Out of Woodland!

Mom and Dad were discharged from Woodland on Friday.   I took them to my house and so far they are doing well.  Mom has a difficult time negotiating the front stairs so we are having a railing built.  They are both happy to have real food.   They would love to hear from you.  Feel free to call.  If you don't have my number let me know and I will email it to you.  

Take care,

Cindy

Step Backward

Mom was having problems this morning with retaining a lot of fluid in addition to non-stop diahrea.  She was so weak she could not get up, so Ron called an ambulance and got her to the emergency room.  They evaluated her, decided her heart was doing fine but was concerned about her progress. We decided that Woodland Park Rehab would be a better choice for her since the at home care was not working for her well.  So until further notice, that is where she will be.  Please visit.  

Thanks,

Cindy

She's Going Home!!!

We are taking Mom home as soon as she finishes her lunch.  She wanted to stay here to eat, so either she is still starving or the food here is really good.  

The foot issues is somewhat serious.  They call it "trash feet."  Debris from the aorta has gone down and settled in the small blood vessels of her feet so she gets very poor circulation.  At its worst the toes and feet can turn black and you can lose them.   This is probably not what will happen.  There is a drug they have given her to make her platelets slick.  Mostly, it just takes time---from 4-8 weeks to resolve.  They need to be watched closely.  If they get more mottled or start turning black, we have to call a vascular specialist.  So if you are visiting, ask to see her toes.  Since I won't be here for a while, I will need help with monitoring.   

As I said, blogs may be few and far between. Bye for now.

Cindy

7/1/08 Update

Mom has all of her tubes out!   Good-bye feeding tube and catheter. She still has oxygen at times.  The plan is to discharge her tomorrow.  She is coming home.  We will have home support services starting part time on Friday, so I can train and check-out the person and then full-time starting Saturday.  Mom's only problem at present is that her feet are swollen and very painful.  We have the doctors checking on this.  She had a Dopler test to look at circulation and it was fine.  We will keep you posted.

We may need a volunteer to take her to her doctors appointment (in Magna) at 10:30 Thursday  July 10th but the the home aide should be able to do that. 

Once we are home, i.e. Thursday and Friday, it will be harder for me to post to the blog since Mom and Dad do not have wireless internet.  If I can escape for a while, I will go to the library or park outside a house that Nicholas and I found that has non-password protected wireless internet.  

Cindy

7/1/08 Update

6/30/08 Update

Mom has had three meals and a snack now and seems to be doing very well with food. She was also given the go ahead to drink water from a straw. They stopped the feeding through the tube but haven't taken it out of her nose as a precaution. It is likely to come out tomorrow.

The current plan is to discharge her on Wednesday. They think that she is doing so well, she could go straight home without going to a rehab facility first. We are in the process of making the decision about whether that would be a good idea. Mom would really like to come home. If she did come home we would have either round the clock care for the two of them (after I leave) or care from the early morning until they went to bed.

When she comes home she will not be able to drive or lift anything over 10 pounds for 6 weeks.

Cindy

She's Eating!

Mom was just given chocolate pudding, raspberry yogurt, and cranberry necter.  "It is out of this world!" she says with each bite.  She is so funny.  She made us open all of the containers at once, having no doubt she would eat them all.  The next step is getting the feeding tube out.  They will wait and get a calorie count tomorrow to see if she has her appetite  is back completely. Apparently,  when people haven't eaten for a while, they don't have an appetite.  Somehow, we don't think this is going to be a problem with Mom.

Cindy

Great News!

Mom passed the test!!! She can eat!!! We just have to wait for the doctor's orders saying so.  Mom is disappointed that lunch is over and she has to wait for dinner.  I think we will persuade the nurse to get her applesauce or pudding or something.

Cindy

6/29/08 Update

Mom is getting stronger by the day.  She walked 1/2 way around the ward today.  They are doing a swallowing test as we speak.  If she passes, she can start eating food as soon as the doctor agrees.   She can also drink water if she passes.  Her oxygen level is great. It appears that the only reason she is using the oxygen mask is to keep the air moist so she can continue to cough out the thick secretions in her lungs.  Her heart functions continue to be great.  Everyone is very pleased with her progress. 

Cindy

6/28/08 Update

Sorry I am posting this so late.  Mom is quite a handful now that she is feeling better.  She is on the cardiac floor in Room 329.  She is getting stronger by the day and speaks quite well now.  

She is still only given ice chips (5-10/hour) and is on the feeding tube.  We think they are being a little too conservative but I guess it is better to be safe than sorry.

Mom is busy begging people to give her ice chips.  She told me to just get her a glass of water to drink, she would be fine.  When I told her I couldn't and explained why, she confessed that she had already gotten up by herself, grabbed a glass, filled it all the way up and drank it!  "It was so good!" she said. I haven't told the nurses for fear they will restrain her arms again.  The doctors have finally given the okay for family to give her ice chips but only 5-10/hour still.  So if you come visit be prepared for very persistent requests/demands.  She can be very persuasive.  "If you know what is good for you, you will get me some water!"  

Speech therapy was just here and she thinks that Mom's swallow response is good.  They will do swallowing studies tomorrow so that maybe she can have water and food on Monday.  Heart functions and blood pressure are great.   Her oxygen saturation level stays in the mid-90's even when she has the mask off.  Mom reports that the physician assistant who saw her today said that she would probably be transfered to a rehab facility in 4-5 days.  

Cindy

Out of the ICU

Mom was moved to room 329.  

6/27/08 Update

News continues to be good.  Mom will be transferred off the ICU unit today.  She gets ice chips now which make her very happy.  She has even promised a nurse a lasagna in exchange for the ice chips.  Sounds like she is back to normal.  Her speech is getting stronger and much easier to understand.  She walked farther today and is gaining strength.

They estimate that she will be on the cardiac floor for a week.  At that point she will be go to Rehab.  We are trying to get Mom and Dad in the same rehab facility so Dad will be taken care of at the same time. 

Cindy

6/26/08 Morning Update

Mom continues to make great progress.  Physical Therapy had her up walking this morning.  She is using the oxygen mask at 40% oxygen but they will be trying to wean her down to less today.  The speech therapist came in to study her swallow response, a crucial step before allowing her food and water.  Her throat muscles are still weak but she was able to swallow several ice chips without a problem.  If the doctor agrees they will give her 5 ice chips an hour.  It sounds like real food and water is a couple of days off.  She is speaking better but her voice is still hoarse.

Since I am scheduled to go home on July 4th or 5th,  we are looking at care options.  I will be speaking to the doctor soon to find out what she predicts the discharge plans might be.  

Morning Update 6/25/08

Mom does have the tube out.  She is using an oxygen mask to keep her oxygen level up.  It is vaporized so it loosens her lung secretions so she can cough them up.   She can talk only in a whisper since her throat is so sore from the tube.   This apparently gets dramatically better in hours and by tomorrow she should be able to communicate better.   

She will remain in the ICU until she can keep her oxygen level above 92-95 while only on 20% oxygen. So far she has been getting 40%.  They will continue to wean her off of this as the day goes on.   They may also keep her in the ICU to see if she can eat and drink without getting anything in her lungs.   

She says she is hungry---always a good sign.

Cindy

Great News!

We haven't been in to see Mom yet because they are busy taking her breathing tube out!!!!  More later after we see her.

Cindy

Morning Update

Okay, Okay, I know it is after 12:00 so it is not technically morning but I was waiting to hear from the doctor.  Mom is making excellent progress.  She is spittin' mad  that she cannot get her breathing tube out today and threatened to cut it off with scissors if they didn't take it out!  (All this is by pantomime and written notes. With the tube down her throat she still can't talk.)  So, you can tell she is doing really well and is back to being herself.

The doctor said she could get the tube that drains fluid from her chest cavity out today.  That is the one that was really bugging her.  Unfortunately, her lung secretions are still really thick so she can't cough them out as effectively as she would need to so that she could get off the breathing tube.  She did breath entirely on her own for the last 24 hours so that is an excellent sign.  They plan to get her up walking today.   

Her temperature is normal, her white blood count is going down steadily, and her blood pressure looks great.  

If you have any questions, please feel free to ask via the blog or give me a call. You can leave a message at Mom and Dad's house.  

Take care, 

 Cindy

Afternoon Update

Hi Folks,

We got a chance to speak with Mom's doctor.  She thinks Mom is doing well. Before they take the tube out she has to be coughing up phlegm by herself.   So, tomorrow is very optimistic.  She thinks Wed or Thurs is more realistic.  

Mom is back on all her usual medications (for those who were concerned about that) with some change in blood pressure meds.  They are also giving her aspirin as an anticoagulant.  

The doctor reassured us that she has never seen permanent neurological problems with the short time that mom was off the heart-lung machine.  She said that sometimes it takes people a bit of time to get back to normal but all have gotten back to their previous level of functioning. 

We are going in to see her one last time and then we will be leaving for the day.  Visits from family members this afternoon and evening would be welcome.  You will be pleasantly surprised by her progress.

Thank you for all the support!

Cindy  

Morning Update

Mom looks great today.  When we came in she was sitting in a chair.  She really acts like herself now.  She still has all the equipment attached to her but is making good progress.  Her pulse is closer to the normal range today.  She will probably not have the breathing tube out today because they gave her breathing assistance last night (though it is not clear she needed it).  She indicates what her needs are.  She is madder than a wet hen about all the tubes they have got running through her nose and clearly wants them out.  When she can talk we are all going to get an earful.  

Morning Update

Hi Folks,

I am taking over the blogging so it will probably have a slightly different tone.  Mom is making steady progress.  Today she is alert and aware of her surroundings.  She nods or shakes her head to yes and no questions. It is so nice to have her responsive. The respiratory therapist reported that she did a good job following his instructions and that he thinks she is making good progress.  Her temperature is normal but her blood count is still a little high (13,100).  She is still receiving an antibiotic, vancomycin every 12 hours.  They think that if she continues to progress she may be off the ventilator (have the breathing tube out) by early in the week.  We are very hopeful and pleased with her progress.  

Cindy

 

Morning Update

This morning we were greeted with mixed news. It turns out she has Gram Positive Coxide clusters hopefully the broad spectrum anti-biotic she was on will help get rid of it and now they might prescribe a new medicine that will help more. She is able to keep her eyes open for short periods of time seeming to recognize us. She is breathing on her own but with the machine compencating for being in her lungs.

Morning Update

This morning grandma seems to be doing much better. THe fluid has gone from her lungs and there is no bacterial growth. She is no longer sedated and will open her eyes. The respiratory therapist says hopefully they will do some weening trials today to get her of the respirator.

Morning Update

We found that there hasn't been much improvement from when we left last night when we came in this morning. She is given 16 breaths per minute and is taking anywhere from 18-32 breaths per minute. Her white blood cell count is 18,100. Otherwise there has been no change.

Into the ICU

We were let into the ICU for the first time today we were given some information by the nurse, Katherine who seems very knowledgeable and nice. They have reinserted the breathing tube, something negative but with some positive effects. She can now focus her strength and energy on getting better. It seems like this has been working as they are giving her 18 breaths per minute and she is taking 22-28 breaths per minute, out breathing the machine, which she didn't when she was in the ICU before. The doctors have replaced the arterial and central line. Her white blood cell count is elevated from the normal range of 3,600-10,600 she has about 23,100. The cultures to tell us if there is an infection should be out tomorrow morning at 9:30 or 10:00. They will not treat her until these are back, so they can treat her more effectively. Unfortunately she will probably be in the ICU for a while at least a few days and the breathing tube will not be removed today.

Back to the ICU

Grandma was transferred back to the ICU this morning around 10 o'clock. The doctors and nurses thought that she needed to be monitored more carefully. Also there was a big fluid build up around her lungs so the doctors gave her some medicine to clear that up and they are giving her a larger dose now that she is in the ICU. She has an oxygen mask on at all times because her blood has low levels of Oxygen. She also has an elevated white count, signaling the possibility of infection, there are currently blood cultures in the works to check for any sign of one.

RE: Updates?

It has come to my attention that the update email service has a great delay on it, so I have deleted the post an if you have had subscribed to it feel free to unsubscribe link at the bottom. Hopefully by tomorrow I will have a different service working with no delay. Sorry for the inconvienence.

End of Day Update

The status now as we are leaving is Grandma has shown much improvement since this morning. She is still thirsty but awake enough to have her mouth swabbed out. She keeps getting up on her own and trying to get out of bed, so the PCT is going to have to stay in here until shift change, making her the favorite patient in the ward. She was given her first dose of pain medicine for day, when she asked for it.

Transfer

Grandma was transfered from the ICU to the J.L. Sorenson Heart & Lung Center room 305 the website has more on visitation information. With day RN: Annalee and PCT: Abby and Evening RN: Evan and PCT: Tiffany. The phone number is (801) 507-4305 but she is in no condition to talk. Also you can email a patient from the website and whom ever is here can read it to her. She is stable but very tired and restless.

Morning Update

A lot of news came over night. Her breathing tube was removed at 9:15 PM. She now is on oxygen, but is having trouble taking deep breaths. Her blood pressure is high. She sat up in a chair for 45 minutes and ate ice chips this morning. She follows commands by nurses and rates her pain level on 1-10, one being none to little and ten being the worst ever, as three.
We went into her room this morning and the nurse asked her to open her eyes and "Who is this?" Grandma responded "My daughter, Cindy," and then when the question was repeated "My husband, Domnick Divino." She is very restless and complains about wanting water, unfortunately we are unable to give it to her as she falls in and out of sleep and if she fell asleep while drinking the water it would go to her lungs. While we were there they took out her arterial line, a good sign.
Later they plan to do a little walking with her and are going to transfer her to upstairs out of the ICU as soon as a room frees up.

End of Day Update

Before we left the hospital we decided to check up on Grandma one last time before tomorrow. We were greeted with good news. When Ron, Cindy, and Grandpa went in she had started breathing on her, own some. Also the nurse asked right before they left if she recognized any of these people and Grandma nodded her head yes, which shows consciousness, cognition, and motor function. She is as I am writing this being given lots of stimulation i.e. TV on loud and lights on, to wake her up so they may remove the breathing tube.

Just Saw Her

We just came back from seeing her in the ICU, they let all of us in because it was the first visit. At all other times it is going to be two to three people, immediate family only, in her room at a time for up to fifteen minutes once and hour at any time except between 6-8 AM and 6-8 PM for shift change. She is definitely going to be in the ICU for over 24 hrs due to her Aorta splitting.
We also learned a lot from the nurse. She was admitted to the ICU at 2:40 PM. She only lost about 330ml (~1 1/3 cups) of blood, something the nurses said was good. She is not going to be put on an anti-coagulant for a while, at least a couple hours, to make sure she won't bleed out. When she is it will probably be aspirin. Her heart volume is low, although not a big thing they are filling it up with what looks to be saline.
When we went in she opened her eyes from time to time and she was moving. They had to restrain her because she was trying to pull out the breathing tube but that's normal. At this point her heart rate was in the low 90s but when we left it was in the low 60s, also normal though. She also wasn't responding to commands like "Curl you toes" or "Squeeze my finger", although this could be for many reasons, at first it was because they didn't have her hearing aide in but once they put it in she still didn't respond, this could be because she is disoriented, something that the nurses say is quite common, or her motor function is not completely back but that is also quite normal too. They also put her on morphine to ease the pain. Her Kidneys seem to be doing extremely well. She is letting the machine breathe for her completely and that is normal for her age, the surgery, and morphine.

Out of Surgery

Grandma is out of surgery, we just talked to the doctor, everything went pretty well. Although, her Aorta split during her operation and it needed to be replaced. To do so the doctors needed to cool her down to a "hibernation" for 22 minutes and take her off the heart lung machine, something that creates the possibility of neurological damage, although doctors feel safe doing this for 90 minutes. The material they replaced it with is made by Gore Tex and is said to last ad infinitum and the only reason her doctor, Dr. Stephen Clayson, said he has ever needed to replace them is due to infections. At this point we should be allowed to visit her in the ICU in about forty minutes.