Maggie Rudy Sat 6/30/18

Maggie is officially out of ICU, moved to a different floor. She's more alert today, and we got her smiling and laughing. 

Her gross motor control is there, but she can't yet work her fingers or toes. Seems like her arm movements are getting better and more varied.

She also still has a bit of a phlegmy cough, one thing keeping a speaking valve from being installed. Hopefully this clears up in the next few days. Maggie says the coughing hurts.

We sure will miss the team in ICU - and the care Maggie received there - but it is fantastic that she's progressing every day on the road to recovery!

Maggie Rudy Fri 6/29/18

8:30 am.  Mags had a good night, and Laura got more sleep (excellent).  Laura and I had a much needed dinner and beer outside the hospital yesterday evening near the O's stadium, and got a chance to look at the road ahead.

Mags will likely be moved out of ICU today or tomorrow.  She is responding to more commands, and doing her best to communicate with us.  Yesterday she mouthed "I want to go home" to me; I reassured her that we want to get her home too, but she needs to be able to thumb wrestle me first, or respond to more commands.  This morning the nurse told her to squeeze her hand and stick out her tongue - she did both!

We expect she will be on another floor of the hospital for a few days until we can get her a bed at a sub-acute care rehab/nursing facility in the Frederick area, of which we've identified 3 from a list.  The case manager is working on getting this set up, where a bed is available.  She will be at a sub-acute care facility until she can handle 3 hours of physical therapy, at which time she will move to an acute care rehab center in the Baltimore area.

She's come a long way in the last two weeks, and we are very grateful for all your thoughts, prayers, and support!  We will plan an Open House when Maggie is back home and ready, and would like to invite all of you to attend  We will target late summer/early fall, and will email you when we get a date and time set, as well as information on where she is rehabbing.

Please use the link below to provide your email address.  Note that the blog posts will continue, but eventually will move to once per week, then diminish further from there.  Email will be a more direct way to contact each of you regarding major updates and the Open House.

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God has truly blessed Maggie and our entire family!  The verse of the day for June 18 was this from Isaiah 41:10 - "fear not, for I am with you; be not dismayed, for I am you God; I will strengthen you, I will help you, I will uphold you with my righteous right hand."  Very timely and comforting for us.  Please continue to keep Maggie in your thoughts and prayers, and we will update you when she's ready to receive visitors (and where)!

Love, Craig & Laura, Nadia, Becca, and Maggie Rudy.

3:30 pm. UPDATE: the occupational therapist and physical therapist were by today, and Maggie answered yes/no questions correctly, stood on her feet (with help), and followed commands. She will skip the sub-accute phase and move directly to accute rehab! 👍

Maggie Rudy Thu 6/28/18

1 pm.  Maggie's plan for today is to continue to reduce meds, especially during the day to keep her awake, and get her out of bed a few times into the chair.  She has been tending to sleep during the day and stay up all night.  Maggie is not yet lucid or interactive completely - the brain recovery part - but she seems to be making daily progress. We're hopeful to see her respond consistently to commands soon.

Due to the tracheostomy, she can't speak.  The team will need to replace her current trach with a smaller one that will accommodate a speaking valve, which could happen in the next several days.  But last night Laura and Nadia saw her mouth some words.  Laura relates that the nurse needed to give Maggie a shot, and as soon as she stuck her, Mags looked at the nurse and mouthed "fudge!" Nadia doesn't think that's the exact word, but close!  A little later she rolled her eyes and mouthed "oh my gosh!" So having language is big. 

Thank you for your positive thoughts and prayers!

Maggie Rudy Wed 6/27/18

7 am.  Maggie is totally off the precedex sedative, which is good. But she had an active and uncomfortable night. Laura did not sleep. Maggie is closer to being back, just not here yet. She did give us a big smile last evening!  We will see what the care team's plan is for the day, and I will update this post with more information by tonight.

Thank for your thoughts and prayers as we continue this journey.


12 noon.  The doctors are encouraged (which means we are too!),  One of Maggie's neuro team who has been with her throughout was out yesterday, but back today and really noted areas of improvement in eye movement and head movement.  Maggie actually laughed this morning, and smiled.  She's got a bit of a fever they're treating, but otherwise physically she's doing well. The team's goal is to get her out of bed today, so I'll report on that next.  

3 pm. So the out of bed experience was moving her from her bed to a chair via a lift. Mags was in the chair for about 2 hours, then back to the bed. Baby steps in the right direction.

Maggie Rudy Tue 6/26/18

10:30 am.  We are very optimistic today, and we and the care team feel Maggie is making positive progress. Just in case, they monitored her for seizures over the past 24 hours, and saw none. The plan today is to cut one of her sedatives to less than half her current dose, because Maggie seems less agitated when she is trying to wake up.  The process is longer and slower than her impatient dad would like, but we see daily improvement!

Thanks again for all the continuing prayers and support - Maggie and all of us truly feel the love!

Maggie Rudy Mon 6/25/18

2 pm. Not much to report today.  Maggie is still active at times, and seems more focused when she is looking around the room.  But she remains asleep.  The team is still weaning her off sedatives. I see an improvement from yesterday, but she is not yet alert and responsive. Thanks again for your continued prayers. Craig & Laura

Maggie Rudy Sun 6/24/18

10 am. Restful night for Maggie. The doctors plan for today is to tweak her meds a bit to help wake her. I'll update when we have more information.

5:30 pm.  The plan today from the care team - written on the white board in Maggie's room - is to "wake her up safely."  Maggie moves a LOT - arches her back, kicks her legs, and generally moves all over the bed when she's active.  As you can imagine - with the IV tubes, they've needed to restrain her arms.  They have her on one sedative that they are bringing her off slowly, and will give her an anti-anxiety medication to help keep her movements smaller and wake her up safely.

She is still not awake yet, but she does seem to be improving in focus when she opens her eyes.  It is only a matter of time.  Thank you for your continued prayers!

Maggie Rudy Sat 6/23/18

6 am.  Tracheostomy surgery is scheduled for 7:30-8 this morning, barring an emergency elsewhere for the surgery team. Her nurses got the word from OR around 3 am that she was first on the list this morning.  Maggie had a good night.

8:30. Mags is in surgery. The procedure takes approximately 2.5 - 3 hours, then she goes back to the ICU for recovery.  The plan then is to bring her slowly off her sedatives.  We're moving forward again!

1 pm.  Maggie is recovering. The tracheostomy was a success, and she's coming off sedatives. She has started a 30 minute breathing test breathing on her own. Once she passes this test, they'll remove the ventilator altogether. She is trying to wake up, but it'll be a gradual process.

5 pm. Still not awake and alert yet, but she is moving - a lot.  Legs, arms, abdomen, neck, arching her back, etc. She's been off the ventilator since 1:30, and all her vitals continue to look great. Doctors are pleased with her progress.

Maggie Rudy Friday

6/22/18

10:30 am. We're just waiting. There were a few emergency surgeries that came in to the hospital, and Maggie's procedure was bumped. Still hope to have it done today.

5:30 pm. Still waiting. Mags is resting. They had her ready to roll out of the room earlier, but an emergency call came in.  Still hoping for this evening for her tracheostomy.  Thank you for your continued prayers!

6:30 pm. This from Laura: "I just spoke to the surgeon.   She just had another emergency come in.  Rather than do Maggie in the middle of the night, she is waiting until tomorrow.  She feels it is safer.  Fingers crossed."

Maggie Rudy Thursday

6/21/18

1:30 pm. Everything remains steady, I am just a little late today. Still preparing for the tracheostomy. All signs good. More details later.

5:30 pm.  Maggie had an active day today, which is a great indicator. Though still under sedation, she is moving all her limbs, opening and closing her eyes, and responding to commands during her neurological exam. She seems completely agitated, per Laura. (I can’t watch these episodes - they tear me up). She has slight pneumonia, which isn’t a surprise to the team, and is being treated for it. A neurosurgeon group examined her neck this morning, in preparation for her tracheostomy, which will replace the breathing tube. Still no date/time for that surgery, but we expect soon.  Becca and Nadia were able to visit the hospital today, and see mom.

I am very hopeful that - as active as Maggie is during her exams - once the tracheostomy is in place we should have much better success waking her.

Your continued thoughts and prayers are very much appreciated! 

6 pm. Tracheostomy is scheduled for tomorrow morning. As with most things at UMD Hospital, the schedule is variable, but could be around 10 am. I will update here as soon as we have more information.

Maggie Rudy Wednesday

June 20, 2018

10 am - A bit of a setback last night. Mags had an MRI which we need to review later with the team.  We have a meeting with the neurologist later today, and will request a tracheotomy to replace the breathing tube, which is causing her anxiety and gagging.  Good news is that all her vitals are normal, she's breathing on her own, and she remains strong. She reacts to the nurses when they perform their exam. Our hope is that the modification in breathing will allow sedatives to be reduced, and we can wake her up. Please keep praying!

2 pm.  We met with the care team.  Maggie's MRI shows some mild to moderate impact due to loss of bloodflow, and the doctors are indicating they believe her recuperation may take a while.  A general outline is approximately a year with the greatest improvement in the first three months.  We won't know the actual starting point until she wakes up, but we remain hopeful.  Again, all her physical signs are where they should be.  We requested - with the doctor's input - the tracheostomy which will be accompanied by a stomach feeding tube.  This will remove the breathing tube - allowing Maggie to wake up without gagging, which will allow less sedatives and hopefully wake her up.  There is no fixed time-frame, but if we get the procedure completed by Friday morning, we could see positive results within the next following days.

Maggie Rudy Tuesday

6/19/18

6:30 am - Baby steps.  Maggie's body temperature is back to normal, and the team has stopped the paralytic, and her shivering is minimized.  She began to gag on the breathing tube, so they gave her a sedative to relax her.  EEG still looks good, but the breathing tube will need to remain for a while as they determine that her lungs are clear and there are no areas of concern for infection.

2 pm - Mags is off the EEG monitor and many of her multiple IVs. She has responded to touch and our voices though she's still sedated.  She has opened her eyes - though unfocused - and responded to commands to blink and squeezing our hands.  All tests look positive.  The doctors have ordered an MRI to see how things look.  The breathing tube may need to be in place for another 48 hours, which probably means sedation too.  It feels like forever, but everything is trending in the right direction.  Thanks again for all your prayers.  Laura & Craig

9 pm - No new information. Care team rounds in the morning will give us more to report by 9 or 10 am.

Maggie Rudy Monday

June 18 2018

11 am.  Not much to report yet today.  We met with the care team this morning (all seven) which includes doctors, nurses, and a pharmacist. The actual time for rewarming her body temperature is 36 hours, which means she should be back to normal body temperature around midnight tonight.  The process is slow and cautious.  All Maggie's signs look good, and her lungs are clear.  Still no prediction on when she may be responsive, but she still has a way to go.

Laura and I are overwhelmed with the outpouring of love, prayers and support!  Thank you all, and keep praying!

7 pm.  Warming continues - she's currently at 36.6 degrees C. During the cooling protocol they gave Maggie a paralytic because she was shivering and throwing off the monitor readings.  They tried to discontinue the paralytic when she reached 36 degrees, but the shivering returned.  The plan now is to bring her off the paralytic when she gets to 37 degrees (98.6 F).  Also, the doctors are very pleased with her EEG readings.  She has been on a continuous EEG since she's been at the ICU with no seizures noted.

Maggie Rudy Saturday Emergency 6/16/18

June 16, 2018

Maggie works for Frederick County Parks and Recreation as Assistant Director of the summer nature center program at Catoctin Creek Park, Middletown. She was leading a group of kids through the creek with Stacey Jones at the back of the line.  Stacey saw her fall, thought she may have tripped on a rock, but she did not immediately get back up.  Stacey and others pulled her from the creek - she had fallen face-first into the water.  They immediately began CPR and called paramedics.  Maggie responded and was coughing water up, but was having some difficulty breathing.  Paramedics arrived quickly and sedated and intubated her.

Background: Maggie has a history of absence or petit mal seizures as a child, and was under neurological care from the age of 4.  These seizures were treatable with medication, and she actually came off medication and was seizure-free for about 5 years in high school and college.  Last summer however, Maggie had a seizure in June that was different - a grand mal, or generalized tonic/clonic.  Paramedics attended her, but she was released without a hospital visit. Her neurologist started her back on her former medication after this event.

In April of this year she had a seizure during a test at college, and in May she had a seizure after graduation.  Her Neurologist started a second medication to treat the generalized tonic/clonic (Lamictal) but it needs to be ramped up slowly.

Back to Saturday: In the Frederick Memorial Hospital ER, Maggie began seizing (probably due to the trauma) which the doctors worked to control with medication.  They also worked to suction the water from her lungs. It was decided that the best treatment course for her was to send her to UMD Shock Trauma in Baltimore.  She was airlifted in the afternoon, arrived to the neurological ER, and later in the day moved to a bed in the neurological ICU.

Many thanks to Stacey and the entire Catoctin Creek staff, the paramedics, the staff at FMH, and the team at UMD shock trauma!

Maggie Rudy Sunday

NOTE: Please press the HOME button at the bottom of this post for UPDATED ENTRIES.

June 17, 2018 - Father's Day

Maggie remains at UM Trauma Center in Baltimore, and she is slowly being brought back to normal body temperature.  She was put into a cold state ("therapeutic hypothermia") for 24 hours to protect her brain and to assess and normalize many markers (blood oxygen, electrolyte balance, etc).  In effect, she is in a medically induced coma.

The journey back to normal body temperature will take approximately 30 hours starting at 5:30 PM this evening.  This morning's meeting with the neurologist was hopeful - I think all of us expect that we'll be talking with Maggie soon - but there is still a long way to go to get through their very detailed process.  The re-warming process will increase her body temp one tenth of one degree C every hour.  There are changes in vital signs that occur with re-warming, and slower is better.

Note here: the UM Shock Trauma unit and the Neurology ICU are fantastic.  They are the gold standard!

So we are waiting.  Thank you for your prayers, prayers, and more prayers!  There is no timeline, but we expect that she would exhibit some responsiveness prior to midnight Monday evening when the rewarming process is complete.  Perhaps later depending on the dosing of medications.

We will update as more information is available, and I'll provide information from the beginning for background information. As always, if there are items that need correction please let me know.