Steve Ruetschle

June 24th, 10:00 p.m. EST

Tonight’s update comes from me, and Michelle gets the night off… Needed rest for a woman who has been incredibly strong.

My name is Mike Ruetschle, I am Steve’s younger brother by 18 months, and was the one on the motorcycle trip with Steve when the accident happened. I was first on the scene with Steve within minutes (or less) of his accident, watched him be flown off on helicopter to the hospital, and was with him from that moment until Sunday when I returned home to my wife and kids in Ohio. This evening was my first time to see Steve since Sunday morning, and I was absolutely blown away…. My brother that in moments I feared I might have lost, is very much alive and well.

Coming right off his second major surgery I was expecting puffy face and eyes (like we were warned) and sedation and no communication similar to the first surgery. I hadn’t really talked to Steve since the accident site. Steve was very much the opposite, and very present. As soon as I walked in the room he wanted me right in his face, to look straight into his eyes, as he shed tears and shared personal things with me. We talked straight away about the accident, his memory of what happened, and he pressed into me not to feel guilty about signing him up for the trip. More than anything he wants me (and all of us) to stay positive for him, as he is acutely aware of the challenges that lay before him, and aware of his need for support when things get hard. Steve knows this is the beginning of a crazy God story and believes that good things are in store for him. Tonight I believe it also.

Steve was showing off for me a silly thing called “baby bar bells”. This is where the nurse rolls 2 wash clothes into tight rolls and lays them on his lap. He goes and finds them with both hands, clenches them with his fist, and pulls the up over his head. This is monumental and was more glorious for me than the US goal in the 91st minute.

This second surgery basically completely fixed his neck – with the insertion of structural platinum rods. His neck brace that he wore up until now is removed and he is free to move his head from side to side. Michelle taped photos of the kids on the side rail of the bed to give him motivation to turn his neck. Steve was shocked that he was able to turn his neck, almost feeling like he shouldn’t be able to do it, and half curious / half afraid to give it a try. I am not sure he even was aware that he would regain full neck mobility – but he has it. He really wanted us to also do lots of foot rubs to keep stimulating his feet as Steve is determined to use them again.

Steve was clear on wanting to go to Seattle for rehab as he understands and trusts the research that is telling us its one of the best facilities in the world. While things were incredibly positive for me – there are still some issues and prayer requests. His drugs are making him paranoid and he still thinks some of the nursing staff are “out to get him”.

He is very tired, so please pray for good sleep tonight. Pray that his bone graft would take and his new wound from surgery would heal. Pray that there would be no fevers tonight or infection. Pray that his medical team would find the right balance for the pain meds – they are trying 2 different ones, one for nerves and one that will induce sleep. Some of these have had adverse affects in the past and pray that the team finds the right balance. Pray for Michelle, a woman who has faithfully been at Steve’s side every step of the way, for a good night sleep also, and renewed strength in the morning.

God Bless all of you around the world who love and care for my brother. His surgeries are behind him and he is on the road to recovery…

UPDATE 6-24-10 4:35EST
Just heard from the post-op nurse.  Steve has been successfully extubated!!!  He is headed up to ICU now and we will hopefully be allowed to see him at 5pm.  Pure joy!  Please pray as he comes to consciousness, for peace and pain management.  I am deeply encouraged and grateful! – Michelle

From Michelle 6-24-10 3:15pmEST
Praise God, praise God, praise God!  I just spoke with Steve’s surgeon and he has come through surgery fine!

Please pray now especially that his lungs and breathing will be stable so that they will be able to immediately extubate him!!!!

Please also pray that he will manage sedation and pain well, and be peaceful.

Inside I am literally jumping up and down for joy!  So grateful for your many prayers which carry us all.

- Michelle

UPDATE FROM MICHE 1:57pm EST
Surgery proceeding smoothly. No updates for another hour or two.

UPDATE FROM MICHE 12:15PM EST
Just heard that Steve is now under and prepped successfully.  They are ready to begin surgery.  No more news for at least an hour and a half.

24 June 2010 11:30 am

Steve is now in the OR and they are prepping him for surgery.  We do not expect to have any news for at least an hour and a half.

Steve was beautifully present this morning, cracking jokes and making us laugh, sitting up with the physical therapists and with slightly less pain than he had had previously.  I had prayed that he would have comfort in the night.  Turns out that in his delirium he thoughts I was in the room and not talking to him because we both didn’t want me to get kicked out!  He also had an excellent visit with the speech therapist who thinks that if all goes well with the surgery, they may have him eating without a feeding tube tomorrow.  Much to celebrate.

These are the harrowing hours.  However, Steve has already shown his capacity to come through surgery.  The same neurosurgeon is operating on him, and the anesthesiologist will be following the same general course they followed during the last surgery.  Steve needed me to be positive for him, so until there is any reason to be otherwise, I am fully expecting to see my love in four to six hours with no neck brace on and doing well!  They allowed me to be with him in pre-op, again an uncommon gift.  He thanked the neurosurgeon so profoundly that I think I saw his eyes get wet!

I am praying for a tangible joyful presence to be in the room with Steve, and for a raving success.  A major prayer request is that they are able to extubate him again immediately after surgery.  That is the goal, and it will prevent more of what we experienced before: great discomfort, risk of damage to his vocal cords, and prolonged sedation.

I am filled with love and gratitude for my amazing man!

Michelle

Dearest friends and family,

A quick practical word as I prepare to visit Steve this morning.

We have been overwhelmed with the most wonderful offers for visits. We are requesting that you refrain from phoning or visiting the hospital at this time.

In time, our community’s real presence will be a gift and motivator beyond telling. But for now, every second of Steve’s emotional and physical energy (and mine!) is bent on his short term recovery. I have imagined the pain as one long birthing contraction without pause. Steve relates to this image. Every minute he is just trying to get through to the next moment. A mere “hello” is costly. Also, with his ever considerate spirit, Steve feels terrible for the pain he is causing others. He literally cannot bear to think of it and so we talk of nothing but what is immediate – the few immediate family members in the room and the moment at hand. I share Steve’s focus and have neither the emotional nor the actual minutes to devote to anything but the most necessary. We are all completely devoted to Steve getting through this initial, critical stage.

We feel so very deeply loved. Your prayers and postings are what keep us afloat, both emotionally and in reality. One day Steve will no doubt spend many hours weeping over your well wishes. Please do not stop!

With love and gratitude for this new day,

Michelle

23 June 2010 10:30 p.m.

Dear friends and family,

Another long day has finally spent itself.  I have been in the ICU all day.  What a blessing!  It is not common for the nurses to allow visitors to stay with the patients, so I was giving thanks for every minute I was allowed to spend, and praying fervently in my head and heart that I might not disturb too much.  In the end, all of those minutes amounted to twelve precious hours!  It was enough to replenish me moment by moment as I watched Steve run his marathon.  To his nurses we will be forever grateful.

Steve has blown us away today.  When I arrived he was conscious but in deep pain and still not communicating very much.  We quickly fell into the rhythm of the day before, stroking his hair, holding his hand and talking him through the pain, which remains great and constant.  He went through phases of paranoia today that were new, and he had to be firmly and frequently reassured as he imagined genuinely disturbing and frightening conversations and people.   At around 3:45 p.m. or so, however, he gave me a great gift.  Steve simply appeared.  It was both astounding and tender.  Although Steve was in terrible pain, he was also very lucid and calm in talking about his accident and its consequences.  He was also able to talk about the children (a subject that until now and even after that moment has been too painful for him to discuss or even hear about), thank and praise his nurses, shower me with love and compliments and generally exude the kind of light and kindness and humor that is so naturally his.  I was hardly able to take it in – this genuine conversation, his love eyes present, and his entire beautiful spirit filling the room.

During that time he unwittingly answered your prayers and mine by clearly and concisely indicating his choice for rehab.  I quickly presented his choices, indicating their excellence and listing that they both ranked in the top ten, Seattle number 3 and Columbus number 9.  He looked at me with the utmost clarity before I had even finished my introductory presentation and stated emphatically, “Well that’s clear, it’s Seattle then.  The best of the best will go there.  I have a lot of work to do and I need the best of the best.”  As we discussed it further, he remained clear in his conviction.  He is extremely, beautifully dedicated to getting well even in the midst of this excruciating pain and simply wants the cream of the crop to get him there.  In fact, I think he needs this conviction of their excellence in order to give him hope for the road ahead.  I cannot tell you what relief this brings, that Steve himself has indicated his choice.  It was the greatest gift.

But there was more, much more.  Sky has written about his progress with the physical therapist.  I am refraining from any great medical detail because these are complex issues and I do not want anyone to misconstrue his progress, however where Steve is, it was like scoring a touchdown in the Superbowl.  Even the therapist could hardly contain her optimism.

And still Steve gave us more.  This evening his nurse gave Steve some washcloths, rolled up and bound with tape.  She asked him to grasp a roll in each hand, and alternately lift it up.  HE DID IT.  I cannot tell you the effort required, or the progress this demonstrates.  Now I was truly leaping in my heart!  His own determination and euphoria were evident.  He wanted a GOAL, and she gave him one.  Five lifts every two hours.  He waited for David and his parents to arrive in great anticipation to show him what he can do.  We all cheered and best of all, he cheered himself at this major accomplishment!  That is how I ended my twelve hours with Steve.

Steve is in and out of clarity and still in such pain that he needs to be talked through the waves and can be present only with great effort.  And yet today he exercised that effort in order to be kind to his nurses, in order to love me, and in order to show us all his determination to get well.  Steve’s remarkable spirit is returning.

I promised him often that I would make PAIN MANAGEMENT his number one prayer request.  Steve is extremely sensitive to the medications, and it has been tricky trying to find a balance between giving him comfort and keeping him mentally present, among what are no doubt a host of other medical considerations.  Even as I left this evening his paranoia was inching back and it is truly terrifying.  The pain is also terrifying.  No true comfort point has been found.  Please pray for Steve, his doctors, and his nurses as they try to find the perfect cocktail of medicines for Steve.

Steve is scheduled for surgery tomorrow at 1145.  Assuming this proceeds as scheduled, please mark your calendars and pray with me.  Surgery will last for 4 to 6 hours.  Steve is naturally terrified but committed.  I am equally terrified and committed.  Please pray for raving success and quick healing.

Please also pray for Steve tonight.  He is now more mentally aware but still in acute pain, as well as being prone to paranoia and delusions and I am no longer there to talk him through it.  Please pray for sleep, of which he has had very little, and for comfort and peace as he negotiates the long night on his own.  I am praising God that in the morning I may possibly be allowed to stay with him again.

Twelve precious hours with Steve.  He continues to surprise and inspire.  He gave us all laughter and tears of joy today, even in the darkest valley.  I praise God for him.

Earlier in the day, the following verse inspired me and I felt its true effects all through the hills and valleys:

“Who shall separate us from the love of Christ?  Shall tribulation, or distress, or persecution, or famine, or nakedness, or danger, or sword? … No, in all these things we are more than conquerors through him who loved us.  For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, nor height nor depth, nor anything else in all creation can separate us from the love of God in Christ Jesus.”  Romans 8:35,37-39

With continued gratitude, love and thanksgiving for your prayers which are heard,
Michelle

Just a quick update from David via cell:

Miche was with Steve all day and although pain meds continue to cause delirium, Miche had 20 good, lucid minutes with Steve.  Steve was present, aware of what has happened, and they were able to really connect during those 20 mins before Steve went back on a new mix of pain meds.

Steve also had his first physical therapy evaluation today and there are encouraging signs.  We do not want to get too detailed here as everything is still very early; the next surgery awaits; and Steve is still in immense pain.

The family remains profoundly grateful for your continued prayers and messages of comfort and encouragement.

- Sean

Just off the phone with David (for those who don’t know, David is Michelle’s brother).

No surgery today.  It’s possible they’ll be able to get him in tomorrow, but no confirmation.

Steve did very well overnight.  His temp stayed below 100; sputum culture was negative; still on antibiotics.

He is progressing out of his delirium; he’s really waking up.  This diagnosis has NOT yet been confirmed, but if Steve does in fact have sensation in his feet (as David and Michelle experienced) he would be classified as ASIA-B. “ASIA” stands for the ‘American Spinal Injury Association’, and they have defined an international classification for spinal cord injuries.

Rather than go into details here about the various ASIA classifications, here are a few links:

• ASIA Classification on Wikipedia
• Spinal Cord Injury information page
• Helpful resources at the Christopher Reeve Foundation.

Steve’s pain continues to be quite severe. The challenge for the hospital staff is to balance pain control with delirium. They do not want him so sedated that he remains delirious, but also want to definitely manage his pain. They are going to try new pain medication today.

Michelle asks for continued prayer for Steve’s pain, as well as wisdom on where to go for rehab. They hope that as Steve wakes up they can have a dialogue with him about this.

Miche is  grateful to have the same nurse assigned today; this means that she’ll be able to stay with Steve for most of the day.

22 June 2010, 11p.m.

Dear friends and family,

It has been a long day, and in many ways a very, very good day, but I am tired and will keep this short. Steve’s progress is steadily improving, however the things that make my heart leap are measured in the smallest of increments, yet miles for Steve. I spent most of the day with my love. By this I mean that as soon as they let me stay I never left his side except to let the nurses attend to him or in order to scarf down a quick meal – for me, pure joy! Steve is conscious enough to indicate that he wants his hand held and his head rubbed, which I did with such a sense of gratitude, finally able to provide some very small relief to my beloved. He remains in pain and disoriented, with many groans and crying out. He is also terribly distressed to have caused his loved ones such pain, which in turn is distressing to us. His words remain few (how in the world did he press out that whole phrase earlier?!) and for the most part he only engages when spoken to. He knows his name, my name, where he lives and for how long, but he has trouble with the date – month or year. I spent the day in the joy and strength of finally being with him – what a gift! However I find now that I am home that I am also processing his incessant pain and crying out. Even now he is a beautiful, beautiful man, but he is also profoundly broken.

Please pray for healing not just of his body but of his mind and spirit. He is processing the accident and its consequences with great anguish. I am speaking calming, loving, simple phrases over him continuously. The verses that spoke to me today come from the apostle Paul: “Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God. For as we share abundantly in Christ’s sufferings, so through Christ we share abundantly in comfort too. … For we do not want you to be ignorant, brothers, of the affliction we experienced in Asia. For we were so utterly burdened beyond our strength that we despaired of life itself. Indeed we felt that we had received the sentence of death. But that was to make us rely not on ourselves but on God who raises the dead. He delivered us from such deadly peril and he will deliver us. On him we have set our hope that he will deliver us again. You also must help us by prayer, so that many will give thanks on our behalf for the blessing granted us through the prayers of many.” 2Cor1:3-5,8-11.

Surgery may still occur tomorrow however we remain uncertain. Please pray for wisdom for the doctors as they make that decision.

I also ask for prayer for the short and long term care of Steve. Steve may be transferred to rehab within a week, depending on his progress. We have considered many institutions and have narrowed it down to two, though this may change – Seattle and Columbus, OH. We are weighing a multitude of factors including the excellence of care, communal support, the welfare of the children, and family among many. These decisions have possible longer term consequences and there is as yet no brilliant clarity. For this major decision, I request your prayers.

With love and the deepest gratitude for your ongoing support,
Michelle

An update from David:

The CT scan was in fact confirmed negative… good news. Steve’s temp also stayed down during the day… hovering around 100… hasn’t spiked. He is still coming out of the delirium, the meds are wearing off, but his cognitive function looks strong and he is waking up.

David continued:

“He knew who I was! And Sky, I was standing there with Miche in the room, and I took his left foot and started massaging it. Steve opened his eyes, looked up, and then Michelle asked, ‘can you feel that?’

Steve said, “yeah.”

“Which foot?” Miche asked.

“The left foot,” Steve said.

So I kept massaging his left foot, and then quietly without saying anything started massaging his right foot. Without opening his eyes, Steve yelled out, “RIGHT!!”

Everyone started laughing; I just felt so happy…it was an incredible, incredible moment.”

David continued to explain that while this is so encouraging, there is much still to learn. As for the second surgery, it is tentatively scheduled for tomorrow (Wednesday), but we’ll see. The nurse will call first thing in the morning if it looks like Steve will go to the OR right away.

What a day… from fever, a possible stroke and impaired cognitive ability… to later in the day Steve calling Michelle the most beautiful woman in the world and able to feel his feet.

If the last several days were two steps back, then today has been the “right” foot stepping forward.

22 June, 2010 2:15 pm

Dear friends and family,

I am riding high. I have just spent over two and a half hours with Steve. Steve’s nurse is allowing me to stay with him until the end of her shift at 7:30 p.m. This is a nurse dependent decision so please pray that the night nurse will feel the same and let me stay longer. Because Steve remains somewhat delirious and in pain, I sometimes wonder whether he cares or not about my presence or how much he knows. But I was deeply reassured when the nurse came in to ask him a few questions and check his mental state. She asked him where he was and he said, “North Carolina”. She asked him what kind of building he was in, and he said, “hospital”. Finally, she asked me who was sitting next to him (me), and he said, “my wife… the most beautiful woman in the world.” I wept with joy. He is here, he is returning.

Mostly, he does not speak, but he moans a great deal. He is in a lot of pain. The doctors have taken him off of all sedation and pain medication. His nurse has just given him a very small dose of something to take the edge off, however earlier he said that he could not even feel me stroking his head for the pain. Please pray for wisdom for the doctors in balancing the healing and his discomfort.

I am running back to Steve but wanted to share with you my joy.

Michelle