not be necessary at this time.

November 17, 2009

Philip took a step backwards today. He is back in ICU due to fluid on his lungs. The doctors have told the Caler family that they will have good days and bad days during his long recovery. So please remember them today.

(Afternoon) Philip is doing much better. The nurses in ICU suctioned his lungs and he was able to breathe much easier. Hopefully, he will leave ICU tonight or tomorrow.

November 18, 2009

Philip spiked a fever last night. However, today things seem back to where they were. A physical therapist worked with Philip this morning and Philip seemed to tolerate that well. He has since been moved back down to the rehab room. Everything else is about the same as it relates to Philip responding.

Mrs. Caler is on her way home today and should arrive home tomorrow. I am quite sure she is looking forward to some quiet time with their daughters.

November 19, 2009

Philip remains much the same today as far as him reacting to stimulation. He is back on the rehab floor. The family is working with a new set of doctors and nurses.

We are still receiving emails of support and prayer plus cards. Please know those are very much appreciated. Also, the doctors overseeing Philip now will be trying new medication. For those who ask for specific things to pray about, please pray specifically this afternoon and tonight that the new medications will have positive effects.

November 20, 2009

Philip remains on his new floor. The hospital will monitor him through the weekend to see if he continues to stabilize. He has begun to receive rehab for his arms and legs. The family feels they continue to see small increments of improved response, especially when hospital personnel work on his right arm. The right arm is the one that received the most damage. In other words, he does not like them messing with this arm and thrashes around some when they do. The small increments of improvement are what keep us encouraged. However, Philip is still in a coma and of course there is no way to determine when that might change.

Hopefully more information will be forthcoming next week. We need to continue to lift this family up.

November 23, 2009

Philip is showing more movement over the weekend according to his father; although he is still in a coma. He has experienced a few spikes in his fever, but the hospital has been able to control that with medication. The cultures through Sunday have been negative, so they really do not know what is causing the spike in fever. Head trauma can be a reason. The hospital continues to try new medications. The family covets your prayers in hope that the new medications will help Philip.

Your emails and prayers continue to be a source of comfort.

November 24, 2009

Philip is approaching a medical stage where he will be stable enough to be moved. The doctors are thinking sometime toward the end of next week for him to reach this stage. His coma is dictating the options that are available at this time. The family is looking at places in Amarillo where he can get the same level of therapy he is now receiving. The therapy he is receiving is called coma stimulation therapy. It is a combination of medication and physical therapy designed to stimulate him and agitate him. Amarillo is about 145 miles from Booker. For those who think that is a great distance please know we drive that far to go shopping. If Phil is moved to Amarillo people from Booker can also go by and see him and talk with him. I do not know when he would be moved.

Philip was rather active yesterday, so he is tiring out easier today. However, the doctors have indicated to Mr. Caler that they also see small improvement. Mr. Caler indicated that sometimes when he talks to Phil, Phil will move his head so he feels Philip hears what he is saying. They just do not know to what level his head injuries are allowing him to function.

I was asked by a news person if there is a possibility that Philip will never wake up. The answer to that of course is yes. However, I remain optimistic that he will eventually wake up and I certainly encourage the prayer warriors out there to continue doing what you are doing.

November 26, 2009

Philip had another day where he seemed rather tired. It sounds to me like the therapists really work him over when they work with him. Mr. Caler indicated that Philip will try to fight against them. I found this a good thing. Philip may have some kind of procedure done on his right arm where the bone broke through. We do not know if this will be a surgery, or deaden the spot and clean it out or the doctor may decide to leave it alone. Apparently the skin is not coming back over this spot like it should.

Philip had his surgery this afternoon on his right elbow where his arm was broke. The plate and skin were rubbing against each other. The doctors were able to make a temporary repair for this problem. Philip has not been responding the past couple of days like he has in previous days. Your prayers are much appreciated.

November 27, 2009

Philip seems to be having the usual post operation issues. He is being treated for pain from the operation on his arm. Now it is a matter of getting back to where he was before the surgery. This will likely delay his return back to Texas for awhile.

November 30, 2009

Philip made it through the weekend ok. They are getting him back to where he was before the last surgery. He has started to open one of his eyes now. They are hoping it is on purpose. The family is taking this as another small increment of improvement.

December 1, 2009

The nurses reported that Philip had both eyes opened early this morning. He apparently wiggled his toes when they asked him to do so. Mr. Caler has not seen both eyes opened. He has seen one eye partially opened two or three times the past couple of days. When he knows Philip is sleeping, both eyes are closed.

December 2, 2009

I was not able to visit with Mr. Caler today. Hopefully, we can get an update tomorrow. I am assuming things are about the same or I would have heard something.

December 3, 2009

I talked to Bobby this morning and the doctors are changing some of Phillip’s medications to try and help them with the physical therapy. They are working with his legs and think the different medications will allow his legs to relax more to allow more movement.

As always, your continued prayers and emails are greatly appreciated by the Caler family.

December 7, 2009

Philip is experiencing a few blood pressure issues. The doctors are trying to control the problem with medication. However, this seems to be keeping him subdued. They do not know what is causing this situation. One possibility is that he is trying to wake up. There are also a few issues with the muscles in his legs. So for those who continue to pray for Philip, these are the specific things that need prayer. On a positive note, the doctors continue telling Mr. Caler that they are seeing progress. We continue to be optimistic.

December 9, 2009

The doctors have been able to improve Philip’s blood pressure. However, it is still high. There are also issues with his right arm again, so decisions will have to be made in that situation. The medication used to help address his blood pressure is also causing him to sleep a lot, so it is hard to tell where he is as far as being able to wake up.

The Caler family needs a facility closer to home to be able to accept Philip until he wakes up. He is stable in most ways, but needs monitoring for the problems above.

Your emails of encouragement and prayers are passed on to the Caler family and are much appreciated.

December 10, 2009

Philip is having problems with his right arm again. Apparently he does not have enough meat on his arm to guard the skin against the hardware that was put inside his arm and it rubs a sore. He will have to undergo surgery again tomorrow to take out the hardware. He will have problems with this arm once he wakes up. His blood pressure is better, but again he is not as alert as they would like.

The doctors stated from the beginning there would be progress some days and some days there would be regression. Tomorrow will be one of the days when he regresses.

December 11, 2009

2:20 p.m. Philip is going into surgery to remove the hardware in his arm and a small bone. I have no idea what small bone or the purpose of the bone.

Philip made it through surgery fine. The plate was removed along with a small bone. There was infection in the elbow. A cotton type material is on his arm with a suction device to keep pressure on the elbow throughout the weekend to pull the infection out as much as possible. Cultures were taken to determine the type of virus. This should allow his elbow to heal.

Julie Mulligan from Perry Oklahoma has arranged an on line benefit auction on behalf of Phlip’s family. You can find information on the following link for those of you who are in the show pig business. I certainly want to express my gratitude for efforts such as these. The Caler family is experiencing several obstacles in trying to get Phil moved closer to home. Your continued help and prayers are certainly needed.

December 12, 2009

Philip had little bit of a rough night following surgery. It must have taken some time to control his pain. The surgery should allow his arm to finally heal without the plate there to rub against his skin.

December 14, 2009

Philip is in surgery again this morning to remove the sponge and vacuum system from his arm. They will flush it out, sew it up and hopefully that will be the end of his surgeries for awhile. The doctors determined that he had staph infection with the plate that was in his arm. It should be treatable. Philip had a hard weekend. Hopefully, he will be allowed to heal again and of course we continue to pray that he wakes up. There are times when his activity increases, so those times are encouraging.

There will be meetings again this week to determine a course of action for the upcoming days. We need to hold the Caler family up as they fight the bureaucracy of insurance and everything that goes with it.

(Afternoon) Philip is out of surgery. Everything went well. They left a drain tube in his arm and will remove that in 3 or 4 days if all goes well.

December 15, 2009

Philip’s family seems to think he continues to show slight improvement. He is also recuperating from his latest surgery. We continue to hope that Philip will be coming closer to home sometime in the near future, but that has not been determined as of this date.

December 16, 2009

Things are much the same with Phil. He is still in his coma, but his family feels that they are seeing slight improvement. They hope to have Phil closer to home sometime soon, but the definition of soon in medical terms is different than in the terms of the general population.

Some of the issues, but not necessarily all of the issues with insurance have resolved. It seems that the right people have been in the right place so far to help with these matters.

December 18, 2009

The hospital staff continues to work with Phil. He is still in his coma, but it does not seem as deep according to his family. Muscle tone of course is an issue since he has been down so long. However, the staff put him in a chair for a few minutes at a time, trying to get him to tolerate that also and of course he receives physical therapy. We continue to hope that Phil can come closer to home.

There have been many people reach out to help in this situation. Ford Motor Company came through with transportation for a period of time, Southwest Airlines has offered flights and of course many people have donated to help with out of pocket expenses. There are many, many wonderful people in this country.

December 22, 2009

Philip’s condition remains much the same. Philip remains in a coma, but he opens his eyes on occasion. The hospital continues to do tests to monitor his condition. They are sitting him up and trying to get him accustomed to doing so. He has not had a CT scan in awhile, so no knew information is there. The family needs for things to come together so Philip can be moved closer to home. This of course is complicated with the holidays upon us.

December 23, 2009

Philip is in Amarillo as of today. I do not know his new mailing address, but if you want to send letters and cards to him at Booker his family will receive them. For those who seek specific prayer requests, please pray that he will improve enough to go to a rehabilitation facility in the next few weeks. Phil being in Amarillo before Christmas probably qualifies as another Christmas miracle.

December 25, 2009

Phil seems to be settling in to his new surroundings. He has not done much therapy or anything yet pursuant to the holidays. He does respond some when people are talking to him. He is still in a coma. For those who ask for specific things to pray for, he needs to tolerate extended time with physical therapy and be able to sit up. Of course, he needs to keep the waking up process going. The next few weeks could be critical.

December 28, 2009

Phil had a good weekend. The hospital is putting him through their assessments. He is opening his eyes for family members. I do not know if he is focusing on them when he does. There will be an effort to sit him up more and work on his balance. Hopefully, the extra stimulation will allow him to continue to make progress and fully wake up.

December 30, 2009

I was able to visit Phil yesterday and found one of our teachers there visiting him. Phil squeezed her hand and it certainly appeared to me that it was intentional. She indicated that he opened his eyes when she first arrived at his room and talked to him. He did not do that during the time I was in his room.

Phil is still in a coma. He receives nourishment through a feeding tube, but he is breathing on his own. We think the new hospital will be sitting him up soon. He has not reached a level of consciousness where he can go to a rehabilitation facility. Hopefully, his progress will accelerate to a point where he can do this soon.

Your emails of encouragement and prayers are passed on to the Caler family and are much appreciated.

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