Monday, April 14, 2014

Nate -- Update

 It is such a comfort to know that Nate has such a great support team full of amazing, caring friends. Tyler and I have been able to feel so much love from all of you, and it truly means the world. 

As a way to keep everyone in the loop, we (with the permission of Nate and his family) will be updating the blog with any new information that we receive. 

Nate and Skyler, a med school friend

Nate's sisters Diane and Amyjo have been keeping Tyler updated. 
Diane sent over this email today for all those who wanted to be updated on Nate's condition and the events that have taken place so far:

Everything is confusing and unclear because Nate does not remember anything from the crash, but I spoke to the race director, Andrew Willis, and although he did not personally see what happened, the riders behind Nate recounted this story to him: The course has two u turns before you get to the finish line. The riders had done a few laps already, so he knew the turns were coming up, but he was pretty close to the finish line. He looked over his right shoulder to determine what his lead on the other riders was as he came in for 1st. Since the course had those 2 u-turns near the end, when he looked over his shoulder he went off course and hit a tree.

Nate refused to give any paramedic contact info for a family member for some time. He didn't want to worry anyone. Finally the woman who admitted him to the ER was able to get a phone number out of him - he had my dads number memorized. I got a call from dad at about 8:30 pm on Thursday, the day of the accident, and left Dallas at about 10pm with AmyJo. We got here around 2am on Friday morning and got on the phone with the PA from the Nero team who said she admitted him and looked at his CT scan and MRI and saw partial tears in the spine. She scheduled surgery for 3pm on Friday the 11th. He slept and was in and out and was saying all kinds of crazy things - he had to be at work in a few hours, where was his bike? where were his biking clothes - they were really expensive so why would they cut them? 

He kept asking when he would be able to feel his feet and legs. They didn't have any final answers before surgery, and we were all hopeful the tear was incomplete so that he could feel them after surgery and some PT. Nate doesn't remember much about what happened before surgery. He remembers nothing from the crash. 

The surgery entailed reconstructing the spine from T8 up to T4 and also some work on L1 in his lumbar region. The T7 and T8 vertebrae controls anything from below about the nipple line or mid ribs. During surgery, the surgeon was actually able to see the chord, which is not typical, (they usually just see the vertebrae and reconstruct the), but because Nate's tear was so severe, they saw the chord. The tear was described as a traumatic dural tear with leaking cerebral spinal fluid (csf). We have to monitor for headaches because with that csf leak, you can get spinal headaches. [I have heard of pregnant women getting them when they have epidurals - I hear they are terrible.] He has had a headache, but not a strong one that indicates the spinal headache. Anyway, the chord was completely severed and snapped right back into place at the time of impact. They used bones from his pelvis and screws and metal to stabilize the spine and to protect the chord from any further damage. Nate is now able to move his upper trunk freely without risking any further damage to his chord. They cut into him right from the base of his neck all the way to above his butt. A long incision. 

His left arm has a fracture that the Otho team said they were originally going to reset during spinal reconstructive surgery while he was already under anesthesia. I am not sure why they changed their minds but he is just in a splint for now. (I think the break can heal on its own and their plan right now is not to reset it.) He needs that hand for practicing podiatry, and he is continuing to ask questions about it. He feels like there is a metacarpal fracture, but x-rays show there isn't and he should regain full mobility in that hand. 

The break in his left hand is on his radial steroid and ulna. The break is non operative so they are just going to let it heal itself with a splint. The neurosurgeon who reconstructed his spine is actually glad they just splinted it because he said that in PT it is better to have full use of the hand rather than it being in a cast. If it is in a cast, Nate can't do the exercises that focus on his upper body strength he will need if he is in a wheel chair - which he will be at least temporarily.His face has no scars or road rash. The only visible scars are on his hands and arms, and are minimal. So his skin on his legs and body and face and neck look really good - still handsome.

The neurosurgeon said Nate is an ideal candidate for some of the most recent and innovative spinal rehab studies. Some of the best work they are doing is in Toronto, Miami, Seattle and Houston. He strongly recommends that Nate go to the best rehab facility, but having family and support from familiar people is vital to the success of his rehab program. Once he does pick a rehab program, any visitors are encouraged to come at that time. Visitors are actually better for rehab than here in the ICU. 

They moved him from ICU to intermediate care (IMC) last night. Today they are doing a physical therapy/occupational therapy evaluation at 3 pm to see how he responds to sitting up out of his bed. After they do the evaluation (getting him out of his bed for the first time and actually sitting in a chair, lifting his body, etc.and see how he responds and how strong he is, that will determine when they will discharge him from this location.  

He is on Zofran and another pain med that keeps him sleepy. He is really involved in what drugs they are giving him; how many mg and what their plans are. He knows all this medical terminology that I don't know and he is really involved every time someone comes in the room. I think it exhausted him so much that he is FINALLY sleeping now. (This is the first day I have actually seen him rest.) He has his phone on him, but it hurts his eyes to look at it. He likes waking up from naps and seeing text messages and voice mails. He was super excited to talk to his mission president and presidents wife yesterday.

Because pain meds really slow down gi tract movement, Nate is super bloated. He looks 5 months pregnant. The stomach bloating pushes on his broken sternum and hurts a lot, and the bloating is giving him constant hiccups. The only time I have seen him frustrated is when the hiccups wont stop. When he finally falls asleep, he is woken up by hiccups. He's tried sugar, gargling water, being scared, pulling on his tongue, tickling the soft palette of his mouth with a cotton swab, etc....because every time he hiccups, his broken ribs really hurt. 

He was so dehydrated when they went in for surgery that after surgery he was drank so much that he got what is called a post op ilius. They tried an NG tube which was HORRIBLE. It is a thick plastic tube that you insert through your nose and it goes down your throat and sits in your stomach and vacuums out liquid in your stomach. It was awful. That is the first time I heard him complain of pain. He said "I know what pain is and this is the most awful thing I have ever felt." The tube pumped out some liquid, but did not relieve his abdominal pain so I made the nurse take it out, even though they wanted to leave it in 24 hours. The hospital has been good about letting him call the shots. 

The cycling world, I have come to find out, is really like a tight-knit brotherhood. They take care of each other. We have had a lot of support from ER docs and cyclists here that take the news super bad. I am tired of making people cry when I drop these bombs on them about his condition. 

Honestly, I am not lying when I say he has been extremely positive. The most frustrating thing for him right now is the hiccups. He has not been resting much because he likes to have people around. (Luckily he is finally starting to let his sleep be a priority today.) He loves to have us read him the scriptures and say prayers with him. He is making jokes and talking to everyone super respectfully. At one point he said "s#!t" when the nurse put the NG tube down his nose, and he was apologizing profusely after that. He has been really kind to me, and I know that must take a lot because he should be really frustrated at this point with not being able to moving anything.

Please help us earn money to offset the medical costs associated with inpatient rehabilitation, by donating at 

Thank you so much for all your prayers, and for all those who fasted with us yesterday.
Nate is a fighter, and with continued prayers we believe he will be able to make miracles happen through faith and the help of our Father in Heaven. 

We love you Nate, hang in there!!


  1. Thanks for posting Tyler and Lexi!!

  2. My heart hurt hearing about Nate. I'm praying for him and his mental strength as well as physical.

  3. Thank you for posting this and keeping us updated.

  4. Lookin' good, Nate. This blog (and the million well-wishers on facebook, etc) is a testament to the magnetic personality that he has. Kick PT's butt!!!

  5. Thanks for posting. Love my brother.

  6. Hiccups fix: hold breath while drinking 10 sips (or so) of water. Worked every time for me as a kid and every time for my kids.

  7. A lot of us in San Antonio are thinking about you Nate. You hang in there buddy! We are gonna miss you kicking our butt on the Tuesday Nighters! If you guys don't mind. Could you give us info on where he is (I'm assuming still in Austin) In case we are up there and want to visit?

    1. Hi Trae! Nate is currently at Brackenridge Hospital in Austin.
      Hope that helps!

  8. Good write-up. Hang in there Nate. Check out the Fundly page his sister set up for him:

  9. I don't personally know you Nate and I first read about your story on Lance Armstrong's Strava page. My thoughts and prayers are with you buddy.