Tuesday, March 29, 2011

Last two days

Monday was a good day.  Nana got moved from ICU to PCU in the morning.  She had another (and much shorter) dialysis session sometime before Laura went to see her.  Some of Nana's friends visited for about an hour, which is always a good thing.  The biggest good news yesterday was when Nana called around 9pm to say that one of her doctors confirmed that her heart went into a normal heartbeat rhythm (not a-fib)!

Tuesday was good then turned kind of so-so. Nana had a busy day--some more friends visited.  She's able to get up and out of bed when she needs.  She had a really good lunch today and ate just about everything.

Dr. C came by and said that Nana's kidneys are doing much better.  Nana's heart doctor came by and listened to her heartbeat, and everything seemed to be in order.  Her heart is still in normal heartbeat rhythm.  Dr. M - thinks she might get out in 2-3 days.

This afternoon, they took out Nana's PICC line.  The area on her arm was starting to turn red and puffy, and an infection is suspected.  If she didn't pick up this infection, she might have been released tomorrow.

The IV to dialysis catheter connection is leaking, which is a bit concerning.  Laura said the nurses were going to change the bandages and see if that helps.  They are trying to avoid putting in an IV line in her arm since they just took the PICC line out (and her left arm is sort of reserved for a more permanent dialysis connection).

Sunday, March 27, 2011

A good day for Nana

Nana had a good day today.  Laura spoke with her this morning, and she'd lost 15 pounds of fluid!  This is very good news, as her body will now have an easier time recovering.

Laura spent the afternoon with Nana.  One of Nana's friends was there visiting when Laura arrived.  Nana was a little bit sleepy, but nothing like yesterday.

The dialysis machine & operator
The hospital staff also performed another dialysis session this afternoon, and got another 3.5 liters (about a gallon) of fluid off of her.  Nana took a nap towards the end of the dialysis session, so it was Laura, Nana, Nana's friend and the dialysis machine operator in the room for several hours -- a full house in that small ICU room.

She's doing well enough that they're moving her out of the ICU into a PCU room sometime tonight.

Saturday, March 26, 2011

Recovery Day

Nana had a good day today.  Laura found out that the dialysis they did last night got three liters of fluid off of her.  There's still plenty of fluid left, and they'll be performing another dialysis on her tomorrow.  One of the things they need to do is fix the electrolytes.  Laura was trying to find out if it was too high or too low, but it's something they need to keep an eye on while doing her dialysis.

Nana's breathing was much easier today, but her blood pressure is still low.  We went to visit her around 3:30 this afternoon.  Since only two people can visit at any one time in the ICU, Laura and our youngest son went in first.  I waited in a nearby waiting room with our other son.  We were in there for 30 minutes or so when Laura came out, and we went in.

Nana was awake when we went in, but fell asleep seemingly mid sentence.  She woke up a few minutes later, and apologized for falling asleep.  We spoke a little more, and then she was out like a light.  After we left, Nana was telling Laura that she's very tired of being in the hospital.

Nana's monitor in the ICU
The graphic here is a cell-phone photo of Nana's monitor.  The number in green is her pulse, the number in light blue is oxygen, and the number in white is breaths per minute.  Her blood pressure is at the bottom left with her pulse in ( ).  Laura says that the 107 is pretty good for her, but the 57 is low.

Friday, March 25, 2011

Another rough day for Nana

After a bad night and having a breathing tube installed and removed, Nana had a pretty rough day.  Let's see...she had some visitors, which is a good thing.  Our pastor stopped by for a visit, as well as some of her friends.  Nana was in and out of sleep today, and it seemed that she was waking up with fresh memories of her dream as she would say things like she was falling out of the chair, or that the cough drop was on the bed.

She had a PICC line installed this afternoon.  It's a lot more invasive than a port, but it should make it easier for the nurses to draw blood or administer needed drugs without having to jab her with another needle.

Laura said that the high doses of diuretic that she'd been given wasn't getting the extra fluids off of her like they should.  Nana's kidneys aren't getting enough blood to remove the fluid.  Nana decided that she wanted to go through dialysis to help her kidneys out.  When Laura left tonight, they had come to install the catheters to hook Nana up to the dialysis machine.  They did start the dialysis sometime tonight.  Aunt D was there and stayed with Nana until 10:45pm.  She said that Nana was doing okay with the dialysis and that it didn't hurt her.

Laura came home just before 7pm, and pretty much crashed.  She'd been at the hospital with Nana since around 10am.  Hopefully tonight will be better and tomorrow will be better still.

Bad day turns into bad night

* * *  U P D A T E  * * *

She doesn't need the breathing tube anymore, and is more aware of what's going on around her.  Praise God!

***********************************
Nana did not have a good night last night.  One of the nurses at the hospital called and said that Nana was having a hard time breathing, and was getting confused on some things (but not all, thank goodness).  They inserted a breathing tube in Nana to help.  Laura is on her way over to the hospital.

As you might imagine, we're pretty concerned over this new development.  Prayers are always appreciated, especially right now.

Thursday, March 24, 2011

Bad day in the hospital...

Nana had a bad day in the hospital today...  When Laura went over to visit her this afternoon, she found out that Nana's swelling had gone down a little bit.  Nana went to sit up, and move her legs to sit on the side of her bed.  When she did this, she stopped and was having difficulty.  Laura said that Nana's heart rate dropped to 40, and she started having a very hard time breathing.

They summoned nurses, and Nana was soon surrounded by people trying to figure out what was wrong.  I'm kind of running from memory here, but she was administered calcium, glucose, a chest xray, an EKG and probably some other stuff.  The nurses also wheeled in the emergency cart so if something more happened, they'd have what they'd need.

Laura told me that Nana was given cardizem, and it was probably too much for her.  The hospital staff was giving her calcium to absorb the cardizem, and glucose (I think) to help thin it.  But they have to be careful with the glucose, as too much fluid isn't a good thing for someone with failing heart valves.

The hospital has moved Nana to the ICU, and Laura came home because they were in the middle of their shift change.  Fortunately, the hospital is less than 10 minutes away.

Laura also told me that Dr. M came by and he, Dr. W as well as the head cardiologist for the hospital are trying to locate a surgeon who's willing to perform Nana's heart surgery.  He indicated that it might be hard to find someone because of the high risk involved.  Age, heart rhythm, kidney function and breathing difficulties are all factoring in to the level of risk.

I really hope that someone will be willing to do this surgery, otherwise, we're likely to have to keep bringing Nana back to the hospital seemingly every 10 to 14 days.

Laura left about 20 minutes ago to see how things are going, and to make sure that Nana's all settled.  She just now got home..around 10:30pm.  Nana's all settled in the ICU as much as possible.  A doctor should be by sometime in the morning and hopefully she'll be returned to her normal room.

Wednesday, March 23, 2011

And here we go again...

Well, Nana's back in the hospital again.  She had been having difficulty breathing, and her body hasn't been flushing fluids efficiently.  Laura took her to see Dr. M today, and during the appointment Dr. M called the hospital and arranged for a regular hospital room.  At least Laura and Nana didn't have to wait for hours in the ER, just hours for the hospital to have a room available.

To add to the confusion, the admitting department has moved to a different building and the faxed admitting papers kept going to the wrong place.

One challenge was Nana's oxygen tank.  Laura took one tank with her, and the tank ran out during the admitting process.  The hospital employee handling the admission called over to have some nurses come and get Nana moved into her room.  Since the hospital is in the midst of opening a new building, the nurses initially got lost which added to the time.

Right now the plan is to get the excess fluid off of her, and then they'll probably schedule open heart surgery to replace her defective heart valves.  Both her mitral valve and her aortic valve are leaky.  This most likely means that Nana will have to go on dialysis afterwards due to her reduced kidney function.  There are so many variables right now, it's difficult to wrap our heads around it all.

When did this all start?

Let's see where this blog takes us...

I'm starting this blog in the middle of our odyssey..lots of ground has already been covered this year.  Nana has congestive heart failure, brought on mainly by a faulty heart valve--which we found out about this year.  Because of this, her heart is not strong enough to flush the fluids that our bodies naturally make, and it just collects.  Her legs swell and feel wooden.  She has a difficult time breathing.  I'm going to try documenting some of the things we've been through to hopefully provide an outlet for the stress and turmoil on our family and hopefully provide something for others in a similar situation to read and commiserate with.  :-)

Most of the posts before today will read more like a blow-by-blow description, and really will be more to document what's gone on before.  It will either be interesting or dry as toast, depending on your perspective.

Here's the cast of characters in this real life drama:

Real People:

  • Nana: My 81-year old mother in law.  She's one of the nicest people you'll ever meet.
  • Laura: My lovely bride.  She's also one of the nicest people you'll ever meet.  She's a stay at home mom, home educator, digital scrapbooker, and of late, Nana's health advocate.  Watch out, my wife can go from sweet to mama bear in about .02 seconds.
  • Aunt D: One of Laura's two aunts and Nana's sister
  • Cousin D: One of Laura's cousins, and daughter to Aunt D
  • Aunt M: Laura's other aunt and Nana's sister
  • Uncle A: Aunt M's husband

The Physicians:

  • Dr. M: Nana's primary health physician
  • Dr. W: Nana's cardiologist
  • Dr. Y: Nana's cardiac electrophysiologist
  • Dr. C: Nana's kidney physician
  • Dr. L: Nana's lung physican
  • The Pharmacy: This one should also be obvious.  The Pharmacy is located in a large store that prides itself on saving money and living better.  All in all, the people working at the Pharmacy have been incredibly helpful.

Other characters:

  • The Oxygen Supply Company

Thursday, March 17, 2011

Duel of the Doctors

Dr. M & Dr. W met on the green at dawn with flintlocks to see who would win.  Not really, but there has been a lot of back-and-forth discussion on what's the appropriate treatment for Nana.

As it stands currently, Nana would need to have a heart valve or two replaced.  This means open heart surgery, which is not to be taken lightly.

Nana has another appointment with Dr. W in a couple of weeks, so we'll see how things are then.

Sunday, March 13, 2011

Pharmacy wrestling match

Laura has been trying to get all of Nana's prescriptions from her latest hospital stay filled.  The pharmacy had a problem with the prescriptions.  It apparently isn't on the correct form.  Since one of the medicines was for a substance that keeps platelets from sticking to and building up around Nana's stent, Mama Bear mode kicked in about .02 seconds later (oh, that poor pharmacist). My sweet wife started reciting the list of who to contact at what hospital and here's everyone's phone numbers and call me when you get it figured out.

She went to pick up all of the prescriptions later that day.  On a Sunday.  Don't mess with Mama Bear. :-)

Apparently there's slightly more to this story:  When the pharmacist called to the hospital to verify with Dr. W, all the pharmacist wanted was Dr. W's FAX number.  The hospital was unwilling to provide that information, but they did provide Dr. W's personal cell number.  Which the pharmacist called and spoke with Dr. W. on a Sunday.  Twice.

Saturday, March 12, 2011

Home at last

Nana's finally being discharged today.  This time for real.  Laura made the 60 mile drive yet again today up to the hospital.  Traffic on the freeways was miserable, and it took her close to 90 minutes to get to the hospital.  Aunt M and Uncld A were visit with Nana.  I think Aunt D was there as well.  Nana's little hospital room was pretty close to a full house that day.

I called the Oxygen Supply company to get things squared away.  At first they couldn't find the information for me.  The gentleman on the phone said he would call me back in about half an hour.  He called back as promised in the time frame promised.  He said that he found the paperwork, and everything was in order.  He said he would be by in another 30 minutes to drop everything off, and wanted to know how many oxygen tanks we wanted.  Amazing...once things were figured out, they really did a nice job.

About half an hour later, he showed up and delivered three oxygen tanks and a 5 liter oxygen concentrator.  He also provided about 60 feet of tubing and several cannulas to go in Nana's nose  Having 60 feet of tubing gives Nana free reign--she can get into just about any room she desires.

Laura and Nana arrived home around 7pm, and we had a difficult time trying to get Nana into the house.  When she was rounding the bend by the rose bush in front of our house, the air hose popped off the oxygen tank.  Her strength just drained away.  We got it re-connected, and my wife turned it up so she was getting quite a bit of oxygen.  One of the boys brought out a chair, and the other brought out this other walker we have that rolls and has an integrated seat.  Nana sat down for a few minutes, then transferred to the rolling walker and I wheeled her into the house.  It was good to have her home, but it was a difficult night as she needed quite a bit of help.

Friday, March 11, 2011

The Oxygen Fiasco

It all started with "Will somebody be home to sign?"  Laura told the Oxygen Supply Company "Yes."  They never said anything about the need for said signer to be at least 18 years old.

So while Nana's ablation is going on, the Oxygen Supply Company was trying to get ahold of Laura on her cell phone.  The hospital in Orange County may as well be one of those dread "dead zones" for cell coverage, as calls drop faster than eggs into soup at a Chinese restaurant.  *ugh*

It turns out that the Oxygen Supply Company was delivering the oxygen concentrator and tanks about 5pm, which was when some friends were picking up our sons for an activity with our church's youth group.  Our daughter (who was originally supposed to sign for the oxygen) wasn't home from work yet, and the delivery person from the Oxygen Supply Company would not leave the oxygen with our 16-year old son.

So Friday night started out with no oxygen being delivered.  Laura called the person whom she spoke with at the Oxygen Supply Company, and had to leave a message.  Since having a portable tank of oxygen was one of the requirements for Nana being discharged, we were thinking they weren't going to discharge her until Monday.

After dinner, Laura was able to get ahold of someone at the Oxygen Supply Company, and arranged for delivery of a portable oxygen tank that night.  Our sons had returned from their activity, and our daughter was home from work so someone there could sign for the oxygen.  It was around 10pm when I received a text message from our daughter saying that someone from the Oxygen Supply Company had delivered a single tank of oxygen.  We were glad for that single tank, but Nana needs oxygen 24/7.  There was a little more of this particular battle to fight.

Catheter Ablation Procedure

Laura and I arrived at the hospital in the early afternoon, and Aunt D was there visiting with her again.  We're so thankful that she was there to spend time with Nana.

Nana had a catheter ablation procedure performed on the upper right part of her heart to hopefully control her heart rhythm.  She has an a-fib (atrial fibrillation) heartbeat, and hopefully this will help change her heart beat rhythm to a normal one.  Her procedure was supposed to begin at 3pm, but it was closer to 4:30pm when they finally began.

Laura, Aunt D, Cousin D and I spent a couple of hours in one of the waiting rooms being afflicted by the wonders that are afternoon TV.  I can now say I've been subjected to Judge Judy and Dr. Phil, and I really don't care to endure that again.  Around 6pm, Laura and I decided to go get some dinner (and to ponder the Oxygen Fiasco).

We got back from dinner around 7pm, and immediately went to the waiting room to see if Aunt D and Cousin D were still there.  Nope--they had left.  I said "Let's go check out Nana's room," and as soon as we got off the elevator on her floor, we saw some orderlies (is that what they're still called?) wheeling a gurney with Nana towards her room.  Praise God for good timing!.

This was another difficult day, as Nana had to lay flat on her back for about 4 hours.  As she was recovering, she kept asking Laura when the spaghetti was going to hatch, and what it does.  I'm not sure if she was just talking in her sleep, or if this was an after effect of the anesthesia, but it was pretty amusing.  What happened is that the hospital staff either washed her hair, or got it wet, and that became the "spaghetti" and the "hatching" was her hair drying.  It's amazing how the human brain connects words together, and if something interferes slightly, the lookup table can be a bit off.  Sometimes humorously.

Dinner for Nana tonight consisted of meatballs, plain white rice and green beans.  Since Nana has a hiatal hernia, swallowing things can be tricky...especially rice.  Again, Laura asked the nursing staff for something else, and they brought orange sherbet and chocolate pudding.  They also brought some green jell-o, which Nana decided to not eat because green jell-o is something to be wary of (this is an inside joke that I really don't want to explain right now).

We managed to get home from the hospital close to 11:30 pm after a long and tiring day.

Thursday, March 10, 2011

Catching Dr. Y

Dr. Y (at Dr. W's request) came and presented an option to Laura and Nana: A catheter ablation procedure to help control her heart rhythm.  He said that it could be done soon, or Nana could return and have it done.  He then left the room.

Nana decided that since she was already in the hospital, that it would be a viable option.  Laura had to go hunt down Dr. Y to let him know their decision.  Laura spotted him in the elevator, and the door was closing.  She jammed her arm in the elevator, and managed to catch Dr. Y and get things set up.  The ablation procedure is scheduled for Friday the 11th.

Wednesday, March 9, 2011

Coming home---NOT!

Nana's supposed to come home today!  She was cruising around in the halls at the hospital, and doing just fine.

Laura made the 60 mile drive up to Orange County to get her today, and started getting all the discharge stuff in order.  Nana was getting dressed, when she started to feel tired.  A nurse took her vitals, and her oxygen level was way down, and her heart rate was way up.  Laura said that she will be re-evaluated for home oxygen tomorrow and have to spend one more night in the hospital.

Tuesday, March 8, 2011

Transferred again & Busier Tuesday

Isn't this the way things always seem to go?  A vital piece of equipment at the hospital where Nana was supposed to have her stent inserted and LAD angioplasty has broken.  So far, I have not heard what that equipment was, but apparently it was pretty vital to the procedure because Nana was transferred to yet another hospital in Orange County.

I took the day off work, and Laura and I made the hour or so long 60-mile drive up to Orange County.  Our plan was to arrive after Nana's procedure, as Aunt D was there visiting.  My wife and I had never been to this hospital, and we had quite a time navigating our way throughout this particular maze to find where they had hidden Nana.  We found her in a recovery room, and Aunt D was still with her (of which we were very thankful).

Nana was in and out of sleep and had to lie flat on her back for another 7 hours after these procedures.  She stayed in recovery until a little after 5pm, when she was moved to a room in the cardiac recovery area at the hospital.  By the time she was sort of settled in her room, it was just about 6pm -- time for the shift change in the hospital.  This gave Laura and I the opportunity to get a rather disappointing dinner at a restaurant we hadn't visited in probably 20 years.

We got back to her room shortly after 7pm and stayed until a little past 8pm.  She was able to sit up at 7:30pm, and was brought a dry turkey sandwich for dinner.  Laura was able to get the nursing staff to bring us some pudding and some yogurt, which she fed to Nana.  There was talk about Nana being discharged the next day.  We were a bit skeptical at this prospect.

Monday, March 7, 2011

Transferred & Busy Monday

Nana was transferred via medical carrier up to Orange County for her heart exam.  I don't know why they decided to ship her up there at 5am Monday morning...that part may forever remain a mystery.  Her procedure was supposed to start at 7:30am, but it didn't start until later in the morning.

Laura made the 60 mile drive up to Orange County to visit Nana.  She arrived shortly after 12pm, when Nana was in recovery.  Poor Nana had to lie flat on her back for 7 hours after the procedure, and it was a bit trying for everyone.  Dr. W decided that she needed a stent and some angioplasty in the left anterior portion of her heart.  These procedures are scheduled for tomorrow. Dr W is hoping this is enough to fix the swelling due to poor circulation and not do the riskier heart valve replacement surgery.

One frustrating yet kind of amusing thing that happened this day was what the hospital brought Nana for dinner--a big beef, onion and bell pepper burrito.  Think Chipotle, and you're getting close.  Now, please answer me this: How on God's green earth are you supposed to eat a massive burrito while laying flat on your back with a severe fluid restriction?  Laura wound up having most of the burrito for her dinner, and asking the nurses for some jello and pudding for Nana's dinner.

Saturday, March 5, 2011

No Test Weekend

Nana was supposed to be transferred to a hospital in Orange County (about 60 miles away) to have her heart examined.  The transfer did not happen, so we had to wait until Monday to find out when she was going to have this test performed.  The good news was that we didn't have to make that 60-mile drive this weekend.

Tuesday, March 1, 2011

The start of the 12-day stay

Nana was admitted to the hospital because of fluid retention and breathing difficulties again.  She was in a hospital about a mile and a half from our house.  She was scheduled to be transferred to a hospital in Orange County (about 60 miles away) to have her heart examined via catheter and camera on Friday, March 4, and schedule a valve replacement.

Dr C, Nana's kidney doctor, came by to tell her that it's almost a sure thing that if she has this valve replacement surgery, she will need to go on dialysis. She only has 1 kidney working, and it's at about 40%. He wants Nana to drink more to help her kidney. Of course Dr M doesn't agree and still wants Nana on the fluid restriction. Wouldn't it be great if doctors could agree on a course of treatment?

On March 3, they performed an electrical cardioversion (shock treatment) on Nana's heart to try to correct her a-fib (atrial fibrillation) heart rhythm.  She came through this procedure with flying colors.  The problem with this was that her heart returned to it's a-fib rhythm within a few days...