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

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).

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.

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.

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.

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.

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