Dorothea was very worn out today.We spent the day in working with the weekend crew in chasing some high blood sugars and increasing her oral care. She is a mouth breather when she sleeps and since she can not have anything by mouth her lips, tongue, and mouth get very dry and crusty. She is now receiving oral care every hour and her last blood sugar, at 5:30 was 214 for which she got three units of regular insulin.
Tomorrow she will be back on dialysis and start pt and ot. She hears every thing that goes on around her but chooses not to comment on most of it. She will however when pressed open her eyes and answer questions and smile and say thank you for all the care she receives.
More tomorrow.
Sunday, February 28, 2010
Saturday, February 27, 2010
Saturday
Dorothea was very tired today, which I expected. I had a feeling the move would wipe her out a little bit. She had dialysis today which also makes her tired. Harold is working to educate the staff at the new hospital... we have specific requests of how we want certain things done... yes we are sort of a pain. But that is okay - we are her advocate!
She is very funny... I visited for less than an hour today, and she was listening to everything I was saying... I would check with her every once in a while and see if she was listening... and she always was. She would smile at the jokes, but rarely tried to speak. They have removed the speaking valve, so she is mouthing words again. They also removed the oxygen in the nose, and put her back on the oxygen shield. I think they might have done the oxygen through the nose so that it would be easier during transporation between hospitals. She is doing fine keeping all of her numbers in a good range.
Before I left I asked her to please show me her eyes (because she had not opened them up for me at all) - and she did oblige. I am getting ready to go on a business trip for a few days, and I really wanted to be able to see her eyes, so I am glad she made the extra effort.
Her spirits are good, she is just very tired. Hopefully she will get a good nights rest, and be more alert tomorrow. She will not have dialysis tomorrow, so that will also help with her energy level.
While I am out of town Harold will be blogging... go Dad! :)
She is very funny... I visited for less than an hour today, and she was listening to everything I was saying... I would check with her every once in a while and see if she was listening... and she always was. She would smile at the jokes, but rarely tried to speak. They have removed the speaking valve, so she is mouthing words again. They also removed the oxygen in the nose, and put her back on the oxygen shield. I think they might have done the oxygen through the nose so that it would be easier during transporation between hospitals. She is doing fine keeping all of her numbers in a good range.
Before I left I asked her to please show me her eyes (because she had not opened them up for me at all) - and she did oblige. I am getting ready to go on a business trip for a few days, and I really wanted to be able to see her eyes, so I am glad she made the extra effort.
Her spirits are good, she is just very tired. Hopefully she will get a good nights rest, and be more alert tomorrow. She will not have dialysis tomorrow, so that will also help with her energy level.
While I am out of town Harold will be blogging... go Dad! :)
Friday, February 26, 2010
Settled in - Friday night
Dorothea is now settled in at the Select Hospital. She is doing well, she remained stable throughout the move.
The phone number to the hospital is 913-596-4000. She is in Rm 408. She is probably not able to talk on the phone yet. She will need some time to get used to the speaking valve, and to have enough energy to use it.
Tomorrow morning they will have someone take pictures of all of her wounds that she has coming in, and will have a wound specialist take a look at all of them. She heals so slowly... but she is healing.
Harold filled the nurses in on all of the details with Dorothea and made sure to come to a compromise in regards to her insulin. I expect that there will be a few days of "transition" as the nursing staff learns how sensitive she is to medications, and how brittle her diabetes is. It feels so good to know that she has improved enough to move on to the next step.
The phone number to the hospital is 913-596-4000. She is in Rm 408. She is probably not able to talk on the phone yet. She will need some time to get used to the speaking valve, and to have enough energy to use it.
Tomorrow morning they will have someone take pictures of all of her wounds that she has coming in, and will have a wound specialist take a look at all of them. She heals so slowly... but she is healing.
Harold filled the nurses in on all of the details with Dorothea and made sure to come to a compromise in regards to her insulin. I expect that there will be a few days of "transition" as the nursing staff learns how sensitive she is to medications, and how brittle her diabetes is. It feels so good to know that she has improved enough to move on to the next step.
It's Moving Day!
Dorothea is moving today to the Long Term Acute Care center - called Select. Wow what a big day this has been!
This morning she was barely responsive and would not open her eyes... later on we learned that she had been given morphine last night. That explains it. Her hemoglobin was up to 12.3 - which is great. They now believe that the 6 she had yesterday was an inaccurate reading.
They removed her chest drainage tube today.
They put the speaking valve on her trach tube, and she is receiving her oxygen through her nose now. She is TALKING! Harold says that if she mouths something that he does not understand, then he tells her to use her voice, and she does! Wow - how wonderful it will be to be able to communicate with her.
This has all happened after I left the hospital - so I am hoping that I remembered to tell you everything I have been told.
She will be transported at 4:00 today, via ambulance I presume. Harold will follow along and make sure she gets settled into her new room and make sure that the staff knows all of the particulars about Dorothea. I will post again after she is transported and settled in.
Thank you, as always, for all of your prayers! Please keep them coming! She has a long road ahead of her.
This morning she was barely responsive and would not open her eyes... later on we learned that she had been given morphine last night. That explains it. Her hemoglobin was up to 12.3 - which is great. They now believe that the 6 she had yesterday was an inaccurate reading.
They removed her chest drainage tube today.
They put the speaking valve on her trach tube, and she is receiving her oxygen through her nose now. She is TALKING! Harold says that if she mouths something that he does not understand, then he tells her to use her voice, and she does! Wow - how wonderful it will be to be able to communicate with her.
This has all happened after I left the hospital - so I am hoping that I remembered to tell you everything I have been told.
She will be transported at 4:00 today, via ambulance I presume. Harold will follow along and make sure she gets settled into her new room and make sure that the staff knows all of the particulars about Dorothea. I will post again after she is transported and settled in.
Thank you, as always, for all of your prayers! Please keep them coming! She has a long road ahead of her.
Thursday, February 25, 2010
Thursday
Dorothea had dialysis again this morning. They are doing extra treatments this week to try to eliminate fluid that has built up in her legs. The doctor says that it is working, but there is still more to drain off of her legs.
It was a busy morning in her room today! We were joking about people taking numbers and waiting in line in the hall. They will be removing her chest tube today. They will also take away the IV feeding since she is tolerating the stomach tube feeding.
She is itching today! Not sure what is causing it, but she says that her whole body itches. Of course that is super frustrating when you cannot scratch. She is scratching her chest area, since she can easily reach it - but I don't like to see her do that. Her skin is so thin, I am afraid she is going to scratch too hard. But then again, it is good to see her using her hands and fingers! Ha!
We gave her some lotion this morning - and it hit me - what good therapy that is for her hands - so we will try to remember to do that on an ongoing basis and help with her motor skills.
Her hemoglobin was down to 6 today... so they gave her 2 bags of blood. There has been no apparent bleeding, so this is a mystery so far.
She has remained on the oxygen shield, and is holding good numbers.
It was a busy morning in her room today! We were joking about people taking numbers and waiting in line in the hall. They will be removing her chest tube today. They will also take away the IV feeding since she is tolerating the stomach tube feeding.
She is itching today! Not sure what is causing it, but she says that her whole body itches. Of course that is super frustrating when you cannot scratch. She is scratching her chest area, since she can easily reach it - but I don't like to see her do that. Her skin is so thin, I am afraid she is going to scratch too hard. But then again, it is good to see her using her hands and fingers! Ha!
We gave her some lotion this morning - and it hit me - what good therapy that is for her hands - so we will try to remember to do that on an ongoing basis and help with her motor skills.
Her hemoglobin was down to 6 today... so they gave her 2 bags of blood. There has been no apparent bleeding, so this is a mystery so far.
She has remained on the oxygen shield, and is holding good numbers.
Wednesday, February 24, 2010
Wednesday morning
Dorothea is doing fine this morning. She is having a dialysis procedure early this morning, and is still on the ventilator. They are planning to remove her chest drainage tube (from the by-pass surgery) sometime today.
Last night the nurse called Harold at home and asked him to come back up to the hospital. Dorothea was insisting that he come up to the hospital and take her home. She says this from time to time - but this was different. Harold stayed with her, holding her hand, and reassuring her for a long time. Every time he told her he was going to go home her lips started quivering. I cannot imagine how difficult yesterday afternoon and evening was for my parents. Sometimes she does not remember what happened the day before - but this time she does. Scary day for everyone. It felt so good to come in this morning and have her alert and talking and feeling well.
As always, please keep the prayers coming for both Dorothea and Harold.
Last night the nurse called Harold at home and asked him to come back up to the hospital. Dorothea was insisting that he come up to the hospital and take her home. She says this from time to time - but this was different. Harold stayed with her, holding her hand, and reassuring her for a long time. Every time he told her he was going to go home her lips started quivering. I cannot imagine how difficult yesterday afternoon and evening was for my parents. Sometimes she does not remember what happened the day before - but this time she does. Scary day for everyone. It felt so good to come in this morning and have her alert and talking and feeling well.
As always, please keep the prayers coming for both Dorothea and Harold.
Tuesday, February 23, 2010
Tuesday late afternoon
Dorothea's great day went downhill late this afternoon. About 4:15 this afternoon Harold was standing next to her bed talking with her, all of her numbers looked good. All of a sudden she mouthed "I can't breathe" - and she stopped breathing.
Harold went into the hall and called for a nurse to come quickly. Apparently many nurses and doctors came to take care of her. They put her back on the ventilator immediately. I apologize for my sketchy details... I was not there, and I am having trouble remembering the details. The lung specialist performed some type of test and determined that her bronchial tubes are red and swollen. He believes that her bronchial tubes went into a spasm, which caused her to stop breathing. They treated her with atrovent.
The doctor says that she has a mild case of bronchitis. In you or me, it would not be a big deal - but for Dorothea it is much different.
She was stabilized quickly, and all is okay.
Harold went into the hall and called for a nurse to come quickly. Apparently many nurses and doctors came to take care of her. They put her back on the ventilator immediately. I apologize for my sketchy details... I was not there, and I am having trouble remembering the details. The lung specialist performed some type of test and determined that her bronchial tubes are red and swollen. He believes that her bronchial tubes went into a spasm, which caused her to stop breathing. They treated her with atrovent.
The doctor says that she has a mild case of bronchitis. In you or me, it would not be a big deal - but for Dorothea it is much different.
She was stabilized quickly, and all is okay.
Standing up!
Wow - today has been a really good day! First thing this morning her nurse told me she was having a good day - and it has continued! :)
She was wide awake and talking with us for hours this morning. Okay mostly listening to me ramble - but she was participating in the conversations. I told her today that I have to talk a lot so I can limit how many words I have to lip read from her. LOL It is really challenging when she tries to start up a new subject...
They have had her on the oxygen shield all day today - hopefully tomorrow they will try to cap the trach so that she can try to talk. It will take a lot of effort on her part - so I told her that she needs to think about what she wants to say - she may only have enough energy for a little bit of talking.
They decided to go ahead and do dialysis again today - she is holding extra fluid in her legs. The doctor said it may take a few days to get that resolved.
She is continuing to be fed by both IV and stomach feeding tube, so she is getting lots of fluids. Her stomach and intestines seem to be working fine, no bleeding - yeah!
Physical therapy came in today and got her sitting up in the chair for quite a while and then stood her up 2 separate times for about 1 minute each time. They are supporting her - but the nurse told me that the second time up she could tell that she was taking on a little bit of the weight herself.
I was surprised that she was still awake and wanting to converse after all of that - but she was!
It has been a long time since they have been able to get her into a standing position - this was very exciting to hear about!!!
Please continue to pray for her strength and patience.
She was wide awake and talking with us for hours this morning. Okay mostly listening to me ramble - but she was participating in the conversations. I told her today that I have to talk a lot so I can limit how many words I have to lip read from her. LOL It is really challenging when she tries to start up a new subject...
They have had her on the oxygen shield all day today - hopefully tomorrow they will try to cap the trach so that she can try to talk. It will take a lot of effort on her part - so I told her that she needs to think about what she wants to say - she may only have enough energy for a little bit of talking.
They decided to go ahead and do dialysis again today - she is holding extra fluid in her legs. The doctor said it may take a few days to get that resolved.
She is continuing to be fed by both IV and stomach feeding tube, so she is getting lots of fluids. Her stomach and intestines seem to be working fine, no bleeding - yeah!
Physical therapy came in today and got her sitting up in the chair for quite a while and then stood her up 2 separate times for about 1 minute each time. They are supporting her - but the nurse told me that the second time up she could tell that she was taking on a little bit of the weight herself.
I was surprised that she was still awake and wanting to converse after all of that - but she was!
It has been a long time since they have been able to get her into a standing position - this was very exciting to hear about!!!
Please continue to pray for her strength and patience.
Monday, February 22, 2010
Monday
Dorothea was wide awake when I arrived at the hospital this morning. I come each day at 7:30, and usually she is still asleep and it takes a little while for her to wake up. Anyway - today she was wide awake and ready to talk. We talked for an hour or so - she was feeling pretty good. She is still on the ventilator, but they are hoping to get her back on to the oxygen shield later today. Since she was having dialysis again today, they wanted to wait until after that procedure before taking her off the vent. They are still needing to monitor her blood pressure closely (and dialysis makes it drop), so they kept her on the vent just to keep everything stable. She also still has an elevated CO2, but that number is coming down as well. Hopefully later today they will have her on the oxygen shield, and if she can keep her numbers good, then they may try to cap the trach again tomorrow.
They have started the peg feeding again today, hopefully her stomach and intestines are ready for it and will cooperate.
Physical Therapists came in today and had her dangle on the edge of the bed for a few minutes, and converted her bed into the chair position so that she could sit in a "chair" after they left. So, by the time I came back this afternoon she was pretty tired! She did open her eyes for me when I asked to see them before I left - but she mostly just wanted to rest. I knew she was listening to me talk, but she just didn't have the energy to participate.
They have started the peg feeding again today, hopefully her stomach and intestines are ready for it and will cooperate.
Physical Therapists came in today and had her dangle on the edge of the bed for a few minutes, and converted her bed into the chair position so that she could sit in a "chair" after they left. So, by the time I came back this afternoon she was pretty tired! She did open her eyes for me when I asked to see them before I left - but she mostly just wanted to rest. I knew she was listening to me talk, but she just didn't have the energy to participate.
Sunday, February 21, 2010
Never a dull moment
Shortly after I left the hospital this morning, there was a little excitement in her room. Hopefully I will re-tell it pretty accurately. I was told the story by Dad and the nurse.
The day before Dorothea had the colon surgery they took her off of all medication. They started her back up on all mediations today. One of the medicines is called Coreg, it is a medicine which lowers your blood pressure. (Remember yesterday or the day before when I was talking about her blood pressure being low...yes, not a good idea) Coreg is a medication that she has taken for years. However, when she first started taking it she had a lot of problem with her blood pressure dropping every time she stood up. So, the doctors had her go back to taking a very low dose, and gradually increased it to where it needed to be. Well, since they stopped giving it to her when they did the surgery, her body was not used to it. Today they gave her a full dose of it - and it did its job - it lowered her blood pressure a whole lot - too much. It also caused her CO2 to be way off also. The nurse called for help and a Harold says there was a mob in the room - and they came quickly. They quickly got her numbers back where they need to be. They went ahead and put her back on the ventilator so to help get the CO2 back to where it needs to be also.
She was wide awake, talking and smiling when I came to visit her this afternoon, so this did not seem to affect her.
She asked me to get her some water and was very surprised when I told her that I couldn't do that. I reminded her that they tried to give her ice chips the other day and she choked on them. It is dangerous to give her anything to eat or drink when she has not re-learned swallowing yet. One thing at a time...
They did allow her to suck on a small sponge that was soaked with water. That seemed to appease her for now.
The day before Dorothea had the colon surgery they took her off of all medication. They started her back up on all mediations today. One of the medicines is called Coreg, it is a medicine which lowers your blood pressure. (Remember yesterday or the day before when I was talking about her blood pressure being low...yes, not a good idea) Coreg is a medication that she has taken for years. However, when she first started taking it she had a lot of problem with her blood pressure dropping every time she stood up. So, the doctors had her go back to taking a very low dose, and gradually increased it to where it needed to be. Well, since they stopped giving it to her when they did the surgery, her body was not used to it. Today they gave her a full dose of it - and it did its job - it lowered her blood pressure a whole lot - too much. It also caused her CO2 to be way off also. The nurse called for help and a Harold says there was a mob in the room - and they came quickly. They quickly got her numbers back where they need to be. They went ahead and put her back on the ventilator so to help get the CO2 back to where it needs to be also.
She was wide awake, talking and smiling when I came to visit her this afternoon, so this did not seem to affect her.
She asked me to get her some water and was very surprised when I told her that I couldn't do that. I reminded her that they tried to give her ice chips the other day and she choked on them. It is dangerous to give her anything to eat or drink when she has not re-learned swallowing yet. One thing at a time...
They did allow her to suck on a small sponge that was soaked with water. That seemed to appease her for now.
Sunday
Mom was feeling a little distressed late yesterday afternoon. Her numbers were all good, so she was not in distress - but she was saying that she felt like she couldn't breathe. I was not there, but after hearing about it, and talking with the nurse that was there, we feel that maybe it was a little bit of anxiety that she was experiencing. They gave her a little bit of pain killer which helped her to relax and be able to get some rest. She seems to still have some of the medication with her this morning though. When I visited her this morning she did not open her eyes, and it took quite a bit of coaxing to get a little verbal acknowledgement that she knew we were there. I expected this though - it will take a little bit for the medication to wear off.
She will have dialysis again this afternoon. Perhaps after that she will feel like waking up.
The respiratory therapist is hoping to cap off her trach late this afternoon or tomorrow - but she will need to be alert for that to happen.
Her hemoglobin number was good this morning - no bleeding has occurred, so it appears that the bleeding issue is solved.
Her wound on her wrist and under her lip is healing very well - Dad and I both are encouraged by seeing that. She is a very slow healer, but it is encouraging to see that the nutrition is staying with her and helping her to heal.
She will have dialysis again this afternoon. Perhaps after that she will feel like waking up.
The respiratory therapist is hoping to cap off her trach late this afternoon or tomorrow - but she will need to be alert for that to happen.
Her hemoglobin number was good this morning - no bleeding has occurred, so it appears that the bleeding issue is solved.
Her wound on her wrist and under her lip is healing very well - Dad and I both are encouraged by seeing that. She is a very slow healer, but it is encouraging to see that the nutrition is staying with her and helping her to heal.
Saturday, February 20, 2010
Saturday afternoon
I just spoke with John about his visit this afternoon, and wanted to pass it along to all of you.
Dad brought their wedding album up to the hospital earlier this week (right after their anniversary)- he has shown it to many of the nurses... and they have loved getting to see it! While John was up at the hospital today he saw the album and started looking through it, and then went through it with mom and had her telling him who people were and talking about all of the details of the wedding that he could see in the pictures. It sounds like it was a great time for both John and mom!
Dad brought their wedding album up to the hospital earlier this week (right after their anniversary)- he has shown it to many of the nurses... and they have loved getting to see it! While John was up at the hospital today he saw the album and started looking through it, and then went through it with mom and had her telling him who people were and talking about all of the details of the wedding that he could see in the pictures. It sounds like it was a great time for both John and mom!
Saturday
Dorothea was receiving dialysis early this morning and was very alert. We talked about weekend plans, and I told her about a scary movie we watched last night. Harold brought in a letter from Lou and we looked through all of the pictures that she sent - I think she enjoyed that.
She did not have any bleeding overnight, but her hemoglobin dropped again to 7 - so they gave her 2 more units of blood during the dialysis treatment. There is no apparent bleeding, so we are not sure why the hemoglobin is dropping, so we will wait and see ... hopefully her numbers tomorrow will be back on track.
She is maintaining good blood pressure today,and doing well breating with the oxygen shield. Physical Therapy is planning on coming by later today and getting her up to sit on the edge of the bed.
She did not have any bleeding overnight, but her hemoglobin dropped again to 7 - so they gave her 2 more units of blood during the dialysis treatment. There is no apparent bleeding, so we are not sure why the hemoglobin is dropping, so we will wait and see ... hopefully her numbers tomorrow will be back on track.
She is maintaining good blood pressure today,and doing well breating with the oxygen shield. Physical Therapy is planning on coming by later today and getting her up to sit on the edge of the bed.
Friday, February 19, 2010
Friday
Dorothea is still pretty tired after surgery, but she opened her eyes a few times, and was responding to questions this morning.
Her hemoglobin had dropped this morning, along with her blood pressure. They gave her two units of blood during dialysis which helped her blood pressure tremendously. They also gave her a bag of plasma to help boost the blood factors. She did have a little bleeding overnight. It is possible that it was from bleeding that occurred prior to the surgery. The GI doctor was in this morning and let us know that this is the time when we wait and see. She believes that she took care of the problem in its entirety - the next few days will tell us.
She is back to just IV feeding so that her stomach and intestines have time to rest after surgery. It will be a few days most likely before they are feeding her through her stomach tube again.
Since she was sedated for surgery they needed to put her back on the ventilator, but hopefully today they will get her back on the oxygen shield.
She is receiving wonderful care from so many people. I am also so very thankful that Dad is there at the hopsital so much, he is able to provide so much "extra" help to the nursing staff to bridge the gap between all of the different nurses. He knows mom so well, and knows what works, what helps, what methods different nurses have used. The nurses seem to really appreicate the extra knowledge that he brings to the situation.
Her hemoglobin had dropped this morning, along with her blood pressure. They gave her two units of blood during dialysis which helped her blood pressure tremendously. They also gave her a bag of plasma to help boost the blood factors. She did have a little bleeding overnight. It is possible that it was from bleeding that occurred prior to the surgery. The GI doctor was in this morning and let us know that this is the time when we wait and see. She believes that she took care of the problem in its entirety - the next few days will tell us.
She is back to just IV feeding so that her stomach and intestines have time to rest after surgery. It will be a few days most likely before they are feeding her through her stomach tube again.
Since she was sedated for surgery they needed to put her back on the ventilator, but hopefully today they will get her back on the oxygen shield.
She is receiving wonderful care from so many people. I am also so very thankful that Dad is there at the hopsital so much, he is able to provide so much "extra" help to the nursing staff to bridge the gap between all of the different nurses. He knows mom so well, and knows what works, what helps, what methods different nurses have used. The nurses seem to really appreicate the extra knowledge that he brings to the situation.
Thursday, February 18, 2010
Thursday
Surgery was postponed till about 3pm. I have had a couple of people ask why the valve has to be removed. The ulcerations are at the very top of the large intestine, and apparently on the valve as well, so they need to be able to remove that section and bring the small and large intestine together.
It is very important that they get this bleeding to stop. Since she has been in the hospital (not incuding the bypass surgery itself) she has been given 15 units of blood. An average human has 8-10 pints of blood in the entire body.
She dangled on the edge of her bed for a short time this morning, and then they configured her bed into a chair position so she rested in a seated position for quite a while.
I was there when the speech therapist came by today and I realized that she is the mother of one of Brooklyn's good friends... small world - I had no idea she was her therapist! Yesterday they gave Dorothea some ice chips to see how she would do with swallowing. Unfortunately it did not go too well, she was not able to swallow them and choked on them a little bit. After this surgery she will need a little time to recover and get the sedation out of her system, then they can start again.
She is still draining quite a bit from the chest tube, so I don't think that will come out today. She will have dialysis in the morning, although she will not have much fluid for them to take since she they cut off her feeding yesterday afternoon after deciding to do this surgery.
It is very important that they get this bleeding to stop. Since she has been in the hospital (not incuding the bypass surgery itself) she has been given 15 units of blood. An average human has 8-10 pints of blood in the entire body.
She dangled on the edge of her bed for a short time this morning, and then they configured her bed into a chair position so she rested in a seated position for quite a while.
I was there when the speech therapist came by today and I realized that she is the mother of one of Brooklyn's good friends... small world - I had no idea she was her therapist! Yesterday they gave Dorothea some ice chips to see how she would do with swallowing. Unfortunately it did not go too well, she was not able to swallow them and choked on them a little bit. After this surgery she will need a little time to recover and get the sedation out of her system, then they can start again.
She is still draining quite a bit from the chest tube, so I don't think that will come out today. She will have dialysis in the morning, although she will not have much fluid for them to take since she they cut off her feeding yesterday afternoon after deciding to do this surgery.
Wednesday, February 17, 2010
Wednesday
Dorothea was wide eyed this morning...it was so nice to see her beautiful eyes! :) I teased with her about being stubborn yesterday and not opening her eyes much, but she didn't really remember what I was talking about.
She had a dialysis treatment this morning. They gave her one unit of blood, they also gave her one unit of blood last night.
Someone from the LTAC came today to evaluate her records and see if she is ready to be transferred to the LTAC. They have basically said that the one thing that will keep her in the hospital ICU is her GI issue. She is continuing to throw blood clots, and her hemoglobin continues to drop. This afternoon they performed some time of scan that shows active "bleeds." They were unable to detect any. They are assuming that all of this bleeding is coming from the top of the large intestine where they found ulcerations previously.
Dorothea was awake and able to be part of the discussion with the doctors. She agreed to the suggested plan put forth by the doctors. They are going to go in laproscopically Thursday morning and remove a 2 inch section of her intestine. The problem area is right where the small intestine and large intestine meet. Apparently there is also a valve there in between the two intestines. I am not clear on how the valve will be affected by this procedure. Harold mentioned that this may make her diarrehea worse, which if you know Dorothea well, this is a big bummer.
Please keep your prayers coming for Dorothea, and keep them coming for Harold as well.
She had a dialysis treatment this morning. They gave her one unit of blood, they also gave her one unit of blood last night.
Someone from the LTAC came today to evaluate her records and see if she is ready to be transferred to the LTAC. They have basically said that the one thing that will keep her in the hospital ICU is her GI issue. She is continuing to throw blood clots, and her hemoglobin continues to drop. This afternoon they performed some time of scan that shows active "bleeds." They were unable to detect any. They are assuming that all of this bleeding is coming from the top of the large intestine where they found ulcerations previously.
Dorothea was awake and able to be part of the discussion with the doctors. She agreed to the suggested plan put forth by the doctors. They are going to go in laproscopically Thursday morning and remove a 2 inch section of her intestine. The problem area is right where the small intestine and large intestine meet. Apparently there is also a valve there in between the two intestines. I am not clear on how the valve will be affected by this procedure. Harold mentioned that this may make her diarrehea worse, which if you know Dorothea well, this is a big bummer.
Please keep your prayers coming for Dorothea, and keep them coming for Harold as well.
Tuesday, February 16, 2010
Tuesday
Happy Birthday Harold!
Dorothea has had a pretty exciting day so far... or at least we think so... she moves her finger around like woo-hoo - making fun of us for being excited. Anyway - here is what she has done before noon today.
She sat in a cardiac chair for 2+ hours, Occupational therapists helped her to wash her face and arms and brush her teeth. That is exciting! Again, she doesn't think so, but we do! :)
She is still being very stubborn about opening her eyes. The nurse said she could get her to open her eyes when she insisted that she do it. For me... it is like she is playing a game -and it is something she can control - and she is not going to do it for me. She did open them once for me when Don and I saw her around lunch time. Of course she only kept them open for a few seconds... but at least she did it when I asked her to.
Harold said that this morning Dorothea said that she felt terrible - but when he asked her if she is in pain she said no. So, we think when she is saying that she feels terrible - she is meaning that she is really down because of still being in the hospital. The nurse sort of said the same thing to me this morning- and she is thinking that is why Dorothea is keeping her eyes closed so much of the time.
Hopefully physical therapists will be in later today to move her around a little more.
Still hoping to get the chest tube removed today... there was no drainage overnight, but there was some today. I imagine there will be a little more today because of being up in the chair.
Dorothea has had a pretty exciting day so far... or at least we think so... she moves her finger around like woo-hoo - making fun of us for being excited. Anyway - here is what she has done before noon today.
She sat in a cardiac chair for 2+ hours, Occupational therapists helped her to wash her face and arms and brush her teeth. That is exciting! Again, she doesn't think so, but we do! :)
She is still being very stubborn about opening her eyes. The nurse said she could get her to open her eyes when she insisted that she do it. For me... it is like she is playing a game -and it is something she can control - and she is not going to do it for me. She did open them once for me when Don and I saw her around lunch time. Of course she only kept them open for a few seconds... but at least she did it when I asked her to.
Harold said that this morning Dorothea said that she felt terrible - but when he asked her if she is in pain she said no. So, we think when she is saying that she feels terrible - she is meaning that she is really down because of still being in the hospital. The nurse sort of said the same thing to me this morning- and she is thinking that is why Dorothea is keeping her eyes closed so much of the time.
Hopefully physical therapists will be in later today to move her around a little more.
Still hoping to get the chest tube removed today... there was no drainage overnight, but there was some today. I imagine there will be a little more today because of being up in the chair.
Monday, February 15, 2010
Monday
Dorothea was still very tired today. Early this morning she had a dialysis treatment and they gave her another unit of blood. The medicine Harold mentioned in yesterday's blog (Paragoric) seemed to be wearing off, so she had 7 bloody stools throughout the night. However,the sedative part of the medicine seemed to be hanging on.
Physical therapy and occupational therapy came later in the day and Dorothea dangled her feet over the edge of the bed for 5-6 minutes. She sat by herself for about 1 minute.
She only opened her eyes two times today, so the entire time she was sitting on the edge of the bed,her eyes were closed.
She would sometimes respond to questions when people would be persistent about getting her to answer them.
The doctors have altered her feeding to something more basic, which they say will be more easily absorbed in the small intestine, which will give the large intestine a break - so perhaps that ulcer can heal better. Hopefully I got that right and didn't misrepresent any of that! So much of this is over my head! :)
We are hopeful that the sedative effects of the paragoric will be gone by morning so that she can sit in a chair again and have the trach capped again and start anew.
Physical therapy and occupational therapy came later in the day and Dorothea dangled her feet over the edge of the bed for 5-6 minutes. She sat by herself for about 1 minute.
She only opened her eyes two times today, so the entire time she was sitting on the edge of the bed,her eyes were closed.
She would sometimes respond to questions when people would be persistent about getting her to answer them.
The doctors have altered her feeding to something more basic, which they say will be more easily absorbed in the small intestine, which will give the large intestine a break - so perhaps that ulcer can heal better. Hopefully I got that right and didn't misrepresent any of that! So much of this is over my head! :)
We are hopeful that the sedative effects of the paragoric will be gone by morning so that she can sit in a chair again and have the trach capped again and start anew.
Sunday, February 14, 2010
Sunday
Yesterday afternoon Dr Miler suggested a method he had seen used to halt diarrhea, slowly titrated dosages of Paregoric. Since Dorothea's weight is about 62Kilos the minimum dosage would be about 15 ml. So he started her with 2 ml. As it turns out this was not only enough to halt the diarrhea but also enough to sedate her for the night and all of today. I was able to get her to open her eyes and smile only twice today but by 4pm she was starting to ease up some. Needless to say, he will try something else. She got another unit of blood this afternoon and will get another with the Dialysis tomorrow. She did have one of her chest drains removed today and the drainage from the other is reduced. She will have Dialysis tomorrow and hopefully be more aware.
Saturday, February 13, 2010
Saturday
Today is Harold and Dorothea's 45th wedding anniversary!!! Happy Anniversary Mom and Dad!!! :)
Dorothea had a great day! This morning she had a dialysis treatment, removing 3.2 liters of fluid. During dialysis they gave her a unit of blood to help boost her hemoglobin again. She is still experiencing some bleeding - hopefully that will subside soon.
The respiratory tech believes that her breathing episode Thursday night might be from the following - she has a lot of secretions (gunk) that is in her lungs. She has a hard time coughing this up, so it builds up for a while, and then they suction it out through her trachea tube. He believes that the other night they had her bed flat, or nearly flat, when they were cleaning up her bed, and he thinks that she may have been choking on the secretions. So, they are planning to always keep her bed at least at a 30 degree angle so that cannot happen.
She sat in a cardiac chair today for 2.5 hours!!! Wow - yes I said 2.5 hours! She was awake the whole time too - which is awesomely amazing. A cardiac chair comes in flat like a gurney so they can easily slide her onto it, and then set it at whatever angle is comfortable for her. This is a much easier transition for her rather than moving to a regular chair.
I went up to see her this evening and she was tired, which I expected, but she did wake up all the way and talk with me for a few minutes. She always wants to know what's going on with everyone...
If you have a chance, please send her a note and let her know what is going on in your life. She loves to hear about things going on.
Tonight the nurse told me that they are considering removing her chest drainage tubes tomorrow (from her bypass) - that would be really nice!
Dorothea had a great day! This morning she had a dialysis treatment, removing 3.2 liters of fluid. During dialysis they gave her a unit of blood to help boost her hemoglobin again. She is still experiencing some bleeding - hopefully that will subside soon.
The respiratory tech believes that her breathing episode Thursday night might be from the following - she has a lot of secretions (gunk) that is in her lungs. She has a hard time coughing this up, so it builds up for a while, and then they suction it out through her trachea tube. He believes that the other night they had her bed flat, or nearly flat, when they were cleaning up her bed, and he thinks that she may have been choking on the secretions. So, they are planning to always keep her bed at least at a 30 degree angle so that cannot happen.
She sat in a cardiac chair today for 2.5 hours!!! Wow - yes I said 2.5 hours! She was awake the whole time too - which is awesomely amazing. A cardiac chair comes in flat like a gurney so they can easily slide her onto it, and then set it at whatever angle is comfortable for her. This is a much easier transition for her rather than moving to a regular chair.
I went up to see her this evening and she was tired, which I expected, but she did wake up all the way and talk with me for a few minutes. She always wants to know what's going on with everyone...
If you have a chance, please send her a note and let her know what is going on in your life. She loves to hear about things going on.
Tonight the nurse told me that they are considering removing her chest drainage tubes tomorrow (from her bypass) - that would be really nice!
Friday, February 12, 2010
Friday news
Dorothea had a good evening Thursday with the boys. They had a good long visit and she told them goodnight when she was ready to rest.
Sometime yesterday evening the respiratory tech decided to put her on oxygen (through her nose). We are not sure if that was a precautionary measure, or if she needed extra help. Late last night she had a pretty rough time with her breathing and her heartrate, so they put her back on the ventilator until things calmed down. She was put back on the oxygen shield early this morning right after I came in.
She had another bleed last night, so we will have to wait and see if that was an isolated incident or not. If not, then they may want to scope her again.
She was very exhausted from the trauma overnight, so she was not very alert early this morning. She had dialysis this afternoon. She will probably be very tired tonight and get some much needed rest.
We visited one of the L-TAC's yesterday and one today. We are very pleased with the one we visited today, so we will let the doctors know that when she is ready to be moved, we would like her to be transferred to Select Specialty hospital - it is on the 4th floor of Providence hospital in Kansas City, KS.
http://selectspecialtyhospitals.com/company/locations/kansascity.aspx
Sometime yesterday evening the respiratory tech decided to put her on oxygen (through her nose). We are not sure if that was a precautionary measure, or if she needed extra help. Late last night she had a pretty rough time with her breathing and her heartrate, so they put her back on the ventilator until things calmed down. She was put back on the oxygen shield early this morning right after I came in.
She had another bleed last night, so we will have to wait and see if that was an isolated incident or not. If not, then they may want to scope her again.
She was very exhausted from the trauma overnight, so she was not very alert early this morning. She had dialysis this afternoon. She will probably be very tired tonight and get some much needed rest.
We visited one of the L-TAC's yesterday and one today. We are very pleased with the one we visited today, so we will let the doctors know that when she is ready to be moved, we would like her to be transferred to Select Specialty hospital - it is on the 4th floor of Providence hospital in Kansas City, KS.
http://selectspecialtyhospitals.com/company/locations/kansascity.aspx
Thursday, February 11, 2010
Sitting up in a chair, breathing on her own!
Woo Hoo! Dorothea sat up in a chair for about one hour this morning! Harold says that lots of nurses stopped by to talk with her when they saw her sitting up. I am sure they were all moved by seeing that!
They have capped the trachea, and she is breathing on her own, with no oxygen support. She has been able to keep her oxygen level around 95%, which is good. I imagine they will keep a close eye on her, and provide oxygen only if necessary. What a great morning!
We are going to visit the L-TAC this afternoon and check out the facility.
They have capped the trachea, and she is breathing on her own, with no oxygen support. She has been able to keep her oxygen level around 95%, which is good. I imagine they will keep a close eye on her, and provide oxygen only if necessary. What a great morning!
We are going to visit the L-TAC this afternoon and check out the facility.
Talking!
Dorothea now has a new gadget...I am going to call it a speaking valve on her trachea tube. It allows her to talk without covering the hole. She is talking, but very softly still. The oxygen machine creates alot of noise, so it is still a little difficult to hear her. However, here is the plan for today. Later this morning they are planning on putting a temporary cap over the speaking valve. This will force her to breathe using her mouth and nose only - not the tube. This will allow her to talk normally. They will give her oxygen through her nose if she needs it. If she is able to hold her numbers without the oxygen, then they will let her do it all on her own. This seems like such a huge step forward!
Mom again said she was ready to go home, and she said she wanted to get dressed! It is so good to hear her have a sense of humor! :)
Harold told her about the plans for moving her to a L-TAC facility and she didn't seem to react at all to that - so that is good. She knows that is one step closer to home.
She was very alert and talkative this morning. They are planning on getting her up into a chair today, that would also be a very positive move forward.
Mom again said she was ready to go home, and she said she wanted to get dressed! It is so good to hear her have a sense of humor! :)
Harold told her about the plans for moving her to a L-TAC facility and she didn't seem to react at all to that - so that is good. She knows that is one step closer to home.
She was very alert and talkative this morning. They are planning on getting her up into a chair today, that would also be a very positive move forward.
Wednesday, February 10, 2010
Wednesday
Early this morning the doctors placed a new port for dialysis in Dorothea's chest. I am sure she is glad to have the tubes out of her neck! :) While she still had some sedation in her, they switched out her trachea tube for a smaller one. With this new tube, she will be able to talk. She was too tired today to try this, but hopefully tomorrow she will have more energy and try it. She will need to cover the hole with her hand when she wants to talk.
This afternoon she had dialysis. As usual, this procedure made her very tired. The physical therapists came when she was having dialysis treatment, so they were not able to do any work with her today. Her nurse did get her to dangle her legs for about 3 minutes though.
Looking forward to tomorrow, hopefully she will have enough energy to try to talk.
This afternoon she had dialysis. As usual, this procedure made her very tired. The physical therapists came when she was having dialysis treatment, so they were not able to do any work with her today. Her nurse did get her to dangle her legs for about 3 minutes though.
Looking forward to tomorrow, hopefully she will have enough energy to try to talk.
Tuesday, February 9, 2010
Tuesday's tale...sort of a mini-novel
Dorothea had a good morning and afternoon. She had one of our favorite nurses today, Candy. She worked mom's arms and legs this morning, and got her up to dangle her feet on the side of the bed. She will have Candy again tomorrow! :) and Candy is planning on trying to get her into a chair tomorrow.
Physical therapists came today also and had her dangle her feet over the side of the bed for 7-8 minutes, a few minutes of that she sat without assistance. And the big news for today is that mom brushed her teeth today! Bless her heart, that had to feel soooo good!
They have her scheduled for 8am Wednesday to have the dialysis port moved from her neck to her chest, then she will have dialysis Wednesday afternoon.
She has developed another infection in her lungs, this one is called Pseudomonas. Apparently it is a common bacteria, but her particular one is resistant to medications. Not exactly sure what that means, but no one seemed overly concerned about it. They are giving her medication to treat it, we will continue to wear a gown and gloves since she will remain in "isolation."
She has been doing really well on the oxygen shield, even overnight. The lung specialist told Harold today that they if she continues to do well this week, they will try her with a different tube on Thursday. I believe they insert a narrow tube into her existing trach tube, and she can attempt to talk around the smaller tube. Keep your fingers crossed - how wonderful it would be for Dorothea if she could fully communicate with us!
We had a meeting in the Conference room with doctors and nurses this morning so that we could all talk and listen to each other about where Dorothea is at, and what we can expect to happen. There are no time lines given of course, every person heals at a different rate. What we do know is that this will take a long time... long is a very vague word... so we will just take one day at a time. When she is ready to leave ICU, she will go to a Long Term Acute Care facility - L-TAC for short. L-TAC facilities will take patients with a trach tube OR dialysis...but not both. So, she has to get off of one or the other before this will be feasible. Once she is transferred to an L-TAC she will need to gain strength. (This has been a real challenge so far because of all the issues with feeding her - she just hasn't gotten much nutrition these past four weeks).
They do not provide rehabilitation therapy at the L-TAC though. A rehab facility would be her next stop on this journey, but they will only admit patients who are able to do 3 hours of therapy a day - in other words, till they are really ready for rehab. As you can see, this will be a long process. However, it is good to at least have an idea of what steps are involved. Harold began researching some of the L-TAC facilities in the area - there are 4 or 5 in the KC Metro area. One of the nurses suggested that we visit some of the facilities to get a feel for which one we like best, that way when she is ready to go, we will be prepared.
After we had the meeting this morning I was thinking about something that I have thought about many times in my life... what a STRONG WOMAN my mom is!!! She has dealt with so many health issues over the years, and she just keeps trudging right along. She doesn't complain about any of it, she just accepts her cross to bear, and keeps on going. Some of you may know these lyrics that give me strength and hope...
Here is part of it:
Strength will rise as we wait upon the Lord,
We will wait upon the Lord
We will wait upon the Lord
You are the everlasting God
The everlasting God
You do not faint, You won't grow weary
You're the defender of the weak
You comfort those in need
You lift us up on wings like eagles
Physical therapists came today also and had her dangle her feet over the side of the bed for 7-8 minutes, a few minutes of that she sat without assistance. And the big news for today is that mom brushed her teeth today! Bless her heart, that had to feel soooo good!
They have her scheduled for 8am Wednesday to have the dialysis port moved from her neck to her chest, then she will have dialysis Wednesday afternoon.
She has developed another infection in her lungs, this one is called Pseudomonas. Apparently it is a common bacteria, but her particular one is resistant to medications. Not exactly sure what that means, but no one seemed overly concerned about it. They are giving her medication to treat it, we will continue to wear a gown and gloves since she will remain in "isolation."
She has been doing really well on the oxygen shield, even overnight. The lung specialist told Harold today that they if she continues to do well this week, they will try her with a different tube on Thursday. I believe they insert a narrow tube into her existing trach tube, and she can attempt to talk around the smaller tube. Keep your fingers crossed - how wonderful it would be for Dorothea if she could fully communicate with us!
We had a meeting in the Conference room with doctors and nurses this morning so that we could all talk and listen to each other about where Dorothea is at, and what we can expect to happen. There are no time lines given of course, every person heals at a different rate. What we do know is that this will take a long time... long is a very vague word... so we will just take one day at a time. When she is ready to leave ICU, she will go to a Long Term Acute Care facility - L-TAC for short. L-TAC facilities will take patients with a trach tube OR dialysis...but not both. So, she has to get off of one or the other before this will be feasible. Once she is transferred to an L-TAC she will need to gain strength. (This has been a real challenge so far because of all the issues with feeding her - she just hasn't gotten much nutrition these past four weeks).
They do not provide rehabilitation therapy at the L-TAC though. A rehab facility would be her next stop on this journey, but they will only admit patients who are able to do 3 hours of therapy a day - in other words, till they are really ready for rehab. As you can see, this will be a long process. However, it is good to at least have an idea of what steps are involved. Harold began researching some of the L-TAC facilities in the area - there are 4 or 5 in the KC Metro area. One of the nurses suggested that we visit some of the facilities to get a feel for which one we like best, that way when she is ready to go, we will be prepared.
After we had the meeting this morning I was thinking about something that I have thought about many times in my life... what a STRONG WOMAN my mom is!!! She has dealt with so many health issues over the years, and she just keeps trudging right along. She doesn't complain about any of it, she just accepts her cross to bear, and keeps on going. Some of you may know these lyrics that give me strength and hope...
Here is part of it:
Strength will rise as we wait upon the Lord,
We will wait upon the Lord
We will wait upon the Lord
You are the everlasting God
The everlasting God
You do not faint, You won't grow weary
You're the defender of the weak
You comfort those in need
You lift us up on wings like eagles
Monday, February 8, 2010
Monday update
Dorothea had dialysis again this morning. They took off 2.7 liters...it is amazing how much fluid they remove from her. Remember the mouth sponge thing I was talking about the other day? Today mom used it herself (with a little assistance) - which I am sure she liked having that control.
Physical therapists came today and had her dangle her feet over the edge and she sat up without ANY support for a few minutes. WOW - these things that we take for granted are such a huge step forward for Dorothea - I wish I had been there to see this. Harold also said that she worked her arms and legs around today on her own.
A few of the doctors are getting together tomorrow morning to have a meeting to get everyone on the same page and review where we have come from, and where we are going. This will be a good opportunity to get everyone talking to each other, and therefore working together. Tuesday will be 4 weeks since she entered the hospital. Friday will be 4 weeks since the by-pass surgery. I hope to have many more good things to tell you tomorrow~
Physical therapists came today and had her dangle her feet over the edge and she sat up without ANY support for a few minutes. WOW - these things that we take for granted are such a huge step forward for Dorothea - I wish I had been there to see this. Harold also said that she worked her arms and legs around today on her own.
A few of the doctors are getting together tomorrow morning to have a meeting to get everyone on the same page and review where we have come from, and where we are going. This will be a good opportunity to get everyone talking to each other, and therefore working together. Tuesday will be 4 weeks since she entered the hospital. Friday will be 4 weeks since the by-pass surgery. I hope to have many more good things to tell you tomorrow~
Monday
Sorry I did not get anything posted Sunday. I was out of town, and I was unable to post from our laptop, it would not allow me to sign into my account.
Harold reported that Sunday was a good day. Dorothea had dialysis in the morning, slept quite a bit in the afternoon. I have just gotten back in town, so I have not seen her yet today. I talked to John earlier today when he was leaving the hospital and he said that all was good. Sorry no details for now, but you know what they say - no news is good news! :)
Harold reported that Sunday was a good day. Dorothea had dialysis in the morning, slept quite a bit in the afternoon. I have just gotten back in town, so I have not seen her yet today. I talked to John earlier today when he was leaving the hospital and he said that all was good. Sorry no details for now, but you know what they say - no news is good news! :)
Saturday, February 6, 2010
Saturday afternoon
The colonscopy revealed a small ulceration at the top of the large intestine. The Dr. "cleaned up" the area, but that is all they can do for it, it will need to heal on its own. They will keep Dorothea off of all blood thinners until the bleeding stops completely.
The physical therapists came in again today (I did not realize that they came yesterday also). Both today and yesterday that had her dangle her feet over the edge of the bed while sitting up with assistance. Both days she was up for about 8 minutes. They felt that she was doing better and becoming looser. She was moving her arms and reached across her body.
I need to tell a funny story - although I am sure it will not be near as funny to any of you. The nurses use a large spongy swab to clean out Dorothea's mouth. She does NOT like this activity. She often turns her head or purses her lips and tries to delay the inevitable. This afternoon she was in pretty good spirits and was having all of her many dressings changed, and at the very end the nurse wanted to swab out her mouth. She asked Dorothea to open up and she shook her head no and pursed her lips. The nurse gently persisted and reminded her that she had to do this and she did not want to have to force her way into her mouth. So, Dorothea smiled,opened her mouth, and then as soon as the nurse started to put the swab in, she closed her lips tightly! She did this two or three times in a row - smiling the hole time - I am sure laughing inside! It was so good to see her have a sense of humor in the midst of all of this. I can't wait to be able to hear her laugh, and hear her voice again.
Today definitely lifted my spirits. The nurse, respiratory tech, and physical therapist also commented on the little improvements they were noticing today.
The physical therapists came in again today (I did not realize that they came yesterday also). Both today and yesterday that had her dangle her feet over the edge of the bed while sitting up with assistance. Both days she was up for about 8 minutes. They felt that she was doing better and becoming looser. She was moving her arms and reached across her body.
I need to tell a funny story - although I am sure it will not be near as funny to any of you. The nurses use a large spongy swab to clean out Dorothea's mouth. She does NOT like this activity. She often turns her head or purses her lips and tries to delay the inevitable. This afternoon she was in pretty good spirits and was having all of her many dressings changed, and at the very end the nurse wanted to swab out her mouth. She asked Dorothea to open up and she shook her head no and pursed her lips. The nurse gently persisted and reminded her that she had to do this and she did not want to have to force her way into her mouth. So, Dorothea smiled,opened her mouth, and then as soon as the nurse started to put the swab in, she closed her lips tightly! She did this two or three times in a row - smiling the hole time - I am sure laughing inside! It was so good to see her have a sense of humor in the midst of all of this. I can't wait to be able to hear her laugh, and hear her voice again.
Today definitely lifted my spirits. The nurse, respiratory tech, and physical therapist also commented on the little improvements they were noticing today.
Saturday
Dorothea was communicating with us this morning, but very tired. She released 4 blood clots Friday evening, and was given 2 units of blood. I imagine this explains some of her tiredness.
The colonscopy will be done today. Hopefully they will find the source of the bleeding and be able to take care of it today. Since the colonoscopy was not going to happen until midday, the doctor decided to reschedule the dialysis for Sunday. She still needs the dialysis port moved, so perhaps they will do that today also.
She used the ventilator overnight, but was back on the oxygen shield this morning. She was breathing easily on the shield, which is good to see. I will post later today to let you all know what they find out with the colonscopy.
The colonscopy will be done today. Hopefully they will find the source of the bleeding and be able to take care of it today. Since the colonoscopy was not going to happen until midday, the doctor decided to reschedule the dialysis for Sunday. She still needs the dialysis port moved, so perhaps they will do that today also.
She used the ventilator overnight, but was back on the oxygen shield this morning. She was breathing easily on the shield, which is good to see. I will post later today to let you all know what they find out with the colonscopy.
Friday, February 5, 2010
Friday update! :)
John just called and gave a much different report from this evening. Dorothea was alert for an hour or more with John and Bob tonight. She listened to them telling her about what is going on with their kids, activities etc., and then she would mouth things to them also. It is great to hear that she was so alert with them. John thinks perhaps the dialysis just wore her out too much earlier today.
She was on the oxygen shield while they were there, but apparently they were going to put her back on the ventilator for night time.
She was on the oxygen shield while they were there, but apparently they were going to put her back on the ventilator for night time.
Friday
Sorry for the late post...
Dorothea had dialysis this morning, taking off .5 liter of fluid today.
She bled out some blood clots last night, so they have decided they are going to go ahead and do the colonoscopy on Saturday. She will also have dialysis on Saturday. They are waiting to move the dialysis port. They are still planning on it though.
They took her off the ventilator this morning and had her using the oxygen shield. I am not sure how long she was on it since I was not there for the duration of the day.
She was not very alert today. She would occasionally open her eyes, and she would show acknowledgement that she recognized us and would smile at us. She seemed to have a lot of trouble keeping her eyes open though - they would only be open for less than a minute and she would blink them really hard like she was trying to force them to open up. It is very hard to see her like this.
Dorothea had dialysis this morning, taking off .5 liter of fluid today.
She bled out some blood clots last night, so they have decided they are going to go ahead and do the colonoscopy on Saturday. She will also have dialysis on Saturday. They are waiting to move the dialysis port. They are still planning on it though.
They took her off the ventilator this morning and had her using the oxygen shield. I am not sure how long she was on it since I was not there for the duration of the day.
She was not very alert today. She would occasionally open her eyes, and she would show acknowledgement that she recognized us and would smile at us. She seemed to have a lot of trouble keeping her eyes open though - they would only be open for less than a minute and she would blink them really hard like she was trying to force them to open up. It is very hard to see her like this.
Thursday, February 4, 2010
Thursday afternoon
The Physical Therapists came today and had mom "dangle" her feet over the edge of the bed for 7-8 minutes. They also loosened her torso up a bit. Harold said that after they did that her respiration was better and she drained a lot of fluid off of her lungs (through the chest tube). PT will definitely be a huge help in Dorothea's recovery.
As I mentioned earlier today Dorothea was having some difficulty breathing. They went ahead and put her back on the ventilator early this afternoon. It was a relief to see her come back to a restful breathing pattern and be able to rest. They set the machine to do 100% of the work, and let her just rest. When I left, the plan was to have her on the machine for 3 hours, and then try the oxygen shield again and see if she could handle it without difficulty. I believe they are going to try a more gradual approach now - she had been on the oxygen shield for about 36 hours and it was just too much for her at this point.
Dr Miller spent a good amount of time in the room with us talking over the situation, it was very nice. The longer he stayed and the more we talked through things, he came up with a possible solution to explain what we were seeing. Yesterday they began to feed her through the PEG(stomach tube), and she is also still being fed intravenously. Her carbohydrate intake had dramatically increased. Apparently when our bodies convert carbohydates to sugar, carbon dioxide is released. So Dorothea has all this new CO2 being released, that she needs to expel. So her body is working really hard to expel all of it - and breathing very quickly and labored. The Dr. decreased her food intake and is expecting her breathing to become easier within 8-12 hours. I really hope he is right. Tomorrow morning will be dialysis time again, which will drain her even more. So it would be really nice if she could at least breathe easily!
They will be putting in a new port for the dialysis. The shunt she has now is on the side of her neck. They want to move it away from the trachea tube (to prevent infection) so it will be placed in her upper chest. This will now allow her to have more movement in her neck which will be good.
Please continue to pray for Dorothea, Harold, and all of the staff involved in her care. Thank you for your continued support!
As I mentioned earlier today Dorothea was having some difficulty breathing. They went ahead and put her back on the ventilator early this afternoon. It was a relief to see her come back to a restful breathing pattern and be able to rest. They set the machine to do 100% of the work, and let her just rest. When I left, the plan was to have her on the machine for 3 hours, and then try the oxygen shield again and see if she could handle it without difficulty. I believe they are going to try a more gradual approach now - she had been on the oxygen shield for about 36 hours and it was just too much for her at this point.
Dr Miller spent a good amount of time in the room with us talking over the situation, it was very nice. The longer he stayed and the more we talked through things, he came up with a possible solution to explain what we were seeing. Yesterday they began to feed her through the PEG(stomach tube), and she is also still being fed intravenously. Her carbohydrate intake had dramatically increased. Apparently when our bodies convert carbohydates to sugar, carbon dioxide is released. So Dorothea has all this new CO2 being released, that she needs to expel. So her body is working really hard to expel all of it - and breathing very quickly and labored. The Dr. decreased her food intake and is expecting her breathing to become easier within 8-12 hours. I really hope he is right. Tomorrow morning will be dialysis time again, which will drain her even more. So it would be really nice if she could at least breathe easily!
They will be putting in a new port for the dialysis. The shunt she has now is on the side of her neck. They want to move it away from the trachea tube (to prevent infection) so it will be placed in her upper chest. This will now allow her to have more movement in her neck which will be good.
Please continue to pray for Dorothea, Harold, and all of the staff involved in her care. Thank you for your continued support!
Thursday morning/Wednesday evening
When John was visiting last night they inserted a smaller tube into Dorothea's trach tube and were trying to get her to talk, but she was not able to do it yet. It is good to see them trying though. I was teasing her this morning... wondering what will be the first thing she will say when she is able to use her voice again.
They decided to put her on the ventilator tube last night since she was working too hard with just the oxygen shield. When we arrived this morning they had taken her off of the ventilator and put the oxygen shield back on. However, her breathing was very labored so they were discussing putting her back on the ventilator tube. They also took a chest xray - wanting to see if there is something going on that is making it more difficult now. When she is having more difficulty breathing her number of respirations increase, her heart rate increases, and her oxygen saturation decreases...and it makes her tired! Don and I were hoping to see her with more energy this morning, but she was zapped from breathing so hard.
She has had a couple of low blood sugars so they are keeping an eye on that and making adjustments accordingly.
Going back to see her mid-day, so if there is anything new I will post again late tonight.
They decided to put her on the ventilator tube last night since she was working too hard with just the oxygen shield. When we arrived this morning they had taken her off of the ventilator and put the oxygen shield back on. However, her breathing was very labored so they were discussing putting her back on the ventilator tube. They also took a chest xray - wanting to see if there is something going on that is making it more difficult now. When she is having more difficulty breathing her number of respirations increase, her heart rate increases, and her oxygen saturation decreases...and it makes her tired! Don and I were hoping to see her with more energy this morning, but she was zapped from breathing so hard.
She has had a couple of low blood sugars so they are keeping an eye on that and making adjustments accordingly.
Going back to see her mid-day, so if there is anything new I will post again late tonight.
Wednesday, February 3, 2010
Slowly improving
We celebrate all improvements - as minor as they may seem, every one seems like a big step to us. Dorothea received another dialysis treatment this morning,and was awake during much of it. She had no bleeding overnight. They did not use the heparin with this dialysis treatment, so later today and tonight will be the true test to see if the bleeding has stopped.
They had planned to put her back on the ventilator last night while she slept, but she seemed to do better on the oxygen shield, so they put her back on the oxygen shield, and that is all she used overnight. That is really good news. She is preferring to do the work herself, so that is very positive. The infectious disease doctor came by and told Harold that her white blood cell count is good, and her fever has remained very low grade or none for days - so feel that the pneumonia is taken care of. As of this afternoon we are still required to wear gowns and gloves, but perhaps that precaution will be lifted soon.
Her kidneys put out 160 ml overnight - wow - that is quite a jump. Slowly but surely it seems as though her kidneys are "waking up."
She continues to be frstrated with all of us when we do not understand what she is saying - but perhaps that will just serve as motivation to strengthen her hands enough to write, and strengthen her lungs enough to get the trach tube out!
They had planned to put her back on the ventilator last night while she slept, but she seemed to do better on the oxygen shield, so they put her back on the oxygen shield, and that is all she used overnight. That is really good news. She is preferring to do the work herself, so that is very positive. The infectious disease doctor came by and told Harold that her white blood cell count is good, and her fever has remained very low grade or none for days - so feel that the pneumonia is taken care of. As of this afternoon we are still required to wear gowns and gloves, but perhaps that precaution will be lifted soon.
Her kidneys put out 160 ml overnight - wow - that is quite a jump. Slowly but surely it seems as though her kidneys are "waking up."
She continues to be frstrated with all of us when we do not understand what she is saying - but perhaps that will just serve as motivation to strengthen her hands enough to write, and strengthen her lungs enough to get the trach tube out!
Tuesday, February 2, 2010
Tuesday tidbits
Dorothea was taken off of the ventilator today. They have placed an oxygen shield over her tracheotomy tube. So she is still breathing through the tracheotomy tube, but she is having to do all of the work herself. An "oxygen shield" is basically an oxygen mask that is placed over the trach tube instead of over her mouth. They also removed the sutures from around the trach tube.
Early this afternoon the physical therapists came in and sat her up on the edge of her bed for about 2 minutes. She was extremely uncomfortable and began to pound her fist into the bed. She doesn't move much, so for her to pound her fist, she must have been really agitated. She did not want to open her eyes up after that. I had to leave shortly after that, and she had quite a frown on her face.
I don't know what they call them - but they have put back on these blow up things on her lower legs. Every so often air blows into them, which increases the circulation in her legs. Her legs and feet are very stiff from lack of movement.
She had two bleeds overnight, so the doctors are still wanting to consider a colonoscopy, but Harold is wanting them to hold off. He still thinks that the heparin from the dialysis might be a contributing factor. Tomorrow they are going to do another dialysis treatment, but they are going to use something different than heparin.
Early this afternoon the physical therapists came in and sat her up on the edge of her bed for about 2 minutes. She was extremely uncomfortable and began to pound her fist into the bed. She doesn't move much, so for her to pound her fist, she must have been really agitated. She did not want to open her eyes up after that. I had to leave shortly after that, and she had quite a frown on her face.
I don't know what they call them - but they have put back on these blow up things on her lower legs. Every so often air blows into them, which increases the circulation in her legs. Her legs and feet are very stiff from lack of movement.
She had two bleeds overnight, so the doctors are still wanting to consider a colonoscopy, but Harold is wanting them to hold off. He still thinks that the heparin from the dialysis might be a contributing factor. Tomorrow they are going to do another dialysis treatment, but they are going to use something different than heparin.
Monday, February 1, 2010
Monday news
Dorothea had a dialysis treatment this morning for 3.5 hours. Shortly after the treatment was over she "forgot" to breathe for a short while. Harold describes it as apnea. She is very tired after dialysis so the nurse thinks that she was just so tired, and while sleeping she forgot to breathe. The respiratory therapist was called and they raised the assistance level of the ventilator to help her get past this issue.
Later in the afternoon mom had another bad bleed. The doctors discussed the possiblity of doing a colonoscopy, but after discussing it with Harold, I believe they are tabling that idea at this time. That seems like it would be way too hard on Dorothea's body at this time. She had one done within the last 6 months. Harold is still thinking that the bleeding may be related to the renal catheter. All of her skin is so fragile, so it is possible that all of this bleeding is because of the catheter. Tomorrow morning they will re-evaluate.
Her kidneys are working a little better each day. The last few shifts (12-hour shifts) she has put out 5ml, then 10, 20, 56, and today her output was 40 - which considering she had dialysis done, 40 is pretty good. Hopefully this means that her kidneys are making a turn around - let's hope! The kidney specialist is considering a different type of dialysis that does not require the use of heparin. Apparently heparin affects your blood clotting, so it may have something to do with the bleeding... again - we will wait and see what they have to say. I do not think she is scheduled again for dialysis until Thursday - so that gives them a little time to work on a solution.
Dorothea was still alert when she was awake, and talked a little. Her mood today was definitley more reserved than yesterday, but again the dialysis zaps her energy level.
Later in the afternoon mom had another bad bleed. The doctors discussed the possiblity of doing a colonoscopy, but after discussing it with Harold, I believe they are tabling that idea at this time. That seems like it would be way too hard on Dorothea's body at this time. She had one done within the last 6 months. Harold is still thinking that the bleeding may be related to the renal catheter. All of her skin is so fragile, so it is possible that all of this bleeding is because of the catheter. Tomorrow morning they will re-evaluate.
Her kidneys are working a little better each day. The last few shifts (12-hour shifts) she has put out 5ml, then 10, 20, 56, and today her output was 40 - which considering she had dialysis done, 40 is pretty good. Hopefully this means that her kidneys are making a turn around - let's hope! The kidney specialist is considering a different type of dialysis that does not require the use of heparin. Apparently heparin affects your blood clotting, so it may have something to do with the bleeding... again - we will wait and see what they have to say. I do not think she is scheduled again for dialysis until Thursday - so that gives them a little time to work on a solution.
Dorothea was still alert when she was awake, and talked a little. Her mood today was definitley more reserved than yesterday, but again the dialysis zaps her energy level.
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