Mom's Blog

Blog entries dated December 9, 2007 to December 15, 2007

Sunday, December 9th, 2007

Mom was doing great today. They had her off the ventilator for 8 hours yesterday and Rick told me they were going to try all day today. So she was breathing the humidified air. Although she seemed to be coughing a bit and they were clearing her lungs several times. She was very awake and alert and writing notes.
 

Tuesday, December 10th, 2007, 2:15 PM

This is Dave in San Diego. I just spoke with Mom's nurse at the hospital. She's doing great again today! She's been off the vent since early this morning and is breathing just fine and says she's comfortable. The nurse said at this point she's really ready to move out of the ICU any day - it's just up to the Doc to make the call as to when her pneumonia and breathing are well enough for a regular room. I also spoke to Cath in the car about 30 minutes ago, and she has another 250 miles to go, so she should be there sometime this afternoon. Mom knows she's coming, so I'm sure she'll be very excited to see her. We should have a much more detailed update later this evening after Cath has had a chance to get caught up on her condition.

Wednesday, December 11th, 10:00 AM

This is Catherine. I arrived at the hospital at 5:00 p.m. yesterday. Mom was awake and in good spirits. She wrote "I am so happy to see you," which made me happy, too. I had a few gifts for her that she enjoyed opening, especially two Care Bears from my student, Sam. I spent a few minutes getting caught up on mom's status with the nurse, Guinevere, whom I have come to know well. She said it was mom's first day to be off the ventilator for the whole day. She still has a tube attached to the trach, but this just blows humidified air. If mom can breath on her own for the next 4 days, then they will start decreasing the size of the trach tube until they can close it completely. Sometime during that process they can manually close off the hole to allow her to swallow liquids. The doctors will decide when she can be moved out of the ICU in the next few days as well. Yesterday they gave her two units of blood because her blood work. When mom's hematocrit is not in the normal range, they usually give her some blood.  Hematocrit (Ht or HCT) or packed cell volume (PCV) measures of the proportion of blood volume that is occupied by red blood cells. (Yes, I got that off Wikipedia.) They also gave her blood because she is showing signs of anemia, which is a condition she and I have always had. She still has a feeding tube, saline tube, and a a small drain coming out from her stomach to remove stomach acids. She is also still on Heparin, a blood thinner. Chest X-rays show that the fluid they drained last week that was in her right lung cavity has not returned. She still has a touch of pneumonia, and they are still using tubing to suction junk out of her lungs through her trach from time to time, and they are still giving her IPV treatments to help break up that junk. Mom told me she would like help writing Christmas cards this week. I just happened to bring a bunch to do myself, so we will start hers first! Better get going.

More later.

7:00 p.m. Mom had a good day. We did all her Christmas cards. She wrote a personal message on each one and I did the addresses. She was on the vent all day today to take it easy. Tomorrow morning they will look at her chest x-ray and decide if she can do another trial off the vent tomorrow. The nurse today decided her blood sugar levels have been good enough that they will stop pricking her finger every six hours, which is very nice. The Occupational Therapists (2) came today and did a lot of exercises with her. She sat up for a while and stood for a few seconds with help. Mom says it is really uncomfortable because of all the tubes that pull when she stands, including the weight of the ventilator on her trach site. When she is moved out of the ICU she will most likely be off the vent and some of the other tubes so it will be easier to do physical therapy. I got a picture of two of our favorite nurses tonight, Guinevere and Kelli.  They were not pleased with the picture, but said we could post it if Dave photo-shops it, and makes them look really good. :) I will be leaving the hospital shortly as my grandma is expecting me soon.

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Thursday Dec. 12th, 2007 3:30 p.m.

I didn't get here until about 11:45 a.m. because I ran grandma around on some errands this morning, and we also got locked out of the house!

Mom was awake when I got here and off the vent again today for another trial. We did her  arm and leg exercises, and I painted her fingernails and toenails bright red. :) Mostly she has been watching TV with me. Then around 3:00 a doctor came in and said that they wanted to downsize her trach tube today to see if it helps her breathing. I was surprised. It only took a few seconds and it was done. She went down from a size 8, to a size 6. I have also been rearranging her cards, pictures and posters, as there are so many now! Mom looks a bit tired today, but the nurse, Marcia, wants her to sit up and maybe stand in a while. Hopefully that will go ok. More later.

7:00 p.m. Mom did sit up for almost a half hour today, but was reluctant to stand. She said she will stand if someone "stronger" was going to help her! :) The nurse, Marcia, laughed at that. The OT attached some tension bands to mom's bed this morning for her to use for exercising her arms. She is still off the vent and she says her breathing is "ok." Hopefully she will be able to make it through the night. Tonight is the ICU's X-mas party, so hopefully there will still be some nurses working!!!

I want to mention that several nurses and also Dr. Song have said that having mom as a patient is a pleasure. Many of the patients they see are drug addicts, alcoholics, or others who do not take good care of themselves. It can be frustrating for them to help someone get better when they know that once they leave they will return to their unhealthy lifestyle. They said that it is exciting for them to work with someone like mom who is so healthy, and wants to get better. Dr. Song even said that mom is one of the "sweetest patients" he's had in the 6 years he's been working at this hospital.

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Friday December 13th, 2007 NOON

A lot of action today! Mom went back on the vent at 10 p.m. last night but is on another trial today for 16 hours. 

Mom also had A CT scan this morning to check on her liver. The scan showed that she has a pseudo-aneurysm in her liver, which is a damaged blood vessel that is swelling. Currently it is 2.4 cm, and the risk is that if it ruptures, she will start bleeding again from her liver. So the team is advising a procedure called embolization. An Interventional Radiologist will insert an IV tube into her groin area and feed a wire through that up the artery into her liver. Once they reach the vessel, they will plug it with a clotting agent that will prevent it from rupturing. They will do this procedure either today or tomorrow. It will not been done in her room, but the doctor said it is relatively simple. She will be sedated and given a local anesthetic. Mom is very anxious about this procedure and has asked that she be sedated so that she doesn't know what is going on when it happens. In her own written words, "I have gone through so much in the last month. I just want to be asleep during the procedure. I have had enough lately." Her hands started shaking and she turned back her notebook back to a page she had written before I got here, in which she had written her wishes for cremation and funeral. I told her that was good to know, but that we were no where near that stage yet and that she is in RECOVERY! Then I had a good cry.

Mom also had a visit from the Speech Therapists. They did a short trial with a Phonate Speaking Valve. This is something that gets attached to the trach, and allows her to breath in through the valve, but pushed the air out past her vocal chords and through her mouth instead of out the trach on the exhale, which allows her to speak. Mom's voice sounded very robotic, but she could speak, which was very exciting! She answered questions, told the ST my name, and said hello to the nurse Marcia.  They will continue to do brief trials with this device when she is off the vent. The nursing staff can also attach and use it when they want. It makes Mom kind of tired and requires an bit more effort, so it won't be on all the time right now. She is a bit worn out from all the action today, so we are going to wait to do her PT and see if she can nap.

Just got news that they are going to do the procedure at 1:30 today, so I am relieved that we don't have to wait too long. We are both anxious.

The procedure is called a hepatic angiogram with embolization of bleeding vessels. They are now stopping her Heparin, starting some pain meds, and starting some sedatives. Her nurse Marcia said she will go down with her for the procedure, which is really nice and comforting to both of us. Dr. Dong, a Radiologist will be doing the procedure, and it should take about an hour. They said she should be back in the room at 3:00 p.m.

4:00 P.M.

The procedure went ok with no obvious complications. They embolized (clotted) the aneurysm which should keep it from rupturing. That is all I have been told so far, but I am back in the room with mom. I squeezed mom's hand and she opened her eyes and smiled at me. I told her she did just fine and she should rest, so she is sleeping now. I will hang out and see how she feels when she wakes up.

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Saturday, December 15th, 2007

Mom continued to sleep yesterday and when awake said she was feeling fine.  I came by to see her before I hit the road back to San Diego, and she was in good spirits. They started another 14-16 hour breathing trial. I left about 11:00 a.m. and got home about 6:30 p.m. Later on I spoke with Diane who spent the evening with mom. She said that mom was doing well and looked good. She was telling mom how much Alyssa missed her, and when the nurse overheard, she said, "Well maybe we could sneak her in for a visit." Usually they don't allow any visitors under the age of 12. So after discussing this with mom, they brought Alyssa in to see her. Diane said that mom smiled the whole time and so did Alyssa. When I spoke to Alyssa she said, "Nana looked much better than I thought she would." Alyssa was also pleased when mom wrote her some notes that said, "I wish I could hug and kiss you," and "I love you." Overall, Diane thought it was good for both of them. It's been well over a month since Alyssa has seen my mom, and she was used to seeing her 3 times a week. Diane will be back to visit mom on Sunday.

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