Friday, November 27, 2009

Dad Update XIII

So...we've FINALLY moved out of the ICU!  I think it was MOSTLY because they needed the bed (holiday weekends are REALLY busy in the ICU...heart attacks from too much food and family...car accidents...etc.), but we'll take what we can get at this point!

He's now in the "transitional vent unit".  Seven beds, three nurses, and specialized care, as far as tracheotomy/respiratory issues are concerned.  It's definitely not a step up, facilities-wise (as Robin so accurately put it...we've moved from the Hilton to the Motel 6...).  Older part of the hospital, small, dark room, one UNCOMFORTABLE chair, older, grungier...etc. etc. etc.  It's DEFINITELY where he needs to be now, and he's getting EXCELLENT care, but, after 30 days in the big new snazzy remodel, we definitely feel like we're "low rent"...ugh!

His first night there was a little "rocky".  The nurse had to call us because he wanted to go home "RIGHT NOW"!  She got him to stay put by agreeing to call us to let us know that he wasn't happy.  We had to assure her that she'd need to use "tough love" to get him to cooperate.

When we got there this morning, we weren't sure what we were going to find, but he seemed to have mellowed overnight, and we have HIGH HOPES that he will cooperate, and work hard to continue to recover.  Robin kept reminding him that it was a MIRACLE that he was still alive, and that he should do all he could to make sure that all of those prayers were rewarded.  I was somewhat less "eloquent" with my "this last month has been CRAP, and you need to work hard to get OUT of here, so that we don't have to eat any more of that DISGUSTING cafeteria food" comment...

His nurse today said that he could spend up to FIVE weeks in the vent unit.  We were under the impression that he could be out in about a week, and then move to transitional care, but, that seems to be an impossibility at this point.  He's still on the respirator, and they are going to attempt to "wean" him from it over the next couple of weeks, but don't think that he's strong enough to do it all on his own at this point.  Time will tell.

So...things are DEFINITELY better than they have been, but we still have a REALLY long road ahead.  He needs to get off the vent as soon as possible, so that they can start working the "physical therapy" angle.  He's been lying in a bed for WAY too long, and has atrophied in many parts of his body.

We got smiles, and saw eyeballs (which we haven't seen for WEEKS), and attempts at telling us stuff today, which was LOVELY (even though we all SUCK at lip reading...), and poor Robin had to wash his feet TWICE (he's hot, and keeps asking to have them washed...not sure WHAT that's about...!)(I was QUICK to remind her that Jesus washed feet, but that was as far as I went towards helping out...).

Keep praying/sending good thoughts...they are working!!!!!!

Wednesday, November 25, 2009

Dad Update XII

So...I've been assured by Robin, who, with the Nordhues clan, went back down to Iowa yesterday, that dad is, truly, doing better.  I will reserve judgement until tomorrow, when I go back myself.

We will be spending most of the "holiday" weekend in that DREADED ICU waiting room, but, my aunt Sharon, who usually has the Thanksgiving dinner, and who lives in Des Moines, is again hosting, so we will be able to leave for awhile to celebrate the holiday with family, and NOT have to suffer through "Thanksgiving in the hospital cafeteria".

I'm thankful for all of your love, prayers, and support during this INCREDIBLY difficult last month.  Keep it coming, because we still have a REALLY long road ahead, but, at least at this point, things look like there MIGHT actually be a happy ending...!

Happy Thanksgiving, dear friends!

Monday, November 23, 2009

Dad Update XI

So...apparently some GOOD NEWS for a change today!  They've been slowly decreasing the amount of sedatives they've been giving my dad over the last week, or so.  Mom said that today dad recognized her.  She said that he puckered up his lips when he saw her, and later, when she was reading a book, pounded on the side of the bed to get her attention.  Not a MAJOR advance, but, at this point, we'll take ANYTHING that isn't bad news!

Dr. Koslo said that this made him "happy"...we would tend to agree.  Dr. Flower said that, barring a heart attack, or more lung issues, or blood clots, things seem to be taking a turn for the better...it's about TIME!!!!

Maybe it won't be such a DREADFUL Thanksgiving after all...

Saturday, November 21, 2009

Dad Update X

As far as I've heard (as of 10:23 today), there isn't really anything new to post.

We met with the ICU team for the "family consult" on Thursday.  They didn't really tell us anything new...except that dad's "odds of survival" are now waffling between 50/50, and 25/75.  The doctors seem to think that IF he doesn't take any more "hits" to his lungs (more infections, more trauma, more fevers, more etc.), that he COULD survive.  If he DOES take another hit, however, the odds of survival are "very low".

His fever continues to spike and decrease, but to a lesser degree (the last I heard was 102).  He's still ventilated, he's still somewhat sedated, he's still unconscious, and the doctors think he'll be in the ICU for another THREE weeks...if he survives the "lung thing".

Yesterday, mom stayed home (after 23 days of driving 90 minutes back and forth to and from Des Moines it was TIME for a "day off").  Robin, Dave, and I stayed until about 3:00, then headed back to the cities.  They'll go back down Tuesday, and I'll head down on Thursday (happy Thanksgiving...).

Here's what I posted as my "status" today on Facebook...24 days in the ICU...$800,000.00...tanks of gas amongst the four family members driving back and forth to Des Moines...$700.00...crappy food from the hospital cafeteria...$300.00...optimism...PRICELESS! Keep those good thoughts and prayers coming, friends!

Thursday, November 19, 2009

Dad Update IX

So...not sure what to post at this point...we've heard from the "lead" doctor today.  We've heard from the "vascular" doctor today.  We've heard from the "infectious disease" doctor today.  We've heard from the "neurologist" today...and NONE of it was "new" information.  Some of the stuff they said was "more hopeful", and some was "less hopeful".

His "vascular" doctor was FRUSTRATED that things with dad weren't better (we laughed...HE'S frustrated??!!).  His "infectious disease" doctor REALLY likes to talk, and went ON and ON and ON and ON about what was going on.  He was a LITTLE condescending, and negative, but, at this point, we want to know WHAT'S GOING ON, so were glad to hear what was happening.

They've "revised" his chances of survival from 50/50 to 50/50 or 25/75 (NOT in our favor), and have said that, basically, his brain is swimming in a toxic bath (the "official" name is toxic encypelitic...something or other...but we couldn't write quickly enough to get the official terminology).

His fever has been vascillating between the high 90's to 104 (last night), but the doctors don't think there is any permanent brain damage.  They aren't SURE, but will be doing a CT-scan and brain wave measurement test as soon as he is stable enough to do them.

They think he might now have a SUPERBUG from the stuff that aspirated into his lungs, and stuff that was already in his lungs, and are adjusting his antibiotics to HOPEFULLY knock it out.  They are concerned that it is "antibiotic resistant".

So...another THREE weeks in the ICU (imagine our glee), and, IF he can fight the infections clogging his lungs, we'll go from there.

One of the doctors DID say that, theoretically, a year from now, everything could be MOSTLY back to normal, and this could all just seem like a bad dream.  He said that dad will wake up, and not really remember ANY of the last month (but we'll all be SURE to fill him in on the details), but that the rehabilitation will be LONG and PAINFUL...if he survives, which we REALLY aren't sure of, at this point...

Keep praying!

Wednesday, November 18, 2009

Dad Update VIII

So...today was not necessarily a good day in the Mercy ICU.  In fact, the WORST of our 22 in the ICU.

Apparently, dad pulled out his feeding tube sometime during the night, and some of the "feeding solution" made it's way into his lungs.  Robin said that they showed them an x-ray of his lungs, and, at this point, they are 1/4 "okay"...which means that 3/4 of his lungs are congested, infected, and/or collapsed.

When Robin called me at school this morning, his fever was 106.  They were burying him in ice, and had him on a cooling blanket set at 40 degrees.

His legs have also started "mottling", which  is a bad thing.  It could be blood clots.  It could be lack of blood flow.  It could be any number of things....ALL BAD.

A neurologist will be coming in tomorrow to look for signs of stroke or brain damage.  They also need to surgically insert a gastric feeding tube, but he's not stable enough to handle the surgery...

He's not completely "stable" at this point, and we will be staying at a hotel nearby tonight, in case there are any new developments.

Keep praying...thinking happy thoughts...offering whatever to the universe...

Saturday, November 14, 2009

Dad Update VIII

Actually...not much new.

Dad was off the respirator for most of the day, which is a good thing.  They are going to put him on it again overnight, so that he doesn't have to work so hard to breathe.

They took the staples out of his legs today, so that's a step forward.  It was a little bloody, because some of the staples are still imbedded fairly deeply.

At this point, he'll probably be in the ICU for another three or four days, then either transferred to a "regular" room, or maybe the respiratory ICU.

Dr. Koslo said the legs are healing well, and dad was moving around A LOT today.  He still has a bit of a fever, and must be hot...as he keeps kicking off the blankets that the nurses keep trying to cover him with.  This would be GREAT...if he wasn't wearing a hospital gown...he tends to keep FLASHING the room...

They've taken him off the sedatives, but the doctor said that it could take as long as he was ON them, to RECOVER from them, which, in this case, would be about two weeks.

At this point, he's lost about 20 pounds...NOT the diet I would recommend for "quick weight loss"...at this rate, he's going to weigh less than I do by next Tuesday.  I'd better get to work on that diet!!!

We found out that insurance WOULD cover 90 days in a "transitional" care facility (rehabilitation, therapy, etc.), and we met with a lawyer today to figure out the power of attorney/guardianship stuff.

So...things are moving foward, and after being told this morning that dad would be "booted out" to a nursing home after 28 days in the ICU (by some MORON infectious disease doctor), and that people generally didn't recover after that point anyway (again...MORON), we have a little more positive news to end the day.

We'll see what tomorrow brings...

Thursday, November 12, 2009

Dad Update VII

So...we're kind of in a "holding pattern" now.  Dad had the tracheostomy yesterday.  He now has a two inch tube connected to an incision in his throat connected to a bag on the outside of his body to assist in breathing.

He currently has a feeding tube up his nose, as the tracheostomy makes it impossible to "eat".

The liver doctor has been called back in, because of elevated levels of something (can't remember at this point) are causing concern.

So...he'll probably be in the ICU for another 4 or 5 days (bringing the total up to 21), and will then possibly be transferred to the respiratory ICU, in which he could be for several months.

At this point in time, mom is facing the DAUNTING task of taking care of some legal stuff...signing up for medicare, looking into VA assistance, insurance issues, etc.  Laws are very tricky when something like this occurs...designed to protect the hospitalized from letting people take their money, institutionalize, and generally SCREW with them.  Unfortunately, they also prevent spouses, children, etc. from getting things worked out.

So...send your good wishes and prayers mom's way, as she tries to navigate this potential minefield of taking care of bills, insurance, and legal crap...

Since nothing new is really happening at this point, and we're still in that dreaded "holding pattern", updates will only come as needed.  Keep checking back...the way things have been going so far, it's SURE to be an interesting journey...

THANK YOU for your concern, prayers, good thoughts, and love...keep it coming!!!!

Monday, November 9, 2009

Dad Update VI

So...they did the TEE this morning (the electro-cardiogram), and determined that it WASN'T a heart valve infection.  They were able to see enough of the heart and lungs that they didn't have to do the scope to test the pressure.

Dr. Flower said that he's still critical, and could still die (a reality check that mom did NOT need to hear...she's really getting more fragile every day).  His heart and lungs are going to continue to get weaker and weaker the longer he lays in the ICU (as well as his leg muscles).

He's still being sedated, and they are going to try to do the tracheostomy tomorrow.  Dr. Flower said that they would then probably move him to the respiratory wing of the hospital where he could be for the next couple of weeks, or several months...

It's going to be a LOOOOOONNNGGGG winter...

Saturday, November 7, 2009

Dad Update V

So...we're still in "critical but stable" mode today.  I actually saw THREE doctors in the space of an hour in dad's room...which is more than I've seen ANY doctor at ALL during all of the time that I've been there (Dr. Koslo actually asked who I was, and when I said "the son", said that he hadn't seen me here before (even though he had), and then he backtracked, stating that he was only there for a few minutes each day, and that he was SURE I had been there, and didn't mean to imply that I hadn't been around...apparently, some people get a little TOUCHY about it being assumed that they haven't been there...whatever...).

Anyway...dad still has a fever.  His heart rate was slightly elevated, but his "numbers", respiratorily speaking, are "better", but they still aren't sure if/when they are going to take out the intibation tube and do a tracheostomy...they are hoping to determine this on Monday.

They took out the neck line and another line that Dr. Koslo determined "excessive", and are content to just have the "pic" line in (pick? pik? I have no idea...), so he's hooked up to a few less bags right now.

They are going to do a TEE on Monday (some form of echo cardiogram) to look at the back of his heart.  One theory is that he has a heart valve infection, and a blood clot broke loose last Tuesday and blocked his already clogged aorta.

If that's the case, they'll increase his antiobiotics, and hope that that brings the fever down a bit, so they can move forward.

They are still VERY concerned about his lungs.  He should be breathing easier by this point, but isn't.  They keep asking if he's a smoker, and we're wondering if his past smoking has permanently damaged his lungs.

His kidney doctor "signed off" today, so they are no longer concerned with them, and dialysis isn't, apparently, in his future.

Dr. Koslo said that this is the first time in his career that the kidneys have been fine, but there's been a problem with the lungs.  Usually, in this type of situation, the kidneys are damaged, but the lungs are fine.  I said that if ANYONE could "buck the trend", it would be dad.

So...Dr. Koslo said that if they can take care of the lung issues (which are still critical), there's only a 5-10% chance of a bad outcome (as far as walking, and being "normal" again), which means, if we can get past the lung issues, that he has a 90-95% chance of being completely healed.

They are reducing the amount of sedatives in his IV drip, and he's been moving around a little more today.  I DID actually see ONE of his eyes open for a few seconds this afternoon (I haven't seen his eyes open AT ALL since I got here on Thursday).  He's also been shifting around in bed, and bending his legs periodically.

Not sure what happens from here, but it APPEARS that we MIGHT be moving forward.  The lungs/breathing are still a HUGE hurdle, but we're hoping that all of the "sedated rest" he's been getting has helped him to be stronger, and that things are getting better.

We won't know anything FOR SURE until they do the TEE on Monday, but consider "holding his own" and not backsliding a GOOD thing!

Friday, November 6, 2009

Dad Update IV

No new news today.  Dad still has a fever, and they are monitoring his oxygen levels.  They are thinking they might do the traceoscopy on Monday...depending on how he reacts to the tube that is down his throat in the next couple of days. 

He'll be in the ICU for AT LEAST another three or four days, and we hope that he gets to be in the "regular hospital" later this week.  He's still sedated, and his doctors are trying to decide whether he needs to remain sedated to catch up on some needed rest, or whether they should start reducing his sedatives to see how his breathing is progressing.

Ran into an old friend in the cafeteria at lunch....Beth Samuelson Bice.  She works at Mercy Hospital, and her mom was in the hospital for observation of some heart concerns (she was released today, and is fine).  It was QUITE a surprise, and really good to see her.  I also got to see Don (her father)...GREAT guy!

The weekend approaches, and they don't do much of ANYTHING on Saturday and Sunday, so now we'll wait and see what happens...

Thursday, November 5, 2009

Dad Update III

So...dad has a temperature again, and they think he might have pneumonia.  While I was sitting in the room, he did a "convulse-y" thing, and I was assured that he was just coughing.

We're a little more optimistic...his doctor thinks he looks pretty good, and is catching up on some needed rest.

I shall remain "cautiously optimistic"...and we'll ASSUME that since things didn't necessarily get WORSE today, that he's holding his own...

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So...it's now midnight, and I've tried to go to bed FOUR times.  Each time, my mind starts going to places that, so far, I've been able to keep it from going.  I can't stop crying, and I KNOW that there's still a chance that this is all going to have a happy ending, but, I can't keep that nagging idea from popping back into my head...my dad might die.

I'm trying REALLY hard to continue to push the thoughts out of my mind, but it's not working.  There's still so much I still want to do with him, and so many things I still want to say to him, and I worry about mom being alone in that big house, and I mourn for my nieces who know him, but might not have the opportunity to REALLY get to know him as they grow up and mature, and form that relationship that adults have with their grandparents. 

I mourn for the holidays that could now be emptier.  I mourn for their trips to the cities to spend the weekend with all of us, and I mourn for the guidance that he's been so AMAZING at giving me in my life, and the possibility that there might not be any more from him coming my way.

I want to talk to my coherent father, and assure him that everything is going to be okay, and to have him assure ME that everything is going to be okay. 

I want to go to Tingley, and get in the back of his pickup, and have him drive down all of those winding, overgrown gravel and dirt roads outside town...and have him stop whenever I yell "that's a great photo op"!

I want him to barbecue pork chops, and hamburgers, and hot dogs...even in January (because he never says no...no matter what time of year it is).

I DON'T WANT TO SPEAK OF MY FATHER IN PAST-TENSE!!!!!

I should have called more.  I should have visited more.  I should have said "I love you" more.  I REALLY want the opportunity to do those things now.

I just want my dad back...

Wednesday, November 4, 2009

NOT Better News...

Well...as is often the case in these situtations (from what I hear, anyway...I've never BEEN in this situation before...), the good news of yesterday was but a BLIP in the big picture.

Robin called this morning to say that dad's heart rate was up during the night, and the doctors are now concerned about his heart, in addition to everything they were concerned about before yesterday's surgery.

Apparently, his lung has collapsed a bit more, the tube down his throat is STILL not allowing enough oxygen into his system, he's agitated, and it looks bad again.

One of the doctors, whether he's just SOCIALLY INEPT, or was trying to be funny, told Robin "well...he isn't going to die today or tomorrow" (to which I wondered "WHAT ABOUT SATURDAY??!!"), so my "cautious optimism" of yesterday is back to being "guardedly terrified".

Robin was at the END of her rope when she called, so I cleared my schedule, and am headed back to Des Moines tomorrow morning.

This SUCKS...!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Tuesday, November 3, 2009

Better News!

For the first time in a week, there's actually GOOD news to report!

I just got off the phone with Robin and dad is more coherent than he's been in days.  They have him strapped down, so he won't mess up the tube down his throat, but, if a family member is in the room, he can have the straps taken off.  He's been writing notes on a pad of paper today, and seems to be doing better...

Dr Koslo, the vascular surgeon, is happy.
Dr, Chuktai, the heart specialist, is happy.
The kidney doctor is happy.
The infectious disease doctor is happy (he has a urinary tract infection).

Now we wait a couple of days to see how things progress.

It's still a LONG road ahead, but at least there's some GOOD news, for a change.  Keep those prayers and happy thoughts coming!

Monday, November 2, 2009

Dad UPDATE II

Today, the doctors went in to sew up the incisions on dad's calves.  Robin called around 3:00 to say that he was back in his room, but that they weren't allowed to go in and see him yet.  They won't know for several months about muscle or nerve damage, but are concerned that it's going to be awhile before they can start physical therapy to get him up and moving around.

They put THREE stents in his aorta, which increased the blood flow from 10% to 80%, so the BIG surgery may no longer be needed.

There's still no prognosis on how his kidneys are doing, and they are still concerned about his pancreas, which has been acting up in the last couple of days.

They did the intibation during the surgery, so he now has a tube down his throat to help him breathe.  They are hoping that there are improvements by Friday.  If not, they'll have to do a tracheostomy, where they'll cut an incision through the front of his neck to help him breathe better.  We're hoping it doesn't come to that!

He will continue to stay in the ICU, at least through Friday.

Keep those prayers/good thoughts/happy vibes coming, and direct a few at mom and Robin, who are currently sitting in the waiting room with four aunts, an uncle, a cousin, a longtime family friend, and two friends from Mt Ayr.  I'm SURE it's quite the "gathering"...

Pray also for the doctors to get it under control...when Robin and mom went into the ICU ward to see how things were going, they got to witness "surgeon pride" in the form of the vascular doctor and the "lead" doctor yelling at each other in the hallway.  GET A GRIP guys...

Sunday, November 1, 2009

Dad UPDATE

Things continue to NOT go as planned...

- his kidneys continue to be a problem.  They've called in a kidney specialist, and they are trying some sort of medication to see if it might take care of the problem, but the prognosis isn't exactly what we were hoping for.

- he's not getting enough oxygen, so they may be doing the "full blown" tube down the throat thing today.

- the medication he's on has made him loopy, and groggy, and a little paranoid.  At this point he's CONVINCED that the hospital is slowly trying to kill him with medication, and he won't let mom leave the room.  Her health insn't the greatest, so it's taking a big toll on her too.

- Surgery has been postponed for TWO OR THREE WEEKS, because the doctors are concerned that he's not "stable" enough to undergo surgery at this time.  At this point, his calves are still split open (they were going to close them up as part of the surgery), the aorta is still mostly blocked (during the emergency surgery on Wednesday morning, they put in a temporary stent), and he still has very limited mobility in his legs.

The doctors told mom that this is the most challenging/difficult/intense surgery that they perform at Mercy Hospital, which doesn't fill any of us with much comfort.

Robin is driving down today to spend a few days with mom.  Duane and I are flying down today as well (Robin and I came back on Friday night to regroup, repack, reassess, etc.).

Keep us all in your prayers...things still don't look good, and the time frame for ever getting back to even PARTIALLY "normal" keeps getting pushed further and further away.

Hug your loved ones, and nag them to get their cholesterol checked if there's even the REMOTEST possibility of it causing problems.  I have purchased my fish oil pills, bought a bag of oat bran to sprinkle on EVERYTHING, and am scheduling the blood test that I've been putting off for a couple of YEARS for later this week!