Weekend Updates

This weekend ended up being very eventful! We did manage to keep Dad on the second floor, much to everyone's relief. There was some disagreement as to whether this would be possible or not, because he needs to be on the 6th floor in order to be weaned off the trache tube, but I guess either Mom or Dad put their foot down about it, because he has been there ever since. Oh, and amazingly enough it turns out that he DOESN'T need to be on the 6th floor to have the trache tube removed. Friday night they put a stopper on the trache tube, essentially a permanent, tight-fitting block, which is the first step down from the trache tube. They said they were going to try him out with that (because it doesn't allow any air in through the trache--making him have to breathe entirely on his own--he only had the small oxygen tube in his nose, like you see all the time) and if he was successful with that after 24 hours, they would take the tube out entirely. Sure enough, after 24 hours (this was Saturday afternoon) I went in to see him, and he had no trache tube any more!! This is VERY exciting. At the time, he didn't even need the oxygen tube, although they have since given him an oxygen mask to use if he feels like he needs it. So much for the sixth, floor, huh? They were supposed to have done this weeks ago, but fouled things up so many times that they never did! His hole seems to be healing really quickly, too. The nurse said it takes 2 to 7 days for the hole to close up, and when she checked it last night, she said there was only a little bit of air coming out of it when he coughed. He noticed the difference, too, in that it was getting easier and easier to speak. I'm going to have him start dictating blog entries to me, so you can have it straight from the horse's mouth, so to speak. I got the idea for this last night after he was saying that it didn't feel all that strange when they removed the tube. What felt weird, apparently, was when he was having trouble coughing, and so they came in and suctioned him--straight through the hole!!! No tube!!! eeewwwww

They did manage to also get him in on Friday to have his stomach tube replaced. They're hoping that with a smaller tube, there will be less leakage, so he will get more of the nutrients. He now has a double-valve tube, one for input and one for outtake. This will have greater control, so he doesn't get over-full. While I was in on Saturday night, they started him on a nutrient feed again, at a very low level--only 25 (mg? mL? mL/hr? no idea). When I went back on Sunday, I was told that they had increased it on Sunday morning, but apparently had done this too quickly, because he ended up vomiting again. So they dropped him down to 20. They're wanting to take it v-e-r-y slowly, so that he keeps all the nutrition in. The PCA (patient care associate) said that sometimes after an extended time without food, the nutrition they give is just too rich, and that might have caused the vomiting as well. His stomach has been empty for so long that to suddenly take in a high amount of calories and a decent amount of fiber and fat and vitamins and so forth, it just can't handle it. He seemed to be doing just fine with the lower amount, and also seems to be processing a good deal of it. This could all be a moot point, however, because they were expecting the speech therapist to come in today and start him on the swallowing test again. With any luck, he will be back on real food very shortly here, and won't need the tube any more at all!! He asked Mom to bring in a clementine for him today, just in case. Poor man--she has been tormenting him with clementines. Dad loves clementines--even under normal circumstances! Mom has been eating clementines in his room, so his whole room smells of them (and they smell SO good) and he is just yearning for food of any type--this must be so difficult for him. So keep your fingers crossed that he does well on this swallowing test. I'm actually feeling fairly confident, because he has been eating ice (and sneaking sips of water when the ice melts--sshhhh, don't tell on him!) for weeks now, and hasn't had any problems. Well, OK, last night he got an ice chip down the wrong tube (which we ALL do from time to time) but it was because he was lying practically flat on his back, and it was a really small piece. So I don't think that counts. And he managed to recover from it himself--no nurse assistance!

We just love the staff on the second floor. They have been so nice and helpful. I'm really glad we've gotten to stay there. It's been good for Dad, and for our own peace of mind! The only difficulty we're having at this point (knock on wood) is getting him up and moving. They've gotten him to sit on the edge of the bed a few times, but he won't try to make it to the chair. He's been feeling too light-headed. Makes sense to me--you would too, if you hadn't eaten in a week and a half!! I hope he'll start making more progress with this now that he's getting some nutrition. His legs are so thin, it's going to take some doing to build up the strenghth again. But they're strong, and he's always been so strong, I'm not worried.

I think that's all there is to say from this weekend. I'm sure someone will fill in anything I might have missed.

Deja-vu all over again

Yesterday (Thursday) morning, Dad was told that they wanted to place a new and improved type of GI tube in his stomach (I don't have all the details, but as I understand it, this one would go in deeper and would have both an input and output tube). Dad agreed to this procedure, hoping it would help with his absorption--he's getting so little nutrition at the moment because he's just not able to absorb much. So what did they do? Took him off the SAME medication that they forgot to reinstate after his surgery, the one whose absence caused all the fibrillation problems last week. Well, as anyone who has taken seventh grade science knows, you can't expect to try the same thing again and get a different result. Sure enough, by the afternoon he was back to fibrillating, heart rate up in the 170's, blood pressure going low. Of course once this happens they can't just quickly give him the proper medication and have everything back to normal. First they have to monitor him for a while, give him fluids, take his vitals, move him to the cardiac step-down unit, get his blood pressure up, etc. They finally gave him this medication around 6:30 p.m. Mom stayed all night again and reported this morning that his heart rate still wasn't steady, but at least when it was high it wasn't quite so high (more like the 140's).

If I have anything to say about it, he's staying on the second floor (the cardiac step-down unit) where the nurses are attentive and seem to have a good deal of common sense and intelligence. I'll forgive one error, but not the same dangerous mistake twice in as many weeks. They also say there was no reason for him to be taken off his medication; even if they were concerned about making sure his stomach was empty prior to this procedure (surely a moot point; he has a tube into his stomach and they can just drain it if they need to!), they could have given him the medication through an IV. And of course because of the fibrillation, they now have to wait until he is stable again before they can try this procedure, which means another length of time with little or no nutrition. It's hard to know how much these stupid errors may cost, both in financial terms (all that time in CCU and the procedures yesterday can't be cheap) and in terms of his overall recovery. I don't know who is luckier--Dad that he's managed to live through these mistakes or the doctors that we aren't all taking a good long look at the full-color attorney ads on the back of the Yellow Pages.

Back to the 6th Floor

With the snowstorm that moved through our area on Saturday, Dad had his first visitor-free day since his heart attack. He called Mom that day to make sure she wasn't going to to anything stupid (like try to drive anywhere!); she wasn't. Between the storm and my family's schedule, I haven't been in to see him since Thursday, but I've been getting daily updates. The one remaining problem that was keeping him in CCU cleared up a bit on Sunday--they gave him three tablespoons of food through his stomach tube and he absorbed it all. Yippee! Once that happened, he was cleared to move back to the 6th floor, a move that didn't happen until late last night or early this morning because they were waiting for a bed to be available. Dad doesn't remember the great nurses in CICU, but he was getting nurses of a similar caliber in CCU and he says he'll miss them. There was one in particular who, he said, should have her name as the dictionary definition of TLC. But the 6th floor has it's good points, none of which spring to mind at the moment. Anyone care to come up with a few?

Roger, to answer your question: yes, Dad is talking. His trache tube has a speaking valve that can be put in place when he wants to talk. It takes some effort on his part (yesterday they replaced his usual tube with a smaller one, which should make it easier for him to talk around), and after his GI tube surgery, it hurt his diaphragm too much to talk, so he was silent for a few days (that is, he wasn't speaking, but he was using hand signals, mouthing words, and spelling out words to communicate). Once the pain subsided, he was back to speaking.

I hope that after this last week of unforeseen complications, Dad's recovery takes on a smooth course. He deserves it after all he's been through!

Calmer Days

Things have calmed down significantly for Dad in the past couple of days. Since realizing their mistake with the medication, his heart has remained largely strong and steady, and the spasming pain from the surgery has also mostly disappeared. The nausea is gone, although he still isn't processing anything through his stomach. All tests and observations indicate that there is no physical problem, just that his digestion hasn't picked up yet. Because of this, he continues to be kept in CCU instead of being returned to the 6th floor.

He's looking really good, though--his color is great, they shaved his moustache so he looks a lot more like himself, and every day he is more alert and stronger. His right hand, weakened from the stroke, is also improving very slowly. He's been using it a bit and even successfully wrote a few words. Boredom is setting in for him--he's not able to focus or concentrate enough to entertain himself with reading or watching television (never a favorite under any circumstances) and most other sources of entertainment are either unavailable in the hospital (he'd probably love to have access to the internet!) or impractical with his weakness (I can't really see him knitting anyway). Today the physical therapist gave him a real workout--they've been sitting him on the side of the bed daily and working his legs, but today they got him up and standing with support for a short time, and then had him side step a couple of steps to get him in a good position for getting back in bed. The effort made him lightheaded, but this was the first time he was on his feet since December 8! He's also eating ice cubes these days, which must be a real treat after a month and a half of nothing. Ice cubes won't help him regain the weight he's lost (he's down to 150 pounds), so my current prayer is that he starts digesting soon so they can get some nutrition in him.

Wednesday, January 19

After Dad's heart rate stabilized on Monday afternoon/evening, it shot up again that night, shortly after I left around 9:00 p.m. Mom was there when it happened and ended up staying the night with him. He was miserable all night--the nausea and pain continued and his heart rate was around 180 bpm for much of the night. In the wee hours of the morning, they suctioned out his stomach again and his heart rate went down to a normal level. Finally on Tuesday, midday, they discovered that all the fibrillation was happening because a medication he had been on since his heart surgery to help regulate blood pressure and rhythm had unintentionally been stopped after his GI tube surgery on Sunday. Apparently the doctor had to give orders to reinstate medications after surgery and he simply forgot that one. Frankly, I'm livid about this--how on earth do you forget a heart patient's heart medication? But once they started him on it, his heart went back to normal and has been strong and steady since then. The pain from the GI tube surgery is lessening gradually. Today he's feeling pretty good and there is talk about moving him out of CCU and back to the 6th floor. His digestion still hasn't picked up, though, although the doctors say that there doesn't seem to be any obstruction--it's just being slow. But because of that, Dad still feels sick and isn't getting any real nutrition. I'm hoping that clears up shortly so he can go back to the business of recovering from everything else!

Late Monday update

Dad's nausea continued to be a problem through all of my evening visit with him. When I arrived, they had given him an anti-nausea medication which did no good whatsoever, based on his vomiting shortly after I arrived. Throughout the visit, he kept this up, either almost vomiting or actually vomiting. They tried a second dose of the anti-nausea medication (explaining that the painkiller he's on as well as the heart medication frequently causes nausea), which again did no good, so they tried a different type of anti-nausea medication. At this point, he was vomiting copious amounts of brown liquid (too much information? Sorry. But wait--it gets worse!) so they pulled out a big irrigation syringe and started suctioning out the contents of his stomach. The nurse said he was checking his stomach volume--he'd pull out some brown bubbly liquid (while we made comments about high tech bulimia and tried to figure out if it looked more like Coke, root beer, or a good stout, which got an actual smile from Dad), put it in another container, pull out some more, and this just kept going and going. In all, he pulled out 500 c.c.'s of liquid (is that right? The math doesn't work out, but I'd swear that's what the nurse said). Dad had been getting 20 c.c.'s of sugarwater per hour since that morning, so basically he hadn't been digesting ANY of it. This is completely normal after surgery; the digestive system often shuts itself down for a couple of days. When some doctors examined Dad early this morning, they said that they'd start him on sugar water on Tuesday, but later they decided to start it today, thinking it might help his pain. Instead, it added to his misery--anytime his abdominal muscles would spasm or he'd have to cough (something that is incredibly painful for him at the moment), it would make him vomit, or nearly vomit. So it seems as if this was simply a volume control problem. But here's the gross part--after suctioning out his stomach, they then put it all BACK IN! The nurse explained that he needed the gastric juices in the fluid so that he could start digesting again. Ewwwww. Needless to say, they've cut off the sugar water for the time being and will reintroduce it VERY slowly later on.

They are also culturing some secretions from his lungs. In the past couple of days, the secretions have increased quite a bit and the color has changed, both worrying signs, and we're concerned that he's developed a new or stronger pneumonia. I'm hoping that the volume increase is just because of his inability to cough out all this stuff himself. There's no sign of fever, so that's a good thing. We'll keep praying that this isn't yet another new complication.

When I left, Dad seemed very tired, still in a lot of pain, and absolutely miserable from the vomiting. He insisted that he was fine on his own for the night. His nighttime nurse is great (a familiar face from CICU) and only has two patients, so I hope Dad is comfortable and able to rest and that the nausea goes away.

Monday, January 17

It's been a somewhat difficult two days for Dad. He had his surgery yesterday morning, and they did succeed in getting the stomach tube in place. But he woke up in significant pain from the surgery, and the doctor had only authorized one dose of morphine, which did virtually no good. His nurse yesterday was unhelpful to say the least -- she seemed to have no interest in helping to find alternate ways of easing the pain, nor even in contacting the doctor; she really didn't check on Dad the whole time she was on duty, unless we insisted, and then only in the most surly manner possible. So she made a difficult day even worse.

When I arrived back in town yesterday afternoon, he was still wincing from the pain every now and then, but he was thrilled to see his grandchildren (heck, nobody stopped us on the way in, so in we went) and he didn't seem to let them see his pain. Mary and Alexander were equally thrilled to see him, with only a bit of hesitation when they first entered (the room was full of strange things, he was laid up in a hospital bed, and he had a mustache!). He was unable to talk, even with the block on his trache; it just required too much effort from his very sore diaphragm, so we had to give up on that. But Katie, who was there all day, was amazing with him -- she understood the vast majority of his soundless speech, and she knew all his signs. She was extremely attentive to him and he was obviously very grateful.

A doctor from the surgical team came in during the late afternoon and was surprised to find Dad in such pain -- he said of course he could have more pain relief, and they'd get him a PCA (a self-administered pain killer pump, for which he only needs to hit a switch to get relief) as soon as he could communicate it to his medical team. "Soon" is not at ALL soon on the sixth floor, however, so it was very late yesterday evening before they got it to him.

Sarah spent the night with Dad and said he had a rough night -- the PCA didn't help him all that much, and he rated his pain a 5 to 10 out of 10. She learned that a small percentage of patients who have this stomach surgery have stomachs which try to reject the pin that's put in place, and that causes stomach muscle spasms. This is what seems to be happening to Dad.

Katie came in this morning and spent most of the day there again (also again acting as his main means of communication). She reported to us this morning that Dad was having some fibrillation, but the machines to monitor this were on the second floor, not the sixth, so he would need a room change. They finally got him shifted downstairs after two o'clock, about the time that the kids and I arrived again, into a much smaller room, but in a place where he could get better attention. His heart rate at that point was about 170. Dr. Hiatt was there and identified his heart pattern as something very familiar (maybe SVT?) to which a standard medication could be applied. However, after first a single dose and then a double dose of the medication, his heart rate remained unchanged, so they elected to move him into the Cardiac Care Unit (one step removed from CICU, so full of very competent, attentive nurses). There they tried him on a blood pressure medication which also had no effect. I'm not sure what other measures they attempted, but they were beginning to get frustrated when Mom sneezed and Dr. Hiatt left the room to get tissues, and at that point Dad's heart rate abruptly went back to normal. So we don't know if the medication, the sneeze, or some kind of Dr. Hiatt magic finally did the trick, but we're just relieved that he's back to normal. He is still in a fair amount pain (though outwardly it seems to have diminished) and he can't talk yet, so that's not quite the normal we had a couple of days ago, but it's better than this morning.

Dad had some nausea and vomiting this morning (they gave him a vitamin solution that he tried to refuse, since it has made him sick before, but they didn't believe him, and whaddya know, he was right) and his stomach was still off this afternoon, but I hope that will go away for good soon as well.

They did let the kids back into the CCU today -- it seemed so high-fallutin' that we thought they might not, and some of the nurses were uncertain about the status of his C. diff (but we were told by an internist it's gone), but his nurse and Dr. Hiatt were both more than willing to have them back there, and it seems to cheer him up so much that no one likes to refuse to allow them!

I had hoped to see Dad in much better shape this trip than he has been in the past, and to a great extent he is, but I'm sorry he's in pain and that his communication is so limited! So we're hoping he'll have a much better day tomorrow, and I'm planning to get back here soon. One thing that does seem better this week than reports have suggested is his motor control with his right hand -- he drew a very convincing picture of a washcloth yesterday (but Amy and I were too obtuse to recognize it) and he has been able to talk to us by spelling things out on a printed alphabet. One of his messages late today, after Katie left, was "Katie has been very helpful. She has been here for many important decisions." That's pretty effusive praise from a guy who can barely move his hand!

Saturday, January 15

I had a nice visit with Dad today around noon. Mom is staying home, at least for today, to recover from her cold (the same one that has plagued the rest of us for the past few weeks) and avoid giving it to Dad.

While I was visiting, one of the pulmonologists came by. He hasn't seen a chest x-ray for a while, and we think that it may have been most of a week since they last did one. They've been basing his recovery on how his breathing sounds. The pulmonologist said that Dad's lungs sound great and his breathing is strong and even. He'll order an x-ray at the beginning of the week to see how things look. Because of the strength of his lungs and lack of complications since the bleeding around his trache tube last weekend, he thinks that after the stomach peg surgery tomorrow, they should be able to start weaning him from the oxygen and trache, first by cutting back his oxygen (currently at 40%, where it's been for quite a while) and then by plugging up his trache tube for progressively longer periods of time.

Dad is getting frustrated with is inability to communicate well with some of the nurses. Today's nurse seemed particularly dense, to put it bluntly. When she came in in the morning, Dad indicated with hand signals that he wasn't able to hear well and would communicate better if she put his speaking valve in place. She looked at the valve in its container, then put it down again. He again tried to get her to put it in place, so she looked at it again, said something about it needing to be changed and that she'd get someone who knows more about it to take a look. Huh? This isn't rocket science. You pick it up, put it over the tube, and that's that. So when I arrived hours later, he still hadn't gotten it in place and consequently hadn't been able to talk to the nurse about getting warm washcloths for his eyes, about his scheduled surgery for tomorrow, about needing to be changed, or anything. So I set Dad up with a series of notes, placed prominently on the box of rubber gloves, that start with "put my speaking valve on so we can communicate better." He and I came up with a number of things he regularly requests--eyedrops, warm washcloths, bed flattening, stopping the "galloping bubbles" sound from his oxygen tube, etc. Dad also requested that we move his bed to cut down on the glare from the window and to give him a view into the hall, but the bed is pretty much in the only place it CAN be in the room, so we rearranged the blinds instead. I think it's a great sign that at the moment his biggest concerns are about his comfort. He has all sorts of ideas for how to better design hospital equipment!

Emily and the kids are coming back into town tomorrow, so Dad is excited to see her and maybe the kids as well. It'll make up for Mom's absence, as it sounds like she's being hit hard with this cold.

Great Progress!!

Wow! I just can't believe how much progress has happened in the last week! I see that we have not updated this in a while - and I apologize for that.

Dad has been in his regular room for almost a week now. He also has spent more time awake than asleep which is the BEST thing for us. Katie and I were commenting the other night that when he was in the ICU we hated having to leave if he was awake at all - now we hate having to leave if he is asleep... We don't like not being able to say goodnight and that we will be back. I know he knows - but it is hard to go anyway.

In his new room visiting hours are a lot more flexible. Basically we can visit anytime between 12 and 8pm. We have often stayed beyond that and have not been kicked out. The nurses continue to be really nice on this floor - but they are overworked. The response times are VERY slow - which worries us. I know they know that we are there most of the time - and if it was an emergency we would come get them right away - but what if we aren't there? Are they that slow when we aren't there? It worries us.

We are now shopping for re-hab facilities. We are not sure when Dad will be able to move to the next level... On Wednesday they indicated that it may be next week - but yesterday that was modified again.

Dad had some chest pains yesterday - the initial tests they did showed it to be nothing - but they ran an ekg just to be sure. They also did blood tests throughout the night. The results from the first one came back normal. It was probably just indigestion... Mom stayed at the hospital last night just to make sure all was well.

He has been having problems with his eye(s) - mostly just one. We have been giving him drops and using a hot cloth on them. The doctor seems to think it is just a touch of conjunctivitis. You know - this along with the C-diff seems just to be adding insult to injury. Isn't it bad enough that he has had a heart attack, stroke, and stubborn pneumonia? Does he have to have diarrhea and itchy eyes on top of it??? Sigh.

Again, the progress Dad has made in the past week has been phenomenal! It is easy to forget at this point how scared we were just two weeks ago. But it is still not over. I will not rest easy until he is WELL ESTABLISHED in his re-hab program - or even out of it completely!

Again, thanks for all of you support and prayers. That is what has brought us this far!

CAT scan results

I just wanted to report that Mom said the internist did show up this evening. Dad's CAT scan showed a small spot that is probably a stroke, but they don't know if it's an old one or a new one, so they're doing the MRI to get a more three-dimensional view. Mom said he never had any sign of a stroke before this, so she thinks this is a result of the heart attack. But we're hoping the MRI will show that the damage is minor to non-existent!

The Weekend

Well, on Dad's one month anniversary of his heart attack, he was rewarded with his very own room, *not* in CICU!!! He has been moved up to the sixth floor (the pulminary wing) where everything seems strange. At least to us, it does. There is carpet in the halls and warm, colorful paint on the walls. It's all much less clinical and sterile looking. This is a huge step, because it means he really is on his way to recovery. Of course, as Amy said, "are WE ready for this?" We miss the nurses and staff in CICU terribly, because they were all so friendly and helpful and calm and efficient. Not that they aren't on the 6th floor, but since Dad doesn't need the round-the-clock care he was needing before, they are a little more scarce. They only show up every few hours or so, unless you call them. And then when you *do* call them, they seem to take forever to answer and show up. I'm sure that's just my perception, though. I don't mean to bash them--they are very busy, with many patients to care for (as opposed to the one or two per in CICU), and they have been very friendly and knowledgeable. We've just been spoiled. I'm sure I'll adjust. But don't they realize that Dad is their most important patient?!

On the health front, Dad appears to be improving by leaps and bounds. He has been fairly alert each time I've been in, and more and more aware of everything. He also seems to be retaining any new information we give him, so his short-term memory doesn't seem to be a problem. Yesterday he developed some irritation around his trache tube, so they took the block off. It was actually pretty gross--because every time he coughed there was blood mixed in with the mucous, which they assured us was not from his lungs, but from this irritation. Today he was much better. The phleghm was a little pink from time to time, but all in all much better looking. The speach pathologist (who is taking care of his swallowing tests and his trache block) said he could have the block back if he wanted, but he decided to wait another day, until the irritation is completely healed. They also decided to wait another day to continue with the swallowing tests, because he was experiencing quite a bit of nausea today. I'm not sure if it was from all the coughing he was doing or what, but he kept worrying that he was going to throw up. Although he never did--at least not while I was there. He was also quite concerned about his diarrhea, from the c. dif. bacterium. We keep assuring him that it will go away, it's just a side effect. It's really neat to be able to say how he thinks he's doing. For so long now we've been reporting how we think he's doing or how the nurses think he's doing. But now he's able to say first-hand what's going on. I get the impression, though, that he thinks he's a lot worse off than he is. Or maybe he thinks he's exactly as bad off as he is, but since he wasn't aware of just how bad he really was for the past month, this seems awful to him, but fabulous to us! To me, at this point, he really seems to be making great improvements.

They did a CAT scan Friday night to test for a stroke. And now they're going to do an MRI to confirm whatever the result of the CAT scan was. But we haven't seen a doctor to tell us the results of the CAT scan, so we ultimately have no idea what's going on in that arena. An internist was supposed to come by today to explain the CAT scan to Mom, but no one had shown up by the time I left, a little after 4.

I think that's all to report at this point. With any luck I will hear from Mom tonight with the results of the CAT scan, and I can post those.

Weekend update (January 8 & 9)

The best news of the past few days is that Dad has been moved from CICU to the sixth floor of the hospital, where they specialize in weaning people from ventilators (or so we are told; I'm not sure if this area of the hospital is specialized in any way, although it seems to be the place people go after ICU. There's a guy down the hall who looks like he was hit by a truck, another person I passed seemed really with it and physically able, but totally unable to talk, so it's quite a variety of people and quite a change for us after nothing but cardiac patients). They made this move late on Friday, when it was clear that his breathing with the oxygen collar was stable and all of his organs were functioning fine. We already miss the nurses in CICU--they were such great people, each and every one of them. All of them were bright, tireless, and had amazing senses of humor. I don't know how they manage with that sort of workload day to day.

Dad is still on the feeding tube, though. After initial success with eating applesauce, he didn't feel up to doing the second day of the swallow test (I'm not really clear on this test. I know it's a three day thing and if you fail one day, you're back to square one. I think a Google search may be in order) so they put that off a day, and then on Saturday they were unable to continue it because Dad started bleeding around his trache tube. They took him off his blood thinners to help the bleeding stop; it took over 24 hours--when I saw him on Saturday night, he was still bleeding freely, but on Sunday around noon it had stopped. In the meantime, they were doing ultrasounds to make sure no new clots were developing without the thinners. I'm assuming they will resume the thinners now that the bleeding has stopped. So once that particular complication is cleared up, they'll go back to the swallow test and weaning him from the feeding tube.

They did a CAT scan on Friday to check for signs of a stroke since his right side is still quite weak. We didn't get the results of the scan, but on Saturday we were told that they were planning to do an MRI today (Sunday) to rule out a stroke. The doctors weren't around, and the nurses were unable to tell us if this was good news or bad. We don't know if the CAT scan indicated the possibility of a stroke and so they want to do an MRI to make certain, or if the CAT scan didn't indicate any stroke took place and so they want to do a more sensitive test just to make sure. Either way, the therapy will be the same--long and difficult. Mentally, Dad seems to be quite with it. He can talk (after a fashion) and read (although can't focus long on anything small and difficult, but he could read his cards), and solve problems (today he said that his heart pillow - given to cardiac patients to hold against their chests to make coughing less painful - should have velcro on it so that it doesn't keep slipping off the bed). He knows who everyone is, and as we suspected early in his recovery, he always wants to know what time it is! When we visited him in CICU, we'd always tell him the day and time because we knew he'd want to know. Sure enough, as soon as they moved him up to the sixth floor, the first thing he asked was where the clock was!

Mom is eager to get Dad home, of course. She knows it'll still probably be a couple of months of in-patient treatment and rehab before he's ready for that, but this has been so hard on her. She's with Dad as often as they'll let her be, which means she's away from her home and her routines all day, every day. She's taken up knitting again and was busily working on a very pretty scarf at the hospital yesterday. A couple more months and we'll probably all have nice, fuzzy scarves.

That guy in the ICU waiting room that first night was right--we're measuring Dad's progress in weeks, not days. Even though I'm thrilled that he's out of CICU, it doesn't seem as big a step as I thought it might be, but then I think back to where he was a week ago, still heavily sedated, planning to get the feeding tube inserted directly to his stomach, and unable to talk and I realize this IS a big move.

Now that he has his own room, he has LOTS of bulletin board space. Mom hung up all of the get well cards he's received and, as I said, he enjoyed reading them. If anyone would like to send one directly to him at the hospital, I'd be happy to provide the address. You can email me to request it: sarahfranATverizonDOTnet

January 5 & 6

Wow! If only you could all see the amazing progress that has happened in the past few days!

I missed visiting Dad a couple of times over the weekend because of an icky cold I was fighting... But I was back in to see him on Monday and then Tuesday. He was sleeping both times - and so looked the same (mostly) as he had the past several weeks.

THEN - on Wednesday Katie and I went in for the 4:30 visit. They were only allowing two people back at a time and Mom was already back there - so Katie sat down and I headed back. I looked in his room and almost fell over. He was sitting up, wearing his glasses and looking about as bright eyed and alert as he always had BEFORE the heart attack. You would never in a million years have guessed that less than a month ago he was fighting just to keep his heart going!

Well - I went galloping towards his room and was stopped cold at the door by Mom and a nurse saying that I couldn't enter without wearing a gown, gloves and scrubbing up before leaving. They then closed the "quarantine door" and put a cart of disposable sterile clothing in front so people like me couldn't cavalierly invade the space. NOW - on top of everything else - he has some sort of aggressive, invasive parasite, virus thing-y that gives you diarrhea. It is common in the ICU we are told - and both he and his room mate have it. I am not sure why we had to protect ourselves - either to not spread it outside of his room, or because it makes the patients vulnerable to the foul outside bugs that we, as visitors, tend to set loose in the area. I don't know... It lasts for 14 days - I do know that.

Anyway - Dad was holding a couple of papers with symbols and letters on them. He can use these to communicate. These aren't good enough because he still wants to tell us stuff. So he mouths words to us - and we attentively watch his lips and then say "yeah, I'm getting nothing..." I told him I never COULD read lips. I never understood people would could. Sigh. He kept trying and didn't seem as frustrated as I would have been in his place. Mom did understand him earlier when he asked "Where amI?" When she told him Sinai he said "Oh!" and nodded. I decided I would make him flash cards that ask the important things like "How's the stock market doing?" and "Can I have a glass of wine?" I handed him a picture of Claire blowing out her birthday candles. He looked at that for a long time and smiled. Then later - when he was trying to get me to lip read he was gesturing for blowing on something... It didn't occur to me until much later that he may have been referencing that picture.

I stayed about 10 minutes or so and then sent Katie back - but no sooner had she arrived when they kicked her out so they could give him a new feeding tube. We hung around waiting for them to call us back in - but then gave up at about 5:30. We walked back and waved at him through his quarantine doors.

I just now spoke to Mom today... She was so excited - understandably. They gave him a block on his trache tube so now he can talk. They have been asking him questions and he has gotten most of them right. Some of his short term memory is a little faulty - but for the most part he is doing OK. I can't wait to go see him and just hear him tell us he is going to make it!!! He wants to see his kids - and his grand kids. He can't see his grand kids yet but his kids will be there - and have been there all along!

They were going to do the "intervention" procedure today. Which is the process where they put the feeding tube directly into his stomach. However, before they did it they decided to see if he could swallow anything. They gave him a bit of blue applesauce - and he kept it down, and didn't breathe it into his tube or anything!! Woo-hoo! Go Dad! So they decided to hold off on the stomach tube... which I am glad about, because that procedure is a little harder to heal from. (They have to cut a hole into your stomach for goodness sake! Doesn't he have enough holes for right now?)

OH! More good news. They now have said that he may not have to go onto the pulmonary wing next. He may be able to go straight into rehab; which will be about a 2-4 week stay. Oh yippee!! He is getting better! The pulmonary specialist still says he is not out of the woods - and won't commit one way or another about his pneumonia - but again - He doesn't know Dad's stubborn streak OR how many people he has pulling for him.

The only slightly negative thing is that Dad - although impressively strong for his condition - is having troubles moving his right hand. They are going to do a CAT scan to check to see if he had a minor stroke along with the heart attack. It is not immobile, just has very little strength at this time. Poor Dad being a right-y too... Oh well, that is what they have keyboards for anyway. Right? We will just strengthen his left hand even more.

Well, that is it for me for now. I hope to make it in for the 4:30 visit today - since that seems to be his better time of day. Keep praying!!!!

January 2 (written on the 3rd)

Last night after I visited Dad, I was ready to dance a jig! It was a really good visit. I hadn't been able to get in for the morning or afternoon visit, because I had to work, but I was able to make it in at 8:30. When I got there, Mom informed me that she had spoken with a specialist from the sixth floor (as opposed to the fourth floor where we have been for almost a month now), because they're looking to move Dad up there sometime in the next few days. Woo hoo! I think this is the step I've been waiting for--to get him out of CICU and into his own room. The person Mom spoke with said that it is still going to be a looooonnnnnggggg and slow road to recovery, but the very fact that they are trying to move him out of CICU indicates that he is very much on the right road. The reason they have opted to move him to the sixth floor is that they have pulmonary specialists there, and Dad will still need to be on oxygen for a little while yet. But up on the sixth floor they will be able to begin weaning him off of the ventilator, continuing the work they've started doing in CICU. Yesterday for a little while they had him on what's known as a trache collar (or oxygen collar), which Mom described as a small bottle attached to his trache tube. They also said that if he has to be on the trache much longer, they will begin teaching him how to speak around it. So at least we'll be able to communicate a little better! They've also been having him sit in a chair for a few hours each day. When I went in on Saturday he was in the chair, and really didn't like it. I think part of the problem is the fact that he has such long legs, and they're practically doubled over in the chair. But the nurse, Carole, said that when they try to sit him more upright, which would give his legs more room, he just slumps back down. She said that all the patients do this, not just Dad, and she has never figured out why! Apparently he was less agitated in the chair yesterday than he had been in previous days, so I think he's getting acclimated to it.

After getting all the updates from Mom, I went over to Dad's bed. He was awake (they have him no longer connected to the fentanyl drip, but have him on a patch for it) and smiled when he saw me. I went to hold his hand and he gave it a nice squeeze and stroked it with his thumb. This was the most responsive I have seen him since the first weekend, so it was absolutely wonderful! He really was very alert, and was watching everything going on around him. I mentioned that they have a tongue depressor taped to his bed, and he tried to turn his head to see it. I think he's getting VERY sick of being in bed. He kept shifting his legs around, from side to side and then bending his knees a bit. And he scratched an itch on his leg at one point (which kind of surprised me--I wonder how much he really is able to feel at this point, if an itch was bothering him--is he in any pain?). I asked him if he was uncomfortable and he nodded "yes" and looked a little exasperated. A little later I was standing there stroking his head, and it occurred to me (as it has before) that it might be driving him nuts--especially since we can only reach the top of his head without lifting it off the pillow! I asked him if it was bothering him, and he kind of got a strange look on his face, as if unsure how to answer. So I said "a little bit, maybe?" and he nodded and mouthed "a little." I think he enjoys the human contact, but at the same time he's NOT a cat, and doesn't need to be petted constantly. And unlike my cats, he can't get up an walk away when he's sick of it! I know all of these things seem like such small things, but after three weeks of him being all dopey and unresponsive, any little bit helps! The big drawback to him being more alert is that I HATE to leave him! I gave him several kisses before I left and then he motioned to Mom that he wanted a kiss from her. She commented that she's scared to kiss him for fear of getting him sick somehow, but as she leaned in to give him a kiss, I saw him mouth "I'm not!" so it's quite clear that he's feeling better. That was such a Dad thing to say, that it really cheered me up.

This was definitely the best visit I've had so far. I know it's still going to be a long time before he's back to normal, but I really finally feel like he's going to be OK. There is a light at the end of the tunnel for me now. And boy is that a good feeling!

January 1

Happy New Year! My apologies for not posting any updates for the last couple of days (especially since they would now be first person accounts, as I've been able to get to the hospital each day). Dad continues to recover slowly but surely. Since getting the trache tube in, they have managed to wean him almost entirely from the ventilator--he's now getting just two breaths per minute from the ventilator and the rest he's doing on his own. They are also switching him from IV fentanyl to a patch (and with a much lower dosage) and are talking about getting him an oxygen collar so he wouldn't be so tied down by the ventilator. This all seems like great progress to me! He looked great when I got in to see him on Thursday--his color was much better and he was far more alert than he had been, and he even had a smile for me when I arrived.

On Thursday, one of the nurses said she thought she heard a murmur while listening to his heart. They got one of the PA's to take a listen and he couldn't hear anything (although he pointed out that he hadn't listened to Dad's heart before so he wouldn't be the best judge of any changes) and later Dr. Hiatt reported that she also couldn't hear any murmur. On Friday, another doctor (I think one of the pulmonary specialists?) said that what he was hearing was not a murmur, but a rub. Apparently this is quite common after heart surgery and is caused by some swelling in the tissues. Also on Thursday, Dad had some problems with nausea; after clearly mouthing "I don't feel so good" and indicating his stomach, he vomited a bit. That was the only incident he had, though, so it was most likely caused by all the medications in him and is not any indication of a stomach virus.

Friday was a rough day for him. They needed to replace all of his lines, so to do this they needed a good x-ray of the area. They took the x-ray and a bit later, the technician called to report that he had forgotten to put film in the machine first (oops). So he came to take another one, and THIS time he ended up doing a double exposure. By this point, Dad's nurse was fuming and encouraged Mom to request another technician for the third x-ray, which she did and this one went fine, fortunately. Someone in the area said to Mom, "I hope you weren't planning on having any more children!" Then after all the x-rays and getting his lines replaced (quite an ordeal, I imagine), they brought in a chair for Dad since they want to start getting him upright. It took five people (including Mom) to get him in the chair and I'm told that he wasn't at all happy to be there! But they kept him in it for a while, in spite of his silent protests. I think all this activity must have been pretty exhausting. By the time I arrived in the late afternoon, he was pretty tired and just slept most of the time I was there.

His pneumonia (which has a name now: klebsiella pneumonia) continues to be a problem. After being down for a while, his white cell count was a bit up on Friday. His chest x-rays aren't really clear. On Thursday, Dr. Hiatt and the PA both said they thought they looked a bit better, but the pulmonary specialist said they looked about the same ("what does he know?" was Dr. Hiatt's comment). Since this is the thing keeping him tied to the respirator and in ICU, we pray that it'll start to clear up soon. But I know from my own experience with Connor that this could take quite a long time, so the message is the same as it was three weeks ago--patience, patience, patience.