Wednesday morning

Dad's tracheostomy yesterday went without a hitch. Per Mom's instructions, they left his moustache on--I can't wait to see him with that! He was at 100% oxygen just after the surgery, but during the 4:30 visit they cranked it back down to 40%, where it had been before. Both his white blood cell count and his bilirubin count are down, which is encouraging. Now they'll begin the process of weaning him from the respirator, a process that'll be slowed down by his continuing pneumonia. The physician's assistant this morning said they'll try to wean him today but that they don't expect to be successful because of all the fluid still in his lungs. If they can't wean him from the respirator, the progress of his recovery will be quite different. With the trache tube in place, he wouldn't be eligible for the in-hospital rehab program but would instead have to go to a nursing home. So we need continued prayers for his lungs--that the pneumonia continues to clear up and that he starts working his lungs on his own! Emily informed us that St. Bernardine of Siena is the patron saint of lungs and respiratory problems. http://www.catholic.org/saints/saint.php?saint_id=7

Today is the three week mark from Dad's heart attack. We've all learned patience, and I'm at least beginning to think that his recovery is proceeding somewhat faster than I had expected a week or two ago.

Monday, December 27

I've been unable to visit Dad since Christmas Eve because of a nasty cold I've got, but I've been getting regular updates from Mom. Today there was at least one positive sign--his bilirubin count was down to 11 (half what it was before, although still quite high!) so his color was much improved. They didn't do a chest x-ray this morning, and in fact it seems as if they won't be doing them daily--they want to get Dad onto a more regular day and night schedule, and those 5 a.m. x-rays would not be conducive to this. This gives us confidence that they are feeling positive about his pneumonia. They have also been cutting back his fentanyl from time to time, and Mom reported that this afternoon he was disturbingly agitated as a result.

The tracheostomy is scheduled for 10:00 a.m. tomorrow and we won't be able to visit for several hours after that. In preparation for the surgery, they reinserted an i.v. in his neck this afternoon, which I hope will be removed shortly after the surgery.

Sunday Morning

Not surprisingly, the last several days have been busy ones for all of us, so we haven't been able to post any updates in a few days. Thursday was an uneventful day for Dad -- they moved his oxygen back down to 45%, but that was about it. I got to see him at the 4:30 visit, and he was awake but quiet most of the time, until he opened his eyes when Katie and I said goodbye.

We did get to speak to Dr. Cho on Thursday, and he was pleased by Dad's progress. We asked him about the jaundice, and he assured us again that they are not concerned. It is not uncommon for bile to fail to move when the body has more major issues to handle, and his liver is working fine, so his color will improve in time. We also asked about Dad's right ventricle, whether it was showing signs of recovery or not. Dr. Cho pointed to the IV medication machines and assured us that if there were going to be any serious problems with the right side of his heart, they could never have weaned him of most of the medications! So that was excellent news. I was able to head home to Virginia on Friday morning with much less concern than I'd had at the previous departure.

On Friday we were greeted with bad news -- Dad's pneumonia had become resistant to the Cipro antibiotic. A physician's assistant inaccurately told Mom that his pneumonia was worse, but in truth his X-ray merely failed to show improvement, and a culture showed that the Cipro had failed. So they switched him to a new antibiotic, but it was a worrisome day nonetheless. We all know logically that some days will be forwards, others not, but it's hard to keep your mind from jumping to the worst-case scenario at any setback. The news hit Mom especially hard; coming on Christmas Eve, it only added to the stress and anxiety of the day.

Christmas Day, Saturday, was a much better day. Dad was back to improving and was extremely responsive to his visitors. Apparently he has become increasingly resistant to the Fentanyl sedative, a common problem with all sedatives, I understand, but not so major a problem as antibiotic resistance. The family gave up on the idea of hiding Christmas from Dad -- the Christmas music playing on the radio all week was a pretty solid giveaway, and if that hadn't done it, the nurses greeting people with "Merry Christmas" for a couple of days probably would have. I haven't really heard how Dad took the news, though. Mom spent Christmas Eve at Sarah's and hung her stocking there, and they had fun on Christmas morning. Mom spent the early afternoon at the hospital while some of the others cooked dinner at her house, and then she came home to eat and celebrate between the late afternoon and evening visits. Mom was much more upbeat last night than she'd been on Friday, and she feels once again that Dad is on the mend.

This weekend we were told that they now think it unlikely that Dad will come off the respirator in the coming week -- they tried to wean him from the oxygen briefly, and apparently it did not go at all well. This was presented to us as bad news, and it's not good that he couldn't be weaned immediately, but that the staff thinks the end is even in sight came as a surprise to us, so that really wasn't bad news at all. They may install a tracheal tube (via a tracheostomy) on Monday, since the rule of thumb is not to keep them on oral tubes for more than three weeks (at Eric's hospital it's two weeks) lest the tubes cause damage to his air passages, and the trache would be more comfortable for him (potentially allowing him to eat or talk). But this is by no means a certainty -- we'll keep posting updates to let you know. Dad is still very, very weak, and the road ahead is no less long and difficult than it was a week ago, so he continues to need our prayers.

Wednesday, December 22

Today marks two weeks since Dad's heart attack. There were not a lot of changes in Dad again -- his oxygen is back at 50%, but we think they just upped it to make him a little more comfortable. He had awful hiccups earlier today, but when I saw him after they'd raised the oxygen the hiccups were gone, so maybe that helped. They also increased the PEEP (some kind of pressure on his airways) to give him a little more support. None of these are setbacks, just fine tuning. He coughed up a lot of gunk today, on his own, not with the help of suctioning -- Mom and the nurses both hope this means the pneumonia is starting to break up. Let's hope so!

Everyone around us seems to be sick or on the verge of it, on top of being overwhelmingly busy with the holidays. And Katie, despite being busy, ventured out, but was impeded by horrendous traffic. So I was the only one besides Mom who made it into the hospital today, and I only managed the first two visits. Dad was awake for the earlier visit (he even nodded in response to my surprised, inane, "Are you awake??" when I arrived) so Mom and I had a nice time then and stayed well past the official end of visiting time.

There's a decorated tree in the house now -- it's a smallish one, nothing like the sprawling balsams of past years, but an easy one to decorate and maintain in a house that will see only limited Christmas celebrations. The real Christmas will be when Dad comes home, so Mom understandably wants to keep things simple.

Tuesday, December 21

Again, not much to report today. Nothing significant has changed in Dad's condition--he's still stable and continuing to recover with all the same medications he was on the past couple of days. Emily spoke with the respiratory therapist and asked about the oxygen support, wondering at what point they switch to no ventilator. The therapist said that they don't go below 30% support (Dad is currently on 40%), but when they take a patient off the ventilator, they continue to give oxygen for some time. It's more of an art, it seems, than anything--there are no hard and fast rules for how they determine when a patient no longer needs the ventilator.

Mom took a much needed break for a bit this afternoon, finally skipping one of the visiting times. With Emily in town and Katie and Amy beginning their Christmas breaks, we are able to get into the hosptial more often to see Dad, so he's certainly not without company.

Monday, December 20 (Day 13)

Fortunately yesterday's ice cleared up by this morning, so I was able to return to Maryland (with kids in tow, but no husband!) on schedule. I managed to get to both the 4:30 and 8:30 visits. The difference in Dad's appearance relative to last week was pretty dramatic -- he looks like himself again, only a bit on the orange side. (Rather like an Oompa-Loompa, I thought, though Amy said he's too tall, and Katie pointed out that the Oompa-Loompas are somewhat better dressed.) His color seemed better at 8:30 than at 4:30, but Mom pointed out that the dimmer lighting probably hid it, so it's hard to tell. He has many fewer tubes and lines going into him now, and his monitor showed only two blood pressures, a pulse, and his oxygen saturation, which was up to a fabulous 98%. His oxygen percentage on the respirator was down to 40%, the lowest yet. They're really trying to wean him from the machines and medications!

Poor Dad has been plagued by hiccups off and on for the last couple of days, and occasionally he has coughing fits which are oddly quiet. I'm hoping such normal body functions are a sign that his system is trying to regain control, but maybe that's overly optimistic. The report this morning was that his chest x-ray might have been marginally better, though it's not easy to tell -- progress happens in weeks, not days.

When I got to Mom and Dad's house today I was touched to find a pile of get-well cards from friends and family waiting for Dad, with more arriving every day. Two were even for Mass intentions. When Dad is well, if he ever doubts that he is loved, he has only to look at these outpourings of affection for reassurance. I'm lucky to have him for a father.

I'm glad to be back with the family this week and am sorry that it's only for the week. Mom is doing rather well, given the circumstances, but she is finding it increasingly difficult to be out of her routine, particularly at this time of year. Lesser women would have collapsed completely by this point.

Sunday, December 19

Today was a pretty good day for Dad. They've now taken him off all of his blood pressure medications, and in the morning they took him off a medication that helps dilate blood vessels around the heart. They had stopped the same medication for several hours on Saturday but he didn't respond particularly well, so they were having another go at it today with the hope that if he did well without it they'd be able to remove the yellow line going into his neck by the evening. Sure enough, the evening report was that the yellow line was gone. We are also told that his morning chest x-ray was a tiny bit better than the previous day's, so we hope that his pneumonia is improving. His color seemed slightly better, but I'm beginning to think that it all has to do with the lighting. On Saturday, the lights in the room were all on, but today they were dim so maybe the yellow skin just doesn't show as well. His medical team continues to be unconcerned about the jaundice.

Mom was at the hospital mostly on her own today. I was in for the 12:30 visit but unable to make the other two because of Brian's work schedule. Amy and Katie planned to be at the 8:30 visit but were thwarted by an ice storm that made the roads dangerous. Mom wasn't aware of the snow and ice until she realized that the waiting room wasn't filling up for the 8:30 visit. By the time she left, the roads were horrible--she saw several cars off the road, one flipped over on the median, and the traffic was crawling along at 5 m.p.h. or less. The real problem was the unavoidable hill between the interstate and her neighborhood--she tried several routes before being able to make it up one of the hills, and then she slid down the hill in front of her house in first gear. But she made it home in one piece, thank God--all we need is BOTH parents in the hospital this week!

Saturday, December 18

There isn't much to report today as Dad seems to be more or less the same as he's been for the past couple of days. They did the gall bladder U/S and said that everything seems to be fine there. His color is worse today from the jaundice, but again, the nurses say everything is functioning fine as far as they can tell and it is nothing to worry about. The other news is that he has pneumonia in both lungs, but again, they think they have it under control. They are suctioning him out regularly and he appears to be uncomfortable from the secretions in his lungs. He's also less "with it" now than he was immediately after the surgery and over the last weekend--I think it's largely because at this point he's been sedated for a week and a half and he's simply weak and tired. When he struggles to wake up when we are visiting, we encourage him to settle down and sleep, sleep, sleep.

Mom spoke with a cardiologist today who has never seen Dad before but who has been following his progress. The doctor said that Dad's numbers are improving slowly and that he WILL get better, but it'll probably be weeks at least until he is "better" in our eyes. I hope that in the next week we are able to get an official appointment with one of his main doctors to get an overall analysis and prognosis rather than trying to catch the doctors as they make their rounds or as they are on their way to another appointment. I know Dad is getting the best care available, but I get frustrated getting all of the information about him second- and third-hand.

It was really quiet on the hall this weekend--I guess not many people schedule major cardiac surgery at the holidays!

Friday morning

Mom called this morning to let me know Dad had a good night. But they're worried about his liver's overload, so they're going to do an ultrasound on his gall bladder today. Just one more thing to worry about.

There are a couple of things I haven't seen mentioned lately. One is that, as of yesterday, Dad still had a spot of pneumonia on his lungs. The doctors and nurses don't seem very worried about it, though.

The other issue is Christmas. We're having to face that half the time from his heart attack to Christmas has gone by, and he's not nearly ready to be off the respirator yet. There's no question that he will still be hospitalized, and seriously ill as well, on Christmas. So yesterday it was decided that we will not tell him that it's Christmas, since that would cause worry and anxiety -- Christmas for Dad will be whenever he's healthy and ready to celebrate with his family (and you can bet we'll all be there!). Mom is going to spend the night at Sarah's house, so she'll get the fun of Christmas morning with the kids. After the lunchtime visit (assuming Dad's still on the same visiting schedule, which is probable), they'll go to Mom's and get dinner going, and everyone (including Kirsten) will eat there after the 4:30 visit, with plenty of time to get back to the hospital for the 8:30 visit. (But the real question is: who is going to be stuck with the dishes?)

Thursday Evening

I saw Dad for the first time since Tuesday. I was getting the early signs of a cold on Tuesday night - so only quickly went in to see him and then left him with Mom and Katie. It's funny how super-sensitive you are to your own health when there is so much at risk... My cold was really virtually nothing - cough, itchy eyes and ears, headache and that's about it. BUT with the thought that it might make Dad worse in mind it became the equivalent of Typhoid Fever! Anyway, so I took the day off from visiting Dad on Wednesday.

So, when I went in to see him last night I was very pleasantly surprised. Mom and Katie had warned me that he was still in rough shape, and that his jaundice was looking worse. BUT, it is amazing what 36 or so hours will do if you aren't monitoring progress every few hours. Dad looked almost like himself to me. He was sleeping - but he looked more comfortable than I had seen him in a while. His hands were warm again (his cold hands had me very worried on Tuesday). His color looked good - and even his tubes and wires and stuff didn't look quite so sticky-out.

On his vitals the only thing that alarmed me was his high heart rate. It was hovering around 120-125. Gasp! But Katie told me that was much lower than it had been in the afternoon. She asked the nurses about it then - and they assured her that it was fine - and they gave her a reasonable reason for it - which I can't remember right now. His breathing looked good - and his blood pressure was excellent.

We all keep thinking it - we want Dad back to his own energetic, alert self NOW. But we also keep saying we will see progress over TIME - which is weeks, not minutes. He is getting better - and a day away did wonders for me. When Emily comes back I am sure she will be delighted! I still have waves of fear about what COULD go wrong still - but I feel so much better today.

Wednesday, Day 8

It's been one week now since Dad's heart attack and surgery. A week ago right about now I was just getting the message as he was headed into surgery. I wish I could say "wow, look how things have changed in just a week!" That first night we were told by a person in the waiting room that progress after surgery would be measured in weeks, not days. And I guess I can look back on the week and at least say that his life isn't as precarious now, but the progress has certainly been hard to track. The way things have changed in the past week is in my own outlook--this week has been a reminder to me that family really is my first priority. I'm also now willing to accept tiny changes as a sign of real progress.

For example: today's changes are that Dad is now on 100% nutrition (meaning no more IV nutrition; he's getting everything through a feeding tube), he was down to 50% oxygen as of the 12:30 visit today, his blood pressure was actually alarmingly up--150/60 at times (which they are trying to adjust with medication, as always), heart rate and oxygen saturation still doing well. Our 12:30 visit was quite good--Dad was a little bit alert and all the signs pointed to really good progress. At the end of the visit, however, he began to get agitated. Mom called for the nurse who shooed her out. Apparently it happened again later too. They think it was partly due to the bed (he kind of flinches whenever the snazzy new bed moves) and also to a mucous plug he was having difficulties with.

Mike, the daytime nurse, was very positive. He told us that the 100% nutrition means that his digestive system is working well. Overall, it looks as if most of his systems are doing well, although they need help. Of course he's still on the ventilator, and they are talking about starting CRRT (continuous renal replacement therapy) to help his kidneys process everything they are being asked to deal with. Mike assured us that his kidneys are just fine, but this would give them some support and allow his body to focus as much as possible on healing. It seems as if everything they do is towards this end--make the business of keeping his body going as simple as possible so all he has to do is heal his heart.

I only got a couple of minutes with Dad during the 4:30 visit, during which time not much had changed (up to 55% oxygen, changed his antibiotic to cipro). Weeks, not hours. I have to keep reminding myself that. Mike stressed to me and Mom that we really need to focus on not overstimulating Dad with long visits or lots of people. Dad may love the company and comfort of his family around him, but he needs to rest.

The 8:30 visit was not as good as the earlier ones. Dad had started running a fever and Charlotte (the nighttime nurse) said that he vomited a bit at the beginning of her shift. I suspect the vomiting may just be due to more food in his stomach, but the fever is worrisome since it may be a sign of an infection. Charlotte was ordering another chest x-ray to check things out. We forgot earlier in the day to ask about the morning x-ray (although I'm sure they would have told us anything noteworthy about it) and when I asked Charlotte, she hadn't yet had a chance to look at it.

We keep telling Dad to just rest and heal and that he's doing well and making progress. I wish I knew what was going on in his head--does he know that he's doing o.k.? Is he frustrated, bored, scared senseless? Or is all the sedation and morphine keeping him from even thinking about his situation too much? I can't wait for him to strengthen and heal so he can tell us his own experiences of this time.

Since I wasn't able to get in for the afternoon and evening visits, I spent some time googling Dad's two main doctors--his surgeon Dr. Cho and cardiologist Dr. Hiatt. They certainly don't hire dummies at Sinai! For some reason, I got a kick out of reading their outside interests--old books and watercolor painting for Dr. Cho and running and playing the flute for Dr. Hiatt.

Information on Dr. Hiatt: http://www.baltimoreheart.com/pcSites/physicianInfo.cfm?section=physician&physicianId=439

And Dr. Cho: http://www.ctsnet.org/home/pcho

Day Seven, Late

I talked to Katie after the 8:30 visit. She said she and Mom stayed there an hour, and Amy was there at the start as well, though Sarah missed it because Connor is sick. Dad had been off the sedatives for an hour and a half and was just beginning to show responsiveness, but it was nothing like the interaction we got before the weekend. It was a good visit nonetheless.

The nurse there was new to us and to Dad, so she was just going over his records for the first time and was happy to explain a lot of things. She filled them in on what all the medications were (but next time they'll have to take notes!). Dad's not processing food as much as they'd like, so they're adjusting his diet -- more potassium and magnesium, more electrolytes. Katie learned all the workings of the respirator -- having mastered the vital statistics chart we'd started trying to decipher that this weekend -- and was able to tell me his lung pressure is pretty good. His heart rate was also good, though it has occasional spikes, which he can fend off without medical assistance, thank goodness. His blood pressure isn't as low as it was earlier, either. His eyes are well on their way back to their normal color, nothing like yesterday's near-orange yellowness. The fluid on Dad's heart and in his lungs was still there this morning, but it had decreased. Dad's going to have the tubes in for a while yet. In short, he's getting better, but it's very, very, very, very, very, very slow.

The good news is that the mother of the other family we'd really gotten to know -- the other long-term ICU patient with full-time visitors -- was moved out of ICU and into a private room today. She's having allergy troubles but is much recovered overall. Their room has a microwave and a fridge -- the high life! Katie says our family misses their company already, but they've invited us to visit them in their mother's room. It's good to see that prayers do get answered.

Tuesday night update

Tuesday was certainly more of the same, and I keep telling myself that no news is good news. They changed Dad's bed--he got his roommate's bed which is one of the snazzy ones that move to prevent bedsores (apparently we were mistaken or misinformed before when we thought he already had one of these), and he got a shave (maybe they heard us discussing his beard?). The yellowness in his eyes is almost entirely gone. He was heavily sedated when I was in there for the 12:30 visit--much more asleep than I've seen him since just after the surgery. I was concerned about his very low blood pressure (average in the 50's, with the diastolic pressure particularly low) and his apparently shallow breathing. We asked about the low blood pressure and the nurse gave him more medication to increase it. Mom said that the pressure average was higher by the 8:30 visit, back into the 60's. I wasn't able to ask about the shallow breathing (when I say shallow, I'm basing that on the ventilator reading--the little red and greed LED's that rise and fall with each breath. Over the weekend they were hitting the 40% mark on most breaths; today they were about half that) but Mom did later in the day and was told that the lower percentage is good--they don't want it any higher than 40% and it has something to do with pressure on the lungs. So that was an improvement.

The nurses all say the same thing--he's holding steady and getting better. It's impossible for us to see the improvement, and that's just really hard. The most difficult thing for me (well, one of the most difficult) is watching other patients come and go on the hall--they get their bypass surgery and are out of the CICU a couple of days later. We are told that he is a long way from extubation.

There is a strange camaraderie among the long-term residents of the ICU waiting room. There are several of us who have been around more than a few days--the wife of Dad's roommate, the daughter of a woman who had kidney failure after her scheduled bypass, and the four children (and various others) of a woman whose colon punctured during a colonoscopy. This last family is just wonderful--four very close siblings, Mo the only daughter and her brothers Blaine, Norman (not his real name, but everyone calls him that!), and Mike. You can tell that they are as close a family as we are, and are SO supportive and loving with each other. Mo is almost always in the waiting room when I go in; I know she and her brothers regularly spend all night there. They tease each other and now us, and we've all gotten to know each other first through overhearing the other family's conversations and now through constant conversation. Everyone in that room is worried and stressed, but everyone is also amazingly supportive and friendly. There's nothing quite like a crisis to pull people together and allow them to show their true strengths. Having Mo and her brothers around makes me feel less alone in all of this. She makes that clear as well--when I had to leave this afternoon and Mom was going to be alone in the waiting room, Mo kept chiming in "she's not alone!"

Day Seven

Tonight is the eighth night of Hannukah. Sinai Hospital had menorrahs everywhere, from a big industrial-looking one on the front lawn, to a twisty, beautiful one in the lobby, to the plastic, blue-bulb ones at every nurse's station. My sisters and I took it upon ourselves to keep the one in CICU up to date when it started falling behind, and I thought of that as I lit my Advent candles tonight.

Today Mom called me right after breakfast. She was wanting to track a Christmas package, but the info was in Dad's email account, which I've been keeping track of this week (since I was the one who was able to recall his password). This is one more thing that Dad did for her that she's having to cope with, like filling the gas tank and managing the big financial picture (though she has always been the one to pay the bills). When this first started and we were told how sick Dad was, that normal heart patients go home within a week but he'd be in there longer, I think we all had it in mind that he'd be in CICU a week or so and home by Christmas. As the reality of "it's going to take some time" is setting in, we're realizing there's a good chance he won't even be out of CICU by Christmas, and we all have a nagging fear that he could be in there forever. Then I remind myself of Sunday's readings: Hope and healing, but Patience. And Faith. Maybe if I repeat this to myself I'll get it eventually.

There was very little update this morning when she called. I called her after the lunchtime visit and got another non-update. Mom has asked the surgeon to call her, since we haven't managed to corner him since Friday, but she didn't leave her cell phone number with him, so it may be a day or two of phone tag before they connect. I talked to Amy after the 4:30 visit because I knew she'd remember the details that Mom (and I) always forget to mention, but her update wasn't much of an update, either. She did say Dad was on 70% oxygen, so I guess that's progress, but it's hard to feel like it is, because on Friday he was at 50%. But, then again, his fluid levels are down and his balloon is out, so clearly we should feel that we're moving forward. But Dad was so sedated during visiting times that it felt like he wasn't there, and he'd needed another pint of blood today. And his blood pressure dropped below the level they're trying to maintain. So it feels like we're not getting anywhere. Amy said it's all very discouraging. We wish we knew if there was progress going on inside, because we can't see it from the outside.

Mom read to Dad again today. I hope that's helping him! It does help him for his family to be close by, I am sure of it. Even the nurse last night (I think it was) said she didn't think it tired him out.

I spent the day running around finishing Christmas shopping and doing a few other errands. I knew I was unstable when I nearly burst into tears when the shoe repair guy said polishing wouldn't make Alexander's dress shoes look a whole lot better. (They're white and blue saddle shoes, and you can't get white shoe polish these days -- only scuff cover, which doesn't do any good if there's a dent in the leather, and there are many.) I was fine so long as I kept moving today, but every time I sat still I could hear Christmas music. I am prone to weepiness over parades, musicals, sappy movies (even terrible ones), and Christmas music all year 'round. Today when I'd get weepy at hearing a Christmas song it kept turning into real distress, because then I'd remember I had a reason to be weepy. And on hearing "It's the Most Wonderful Time of the Year" I got weepy and angry. It's supposed to be wonderful, but instead I'm distracted, worried, and grouchy at my children.

Day Six

On Monday morning Daniel, the kids and I packed up at Mom and Dad's house and got ready to head back home. I hated leaving but it's unfair to keep my entire family's lives on hold when this could go on for months. Mary has activities and Christmas programs this week, and Daniel has a grant proposal to write. But we've sworn to return in a week, when we have a few days of calm.

I called the hospital for an update on Dad before I left. They asked me to wait before I came in, because they had a collection of procedures going on -- mostly doctor's visits, but they were also giving him blood to help boost his blood pressure and improve his oxygen levels (which weren't bad, but they are always a concern). But we went to visit, and I was allowed back at 10:30, a good two hours before visiting time. Dad's eyes were half-open, but he was heavily sedated, so he really couldn't even squeeze my hand. But he knew I was there -- it looked like he mouthed my name around the respirator tube.

While I was back there, I got an update from the nurse and a respiratory MD who were on hand. Dad's eyes were yellow, which meant he had some jaundice -- probably nothing to worry about, I was told, but he had so many medicines in his body that his liver was getting a bit backed up. And the respiratory expert said he was there because Dad had fluid in his lungs and on his heart. They didn't know if that was a worry or not, but he said it probably wasn't. (It seems to me that if there are enough non-worries, don't they pile up and become a worry? And do they mean it shouldn't be a worry for me, which is useless since everything worries me, or that it isn't a worry for them, which also seems wrong since they don't have the emotional investment in this that we do, so something negative might not actually bea worry?) At any rate, he said the fluid either meant he had too many fluids in him, which was a possibility since they'd had to boost them after his first diuretic and subsequent rough night, but seemed unlikely because those same fluids were supporting his blood pressure and oxygen levels; or that something was leaking inside, which still wasn't a serious problem, given all he'd been through, and it was certainly likely that the leak would heal itself.

After the surgeon stepped aside, I started trying to talk to Dad. Unfortunately, the surgeon sat across from the foot of his bed and started a phone conversation during which he began discussing lung transplants. He didn't want to do a lung transplant, he said, because the patient was still on a respirator, and couldn't even be transferred, let along transplanted. I was starting to get very alarmed -- lung transplants?? How serious is this problem of fluids, after all?? It was very hard to keep my train of thought talking to Dad. Finally I heard the doctor refer to the patient as "she". Phew. Doctors need to think about where they are when they have a conversation like that!

Anyway, I surprised myself by managing to keep up a 10-minute-long monologue to Dad, discussing inane things about my plans for the week at home, and avoiding the issue of my impending departure. But finally it became clear that I had to leave or we'd never get back home in time for Mary's Daisies party. When I opened my mouth to tell Dad it was time for me to go, I could hardly speak. It took me at least a full minute to squeak out the word "Goodbye." I just have no idea what a week will bring, and giving up even one precious minute with Dad was at that moment all but unthinkable. I made it as far as the empty mini-waiting room within the ICU before I fell apart -- the first time I'd cried since Wednesday. It didn't matter that I pulled it together to say goodbye to Mom and my sisters (Katie, Amy and Mom had arrived while I was back with Dad), because it was obvious I'd lost control of the front I'd been maintaining (as we all have been attempting to to), and I think I cried through the whole first hour of the drive home.

All my news since I left has been second-hand, so I'm hoping the others will start posting with more detailed info than I can give. I called after each visiting half-hour for updates. They reintroduced the diuretic yesterday, which I guess went better than the first time. Katie reported that Dad's eyes were only yellow in the lower half -- when they visited he had his eyes open fully. Mom read to Dad from a James Herriot collection, which he seemed to enjoy, though he nodded that he'd had enough after one chapter. He was responsive, but not extremely so -- Amy said today she suspects he has his eyes open because he's really not sleepy (how much can one person sleep in a week?) and wants to be with us, but he's so heavily sedated that he can't move much, even to squeeze our hands. They dropped his oxygen level a bit, which we also have to consider forward progress.

Sunday continued

As I mentioned before, to us Sunday was mostly a day of holding steady. His numbers looked good (and the nurse commented that there wasn't much to tell us when we came in for visits, because we could by then read his vitals as well as anyone could!). The most medically interesting thing that happened that day was that they removed the balloon that was supporting his heart, and his heart continued to beat steadily and strongly. As far as I know, there is still no indication as to whether his right ventricle will recover or not. They kept him well supplied with oxygen and they kept his fluids up to help support his heart.

As of Sunday we were really getting to know some of the other regulars in the ICU waiting area. One family of four siblings, about our age, is there for their mother. The family seems very much like us -- they are completely settled into their space with reading material, craft projects (mainly home-made playdough!), and rosaries piled around. They see that someone stays there all night, which is serious dedication, since the waiting room sofas are four feet long at best, not to mention seriously uncomfortable. (After four days of sitting on these chairs my legs, hips, and back were aching -- being four months pregnant doesn't help -- so I can't imagine four days and nights of this.) When I arrived on Sunday morning, one of the men told me that during the night a young man was brought in. He had been stabbed in the eye with a screwdriver. It had missed his eye, but his brain was damaged, and they couldn't get him to respond. Just when you think you've hit a low point, you learn that someone has it worse than you. My mental prayer list is getting long.

We occupy ourselves in the waiting room with reading (but less than you'd expect, for a family that is inclined to read all the time), card-making (all of us girls are into rubber stamping), watching videos (Amy decided this was a good time to buy a portable DVD player -- when Dad is more alert he'll get it on extended loan), and conversing with one another. And trying not to worry. At times it gets tense. Eric is frustrated at the lack of progress and prognosis and would like to have a doctor friend of his see Dad's medications (and chart, if possible). The rest of us feel this would express a lack of confidence in the Sinai medical staff, and we know there's no prognosis because they really don't know it. Mom worries that Eric is trying to be pushy, but the daughters think he's just feeling as helpless as the rest of us and is grasping at one of the few things he might be able to do for our family. It's a moot point, because no one outside Dad's approved medical team is allowed to see his charts. But it causes more tension on already frayed nerves.

Dad was pretty responsive for the evening session, and we stayed for an hour and fifteen minutes. He didn't want us to go -- he never wants us to go, and I can't blame him for that! I was also reluctant to leave, because I was due to leave on Monday morning, and there was no guarantee I'd be able to see him the next morning. Fatigue won out all around, though. Mom did ask Dad if he'd like her to bring a book to read to him on Monday, and he nodded, so maybe that will help keep his mind away from worry. Or boredom. Or confusion. I wish we knew what he was thinking. I bet he does, too.

The Weekend

I don't have posts from Saturday and Sunday, so from here on out what I write here will have been written just for here.

Saturday was, for me, the worst day to date. I drove Mom to the hospital, as I did each day that I was in town, and when we got there Mom went straight back to visit him (well before the official visiting time!). When she came back, her report was grim. Dad had had a rough night, with his oxygen levels dropping quite low, so that they had to bring his respirator back from 50% oxygen to 100% oxygen. Then the morning X-ray showed him with a spot on his lungs, probable pneumonia, which meant they had to introduce antibiotics. We had been warned that any recovery depends on his staying free from infections, so this was extremely alarming.

On Friday they had given Dad a diuretic to clear some of the excess fluids from his system. Mom guessed (correctly, the nurse later confirmed) that this had been done too soon -- the fluids were supporting his heart, and his badly weakened right ventricle needed all the support it could get to get the blood flowing to and from the lungs properly. So of course they were re-introducing the fluids, which meant he'd be swollen again.

When we saw Dad at the 12:30 and 4:30 visits, he was heavily sedated and looked worse than he had the day before. We had been allowing ourselves to be buoyed by Dr. Cho (the surgeon)'s comments from the day before, and this took the wind out of our sails. Mom was blue a good portion of the day and we were all emotionally drained.

After the 4:30 visit, Mom and I headed back towards her house, stopping at Kirsten's group house on the way. There we told her that Dad was in the hospital, recovering from a heart attack, and that we couldn't bring her home for a while. Normally she comes home once a week for a few hours, but Dad has to bear her weight and keep her from falling, and without his help she's impossible to move. We also didn't expect to have a few hours at home anytime soon! Kirsten, who is both physically and mentally disabled, took the news about Dad much better than I expected -- she did want to make sure he was just sick, not dead, but she accepted our responses without much emotion.

We stopped back home and got some dinner (my husband Daniel cooked us the first hot meal we'd had since Tuesday) and then headed back to the hospital. I wasn't sure how I'd get through another rough half hour with Dad, but it's one of those things you just have to do -- and not seeing him would be unthinkable.

Fortunately, our final visit with Dad was dramatically better than the previous two! He was somewhat responsive and all his numbers looked better (as did he). His oxygen was still at 100%, but he tried to open his eyes, and he squeezed our hands so often and so firmly that we worried he'd wear himself out. We stayed well beyond the end of visiting half-hour and left in a much better collective mood than we'd had to start.

Sunday started out with Mass for all of us (except Dad, of course). It was Gaudete Sunday, the joyful Sunday of Advent, and I don't know when I've ever heard readings that were more apt. The first reading spoke of hope and healing -- Strengthen the hands that are feeble, make firm the knees that are weak ... the lame will leap like a stag. It felt like reassurance that Dad would be well. Then the second reading was all about patience, which was both hard to hear and comforting at the same time -- our prayers will be answered in time, but it could be a long time. (I have a tough time finding patience with ordinary things. After Dad's first couple of days, I felt like his recovery was going to take off and he'd be well in no time -- even though I knew intellectually that wasn't probable -- so Saturday's setback felt much worse than a mere setback. I needed to be reminded that patience is always required.) Finally, the Gospel reading repeated the message of healing, and urged us to have faith. I think I should bookmark the online lectionary for that day and read it every day until Dad is well!

Sunday at the hospital was a day of holding steady. Dad's oxygen levels remained more or less right, but they kept his input at 100% for most of the day. Even though it was just yesterday, I'm having a hard time remembering the details of our visits, so I'll have to leave the rest of my updates for tomorrow (or for someone else to do) when my mind is clearer.

Day Three

Posted 10:45 pm on Friday, December 10 (though it seemed like weeks since the beginning of the ordeal):

We just got back from the hospital, after another long day today. Apparently Dad was conscious before we got there, and my sisters got to talk to him a bit, but he was asleep for both of the first two visiting half-hours, so Mom and I didn't get communicative time with him until tonight! Even tonight he was pretty much asleep, though he was a bit more responsive to Mom when it was just her, I believe. He doesn't look a lot different today than yesterday (though we saw today that their idea of a "small" incision on his leg is WOW, long) but he feels better to the touch, warmer and more comfortable. (And they put Blue's clues-covered socks on his feet, so they hid the non-pedicure and kept him warmer that way!) And his non-conscious periods seemed to be true sleep, not sedation -- his face was active (dreams?) and his legs would move a bit at times. So that's a good thing, I hope.

The interesting part today is that the surgeon came and talked to us for a long while. He admitted today that he and the cardiologist the first night were debating under whose care he'd die -- whether the surgery would kill him outright, or if his heart would give out just after. Scary. But he has done SO much better than they expected (and they didn't know my Dad -- he doesn't give up that easy and comes from strong stock -- and had NO idea of the enormous network of prayer and support he has!) that he now feels confident that, barring infection or other complications, Dad should make a more or less full recovery.

Dad's blood pressure is much more stable than yesterday, though still not perfect, and all his other vitals are good -- it was such a relief to watch the heart monitor today and see it doing rhythmic, two-part beats. But Dad is not completely out of the woods yet. The right side of his heart is almost completely non-functional at the moment. The right side pumps to the lungs, and the left to the rest of the body, so the right has the easier load to start. If it recovers, fabulous. If not, the left is often able to compensate. We asked the surgeon what happens if *neither* of those options takes place, and he said that means he'll have a weak heart and need a lot of care indefinitely. They don't know yet if that side of the heart is dead or just strained, but based on other signs he suspects it's just very, very badly strained, and he thinks it will mostly (but probably not all) return to normal functionality.

Dad is still in intensive care and will be for a while. (We overheard another family's doctor saying their mom would be out of IC less than 24 hours after a quad bypass -- that's what a difference a scheduled bypass makes, rather than an emergency, post-heart-attack bypass!) So I can't even assume that the recovery will be longer than they say yet, because they can't even begin to say how long it will be!

Tomorrow and Sunday will be two more long hospital days for me -- we'll try to get in earlier to see him awake, if that's going to be his awake time. They do like him to be sedated mostly, not only because of the pain, but because the majority of the healing has to happen when he's fully relaxed. I belive we will have to return home on Sunday night or Monday morning, and I'm dreading leaving -- my prayer is that he can be tube-free by then (or significantly tube-reduced) but I don't think he will be. I will be impatient to return.

Please keep praying. This isn't over yet, but our prayers are definitely being heard.

Day Two, part two

My post from 11 pm on December 9:

We spent pretty much the entire day at the hospital, though visiting hours were few and far between. But he looked MUCH better today -- not so much swelling and more color (though still very, very ill). The second trip in four hours later was a bit depressing, because he looked the same as before, but we were reminded that his progress will be measured in weeks, not hours. The third time, this evening, however, was a huge improvement -- they had taken him off the sedation for a while, and he was conscious and responsive (but forbidden to talk -- he had a breathing tube in and all sorts of other apparatus types). My mother, my sister and I were in there at one point, and my sister and I said we might go, and he shook his head no!! My other two sisters came in shortly thereafter and we all had a long visit. Dad even showed a sense of humor -- my younger sister joked, "Dad, you need a pedicure!" and he wiggled his toes. Then the most remarkable thing happened as we were leaving -- my mom leaned to give him a kiss, and he not only kissed back, but puckered up insistently for more! The nurse said in 12 1/2 years she's never seen the like. It was SO cute.

From a medical standpoint, he's not completely out of the woods yet. His blood pressure is a bit unstable, so his condition is still technically critical. But at mid-afternoon the surgeon said my father was doing better than he'd expected, so that's very good news. We are hoping that tomorrow will bring further progress. My brother is a patient advocate at another hospital, so he's familiar with how things work for cardiac patients (and he has known all the right questions to ask, so he's been very useful this week). He said they're normally in the hospital for 5-7 days, but my Dad's heart was so damaged by the heart attack (I gather they're talking about the strain on it, aside from the blockage itself -- this is all new to me) that he will probably have to spend some time in rehab before he comes home.

Anyway, tomorrow will be another long day at the hospital for us all, but I hope in another 24 hours he'll be declared stable. This was such a long day -- I can't quite grasp that it's been less than 24 hours since he got out of surgery, and only 30 hours since the onset of the attack. It feels like weeks.

Day Two

Here was my post to my board around 11 am on December 9:

The heart catheterization was non-fatal but not exactly a success -- the blockage was so severe that the catheter couldn't do much. They gave him a choice of surgery or a whole lot of blood thinners to get him through the night, but they said either was risky and surgery was the best option. So he had emergency quadruple bypass surgery. They finished in just under the 4 hours they promised (first surgery I've ever heard of being on schedule) and he was conscious within an hour of that. The surgeon, who had apparently been somewhat grim beforehand, was very optimistic afterwards, and as my father has now made it through the night, the odds are in his favor. He still has a very long haul to go through, and the heart attack caused considerable damage to his heart, so he will be very weak for a long time.

We started getting ready to travel as soon as we talked to my Mom the first time, and DH had the presence of mind to call my sister to get a more honest assessment of Dad's health and of whether we should travel. She said we should, so we were on the road 2 hours later and made the trip in about 4 hours and 15 minutes (it's normally 5 or so -- Someone was watching out for us!), arriving just after the surgery ended. My mother was allowed to see my father when he was awake, and my sisters and I were able to go back shortly thereafter and see him when he was sedated. I have seen post-op heart patients before, so I was somewhat prepared, but it was still alarming -- I would never have recognized him because he was so full of fluids (one of my sisters commented that he should never become overweight -- he looks so much better thin!). But he is alive and the prognosis is good.

My mother has had about 20 minutes' sleep since yesterday but is an insomniac at the best of times. (I had a good four hours before my internal clock overrode my desire for sleep.) She is always a worrier and my dad is the go-to guy in the family, so she's feeling pretty overwhelmed -- DH and I will do what we can to keep the household running while we're here, so she is free to focus on my dad.

We will be at my parents' for about four days (but unfortunately can't be here longer because of DH's work and Mary's heavy December activity schedule -- I may make a return trip by myself later) so I will be more scarce than usual this week. I appreciate your continued prayers -- I can't tell you how much it touched me to see so many responses to my post from last night, and I will pass your thoughts onto my mother as well.

Day One

The real beginning of this whole event was about two weeks ago, when Dad experienced some minor chest pains. Mom suggested he call the doctor, but the pains faded quickly, and he decided not to worry about it. Then late in the afternoon on December 8, as he was preparing to install a laminate floor in Amy and Katie's house, the chest pains started again, much more severe. The paramedics were called and arrived quickly (one running across the lawn from within the neighborhood, shoes still untied), and they took him to the closest hospital that could handle an attack like this, Sinai Hospital. At the hospital they started him on blood thinners and did a catheterization to see what they could learn. Dad was conscious and able to provide them with all the information they needed. Mom called me in the middle of the procedure.

Sarah and I both post to some online boards, so I can at least track my first few days through my posts. Here's the first, right after I heard from my mother, around 6:30 on 12/8/2004:

Please pray for my father! He had a heart attack this evening! He's 76 but I forget that that's supposed to be old, because he lives like he's young and he seems so healthy. But this afternoon he started having chest pains. They got him to the hospital pretty early on and that saved him, but they say it's a pretty severe one. He was conscious and in good spirits despite all that, so that's a good thing. He's undergoing a catheterization right now and there's a chance his heart could stop. I can't stop crying, I'm so scared for my daddy. Please pray for him.

Introduction

Our Dad had a heart attack. It was about as severe as it could have been without killing him, and without some amazing paramedics, doctors, nurses, and various and sundry other medical professionals, it would have killed him. It could yet. But we've gone looking online for information on heart attacks, surgery, and recovery, and we have yet to find any useful information or even voices of experience for anyone who has had an attack that was this bad and this sudden. What we read is that after an attack, there might be medication, maybe surgery, and from the sound of it you have days, weeks, even months to schedule the next step. Those who have surgery, we're told, are off the respirator in under 24 hours and often home in a week. This is about as far from our experience as we could imagine, so it inspired us to create this blog, in the hopes that others who go seeking information can find someone out there who has been through it.

There are six children in our family: Kirsten, Eric, Amy, Sarah, Emily, and Katie. We range in age from 27 to 40. Kirsten is severely disabled. It will probably be Amy, Sarah, Emily, and Katie doing most of the posting here, and we'll try to remember to identify ourselves when we post.