Ron is back at Regency Hospital tonight, in room 121. They took him at about 7:00 p.m. I stayed until 10:00 p.m., after he'd had his night medicines and was settled in.
He had a pretty good day at St. V's, and was sad to have to leave the great care. He was on C-pap mode on the vent all day. The rehabilitation therapist helped him give himself a sponge bath and brush his teeth. Then he sat up in the chair for an hour and ate most of his lunch until his tailbone started to hurt. He had a headache from coughing, and did do a lot of that!
He's looking forward to his mom and Charlie getting here tomorrow from Florida. They are driving up in their RV.
Thanks for the prayers, help, cards, and messages!
Love,
EJ
Tuesday, March 31, 2009
Monday, March 30, 2009
Dr. Katragada took out Ron's chest tube at about 4:00 today, here in the room. The worst part about it was when he was taking off the tape! Debbie, his nurse, gave him a double dose of Fentanyl right before it, so he wouldn't feel much pain, and he didn't. I was amazed at how long the part was that was in his chest. So far, no reaction from his heart. :)
They also discontinued his IV fluids today, so he is now not "connected" to anything but the vent. He was on C-pap mode on that from 8:00 a.m. until 2:30 p.m. today. He was even breathing on his own when Sister Julie, the physical therapist, had him up in the chair from 12:30 to 2:30! He ate his lunch while sitting in the chair. Sister Julie also had him do exercises - just more slowly since he was breathing on his own, with only C-pap support.
"Plumbing" is all working fine, today, and aside from some gas, belching and passing, he's had no problems... no headache or backache, either.
Dr. Corman, one of the gastroenterologists was in this afternoon and said they can find no reason for the low hemoglobin gastro intestinally. His iron level is fine; B12 is OK; and folic acid is OK. He was going to check the gastroscopy from when they put his gastro tube in to see if it showed any ulcers. He said his hemoglobin level today was 8.1, so at least it's not going down.
He ate well again today, but a new respiratory therapist suctioned him too aggressively this evening, and he threw up his supper from coughing too hard! I was out of the room for a quick walk-about, and missed the shift change. You'd think they would have those notes in his chart by now about his bad gag reflex, and how they can't go way down with the suction tube!! He was upset about it when I got back. He was going to not have the tube food tonight, but now he'd probably better. Everything I've read says that proteins are the best treatment for lung illnesses, so we're trying to be sure he eats well, and drinks Enlive juice (with 9 g of protien in each box.)
If all goes well tonight and tomorrow morning, it looks like he'll be going back to Regency tomorrow. They don't know what time, at this point. I will try to get up here earlier in the morning, or Deb, his night nurse, said I can call and tell them not to send him until later when I'm here. He's sad to be leaving St. V's, and will miss all the wonderful care, the nurses, RT's and aides, but Regency is one step closer to home... Hopefully he won't have to be there long. Debbie talked to the intake gal from Regency today and had it put in his notes to do an immediate chest x-ray if he feels any chest pain like last time - even if his numbers look OK! There are one nurse and aide that he had last time he was there, that we are going to request not be assigned to him.
Thanks for all the continued prayers and positive thoughts!
Love,
EJ
They also discontinued his IV fluids today, so he is now not "connected" to anything but the vent. He was on C-pap mode on that from 8:00 a.m. until 2:30 p.m. today. He was even breathing on his own when Sister Julie, the physical therapist, had him up in the chair from 12:30 to 2:30! He ate his lunch while sitting in the chair. Sister Julie also had him do exercises - just more slowly since he was breathing on his own, with only C-pap support.
"Plumbing" is all working fine, today, and aside from some gas, belching and passing, he's had no problems... no headache or backache, either.
Dr. Corman, one of the gastroenterologists was in this afternoon and said they can find no reason for the low hemoglobin gastro intestinally. His iron level is fine; B12 is OK; and folic acid is OK. He was going to check the gastroscopy from when they put his gastro tube in to see if it showed any ulcers. He said his hemoglobin level today was 8.1, so at least it's not going down.
He ate well again today, but a new respiratory therapist suctioned him too aggressively this evening, and he threw up his supper from coughing too hard! I was out of the room for a quick walk-about, and missed the shift change. You'd think they would have those notes in his chart by now about his bad gag reflex, and how they can't go way down with the suction tube!! He was upset about it when I got back. He was going to not have the tube food tonight, but now he'd probably better. Everything I've read says that proteins are the best treatment for lung illnesses, so we're trying to be sure he eats well, and drinks Enlive juice (with 9 g of protien in each box.)
If all goes well tonight and tomorrow morning, it looks like he'll be going back to Regency tomorrow. They don't know what time, at this point. I will try to get up here earlier in the morning, or Deb, his night nurse, said I can call and tell them not to send him until later when I'm here. He's sad to be leaving St. V's, and will miss all the wonderful care, the nurses, RT's and aides, but Regency is one step closer to home... Hopefully he won't have to be there long. Debbie talked to the intake gal from Regency today and had it put in his notes to do an immediate chest x-ray if he feels any chest pain like last time - even if his numbers look OK! There are one nurse and aide that he had last time he was there, that we are going to request not be assigned to him.
Thanks for all the continued prayers and positive thoughts!
Love,
EJ
Sunday, March 29, 2009
Ron is having another good day! :) Drs. Jamal and Mahajan said his x-rays and CT all look good with his chest tube clamped off, so they will probably take that out tomorrow. I'm a little nervous about how his heart will react to that... I guess they don't numb him or anything - just pull it out.
His hemoglobin is up to 8.0, today (was 7.6 Thursday, 7.3 Friday and Saturday), so that downward trend has stopped for now. :) I want to ask what other tests they are doing to check on why it is still so low. (Normal is 12-15.) The GT doctor indicated they would do tests, but I haven't heard any more.
He did better with the tube food on only 50% last night. He has to eat very slowly, but he ate his whole breakfast, lunch, and supper today. I don't know what the plan is for tonight, whether they can discontinue the tube food or not. Jen, his nurse took out his catheter today, so tomorrow they plan to do more physical therapy and rehabilitation. If all goes well, Jen said they may take him off the saline IV fluids tomorrow, too. His pic-line will remain for "just-in-case" IV access. They draw blood from it, and can give his Fentanyl through it.
Doris, his respiratory therapist, has had him on C-pap mode on the vent twice today... from 8:00 a.m. to 10:30 a.m., and from 3:30 p.m. until now (8:15 p.m.). He did great both times -- again, she didn't tell him about it. She's so cute the way she tells me about it when we're in the hall, or when he is asleep, so he won't know. She doesn't want him to worry about being "off" the full vent support, or think he has to breathe differently.
He said he slept well last night (they gave him a different sleeping pill - Ambien, I think) but woke up with a migraine-type headache. They gave him some liquid Tylenol 3, and that helped. He hasn't been having the terrible coughing fits today, so his head and back don't hurt as much.
Thank you all for the prayers and get-well wishes! I love having these good days! I'm just a little leery to breathe too easily, after our recent bad experiences when we thought things were going well...
Love,
EJ
His hemoglobin is up to 8.0, today (was 7.6 Thursday, 7.3 Friday and Saturday), so that downward trend has stopped for now. :) I want to ask what other tests they are doing to check on why it is still so low. (Normal is 12-15.) The GT doctor indicated they would do tests, but I haven't heard any more.
He did better with the tube food on only 50% last night. He has to eat very slowly, but he ate his whole breakfast, lunch, and supper today. I don't know what the plan is for tonight, whether they can discontinue the tube food or not. Jen, his nurse took out his catheter today, so tomorrow they plan to do more physical therapy and rehabilitation. If all goes well, Jen said they may take him off the saline IV fluids tomorrow, too. His pic-line will remain for "just-in-case" IV access. They draw blood from it, and can give his Fentanyl through it.
Doris, his respiratory therapist, has had him on C-pap mode on the vent twice today... from 8:00 a.m. to 10:30 a.m., and from 3:30 p.m. until now (8:15 p.m.). He did great both times -- again, she didn't tell him about it. She's so cute the way she tells me about it when we're in the hall, or when he is asleep, so he won't know. She doesn't want him to worry about being "off" the full vent support, or think he has to breathe differently.
He said he slept well last night (they gave him a different sleeping pill - Ambien, I think) but woke up with a migraine-type headache. They gave him some liquid Tylenol 3, and that helped. He hasn't been having the terrible coughing fits today, so his head and back don't hurt as much.
Thank you all for the prayers and get-well wishes! I love having these good days! I'm just a little leery to breathe too easily, after our recent bad experiences when we thought things were going well...
Love,
EJ
Saturday, March 28, 2009
They took Ron for his abdomen CT at about 5:30 p.m. We'll probably find out the results tomorrow... or maybe Monday. He is feeling pretty well tonight... does not seem as tired as last night. He ate a pretty good supper...
They switched his pain medicine from Fentanyl to Morphine tonight to see if it will last longer. He got good relief from the Fentanyl, but it was wearing off quickly. The morphine takes longer to help, but should last longer. They're trying it... They're also giving him something to help him sleep tonight.
All-in-all a really good day! Not as much coughing, and not as much headache.
Thank you, everyone for the caring support!
Love,
EJ
They switched his pain medicine from Fentanyl to Morphine tonight to see if it will last longer. He got good relief from the Fentanyl, but it was wearing off quickly. The morphine takes longer to help, but should last longer. They're trying it... They're also giving him something to help him sleep tonight.
All-in-all a really good day! Not as much coughing, and not as much headache.
Thank you, everyone for the caring support!
Love,
EJ
Another good day, so far. They clamped off his chest tube at about 12:30 p.m. and no issues so far with that. They did an x-ray at 3:00 to check his lung, and I haven't heard the results, yet. Dave Mason was here for a visit which raised Ron's spirits. :) Physical Therapy came in and got him sitting on the side of the bed and then into the chair. He did some leg lifts, arm lifts, and pulled on the red elastic band. He sat up in the chair from 1:15 to 3:15!
Dr. Riley from Gastroenterology came to see us this afternoon for the consultation requested by Dr. Mohajen yesterday. He said they have been checking stools for any blood all along, and found none. He said they will do more tests to check for other causes of the anemia, like iron levels, etc. He also said it could be still low due to the strep pneumonia suppressing the bone marrow. They will be doing another abdominal CT today.
Ron has had some pain, today from the site of his chest tube. He had crepitus in the skin around the site, and when they changed the dressing the other day, his skin peeled off. It has been sore ever since.
He also still has a little headache and backache from coughing. He ate a good breakfast, and a pretty good lunch, and they are cutting his tube feeding in half for tonight. He is napping right now, so I'm going to go out for a walk around the hospital.
I'll add more later.
Thanks for the prayers, cute cards and cheery emails!
Love,
EJ
Dr. Riley from Gastroenterology came to see us this afternoon for the consultation requested by Dr. Mohajen yesterday. He said they have been checking stools for any blood all along, and found none. He said they will do more tests to check for other causes of the anemia, like iron levels, etc. He also said it could be still low due to the strep pneumonia suppressing the bone marrow. They will be doing another abdominal CT today.
Ron has had some pain, today from the site of his chest tube. He had crepitus in the skin around the site, and when they changed the dressing the other day, his skin peeled off. It has been sore ever since.
He also still has a little headache and backache from coughing. He ate a good breakfast, and a pretty good lunch, and they are cutting his tube feeding in half for tonight. He is napping right now, so I'm going to go out for a walk around the hospital.
I'll add more later.
Thanks for the prayers, cute cards and cheery emails!
Love,
EJ
Friday, March 27, 2009
Today was another good day! He has had a headache again this evening due to the coughing, but no major problems. His respiratory therapist had him off the vent (just on C-pap mode) from 10:00 a.m. until 3:30 p.m. She didn't tell him she was doing it, so he wouldn't be anxious about it. He did just fine. :) O2 saturation stayed at 95% or above. His respiration rate was a little fast - 30 and above - at times, but he could concentrate and slow it down when reminded.
Dr. Mohajen (medical and pulmonologist) came and checked on him this evening and said everything with the chest tube looks good. He wants to cap it off, get another CT, and see how his chest looks. I asked him about the low hemoglobin (7.3 today), and he wanted to go study his chart and check the history on that. I went out to the nurse's station later to see what he'd found, and he said he has asked for a GI consultation to make sure there is no internal bleeding. It's possible that the strep pneumonia's suppression of the bone marrow is still affecting his ability to make enough red blood cells. Ron's nurse tonight, Deb, said it does take the body a long time to make blood cells once that process has been interrupted. She said if they would decide to give him another transfusion, they would give him Benedryl and Tylenol BEFORE they do it since he had that bad reaction last time.
Dr. Mohajen said Ron's making good progress weaning from the vent, but he's in no rush to send him back to Regency. I told him, and Ron's day nurse told him that I don't want Ron to leave here until the tube is removed and he is stable for a couple days if that is possible. I don't want him having heart issues, etc. at Regency, and end up being brought back here again.
He's been eating pretty well. They said if he eats 70% of his meals, they can discontinue his nighttime tube feeding. He did that yesterday and today, so hopefully, they'll cut that out pretty soon. I think (pretty positively) it is what is giving him so much gas. He never has tolerated it well, from the first time they started it. When the nurses open his stomach peg to give him meds, gas just sprays out of it. His day nurse today said she regularly sees that from the tube feeding, even though dietary swears it doesn't cause gas. He's in enough pain! He doesn't need gas problems on top of the rest!
Ron has really enjoyed reading the cards and messages. He said to thank everyone for all the prayers and support.
We are so grateful for help with things like babysitting for Lauren and Hannah, taking care of the dogs, and covering my classes at school! It is so much easier to bear with everyone's support. It seems like a never-ending nightmare... We both have to remember to relax and breathe...
Love,
EJ
Dr. Mohajen (medical and pulmonologist) came and checked on him this evening and said everything with the chest tube looks good. He wants to cap it off, get another CT, and see how his chest looks. I asked him about the low hemoglobin (7.3 today), and he wanted to go study his chart and check the history on that. I went out to the nurse's station later to see what he'd found, and he said he has asked for a GI consultation to make sure there is no internal bleeding. It's possible that the strep pneumonia's suppression of the bone marrow is still affecting his ability to make enough red blood cells. Ron's nurse tonight, Deb, said it does take the body a long time to make blood cells once that process has been interrupted. She said if they would decide to give him another transfusion, they would give him Benedryl and Tylenol BEFORE they do it since he had that bad reaction last time.
Dr. Mohajen said Ron's making good progress weaning from the vent, but he's in no rush to send him back to Regency. I told him, and Ron's day nurse told him that I don't want Ron to leave here until the tube is removed and he is stable for a couple days if that is possible. I don't want him having heart issues, etc. at Regency, and end up being brought back here again.
He's been eating pretty well. They said if he eats 70% of his meals, they can discontinue his nighttime tube feeding. He did that yesterday and today, so hopefully, they'll cut that out pretty soon. I think (pretty positively) it is what is giving him so much gas. He never has tolerated it well, from the first time they started it. When the nurses open his stomach peg to give him meds, gas just sprays out of it. His day nurse today said she regularly sees that from the tube feeding, even though dietary swears it doesn't cause gas. He's in enough pain! He doesn't need gas problems on top of the rest!
Ron has really enjoyed reading the cards and messages. He said to thank everyone for all the prayers and support.
We are so grateful for help with things like babysitting for Lauren and Hannah, taking care of the dogs, and covering my classes at school! It is so much easier to bear with everyone's support. It seems like a never-ending nightmare... We both have to remember to relax and breathe...
Love,
EJ
We understand that some of you are still having trouble posting comments to the blog~ we're sorry for the inconvenience. If you can't post the blog please feel free to email your notes for Ron to andy.stout@gmail.com. We are printing out all the comments from the email and blog and taking them to Ron daily. He loves getting the printouts with everyone's notes and really appreciates everyone's get well wishes!! It's one of the highlights of his day!
For those of you that have asked about sending cards ~ please send them to Ron & Ellyn's home address & Ellyn will take them up to him so he can open them.
We've been taping up the cards to the walls around the room :-)
Thank you everyone for your prayers and support. It means a lot to the whole family!
~ Andy & Jenny
For those of you that have asked about sending cards ~ please send them to Ron & Ellyn's home address & Ellyn will take them up to him so he can open them.
We've been taping up the cards to the walls around the room :-)
Thank you everyone for your prayers and support. It means a lot to the whole family!
~ Andy & Jenny
Thursday, March 26, 2009
Today has been another pretty good day... He has been coughing quite a bit, still, and did throw up some of his lunch again, but not much. He ate a good breakfast, lunch, and supper. He slept well last night, woke up for breakfast, bath, and shave, and then slept most of the morning. I got here when his lunch was delivered, and he hadn't gotten to order because he had been sound asleep, so they just sent meatloaf and mashed potatoes. Their food here is really good!
They turned off the suction on the chest tube, today, which is one step toward getting that taken out, eventually.
Drs. are all happy with his stable heart and lung. He had some trouble breathing after they had turned off the chest tube suction this morning, so they did a second chest x-ray to make sure his lung had not collapsed again, and it was OK.
His white count was good today, but his hemoglobin is still only 7.6... I didn't get to see the medical dr. / pulmonologist to ask about that today. I hope to tomorrow.
I thank God for another good day! Ron's even being a little impishly ornery, so I know he's feeling better than a couple days ago! :)
Thanks for all the continued prayers, cards, emails, help, and hugs!
Love,
EJ
They turned off the suction on the chest tube, today, which is one step toward getting that taken out, eventually.
Drs. are all happy with his stable heart and lung. He had some trouble breathing after they had turned off the chest tube suction this morning, so they did a second chest x-ray to make sure his lung had not collapsed again, and it was OK.
His white count was good today, but his hemoglobin is still only 7.6... I didn't get to see the medical dr. / pulmonologist to ask about that today. I hope to tomorrow.
I thank God for another good day! Ron's even being a little impishly ornery, so I know he's feeling better than a couple days ago! :)
Thanks for all the continued prayers, cards, emails, help, and hugs!
Love,
EJ
Wednesday, March 25, 2009
Two cardio-thoracic surgeons, Dr. Reardon and Dr. Durham, came to see us this evening. They both do not feel surgery is warranted at this time. There is no guaranteed benefit, and any benefit does not outweigh the risks. They said the badly diseased upper part of his right lung did not collapse with the rest of his lung because it is pretty much all scar tissue. In the CT done at Regency on 3/19 when it was collapsed, the upper part of the right lung looks just like the one done here on Monday, 3/23. They said once they do remove the chest tube (after they try capping it off and checking the lung for a few hours) there will be scar tissue from the tube, adhering the bottom part of the lung to the chest wall. If one of the air cysts would burst, the lung would probably not be able to collapse due to all of the scar tissue. He will probably not have any use of the top right lung no matter what. Surgery right now would be very risky while the lung is in such bad shape. The swollen tissue would make the layers indistinguishable, and they could accidentally cut a vein.
Anyway, the bottom line is they do not want to do surgery now.
Ron is exhausted tonight from coughing all day. He coughed so hard, he threw up twice... had swallowed a lot of phlegm. But that is good to get that stuff out of his lung. He has a slight headache, but that's his only issue... That's a great day in Ron Stout land lately. I'll take it! :)
Thanks, everyone, for the cheery messages, prayers, cards, help, and good wishes!
Love,
EJ
Anyway, the bottom line is they do not want to do surgery now.
Ron is exhausted tonight from coughing all day. He coughed so hard, he threw up twice... had swallowed a lot of phlegm. But that is good to get that stuff out of his lung. He has a slight headache, but that's his only issue... That's a great day in Ron Stout land lately. I'll take it! :)
Thanks, everyone, for the cheery messages, prayers, cards, help, and good wishes!
Love,
EJ
Ron's stomach and back pain were resolved last night and this morning. He has had only a headache today, and that's from all the coughing he's been doing. He has gotten LOTS of phlegm out of his lungs today. They did come do an abdominal x-ray this afternoon.
I talked to Dr. Jamal and Dr. Tita today. They are both critical care medical doctors and pulmonologists. They conferred and compared notes, and both want to get the opinion of a cardio-thoracic surgeon. They are concerned about the very poor condition of his right lung. It has air cysts called pneumatocoeles that are in danger of bursting. They think one of them did burst to cause the lung collapse last week, and he has many more of them. The top part of his right lung may need to be removed to get rid of that risk. I haven't seen the surgeon, so I don't know if he will be here still today to evaluate Ron, or if it might be tomorrow. They said there are a lot of scar tissue and infiltrates showing in the scans and x-rays. The CT done Monday, 3/23 is not any different than the one done Saturday, 3/7.
The cardiologist, Dr. Maaieh, said Ron's heart is doing fine, and he has switched the Lopressor from IV to stomach form. He said Ron my need to be put on Coumadin blood thinner.
I will write more when I have talked to the surgeon.
Love,
EJ
I talked to Dr. Jamal and Dr. Tita today. They are both critical care medical doctors and pulmonologists. They conferred and compared notes, and both want to get the opinion of a cardio-thoracic surgeon. They are concerned about the very poor condition of his right lung. It has air cysts called pneumatocoeles that are in danger of bursting. They think one of them did burst to cause the lung collapse last week, and he has many more of them. The top part of his right lung may need to be removed to get rid of that risk. I haven't seen the surgeon, so I don't know if he will be here still today to evaluate Ron, or if it might be tomorrow. They said there are a lot of scar tissue and infiltrates showing in the scans and x-rays. The CT done Monday, 3/23 is not any different than the one done Saturday, 3/7.
The cardiologist, Dr. Maaieh, said Ron's heart is doing fine, and he has switched the Lopressor from IV to stomach form. He said Ron my need to be put on Coumadin blood thinner.
I will write more when I have talked to the surgeon.
Love,
EJ
Tuesday, March 24, 2009
I knew a full good day was too good to be true... Ron's stomach started to hurt this evening at about 7:00 or so, and got progressively worse. By 8:30 he asked me to ask the nurse, Frank, for something like Maalox to help his stomach. Before Frank could get a doctor's order for something, the pain was up to a level 7 (out of 1-10). By 9:30 it was an 8, and Frank gave him some Fentanyl. Then the pain moved to his back, and was going up and down his back. At 9:45 the resident came to evaluate, consulted by phone with Dr. Tita, and ordered a chest x-ray to make sure that the chest tube had not moved, and that his lung had not collapsed again. At 10:45 the pain was still very bad, 8-9 when they got here to do the chest x-ray. By 11:30, both the resident and Dr. Tita checked the x-ray, compared it to the ones from this morning and yesterday, and it looked the same. They ordered another dose of Fentanyl, and Ron is finally asleep... 11:45. Still not sure what is causing the pain. Stomach sounds fine - normal sounds. Lungs sound bad, but like they have been sounding. They will keep checking on him all night. I'm going home... G'night
Love,
EJ
Love,
EJ
They moved Ron back from 127 ICU to 108, the step-down unit down the hall, at about 2:00 this afternoon. The cardiologist, Dr. Maaieh, said the echocardiogram done yesterday showed his heart is strong, not damaged at all from his three tachycardia episodes. He said, again, how the heart is so sensitive, and it is probably just reacting to the pneumothorax pushing everything aside in his chest, and then everything shifting back. He had the ICU nurse discontinue the Cardizem drip as of 12:10 p.m. She watched him until 2:00 before they moved him, to make sure he was doing OK without it.
I also talked to the Infectious Disease doctor, Dr. Awad, who said that at the moment, the pneumonia is not active. No cultures, blood or sputum came back positive for strep pneumonia or acinetobacter. The CT scan showed scarring on his lungs, but no areas are actively infected. His temperature and white count are normal, and temp has stayed down all day. His chest tube site is healing well, and is not hurting unless he really moves. She said to pray that he stays with no infections! They discontinued the Cefepine antibiotic as of Monday afternoon.
I missed the pulmonologist, which I guess was just the resident. Ron said someone told him Dr. Tita and Mohajen don't do regular rounds on Tuesdays. I want to talk to one of them tomorrow. I want to know when they think they may be ready to send him back to Regency, or if he can stay here at St. V's until the chest tube comes out. I do not want him having the heart tachycardia episodes at Regency... The nurses have all told me to voice that concern to them. It seems that the chest tube and the tachycardia have some connection, whether or not the pulmonologists have ever seen a chest tube cause such a problem.
They did not give him any more blood last night (after the first unit caused such a terrible reaction.) They had planned to give him 2 units, as his hemoglobin was down to 7.5. His morning bloodwork showed it was 7.7 today, which is a little low (12-15 is normal) but not extremely so. They want to just keep him stable right now.
He ate pretty well today, and so far (knock on wood) it has been a good day! His heart is behaving itself for the first time in 4 days! He looks much better than yesterday, overall. Yesterday was VERY scary! Watching him shake and turn blue with 3 heated blankets on him and that phone call at 5:20 this morning were the worst parts of this whole thing since the first two or three days back in February. It has been 5 weeks as of today, that he's been on a ventillator.
Thanks for all the prayers, supportive notes and emails, help with the dogs, and hugs.
Love,
EJ
I also talked to the Infectious Disease doctor, Dr. Awad, who said that at the moment, the pneumonia is not active. No cultures, blood or sputum came back positive for strep pneumonia or acinetobacter. The CT scan showed scarring on his lungs, but no areas are actively infected. His temperature and white count are normal, and temp has stayed down all day. His chest tube site is healing well, and is not hurting unless he really moves. She said to pray that he stays with no infections! They discontinued the Cefepine antibiotic as of Monday afternoon.
I missed the pulmonologist, which I guess was just the resident. Ron said someone told him Dr. Tita and Mohajen don't do regular rounds on Tuesdays. I want to talk to one of them tomorrow. I want to know when they think they may be ready to send him back to Regency, or if he can stay here at St. V's until the chest tube comes out. I do not want him having the heart tachycardia episodes at Regency... The nurses have all told me to voice that concern to them. It seems that the chest tube and the tachycardia have some connection, whether or not the pulmonologists have ever seen a chest tube cause such a problem.
They did not give him any more blood last night (after the first unit caused such a terrible reaction.) They had planned to give him 2 units, as his hemoglobin was down to 7.5. His morning bloodwork showed it was 7.7 today, which is a little low (12-15 is normal) but not extremely so. They want to just keep him stable right now.
He ate pretty well today, and so far (knock on wood) it has been a good day! His heart is behaving itself for the first time in 4 days! He looks much better than yesterday, overall. Yesterday was VERY scary! Watching him shake and turn blue with 3 heated blankets on him and that phone call at 5:20 this morning were the worst parts of this whole thing since the first two or three days back in February. It has been 5 weeks as of today, that he's been on a ventillator.
Thanks for all the prayers, supportive notes and emails, help with the dogs, and hugs.
Love,
EJ
When I left the hospital last night at 12:30 a.m., Ron was still in tachycardia: heart rate was 160 and had been since 9:15. The Lopressor and Cardizem they were giving him lowered his blood pressure way down, to 70's/50's. His nurse, Frank, called me at 5:30 a.m. (after I had just gotten to bed at 2:30 a.m. -- that made my heart drop into my stomach!!) and said they had moved him back over to regular ICU unit -- room 127 again -- to keep a closer eye on him. His blood pressure had dropped into the 60's/50's!! I called his nurse in ICU, Lisa, and she said that as soon as they moved him, his heart rhythm converted to a sinus rhythm, and rate came down to 90's. His blood pressure went back up to 95/70, and he was watching TV. If things stay stable this morning, they will probably move him back to the step-down unit again.
I'm getting ready to head back up there to be there, hopefully, when the doctors come in.
Love,
EJ
I'm getting ready to head back up there to be there, hopefully, when the doctors come in.
Love,
EJ
Monday, March 23, 2009
At 9:15 he had a bad reaction to the blood transfusion... was freezing, shivering, shaking terribly. His temp shot way up, and he looked blue! They brought him warm blankets, gave him 10 mg. Lopressor, Benedryl, Tylenol, and some normal saline. He finally stopped shaking, and is relaxed... The Benedryl made him sleepy. His blood pressure is now very low...89/58. They have started the Cardizem drip again. Earlier, before the reaction, they had given him Cardizem by stomach tube.
The resident, Dr. Gupta, told me the Infectious Disease doctors had stopped the Cefepine antibiotic today after his morning dose. The Acinetobacter is apparently being resistant to it, and they want to change that treatment. Some of his trouble this evening could be from that infection.
His temp is now 101*, and heart rate is still 160. The Cardizem and Lopressor haven't help convert the heart rhythm, yet...
The resident, Dr. Gupta, told me the Infectious Disease doctors had stopped the Cefepine antibiotic today after his morning dose. The Acinetobacter is apparently being resistant to it, and they want to change that treatment. Some of his trouble this evening could be from that infection.
His temp is now 101*, and heart rate is still 160. The Cardizem and Lopressor haven't help convert the heart rhythm, yet...
This afternoon they did an echocardiogram. They also did a CT scan at about 5:30. I haven't heard any results. Ron's hemoglobin was down to 7.5 again, so they are getting ready to give him 2 more units of blood. That will be 9 units in 5 weeks...
He's very tired today... has napped off and on all day...when no one was in here. His numbers look good; heart rate is staying where it should, in the 90's, and O2 saturation is 96. Respirations are 24. His bp has been fine all day, but a little low right now, 105/54. He is still getting Cardizem and Lopressor, but by stomach, not by IV.
I want to talk to the doctors again tomorrow. I want to know more about the acinetobacter pneumonia.
He's feeling nauseous, now like he might throw up... He did have a regular supper... His nurse is giving him something to help the nausea. He's not looking well at all right now...
Ooops! His heart rate just popped up to 165!! Great!! Here we go again!!
He's very tired today... has napped off and on all day...when no one was in here. His numbers look good; heart rate is staying where it should, in the 90's, and O2 saturation is 96. Respirations are 24. His bp has been fine all day, but a little low right now, 105/54. He is still getting Cardizem and Lopressor, but by stomach, not by IV.
I want to talk to the doctors again tomorrow. I want to know more about the acinetobacter pneumonia.
He's feeling nauseous, now like he might throw up... He did have a regular supper... His nurse is giving him something to help the nausea. He's not looking well at all right now...
Ooops! His heart rate just popped up to 165!! Great!! Here we go again!!
I talked to Dr. Tita, pulmonologist and critical care doctor, this morning. He was the Dr. who saw Ron last Sat. and Sun. March 14 and 15, and said his numbers looked good, and he was progressing, when his lung was actually collapsed. I asked how that happened. He said his lung is pretty much like swiss cheese, and it sounded the same when it was collapsed as it did when not. He said in retrospect, it makes sense that when he thought he pulled a muscle, it was his lung collapsing, but nothing in the vent or CO2 monitor numbers indicated a problem. Only a chest x-ray or CT would have shown the collapse, and of 100 people on a vent, only 1 will have a pneumo thorax, so it does not make sense to do a daily chest x-ray and expose him to all that radiation.
He said the secondary infection that he got has caused much more damage than they originally thought. His sputum culture shows that that Acinetobacter disease is still active. His lung has much more damage than strep pneumonia generally has. It looks almost like a staff infection (like the boils you get on skin) is on his lung. There are no more bubbles coming out through the tube, so it looks like the hole has healed, but he wants a CT scan done today. The x-rays are not as clear as he would like.
Dr. Maaieh, cardiologist, was in at about 11:15. He said his heart recovery from the tachycardia was "quick", which is good. He said sometimes it takes days to convert to a regular pattern. He said it indicates a healthy heart. He said the heart is such a sensitive organ, that the displacement and/or the lung disease could set it off. It could happen again... Ron is still very sick and at risk for tachycardia. Dr. Maaieh wanted to know if the pulmonologist had said when they plan to remove the chest tube. He ordered the Cardizem drip reduced by half.
Dr. Tita had said it needs to stay for maybe a couple more days. The CT scan will tell him more. When they are convinced the pnuemothorax is gone, they will cap off the tube, wait a couple hours, and see what the lung does. If it starts to collapse again, they will uncap and leave the tube in longer. If it looks OK, they can remove the tube.
Dr. Tita also has ordered the tube feeding turned off during the day -- just on at night -- so Ron will have room to eat regular food. I don't think his stomach is tolerating the tube food very well.
Dr. Jauregi, the Infectious Disease Center doctor wants his door kept shut. He also wants to see how the pneumonia looks on the CT scan. He is concerned about the acinetobacter. This strain of it is relatively new to this area -- showed up here about 2 years ago, apparently from the Far East.
We are not as far through the woods as we thought last week... It is still pretty scary!
Thanks for your continued prayers and good wishes! The support is SO appreciated!! Ron enjoys reading your messages!
Love,
EJ
He said the secondary infection that he got has caused much more damage than they originally thought. His sputum culture shows that that Acinetobacter disease is still active. His lung has much more damage than strep pneumonia generally has. It looks almost like a staff infection (like the boils you get on skin) is on his lung. There are no more bubbles coming out through the tube, so it looks like the hole has healed, but he wants a CT scan done today. The x-rays are not as clear as he would like.
Dr. Maaieh, cardiologist, was in at about 11:15. He said his heart recovery from the tachycardia was "quick", which is good. He said sometimes it takes days to convert to a regular pattern. He said it indicates a healthy heart. He said the heart is such a sensitive organ, that the displacement and/or the lung disease could set it off. It could happen again... Ron is still very sick and at risk for tachycardia. Dr. Maaieh wanted to know if the pulmonologist had said when they plan to remove the chest tube. He ordered the Cardizem drip reduced by half.
Dr. Tita had said it needs to stay for maybe a couple more days. The CT scan will tell him more. When they are convinced the pnuemothorax is gone, they will cap off the tube, wait a couple hours, and see what the lung does. If it starts to collapse again, they will uncap and leave the tube in longer. If it looks OK, they can remove the tube.
Dr. Tita also has ordered the tube feeding turned off during the day -- just on at night -- so Ron will have room to eat regular food. I don't think his stomach is tolerating the tube food very well.
Dr. Jauregi, the Infectious Disease Center doctor wants his door kept shut. He also wants to see how the pneumonia looks on the CT scan. He is concerned about the acinetobacter. This strain of it is relatively new to this area -- showed up here about 2 years ago, apparently from the Far East.
We are not as far through the woods as we thought last week... It is still pretty scary!
Thanks for your continued prayers and good wishes! The support is SO appreciated!! Ron enjoys reading your messages!
Love,
EJ
Sunday, March 22, 2009
The electro physiologist thinks the chest tube may be the problem, and the pulmonologist disagrees... has never heard of a chest tube causing tachycardia. The medical doctor and the cardiologist said to try the Lopressor again since his heart rate was still 160, and still a flutter rhythm. They wanted her to give 10 mg., so at about 6:10 Nan gave him 6 mg. veeeeery slowly... over 6 minutes. His blood pressure dropped to 85/62, so she stopped. Then 10 minutes later, his heart rate came down to 95, and then went slowly back up to 160!! His blood pressure came back up to 107/70. At 6:30, Nan gave him 3 mg more, and his heart rate came down to 80 and stayed, and started a regular sinus rhythm! Whew! His blood pressure is staying around 103/63.
What a nerve-wracking afternoon! Ron says he has felt fine other than the drugs they gave him to stop and start his heart gave him a bad headache. He says he was scared... keeps asking me what the monitor says since he can't see it.
They are going to check this last x-ray to see if it shows what might be causing the tachycardia. Let's pray it doesn't start up again! Nan said it's possible, since the organs were all so displaced, the heart may be still reacting to things shifting back into place.
The pulmonologist says the pnuemothorax is pretty well healed... no more air bubbles coming out.
Hopefully it will be a good night... I'm staying until they say what the x-ray showed. I plan to be here tomorrow morning to see what all the doctors have to say, and if they have to move the chest tube.
Love,
EJ
What a nerve-wracking afternoon! Ron says he has felt fine other than the drugs they gave him to stop and start his heart gave him a bad headache. He says he was scared... keeps asking me what the monitor says since he can't see it.
They are going to check this last x-ray to see if it shows what might be causing the tachycardia. Let's pray it doesn't start up again! Nan said it's possible, since the organs were all so displaced, the heart may be still reacting to things shifting back into place.
The pulmonologist says the pnuemothorax is pretty well healed... no more air bubbles coming out.
Hopefully it will be a good night... I'm staying until they say what the x-ray showed. I plan to be here tomorrow morning to see what all the doctors have to say, and if they have to move the chest tube.
Love,
EJ
Ron is having another heart issue today. His heart rate has been 159-165 since before 1:00. The cardiologists and electrophysiologist were all in to see him. They did another EKG and gave him one medication that stopped his heart for a few moments, and then another to restart it. It was still racing. Then they have been giving him the Cardizem like last night, but it is 5:45, and his heart rate is still 161! They have tried Lopressor to bring his rate down, but all it did is bring his blood pressure down to 95/70... too low! His nurse is Nan, the same one he had Thursday and Friday nights. She is on the phone right now with the doctors telling them they had better do something else!
The electrophysiologist said the chest tube may be pressing on something that is upsetting his heart, so they may have to move it.
She is coming in to do another chest x-ray, so gotta go.
Love,
EJ
The electrophysiologist said the chest tube may be pressing on something that is upsetting his heart, so they may have to move it.
She is coming in to do another chest x-ray, so gotta go.
Love,
EJ
Saturday, March 21, 2009
A resident medical doctor came in and checked the EKG and checked Ron over. Heart rate was still 160. He called Dr. Dibenedetti, Ron's cardiologist, who happened to be on call here tonight. She said to give him a Cardizem drip IV to bring down his heart rate, and she will come see him in the morning. They collected sputum, urine, and more blood to check for any infections. They started the drip at about 7:00. His heart rate is still 164. His hemoglobin is up to 8.4 this evening. Temp is 100.4*.
He did manage to eat some supper through all this... not much, but a tiny bit of turkey, mashed potatoes, and stuffing, and about 1/3 c of sliced peaches. She had stopped his tube food at about 4:30 to let him have some room to put his supper. I hope they can get him off the tube food during the days, so he can have more room to eat regular food. She said sometimes they run it just at night, but she has to get a Dr. order to do that.
Love,
EJ
He did manage to eat some supper through all this... not much, but a tiny bit of turkey, mashed potatoes, and stuffing, and about 1/3 c of sliced peaches. She had stopped his tube food at about 4:30 to let him have some room to put his supper. I hope they can get him off the tube food during the days, so he can have more room to eat regular food. She said sometimes they run it just at night, but she has to get a Dr. order to do that.
Love,
EJ
At 4:45 I went out for a walk around the hospital... at 4:55 Ron said he felt a pain in his right upper chest. His heart rate went way up 159 and higher. When I got back, it was still way up... 175. They are doing an EKG now (5:30). Doctor has been called... they are drawing blood to check blood enzymes. I'll update when I know more...
Ron is doing much better yesterday and today. I wrote last night, but when I hit "send," the hospital internet had disconnected, and I lost the whole thing! His stomach is finally moving, as of 4 a.m. Friday morning...Hurray!! :) They started the tube food back up yesterday at about 3 p.m., plus they brought him supper last night. He ate some Mac and cheese, milk, and apple juice... the first solid food he's had for over a month! When he was allowed to eat Monday, he couldn't because his stomach was so full and pushed over by the air pocket.
His pulmonologist, Dr. Mohajen (sp?), said last night that the stomach issue was most certainly caused by the huge pneumo-thorax (air pocket in his chest.) It was so big, his diaphragm, liver, pancreas, etc. were pushed completely over to the left side and down, blocking his intestines. He said he is pretty sure his lung collapsed last Saturday when he coughed and thought he had pulled a muscle in the right chest and shoulder area. The vent then pumped air through the hole in his lung into his chest until Thursday when they put in the chest tube and his right lung reinflated. His terrible back pain was also a result of the air pocket rearranging everything, and it is gone now, too.
At Regency, they did CT scans of his belly and lungs to try to find out why he was in so much pain. When they saw the size of the air pocket, and how his organs were all displaced, they called St. V's and the transport before they even had him back in the room. They gave him a unit of blood at 2:00, and he was taken at about 3:00 to St. V's ER where they immediately did a chest x-ray. The chest tube procedure was done in the ER under local anesthetic at about 4:00. I got to stay in the room and watch. Laura got there just when they were getting the air and liquids out and stitching him up. Ron was awake and staring at the ceiling. It relieved her fear when she saw that he was awake and OK. Andrew and Jenny got there a few minutes later, so we had a family support group going right there in his ER room.
His lung reinflated just fine, and they did another chest x-ray to check the position of the tube. It was not quite right, so they had to reposition it and restitch, and do another x-ray. They watched him for a while, did blood work, and found that his potassium level was way high, and blood sugars were out of whack due to the distress of his liver and pancreas. They had to give him dextrose and insulin and K-extrate (or something like that) to get rid of the potassium. They did an EKG because they were worried about the effect of the potassium on his heart. That was OK. They were still worried about his intestines, so had him NPO for the rest of the night. He was taken up to room 108 at about 8:30 p.m. He was in so much pain from his back, he did not even feel the chest tube. I was here until 11:00 p.m. helping his nurse get his medications straightened out. She had a list of his home medicines, his meds from when he was here at St. V's a week and 2 days ago, and his meds from Regency all mixed together! Some were from when he was NPO, and had to have IV meds, and some were from when he could have stomach-tube meds. Once he had his Fentanyl pain medicine, and she was going to get his Atavan, I went home.
He is in the ICU step-down unit in the same general area that he was in when he was in 127. You go through the same double door, but turn left instead of right. He will be here until Monday, at least. His chest tube is still bringing out some air bubbles, so Dr. said the lung still has a small hole in it. It is bringing out much less air than it was Thursday evening, so it is healing, but not completely gone, yet. They do a chest x-ray every morning, here, to keep a close watch on things. They gave him 2 more units of blood last night, as his hemoglobin level was low -- 7.5.
He had a low-grade fever yesterday and today - due to the chest tube surgery. He has some discomfort from the tube site, but not anything like the pain he was in before the procedure. Hopefully we'll have a few forward steps now...
Thanks to all the guys who helped get his shop moved today! You are the best!!!
Thanks for the continued prayers!
Love,
EJ
His pulmonologist, Dr. Mohajen (sp?), said last night that the stomach issue was most certainly caused by the huge pneumo-thorax (air pocket in his chest.) It was so big, his diaphragm, liver, pancreas, etc. were pushed completely over to the left side and down, blocking his intestines. He said he is pretty sure his lung collapsed last Saturday when he coughed and thought he had pulled a muscle in the right chest and shoulder area. The vent then pumped air through the hole in his lung into his chest until Thursday when they put in the chest tube and his right lung reinflated. His terrible back pain was also a result of the air pocket rearranging everything, and it is gone now, too.
At Regency, they did CT scans of his belly and lungs to try to find out why he was in so much pain. When they saw the size of the air pocket, and how his organs were all displaced, they called St. V's and the transport before they even had him back in the room. They gave him a unit of blood at 2:00, and he was taken at about 3:00 to St. V's ER where they immediately did a chest x-ray. The chest tube procedure was done in the ER under local anesthetic at about 4:00. I got to stay in the room and watch. Laura got there just when they were getting the air and liquids out and stitching him up. Ron was awake and staring at the ceiling. It relieved her fear when she saw that he was awake and OK. Andrew and Jenny got there a few minutes later, so we had a family support group going right there in his ER room.
His lung reinflated just fine, and they did another chest x-ray to check the position of the tube. It was not quite right, so they had to reposition it and restitch, and do another x-ray. They watched him for a while, did blood work, and found that his potassium level was way high, and blood sugars were out of whack due to the distress of his liver and pancreas. They had to give him dextrose and insulin and K-extrate (or something like that) to get rid of the potassium. They did an EKG because they were worried about the effect of the potassium on his heart. That was OK. They were still worried about his intestines, so had him NPO for the rest of the night. He was taken up to room 108 at about 8:30 p.m. He was in so much pain from his back, he did not even feel the chest tube. I was here until 11:00 p.m. helping his nurse get his medications straightened out. She had a list of his home medicines, his meds from when he was here at St. V's a week and 2 days ago, and his meds from Regency all mixed together! Some were from when he was NPO, and had to have IV meds, and some were from when he could have stomach-tube meds. Once he had his Fentanyl pain medicine, and she was going to get his Atavan, I went home.
He is in the ICU step-down unit in the same general area that he was in when he was in 127. You go through the same double door, but turn left instead of right. He will be here until Monday, at least. His chest tube is still bringing out some air bubbles, so Dr. said the lung still has a small hole in it. It is bringing out much less air than it was Thursday evening, so it is healing, but not completely gone, yet. They do a chest x-ray every morning, here, to keep a close watch on things. They gave him 2 more units of blood last night, as his hemoglobin level was low -- 7.5.
He had a low-grade fever yesterday and today - due to the chest tube surgery. He has some discomfort from the tube site, but not anything like the pain he was in before the procedure. Hopefully we'll have a few forward steps now...
Thanks to all the guys who helped get his shop moved today! You are the best!!!
Thanks for the continued prayers!
Love,
EJ
Thursday, March 19, 2009
The surgery went just fine today!! They got a lot of air and blood out of his chest today and the lung seems to be doing fine so far. He is probably going to remain at St. V's for a couple of days...so his doctors there can keep an eye on everything. They already registered him a room and were planning on moving him back up to the ICU later this evening. He was still having some back pain after the chest tube was put in.... but nothing compared to what it was before so that is good :)
~Laura
~Laura
Transferring to St. V's for Chest Tube Surgery
Ron has been in pain for the past few days- they did a CT this morning and found out that his right lung is collapsed and he has a huge pocket of air that is causing his organs to be pushed out of the way. They are transferring him back to St. V's right now so that they can surgically put in a chest tube to release the air pocket and re inflate his right lung. He will be under general anesthetics for the surgery and they have told us that it could be in for a week or so- it just depends on the individual case and the amount of scar tissue that his lungs have from the pneumonia for how long the recovery will be. They are speculating that he probably cracked a rib from coughing so hard and it punctured his lung.
We will update more after the surgery. Thanks for your continued prayers!
We will update more after the surgery. Thanks for your continued prayers!
Wednesday, March 18, 2009
Wednesday, March 18
Ron's stomach still was not moving today, so they suspended his tube feeding and all food by mouth to give his intestines a rest. They are suctioning the food back out of his stomach through the tube on low-level suction. They said gas and some liquid is getting through, but they think there may be a bowel obstruction. A surgeon will be consulted tomorrow if things do not start working... Ron said, "Time for Roto-Rooter!"
His stomach hurt too much today to be off the vent, but he did sit up in the chair for a while. No more pulled muscles :). He's pretty down about things. He wants out of there in the worst way! I don't know how he does it -- just sitting there, often in pain, day in and out, having to work hard just to breathe. He got some cards today with nice notes that helped cheer him, and he has appreciated visits from several wonderful friends. He is still a bit frustrated at not being able to talk, but at least he is able to write what he can't get across to us.
Gotta get some sleep...
Thank you, everyone for all the cheery cards, messages, visits, prayers, help with the animals, hugs, and support!
Love,
EJ
Ron's stomach still was not moving today, so they suspended his tube feeding and all food by mouth to give his intestines a rest. They are suctioning the food back out of his stomach through the tube on low-level suction. They said gas and some liquid is getting through, but they think there may be a bowel obstruction. A surgeon will be consulted tomorrow if things do not start working... Ron said, "Time for Roto-Rooter!"
His stomach hurt too much today to be off the vent, but he did sit up in the chair for a while. No more pulled muscles :). He's pretty down about things. He wants out of there in the worst way! I don't know how he does it -- just sitting there, often in pain, day in and out, having to work hard just to breathe. He got some cards today with nice notes that helped cheer him, and he has appreciated visits from several wonderful friends. He is still a bit frustrated at not being able to talk, but at least he is able to write what he can't get across to us.
Gotta get some sleep...
Thank you, everyone for all the cheery cards, messages, visits, prayers, help with the animals, hugs, and support!
Love,
EJ
Tuesday, March 17, 2009
Tuesday, March 17
Happy St. Patrick's Day!
Sorry I did not update last night. I started back teaching full days yesterday and today, so I was too exhausted last night. My computer does not work on their WiFi at Regency... something about my Vista and their Cisco system isn't compatible, so I can't update from the hospital.
Ron had a pretty rough day yesterday. It started when he did not sleep well Sunday night, and then at 3:00 a.m. when he finally was asleep, he says they got him up to give him a bath. He was standing beside the bed for the bath, and apparently pulled a muscle in his back. His right shoulder was still a little ouchy from the pulled muscle he had there on Saturday, but the back muscle was much worse pain. It hurt terribly just to breathe. He had sort of a panic attack at that point. They got him back to bed and gave him his medications. When the day shift came on, the respiratory therapist was ready to do the 4 hours of bi-pap, 4 hours of vent that he had done all weekend, but Ron couldn't do the breathing well enough because he hurt. He told the physical therapist when she came in that he couldn't do anything because he hurt too badly. That was very disappointing to him because he had waited all weekend to get back to work with the physical therapist.
They did do the swallowing test with the blue dye on Monday. He had some applesauce and jello with the dye. They put a scope up his nose and down to his throat to watch while he swallowed. Everything went down the correct tube, so they tried a graham cracker and milk, and he swallowed just fine! :) He had no blue dye in the tube when they suctioned his lungs. So, today he got breakfast, lunch, and supper trays. They also had the tube feeding for support as needed.
Dr. Tita's nurse practitioner came to see him Monday evening. She switched him from Percocet to Toradol (sp?), an anti-inflamatory for the muscle pulls / spasms. His numbers all looked good. Bp was 122/57, heart rate, 101; respirations were 24-26.
They let him sleep last night, and he felt somewhat better today.
Today, he did get to work with the PT, and sat up in the chair for 2 hours. He was on bi-pap mode for 2 1/2 hours in the morning, and again in the evening. He was able to talk for about an hour while the machine was on talk mode this evening. He really likes that! Apparently the Percocet caused constipation, so he was feeling too full to eat his breakfast (he did eat 1/2 a slice of bacon and drank some juice), lunch, or supper. They have to get things moving again, so had suspended the tube feeding for a while this afternoon. His blood pressure was down again today, like the other day, so they started IV fluids, and bp was back up OK this afternoon. His fluid output was not keeping up, so he had to be catheterized again this evening. (Boy, he was NOT happy about that!) I think the urologist / kidney Dr. will be consulted tomorrow to see what the problem may be there.
He pulled another muscle in the left chest today when rolling over in the bed, and it was hurting from his left shoulder down across his chest. They did another EKG just to make sure it was not his heart, and apparently it was OK. He hurt all over for a while, shoulder, back, and stomach! But after his evening Toradol, he felt better, and breathed on the bi-pap mode for a couple hours this evening.
He was watching "Wild, Wild West" episodes on his DVD player when I left tonight.
Baby steps, but he IS making progress!
Thank you for all the support, visits, cards, encouragement, and prayers.
Love,
EJ
Happy St. Patrick's Day!
Sorry I did not update last night. I started back teaching full days yesterday and today, so I was too exhausted last night. My computer does not work on their WiFi at Regency... something about my Vista and their Cisco system isn't compatible, so I can't update from the hospital.
Ron had a pretty rough day yesterday. It started when he did not sleep well Sunday night, and then at 3:00 a.m. when he finally was asleep, he says they got him up to give him a bath. He was standing beside the bed for the bath, and apparently pulled a muscle in his back. His right shoulder was still a little ouchy from the pulled muscle he had there on Saturday, but the back muscle was much worse pain. It hurt terribly just to breathe. He had sort of a panic attack at that point. They got him back to bed and gave him his medications. When the day shift came on, the respiratory therapist was ready to do the 4 hours of bi-pap, 4 hours of vent that he had done all weekend, but Ron couldn't do the breathing well enough because he hurt. He told the physical therapist when she came in that he couldn't do anything because he hurt too badly. That was very disappointing to him because he had waited all weekend to get back to work with the physical therapist.
They did do the swallowing test with the blue dye on Monday. He had some applesauce and jello with the dye. They put a scope up his nose and down to his throat to watch while he swallowed. Everything went down the correct tube, so they tried a graham cracker and milk, and he swallowed just fine! :) He had no blue dye in the tube when they suctioned his lungs. So, today he got breakfast, lunch, and supper trays. They also had the tube feeding for support as needed.
Dr. Tita's nurse practitioner came to see him Monday evening. She switched him from Percocet to Toradol (sp?), an anti-inflamatory for the muscle pulls / spasms. His numbers all looked good. Bp was 122/57, heart rate, 101; respirations were 24-26.
They let him sleep last night, and he felt somewhat better today.
Today, he did get to work with the PT, and sat up in the chair for 2 hours. He was on bi-pap mode for 2 1/2 hours in the morning, and again in the evening. He was able to talk for about an hour while the machine was on talk mode this evening. He really likes that! Apparently the Percocet caused constipation, so he was feeling too full to eat his breakfast (he did eat 1/2 a slice of bacon and drank some juice), lunch, or supper. They have to get things moving again, so had suspended the tube feeding for a while this afternoon. His blood pressure was down again today, like the other day, so they started IV fluids, and bp was back up OK this afternoon. His fluid output was not keeping up, so he had to be catheterized again this evening. (Boy, he was NOT happy about that!) I think the urologist / kidney Dr. will be consulted tomorrow to see what the problem may be there.
He pulled another muscle in the left chest today when rolling over in the bed, and it was hurting from his left shoulder down across his chest. They did another EKG just to make sure it was not his heart, and apparently it was OK. He hurt all over for a while, shoulder, back, and stomach! But after his evening Toradol, he felt better, and breathed on the bi-pap mode for a couple hours this evening.
He was watching "Wild, Wild West" episodes on his DVD player when I left tonight.
Baby steps, but he IS making progress!
Thank you for all the support, visits, cards, encouragement, and prayers.
Love,
EJ
Sunday, March 15, 2009
Ron slept better last night from 10:30 to 3:00 a.m. The doctor left orders for him not to be wakened up for cough / suctioning or blood pressure / temperature checks unless he was already awake. Then he slept all morning from 7:30 to noon -- right through Laura stopping for a half-hour on her way to work. They were weaning him from the ventilator yesterday and today -- four hours on, four hours off... He did very well, except for the anxiety attack last night. His O2 saturation stayed right up at 96% and above. It switches so gradually that he can't tell when they do it, and slept right through it most times. Soon they will be having him on the vent only at night for 8 hours. The doctors are all very happy with his progress. they say the numbers look great, and he's gaining strength well.
He is still on the Cefepime antibiotic for 12 more days. They are still treating the mouth infection, and his Atavan has been cut to an "as-needed" basis. He did get some this afternoon when he had a headache. His pulled muscles were not bothering him today, so he was able to do more coughing to get the stuff out of his lungs.
He sat up in the chair this evening for an hour. I gave him a "pedicure" and trimmed a couple fingernails. He was in pretty good spirits today. Hope he sleeps well tonight.
Thank you, everyone for all the help, the cards, the prayers, the messages, the meals, and visits!
Love,
EJ
He is still on the Cefepime antibiotic for 12 more days. They are still treating the mouth infection, and his Atavan has been cut to an "as-needed" basis. He did get some this afternoon when he had a headache. His pulled muscles were not bothering him today, so he was able to do more coughing to get the stuff out of his lungs.
He sat up in the chair this evening for an hour. I gave him a "pedicure" and trimmed a couple fingernails. He was in pretty good spirits today. Hope he sleeps well tonight.
Thank you, everyone for all the help, the cards, the prayers, the messages, the meals, and visits!
Love,
EJ
Saturday 3/14
Sorry, I was too tired to update Friday night. He was up in the chair twice on Friday, but his blood pressure was so low (90/61), that they had to wait a couple hours before they got him up the second time. I asked if he was getting enough fluids, and they said he was only getting what was in the tube feeding, and a little that they put in the stomach tube with his Atavan every six hours. I said that at St. V.'s he had been getting water in the stomach tube every two hours after they took him off IV fluids. The nurse said she had not seen an order for that. I said perhaps is blood pressure was low because he needed more water.
I was already being a pain in the butt, so I went out to the nurse at the station and asked about the reason they had changed his anti-depressant from the one he's been on for 15 years, and she could not give me a good reason... said maybe they couldn't get it in liquid form. I explained that his psychiatrist that he's been with for about 5 years had said she would get him the liquid form if they couldn't, and I would bring it up. She had also said they could open the capsule and mix it with juice to put it in his stomach tube. (She's the one who encouraged me to ask for a reason.) The nurse called the pharmacy, and they said yes, they could do that. I also wanted to know if he was being treated for the thrush infection in his mouth, and the nurse said no. So I said why not? How is it going to get cleared up for him to be able to drink water, if he's not getting medicine for it? At that point, she called the doctor. He said to start a statin for the thrush and start him back on his regular anti-depressant. They started both last night. I'm sure they love me up there now! But today, he had a bag of water going through the stomach tube at intervals, too.
Today was another kind of rough day for Ron. He had a sharp pain in his right chest and going up over his right shoulder starting at about 6:30 this morning. They brought in the EKG machine and checked his heart, and it was OK. They decided he must have pulled a muscle from coughing. Then a klutzy nurse knocked his DVD player off his tray table onto the floor, twice. (He had a poor nurse all day.) When I got there this afternoon, he was still in pain, and they had apparently not given him anything for it.
This evening, he felt like he was not getting enough air, and was working really hard to breathe. His respirations were over 30. He was really starting to get sweaty from working so hard. The RT came in and changed the wave setting on the machine to try to help him breathe more easily. He started having a sort of panic/anxiety attack, and his back got all tense. The more he felt like he couldn't breathe, the more he tensed up, and was breathing too fast. The nurse came in and gave him his Atavan. He tried to relax and concentrate on breathing slower, and eventually calmed down. Then his back hurt as bad as his right shoulder! Dr. Tita (one of his pulmonologists from St. V's) came in and checked on him at about 7:00 pm and ordered Percocet for the pain. He also ordered his regular Xanax to help him relax and be able to sleep.
Hopefully, tomorrow will be a better day... Everyone has said to expect, "Two steps forward, one step back."
Thanks for all the prayers and good thoughts!
Love,
EJ
Sorry, I was too tired to update Friday night. He was up in the chair twice on Friday, but his blood pressure was so low (90/61), that they had to wait a couple hours before they got him up the second time. I asked if he was getting enough fluids, and they said he was only getting what was in the tube feeding, and a little that they put in the stomach tube with his Atavan every six hours. I said that at St. V.'s he had been getting water in the stomach tube every two hours after they took him off IV fluids. The nurse said she had not seen an order for that. I said perhaps is blood pressure was low because he needed more water.
I was already being a pain in the butt, so I went out to the nurse at the station and asked about the reason they had changed his anti-depressant from the one he's been on for 15 years, and she could not give me a good reason... said maybe they couldn't get it in liquid form. I explained that his psychiatrist that he's been with for about 5 years had said she would get him the liquid form if they couldn't, and I would bring it up. She had also said they could open the capsule and mix it with juice to put it in his stomach tube. (She's the one who encouraged me to ask for a reason.) The nurse called the pharmacy, and they said yes, they could do that. I also wanted to know if he was being treated for the thrush infection in his mouth, and the nurse said no. So I said why not? How is it going to get cleared up for him to be able to drink water, if he's not getting medicine for it? At that point, she called the doctor. He said to start a statin for the thrush and start him back on his regular anti-depressant. They started both last night. I'm sure they love me up there now! But today, he had a bag of water going through the stomach tube at intervals, too.
Today was another kind of rough day for Ron. He had a sharp pain in his right chest and going up over his right shoulder starting at about 6:30 this morning. They brought in the EKG machine and checked his heart, and it was OK. They decided he must have pulled a muscle from coughing. Then a klutzy nurse knocked his DVD player off his tray table onto the floor, twice. (He had a poor nurse all day.) When I got there this afternoon, he was still in pain, and they had apparently not given him anything for it.
This evening, he felt like he was not getting enough air, and was working really hard to breathe. His respirations were over 30. He was really starting to get sweaty from working so hard. The RT came in and changed the wave setting on the machine to try to help him breathe more easily. He started having a sort of panic/anxiety attack, and his back got all tense. The more he felt like he couldn't breathe, the more he tensed up, and was breathing too fast. The nurse came in and gave him his Atavan. He tried to relax and concentrate on breathing slower, and eventually calmed down. Then his back hurt as bad as his right shoulder! Dr. Tita (one of his pulmonologists from St. V's) came in and checked on him at about 7:00 pm and ordered Percocet for the pain. He also ordered his regular Xanax to help him relax and be able to sleep.
Hopefully, tomorrow will be a better day... Everyone has said to expect, "Two steps forward, one step back."
Thanks for all the prayers and good thoughts!
Love,
EJ
Friday, March 13, 2009
Ron walked to the chair and sat there today for an hour and a half!! That is very helpful for his lungs for him to be more upright. They have his O2 input at 35% still today, but have lowered the peep from 8 to 5. His saturation level was staying up at 98-99%. They have added another machine to measure his CO2 output as he exhales. It will help monitor things as they slowly wean him from the vent. They also got him a different ventilator with a talk mode, and he was able to talk for 5 minutes or so. They can only have that mode on for short periods right now, as it gives him less support from the vent.
He passed the ice-chip and water swallowing evaluation today. Boy, you should have seen that smile when he tasted that first swallow of water! He has a bit of thrush on his tongue, and they have to be careful that is does not get to his lung, so they will be treating that before he can have more water or food by mouth. Meanwhile, he will continue on the feeding tube.
His Infectious Disease Control doctor said he will need to be on the Cefepine antibiotic for at least another 2 weeks. His lung x-ray still has quite a bit of white, especially the right lung.
They removed the stitches from the trach site, and will be changing it to a smaller trach tomorrow. He still coughs quite a bit... so hard sometimes that it gags him and he starts throwing up his tube food. That is scary, because he could aspirate on it. He says it really burns when that happens, due to the stomach acid. I don't think he's tolerating that tube food well, yet, even though it's the third or fourth one they've tried. Hopefully, he won't have to be on it much longer.
They are still adjusting his depression medication, and he has been quite down. We try to help him stay up, but so much of it is body chemistry that is just out of whack. He has his little DVD player, and last night watched Down Periscope and today had Support Your Local Sherrif on. Both of those usually bring up his spirits. He has been reading everyone's messages. Those help, too.
Thank you, everyone for being so suppportive! He's come such a long way in these 3 weeks!
Love,
EJ
He passed the ice-chip and water swallowing evaluation today. Boy, you should have seen that smile when he tasted that first swallow of water! He has a bit of thrush on his tongue, and they have to be careful that is does not get to his lung, so they will be treating that before he can have more water or food by mouth. Meanwhile, he will continue on the feeding tube.
His Infectious Disease Control doctor said he will need to be on the Cefepine antibiotic for at least another 2 weeks. His lung x-ray still has quite a bit of white, especially the right lung.
They removed the stitches from the trach site, and will be changing it to a smaller trach tomorrow. He still coughs quite a bit... so hard sometimes that it gags him and he starts throwing up his tube food. That is scary, because he could aspirate on it. He says it really burns when that happens, due to the stomach acid. I don't think he's tolerating that tube food well, yet, even though it's the third or fourth one they've tried. Hopefully, he won't have to be on it much longer.
They are still adjusting his depression medication, and he has been quite down. We try to help him stay up, but so much of it is body chemistry that is just out of whack. He has his little DVD player, and last night watched Down Periscope and today had Support Your Local Sherrif on. Both of those usually bring up his spirits. He has been reading everyone's messages. Those help, too.
Thank you, everyone for being so suppportive! He's come such a long way in these 3 weeks!
Love,
EJ
Thursday, March 12, 2009
Visiting
Ron said he is up for some visitors ~ it's getting pretty boring for him now that he is alert and awake most of the day. Visiting hours are 9:00am-9:00pm and Regency Hospital only allows 2 visitors at a time and are being pretty strict on the policy.
If you would like to visit please call Andy at 419-409-0432 before you go so that we can make sure we don't have more people than allowed in the room at one time. To protect Ron from any outside germs they do require all visitors to wear masks, gloves and gowns (which are provided for you in a cart right outside his door)
There is a map at the bottom of the page for Regency Hospital and he is located in their ICU room 106.
If you would like to visit please call Andy at 419-409-0432 before you go so that we can make sure we don't have more people than allowed in the room at one time. To protect Ron from any outside germs they do require all visitors to wear masks, gloves and gowns (which are provided for you in a cart right outside his door)
There is a map at the bottom of the page for Regency Hospital and he is located in their ICU room 106.
Wednesday, March 11, 2009
Another good day! Ron's oxygen is now down to 35% and his saturation is staying at 98/99- which is great! His peep is currently 8 but they are going to start lowering that soon which is also one step closer to getting off the vent! His heart rate is 88 and blood pressure 106/66. His respirations are at 24 which are kind of high. They currently have his respirator set to match his breathing rate so he isn't fighting the machine, but they are hoping that they can slow down the respirator and his body will start to match the machine's rate.
His x-ray this morning was still a little patchy but the Doctor who read the x-ray hasn't seen his previous x-rays so we don't know how much has changed.
Physical Therapy is going well - he was able to walk a few steps to a chair in his room and was able to sit there for 30 minutes without getting light headed. It's a pretty uncomfortable chair so they are trying to get an easy chair in the room for him so he can sit for longer periods of time.
Doctor Darr said he wants him to do a swallowing evaluation tomorrow because he would like to get him off the tube feeding- he thinks Ron will progress quickly! The swallowing evaluation entails Ron eating applesauce or diced peaches that have blue dye in them and as long as there is no blue dye when they suction the trach he will be able to start eating again!
Due to the trach, Ron is still not able to "talk" but he can mouth words and is getting better at writing so he can communicate with everyone better.
Ron said he is up for some visitors ~ it's getting pretty boring for him now that he is alert and awake most of the day. Visiting hours are 9:00am-9:00pm and Regency Hospital only allows 2 visitors at a time and are being pretty strict on the policy.
If you would like to visit please call Andy at 419-409-0432 before you go so that we can make sure we don't have more people than allowed in the room at one time. To protect Ron from any outside germs they do require all visitors to wear masks, gloves and gowns (which are provided for you in a cart right outside his door)
Thanks to the Masons for your visit today and to all of you for your good wishes. Ron is reading all of your notes you've left him on the blog as I'm typing this.
His x-ray this morning was still a little patchy but the Doctor who read the x-ray hasn't seen his previous x-rays so we don't know how much has changed.
Physical Therapy is going well - he was able to walk a few steps to a chair in his room and was able to sit there for 30 minutes without getting light headed. It's a pretty uncomfortable chair so they are trying to get an easy chair in the room for him so he can sit for longer periods of time.
Doctor Darr said he wants him to do a swallowing evaluation tomorrow because he would like to get him off the tube feeding- he thinks Ron will progress quickly! The swallowing evaluation entails Ron eating applesauce or diced peaches that have blue dye in them and as long as there is no blue dye when they suction the trach he will be able to start eating again!
Due to the trach, Ron is still not able to "talk" but he can mouth words and is getting better at writing so he can communicate with everyone better.
Ron said he is up for some visitors ~ it's getting pretty boring for him now that he is alert and awake most of the day. Visiting hours are 9:00am-9:00pm and Regency Hospital only allows 2 visitors at a time and are being pretty strict on the policy.
If you would like to visit please call Andy at 419-409-0432 before you go so that we can make sure we don't have more people than allowed in the room at one time. To protect Ron from any outside germs they do require all visitors to wear masks, gloves and gowns (which are provided for you in a cart right outside his door)
Thanks to the Masons for your visit today and to all of you for your good wishes. Ron is reading all of your notes you've left him on the blog as I'm typing this.
The move went smoothly. He's all settled in... He's in room 106 in their ICU. They require all of his visitors to wear isolation gowns and gloves, and they would prefer masks, too. It doesn't sound like he's going to get much sleep there either... Just like any hospital, they're coming in every hour to do something. Everyone seems friendly, and the room is very nice. He doesn't have his air bed, but since he'll hopefully be moving more, he shouldn't need it. He's still down, but if we keep stressing how far he's come, rather than what he can't do, maybe he can get more positive. He really wants to be able to get up to go to the restroom, so that is his goal right now.
Thanks to all for the prayers, cards and messages!
Love,
EJ
Thanks to all for the prayers, cards and messages!
Love,
EJ
Tuesday, March 10, 2009
Apparently Ron slept most of the morning. That is probably a good thing since it sounds like he may be moved today, and we'll have a busy afternoon and evening.
Physical Therapy was in and had Ron do foot, leg, and arm exercises (with the yellow bands.) Then he stood beside the bed with a walker for a few minutes. He was pretty weak and white-faced, but heart rate did not go wild. He sat down for a bit, then stood again and took a couple sliding steps to the head of the bed and sat back down. She said she could tell he would progress quickly, as he was pretty strong and stable for someone who'd been down flat for 3 weeks. He got pretty sweaty from the exertion, but said it felt good to move and be out of the bed. :)
Dr. Awad (sp?) was in and said his white count was down a little bit, though still a little elevated. She wants him to complete another week of the antibiotic, but she approved his discharge to Regency Hospital. She and Dr. Jauregi both go to Regency, so there will be continuity of care. His pulmonologist, Dr. Tita goes there, too.
His transport is set for 5:30 today to Regency Hospital on Alexis Rd. in Sylvania. They are a hospital, and do simple procedures there, like trachs, etc., but patients are there longer than in a regular hospital. They will do physical and occupational rehabilitation there. The length of his stay will depend on his progress, but the average length of stay there is 25-30 days. He asked for his portable DVD player, so he can put on headphones and watch movies. He's bored! Laura is going to bring it up when she comes to Regency this evening.
He is getting better at writing, and it won't be long before he'll be able to write what he wants to say. Some of what he says we can decipher by lip reading, but he does not like to slow down for us.
His emotions have been swinging, so I've been asking about getting him back on his other meds. They are finally starting to listen...
The nurses have been great! very patient and cheery with us.
Will add more after the move...
Love,
EJ
Physical Therapy was in and had Ron do foot, leg, and arm exercises (with the yellow bands.) Then he stood beside the bed with a walker for a few minutes. He was pretty weak and white-faced, but heart rate did not go wild. He sat down for a bit, then stood again and took a couple sliding steps to the head of the bed and sat back down. She said she could tell he would progress quickly, as he was pretty strong and stable for someone who'd been down flat for 3 weeks. He got pretty sweaty from the exertion, but said it felt good to move and be out of the bed. :)
Dr. Awad (sp?) was in and said his white count was down a little bit, though still a little elevated. She wants him to complete another week of the antibiotic, but she approved his discharge to Regency Hospital. She and Dr. Jauregi both go to Regency, so there will be continuity of care. His pulmonologist, Dr. Tita goes there, too.
His transport is set for 5:30 today to Regency Hospital on Alexis Rd. in Sylvania. They are a hospital, and do simple procedures there, like trachs, etc., but patients are there longer than in a regular hospital. They will do physical and occupational rehabilitation there. The length of his stay will depend on his progress, but the average length of stay there is 25-30 days. He asked for his portable DVD player, so he can put on headphones and watch movies. He's bored! Laura is going to bring it up when she comes to Regency this evening.
He is getting better at writing, and it won't be long before he'll be able to write what he wants to say. Some of what he says we can decipher by lip reading, but he does not like to slow down for us.
His emotions have been swinging, so I've been asking about getting him back on his other meds. They are finally starting to listen...
The nurses have been great! very patient and cheery with us.
Will add more after the move...
Love,
EJ
Monday, March 9, 2009
Ron is about the same numbers-wise today... Still 40% O2, 97% O2 saturation. Peep is still 8, respirations 24. Bp was 113/84, and heart rate is 100 unless he's coughing, which he does a lot. He has popped the vent off the trach tube again today by coughing so hard... getting a bunch of stuff up and out of those lungs...
The Physical Therapist did have him stand beside the bed today, and they thought about having him take a couple steps and sit in the chair, but he got lightheaded, so they stopped with just the standing by the bed. He is moving arms and legs much more easily today.
His pulmonologist, Dr. Tita (sp?) said this morning that he was ready to be discharged to a long-term care facility tomorrow. The social worker was waiting for me when I got here, wanting me to make a decision about where. There only are 4 facilities in the area that can take vents: Heartland of Waterville, and Arbors of Sylvania, which are skilled nursing facilities, then Regency Hospital in Sylvania, and Advanced Specialty Hospital near MUO near S. Detroit Ave. and Glendale. His pulmonologist, Dr. Tita, and his Infectious Disease Doctors, Dr. Jauregi and Dr. Awad (sp?) all go to Regency Hospital, so many phone calls and emails later, we finally decided on it.
MEANWHILE, Dr. Awad (?) came in to see him and said his white count was up today. She did not like that at all... ordered blood cultures and urine cultures, checked him all over for possible infection sites, and had everyone jumping to find out the cause. He has not run a fever at all for at least 3 days, but she was not at all happy about that elevated white count! She is so quiet and quick, but boy, do people jump when she speaks! They had all the tests run within the hour! I doubt that she will release him for discharge until she is satisfied about the white count.
They took out the catheter, so little by little he is being disconnected from everything. He was so excited when he heard the word "discharge". He thought he was going to get to go home... was Very disappointed when he found out it would just be to another facility, and he may be there for up to another month.
At this point I don't know whether he will be moved tomorrow or not... Or what time it would happen if it is tomorrow. I just found out the cultures take 3 days to get results back.
Thank you for keeping us in all your thoughts and prayers. Thank you for all the hugs and good wishes. Thanks for all the help with my classes and duties at school, with Ron's business, with the dogs, and for the babysitting for Lauren and Hannah. Thank you Brenda and Rick for the wonderful home-cooked meals and company as I "fly by" on my way home. You all are appreciated more than words can express!
Love,
EJ
The Physical Therapist did have him stand beside the bed today, and they thought about having him take a couple steps and sit in the chair, but he got lightheaded, so they stopped with just the standing by the bed. He is moving arms and legs much more easily today.
His pulmonologist, Dr. Tita (sp?) said this morning that he was ready to be discharged to a long-term care facility tomorrow. The social worker was waiting for me when I got here, wanting me to make a decision about where. There only are 4 facilities in the area that can take vents: Heartland of Waterville, and Arbors of Sylvania, which are skilled nursing facilities, then Regency Hospital in Sylvania, and Advanced Specialty Hospital near MUO near S. Detroit Ave. and Glendale. His pulmonologist, Dr. Tita, and his Infectious Disease Doctors, Dr. Jauregi and Dr. Awad (sp?) all go to Regency Hospital, so many phone calls and emails later, we finally decided on it.
MEANWHILE, Dr. Awad (?) came in to see him and said his white count was up today. She did not like that at all... ordered blood cultures and urine cultures, checked him all over for possible infection sites, and had everyone jumping to find out the cause. He has not run a fever at all for at least 3 days, but she was not at all happy about that elevated white count! She is so quiet and quick, but boy, do people jump when she speaks! They had all the tests run within the hour! I doubt that she will release him for discharge until she is satisfied about the white count.
They took out the catheter, so little by little he is being disconnected from everything. He was so excited when he heard the word "discharge". He thought he was going to get to go home... was Very disappointed when he found out it would just be to another facility, and he may be there for up to another month.
At this point I don't know whether he will be moved tomorrow or not... Or what time it would happen if it is tomorrow. I just found out the cultures take 3 days to get results back.
Thank you for keeping us in all your thoughts and prayers. Thank you for all the hugs and good wishes. Thanks for all the help with my classes and duties at school, with Ron's business, with the dogs, and for the babysitting for Lauren and Hannah. Thank you Brenda and Rick for the wonderful home-cooked meals and company as I "fly by" on my way home. You all are appreciated more than words can express!
Love,
EJ
Sunday, March 8, 2009
Ron is a little more alert and awake today. He does remember some of yesterday, like Dave, AJ, and Laura Donnell being here. The doctor was here before I got here, today, but the nurse told me things look better on the CT scan. The lungs have patches instead of being all white. His hemoglobin is up to 9 today from 8.8 yesterday. His potassium and all are fine. Daily blood sugars are fine. He's still on 40% O2, and staying at 96% saturation.
The nurse said the Social Worker will probably be in to talk to us tomorrow. They may be ready for him to go to a rehabilitation facility before too long, so he can start to relearn walking, etc. First he has to get off the ventillator, etc., but it was good to hear about the next steps. I don't think he'll be going anywhere for at least a week.
He's still getting frustrated at not being able to talk, and doesn't like to give us one word at a time. He's still coughing up a bunch, and wakes himself up sometimes with a coughing fit. He coughed so hard today, he popped the vent tube off again. I just put it back on, so the nurse didn't have to come.
Thanks everyone for all your prayers and get-well wishes!
Love,
EJ
The nurse said the Social Worker will probably be in to talk to us tomorrow. They may be ready for him to go to a rehabilitation facility before too long, so he can start to relearn walking, etc. First he has to get off the ventillator, etc., but it was good to hear about the next steps. I don't think he'll be going anywhere for at least a week.
He's still getting frustrated at not being able to talk, and doesn't like to give us one word at a time. He's still coughing up a bunch, and wakes himself up sometimes with a coughing fit. He coughed so hard today, he popped the vent tube off again. I just put it back on, so the nurse didn't have to come.
Thanks everyone for all your prayers and get-well wishes!
Love,
EJ
Saturday, March 7, 2009
Ron was sound asleep earlier, so I left the room from 5:05 to 5:20 to walk and exercise by going up and down the stairs. When I got back, the curtain was pulled, the nurse was in here, and I thought she was just repositioning him, so I waited in the waiting room down the hall. His brother, Thom called me, so I talked with him a few minutes. When I came back in, the nurse told me she had heard his ventillator alarm, came in to check it, and found him scrunched down to the bottom of the bed, his legs off the side, with the vent tube popped off his trach tube! He had wakened up, didn't recognize where he was, and apparently tried to get up out of the bed!!! He asked me when he saw me if he was in the right room, still a little confused. Needless to say, the bed alarm is now on, and both rails are up.
We were both surprised that he was strong enough to move that far! He is getting his strength back pretty quickly. He can now hold the TV remote and push the channel changing button (which is, of course, at the top of his priority list.) He was determined enough to do that yesterday, I knew it wouldn't take long.
We were both surprised that he was strong enough to move that far! He is getting his strength back pretty quickly. He can now hold the TV remote and push the channel changing button (which is, of course, at the top of his priority list.) He was determined enough to do that yesterday, I knew it wouldn't take long.
Ron is pretty alert today, but he does not remember yesterday. Andrew, Laura, and I were all here with him yesterday evening, and were able, between the 3 of us, to figure out some of what he was saying. He has not lost his sense of humor; when the night nurse came in to introduce himself and tell Ron he'd be taking care of him, he asked if he could get him a Bud Light. He was figuring out where he is and why, but today, did not remember.
They have taken away his IV fluids except the Cefepine antibiotic every 12 hours. The fluids and Atavan, they are giving him through his stomach tube, which is moving the right direction to wean him gradually from all the hook-ups and machines. He is still on 2 mg of Atavan every 4 hours, and Fentanyl as needed. His temp is normal, 98.2, and all the numbers are the same as yesterday. They had lowered his O2 input to 40% by last night, and it is still there today.
A resident surgeon was in to remove some the gauze that had been packed around the trach. He said it looked good, and did not even bleed when he was working on it.
They just took him down for a CT scan of his lungs. The morning xrays must not have told them enough information. His last CT was 2 weeks ago tomorrow, so they can compare to that.
He is still coughing up a lot of stuff from his lungs. He is getting movement back and can get his hand up to his face more easily today. He is still weak and couldn't write words when he tried with a pen. He could hold the pen and make marks on the paper which he couldn't do yesterday.
Laura and I trimmed his toenails and fingernails, and they have shaved him about every other day or so. He's in pretty good spirits and says he's comfortable. He still is emotional from the Atavan, and tears up when one of us leaves after a visit. He is starting to get used to all the tubes and wires.
We appreciate all the cheery messages, cards, prayers, and phone calls. Thank you, everyone!
Love,
EJ
They have taken away his IV fluids except the Cefepine antibiotic every 12 hours. The fluids and Atavan, they are giving him through his stomach tube, which is moving the right direction to wean him gradually from all the hook-ups and machines. He is still on 2 mg of Atavan every 4 hours, and Fentanyl as needed. His temp is normal, 98.2, and all the numbers are the same as yesterday. They had lowered his O2 input to 40% by last night, and it is still there today.
A resident surgeon was in to remove some the gauze that had been packed around the trach. He said it looked good, and did not even bleed when he was working on it.
They just took him down for a CT scan of his lungs. The morning xrays must not have told them enough information. His last CT was 2 weeks ago tomorrow, so they can compare to that.
He is still coughing up a lot of stuff from his lungs. He is getting movement back and can get his hand up to his face more easily today. He is still weak and couldn't write words when he tried with a pen. He could hold the pen and make marks on the paper which he couldn't do yesterday.
Laura and I trimmed his toenails and fingernails, and they have shaved him about every other day or so. He's in pretty good spirits and says he's comfortable. He still is emotional from the Atavan, and tears up when one of us leaves after a visit. He is starting to get used to all the tubes and wires.
We appreciate all the cheery messages, cards, prayers, and phone calls. Thank you, everyone!
Love,
EJ
Friday, March 6, 2009
Ron is now in room 402, out of ICU. He is only on 2 mg of Atavan today, so is very emotional and frustrated. He still is trying to talk, and we can't always tell what he is saying. His chest xray looked "much better" this a.m. according to Sheila, the nurse he had yesterday and this morning in ICU. He is still on Cefepine antibiotic. His temp. was 98.4 when she took it at about 1:30. He's on 50% O2 input, which is up from yesterday, but I assumed that was due to the move. His O2 saturation is 98%, peep 8, respirations 24. His heart rate is 95, bp 120/76. His nurse now is Leah, and she's very nice. He likes her. They brought him a fan because the room is too warm to suit him, so some things we can figure out that he wants. He asked for the TV remote, but couldn't push hard enough to change the channel.
The floor charge nurse was in to welcome him to the floor, and said this is the "Step-Down" unit. They will slowly start to wean him from the ventillator, lowering the settings, and eventually change to like a Bi-Pap Machine, and then to an O2 tube. Then they can take out the trach when he does well on the O2 tube.
He asked Leah for some 7-Up, and she brought him a can of Sierra Mist with a sponge on a stick to let him suck some into his mouth. He smiled a huge smile and mouthed, "Thanks!"
He was asking how all this happened, and I tried to explain about the pneumonia, but he probably won't remember the next time he wakes up...
They came and put in a different IV- pic (sp?) line - in his arm, and will be taking out the central line in his neck. He doesn't have to have the blood pressure cuff on all the time, and he's happy about that.
I'll write more later. Dr. coming in...
Love,
EJ
The floor charge nurse was in to welcome him to the floor, and said this is the "Step-Down" unit. They will slowly start to wean him from the ventillator, lowering the settings, and eventually change to like a Bi-Pap Machine, and then to an O2 tube. Then they can take out the trach when he does well on the O2 tube.
He asked Leah for some 7-Up, and she brought him a can of Sierra Mist with a sponge on a stick to let him suck some into his mouth. He smiled a huge smile and mouthed, "Thanks!"
He was asking how all this happened, and I tried to explain about the pneumonia, but he probably won't remember the next time he wakes up...
They came and put in a different IV- pic (sp?) line - in his arm, and will be taking out the central line in his neck. He doesn't have to have the blood pressure cuff on all the time, and he's happy about that.
I'll write more later. Dr. coming in...
Love,
EJ
Thursday, March 5, 2009
Ron is doing better today. His O2 input is down to 40%, and O2 saturation is staying at 92%. The peep is down to 8, which is better. Respirations are 26-27; heart rate is 94, and bp is 133/76.
A Physical Therapist came in and worked with him to help strengthen his arms and legs. He did spike a fever last night, but Tylenol brought it down, and it has been just low grade today.
When his nurse asked him this a.m. if he was in pain, he said, "F---, yes!" She said she had to chuckle, because it probably was a silly question after two surgeries yesterday. I thought, "Yep, sounds more like Ron."
When I got here, she was cleaning him up and repositioning him, so he was awake. She was swabbing his mouth with a mouthwash sponge, and I heard her say, "No, don't bite!" I have a feeling that as he wakes up more, he's not going to be very happy and cooperative, but then, that's Ron!
The Infectious Disease Doctor was just in, and she said he is looking better. Today's lung xray showed some improvement, and his O2 numbers are better. If he continues to improve, they can move him out of ICU into "Guarded Care", which is in the same general area, just turn left after the limited entry "guarded" door. His nurse said they might have moved him today if he hadn't spiked the fever last night. She said they will probably move him tomorrow if all goes well.
He's still been trying to tell us things that we can't understand, and he gets very frustrated that he can't communicate. He doesn't understand why he's so weak because I'm sure he has no idea how long he's been here. We have told him the day and date, but every time he "wakes up" again, I think he's forgotten. He's still on some Fentanyl and Atavan, but lower amounts.
I'll update if there are more changes.
Thanks for the prayers and cheerful messages! We appreciate every one!
Love,
EJ
A Physical Therapist came in and worked with him to help strengthen his arms and legs. He did spike a fever last night, but Tylenol brought it down, and it has been just low grade today.
When his nurse asked him this a.m. if he was in pain, he said, "F---, yes!" She said she had to chuckle, because it probably was a silly question after two surgeries yesterday. I thought, "Yep, sounds more like Ron."
When I got here, she was cleaning him up and repositioning him, so he was awake. She was swabbing his mouth with a mouthwash sponge, and I heard her say, "No, don't bite!" I have a feeling that as he wakes up more, he's not going to be very happy and cooperative, but then, that's Ron!
The Infectious Disease Doctor was just in, and she said he is looking better. Today's lung xray showed some improvement, and his O2 numbers are better. If he continues to improve, they can move him out of ICU into "Guarded Care", which is in the same general area, just turn left after the limited entry "guarded" door. His nurse said they might have moved him today if he hadn't spiked the fever last night. She said they will probably move him tomorrow if all goes well.
He's still been trying to tell us things that we can't understand, and he gets very frustrated that he can't communicate. He doesn't understand why he's so weak because I'm sure he has no idea how long he's been here. We have told him the day and date, but every time he "wakes up" again, I think he's forgotten. He's still on some Fentanyl and Atavan, but lower amounts.
I'll update if there are more changes.
Thanks for the prayers and cheerful messages! We appreciate every one!
Love,
EJ
Wednesday, March 4, 2009
Ron is doing fine after his surgery. He has opened his eyes and looked around, but is still pretty sedated. Dr. Katragada was here a little bit ago and said the secondary lung infection still is in both lungs, but it is a relatively common infection, and the antibiotic he's on is definitely the right one to take care of that. It will take some time. Being patient is the hard part. We all want him better, out of here and home yesterday! He does look much more comfortable, though his lip is swollen from the ventillator tube, and he has indentations on both cheeks from the supports. Those will gradually go away. We are going to get a white board for him to write on when he is a liitle stronger and awake, so he can, hopefully, communicate. Deb, his nurse, said he will be able to mouth words, just no voice, as the air does not pass over his vocal chords.
They changed him over to an air bed when they finished the surgery. It sort of waves the air under him so the pressure points are constantly moving.
He was pretty alert and awake before the surgery. I told him how Allie loves Nancy so much cuz she throws the ball for her over and over, and he "smiled" around the tube and nodded. I asked him if he was comfortable, and he nodded.
Since the surgery, he has squeezed the nurse's hand when asked, and wiggled his toes. She asked him if he was too warm, and he shook his head.
They will start the tube feeding again 24 hours after the surgery. He's back up to 70% O2 temporarily, but they will lower that again gradually. O2 saturation is staying up well at 98%. Peep is 11. Bp is 104/62, heart rate 81, respirations 36.
Thanks for all the extra prayers to see us through the surgery. I knew when I woke up today that it would be a good day. Nicky was even helping this morning by not having even one pile in the barn!! :)
Love to all,
EJ
They changed him over to an air bed when they finished the surgery. It sort of waves the air under him so the pressure points are constantly moving.
He was pretty alert and awake before the surgery. I told him how Allie loves Nancy so much cuz she throws the ball for her over and over, and he "smiled" around the tube and nodded. I asked him if he was comfortable, and he nodded.
Since the surgery, he has squeezed the nurse's hand when asked, and wiggled his toes. She asked him if he was too warm, and he shook his head.
They will start the tube feeding again 24 hours after the surgery. He's back up to 70% O2 temporarily, but they will lower that again gradually. O2 saturation is staying up well at 98%. Peep is 11. Bp is 104/62, heart rate 81, respirations 36.
Thanks for all the extra prayers to see us through the surgery. I knew when I woke up today that it would be a good day. Nicky was even helping this morning by not having even one pile in the barn!! :)
Love to all,
EJ
Surgery went well!!! He should be back up in his room in about 15 minutes. We will update with more information when we get back in the room. He was awake this morning before the surgery and was trying to talk, so hopefully we will be able to communicate with him more after this :)
~ Laura
Sent on the Now Network� from my Sprint® BlackBerry
~ Laura
Sent on the Now Network� from my Sprint® BlackBerry
Tuesday, March 3, 2009
Ron's tracheotomy is scheduled for 10 a.m. tomorrow. I will need to be here by 8:00 a.m. They said it may take 1 1/2 hr. to 2 hrs. to do both the gastro tube and trach. Hopefully Ron will be a lot more comfortable not having the contraption in his mouth and down his throat.
No real change today. He is on 7mg of Atavan, and has not needed any Fentanyl yet today. Temp was 101*, and later came down to 99*. Still 50% O2 input, and 93-94 O2 saturation. Peep is still at 10. Bp is 118/70, heart rate 96, and respirations 36. His potassium is still 5.4, so the low-potassium food hasn't made any difference yet. His rash has not gotten any worse, but is still there, mostly under his right arm and some on his right chest. He is still on the Cefepine antibiotic.
Everyone's prayers are so appreciated! When I get tired and worried, I read your messages and cards to Ron, I feel your support, and it truly does help!
Love,
EJ
No real change today. He is on 7mg of Atavan, and has not needed any Fentanyl yet today. Temp was 101*, and later came down to 99*. Still 50% O2 input, and 93-94 O2 saturation. Peep is still at 10. Bp is 118/70, heart rate 96, and respirations 36. His potassium is still 5.4, so the low-potassium food hasn't made any difference yet. His rash has not gotten any worse, but is still there, mostly under his right arm and some on his right chest. He is still on the Cefepine antibiotic.
Everyone's prayers are so appreciated! When I get tired and worried, I read your messages and cards to Ron, I feel your support, and it truly does help!
Love,
EJ
Monday, March 2, 2009
The nurses have been telling us for a couple days that since Ron is not getting much better, the next step is to do a tracheotomy. They cannot keep him with the tube down his throat for more than 2 weeks (which it will be tomorrow.) He will still be on the breathing machine, but through the trach tube in his neck instead of through his mouth. They came in to ask me about doing the procedure just a little bit ago. It should actually be more comfortable for Ron. They will ask the surgeon to consult, he will come see Ron, and then they will schedule the surgery, probably tomorrow. I will need to be here 2 hours before the surgery, but I don't think the surgery itself takes long. The guy in the room next door (who came in the same day Ron did) went down for the same surgery this afternoon at about 1:30, and was back in his room by 2:30. They will put in a stomach tube for feeding at the same time, so that won't be down his throat either.
His chest x-ray is no better, and he has a secondary infection, now, that has taken up residence in that same right lung (showed up Saturday when they cultured his sputum, which they do every monring.) He had a 102* fever this a.m., so got Tylenol, and fever was still down at 2:00. They have lowered the Atavan (sedative and anti-anxiety drug) from 8mg. to 6mg., and only had to give the Fentanyl (pain killer) once so far today at about 1:45.
He is still on the Cefepine antibiotic every 12 hours. He does have some slight skin rash, but they don't think it is caused by an allergic reaction to the Cefepine. They are watching it closely, but it does not seem to be getting worse. They tried unbleached linens yesterday and today, and that did not seem to make any difference.
His numbers still look OK: heart rate is 91; bp is 125/70. O2 input is still at 50%, and O2 saturation is 95%. His respirations are 30, and the peep has been lowered to 11. (Peep is a setting on the respirator that is something like how long the lung holds a breath in while it absorbs the O2, before it is exhaled.) As long as his saturation level stays up, they will try to gradually lower the peep.
They have switched him to a lower potassium feeding to get his potassium level down.
Thanks for your continued prayers and positive thoughts!
Love,
EJ
His chest x-ray is no better, and he has a secondary infection, now, that has taken up residence in that same right lung (showed up Saturday when they cultured his sputum, which they do every monring.) He had a 102* fever this a.m., so got Tylenol, and fever was still down at 2:00. They have lowered the Atavan (sedative and anti-anxiety drug) from 8mg. to 6mg., and only had to give the Fentanyl (pain killer) once so far today at about 1:45.
He is still on the Cefepine antibiotic every 12 hours. He does have some slight skin rash, but they don't think it is caused by an allergic reaction to the Cefepine. They are watching it closely, but it does not seem to be getting worse. They tried unbleached linens yesterday and today, and that did not seem to make any difference.
His numbers still look OK: heart rate is 91; bp is 125/70. O2 input is still at 50%, and O2 saturation is 95%. His respirations are 30, and the peep has been lowered to 11. (Peep is a setting on the respirator that is something like how long the lung holds a breath in while it absorbs the O2, before it is exhaled.) As long as his saturation level stays up, they will try to gradually lower the peep.
They have switched him to a lower potassium feeding to get his potassium level down.
Thanks for your continued prayers and positive thoughts!
Love,
EJ
They decreased his level of sedative 2mg this morning and he has tolerated that well . He was able to squeeze the nurses hand and opened his eyes when I talked to him today.
His heart rate is 90
blood pressure 119 /63
Oxygen sat 97
Oxygen level still at 50
~ Laura
Sent on the Now Network� from my Sprint® BlackBerry
His heart rate is 90
blood pressure 119 /63
Oxygen sat 97
Oxygen level still at 50
~ Laura
Sent on the Now Network� from my Sprint® BlackBerry
Sunday, March 1, 2009
Sunday 3/1
Another good day... White count is about the same; hemoglobin is 9.3, up from 8; and potassium is 5.4 - not a huge concern. Heart rate is 91, bp 124/73. O2 input is still 50%, and O2 saturation is staying at 96-97. Peep is down to 13, which is better. Respirations are 31-33. He is on the same antibiotic, Cefepine. His fluid retention is not as bad, and he did not get any Lasix today. They are still getting lots of mucous and secretions out of his lung. Everything else is the same. Looks as though he'll be on the respirator for at least another week. His eyes have been sometimes open and blinking again today. He's still on the Atavan and Fentanyl.
Thanks for all the great messages!
Love,
EJ
Another good day... White count is about the same; hemoglobin is 9.3, up from 8; and potassium is 5.4 - not a huge concern. Heart rate is 91, bp 124/73. O2 input is still 50%, and O2 saturation is staying at 96-97. Peep is down to 13, which is better. Respirations are 31-33. He is on the same antibiotic, Cefepine. His fluid retention is not as bad, and he did not get any Lasix today. They are still getting lots of mucous and secretions out of his lung. Everything else is the same. Looks as though he'll be on the respirator for at least another week. His eyes have been sometimes open and blinking again today. He's still on the Atavan and Fentanyl.
Thanks for all the great messages!
Love,
EJ
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