Saturday, March 7

He's talking up a storm

As Dad continues to come out from under the effects of the pain medicine he is "talking up a storm." Unfortunately you can't always understand what he is saying even though he is more understandable than he was immediately after the stroke. I'm not sure he understands everything that has gone on in the past few weeks. This may not be a bad thing though. Hopefully he doesn't remember a lot of it. I have a feeling it may be several more days before we can begin to see the damage to his memory and mood from the stroke and surgery vs. confusion from having lost weeks out of his life.

Dad appears to be swallowing better and they are consistently allowing him to have ice chips. He can't quite get the hang of the call bell on the side of the bed so he has developed a new method for getting the nurse---he calls for them. I didn't know Dad could yell that loud.

I hope they begin physical therapy soon so Dad can work toward regaining his strength. Thank you all for your continued support. Mom was able to bring Dad a bunch of cards today and I think it helped keep up his spirits.

HAPPY BIRTHDAY MOM!!!!!

Thursday, March 5

MORE GOOD NEWS


Just a quick update. Dad's alertness continues to increase. This evening he was talking to Mom and Matt "up a storm" even though he was difficult to understand. He continues to be very weak but this is understandable with all he has been through. An opthamologist checked Dad's eye tonight from where he had his cornea transplant to rule out any problems. His eye is doing great too. He still has a long way to go but we are hopefully back to where we were mentally before he was given the morphine.

I came across the photo above tonight as I was going through some on my computer. Dad is to the left and my Uncle Sam is to the right.

I think we will all sleep a little better tonight. Thank you all for your support.

3/05/09 -- Quick Update


Good news. Anne reports that the neurological workup showed no further issues, and that Dad is slightly more responsive today. The doctors believe his alertness will slowly improve as the pain meds work out of his system and as he heals from the surgery. I'm sure Anne will post more of the details later, but this sounds like as good a report as we could have reasonably expected.

3/4/09 to 3/5/09 -- Back on the Rollercoaster

Sorry for no update yesterday; I was just too tired to write when I got back from Charlottesville last night.

Yesterday's news on Dad was something of a mixed bag (which seems to be the situation all too frequently.) On the positive front, his vital signs remain stable and strong, the numbers in his labs continue to go in the right direction, and his kidney function continues to be good. I met for nearly an hour yesterday with the surgical resident on Dad's team, who explained that physically he appears to be healing well from last Friday's surgery.

On the "we're not quite sure what this means" front, Dad continues to be disoriented and not very responsive verbally. The medical staff thinks this is most likely due to lingering effects of the pain meds he was on earlier this week and/or a not uncommon reaction to the trauma of major surgery. To make sure, however, they are (at my insistence) doing a neurological workup. That started last night, and we will hopefully hear the results today.

On a personal note, I want to thank everyone for their kind comments and all the support you've shown my Mom and my family. It is comforting, to say the least, to know that Dad has so many friends and relatives pulling for him.

Tuesday, March 3

3/3/09 -- The Evening (Good) News


Matt and Mom are taking the evening watch in Charlottesville, and their report is pretty much all good news.  Dad's vitals are stable, and he needed no pain meds at all today.   Also, he has been moved out of the ICU and back on to the Internal Medicine floor.   Mentally, he is responsive, but still appears to be suffering some disorientation.   The staff thinks this is probably a lingering effect of the pain medications, and should go away as those meds work their way out of his system. 

All in all, not a bad day.

        

Feeling Torn - March 3, 2009

As of this morning, Dad continues to recover. He is off antibiotics and is only receiving pain medication as needed. When I called about 9:30 a.m. he had not had any pain medication since about 2:00 a.m. Unfortunately, after taking him off IV pain medication yesterday, they gave him morphine to help with the pain. Dad and morphine do not appear to get along. Luckily there are many other options to help relieve his pain but it is going to take a while for the morphine to get out of his system.

The staff in the ICU have been absolutely wonderful!!!! It is so hard though, wanting to be at Dad's bedside all the time, wanting to be with my own family, and needing to carry on with daily life. I feel so torn. I worry about not being there if Dad needs anything, whether they can understand what he is saying, whether the doctors could be missing anything because they don't know Dad's baseline functioning, and whether I have done everything I could. I find it very hard to trust strangers caring for Dad after all the setbacks he has had. On the other hand, I know when we are there he worries that we are taking time away from our families and is continually telling us to go home. I realize he will need us later when he returns to rehab and home and now is the time to rest but it is so hard.

Shortly after Dad had his stroke I was at his bedside. He began talking about the time I was 16, working at Nimrod Hall and a gas broiler blew up in my face. Dad came from work to take me to the hospital where I stayed for several days. He talked about how worried he was driving to pick me up. He prayed all the way that I would be o.k. He talked about how he had to be strong because I was so scared. I didn't think to ask him at the time why he told me this story but maybe it was to remind me that now was my turn to be strong and trust in the Lord.

Monday, March 2

3/2/09 -- Trout Fishing on Pads Creek

Having spent last night in Charlottesville instead of driving back to northern Virginia through a snowstorm, I had the opportunity to see Dad early this morning.  I'm please to report that his post-operative recovery seems to be going well.   In particular, his kidney function continues to improve, which is great news.   The one fly in the ointment (and there always seems to be at least one, doesn't there . . .) is that his pain medication was not working particularly well and was causing him to be disoriented.   This afternoon the ICU team switched him to a different medication that will hopefully perform better on both counts.

At one point I mentioned that Matt and his son had recently gone trout fishing on Pads Creek, which prompted Dad to tell me a wonderful story about fishing for trout on that same creek with my "Uncle" Warren back in the 50's.  He still remembered that Warren "beat me, 6 fish to 2," and "caught the biggest trout I've ever seen" even though Warren was using a "branch he hacked off of a tree" for a pole.  For someone who has been through what Dad has suffered the last few weeks, his memory of things that happened nearly a half-century ago is frankly amazing.
  

Sunday, March 1

It's a New Month and a New Start

Every day Dad is improving. Yesterday Dad began to have some kidney function. They decided to leave him on the ventilator one more day. This would allow them to give him more fluids and give his kidneys a greater chance of coming back "full force." When we went in to see Dad on Saturday morning he looked at peace, even with the ventilator. There was quiet music playing in the background and a normal color was returning to his face. His nurse said he was a "darling." (Which we all knew already) She indicated it was often difficult for patients not to "pick" at their ventilation tube but Dad was being a "perfect gentleman." His white blood cell count had gone from a high of 39,000 to 24,000 and his creatnine level was going down.

Today, when we arrived, they were in the middle of a test to see whether he could be taken off the ventilator. We had been there about 10 minutes when they drew blood gases to check the oxygen level in Dad's blood while he was breathing on his own. While we were waiting for the results, Dad wrote me a note...WATER! I have become the water and ice person to my Dad. Dad passed the test and we were asked to leave while they took out the breathing tube. When we came back in, Dad had told the respiratory therapist and the nurse he loved them. His next words weren't so nice, "I want some damn ice." Who could blame him. On that note I let my brothers in to see him and made a quick exit still hearing him call for ice. Dad is definitely starting to feel better.

Dan the Ice Man, Julie the Angel and the ER from Heck

Sorry we haven't had a chance to update the blog in the past few days but a lot has happened. When I heard Dad had C Diff and was to go back into the hospital I couldn't help but remember many years ago when my Grandmother Cruise had knee surgery, developed a staph infection, spent a month at UVA receiving IV antibiotics, and then went home without incident. In my mind I saw the doctors managing this infection much like my grandmother's especially with today's newest antibiotics. My biggest concern was how all of this would affect Dad's rehab. This "wishful thinking" continued despite everything I had read online about C Diff being a very strong, drug resistant bacteria.


Things didn't go quite the way I planned though. Dad spent over 34 hours in the emergency room since there "was no room at the inn." This was an experience I would never want anyone to have. As was mentioned earlier in the blog, Matt met Dad in the emergency room upon transfer from Health South. He spoke with Dr. Ling, the attending for my father, and sat with Dad most of the first night. Matt had to leave that morning and I went on to Charlottesville to take the next "shift." I was appalled when I arrived. They had Dad in a tiny cubicle that was hot and stuffy with emergency room "trash" all over the floor. There were sheets on a chair as if someone had planned changing Dad's sheets but hadn't had the time. Dad, his usual stoic self, was trying to cope with his environment even though he looked worse than I had seen him since this whole fiasco started. He was obviously in pain, the lights from the nurses' station across the hall were glaring, and the noise was deafening to ears that just wanted silence and sleep. They were busy and it took a while to find his nurse but they were helpful and gave me all the information they could, basically there was no change from information Matt had received earlier. They could not find recent blood work and had no idea when it had been taken. Mom arrived and got to see Dad. After giving one of the nurses my "list" of issues and questions around Dad, I left the ER which by then was packed with patients stacked in the hallway like sardines, to take Mom to our hotel room. Feeling very uncomfortable with the whole situation and questioning how anyone with a serious illness could be properly managed in this chaotic setting, I talked with my siblings and we decided to try and do everything we could to get him up to the floor where he would be able to obtain more consistent care. After several telephone calls, I slept a couple of hours and went back in to the ER to be with Dad.

 There I met the Angel of Ice Chips, Dan. Dan had been assigned as my father's nurse. He was a competent, no nonsense type of man with long black hair braided in a ponytail that ran down his back. He was able to give me up-to-date information on Dad's care and had done the kindest thing imaginable--he was allowing Dad to have one or two little ice chips at a time. Despite the pain, Dad was in heaven. Here was someone who cared enough to stand beside Dad's bed and monitor him having an ice chip or two. With the help of the nursing supervisor/patient representative, they found an isolation room in the wee hours of Thursday night/Friday morning. Dad was moved to a quiet room on 5 west--the surgical unit. At first I though they had just placed him on surgery because it was the only room available but this would later be a Godsend.


Feeling Dad was in good hands I went back to the hotel room for some sleep. Mom and I slept in a little late and arrived at the hospital about 10:30 a.m. This is when I got to meet my next "Angel of Mercy" Julie. Julie would prove to be not only a wonderful nurse but a wonderful wonderful support throughout the day of many fearful changes. When I arrived, Dr. Ling had already made rounds and Dr. Black was reviewing my Dad's chart. Dr. Black is a surgeon. Somewhat startled by a surgeon he explained the surgeon's role in my Dad's care. He explained there are times when C Diff does not respond to antibiotics and the "last ditch" response was to remove the colon due to the amount of damage done by the bacteria to this organ. This is an extremely invasive surgery and only completed when everything else has been tried and fails. Julie told Dr. Black and me the newest development ---my Dad's kidneys weren't working enough. Matt and I had noticed it the day before and had mentioned it to the doctors. Julie confirmed our fears, for whatever reason the kidneys were not working as they should. Shortly after that I was able to talk with Dr. Ling. He informed me that my father was, "a very sick man." We discussed the problems facing Dad. For whatever reason the large amounts of fluid they were giving Dad were staying within his body. He looked swollen all over. The plan was to continue giving him fluids in hope of getting the kidneys to "kick back in." They had to be careful though... if they gave him too many fluids they could cause further complications. Dr. Ling indicated the goal was manage the problems caused by C Diff until the antibiotic began working. This could take several more days. Katie came to get Mom and take her home. I stayed as I didn't feel comfortable leaving him.

Suddenly, all heck broke loose. The doctors indicated Dad had taken a turn for the worse, it looked as if they needed to do surgery now. One bright spot though. The head surgeon was to be Dr. Shirmer, an excellent surgeon, who had operated on Dad several years back when they found a tumor in Dad's leg. Dad, who was aware of everything happening, trusted Dr. Shirmer and felt comforted knowing he was in charge.

Matt had arrived, we contacted Mom and the rest of the family and Matt signed the papers for surgery. Terry and Katie brought Mom back to Charlottesville, Dad was wheeled into surgery and we all began one of the longest night of our lives. I could only think of one worse place to be--in Boston--like Mark was, unable to be at the hospital as everything unfolded. I know we felt helpless, I can't imagine how Mark felt. 

After over three hours of surgery we heard that Dad made it through with flying colors (Go DAD!!!!!!) Dad will remain on the respirator for at least a day to take the pressure of breathing off his body so it could recover. We all went to the hotel tired but at peace.