Angie & Jim

The Home Stretchby Jim

The doctors just came and chatted with us for a bit.  Dr. Rogers, who has been heading up Angie’s care while she’s here, talked to us about the plan for the day and mentioned the plan for getting home.  That is good news, but we’re not out of the woods yet.  Here’s the scoop:

They’re doing a CT Scan this morning (just took her away, actually) to check her liver and other organs.  Her fluid is much lower and she’s only drained about 100 ccs since last night.  Dr. Rogers said they are going to lower her dosage of the drugs that make her lose fluids (which should help with the blood pressure).  Her oxygen saturation levels have been looking good, but she’s on a lot of extra oxygen.  He said he wants her levels to get back to normal without any oxygen before she goes home.  He also wants her able to get up and walk around without it completely wearing her out.  So, those are our goals for going home: weaning her off of the oxygen over the course of the day (as her levels permit), and getting up and taking walks.  We can do that.

Over the first 24-36 hours of being here, Angie lost about 4.5 L of fluid, which is about 10 lbs of weight.  This was after she’d lost several pounds in just the last couple months.  She’s down to under 100 lbs, which is definitely in the “underweight” classification.  We were concerned about it, so we’ve asked about getting a nutritionist to stop by and consult with us to find a way to healthily (is that a word?) get her back up to normal weight.  We believe that with all the fluid that was building up inside her, it was putting extra pressure on her digestive system and making her have very little appetite.  When she did eat, she would eat very little before feeling full.  I’m hoping that now that the fluid is gone, she’ll bounce back to her usual self and her appetite will return to normal.

After the doctors left, and I think to try and gauge her levels, Angie wanted to get up to brush her teeth.  It may have been a bit premature, because it really took a toll on her.  Just as she sat back down and was catching her breath, the CT scan people came to cart her away.  She got on the bed and they wheeled her out.  I will post again after I’ve heard the results from the CT scan.  Thanks for reading.

A Long-Expected Visitby Jim

Last year when we were in the hospital, I noticed an interesting sign posted in the hallway as I was leaving Angie’s room.  I snapped a photo on my phone and we talked about it later.  Apparently, Stanford has a group of volunteers that bring their dogs to help patients heal.  Well, she asked about it and requested a visit.  We were told they would stop by sometime today.  Angie was really excited and was rather anxious all day while we waited.

Max, the Labradoodle, came to visit us this afternoon at about 4.  A team of about 4 very kind women came in and chatted with us for a bit.  Max is fairly new at his job and is still in training with his owner.  He was very kind and did very well.  He is 7 years old and has been doing visits for about 6 months.  They are a service called PAWS, which is an acronym for Patient Assisted Wellness @ Stanford.  They even gave us a little card with Max’s picture and information on the back.

I knew it would cheer up Angie, but I was actually surprised by how much it lifted her spirits.  There is really something very special about animals and their healing influence.

Today was a lot better than yesterday.  I’m sorry I didn’t post until now, I’m running very low on sick leave, so I had to spend more time working than I have previously.  Between attending Angie and trying to keep up with things in Livermore, my day was pretty full.  That and no procedures to give me some time to post.  Anyway, enough about me…

Pain was in control all day and her vitals have looked great all day.  Her O2 saturation levels have been in the 90s most of the day (94 as of right now), which is fabulous.  Of course, she’s on 6 L of oxygen, so we’re not back to normal yet.  But, the bottom line is that her breathing is good and she’s feeling well.  She even muscled through a wall all the way down the hallway.  (That was right after a dose of morphine, so she was extra brave.)

This afternoon, they wanted to turn on the suction for her chest tube again, as per doctor’s orders.  Last time she got up to -10 mmH2O, but it was causing extreme discomfort and severe pain, so they turned it off.  They wanted to give her some pain meds and ease it up to -20 mmH2O, which is where she is now.  We’ve got a plan to keep her medicated through the night with the scheduling of the different things she can have, so I think we’re set.

This afternoon a medical student training to be a doctor came and asked Angie a bunch of questions.  It is part of a program where they have students come and talk to patients to see if they ask the right questions to try and diagnose the problem they came into the hospital for.  They asked us to pretend it was Monday and answer questions as if he were the doctor we saw a few days ago.  After that, he asked for a complete medical history.  I’m not sure he knew what he was asking for!  We proceeded to recount, with as few back-tracks as possible, a chronological list of all of the surgeries and procedures over her lifetime and especially in the last 6-8 years.  He seemed genuinely interested (he even admitted he’d like to become a heart surgeon, I think) and had very good bedside manor.  I’m sure he’ll be a great doctor.  One funny thing did happen: while he was doing his examination, he wanted to check Angie’s eyes.  He didn’t have a flashlight on him, so he pulled out his phone to use the camera flash as a flashlight and then sheepishly looked up at the man who was observing his interview and asked, “This probably isn’t appropriate, is it?”  “No, it isn’t appropriate at all.”  Whoops.  He went on to say, “Some older patients think you are taking their picture because they don’t realize you can use it as just a flashlight.”  Yeah, I can see why that’d be bad.  Poor guy; besides that, he did a fantastic job.

Jon came by a few hours ago to drop off a couple things and to chat for a minute.  As we were explaining the current state of things he asked, “So, what does it feel like to have the fluid sucked out of you?”  Angie retorted, “Draining, literally.”  We all cracked a wry smile at her humor.  It was good to see Jon and visit for a bit.

Tomorrow we’ve got a CT scan planned to look at Angie’s liver to make sure it is still functioning properly.  I’ll let you know how that goes.

Well, I think that just about covers events for the day.  Sorry for the wait.  I hope you find it was worth it 🙂

Pneumothoraxby Jim

The doctors just came by for their morning rounds to give us an update.  The plans for today are the same: just rest.  Dr. Rogers told us the chest x-ray from last night looks great as far as fluid build-up is concerned.  He said it was, “dramatically different” from the x-ray taken when she first arrived.  So, that’s good.  He also told us about the pneumothorax that has developed in her right lung (this is the collapse I mentioned last night).  He said it is very small and isn’t dangerous as long as it doesn’t get any bigger.  They’ve got another x-ray scheduled for this morning to keep an eye on it.

http://en.wikipedia.org/wiki/Pneumothorax

A Well-earned Day of Restby Jim

After the events of yesterday, the doctors have decided to cancel everything scheduled for today so Angie can just recover.  Her body went through a lot yesterday and just needs some time to rest.  Ironically, weeks ago, Angie had a CT scan scheduled for today.  Last night we got a voicemail from Lucile Packard Medical Center to remind us of her appointment tomorrow and gave instructions about when to arrive, etc.  Apparently, the didn’t get the memo that she was already here.  We thought it would be convenient because as it turned out, they wanted to do the CT scan today anyway, so we could just keep the original appointment.  But, after last night, everything has been canceled.

When I came in this morning, Angie was feeling much better and was just about to eat breakfast.  I was really worried when I first came in, because she was sitting in front of her meal with her eyes closed just sitting there.  I thought maybe she had fallen asleep or that she was in a lot of pain.  She was praying.  😉  I guess we don’t generally smile while we pray… maybe we should.  After she finished, I saw that she was is very good spirits and feeling much better than last night.  Breathing is still good and pain is under control.  When Angie got up earlier today to use the restroom, she commented that her body felt really exhausted.  The pain wasn’t bad (considering), but the hardest thing was just feeling weak.  She could tell that her body is just tired.  I think after today, we’ll be in much better shape.  CT scans aren’t fun, so I think a day of rest will better prepare her for the strain.

Thank you all for all of your prayers and love.

Roller Coasterby Jim

The rest of today was kind of a roller coaster.  Angie would be doing great, but then after getting up she would start experiencing terrible pain and have difficulty breathing.  We went back and forth with the chest tube in suction, then off, then on, etc.  They want her to drain, but I think it drained too much too quickly.  After the second episode, they called in the doctor and got some morphine ordered (she was at 8 — yes, we cracked Brian Regan jokes later) and did a chest x-ray.  A couple hours later, after the pain was more under control, the doctor returned to tell us that the fluid was almost entirely gone from the lung (for now), but that the lung has collapsed a little bit on the right side.  This is probably due to the amount of fluid she’s lost.  Her drainage tube is currently clamped, so she should be good until tomorrow.  She was able to get up and walk a bit with it clamped and she didn’t have as much pain as before, so we’re hoping that was the cause and now it is under control.
Now that she is comfortable, I finally feel like I can go get some sleep.  The very kind nurses have let me stay WAY past visiting hours without saying a word.  They have been very good to us.
Tomorrow the plan is for a liver CT scan, though I’m not sure when.

Catheterization Finishedby Jim

They just brought Angie back to our room.  I thought I’d have to go wait outside the recovery area, but they brought her right back to her bed.  She’s trying to sleep now since she isn’t supposed to get up for 4 hours after the procedure.

The cath went reasonably well.  Her pressures were really high, but they found lots of fluid around her right lung, and after draining it, the pressures improved.  Not yet to normal, but improved. They took out an additional 1.5 L of fluid during the procedure.  The catheterization revealed that her heart circuit is working properly.  The heart function is below normal, but isn’t “bad” (according to Dr. Lui).  They didn’t do any sort of repair while they were in there, because everything looked fine.  However, they still haven’t identified why the fluid is accumulating, but they have a few more things to check into.

During the ultrasound this morning, they saw some abnormalities in her liver.  They want to do a CT scan to investigate further, but not today.  It isn’t scheduled yet, but I presume we’ll be tackling that tomorrow sometime.  The rest of today is devoted to resting and recovering from the day’s events.

Thanks for your prayers and concern.

Cardiovascular Catheterizationby Jim

They just took Angie back to the cath lab to get started.  They have about an hour of prep (from what we were told last night) before they actually begin the procedure.  If everything looks normal, it should only be about two hours in the lab.  They are able to do some minor repairs while they’ve got the catheter in her heart, which could add an additional 2 hours.  They are able to install a stint and do a fenestration while they’re in there, but we’re hoping it won’t come to that.  I have to admit, I’m a little anxious about the procedure.  If they find something wrong with her heart, that could explain the problem with the fluid, but then there’s something wrong with her heart that they have to fix.  If they don’t find anything wrong, then we’re back to the guessing game to try and figure out what is happening.  I’m not sure which would be better.  I guess the best case would be that they find something wrong that they can fix while they are in the cath lab and that after she gets out, things start to improve.

Thank you all for your love and support at this difficult time.

Keep the prayers coming.