Remembering Nana

Here's a slideshow that I put together for Nana's memorial service.



I hope you enjoy it. Please feel free to comment and post any memories of Nana that you wish to share.

Blog winding down

It's getting close to the time to wind down this blog, as there really isn't much more to add, other than Nana's memorial is this Saturday.  She was quietly and peacefully interred last Thursday at Forest Lawn in Cypress.  Laura put together several pages for a guest book that I sent off to a printer earlier today (and hopefully it arrives without any problems).  We are currently working out how the program for the memorial will go, as we'll be meeting with our pastor this week to go over the arrangements for the memorial.

In thinking over the past nearly two weeks since Nana's passing, I'm grateful that she was on hospice care.  The hospice people were so incredibly helpful.  Nana was able to be at home with her family and have her needs met and exceeded in many cases.  Laura and I are both thankful that Nana wasn't bedridden.  Had she been, her care would have been especially difficult for Laura.  The Lord saw fit to take Nana when the timing was right according to His purposes and not ours.  We're all thankful that Nana is rejoicing in Heaven with her Savior.

1 Corinithians 2:9
But as it is written, Eye hath not seen, nor ear heard,

neither have entered into the heart of man, 

the things which God hath prepared for them that love him.

It's been a week...

It's been a week and a day since Nana passed away.  The house is quiet.  Feeling is slowly starting to creep back in, but time still feels like it's standing still.  We're trying to plan Nana's memorial service, and things just seem to take too long to do.  Things that should take a few minutes drag into hours.  Everyone has been so gracious and understanding during this time.  I'm truly amazed.  We're in a valley right now, but we'll get out of it.

Since Nana didn't want a funeral, just what they call a "direct burial," that should be happening sometime today.  I hope they'll let us know when, but I kind of doubt it as the burial is at their convenience.  Her memorial will be June 4th at 2pm at our church.  More info later...

Thursday...

A representative from Forest Lawn called later in the day on Wednesday and wanted Laura and I to come up on Thursday and make Nana's final arrangements.  Nana had requested no viewing, no funeral, no graveside ceremony...just a simple burial.

We made the long drive from our home to Cypress to meet with them, and they were the very model of professional.  The person we worked with was efficient, very cordial and respectful, and answered all of our questions.  Laura was doing pretty good until it got to the part where he wanted us to go with him upstairs to select a casket.

I told him "That's where I come in..."  He then turned to me, and I'd mentioned that I'd found a casket on Costco, and could they match the price.  He said they couldn't, and that many people go that route.  I went in completely expecting a scrap over the casket, and they're fine with it.

We finished our business with them, and paid for everything.  We then went and visited Papa's grave, and Laura's grandparents' grave.  We made note of how things were engraved on Papa's memorial plate so we could make sure that Nana's will match.  After visiting for a little bit, we made our way back to my truck and started on the long drive home in heavy traffic.  It was a very tiring and draining day.

One thing that was very interesting happened.  When the representative came into the little meeting room, he produced some sort of hand filled out document from his leather dayrunner.  I couldn't see it clearly, but it had all sorts of information written on it.  My guess was that it was the document that the people from Forest Lawn brought out the day before when they collected Nana's body.  Boy, was I wrong.  It was the original information sheet that Nana filled out in June of 1966 when she and Papa had bought their plot!  As we were wrapping up, the representative said that we could keep the information sheet.  I was (and still am) amazed by their document and filing system that can make a nearly 45 year old document look and feel like it was filled out just the day before.

Just the day before...

These last few days seem like they've all been merged together into one long blur.  Here's some more on what happened Wednesday.

Nana managed to poke herself in her left eye last week, and Laura had fitted her with an eye patch the day before.  Nana was saying "Arrr" like a good pirate while wearing that eyepatch.  Just the day before.

The hospice nurse got here very quickly on Wednesday.  She was very shocked about Nana, as she had just been out to check on her.  Just the day before.  The hospice nurse was so very helpful on Wednesday.  She had to check Nana's body, then repositioned her in her bed and covered her.  Then she started making phone calls.  Laura and I were in no real shape to do more than just call people and inform them.  Nana seemed to be doing so well just the day before.

It seemed to take a long time for the people from Forest Lawn to come to collect Nana.  I suspect the underestimated the traffic on the freeways, as the mortuary is quite a ways away.  The gentlemen who came were consummate professionals--very understanding, polite, gracious and did their work quickly and efficiently.

Hospice came later in the day to pick up their bed, the oxygen enricher, and some other stuff.  This left us with a nearly empty room and silence.  We'd gotten used to the hum and puff of the oxygen enricher running.  It was a normal noise in the house, and now it's just so quiet in the house.

After the equipment left, our cat was wandering around downstairs making these strange, sad little meows.  Nana's rooms seem so empty, even though they sill contain her stuff.  Quite a change from just the day before.

Nana passed away last night...

Nana usually gets up around 8am.  Laura didn't hear anything in Nana's room like she normally does.  Laura went in to check on Nana and found she had passed away last night.

I'll post more when I'm up to it... It's a pretty difficult right now.

A night on the floor

I'm going through my normal morning routine, reading the paper, eating a bowl of cereal and having a cup of coffee.  There are normal noises in the house for this time: Nana's oxygen enricher, coffee pot making noises, refrigerator running, that kind of stuff.  I hear a noise coming from down the hall leading to Nana's room.  Our cat gets put to bed in our downstairs bathroom at night, so it could just be her starting to make her "let me out" noises.  But it doesn't sound right.

I went upstairs to get Laura, and encounter my daughter who's getting ready for work. "I think I heard Nana" she says with a nervous voice.  Okay, that confirms it..something happened.  I get Laura and she goes in to investigate.

She finds Nana sitting on the floor between her bed and her bookcase.  Nana had gotten up sometime during the night to use the bedside commode and stumbled.  She couldn't reach her cell phone which was on the other side of her bed.  She couldn't call out loud enough for us to hear.  So she pulled the covers off her bed and made a little nest out of it.

Needless to say, she's been pretty sore today and moving slowly having sat on the floor for who knows how long.

And the odd thing?  Her oxygen cannula was off and placed by a box of tissues on the other side of the bed.  She spent the night on the floor, wrapped up in blankets without oxygen.

I sure hope this doesn't happen again.

Disaster Averted....for now

Laura started calling Dr. M's office yesterday about Nana's midodrine prescription.  They called her back today, and, after speaking with Laura, Dr. M. called the prescription into The Pharmacy.  The Pharmacy at first said "No," but Dr. M can be very persuasive when necessary.

Laura went over about 5:45pm to pick up the prescription!  And we can get this prescription refilled twice!  Praise God!  This will allow Nana's blood pressure to be at a level where her kidneys will function (albeit at a lower-than-normal efficiency).

Now we won't have to fight this battle again for 90 days.  Sorry for the lousy cell phone shot...it was the quickest way to get a photo online.

All in all, Nana had a good day.  She had a visit from the nurse's aid, some friends came by to visit, and even our Pastor stopped by.  We're currently playing musical beds in prep for the hospice to deliver a hospital bed tomorrow.

A punch in the gut...

Well...more like a body blow followed by an upper-cut to the chin...

So the hospice doctor came out on Monday with a nurse to check up on Nana.  The visit went pretty well, and they discussed some options with Laura.  What Laura found out yesterday was not encouraging at all...

One of the medications that Nana receives to keep her blood pressure up (so that her kidneys are able to do their job) is midodrine.  Her supply runs out Thursday morning.  The nurse called the pharmacy and found out it's been pulled off the market, and that there are no meds to take its place.  We're going to do a bit of research in this, as it looks like the FDA called for it's withdrawal from the market in August 2010, and relented from this in September 2010.

If we aren't able to get in a supply of midodrine, Nana's blood pressure will drop.  The doctor said that a pacemaker would help, and possibly extend her life several extra months.  When Nana heard the cost of such a device (around $20K), she said she didn't want it.  :-(

Laura was saying that she thinks it might be time to start making some phone calls...

Home Hospice Care

The other day when the visiting nurse was checking out Nana, she suggested hospice care as an alternative to having to continually take Nana in to see different doctors.  This would provide a means by which a doctor and nurses could continue to come to Nana to evaluate her.  So Nana decided to go with it.  This started last Thursday...

My big problem with this is that it's hospice care.  EOJ  EOT  exit(0);  halt -q  margin :0,:1  That's it. Your done. End of the road.

In talking it over with Laura, they (Laura and Nana) felt it would be best for Nana to be able to receive care at home instead of having to go through all of the stuff they need to do when taking Nana out.

So far, we've gotten a new oxygen enricher, new oxygen tanks, new transport chair, and I think they'll be trying to deliver a hospital bed next week.  She'll be getting a visiting nurse coming by twice a week, and some sort of assistant two other days of the week.  And a doctor will be stopping by from time to time to check up on her.

The good news is that Nana can go off hospice at any time.  I first thought that it was a one-way street, or like a roach motel--once you check in you can never check out. Until you Check Out.  I'm still not entirely certain about whether or not this is a good thing, but Laura has spoken with several of the people who have come out and she's much more at peace with it now.

I'm really hoping that she can build up enough stamina that she doesn't need all this support, and I certainly hope I'm not disappointed.  Things are so crazy hectic in the house right now, we just need to get to some form of stability going.  I'm glad that the kids are old enough to mostly take care of themselves, but school work seems to be coming less and less of a priority.  Especially as Laura has to spend more and more time daily helping Nana with just simple little things.

Good Friday, Good Dr. Visit

Today is Good Friday, and it really is a good Friday.

Things have been going pretty well this past week.  Although Nana's surgery recovery seems to be taking a very long time, we're having more good days than bad ones.  It is taking a long time for her to build up her stamina.

We had started looking into how much transport chairs cost, and requested one from the insurance company on Apr 18th. The transport chairs are small wheelchairs, so they are much lighter and easier to get in and out the trunk.This will be very useful for when Nana has to go visit Dr. M, Dr. W, or just going out in general.

When the company delivered the wheelchair on the 20th, it was a full size one. It's heavy and doesn't fit in Nana's trunk without taking off the feet pedals. It was quite a workout manipulating the thing, but it let Nana ride instead of walking for her doctors appointment!

Nana went to see Dr. M yesterday, and saw Dr. W today.  Both trips went very well.

Dr. M removed most of the bandaging on the hand Nana hurt when she fell in her bedroom.  Her poor hand looks like it's quite painful, but it doesn't seem to bother Nana.  It could still be a while before it fully heals up.

Dr. W is reducing the amount of sotalol from 2 pills to 1.5 pills a day.  He said it should help Nana with more energy since the medicine slows down her heart. Her next appointment with Dr. W will be in a couple of months, and it's likely that she'll go down to just one a day.

It was also a busy day for phone calls, with different care providers wanting to schedule a time to come out.  The visiting nurse, occupational therapist and physical therapist called, and even someone from Nana's insurance company.  The only one who managed to get time in today was the physical therapist, so I'm expecting Nana to be tired tonight.

Have a happy Easter!  Don't forget the real Reason for it.

He is not here: for he is risen, as he said.

Come, see the place where the Lord lay.

Matthew 28:6

A little forward, a little backwards

Wednesday was such a good day for Nana.  She was feeling better, had an appetite, and could taste her food.

However....  Laura and I were startled out of a deep sleep at 3am with Nana calling Laura's cell phone to say that she fell.  We got downstairs to find Nana sitting next to her bed, and daubing the back of her hand with some sort of gauze.  We got her on the edge of the bed easily enough, and were able to get a better look at her hand.  She managed to whack something while she was on her way down, and cut the back of her hand pretty badly.  Laura and Nana just left to go to the ER to get her hand checked out.

Edited to add:

Laura and Nana got home from the ER around 6am, so this was a quick trip.  The doctor decided that since Nana's skin is so thin on her hands, he wouldn't be able to use sutures.  So he used some skin tape to get things back together.  Nana's poor hand is just one massive bruise.  The doctor said that it will take a few weeks for her hand to heal.

Nana was on her way back to bed, and was within two steps of getting back in bed when she fell.  The problem was that her legs became wobbly.  She described it as she was staggering like a drunkard.  Laura reminded her again that when she feels this way, either lean up against the wall or sit down for a few minutes to catch her breath.  We might just have to locate another chair in Nana's hallway so she has a landing space between her bathroom and her bedroom.

It's the little things

One of the things that has been a bit of a downer is that all food seems to taste mushy and bland to Nana whenever her lungs are affected with the fluid retention.  Part of this might be attributed to her low salt diet, but even with fruit?

Yesterday was a busy day for Nana.  Both the home nurse and the physical therapist stopped by.  She did fine with both, but her pulse always seems to be on the low side and the nurse was worried about the increased swelling in the legs. She called Dr M. to tell him about the changes and he changed Nana's medicine.

Today, Nana's weight was down about 6 pounds from yesterday, and she's breathing a bit easier. We're thankful for that!  Laura says that her legs are still swollen, but when Nana ate a banana for breakfast, she was able to taste it!  For the first time in a long while, it didn't taste like mush. We're hoping that means her lungs are clearing up!

Long days

It seems that with the time change, the days truly are getting longer.  A feeling of ennui is starting to set in, and this isn't a particularly good thing.  Laura's days are a flutter of activity between school for the boys, running Mom's Taxi Service, the routine household chores and now caring for Nana, coordinating doctor and in-home health care visits, doling out medications, and a new one: working with the insurance company.  Laura really does deserve a gold star for doing all this, but I think she'd just settle for a good long nap.

One piece of good news is that the catheter incision on Nana's leg has stopped seeping, and has been dry for the last couple of days.  We had just gotten enough supplies to deal with this and that's when it stopped.  Even though that's a bit ironic, I'm happy that her leg healed up.

The down side is that Nana is having a harder time breathing, she's still swelling, and it's getting progressively more and more difficult for her to get around the house.  We've had to put one of our sturdy kitchen chairs in the hall way leading to Nana's room so that she has a good place to grab or sit if she starts feeling weak while moving in our out of her room.  Also, one of her medications has a side effect that causes her to feel itchy, and this is making it difficult for Nana to sleep at night.

A fairly rough night

Last night / this morning was pretty rough.  Nana was using her little walker to get into her bedroom when her legs decided to no longer support her.  She had a slow speed fall just at the door to her room.  Laura was there to keep her from hitting the sharp corner on a book case.  Nothing was broken, but she did bruise herself on her arm.  This all happened about midnight.

With some help from my son, we got Nana sitting on the seat of her larger walker.  She was pretty tired, and not terribly pleased that she fell.  Laura and I were very puzzled about why her legs gave out.  Laura thought of several culprits: a side effect from one of her medications, her low blood pressure, or a sodium imbalance due to the fluid that's still seeping from the dialysis catheter incision in her leg.

Laura and I were discussing what to do given that Nana has an appointment with Dr. M later today.  I thought that if it were an imbalance or side effect, that might clear up (or change) by the time the appointment rolls around.  Laura went to talk to Nana about going to the ER, and they decided to go.  So about 1:30 or so in the morning, Laura drove Nana over to the ER.

I haven't had much of a chance to speak with Laura about what transpired at the ER as they got home a little after 7am.  When I got downstairs today, Nana was sleeping and Laura was ready to go take a nap as she'd been up all night.  She did tell me they didn't find anything.

I guess they now have something to talk about with Dr. M...

Nana is Home!

Nana was released from the hospital today.  Laura brought her home this afternoon, and it was so much easier than the last time.  Nana had no trouble walking from her car to the house, as we still have the oxygen concentrator.  We had a good evening together.

Laura still has to get some of Nana's medication from The Pharmacy.  The pharmacy called because some of the medications were tagged as allergic, so we still have to figure that out.  The pharmacy spoke with Dr. M, and Nana will be seeing him next week.  There's a bit of confusion about when the appointment is, but that'll be easy to figure out Monday morning.

One thing that's a bit of a concern is one of Nana's incisions is seeping clear fluid.  It seems like walking around encourages this.  It's more of an annoyance than anything, but Laura's keeping an eye on things.

Nana's heart rhythm is still normal.  We're hoping that the a-fib rhythm is a thing of the past.

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).

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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...

Interim period

No hospital trips, but lots of visits with Dr. M.  We also had a physical therapist and a home health nurse stop by to check on Nana.  She was doing okay, but knew that she was going to have to go back into the hospital.  There was more fluid buildup during this time, but it was mainly controlled by a diuretic.  She would occasionally have difficulty breathing, but a nebulizer with a breathing treatment seemed to help.

One bright point during this time was that we were able to have our New Year's get together with family.  Having everyone over to visit with Nana really buoyed her spirits.

Nana discharged

Nana was discharged from the hospital today after a nearly a week.  She had  numerous exams and lost a lot of the fluid weight.  Her red leg had returned to a normal color as well, in spite of testing negative for staph.

Doctor visit turns into trip to ER (and Red Leg solved!)

Laura took Nana to see Dr. M again today.  Towards the end of the exam, Dr. M decided she needed to go to the straight to the ER due to the pneumonia.  Treating it at home just wasn't working. He called for an ambulance, which got her right in to a bed in the ER.  Laura followed in Nana's car, and got to the hospital ahead of the ambulance.  Nana was able to get a bed in the hospital after she and Laura spent around 4 hours in the ER.

I'm really stretching trying to remember what happened during this hospital stay.  The only thing they could find about the red leg was that it was a reaction to being so swollen.  If you're thinking staph, they didn't find any staph in her leg--it was in her nose, of all places.  Nana got moved to the quarantine section of the hospital, and all visitors had to wear a gown and gloves.

She was feeling much better by the 16th, and was able to even spend some time outside in a wheelchair in addition to walking up and down the hall at the hospital.

The Red Leg, part 2

Laura took Nana to see Dr. M again today, mainly to get her swollen red leg examined.  They performed all sorts of exams to her leg (including an x-ray and an ultrasound), but there was nothing conclusive except that it was not a clot.

The Red Leg, part 1

Big mystery!  Nana's leg has turned red.  Laura called Dr. M's office and was told to monitor her temperature.  If the temperature is elevated at all, Nana would need to go to urgent care or the ER.  Her temp is normal, but the red leg feels warm to the touch.  Laura is concerned that it might be a blood clot.

Pneumonia?!?!?!!

Nana is wheezing, sick, and is still having a hard time breathing (though it is a bit better today).  Dr. M thinks that she has pneumonia and the antibiotics for that are rather harsh on her.  It will be nice when she gets her appetite back