Today, I took a morning break and didn't go into the hospital until the early afternoon. It was hard to do, but I needed to just stare at something other than hospital walls. Instead, I stared at the TV and watched pointless jibberish. It was very nice!!!
Dad is doing pretty good. They took out his 2 surgical chest tubes and a-line today, and just have him on a nasal cannula for oxygen. He is hurting when he coughs, as expected, but is doing pretty good as far as pain. His swelling is going down and he is doing his little stretches and moves to decrease the stiffness he has from laying in bed. He stood up with physical therapy and sat at the side of the bed for a few minutes later in the day. He is no longer on any drips and is down to one maintenance IV.
Unfortunately, his white count jumped today from 12 to 20. The infectious disease doctor saw him and said that we are heading closer and closer to surgery for his lung. They have been trying to buy some time with the heavy duty antibiotics, but it doesn't seem to be responding. They are not all that surprised since there is no blood flow to an abcess, so antibiotics aren't really getting to it either. They are planning to do another CT scan in a day or so to evaluate the abcess and go from there. Of course, they don't want to put dad thru more than he has to, but obviously it has to be resolved somehow. Despite all of this, they were able to "turn down" his chest tube (put to waterseal) and he has tolerated that great. I asked him if his breathing felt better than he was before all of this at home, and he said yes, so that is a good sign. He is on a better regime for his COPD, so I am glad that he is feeling some difference.
We had some tough talks today about what things will be like when this is all said and done, and he seems to be responding well. He knows that this is going to be a long haul and he is willing to do what needs to get done to recover. He says that things seem different to him this time. Although some may not agree with my tactics, I am honest with him. I have told him straight out that he would have died shortly without this surgery and the whole lifeline transport combined with that has made him realize how close he was to serious trouble.
We also had to have some serious discussions about some other things as well. As some of you know, Mom and dad are in the process of buying a home here locally. Things have been on somewhat of a hold due to inspection stuff, which has been a blessing, but deadlines are up this weekend. I asked dad what he wanted to do about it all and he said to just let the house go. Although I know that was hard for him to say, for him to realize that he may not be able to handle things was a big step for him. When I told mom, she wanted to talk to him more about it, so we did. He said that he was worried that he was not going to be able to do the things he wanted to with the house. We both told him that we could hire help to do things if he still really wanted the house, but that if he was worried about not being able to maintain the house, that was a different story. In the end, he said that he is more worried about now, so we decided to go ahead with it with the understand that he will not do ANYTHING and will just focus on recovery. I also threw in the stipulation that he would not be allowed to stay alone for awhile while mom travels. He agreed and said he doesn't want to stay alone, so that was good.....and amazing. He has even agreed that he will need to stay downstairs at my house and didn't even try to talk me out of doing some rearranging before he comes home. Usually he would try to talk me out of things like this and say that he can do it and that he will be just fine. This is all relieving to me, because as you all know....it's much easier to help people who are willing to be helped!
Tomorrow is Aunt Carol's last day here and I know that it will be hard for both her and dad. It has been a huge help to have her here, but we know we she will only be a phone call away. Maybe we can even set her up on Skype, so dad can video chat with her from the hospital!
The support that continues has been amazing and I am so thankful for you all. It is amazing what a familiar face or voice can do to ease your spirits during tough times! Thank you all for everything! Oh and by the way, Happy Nurse's Day/Week....I just realized today that I think I missed that!
Friday, May 6, 2011
Thursday, May 5, 2011
Dad - Day 7
Well, here we are a week later!
I never would have guessed last week when dad was admitted that I would be watching him get intubated, life lined to Methodist and have heart surgery! Definitely overwhelming but everything has been also very amazing. Dad has received amazing care both here and at North and has done well with every challenge that he has been presented with.
At this moment, his is still on the breathing machine. They are planning to removed that at some point today, but are waiting for the doctors to come do their rounds. He is still on continuous sedation and pain medication, but has built a bit of a tolerance and is more alert that he was previously. He is still on a small dose of Dopamine, but they are trying to wean that off slowly. The Amiodarone drip for his funky heart rhythm has been turned off without any problems. They also had him on a Nitroglycerin drip, which I forgot to mention, and that is off now, too. He is getting some maintenance IV fluid and antibiotics intermittently. They will remove his Swan Ganz cath today (internal measuring device) and I am hoping also his a-line. He will be left with his 3 chest tubes, central line, PICC line and catheter. Although that still sounds like a lot, it will be a lot less and a lot easier on him.
Mom and I were visiting in his room and I was helping the nurse turn him, and he opened his eyes and was moving about with stimulation. After he had calmed back down for a few minutes, he randomly opened his eyes and squeezed my hand to command. A few minutes later, his sister Carol came in and started talking to him. She asked if he could hear her and he shook his head yes. Mom then started talking more to him and he was also nodding. Mom had mentioned something about surgery and he furrowed his eyebrows. I asked if he remembered anything about needing or having surgery and he nodded no. I briefly told him about the heart surgery and explained that he may also be feeling pain in his leg from the graft site. I also caught him up to speed on his lung. I told him that he would probably forget this again, and that we would keep reminding him. We then told him that we would let him get some rest, and have left him alone for a bit. I will go back in there shortly and may or may not need to do another update later today.
He still looks good, from a nurses perspective, though, it is hard to see him in this state.
If things follow the plan and the information stays the same, I may not put another update, but if anything changes, I will let you all know.
As, always, big thank yous to everyone!
I never would have guessed last week when dad was admitted that I would be watching him get intubated, life lined to Methodist and have heart surgery! Definitely overwhelming but everything has been also very amazing. Dad has received amazing care both here and at North and has done well with every challenge that he has been presented with.
At this moment, his is still on the breathing machine. They are planning to removed that at some point today, but are waiting for the doctors to come do their rounds. He is still on continuous sedation and pain medication, but has built a bit of a tolerance and is more alert that he was previously. He is still on a small dose of Dopamine, but they are trying to wean that off slowly. The Amiodarone drip for his funky heart rhythm has been turned off without any problems. They also had him on a Nitroglycerin drip, which I forgot to mention, and that is off now, too. He is getting some maintenance IV fluid and antibiotics intermittently. They will remove his Swan Ganz cath today (internal measuring device) and I am hoping also his a-line. He will be left with his 3 chest tubes, central line, PICC line and catheter. Although that still sounds like a lot, it will be a lot less and a lot easier on him.
Mom and I were visiting in his room and I was helping the nurse turn him, and he opened his eyes and was moving about with stimulation. After he had calmed back down for a few minutes, he randomly opened his eyes and squeezed my hand to command. A few minutes later, his sister Carol came in and started talking to him. She asked if he could hear her and he shook his head yes. Mom then started talking more to him and he was also nodding. Mom had mentioned something about surgery and he furrowed his eyebrows. I asked if he remembered anything about needing or having surgery and he nodded no. I briefly told him about the heart surgery and explained that he may also be feeling pain in his leg from the graft site. I also caught him up to speed on his lung. I told him that he would probably forget this again, and that we would keep reminding him. We then told him that we would let him get some rest, and have left him alone for a bit. I will go back in there shortly and may or may not need to do another update later today.
He still looks good, from a nurses perspective, though, it is hard to see him in this state.
If things follow the plan and the information stays the same, I may not put another update, but if anything changes, I will let you all know.
As, always, big thank yous to everyone!
Wednesday, May 4, 2011
Dad - Day 6 - Part 3
Ok....this one is going to be a quickie!
We have just made it home and are going to turn in early after a very long and exhausting day at the hospital.
Not too much new since the last update.
The plan is to extubate dad tomorrow (take him off of the breathing machine). The doctors are all aware of his stubborn nature and strong will, so the pulmonologist (lung doctor) has said that they will probably just turn off the sedation and extubate right away. Often they like to wean the medicine off and watch for a few hours and then pull out the breathing tube. In dad's case, I don't know how well he would handle that. The pulmonologist said that he really thinks that dad will need a lung surgery but doesn't want to just keep him on the breathing machine if we don't have to.
The anesthesiologist also came by to check on dad, which I thought was nice. He also mentioned that during surgery they did an internal ultrasound of his heart. He said they saw that his left ventricle was enlarged, which is common with untreated high blood pressure, like dad's. He also said he had some issues with his mitral valve and that we would need to watch that. He said, obviously, they wouldn't do anything surgical to it at this time and that he may do fine for years with out needing any surgery. I think he just wanted to give us a forewarning. I will ask the surgeon/cardiologist more about that tomorrow, since it isn't something that he discussed with us earlier.
Today was a long, exhausting day, but tomorrow is going to be the real test! We are going to eat our Wheaties for sure!!!
I am sure that I will be in bed before Delainey tonight and am hoping and praying that dad will surprise us with calmness and understanding! We can use all the good vibes we can get!
We love you all and appreciate everything!!!
We have just made it home and are going to turn in early after a very long and exhausting day at the hospital.
Not too much new since the last update.
The plan is to extubate dad tomorrow (take him off of the breathing machine). The doctors are all aware of his stubborn nature and strong will, so the pulmonologist (lung doctor) has said that they will probably just turn off the sedation and extubate right away. Often they like to wean the medicine off and watch for a few hours and then pull out the breathing tube. In dad's case, I don't know how well he would handle that. The pulmonologist said that he really thinks that dad will need a lung surgery but doesn't want to just keep him on the breathing machine if we don't have to.
The anesthesiologist also came by to check on dad, which I thought was nice. He also mentioned that during surgery they did an internal ultrasound of his heart. He said they saw that his left ventricle was enlarged, which is common with untreated high blood pressure, like dad's. He also said he had some issues with his mitral valve and that we would need to watch that. He said, obviously, they wouldn't do anything surgical to it at this time and that he may do fine for years with out needing any surgery. I think he just wanted to give us a forewarning. I will ask the surgeon/cardiologist more about that tomorrow, since it isn't something that he discussed with us earlier.
Today was a long, exhausting day, but tomorrow is going to be the real test! We are going to eat our Wheaties for sure!!!
I am sure that I will be in bed before Delainey tonight and am hoping and praying that dad will surprise us with calmness and understanding! We can use all the good vibes we can get!
We love you all and appreciate everything!!!
Dad - Day 6 - Part 2
Dad is out of surgery and all went well. The surgeon bypassed 3 vessels and removed his left atrial appendage to get rid of the atrial fib that he was in (the funky heart rhythm that started the other night). I was thankful for this because it will cut down on one medication that he will need to take when this is all said and done.
We just were allowed to go back and see him for a few minutes and I am sure everyone else would have a different opinion, but from a nurses perspective, I think he looks good. They had him on a touch of Dopamine (a medicine to keep his blood pressure up), but it is at such a low level that I am sure the nurse will be able to turn it off shortly. Because they fixed his heart rhythm, I believe they will turn that medication off shortly, as well. They were getting ready to start his sedation back up to make sure that he stays calm and comfortable. He will most likely also stay on the breathing machine for at least the day (hopefully more). He still has his PICC line from the other day and now has a new central line with Swan Ganz (a fancy internal measuring device for my non-nurses), an a-line and a total of 3 chest tubes. The surgeon did say that his lung definitely has an abcess and he didn't want to get involved with that today. He is going to treat him with antibiotics and see what happens in a few days. He may need to surgically fix that as well, but it is a wait and see kind of thing. Dad's white blood cell count has cut in half since his admission, so he is definitely already responding to the antibiotics that they have him on.
Today they are really going to cut back on the visitation. They asked for 2 hours to get him organized and settled and then will allow us to go back two at a time. I think that they saw how rowdy we were in the waiting room....reminiscing was a good way to pass the time, but we laughed a little more than I think they expected. They actually put us in a private waiting room they call the quiet room....what were they thinking!!! With my family, this room will never be quiet, but it is nice that they have allowed the rest of the visitors some quiet time away from us.
I will try to do at least one more update later today, as I am sure that we will get more information later.
It sounds like we get one more day to gather our strength, so I am thankful. As soon as he gets his strength back and the tube out, the true test will begin.
Once again, I have been amazed by everything! I thank God for all of you and everything that you have all done for me and my family! We are so blessed!!!! Thank you, thank you, thank you!
We just were allowed to go back and see him for a few minutes and I am sure everyone else would have a different opinion, but from a nurses perspective, I think he looks good. They had him on a touch of Dopamine (a medicine to keep his blood pressure up), but it is at such a low level that I am sure the nurse will be able to turn it off shortly. Because they fixed his heart rhythm, I believe they will turn that medication off shortly, as well. They were getting ready to start his sedation back up to make sure that he stays calm and comfortable. He will most likely also stay on the breathing machine for at least the day (hopefully more). He still has his PICC line from the other day and now has a new central line with Swan Ganz (a fancy internal measuring device for my non-nurses), an a-line and a total of 3 chest tubes. The surgeon did say that his lung definitely has an abcess and he didn't want to get involved with that today. He is going to treat him with antibiotics and see what happens in a few days. He may need to surgically fix that as well, but it is a wait and see kind of thing. Dad's white blood cell count has cut in half since his admission, so he is definitely already responding to the antibiotics that they have him on.
Today they are really going to cut back on the visitation. They asked for 2 hours to get him organized and settled and then will allow us to go back two at a time. I think that they saw how rowdy we were in the waiting room....reminiscing was a good way to pass the time, but we laughed a little more than I think they expected. They actually put us in a private waiting room they call the quiet room....what were they thinking!!! With my family, this room will never be quiet, but it is nice that they have allowed the rest of the visitors some quiet time away from us.
I will try to do at least one more update later today, as I am sure that we will get more information later.
It sounds like we get one more day to gather our strength, so I am thankful. As soon as he gets his strength back and the tube out, the true test will begin.
Once again, I have been amazed by everything! I thank God for all of you and everything that you have all done for me and my family! We are so blessed!!!! Thank you, thank you, thank you!
Dad - Day 6 - Part 1
Well, dad is back in the OR now. He went back at about 830, as scheduled. We are camping out in the surgery waiting room , and have pretty much taken over a nice lil corner. Dad is severely out numbered by women, and if he had the ability he would be rolling his eyes about now.
When we saw him this morning, he was still on the sedation, and they had added a pain medication drip, so he looked much better. As soon as his sister, Carol, spoke to him, he turned his head to her quickly. We joked that we know who his favorite is. I joked and said we should manicure his eyebrows while he is asleep and he immediately turned his head away from me. Good to know Propofol and Fentanyl cannot tame his stubbornness!
While taking a potty break at about 920, I ran into the phyisician's assistant that is scrubbed in for his surgery. He said they hadn't started yet, but had a new central line and swan in and had been having a difficult time getting the a-line in. He said they were about to begin the actual surgery and that he still thought they would be out by noon....I held back my laugh out of respect, but really I do not think that they will be out in under 3 hours. We shall see though!
I will do multiple updates today, as both my mind and hands are hard to keep still, and I am sure that we will have periodic updates through the day.
And, as always.....thank you all for everything!!!!
When we saw him this morning, he was still on the sedation, and they had added a pain medication drip, so he looked much better. As soon as his sister, Carol, spoke to him, he turned his head to her quickly. We joked that we know who his favorite is. I joked and said we should manicure his eyebrows while he is asleep and he immediately turned his head away from me. Good to know Propofol and Fentanyl cannot tame his stubbornness!
While taking a potty break at about 920, I ran into the phyisician's assistant that is scrubbed in for his surgery. He said they hadn't started yet, but had a new central line and swan in and had been having a difficult time getting the a-line in. He said they were about to begin the actual surgery and that he still thought they would be out by noon....I held back my laugh out of respect, but really I do not think that they will be out in under 3 hours. We shall see though!
I will do multiple updates today, as both my mind and hands are hard to keep still, and I am sure that we will have periodic updates through the day.
And, as always.....thank you all for everything!!!!
Tuesday, May 3, 2011
Dad - Day 5
Let me start off by saying that I am humbled by all of the support. I am humbled by the outpouring of offers to help with Delainey, cook meals, do favors, etc... I am very humbled by all of wonderful friends and support that I (or more accurately, we) have both back in California and here in Indiana. This situation has been very eye opening and I am just amazed (and extremely thankful!).
As for dad, today has been pretty much the same. I got a phone call from the hospital in the middle of the night just to let me know that dad had gone into another funky heart rhythm (afib, for my nurses) and they started him on medication to control it. Besides that, he has been behaving himself. He is still on the breathing machine and still sedated. He does need more medication today than yesterday and still opens his eyes occasionally and we can still tell when he is mad (a good sign, in my opionion).
I talked to the surgeon and surgery is on for tomorrow at 8:30am. For now, they can only attempt to fix the heart and will need to try to bypass 3 and possibly 4 vessels. His lung looks more like there is an abcess and he doesn't want to risk introducing the infection into his heart cavity. He said that after the heart surgery we will see how things go and may still need to do lung surgery in a few days.
We are not sure how long he will need to be on the breathing machine and will have to see how that goes. Typically, people come off after a few hours, but dad is a bit more complicated. We are going to try to have an early night tonight so we can get up here early to see him before surgery.
Aunt Carol (dad's sister) and Auntie (aka Aunt Brenda, mom's sister) are both here now and I am so thankful!! Even with all of the support we have had, it is nice to have both of them here as well!
Continued thanks for EVERYTHING!!!! Words can not express!
As for dad, today has been pretty much the same. I got a phone call from the hospital in the middle of the night just to let me know that dad had gone into another funky heart rhythm (afib, for my nurses) and they started him on medication to control it. Besides that, he has been behaving himself. He is still on the breathing machine and still sedated. He does need more medication today than yesterday and still opens his eyes occasionally and we can still tell when he is mad (a good sign, in my opionion).
I talked to the surgeon and surgery is on for tomorrow at 8:30am. For now, they can only attempt to fix the heart and will need to try to bypass 3 and possibly 4 vessels. His lung looks more like there is an abcess and he doesn't want to risk introducing the infection into his heart cavity. He said that after the heart surgery we will see how things go and may still need to do lung surgery in a few days.
We are not sure how long he will need to be on the breathing machine and will have to see how that goes. Typically, people come off after a few hours, but dad is a bit more complicated. We are going to try to have an early night tonight so we can get up here early to see him before surgery.
Aunt Carol (dad's sister) and Auntie (aka Aunt Brenda, mom's sister) are both here now and I am so thankful!! Even with all of the support we have had, it is nice to have both of them here as well!
Continued thanks for EVERYTHING!!!! Words can not express!
Monday, May 2, 2011
Dad - Day 4
Well, this day has been chaotic....to put it lightly.
I called the ICU for an update this morning and all was pretty much the same. I got myself ready and was on the way to take Delainey to school when I got a phone call from the Cardiology NP saying that they wanted to take dad down for a heart cath within the next hour. I was a bit upset because over the weekend they had stated that this could wait until dad's lung situation had improved a bit. The way he is now, he is not going to tolerate laying flat. The NP stated that dad's lung wasn't improving/getting worse and there was concern that he was going to need lung surgery. With his heart status the way it is, they wanted to get heart clearance before putting him under for lung surgery. I understood the rationale but was very concerned about how dad would tolerate laying flat for prolonged periods at time. We agreed to go thru with it, and they took dad down for the procedure and discovered that he has extensive heart damage and needs open heart surgery. I was afraid of this happening and tried to talk to dad about this exact situation yesterday, but as expected, he wouldn't talk to me about and just kept saying we'll see when that happens.
I called the ICU for an update this morning and all was pretty much the same. I got myself ready and was on the way to take Delainey to school when I got a phone call from the Cardiology NP saying that they wanted to take dad down for a heart cath within the next hour. I was a bit upset because over the weekend they had stated that this could wait until dad's lung situation had improved a bit. The way he is now, he is not going to tolerate laying flat. The NP stated that dad's lung wasn't improving/getting worse and there was concern that he was going to need lung surgery. With his heart status the way it is, they wanted to get heart clearance before putting him under for lung surgery. I understood the rationale but was very concerned about how dad would tolerate laying flat for prolonged periods at time. We agreed to go thru with it, and they took dad down for the procedure and discovered that he has extensive heart damage and needs open heart surgery. I was afraid of this happening and tried to talk to dad about this exact situation yesterday, but as expected, he wouldn't talk to me about and just kept saying we'll see when that happens.
Today, when mom and I were faced with the decision, neither of us thought that dad would listen to what needs to be done and didn't think that it would be a good option for him. The doctors wanted a decision right then, and I said we needed to try to talk to dad. They took him back up to ICU and I tried to talk to him about it. He was still very drowsy but was able to tell us that he wanted to try the surgery. I made him repeat it to me a few times and I told him he needed to decide now, because if so, we needed to transfer him to another hospital quickly. He said "then lets move". So the scramble began....
The hospital arranged for his transfer downtown to a bigger hospital. As they were getting ready to move him, his breathing became more difficult and they decided to intubate him. They also put him on heavy sedation, and by the time we got downtown, they were able to wean off the two cardiac drips they had him on. His heart rate and blood pressure were much better and he breathing is much more relaxed now that he is sedated and the machine is doing most of the work for him.
We have family coming in to be here with us and we just learned that the plan is for open heart surgery on Wednesday. They delay is because the cardiothoracic surgeon is ill today. They will most likely fix his lung as well, during the surgery, if he tolerates it.
Right now we are pretty much in a wait and see position. I will keep the updates coming and appreciate everything from all of you. Please know that we are getting all of the well wishes but just haven't had a chance or the clarity to respond.
Thank you again to everyone!
The hospital arranged for his transfer downtown to a bigger hospital. As they were getting ready to move him, his breathing became more difficult and they decided to intubate him. They also put him on heavy sedation, and by the time we got downtown, they were able to wean off the two cardiac drips they had him on. His heart rate and blood pressure were much better and he breathing is much more relaxed now that he is sedated and the machine is doing most of the work for him.
We have family coming in to be here with us and we just learned that the plan is for open heart surgery on Wednesday. They delay is because the cardiothoracic surgeon is ill today. They will most likely fix his lung as well, during the surgery, if he tolerates it.
Right now we are pretty much in a wait and see position. I will keep the updates coming and appreciate everything from all of you. Please know that we are getting all of the well wishes but just haven't had a chance or the clarity to respond.
Thank you again to everyone!
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