Tuesday, June 9th - Saturday, June 13th

I haven't been posting on here much recently because, honestly, not much has gone on. Dad is still occasionally running a fever that hovers around the 100* mark, but a dose of Tylenol seems to clear that up. Dad was on 5 mg of Ativan today, which is a rather large dosage (in fact, it's the most they are allowed to give him.) This is to pretty much sedate him, although it's not quite doing the job. This is probably due to his body building a tolerance to the drug. Because of this, the medical staff is thinking about switching him off the Ativan and Fentanyl (pain medication) and putting him on another drug that would work both as a sedative and a pain reliever. Again, today Dad was at 100% dependent on the ventilator, but his O2 stats were good at that. His white count was down around the 16,000 mark...I believe 10,000 is deemed normal...but he's been as high as 26,000 so that's a positive sign. One more key thing that the nurse said today was that when she last saw him this past week, they were able to see the hardware in Dad's back through the incision. Now today when neurosurgery came in, they were unable to see the hardware because some tissue had grown over it. This goes to prove that his back is making an attempt to heal now with the aid of the "WoundVac." Once they feel it's ready, they will sew his incision shut and allow the wound to finally close shut and heal completely. The talks about having to remove the hardware were in the past and no longer seem to be a plausible option.

Friday-Monday, June 5th-8th

So I haven't been back in Iowa City since Thursday so I'm a little rusty on the update this time. So far, to me, everything's staying about the same. Again, Dad still does not have a temperature which is definitely a positive sign. Mom said that today he was "snowed in" or pretty heavily sedated. There was some blood in Dad's urine today so they are wondering if he might have a urinary tract infection, or if that was due to a new catheter insertion. Regardless, he is still hovering around on his ventilator pressure support...somewhere between 55 and 80 percent dependency. Other than that, I don't think there is much more to update you on...things are kind of at a stand-still at this point. It seems to me like this is a down time to let his back heal up a bit before they start doing much of anything else.

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Thanks!

Heidi

Wednesday & Thursday, June 3rd-4th

Mom and I haven't been able to stay in the room with Dad very much over these past two days because every time he sees us, he makes attempts to sit up out of bed and pull out his ventilator. I think all he wants to do right now is go home at any cost. However, he isn't very mentally competent at this time so I'm sure if he knew what was going on he would know to calm down and just rest. On Thursday, Mom and I went in to see him and when Mom grabbed his hand he woke up and immediately his O2 stats plummeted, his respiratory rate nearly doubled, and he tried to pull his ventilator out. At this point we have decided that by him seeing us, it's just making him want to leave more. From a medical standpoint, they upped his Ativan dosage to 2 mg which has pretty much sedated him. When Dad is sleeping his oxygen saturations are much better and he requires a lot less attention. At this point, the medical staff thinks this is the best thing for his recovery. Over the past two days he has lost the temperature, which is a huge positive at this point. They've also been talking about placing some kind of tube in his back to clean out the infection and then stitching his incision back up...but neurosurgery is going to wait a few more days before they do anything. So we're pretty much in a stage right now of letting him rest and hoping that this will further improve Dad's condition. I'll keep you posted.

Sunday, Monday and Tuesday, May 31 - June 2nd

The last three days have been pretty non-eventful. One of the possibilities in the last post was the threat of pneumonia. Although not completely clear yet, doctors do believe that he has it. The hardware placed in Dad's back has come up positive for an infection, so the neurosurgery team is going to wait a few days to see if his spine has fused yet. If this is the case, which is unlikely, they would be able to take him in for surgery and have the rods and screws removed from his back. Again though, it is not only unlikely that the bone has fused, but it's also unlikely that Dad would be able to go through such a surgery in his current condition. The pressure support on his ventilator has been ranging between 60% and 100%. Which means he is still very dependent on the machine to do the breathing for him. Yesterday Dad was very alert and very agitated. Whenever Mom and I were in the room he would constantly be needing or wanting something from us. Today was about the same. He was back at 100% on the vent and he was constantly moving around, telling us he wanted to get up and walk out of here. It was hard for us to explain to him that he wasn't healthy enough to do that yet. I think he realized that before we even told him. They have decided to keep him up on 7th floor instead of trying to put him back in the MICU since Dad likes it better up there. The staff decided to go ahead and put a suction machine on his back so that they don't have to continuously roll him around and change the gauze out. When we called in tonight, his nurse told us that Dr. Klesney-Tait decided to give him a high enough dose of Ativan to make him sleep. Her thought process is that Dad has too many things wrong with him right now for him to be awake and struggle through the pain. After being home and talking to a lot of you already, I can tell that some of you are still a little confused about what exactly is wrong with Dad. So I will use this time to "debrief" you on all of his current problems:

Lungs: looked at the CT Scan today and his lungs have a moderate amount of inflamation and mucus build-up. This is caused probably by both his infection and the pneumonia. This is the reason he is on a ventilator through the tracheostomy.

Kidneys: Lately his kidney functions have been improving, although they are not back to normal yet. His creatine levels are at about 2.3...normal functioning is right at 1.0. He was at one time on dialysis, but he is no longer requiring that amount of assistance.

Back/Spine: Dad had to have emergency back surgery after he suffered a compression fracture of the Thoractic 11 vertebra. The fracture occured due to a combination of Prednisone use over the last 9 years, his recently diagnosed Ureaplasma, and a couple of falls while walking. Ureaplasma is a rare bone infection that can be found in transplant patients. Iowa City has had 8 cases in 25 years. Dad is currently on Zithromiacin and will have to be for the rest of his life as a preventative measure. His surgery was risky and involved the placement of two steel rods and screws to help fuse the vertebrae back together. His incision is still open because of the reoccurence of puss build-up. So Dad literally has an open wound in his back at this time that requires constant daily attention.

Shoulders: A few years ago, Dad suffered a torn rotator cuff in his right shoulder. They were never able to perform surgery on this due to his poor lung condition. Since he has been in the hospital, they also discovered some bone deterioration in his left shoulder. So at this time both of his shoulders are extremely weak and painful.

Stomach: While in the hospital, Dad complained of stomach discomfort. Following this, the doctors found that he had two ulcers. Although this is painful for him, they should heal on their own.

Cardiovascular System: Almost two months ago, Dad had some complications with his medications. When he was admitted into the MICU at that point, they discovered he had suffered from what appeared to be three small strokes. They in no way should have any affect on his life. This was later explained to us as being caused by a minor flaw in the sewing of the new lungs into the heart valves.

Infections: Dad has suffered from a variety of infections already. As I explained above, he still has the Ureaplasma infection in his back, but it is being treated with a drug called Zithromiacin. However, Dad is still breaking temperatures so there is still an infection in him that they haven't found yet. They are testing his blood every day in an attempt to pinpoint where it is coming from.

Overall: For those of you who don't know what's still keeping Dad from going home, this is my best explanation: The hardware (rods and screws) in his back are carrying an infection. They have to wait until his bone has fused before they can remove that and sew his incision back up. Dad's lungs are suffering from inflamation and fluid build-up due to the unknown infection, and pneumonia. These two things are the most important factors holding him back. His healing process will have to come one step at a time. First, they have to pinpoint the infection and eliminate all fevers. This will probably coiincide with the elimination of the pneumonia. Once they are able to do this, he will have to lose the infection in his back and go through surgery to have the hardware removed from his back. If he is able to make it through all of this, he will have to rehab and build strength back in his legs and basically learn to walk again. It's a long, scary road ahead of us and all we can hope is that we have as few stumbles along the way as possible. Thanks for your continued support and comments.

Thursday, May 28th - Saturday, May 30th

Hey everyone...I'm sorry that I haven't been on here lately to post but I have been back home and working. If Mom was a little more tech-savvy she could do this, but I think she's got enough on her plate already. So since I haven't been around, I can only tell you what Mom has told me over the phone. Thursday was a very slow day...Dad was asleep for a lot of the day and the staff kind of wanted to let him get his rest. Friday was when I headed back to Coon, but I remember that at that point, Dad's blood pressure seemed to be doing a lot better than on Thursday. He was running about 85/60 Thursday and around 110/70 on Friday before I left. They put Dad back on Lasix to both assist his kidneys and to remove some of the liquid build-up in the lungs. As far as I know, he's been having some anxiety lately, specifically on Saturday, about being in the hospital still. Mom updated me earlier today (well, I guess it's technically yesterday since this post is so late)...Saturday...about the fact that there are a couple of reasons the doctors may have discovered for his slow recovery...one having to do with the lungs, and one having to do with his back. I'm sorry, but at this point I don't feel it is in our best interest as a family to release those discoveries at this point because they are just theories from the doctors. They aren't exactly life-threatening discoveries, but they are very serious and hopefully they will make it official soon, so I can let you all know. It shouldn't be more than a few days before they find out for sure. Please don't be too alarmed by this....these are both things that Dad has fought through in the past. The only reason I am not releasing this is because I don't want to put something out there that might not be true and/or finalized. All I can say is to hold tight and keep checking this for updates! Thanks for the comments everyone and I will continue to try my best to relay them to Mom and Dad both.

Wednesday, May 27th

This morning was a rough one. When my mom and I arrived on 7th floor at about 9:00 a.m., Dad's nurse told us that his temperature had risen all the way up to 40.2 degrees centigrade, or 104.4 degrees fahrenheit with Tylenol. The medical staff countered this by placing a water-cooled blanked underneath Dad's covers to help lower his core body temperature. It worked well and by the end of the afternoon he was back down to 98.8 degrees. Dr. Klesney-Tait decided to take Dad off of all his antibiotics except for the one fighting off the Uriaplasma infection in his back. Once again he was very drowsy and fairly unresponsive when we first got to the hospital, but once the temperature began to regress and the afternoon wore on, he was wide awake. At this point he decided he wanted to watch one of his DVD's of an Eric Clapton concert. Shortly after this, however, he began complaining about a constant pain in his lower abdomen and explained to us that he felt like he had to urinate, but was unable to. His nurse checked his urine sample and said that something didn't look right in it, so she sent it in to be tested for an infection. So at this point, we are waiting for that sample to culture, as a urinary or bladder infection seems to be a strong possibility.