20 January 2015

The Forney Journey: Beginning anew

(continued from July's story, Tiger Flight 45, pts 1-3)

24 Feb 13: Maj Forney is prepped and wheeled into surgery for full debridement – removal of all the dressings placed on his body in Singapore – assessment of his wounds and the start of skin grafts.  There are five surgeons involved in this process.  They also remove his left arm during this surgery.  The next day, Maj Forney jokes, “What do I have to do to get out of the hospital?” He hasn’t fully grasped the extent of his injuries, even as he is aware that they are severe.  He is wheeled to his room in the Burn ICU (BICU).

Over the next week, hallucinations and clouded concepts weave into his daily life. The time he believes the physical therapy tilt table was actually located in a storage shed behind the hospital, next to trees, even to the point of feeling the sun and recalling the woodsy smell of the shed.  The time he demands sodium-free water because he overheard that his sodium count was high and figured that was why he wasn’t being given water (turns out, his body was so damaged, the doctors didn’t want to waste giving him the empty calories of water, so were only providing protein drinks).

Infections start to hit his system and Maj Forney is no longer lucid nor communicative.  He fights pneumonia and there are infections in his lungs as a result of the smoke inhalation which result in him being placed on a ventilator. The toxins in his blood from all the burned tissue wreak havoc on his kidneys and he ends up on CRR therapy, an aggressive form of dialysis. It is four days since his arrival in Texas.

1 Mar 13: Maj Forney returns to the OR for another a series of debridement and skin graft surgery. These surgeries will extend through May.

3 Mar 13: J. explains to him that he will be in the BICU for another two months, then hopefully transferred to inpatient rehab for another three, followed by another two years of outpatient rehab. He replies, “I’m alive,”  but in truth, doesn’t recall the conversation, only realizing it once he goes back over J.’s notes from this period.  He is on amnesiac drugs in addition to the other medications so that his mind won’t remember the pain.

18 Mar 13: Maj Forney has now been through seven surgeries in three weeks, his wounds 78% covered by skin grafts and his own injured skin. The remaining 22% are open wounds and allografts (cadaver skin).  The surgeons now also remove the heads of each of his calf muscles to create “flaps” to cover his knee joints and provide tissue for the skin to attach over his knees.  As a result, he is left with no calf muscle on his left leg and 1/3 on his right.  Shortly after, Maj Forney’s  left patella, which was dead but intact, shatters while he is being moved in the OR and must be completely removed.

April 13: Graft surgeries continue. Maj Forney begins to eat and the hospital nutritionist aims for 4000 calories a day to help his body heal.

27 Apr 13: Maj Forney speaks on the phone to his three children for the first time since the crash.

May 13: Progress and breakthroughs abound for Maj Forney. The doctors say he won’t lose the fingers on his remaining hand. The tracheotomy is removed. His sarcastic sense of humor returns, so says J. The surgeries are only spot grafts to cover up the last bits of open burn wounds.

21 May 13: He is discharged from the BICU to the stepdown unit, 4 East.

22 May 13: Maj Forney sees his kids for the first time. His oldest son takes it well right off the bat. His daughter is a little freaked out by his appearance but warms up after about 30 minutes. His youngest son is completely unphased.

May-Jun 13: The focus is now on wound care and rehab so Maj Forney can be discharged. He receives his first Ankle Foot Orthosis (AFO), an off-the-shelf temporary solution which enable him to stand and walk. With the removal of his calf muscles and the nerve damage in his lower legs, Maj Forney has almost no control over his ankles.  The AFOs provide stability and rigidity so he can stand and walk.  (The AFO consists of a footplate underneath the foot and a portion which goes up the leg (back, front, or both) to stabilize the ankle.)

Rehab first consists of working from sitting to standing, which he does for the first time in May, for about 20 seconds.  Once he progresses to standing on his own for a few minutes, the therapists move to walking therapy. Maj Forney uses a platform walker, which is a regular walker with a raised platform on the left side on which he can rest is left residual limb, to counter the new imbalance.

8 July 13: Maj Forney moves to the Solo-Step – a harness hanging from an overhead track- in conjunction with the walker.  He works up to about 150 feet on that and then transitions to walking around the ward with only his walker.  He is making phenomenal progress but is extremely grumpy and short with his PT staff during this time.  He also receives a power chair, which the entire staff immediately regrets giving him upon remembering that he is a helo pilot. Maj Forney finds new freedom of movement and never actually runs anyone over

J. comes in to 4 East every day for several weeks to learn the wound care procedures for Maj Forney. It is a steep learning curve but required for him to go home.  Simultaneously, the hospital staff and case managers are gathering the ramps, shower chair and other basic equipment needed at the house so he can be discharged.

26 July 13: J. rolls up to the hospital in the modified van and Maj Forney gets in to go home.

Home!! July 2013  (photo courtesy of the Forney family)
Questions for LtCol Forney:
1) When did you realized the extent of your injuries?

To be honest, I don’t know when I truly grasped the extent of my injuries, if ever, in the hospital.  I remember thinking in the cockpit waiting to get pulled out that I would lose my left hand, but I don’t know if I remembered that when she told me in the hospital that they had cut it off.  It was a long time before I could sit up and move enough to even see where my arm ended, and even longer before it was uncovered for me to see it.  I think the drugs kept me from really realizing it, which is good, because it kept me from being overwhelmed so I could focus on just getting through.  I would say I didn’t truly grasp it until I was in inpatient Burn rehab in June.  That’s when I realized how much I’d lost and that not all of it would come back.  Those were the hardest days.  I was off drugs, awake, trapped in the hospital, and physically wore out quickly.  I had plenty of time to think, and it sucked. Getting out of there was huge.

2) How many surgeries did you have those first months?

By the time I discharged in July, I was up to 17 surgeries, most of the debridement and grafts.

3) How did the Semper Fi Fund help you and your family during this time?

To the point of my discharge, SFF had:
  • given J. a check upon her arrival to cover immediate incidental expenses;
  • gift cards for chow; 
  • an iPad so she could have visual communications with our kids (who had come from Japan and were staying with relatives in NE);
  • paid for a bunch of the equipment for the house to speed up the process and get me home, and
  • provided the loaner wheelchair capable minivan at no expense to us.

Our SFF representative, Cheryl Reid, was efficient, responsive and amazingly helpful.

4) How was the Marine Corps’ assistance during this time?

The Marine Det was awesome, especially the S-1.  The 1 Chief knocked ITOs for Jennie and the kids, did all the paperwork, handled the PCS, all the pay stuff, my parents travel and lodging.  He even spent a day on the phone with United getting a refund for our plane tickets we were going to use for a summer trip home if I hadn’t gotten hurt. Amazing support.  Tons of emotional support for J.  Exactly what you’d hope your family would get from Corps!

The journey continues….

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