Dustin’s intracranial pressure continues to be higher than desired. That being the case, the doctors are keeping him on the medication that is designed to decrease the swelling in his brain. They are having to balance that drug’s positive effects (decreased swelling, hopefully) with its negative effects (dehydration). Dustin continues on the sedation medication (and on the ventilator, therefore) which allows his body to do less work.

He is scheduled for a CT scan at some point today as well as a tracheotomy — placing a breathing tube in his neck — and to have a feeding tube (PEG) placed directly into his stomach tomorrow afternoon. These latter two are neither decidedly positive or negative procedures. They are normal steps taken at this point when it seems a patient will be in this state for a while. They are designed to help facilitate breathing and nourishment respectively, as well as help prevent complications (like pneumonia, etc.).

If you would like to leave Leigh Anne or anyone else in the family a note, simply click on the “Comments” link at the end of any post and we will make sure that she or whomever you address it to receives it.

From Leigh Anne, the family and those of us here ‘on the ground’, thank you for your faithful and fervent prayer.

Praying Friends,

For those of us sitting at the hospital, we wait for news as you do. We can go back to see Dustin in twos, pray for him, sing to him, talk to him. Dozens of us have over the past few days. You would be very encouraged by the number of people who have driven in, flown in, slept in recliners, and even stayed awake at his bedside since last Wednesday evening. Of course, we have received word from literally hundreds of people across the country and even around the world who have been praying for him and Leigh Anne and the family. Leigh Anne has been upheld, literally, by the hand of God through the prayers of his people. The Father hears you pray.

Locally, brothers and sisters in Christ have rallied around the Salters in ways that make you proud to be part of the family. You and they have brought honor to Christ and have been a TREMENDOUS support to Leigh Anne especially. They are surrounded. Please don’t stop surrounding them with prayer and your presence. Further, one of the Christian doctors who has been a tremendous source of information and support told us that he had “never seen a better ICU.” So Dustin and his family are receiving the best care.

As for the medical update, the doctors continued the medically-induced paralysis today. As we informed you earlier, this was the last medical intervention left to them, in hopes it would give his brain opportunity to heal and reverse the swelling. They did not see the improvement they had hoped for. It was not a very good day for Dustin. His brain continues to be swollen with no sign yet of reversing.

Where does that leave us? We don’t really know, to be honest. It’s not the worst news possible, but it’s not good news either. We certainly want to ask you to continue to pray. What should you pray for?

No new news on Dustin’s condition at this point.

Just wanted to make you aware, if you’re not already, that you can download Dustin’s last sermon (from 11-5-06, three days before the accident) here. In God’s providence, Dustin preached on the doctrine on Providence, from the life of Joseph (Genesis 37 & 50).

Dustin used the following from the Heidelberg Catechism, questions 27 & 28 as a confession of faith before he preached that sermon.

Q. What do you understand by the providence of God?
A. Providence is the almighty and ever present power of God by which he upholds, as with his hand, heaven and earth and all creatures, and so rules them that leaf and blade, rain and drought, fruitful and lean years, food and drink, health and sickness, prosperity and poverty—all things, in fact, come to us not by chance but from his fatherly hand.

Q. How does the knowledge of God’s creation and providence help us?
A. We can be patient when things go against us, thankful when things go well, and for the future we can have good confidence in our faithful God and Father that nothing will separate us from his love. All creatures are so completely in his hand that without his will they can neither move nor be moved.

Trusting that providence …

As of this morning, there continues to be little change. The update is … there is not much of an update. One note: the doctors are going to continue to keep Dustin in the medically-induced coma a little while longer. Originally had heard that they would turn that medication off this morning, but that is apparently not the case. No word on exactly when they now intend to turn it off.

If you want to send Leigh Anne (or anyone else in the family) a note, the hospital has an E-card service that you can access at the following address (http://www.ghs.org/egreeting.asp  NOTE: Select “Greenville Memorial Hospital”). They print these off about once a day and hand them to Leigh Anne. Send her a note and let her know you’re praying.

Will update as soon as anything substantial changes.

Dustin remains in a medically induced coma, the goal of which is to help his body focus its attention on healing his brain. The doctors are planning on using this sedation medication for another 36 hours or so, periodically taking Dustin off of it to test his reactions, etc. Most recently, when tested, Dustin did show some positive signs … his reactions were of a higher order than they have been to date. His brain pressure has been a little lower, as well.

Tuesday will be a significant day, as the sedation medication will have run its course. At that point, doctors will better be able to say what the future may look like.

Pray:

• the swelling in Dustin’s brain to decrease
• his reactions (brain activity) to increase — even small incremental increases are good signs
• Leigh Anne’s emotional & physical endurance
• give thanks for all the support Leigh Anne & the family are receiving

Thanks everyone for eagerly signing up to pray for Dustin and his family. Here is a reminder of the times you signed up for, and also a place to visualize all of your brothers and sisters who are joining you in this endeavor.

In an attempt to allow Dustin’s body to divert its energies to helping his brain heal, the doctors have given him some medicine that places him in a deeper coma. This means several things:

     - he is back on the ventilator

     - his brain activity is a level 3

 Both of these things (which seem negative) are intentional and expected results of the medically induced coma — which is an attempt to help his brain heal.

 We are still simply in a waiting pattern … waiting to see if his brain stops swelling, waiting to see what the Lord will do. He is able to do more than all we ask or even imagine (Daniel 3.17).

A few notes for you on Dustin’s condition.

• Dustin spent most of the day today breathing on his own. The ventilator was still in, but turned down low, just in case he needed it to assist him.
• this was, what seemed like a good sign
• however, the doctors ordered some tests to be run this evening since we are at the 48 hr mark. Those tests indicate that Dustin’s brain, though certainly not getting worse, is neither improving. There is a numeric scale that measures brain activity, maybe something like an Apgar score for newborns. Normal adults, while carrying on conversation are at a 15. When Dustin came into the hospital, his brain was at a 3. After the surgery, his brain was at a 4. This evening, 48 hrs after the accident, his brain is still at a 4.
• what that means … The surgeon has said that Dustin’s injury is not a lethal injury. However, given the lack of improvement in brain activity and the difficulty he continues to have in self-regulating the pressure in his head, the doctor’s have said there is great potential for serious brain damage. They have essentially said that Dustin is not likely to get worse. However, he is not (at this point) very likely to improve.

This is heavy news that certainly weighs on us. These doctors are good. They know what they are talking about. This is no insignificant news. However, we trust in a God who is weightier than this news. The hands that made 5 little loaves and 2 little fish feed over 5,000 people is not subject to probabilities and brain activity scales. God is able, at any point, to intervene and disrupt the ‘normal’ course of events. It is this that we must now pray for.

Be still, my soul: thy God will undertake to guide the future as he has the past.
Thy hope, thy confidence let nothing shake; all now mysterious shall be bright at last.
Be still, my soul: the waves and winds still know his voice who ruled them while he dwelt below.

For Jesus’ sake,
grant

There is not a lot of change in Dustin’s condition. He remains in ICU, in a non-medically induced coma, on a ventilator and in serious condition. There are some small, though positive signs of brain activity. With a brain trauma of this nature and magnitude, things get worse quickly and they haven’t to this point - which is good. On the flip side, things do not get better quickly. Improvement is normally slow and in small increments.

things you can do:
1) give thanks!
2) pray fervently!
3) serve joyfully!

1) give thanks:

• many, many expressions of concern, support, etc.
• Leigh Anne’s friends in from TX and AZ
• an RUF family in from NC to stay with the Salter children
• skillful and knowledgeable doctors, nurses and caregivers
• the body of Christ rising to the occasion

2) pray fervently:

• the swelling of Dustin’s brain to go down
• increased brain activity
• Leigh Anne (comfort, encouragement, rest! [physically and spiritually], endurance)
• Jacob, Nathan and Meredith
• RUF @ Furman (there are about 100 sheep currently without a shepherd)

3) serve joyfully:

• To help in the following ways, contact the person listed:
• Meals: Lori Luttrell (610.2737 )
• Sitting with Leigh Anne: Judy Kay Kyker (610.9082, jvkyker at hotmail.com )
• Childcare and General Help: Mary Ellen Kistler (610.9400, redeemeradmin at gmail.com)