Friday, September 19, 2008

December 12- day 92

We seem to be heading in the right direction finally. Jeff had a good day again. This morning when my parents were visiting he sat up for 45 minutes to 1 hour. He is now on a mechanical soft diet. This is a diet of very soft food. Pasta, mashed potatoes, casseroles, ground meats, and soft vegetables. He had a mashed potatoes and chicken casserole for lunch. His nurse said that he did not eat much but she feels like because he is receiving tube feedings that his belly is full and he is not hungry. She has suggested to the doctor that during the day the tube feeding be suspended and he might actually be hungry. When I was able to go after school to see him he sat up for 2 hours. He ate a little of the supper he ordered.
The rehab hospital has a bed for him but his pulmonologist still is not ready for him to go. Jeff's social worker at the hospital called me while I was driving to the hospital and said that Jeff's doctor wanted to discuss his concerns with me. He is supposed to call me in the morning so we can discuss his concerns. I told her if the doctor had concerns about sending him to rehab then I had concerns also. I am leaving the decision up to the doctor. The social worker told me that next week there may not be a bed for Jeff at the rehab hospital.

December 10- Day 90

UPDATE- MONDAY EVENING 12/10

Jeff had another good day. He got his speaking valve for his trach and can now talk when he needs to. The speech pathologist also did a swallow study and Jeff is now getting clear liquids again. He is only allowed sips and someone needs to be present when he is drinking to monitor his breathing. Jeff will not be going to rehab tomorrow as he had hoped. The pulmonologist wants him to be stronger before he sends him. He did get bummed out when he found out he would not be going as soon has he had hoped.
Jeff is having some problem with his tube feedings. They are not able to get him up the the goal rate. He gets nauseous when they get to the higher levels. They switched his tube feeding today to a formula with more protein and calories with less volume. They think this will help with the nausea.

December 8- day88

UPDATE- SATURDAY EVENING 12/8

Today was another good day for Jeff. He was able to write today and it was legible. He has tried to write in the past and no one could read it. We played tic-tac-toe and hang man. The nurse said that it would be good for his fine motor skills to write as much as possible. He was off the ventilator for about 13 hours today. The respiratory tech said that each day they would increase the number of hours off the ventilator and use the trach mask. Jeff realizes how long he has been in teh hospital but he does not remember most of it. Nurses would stop by to speak to him and he would ask me if they had been his nurse.

He is very anxious to go to rehab and keeps asking how long he will have to be in rehab. I keep telling him to take it one day at a time. He has not lost his faith. He wants people to pray with him. He is not angry. He has not asked why me? He is an incredible person.

December 7- day 87

UPDATE- FRIDAY EVENING 12/7

Today was another good day for Jeff. The cardiologist, the infectious disease doctor, and the surgeon have given their approval for him to go to rehab. The pulmonologist is the only one left to give approval. He is not on board with the rest of the doctors. Dr. Cervoni wants to make sure that Jeff's breathing is ok and that he gains some strength before he goes to rehab. I agree with Dr. Cervoni. I want Jeff in rehab but I want him stronger before he goes. At Select he will not be on monitors and that part scares me just a bit.

It amazes me how quickly the ICU psychosis went away. He is very coherent now. His mind is very clear. When he was so delusional it was very difficult to see but I had to stay with him as much as possible. He is resting very well so he is no longer sleep deprived.

December 6- day 86

UPDATE THURSDAY EVENING 12/6

Today was better for Jeff than yesterday. His spirits were better. Our pastor went this morning to visit him, then my parents went for a large portion of the day, after they left another pastor friend of ours went to see him. I went after school and then after I left one of his best friends from church went to visit him.

Jeff did well with his therapy today. He sat on the side of the bed and did leg lifts. He did all of this with no support after they helped him sit up. He is also gaining strength in his arms daily.

The nurse said that possibly he could go to rehab as early as Monday but after I left tonight he aspirated again. Luckily this time he did not stop breathing. The nurse suctioned his stomach and shut off his tube feedings for the night. She said that she was going to start them back at 4 am. I am afraid that he will not go to rehab next week. I know that he wants to go there so he can get home sooner, however I do not want him to go if he is not ready. Before I left tonight I prayed with him and asked God that if Jeff was ready to go to rehab then open the doors and allow him to go. Pray that he will stop aspirating and get to rehab soon. He is so anxious to get there so he will be able to come home soon.

December 5- day 85

UPDATE- WEDNESDAY MORNING 12/5

I worked all day yesterday and my parents went to see Jeff in the hospital. I went after work and he did not remember my parents visiting him. His nurse cut his diprivan in half so maybe he could remember more. He has a urinary tract infection. His MRSA came back negative again yesterday. The infectious disease doctor wants more cultures ran today because he has a fever.
We had snow last night so school is closed today. However I do not know if the roads are clear enough to drive to Fort Wayne. Pray that I am able to drive there to see him today.

UPDATE- WEDNESDAY EVENING 12/5

Jeff is very depressed now. He asked his nurse today why he had a trach. She explained to him about what happened to him on Friday. She told him that he aspirated and food clogged his air passages and that he had some problems with his heart due to the lack of oxygen. Then she told him they had to do CPR on him but that he was doing better now. Every time I tried to leave he got very emotional. I think it would do him good to have visitors now. Especially since I am back at work and can only be there in the evenings after school.

December 3- day 83

I went back to work today. I only worked until 10 am. The hospital called and the surgeon wanted to do the tracheotomy today. I had told the school that I might have to leave at a moments notice so they were ok with me leaving.

His surgery went well and the pulmonologist wants to try to get him off the ventilator tomorrow or Wednesday at the latest. He will have a smaller trach inserted in two weeks. He will be able to eat and talk then. Jeff does not understand what is going on. The nurse just told me on the phone that they have lessened his sedation. Tomorrow I will try to explain why he has this.

I am going to try to work again tomorrow. It was so hard not being with him. I just want to sit and hold his hand all day.

December 1- day 81

I just spoke with the pulmonologist and they will be putting a tracheostomy. He feels that this is the only way to insure that something like this does not happen again. He feels that it will be short term (6 to 8 weeks). He will only be on the ventilator for a few days and then they will get him off the ventilator and he will breathe through the trach. They told me that he would be mad at me for allowing them to put the trach in but I have no choice. The doctor said that this is the only option.

November 30- Day 80

UPDATE- FRIDAY AFTERNOON 11/30

JEFF CODED TODAY AND IS BACK ON THE VENTILATOR. PRAY

UPDATE- FRIDAY NIGHT 11/30

Jeff choked on a piece of food. They think that either it was still in his mouth when he fell asleep after lunch (my dad and I fed him lunch and he did not eat much and when we left he was asleep and we moved his food tray out of his reach) or that he had started to swallow it and because of the weak muscles in his throat that it did not go down completely. When he choked and stopped breathing his heart stopped. They had to do CPR for 8 minutes. The nurse told my mother that they were bagging him the entire time and that he was receiving oxygen. Before we left tonight he was responsive. He looked at me, blinked in response to a question and he squeezed my hand. His heart doctor is confident that he will be fine. They are planning on getting him off the ventilator in the morning. I am going back there early in the morning. I have called several times and the nurse assures me he is doing fine. He is resting well but does awaken when she ask him questions.

It is truly a God thing that he was still in the ICU today when this happened. Two days ago they took him off the haldol but last night the psychologist put him back on .3 milligrams an hour ( he had previously been on 4 milligrams an hour). This morning the rehab hospital came to transfer him and because he was on the haldol he could not go. If he had choked at the rehab hospital it could have been much worse.

November 28 - day 78

UPDATE- WEDNESDAY MORNING 11/28

Last night was not a good night for Jeff. He lost more blood yesterday. His hemoglobin was down to 6.1. That is the lowest that it has been since he has been in the hospital. They had to give him 4 units of blood and 2 units of fresh frozen plasma. They are not through giving him the plasma. He is on the first unit now and will receive the second unit by 8:30 am. I am to call at 9:30 to see what his hemoglobin is. They had to change his dressing several times yesterday during the day and it tapered off during the evening. The surgeon was there at 11 pm and said that there could be internal bleeding. If the blood products do not get his hemoglobin up they will decide what to do at that time.

UPDATE- WEDNESDAY EVENING 11/28

Jeff is still not doing well. This afternoon after receiving 4 units of blood and 2 units of plasma his hemoglobin was only 7.2. Before the blood and plasma it was 6.8. They just finished infusing him with 2 more units of blood and have drawn blood to send to the labs. I was told to call back at 11:30 pm to get the results.

God has brought him through so much I have to have the faith that God will bring him through this too.

November 27- day 77

UPDATE- TUESDAY EVENING- 11/27

I was not able to go to the hospital today. Last night by the time I got home I had a fever of over 100. I felt horrible. When I called the nurse this morning she told me that she did not want me to come to the hospital for at least 2 days.

Jeff had to get 4 units of blood between last night and today around noon. The surgeon was in Jeff's room when I called this morning and he was not that concerned that he was loosing blood. He feels that due to the number of surgeries that Jeff has had that it will take his body time to build back its blood supply. Jeff was also very delusional again today. They took him off the fentonyl (I know I probably spelled it wrong sorry) today. The nurse said that it could be a reason for his delusional thoughts.

He stood by his bed today. My parents went to visit him for me and said he wanted to do more but they are making him take it slow.

November 26 - Day 76

Jeff had surgery this afternoon and they got him closed. PRAISE THE LORD!!!!!! The surgeon did say that the tissue looked angry, but that for me not to worry. He said all went well with the surgery. He is still very confused and agitated. He pulled out part of his wound vac during the night last night. He keeps pulling and picking at things. They say that his mind will clear up but this is part of being in the hospital for so long. If all goes well this week I will go back to work next Monday so I can save the last 5 weeks of my FMLA for when he comes home from the hospital. The nurses say he will need me home when he comes home.

November 23- Day 73

I called the hospital at 3 am and Jeff has been very confused and disoriented. His nurse says he keeps taking off his gown and his blankets. He has pulled his IV line from his wrist and has started messing with his PIC line. I asked her if he has had any morphine. I think that is what is causing him to have these problems. She says he does these things while he is asleep and appears to be having bad dreams. Two more surgeries and he should be done. Pray that these bad dreams stop and he becomes more coherent. I cannot get back to sleep. I will be leaving home by 5 am to get to the hospital for his surgery at 7 am. I am ready to go I just need to wake my father to go with me. I do not know what I would do if my parents were not here to help me. I know my church family would be there for me if my parents could not be here but it makes it so much easier that my mama and daddy are here with me. My mama is staying home with the kids today so they do not have to get up early and be taken to a friends house.

November 22- Thanksgiving Day -Day 72

Jeff had surgery again on Wednesday morning and they have him closed all but about two inches. Everything looked great when they removed the dressing. He is scheduled for surgery again on Friday morning at 7:00 am. Dr. Stevens said that if Dr. Lippy could close him one more inch that he would be able to close him on Monday. Pray that all goes well in the morning and he is not swollen and they can close him more.

His MRSA test came back negative again today. Family no longer has to wear gowns and gloves when we visit him. Things are really looking up. Praise God for all he has done for Jeff and for us.

November 20 Day 70

Jeff was in a lot of pain today. His pain is again due to the muscles being pulled together. He will not eat much, I think he is afraid to eat much because of what happened last week. He is still on clear liquids. The good news for today- the MRSA swab they did today came back NEGATIVE!!!!!!!!!!!!!!!!! The C.Diff they cultured for today also came back NEGATIVE!!!!!!!!!!!!!!!!!! I still don't know about the yeast in the blood. I am keeping faith that that will go away with the treatment he is receiving.

November 19- Day 69

UPDATE- MONDAY EVENING 11/19

Jeff had surgery again this morning. Due to the distension in his abdomen last week the dressing they were using to close his belly pulled away from the connective tissue. The surgeon had to reattach the dressing and begin the closing process again. He is scheduled for surgery again Wednesday and Friday. If all goes well on Wednesday and Friday they will be able to close him on Monday. If when they take him to surgery on Friday they do not think they will be able to close him on Monday they will call in a plastic surgeon to do a skin graft over the opening. We are praying that they get him closed by Monday.

His blood cultures still show yeast in the blood. I am still unsure what that means. I know they caught it early because they do blood work everyday.

November 18- Day 68

Yesterday Jeff was still very confused and disoriented. He would dream and wake up and think it was really happening. The nurses say that he did not sleep much for three days and nights. When he would sleep he would move his arms around and talk in his sleep.

His MRSA test came back NEGATIVE. The infectious disease doctor said that since he was on Vancomycian when the test was done that she wants him off the Vanco and have him retested on Tuesday. He also had yeast show up in his blood so he is on a different antibiotic for that.

Today he is more coherent today and he is eating better. He did not eat much yesterday and they took his TPN (food given by IV for those of you who are not in the medical field)away for 24 hours because the TPN has sugars in it and it can harbor bacteria.

November 15- day 65

THURSDAY MORNING 11/15

JEFF'S BLOOD CULTURE CAME BACK POSITIVE AND THEY THINK HE HAS DEVELOPED MRSA. HE HAS BEEN A CARRIER OF IT AND THEY HAVE BEEN TREATING HIM WITH VANCO BUT NOW THEY THINK HE HAS IT. PLEASE PRAY AND CALL ANYONE YOU KNOW TO PRAY. HE HAS MADE IT SO FAR AND NOW THIS.
THURSDAY AFTERNOON 11/15

Jeff had surgery and his belly was distended and swollen so they lost ground on the closure process. He is now more open than he was before. The surgeon also had them put the NG tube back in and so he will not get any lunch. He is so bummed out about this. They are hoping they can remove the tube by tonight so he can have supper. I did meet with the lady from the rehab hospital and the process of getting him to rehab has started. They have a waiting list and he needs a private room due to the MRSA. They also have to get him closed before he can go to rehab. He wants to be home by Christmas so please pray that they get him closed. This infection goes away and it is not MRSA and that they get him closed soon.

November 14- day 64

UPDATE- WEDNESDAY EVENING 11/14

Jeff spiked a fever today. When I left the hospital at 7:00 his temperature was 103.3. It is now down to 102.8. They are giving him Tylenol every 3 1/2 hours. They pulled his PIC line from his left arm and are running cultures on it. They have already ran blood cultures which came back negative. They are also running cultures on his urine and his stool (I know TMI). They had stopped the vancomycin but started it back today. Please pray that his fever breaks and if he has an infection that it is minor. We have good news and then something like this happens. It is a constant roller coaster.

November 12- day 63

UPDATE- TUESDAY EVENING 11/13

I stayed home from the hospital today to get rest. While I was home resting Jeff was at the hospital working on his physical therapy. He sat on the side of the bed again and he stood three times. They wanted to sit him in a chair but he was not able to move after standing, but he stood! They took him off the reglan (a medicine used to stimulate the bowel muscles) and the milk of magnesia and his stomach and bowels still worked. They let him drink water and he was able to tolerate that. So today for the first time since September 13 he got to eat. He had jello, chicken broth, juice and a popsicle. He was able to tolerate that so he had a snack of applesauce. Things are looking up. I am so excited.

I made the decision to move. My church is going to organize the move. Our Children's Ministry Director is putting together information to go in our church bulletin to get volunteers. The retired ladies in our church have been itching to help us, so now they are going to be able to help us with packing and cleaning the new house before we move in and cleaning this house after we move out.

November 12 -day 62

UPDATE- MONDAY EVENING 11/12

This morning physical therapy came to work with Jeff. They did leg exercise with Jeff and then had him sit up on the side of the bed for 5 minutes. I know it doesn't sound like much but it was a lot for him. He was so worn out. He realizes now that he has a long road ahead of him. They also had OT come in and work with his arms. He will have to work hard to get enough control of his hands so he can write again.
Jeff had another procedure today. They did the procedure in his room again. They brought the whole surgical team into his room and did the dressing change. The surgeon said that he closed him a little more, but to me it looks like it is more open. He also said that they are taking him into the OR on Thursday with the anticipation of closing him. I hope that they are able to. They have not removed the NG tube but it has been clamped since 4 am Sunday morning. The surgeon said that maybe tomorrow they would remove the NG tube. They will have to place a new NG tube to feed him through when they decide to begin tube feedings. They have also started talking about getting him off of the ICU. I want him off ICU but I love the nurses and the care he has received. Each nurse on the ICU only has two patients to take care of. When he gets on a regular floor the nurses have 5 patients to take care of. The nurses said that it would not be anytime soon. He has to be able to take medication orally so they can get him of the Amiodarone drip and off the fentanyl drip. I think that by Thanksgiving he will be in a regular room if they can close him this week.

Please pray that the C.diff is gone. They are still giving him vancomycin to fight the C.diff. He has come so far and I could not bear it if he has overcome all of these other issues and the C.diff keeps him from making a full recovery. Your prayers are working. God has done so much for him already. We have been so blessed by the showing of love and support from everyone.

November 11 (evening)

UPDATE- SUNDAY EVENING 11/11
I found out Friday evening that our house that we are renting is being put up for sale. They want me to have the house ready for showing. Now I kept a clean house before Jeff went into the hospital but since he has been sick I cannot keep up with everything. I have an air mattress in our bedroom for my kids to sleep on. I cannot get it ready right now. So a man in our church has a house that I went to look at after I left the hospital. The rent is half of what we are currently paying. The house is smaller than our current house. I will also have to buy a stove. I have never made a decision like this without Jeff's input. People in my church will move us so that will not be a problem. Pray that I make the right decision. My parents are gone until Friday night. They are going to look at it with me on Saturday morning and I will decide then so I can let my current landlord know so I can move by early December.

November 11 Day 61

They did Jeff's surgery in his room on Friday afternoon. They got him closed just a little bit more. The surgeon said that they would get him closed in a week or two. I was hoping that they would get him closed by Monday. He has very little drainage from his NG tube. The nurse told me that the surgeon said that if Jeff had a BM that they could take the NG tube out. So I am praying for poop. When they get the NG tube out they can start giving him tube feedings. He is in a lot of pain still from the the muscles stretching. Physical therapy came by and sat him up yesterday for a few minutes. That was the first time that he has
sat up since October 11.

We have finally turned that corner toward recovery. We do not know when he will be moved to rehab but I know that it cannot be too far away.

November 9-Day 59

Jeff had surgery on Wednesday and they were able to close him one more inch. He is not open just three inches. He is scheduled to go back in for another closure today. They will not be able to close him completely today, he will have to go back in on Monday. The doctors are hopeful that they will be able to close him on Monday. They are only closing the muscle and connective tissue, they will pull the skin over and stitch it together next week. They also hope to begin tube feeding next week. This is a good sign, they think his belly may be able to tolerate food. Jeff is in a lot of pain from the muscles being pulled to close him.

November 6- day 56

Jeff had surgery again yesterday. The doctor said everything looked good and they closed him just a little more. He is scheduled to go back in on Wednesday and Friday. The surgeon indicated that he hoped to close him by Friday if possible. He has more fluid that has built up around his right lung. He has a thoracentesis again today. Since he is off the sedation medication he will feel this one and be in more pain. He is in a great amount of pain. The muscles are being pulled across to close him is very painful. They are also going to start Jeff on a diuretic to help remove some of the fluid off of his body. Jeff is terribly swollen.
He told us yesterday that he is hungry so I felt that was a good sign. He also felt it when they flushed his NG tube before surgery. That was the first time he felt anything go into his stomach. He asked the nurse what was going into his stomach.
Please continue to pray for his healing so he can get to rehab and then come home.

November 4- Day 54

Jeff had surgery again yesterday and he had a thoracentesis(to remove fluid from around the lung) done again yesterday. They did not get him to surgery until 4:30 in the afternoon due to emergency surgeries. They put a different dressing on his wound. Instead of the wound VAC they have a velcro type closure on the wound. I am hopeful that they will have him closed by the end of the week. He has three drainage tubes in his belly to drain the wound.
They got him off the ventilator which is great. However due to all the medication they have had him on to keep him sedated and the length of his illness he is now delusional. He asked me to kill him when I first got to the hospital and then he thought we were trying to kill him because we are keeping him restrained. He has to be restrained because he is trying to pull his tubes out.
Please pray that his nerves will settle down. The kids really want to see their dad but they cannot see him like he is.

November 2 -Day 52

Yesterday Jeff developed a place on his left arm. It sort of looks
like a bruise or a rash. They had the infectious disease doctor look
at it and she thought it was possibly a blood clot from his PIC line.
She ordered an ultrasound, the results were negative. He does not
have a blood clot. They are still unsure what it is.
His heart doctor came by and said that everything looks good today
from a heart standpoint. The lung doctor came by and set his
ventilator on CPAP mode. Jeff is currently breathing on his own.
They wanted to take him off the ventilator today but Jeff has surgery
scheduled at 8:30 in the morning. Jeff also has fluid in both of his
lungs so they are going to drain the fluid off his right lung today
and his left lung tomorrow and get him off the ventilator tomorrow
after surgery.
Jeff is retaining a lot of fluid and his BUN number went up today
instead of down. I am praying that this does not mean his kidneys are
not working as well as they had been. Pray that his body will start
getting rid of the excess fluid.
Jeff is also in more pain today. They had to cut his pain medication
in half and will soon take away the sedation medication as you cannot
be on sedation medication and off the ventilator.