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Spacey

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Joined: 01/07/2005 21:28:14
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Since a number of you have heard that my Dad was back in the hospital and had asked for updates, I figured I would give folks the latest in the adventures we have had since Dad's fall last July.

Dad had been having increasing trouble breathing this past weekend and was admitted to the ICU on Monday. They had done x-rays and found nothing, but he was having considerable difficulty exhaling, so they put him on helium/oxygen rather than normal oxygen or a nitrogen/oxygen mix (air), as this does less harm to the airways, which is always a concern with COPD and a problem like Dad had. They had planned on doing a brachioscopy Tuesday, but his prelim bloodwork showed his hemoglobin was only around 8, where he has been for quite awhile, which is below the 13 where they prefer it to be before surgical procedures. So Tuesday he got 3 units, probably of just red cells, and yesterday they did the procedure. They found nothing which would explain the blockage, except for possibly some mucus, which they suctioned out, and signs that he has been suffering from a persistent, low grade infection. This meant that Dad did not have to have surgery to fix a problem, nor did he have to have a tracheotomy or be put on a respirator. Since Dad also suffers from the weak throat muscles the elderly often have, and asperates food when eating (having it go down his wind pipe, which can cause problems like this), they wanted to make sure he was not asperating any more than he had been. Dad still is not chewing/swallowing like he has been taught/told to do, but the aspiration has not worsened since he was in the hospital about 4-6 weeks ago, so he did not get a feeding tube either.

So...with all this, Dad was moved out of ICU today, and will be in through at least Monday. He is going to get some antibiotics for the infection, some more training to re-inforce the "how he should be eating", and additional PT so that he does not weaken any more like he has in the past while in the hospital, stuck in a bed. They will then re-assess next Monday, and he may be released to go back to the assisted living facility where he has been since October.

The only major downside left...Dad had said something to my brother Fred about having fallen over at Wright-Pat AFB (he has been out of the AF since the early 60's), and having some sort of apppointment up in Zanesville (he has not been there in probably 10-15 years), so Dad's mental recall is getting worse, which is not a good thing. So my brother and I are starting to wonder how long Dad has... But on the bright side, he has lived a very long life (84 years), and seen many great and horrible things, but he survived this long.

BTW...A bit of trivia...my Dad is one of the few folks to have been involved in actively trying to rescue the survivors from the USS Indianapolis the first night after they were spotted. Dad was a flight engineer for one of the two PBY's which was in the water that night, and spent most of it in a raft tied to a rope attached to the plane, as they taxied around trying to find survivors. He was made an honorary member of the survivors association, and was interviewed for at least one book, All The Drowned Sailors by Raymond Lech. Amonst names like Nimitz and McVay, there is mention of dad and his crewmates. Trying to get him to talk about that night has always been difficult, and unfortunately, too many stories like his have been lost as the folks who served in WWII pass. I would highly recommend getting a copy of the book from the library if you are a military or WWII history buff, but be aware, it is a book filled with detail after detail, so it could be a bit boring.

(I also know I need to start thinking about scanning in lots of pics, including pics he took during WWII, including one looking down on the Big Mo as the the documents of surrender were being signed.)

*BEL*_e (spacey), BEL Clan General -- You Frag em, I'll Slag em!
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Shadow-Yoda

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I understand what you are going through. My mom past away 4.5 years ago after 11 years of a rare strain of leukemia. I truly hope everything works out for you so you can have as much time with him as possible. That is probably the only thing I regret in my life (not spending time with my family and going out with friends).

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"Ready are you? What know you of ready? For eight hundred years have I trained Jedi. My own counsel will I keep on who is to be trained. A Jedi must have the deepest commitment, the most serious mind. This one a long time have I watched. All his life has he looked away... to the future, to the horizon. Never his mind on where he was. Hmm? What he was doing. Hmph. Adventure. Heh. Excitement. Heh. A Jedi craves not these things. You are reckless."

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Thanks for the upate Bel, Your Dad sounds like he's had an adventurous, long life. I truely hope everything goes well for you and your Dad.
I've read that crew mates had to watch as their mates were eaten by sharks as they waited for rescue. I can only begin to imagine how that could effect someone.

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Spacey

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Ooo wrote:

Thanks for the upate Bel, Your Dad sounds like he's had an adventurous, long life. I truely hope everything goes well for you and your Dad.
I've read that crew mates had to watch as their mates were eaten by sharks as they waited for rescue. I can only begin to imagine how that could effect someone. 


He was not a part of the crew of the Indy, but one of the things I think disturbs him the most is the fact that they spent an entire night out on that water, trying to find folks from their screams and yelling, and never did find a single survivor. When we talked about it, he generally switched off to other memories, such as what they did when Tibbets & co. took off to drop the bomb (they were on the next island over, literally an easy swim, or if the tides were low, a walk through the water away). As a result, I know he talked about doing rescues just like it where they would land at sunset and be out in the raft tied to the plane, where you could be sitting on top of the wing and have to look up to see the wave crests when the plane was in the trough, but I do not know if it was that night, or some other. Many people like Dad saw many horrors during that war (his brother was in Germany right at the end of the war there, and saw the camps), and I fear that we have too many folks in power who have forgotten the lessons those of Dad's generation have tried to teach us. But then again, there will always be tyrants...such is the nature of humans (kinda a pessimist on humanity, ain't I??).

And to everyone...thanks for the well wishes.

*BEL*_e (spacey), BEL Clan General -- You Frag em, I'll Slag em!
LA -- *BEL*_e (level 283 - Extreme AM), LW -- *BEL*_o (level 26) MM - ?? ( *BEL*_Rolaids ?? *BEL*DrWho??, Engineer... *BEL*BS_E_E [BSEE '89, Ohio U] (level 22)

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Spacey

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Well, Dad was released to a skilled care facility (nursing home) last Monday, but we got a call around 5:30 this AM (ET/GMT-4), oddly enough during the one 3.5 hour period when my daughter, wife and I were all three asleep Dad was once again having trouble breathing, and they did a blood count (WBC/HB). The results came back, and his WBC was "29 somthing" (e.g. around 29000), and his HB was around 4.8. Since the normal high-end of the range for the WBC is around 11000, Dad clearly has an infection, and his HB is below the normal low-end 13 and even below the 8 where intervention takes place. So around 5:30, the doctor (who is a partner with Dad's normal doc) ordered him transported back to the ER, where he is getting re-admitted. He will likely end up in the pulmonary care unit. But instead of having a nice Saturday playing and watching Doctor Who, I am off on a 2.5 hour one way trip to the hospital. More updates later...

Hey, for those of you who like looking at web pages and such, take a look at http://www.ka8zrt.com, and let me know what you think. This is my own site, for professional topics, and is just another area of the overall server which runs http://belclan.ka8zrt.com, which is the clan web site. I spent some time playing around with a re-skinning of my site, and would like to know what folks think. Feedback can be via PM, email or other means. My one request is that unless you are a techie who would normally be interested in my site, please do not register on it. You may also want to take a look at an area I am developing, where I was putting some thoughts down last night (even though I have yet to fix the STX formatting). This new, not yet linked in area is http://www.ka8zrt.com/blog.

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Spacey

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Well, the past few days have been a real roller coaster. Saturday, things were not looking good at all, with Dad showing all the signs of renal failure and a massive systemic infection. Dad had had 0 output after 3L of normal saline push along with a diuretic, and midday Saturday, his WBC was over 33K. Thoughts were that he possibly had an abcess or something else in the abdomen, which was really swollen. The only good part that day was him wanting to drink and then eating a fair amount after saying he was not hungry.

The update yesterday (Sunday) AM was that the CAT scan showed the swelling was apparently gas, and no signs of fluid, abcesses, etc. This would tend to agree with other things which seemed to indicate a c-diff infection. This latter is pretty major, and happens when antibiotics kill off all the good bacter in the GI tract and allow this bad one to flourish. So they started running some tests, but started him on a antibiotic which targets cdiff, and eating yogurt to replenish the good bacter. In addition, the saline push finally started showing some results. Renal output was 75ml late Sat and 400ml early Sunday, so the kidneys were back up and doing their thing. Dad also seemed much better, according to my brother, being more alert/oriented. The doctors were figuring that if the gas pressure did not drop, they could do a colonoscopy tomorrow, but that it was not critical.

Now this AM, word from the doc who has been handling his respiratory problem is that he had to suction a large volume of crud which indicated Dad is once again aspirating. He is going to be consulting with the surgeon on the case, but it is looking quite likely that Dad will get a feeding tube, which means he will be forced into a nursing home instead of the assisted living facility, due to the care level needs.

One heck of a roller coaster, but not one which I necessarily want to end.

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Spike

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Hang in there Spacey - I know there isn't much we could say but we're "virtually" here for you.

"Not all those who wander are lost" -J.R.R.Tolkien
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Spacey

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Thanks for the well wishes, prayers, etc. While we are a virtual community, every little bit helps, and it really is.

Latest update. Dad had a Endo-trach tube and a GI tube put in and was started on IV feeding yesterday. after the doc handling his respiratory problems suctioned out around 2L of material from Dad's lungs and brachial tubes. So he is now on his second day of being sedated and on a ventilator, mainly to help him get through this period with more ease. As noted earlier, the docs were suspecting a c-diff infection, but the first round of tests came back negative. Also, Dads renal output is now averaging around 400-450ml every 8 hours, and his WBC is down to 15K. His hemoglobin is around 9.6 (his longer-term average), and his hemocrit is around 30. Not normal, (HCT for men is 44-54%, HB should be >13) but, the lessening of these numbers is certainly in part due to Dad's being more hydrated, and his WBC is a great improvement over what it was.

Well...tonight they are going to give Dad more barium for an x-ray tomorrow morning. They have seen no improvement and are still trying to find the confirmed source of the infection, so this time they are looking again and also seeking any movement through his GI tract.

More later. And again, thanks all!

*BEL*_e (spacey), BEL Clan General -- You Frag em, I'll Slag em!
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Shantara

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E asked me to post the latest update from him:


> About 10AM ET today, I got a call from my brother. Dr. Lee said that
> Dad had been having some problems with his heart, even after they got
> him into getting his cardizam via IV (that had been stopped for about
> 2 days). Dr. Lee has said that the heart has gotten to the point
> where Dad is all but having a heart attack, and that when he has it,
> even at full code, they are very unlikey to be able to get it
> restarted and keep it going for very long. His suggestion was to take
> Dad off of Full Code.

E stated that due to his father's worsening condition, he is uncertain when he will be back online. Please keep E and his family in your thoughts.

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Spacey

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Back home for at least the evening, and may hop in to game some to get my mind off things. Here are the latest updates...

1) Dad's WBC has been fluxuating between 13K and 25K the past few days, indicating that the fungal infection in his lungs and his GI infection are still around. However, I suspect at this time it is mostly his lungs, and they are still suctioning gunk which indicates the infection is still there. The only good news on this front is that they reduced the O2 on the ventilator from 80%+ to 30% this past few days, and his blood O2 levels remained near 99%. Tomorrow, we find out if the doctor handling this wants to see about getting Dad breathing on his own, or hold off for a day or two more, or go ahead with a TEG or TEG/PEG.

2) Speaking of PEG, they started feeding him through his GI tube instead of solely relying on IV feeding. He even finally got the barium they put down him to see how his GI tract was moving to the point where he was passing it. But he has had a few bouts where he was not absorbing the food, so things are not out of the woods here yet.

3) His blood chem also showed a creatinine of around 2.3 and BUN (blood urea nitrogen) of 102 yesterday. As a result, they installed a temporary dialysis stint in his femoral artery, figuring 2-3 days of dialysis. The hope was to get him gently down to around 50 on the BUN. However, today he was only down to 100, and the doctor was indicating the possibility of a month of this, which is almost certainly not something Dad would want... worse, there was some concern about how his heart would take it. While he was "OK" yesterday, today they had to stop early, as his heart rate jumped to over 160 and his BP dropped.

4) Speaking of his heart, it has been throwing PVCs at a rate of about 10-18/min along with other anomalies (spikes, irregularity, etc), with a heart rate of around 90-95. And even without the stress of things like dialysis, he has been prone to a fast pulse at times (120 or so), regardless of what his heart meds are supposed to be doing, and his BP has occasionally dropped to below 75/?? or ??/(very low).

In summary, things are not looking good. I am likely to be back down there tomorrow, and my brother and I will likely have to make the tough decision...just how much would Dad want to go through this, and should we just decide to just make sure he is comfortable. But either way, we at least did have a chunk of the family in visiting with Dad, and we have all pretty much come to terms with what is likely to come soon.

Thanks for the well wishes and all!

- Doug/Spacey

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Keep the chin up, Spacey--been there with my mother, finally had to pull the plug after her heart went on the blink. I know what you're feeling right now and knowing there is nothing that really can be done except wait.

Thoughts, prayers, and love for you and your family.

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Miss Kitty

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My heart goes out to you Spacey I am sending you lots of hugs. I hope your dad is comfortable and I pray for him and your family.
xxxoooYvonne
Spacey

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Well, it has been a very interesting week two weeks. As you may have noticed, I have only been on for an hour or so this week, but it was trying to catch up at work, instead of being with Dad down at the hospital. And that was after last week. Here is a quick summary of the past two weeks...

As you know, I had planned on going back down right after my last post, and that is what happened. The antibiotics were not doing any good, and his WBC was easily over 50K, and his kidneys were in a state of failure. So we actually decided sometime on the 22nd to discontinue all treatment with Dad and go to a pure DNR-CC (comfort care) situation, with minimal treatment except for pain (with morphine). It was a very difficult situation with a nasty twist. Dad does not have a living will. That means that my brother Fred and I, as co-powers of attorneies, have to make the decisions in concert. No big deal, until you realize that my brother, while raised as a Catholic, converted to Judiasm about 15 years ago, and Jewish law forbids removing things like ventilation, feeding, and hydration once started, unless the person clearly has either died or will not suffer in any way as the result. It made it tough on him, as we all knew that Dad had all but said he did not want to be kept alive through means such as this, especially after having seen Mom drag on and on and on when she was dying from cancer. So while we could not do any more dialysis, stop the medicine which was supposed to stabilize his heart, stop the antibiotics, etc., we could not remove the ventilator, nor stop the feeding and saline IV. However, while talking with all of Dad's doctors, it was clear that we should go ahead with the trach/peg, as it would be more comfortable for Dad, and would allow more options, such as possibly Dad being able to start breathing on his own, not having to fight against the dead spaces of the throat, mouth, sinuses and nose. It would also prevent Dad aspirating and essentially drowning over the day or two after removing the ET tube, assuming he could even breath on his own. So... he was evaluated for the trach/peg by his surgeon, and found to be so unstable that he would not survive in their estimate. So Dad was stuck with the tubes going down his throat, a machine breathing for him, and us just waiting. In retrospect, both Fred and I realized to our horror that we had painted ourselves into a corner when Dad was placed on the ventilator.

And so we waited, while Dad spent over three days with his heart racing at over 170bpm, sometimes averaging over several hours at even 200 or 220bpm. At one point, he even was up to around 260-270. But no PVCs at those rates... the heart really does not have a chance to throw PVCs at that rate. And we waited, while Dad's skin got more brittle and prone to oozing and such. And we waited while other things seemed to get worse. But late on the 26th or sometime on the 27th, something wierd happened...Dad's heart rate dropped into sinus rhythm at about 90-110bpm. No clue on whether it was irregular or if he was throwing PVCs. And on Sunday, we got a call from Dad's surgeon stating that if Dad remained as he was, we could get a trach/peg done. We said go for it, knowing that regardless, Dad would have a better chance of getting off the ventilator, would stand less chance of yet another infection, and would be able to be moved out of ICU into a different unit at the hospital, and possibly into a nursing home. So, they did the first blood test in about a week. WBC was around 12K (remember, normal is 4K-11K, and last we knew, he was over 50K), his hemoglobin was 9.4, his BUN was 80, and his creat was 2.0. So he was a anemic, but around his average the past few months, and his blood toxins were down, even without dialysis. So they transfused a unit of whole blood, and Dad had his trach/peg on Monday. He made it through that pretty much OK... And we had Dad scheduled for an EEG to try to see if there was an explaination why Dad was still in a coma, and we started back up some of the treatments, but not all of them, and especially not the dialysis. And we continued to wait...

Well, on Tuesday, he got the EEG. We got the results yesterday which showed the lowered activity due to the pain meds, but no reason for his coma. On Tuesday, he also went back into tachycardia, with his pulse back at 170+, but he was able to be moved into the special care unit, one floor down from ICU. And we continued to wait...

Now, late today, we got a update which we were happy to get. Dad actually started opening his eyes, and he kinda tracks on folks. And he even "said" ouch today when they were moving him around. What is meant by "said" is a bit vague at the moment, but with that tube down his throat and the ventilator hooked to it, it would be hard for him to verbalize, so it may just be that he mouthed it with a facial expression that helped them know what he was trying to say.

Dad is definitely not out of the woods yet, nor is he near the edge of those woods. But the trees have started thinning out to the point where the edge of the woods may be in sight. More updates later, but I will be going down to see him on Saturday. In the meantime, I want to thank you all for your thoughts, well wishes, prayers, and what ever else you have been doing to end this suffering. It seems to have helped Dad get to a point where none of the doctors and hospital staff, myself with my limited EMT/medical training (received while I was an emergency responder up in Fort Wayne), nor the rest of my family and friends figured Dad would ever be. We all never figured he would make it through the several days of tachycardia.

And so, now, the waiting continues, while we wait and see how much more he recovers, and what sorts of problems he will have as a result of all this trauma.

BTW... If Dad gets to the point where he can make decisions of a sort, we do plan on trying to get an official living will into place. And as my nephew's wife (who worked in the medical profession for a number of years, and whose sister is still in the profession) said, there are going to be quite a few of them put into place with our family over the coming months. And if you are smart, you will too, even if you have a PoA in place....It may just save your family some grief in the long run.

EDIT: I forgot to mention...they finally got the double positive on the C-Diff infection, so when we visited him last, we were forced to avoid contact, or to wear gloves, gown and mask. Don't know if that is still in effect, but...

*BEL*_e (spacey), BEL Clan General -- You Frag em, I'll Slag em!
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(DC)DEMONSLAYER

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Good new for a change pal---keep us posted

Let us not fool ourselves into thinking we went to the Moon because we are pioneers, or discoverers, or adventurers. We went to the Moon because it was the militaristically expedient thing to do. Neil deGrasse Tyson

Every job is a self-portrait of the person who did it....Autograph your work with excellence. Author Unknown

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Spacey

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USA wrote:
DEMONSLAYER]Good new for a change pal---keep us posted 


Indeed. Given where we were, I would say GREAT NEWS! < Now if he can only continue to improve. The one thing I do know is that if he goes back to eating on his own, this is likely to be a recurrent issue. I don't know where we are headed long term, since they could also at some point pull the trach/peg and allow him to return to his normal, run-down self, which will leave him prone to aspiration. But we are hoping that we can get him to come up here to Columbus with us, so that my brother and I do not have to worry about 2.5 hour trips, one way.

Thanks!

*BEL*_e (spacey), BEL Clan General -- You Frag em, I'll Slag em!
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