Catching Up

Mia sent a water color picture for Grandpa. She made it at preschool and wouldn't let her mom have it. She said, "No, it's for Grandpa." He loved it Mia! Thank you sugar.

Woohoo! Mike made short order on this serving of meat. It is the *largest* meal he has eaten in a long, long time. 3/29

We were supposed to leave but the transport company didn't show up and then after agreeing Mike could just ride in ouR vehicle, theY realized he had a central line instead of a PICC line and told us we'd have to stay another night. It seemed as though we had taken up residence so I borrowed the idea from a sign Scotty and Billie had on their porch. A few people laughed. Mike and I enjoyed it. 3/29

TJei grabbed up my camera while I was on the phone. Jodie had gone in to see Mike for a minute, I was sitting in the vehicle with the girls. 3/29

It was a good idea, just didn't work out well. After eating so well last night, Mike decided to see if they had  breakfast burros. They did and he ordered one...but didn't eat much more than this. :(

After we left the hospital, we stopped for gas at Circle K. Oh my heck, these fuel prices are a killer. Mike saw a roadwork ahead sign warning of delays on 260 and instructed me to go through the Canyon instead of the Rim. The Rim might have been a bit closer but the Canyon was a pretty drive, too. 3/30

SNC

Skilled Nursing Center - That's how care centers are classified. Skilled nursing, or not. Scottsdale Heritage Center is a skilled nursing center. There is no denying it, when we first arrived and I came into this building to get instructions on how/where to bring Mike inside, my heart sank and I was overwhelmed with sadness at the sight of elderly patients, in all stages of consciousness and all stages of dress, lined up along a hallway wall. The sights, sounds, and smells is something I was not at all prepared for. I honestly had the thought, "Oh my stars. What are we (he, thereby me too) in for?" I wanted to cry and run all at the same time.

Mike woke up this morning and smiled at me. He asked, "When did you put that up?" pointing to the collage of the grandchildren. I told him I'd put it up late last night. He said, "Oh. I was just seeing in my mind that the pictures weren't there and was going to tell you to put them up. Then I opened my eyes and the pictures were there."

I felt really good that I'd put that up last night. :)

And how do you like this? I sure didn't!

What on earth??? Cost was never even discussed other than a generic, "it'll be expensive and I (the discharge consultant) don't think your insurance will pay it." That was the ONLY time cost was mentioned by anyone and that was at the start of the planning for him to come to the Valley. It seems they forgot all about an entire day of waiting for the transport service and when they didn't show, me asking if I couldn't just take him in our vehicle. The transport no show, the central line being "forgotten" and the need to stay an additional day so a PICC line could be put in the next morning had little to do with it...it all came down to me and expense. Talk about some cover your butt record keeping!

Here's some more of it, things that were listed in discharge diagnoses:

Diabetes? They said over and over again that he isn't diabetic. And, they didn't send any orders for diabetes testing or care. When I finally talked Cara, the nurse here, to test his blood sugar a bit ago, it was 106, just a bit elevated, no need for insulin or other intervention. What the heck? Where did this diabetes mellitus come from on the dischare diagnoses?

Acute renal failure??? Again, over and over again they said there was no issue with his kidney and yet they've identified acute renal failure as one of his diagnoses on discharge.

Mike was forgotten during the breakfast rush around here. At about 8:45am I stepped out of the room into the hall. The nurse asked how Mike liked his breakfast and I told her he might like it just fine if he could get some. People scurried on that one. They didn't realize he had been missed.

Mike got up from bed a bit ago and sat in a wheelchair. He wanted to go outdoors to a patio for some sun. The nurse said she'd have a portable oxygen bottle brought to him. After a while Mike asked me to just help him get back into bed. It was about 15 minutes later that someone came in all cheerful with a portable O2 tank. Oh well. It's here now if he gets a wild hair again. :)

So far, we haven't heard anything at all from physical therapy although we did manage to get out of a follow-up visit at Dr. DeLange's office in one week. Just wasn't going to haul him up the mountain and back for an office visit. ha! I've no idea how that got scheduled. Dr. DeLange had told us to see him after Mike gets out down here. That's more doable.

Family Support

Over and over again I am realizing how important it is for an alert, questioning  family member to be with someone through all phases of medical care. I woke up at 3:45 this morning and noticed Mike's IV pole was still sitting empty. His nutrition wasn't started until late last night. He had already gone to sleep, I was falling asleep. I expected the IVs would have started right after the feeding got going.

I picked up his water pitcher and emptied the warm water into the sink. I carried the pitcher into the hall and approached two aides sitting at a work station. I asked the nurse about his meds. "He isn't due for anything until 6:00am" she replied. I didn't recognize the name of the med she did say after that. I asked about the Vancomycin Hydrochloride, the powerful antibiotic he is supposed to be getting, and she replied there are no orders for that. What the heck?

Several minutes later an aide came into the room with the refilled water pitcher. "The nurse also asked me to let you know she was wrong on the med orders." Fine, but now it is anther 1-1/2 hours later and he still isn't getting the needed medication.

Update: 0525am Maybe she's a mindreader. Elizabeth, RN just started the Vanco

There Are Nurses Here

Finally, a nurse has come into the room...3-1/2 hours after we arrived a nurse finally came in to start Mike's assessment.

First Impression

This isn't looking good. We have been here, Mike actually in a bed because I got a wheelchair and wheeled him in, since a bit after 4:00pm. A nurse has flitted by a couple times saying she'd be right back but thus far, no one at all has been here to Mike's rrom until just a moment ago when someone came in with a tray of pureed food! What the heck???

Yes, a Yo-Yo

A friend questioned whether we feel like a yo-yo with all the changes being tossed our way on a regular basis. Yes, a yo-yo decribes well what it seems like. A nurse came in a short while ago carrying a clipboard and telling Mike, "I have insulin for you. Your blood glucose was 143 so I have four units of insulin." Are you sure? Mike's glucose was 162 this morning and they gave him four units of insulin then. Then, the pitter patter of little nursey's feet as she scampers over to the computer to check things again, "Oh, yeah, you're right. You did get four units."

Seriously.

But that wasn't the oddest thing of the morning.

Paula, RN also handed Mike a piece of paper and asked if she could get his signature saying it was a form that should have been done when he first came into the hospital...a permission to treat form! Oh my heck.

They have scheduled to take Mike for getting a PICC line at 8:00am. Paula will be removing his central line, not sure if that will be before Maybe after since they'd want to make sure he has a line. Sometime after he gets the PICC line we should be given a go ahead for leaving the hospital and starting the journey down the Beeline.

No Transport

Okay, I would seriously laugh if this weren't so serious. No transport today after all. He can't go with a central line, they have to do a PICC line in the morning.

Transport

Doc was in a few minutes ago. A new one, Dr. Roony. First time we've met him. We've been waiting to hear all day what the travel arrangements were for Mike being transported to the Valley. We haven't heard a word. So, I asked the doc, "Can't I just take him down in our truck? We have OnStar in case of an emergency and I have a cell phone." To our surprise, he said yes. He said I could drive him down. Hooray! Now we just have to wait again for them to come back with all the discharge instructions. I made a mad dash over to Walmart and grabbed a couple flat sheets and some pillows & cases.

Hopefully soon, we'll be off!

Blue Crew

Mike nicknamed the physical therapy team "Blue Crew" because, of course, they have to don blue gowns when they come into his room. Here the Blue Crew is walking Mike in the hallway. Yes, he's there behind the IV pole. Okay, seriously, he's there. I just didn't let the picture get too many details because he is in a hospital gown after all. Sometimes a guy has to do what a guy has to do.

Friend of a Friend

This has got to be the sweetest thing ever!

Mike and I were so surprised to receive mail from Canada. My mind raced trying to think of who we knew in Canada that would be sending him mail at the hospital in Show Low. hmmm Well, it turns out it wasn't from anyone we knew. It was a sweet note and well-wishes from a total stranger, a friend of a friend.

I could be wrong, but I think this was one of the kindest actions ever, taking the time to write a personal note to someone you don't know who is in a hospital. I hope my heart grows to be that big someday. Thank you Cheri and Calvin!

Letter for Grandpa

TJei called this morning to ask if Grandpa liked his letter. Oops! I had forgotten to give him the letter she wrote during sacrament meeting.

Yes, TJei, Grandpa liked your letter. :)

Another Chest X-ray

It really does make me wonder, why are they doing a daily chest x-ray if they're not learning much about the lung's progress with day to day imaging.

Mike needed 8 units of insulin this morning because his blood sugar was at 205, the highest its ever been during all of this. He received 4 units during the night when the blood sugar level was at 178.

Thursday, Maybe

Mike continues to get stronger and healthier each day. It was rather tough, I left for several hours his morning to drive back to SJ and attend ward correlation and church.  More than one person acknowledged, he must be better or you wouldn't be here. They're probably right.

Jodie attended sacrament meeting and it was good to have her in attendance along with the girls. That was nice.

Mike needed a unit of blood again today. That makes eight units he has received since his surgery and I believe there were four units during surgery. Men, on average, have 10-12 pints of blood. Mike has essentially had all his blood replaced it would seem. :(  He also needed another unit of iron and still needed potassium.

Hopefully, they will have all his body chemistry back in balance before releasing him from the hospital and they're talking about maybe releasing him this week. Thursday, maybe.  It just seems they should have things back in order for a day or two before that. They have discontinued two of the antibiotics. He is still on Vancomycin. He had a low-grade fever all day, 99.3.

Apparently, little went smoothly in my absence. The first clue I had of things not going well was when Dr. Delange said something about Mike not working enough with physical therapy. Huh? Mike likes working with PT. He wants to get out of this place and he wants to get stronger. I asked Mike what the doc was talking about and he said he didn't know. He said PT had come to the room while he was getting a blood transfusion and getting iron via IV and the nurse had told them they needed to come back, he couldn't do PT at that time. PT left and never returned. So, what the heck, that becomes a matter of Mike not working with them enough?

Then, a short while later, a social worker comes into the room and begins talking with Mike. He eventually gets to the big question, "So have you had thoughts on giving up, of just not going on?" What on earth? Mike pointed to the picture of our grandchildren and said, "I have every reason to go on." Apparently, the nurse, Scott, and respiratory therapist, Laura, each had come to the conclussion Mike was depressed and unwilling to cooperate with his treatment because he was "slow" and unresponsive in answering their questions. They were concerned about his mental well-being and contacted social services for crisis intervention. I just felt like screaming, "Okay dummies. He is slow to respond because it is difficult for him to breath deep. He stays winded and has to build up the energy to talk." Apparently these jerks haven't noticed Mike has been slow to respond all along, they only noticed it this morning in my absence. And, of course, they themselves were so very responsive. Laura had come by early in the morning and hadn't been back. She told me that when I passed her in the corridor near the cafeteria. Two days ago the doctor said he wanted increased respiratory care because of the fluids in Mike's lungs. The following day is when Nick didn't appear at all until the end of his shift and now Laura stopped in once during the entire day...making an appearance just long enough to form an opinion he is ready to call it quits. It probably took her longer to do this crisis intervention report than it would have taken to give Mike a breathing treatment!

Now, I need to try locating copies of lab results over the last couple days. The nursing staff says they can't give us copies, we have to go through medical records. Medical records says they have nothing available on the current stay.

Bishop Sexton and his wife, Michele, visited. It was good to see them again today and it was great to hear Michele's positive comments in comparing Mike's progress now to how he had been when she saw him in ICU.

Today, I am praying that Mike's lungs stay healthy and the fluids are reduced, that he doesn't develop full-blown pneumonia. (It is pneumonia, praying it doesn't worsen.)  I am also praying for a friend's little grandbaby. Carter was born nine weeks early and has been hospitalized for these first eleven weeks of his life. I pray that Carter's little body will gain the needed weight and be healthy so he can leave the hospital and go home with his family. And I pray for his sweet parents and siblings as they await Carter's homecoming.

Define Much

Karen: How did Mike's chest x-ray look this morning?

Dr. DeLange: Unfortunately, a daily chest x-ray doesn't tell us much about the lung progress.

Really? Then why is he having a daily chest x-ray???

Mike just rubs his fingers and thumb together, counting money.

Labels

It is so easy for people to apply labels. Sadly, it is probably far too easy. It is curious how one label or another happens to get tagged on a person (or situation) and all perceptions after that are somehow shaped to reinforce the label. I need to do a better job of eliminating labels from my thought process. I want to do better at seeing each person, each action, each situation as a new and unique opportunity to forge a good relationship with another person.

Irony? Now I have to "label" this post!

Busy Day

This is one of the several ways they are trying to increase Mike's protein level. Odd, I know, they've said over and over again that his protein levels are low. It just this very moment struck me what they actually mean by low. I am learning so many of these things as we go along, it's like a mixture of Greek and Chinese  to me. For several days now, they have been encouraging Mike to increase proteins in his diet. Mike has done what he can but he cannot eat very much at all. This morning, we celebrated that he was able to eat 2 sausage links. That was a big meal compared to what he's ate over the past couple months. So Mike has been eating meats as often as he can tolerate. Along with that, he is receiving a high calorie four ounce shake with each meal order and a four ounce protein shake about an hour after each meal. At night he receives a high protein food formula through a feed tube into his stomach and yet, his protein levels still are only half what they should be. Whatever the unit of measure is, he should be 20 and has made it back up to 10 after all this effort to increase the level. The doctor said he had just been completely depleted of protein.

Maybe iron, too. They are giving him a lot of iron and they have doubled up on the amount of potassium they are giving him. He's just depleted all of it!

And, okay, this is groddy but still. These are two of the drains from Mike's abdomen. These two are definitely the less gross ones. The one on the left has yucky stuff the one on the right has serum, what they want to be seeing at the drains. One in four isn't bad, I guess. It's progress.

I know my kids aren't going to believe this, not after seeing the picture above and knowing I was just writing about groddy stuff, but a quick change of subject here. I have to say THANKS and send {hugz} to Craig and Lori Crockett. You're awesome! Lori has stayed in touch with me on a
regular basis, even when she traveled to Idaho with her family. She and Craig came and visited while Mike was in ICU and brought a bag of reading material and snacks. Today, they came into the hospital room bearing gifts again.

How awesome is that? They brought an entire cooler packed with snack foods and a couple Pepsi's on ice! This is amazingly unreal. I'm speechless, and that sure doesn't happen often. ;) And, it wasn't until looking into this cooler that I realized I have not eaten a single bit of fresh fruit the entire while Mike has been in the hospital. It didn't take long for one of those bananas to be history and it didn't take long for a tortilla to become a wrap for lettuce, tuna, and mayonnaise to become a wrap for lunch.

Yum! This really hit the spot. It was so nice to visit with Craig and Lori, too. It sounds like Cass had a super time visiting BYU-I and it was nice she was able to say hi to others from SJ while up there visiting.

Mike had a couple special visitors, too.

It was the cutest thing ever to see Mia pulling up the bottom edge of the curtain looking in and waving to Grandpa with a huge smile while she waited for TJei to get suited up too. The girls were so anxious to see him and he was ready to see them!

They both were taking in all these unusual sights and sounds (Mia asked why Grandpa was breathing water) but TJei had a bit of advantage now that she can read. Here she is reading all of the whiteboard in the room.

Then she caught sight of the controls on the side of the bed and had to check all them out.

They didn't stay long, just a few minutes but it was enough for them to see Grandpa and know that he is getting better and long enough for him to realize again how much all the little ones love him.

This is what they're feeding Mike at night now, through his feed tube. He gets 3 cans of this stuff during the night.

The respiratory therapist, Nick, didn't get his name on the board today. That's because we didn't have a clue who the Resp Therapist was until 5:15 this evening when he stopped in to set down a breathing device and say night shift will be using it with Mike. His shift is 6am-6pm so essentially he was getting ready to get off work when he stopped in. Nice.

Changes Ahead

Mike's skin has become so dry and sensitive since he has been in the hospital. Even with moisturizing soaps, and frequent application of lotions his skin just dries and cracks. His feet and palms look reptilian with the skin drying up and peeling off.

Mike is moving more but still tiring so very quickly. He walked in the hall with physical therapy this morning after he and I had breakfast together. I had oatmeal, he had two (turkey) sausage links and a bowl of cream of wheat with an orange juice. He drank the juice and managed to eat both sausages. He couldn't get the cereal down this time.

It is the first time in ages we've ate together though. That was nice. Did you notice he was sitting up? Hooray!

Dr. Lee (hospitalist) stopped in and visited this morning. He said yesterday's CT scan confirmed x-rays from recent days. It isn't just one lung, Mike has fluids building in both lungs. He'll need to work hard with that spirometer to keep his lungs expanded and fend off pneumonia.

Mike has been several days, five I think, without a fever. The doctors are taking him off two of the antibiotics to see how he does. Hoipefully, the fever doesn't come back and number of white cells doesn't increase. Yep, that'd be good...no changes.

The doctors agree, Mike may be able to leave the hospital next week. They also agree, yes, he does need to go to a rehab facility instead of a private home. He couldn't go to our home just yet, he couldn't do the stairs to get into the house and the stairs to get up to the bedroom. We talked to them about our house in STV but they still feel he needs a rehab facility.

There are changes ahead, we just don't know what kind or hom many just yet.

Visitors

It was a surprise to get a visit from Jacob Bennett, a long-time friend from back in 4-H days. When I mentioned to our Jacob that he'd visited, he said, "Wow. I can't believe he's still in touch." Yeah, it's been maybe 14-15 years or more since 4-H camps but I believe the last time I saw Jacob was when he came home from his mission. I went over to Winslow when he reported. It was sad to learn his dad passed away about 4 years ago. What a challenge his mom has had over these years.

Mike Goodman came by too. Claudia waited out front for him, she is just too susceptible at this time. Mike and Mike had a nice visit and Mike G was impressed with Dr. Lee when he stopped in to check on Mike. When Mike G left, he went to medical records and missed Claudia when she came in looking for him. She made it all the way back to Mike's room and said hi at the door. I walked back out to the lobby with her and we caught up with Mike G there. It is so hard to not give her a hug when I see her, I love that lady bunches. She and her husband Mike have been through so much with the two of them battling cancers for so long.

Mike's pool team buddies came tracking him down, too. Seems he hasn't shown up to play with the team for a couple weeks. :) Alex Marino and Albert Chavez stopped in for a visit. It was so good of them to come by!

It's been so nice that people have stopped in to visit Mike. He has enjoyed the visits.

CT Scan

Mike is sitting in a chair. He got up from the bed about 45 minutes ago and has been sitting up during this time. He moved much more easily than he has although it is still painful to watch him struggle. Earlier this morning, about four o'clock, they removed the Foley catheter and Mike is quite happy to get rid of that little tether.

He has been waiting for a CT scan. They told him it would be done at 8:00 but so far, no one has even gotten here to transport him for the scan. So we wait.

Emotion and All

Someone mentioned to me today that the new social medias have given them a short attention span and suggested I learn to make my posts in 150 characters or less. No can do. With me, you get all the thought and emotion, too. It's just me. Sorry about that. ♥ ♥ ♥

Rewired and Rewrapped

Dr. DeLange stopped in this afternoon and took care of a couple things for Mike. He redid the central line at his neck. That was weird! Essentially, he threaded a fine wire down through the tubing that was already in his vein. It seemed that wire went in, and in, and in some more. Watching the process, I wouldn't have been surprised at all if the doctor had suddenly stopped and declared he had punctured the liver. It seriously went a long way in. Once the wire was in, the doctor guided the tube (catheter) out and spooled it onto the sterile area he had created with a sheet, those kind used for surgery with an opening for the area being accessed. Then, he lined up a new catheter over the wire and fed it down into the vein following along the wire. Once it was positioned, and new ports (three of them) attached, he removed the guide wire.

Then came time for checking the incision and applying new dressing. Ugh, was that ever ugly. As the dressing came off, first time changed since 3/17, it was apparent there was an open area oozing bloody pus in the center of the incision area. The open area is maybe a bit smaller than a half-dollar coin but larger than a quarter. The tissue has just eaten away, leaving the staples laying there in the middle of the opening. One bit of the two staples was slightly attached, the doctor had to grasp them with a tool. Then he used bunches of betadine to scrub things up around the opening and used swabs to get inside it and under the skin at the edges. Oh my stars, I had all I could do to not gag.

Dr. DeLange then removed the remainder of the staples and checked out the drainage tubes. Mike has four tubes draining pus and fluid from inside his abdomen. The drain tubes at the top of his abdomen have pulled from the weight of the tubes and one of them has actually pulled out 3/4 inch or so. They are actually stitched in place so that means the stitches and the skin have each done some stretching.

They are going to begin "training" his bladder so he can get off the Foley tube in the next day or two. By training they mean, clamping off the catheter so he has to "hold" the output in his bladder. They'll clamp it for two hours then unclamp to let it drain and then reclamp it for another two hours. Good thing Mike's always had a huge bladder, he'll need it with all that Lasix (diuretic) going in to him to get excess fluid out of him.

He piled on the pounds (Kilos) while in ICU going from 106 to 121 kilos, 33 pounds. And all that was fluids being retained in his system.

The doctor said today we may be looking at a week for him to get out of here. It seems he said that last week at this time, too. Only this time he means it. I'm sure.

Making Progress

A couple days ago, Carolyn stopped by to visit and I was snoozing. I had drifted off apparently while sitting here in quiet, darkened room. She left a note at the nurses station and when the nurse came in to leave the note, I snapped to attention. I went out front real quickly but she was already gone. Sorry I missed you, thanks for stopping by.

They added a bit of iron to the mix in Mike's IVs. As you can see, it is a bit more than simply taking a multi-vitamin with added iron. And now, with him having only one line it is more difficult to get needed meds, nutrients, and electrolytes into him.

One of the techs (nurse assistant) has taken pity on me and given me a comp meal ticket. Her kindness is so very much appreciated. Even though I've tried keeping costs and overhead at a minimum, it is pretty costly to eat meals here. And, it was nice...I used the comp ticket to get a sandwich and bottled water for lunch.

I purchase meals to go, even my bowl of oatmeal or cream of wheat in the mornings, and return to the hospital room to eat the meal with Mike. This one was beef brisket on grilled sourdough. There is a first in there. That red onion at the left, I actually picked it up and took a bite...I'm sure the first time ever that I have biten into a  raw onion. It was pretty good. I ended up finishing it off.

The iron is done and now the potassium is going in. That's his nutritition on the right. It goes directly into his small intestine through a tube in his stomach.

He isn't able to get food in at this time although he does try. This is remnants of a one egg omelette and a small bowl of yogurt. He is beyond the bite or two, but still has a long way to go for getting food in. The nutritionist would like for him to get 17 ounces of protein each day. Mike is pushing it to get 4 or 5 ounces in a day. Fortunately, they are giving him protein shakes to supplement.

I discovered a back parking area at the hospital which also has an entrance open during the day. Not that I'm going anywhere but I did go out and move my truck from the high-traffic area in front and parked it in the back. That's reduced my stress a bit with worrying over dings in the door. I know. Still. From the right, the third window set is Mike's room. There are two panes in each room.

Mike continues to make progress this morning and is looking better and regaining strength, little by little. He walked a lap in the hallway this morning with help from the physical therapists. Hooray! He is so determined to get back on his feet. He knows it'll be a lot of hard work and he's ready to take to take on that challenge.

Kip Rothlisberger stopped in for a visit.That was good. It gave Mike a chance to "talk shop" and also gave me a chance to tell Kip how very much I appreciated Blake's talk at church on Sunday. I really needed to hear his message. I am so glad Jacob was here so I could attend meetings.

Art Lee stopped by for a visit last evening. What a surprise it was to look up and see him standing at the door. Mickey had called the night before and said they'd heard he was in the hospital. It was nice of them to take time to call and stop by. I know Mike really appreciated the visit.

For now, he's doing what he needs to do at this time, resting.

Plugged Up

Mike has been prodded, patted, and poked so much since he has been in here. At one point, he had three different locations with IV lines x three, each location having an octopus of ports going in. Here's where he had one in his left hand.

Then he had another by way of a PICC line in his upper arm. It's healing up pretty well, too.

He still has a central line going in at his jugular vein at the side of his neck.

Problem is, the first two sets of three plugged up and were eventually removed. And the bigger problem now is that two of the three lines going in  the jugular have also plugged. :(  He has only one line going in...the nurse tried to do a regular IV line so they'd at least have two but she wasn't able to get it going. You can see in the first picture he is dehydrated. One line isn't going to work for too long though...

Even when combined, the meds are still piling up. Today, along with the antibiotics he needed potassium, magnesium, and iron. He is drinking three protein shakes a day between attempts at eating meals. He only manages a few bites during a meal. He's trying.

God Bless You

Mike is making improvements by the hour. :)  It feels so good to be looking to the future. It is time I start stepping up to the plate and working on ways to let go of this anger, too.  It has really drug me down over these past weeks and it is time for making changes.

Mike was moved from ICU yesterday afternoon!!! Hooray! Before going further, I'll also mention...Mike loves when I read the comments to him so load him up. Leave lots of comments. :) As I was saying, Mike was moved from ICU, he was downgraded (their words) which actually means he was upgraded, getting better. Mike is using a nasal cannula and has been off the masks for several days now. He is still very weak but has gotten on his feet a couple times with help from his "Blue Team" (physical therapists donning blue disposable gowns) and even managed to walk a little way down the hall. I don't know the distance but past several other rooms. He returned to bed and slept like a baby after each attempt to take a stroll.

His color is looking good again, no more of the death warmed over ashen gray appearance. The blackened crusty area on his nose looks terrible but even that isn't so horrible now that he's able to carry on a conversation and look around the room. I don't notice the injury so much any more.

For right now, Mike is receiving only antibiotics and whatever minerals and elements he needs by IV. For today, that would be iron and potassium along with the antibiotics. They have cut back on his feed tube today. He'll be getting supplemental nourishment between 6:00pm and 6:00am now. They'll double up on the delievery rate so he's still getting the same amount of nourishment just over a specified length of time instead of round the clock. They're hoping his appetite will pick up a bit, right now it is non-existent.

Dr. Karlick and Dr. Greko both visited with Mike this morning and checked out his abdomen. They are each quite friendly and communicate readily with Mike and with me.

Dr. Karlick used his hands to draw a picture of Mike's recovery. I've transposed his hand motions into images so people reading on my blog would realize the same visual impact. The slope on the right is what they are aiming for with Mike, slow and steady progress. Every now and then, Mike's system decides to be a little stronger than anticipated, a little quicker to respond. The left slope is the path he is on at this time. A little ahead of where expected. A bit more responsive, a bit more alert, and a bit stronger. Everyone around here is surprised on a regular basis that Mike does not require any pain medication. He hasn't had any at all in about five days. I know there have been angels guarding over him as he has battled these dibilitating conditions. I know he has not been alone.

I am grateful for the prayers said in his behalf and for those who have taken time to place his name on the temple rolls. I am eternally grateful to those who fasted and prayed for him and for the blessings he (and I) have been given during these difficult days.

Dr. Karlick gave me real reason to pause and reflect as he said these words leaving Mike's room, "God bless you." Quite honestly, those words are far too scarce these days from professionals. It really touched my heart that this man caring for Mike is not afraid to say, "God bless you."

Eating, or Inability to Eat

The western omelette did arrive, and it was, as requested pretty small. I didn't get a picture although I did manage to cut it into small bites even with those tomatoes in there. When Mike asked me to pour the salsa on it, I had to pause several seconds before I could do it. Mike took a bite of the eggs with salsa...said it was way too hot, he couldn't eat it. This from the guy with the asbestos throat! Luckily, I'd poured salsa on only half the eggs. The other half was just the omelette and Mike did manage to eat five small bites in total.

The doctor came in just before Mike started eating. This time it is Dr. Karlick, another hospitalist. The nurse began talking about downgrading Mike...moving him from ICU to the med/surg unit on the floor. That is good, except all their rationalizing just doesn't make sense. The nurse says Mike is eating. I said he isn't really eating, he's tasting food at times. The doctor asked how long he's been eating, I told him this is his real food order. The nurse jumped in and said yeah but he's been doing jello and broth and liquids. No one wants to listen to the fact that he ORDERS those items to try eating but has been unable to CONSUME those foods. She mentioned he had a turkey sandwich, they didn't want to hear he ordered a sandwich but was unable to EAT it. He instead had me take one slice of the shaved turkey from the sandwich and tear it into small bites so he could eat it. With several attempts (five individual small bites) he managed to eat that one thin slice of turkey.

Moving him to the floor is also going to be a huge problem in regards to mobility. This hospital bed in the ICU has a foot board that can go in and out, shorten and lengthen. We are able to shorten the bed and Mike use the footboard ot help push himself up in bed when he gets all scrunched up. That won't be available in a regular hospital bed and he doesn't have the strength at all to use a trapeze bar.

It looks like he is going to be moved though. That's a good thing, I just pray that he is really ready for the move.

Mg and K Today

He's not halting us, he's waving hi! Mike looks better each passing day. As we are reminded so very often, it is going to be a long time before he gets over these debilitating conditions. Today, Mike's WBC is down to 11K! Celebrate, celebrate! That is such good news and we're trying to stay focused on that instead of the fever creeping upward again or pus draining again from one of the tubes that had been without drainage. Mike says his abdomen is starting to feel like it did before this latest round of medical care; full, nauseous, bloated, no pain except when he coughs.

This morning, Mike is receiving Magnesium (Mg) and Potassium (K) by IV to replace elements that are low in his system. Even with an octopus-like series of  tubes going in at his jugular, this morning they had to disconnect his feeding for a bit and use that line to give him some meds. It's just a mish-mash of IV bags and spaghetti of tubes.

Now this should be interesting. Mike is getting ready to order breakfast. He wants me to order a Western Omelette with salsa on the side and a lemonade. This will be a great comparison photo opportunity! We'll see what it looks like on the plate before and after he finishes eating. When I ordered, I did ask them to make it a real small omelette, he won't be able to eat much so there's no reason to have a large portion.

This is going to be a good day, I just know it. He's asked for food.

Improvements

Mike has been making improvements, little by little, each day. Today he is able to carry on a conversation, with PT assistance he was able to stand and sit at the edge of the bed three times, he ate one deli-type small slice of turkey breast (in about five small bites), and this evening he has managed to sip away at a 4 ounce protein shake. Yippee! The best part of his day was spending time with Jacob...Jacob and Maria traveled up yesterday and Jacob visited for a couple hours yesterday, Maria had traveled on to SJ with the kids. Jacob took my truck and went to SJ returning bright and early this morning to stay with his dad while I went to church. More on that later.

I didn't really finish updates yesterday so I'll try to pick-up there. Mike's system had been completely depleted of iron and potassium so he was given those two minerals by IV infusion. I didn't realize until researching those two minerals that either of them could have played into Mike's slow response and the inability to communicate yesterday morning along with excessive fluids/slime in his lungs.

Dr. Greko stopped in again after he completed an emergency surgery. He checked out Mike's abdomen and the J-tubes, the four tubes used for drainage inside his abdomen, and commented on how well Mike is doing for all he's been through. That was encouraging.

Still last night, it was the weirdest thing ever, I was talking to the bishop by phone and giving him an update on the progress Mike has made. I told him about the iron and potassium depletions and IV infusions. Then, I told him the very thing all the docors (and there's plenty of them) are telling us, "Mike is making progress but still has a long way to go." All of a sudden, Diane, RN, starts calling out to me, "Don't lie to people. He's almost well. I think he'll be out of here today or tomorrow. Don't lie." What the heck???? Jacob looked at me and laughed, "Mom, I'm going to call her to ask how dad's doing.  I like her version better." Mike is  off  looking at her like she's nuts as she also looks down to him, "Mike, don't you believe her. You're almost out of here. Your numbers are all looking good. You're healthy as anyone."

Yeah, except he can't walk, eat, sit, stand, talk, or go potty without help. He has no iron, no potassium, his white cell count is still high, his red count still low. He needs respiratory therapy and physical therapy. He has occasional  nightmares. He has tubes coming out of his abdomen that are still draining garbage from inside him and he has a catheter to drain other fluid. But yep, he's healthy as anyone. What the heck is up with that? It was insane! I told bishop I'd have to  talk to him later. I couldn't concentrate on the call with her going off like that. It was weird.

Mike slept well during the night last night but it was an aided sleep. The nurse was giving him Benadryl throughout the night. It would be nice if he could just sleep because he's ready to sleep. And, of course, it'd be real nice of he could sleep without the nightmares and panic they trigger.

Today, Jacob arrived about 5:00 am (thank you Jacob!) and stayed the day with his dad while I went home to attend church. I felt bad, mostly for Jacob, when I realized I didn't have a meeting with the bishop like I thought so he could have arrived here a bit later in the morning. It was good though. I had plenty of time to go to the Wilhelm's and see the grandchildren after showering and washing my hair. Christine was so kind, making me toast and offering up a glass of grapefruit juice. When I arrived back, about 4:00 pm (still can't believe I was gone so long!)  Maria was also here visiting with Mike. I  know he enjoyed their visit.

Joe and Candy's daughter Jodie worked in ICU today. When I heard her name this morning, I was comforted knowing she, too, would be here while I was gone. That was such a relief to me! After I returned, Sarah came over from med/surg, Mike told me she had been here earlier in the day. Sarah is Little Ann's daughter. Her Aunt Alice had told her Mike was here. I'm so glad she stopped in.

Donna called this evening and talked with Mike. I know he was glad to hear from her. It's been a long time. Brenda sent a note on Facebook. It was good to hear from her, too. I shared with her that Katie has been in our thoughts and prayers since we learned of her battles. She's an awesome young lady, she's fighting valiantly.

Dr. Hinchman was Mike's doctor today. He stopped in and visited with Mike earlier.

Overall, it's a good day. :)

Doctors and More Doctors

We've met two new doctors, one yesterday and one today. Dr. Rutlegde has seen Mike for a couple days. He is from Flagstaff and he has expressed great interest in the many fragments of Mike's medical challenges. Dr. Rutledge, like the rest of us, was surprised at Mike's inability to talk well this morning. He experienced some serious shortness of breath; could only say a single word, stop and breath, say another word, pause and breath. It was quite difficult for him. He ordered a chest x-ray and started Mike on Lasiq to remove some of the excess fluids from his body. A couple hours later, Dr. Rutledge said the x-ray had confirmed his suspicion of excess fluids.

They are also giving Mike iron and potassium by IV to compensate for losses due to not eating.

Dr. Greko paused at the doorway for a couple seconds to introduce himself and say he was covering for Dr. DeLange this weekend.

Mike ate a few bites of cream of wheat this morning and he had a couple sips of tomato soup for lunch.

Physical Therapy has worked with Mike a couple times today and he has been able to sit up in a chair for just a brief period of time. That was quite a challenge, for him and for the therapists. It was hard for me, too. Watching him struggle so very hard to do simple things is not easy.

Frightening

After what seemed to be a great day, Mike experienced the most frightening night ever. He had several visitors throughout the day. Ron and Kristen were the first to stop by and Mike loved having them visit. He really enjoyed hearing about Kristen's three little boys and he pointed out the pictures of his own grandchildren to them. Actually, he has pointed out those pictures to nearly everyone who comes into his room. It was a good idea to put those pictures where he can see them. They've made a difference.

Other visitors, mostly brief hellos, were Alice and John, Sonja and Randy, Jolene and Tim, and Mark. Mark stayed a bit longer, laughed a bit more. Some of that was nervous laugh, recalling bygone days and I know looking to the future. We have to try laughter when we can, it can be a powerful medicine for good. Alice (Pat and Alice) called, Aunt Eleanor called, and our kids called. TJei was able to Skype, mostly with grandma but she did get to see grandpa and tell him she loves him. They both felt good about that.

It was a busy day.

Sweet Words

We will be able to secure for ourselves and for others blessings that He is ready to give if we will but ask in faith.

As she looked over the early morning lab results, the nurse said, "Mike, you beat the odds again."

Those are some sweet words.

Mike's self-defined goal today:

Guess where I went last night.

Okay, all this bathroom chatter might be too much for some but you must know, I feel like the luckiest gal ever. I scored the passcode for the staff shower! Uh huh, this gal finally had a real shower instead of just a sink basin to wash up and shampoo my hair. Did you know that little overflow hole on the front of bathroom sinks lets sewer gas into the room? I wouldn't have thought so but I can tell you after getting up close to that thing on a regular basis, there's a lot of stink in there. No wonder they can market air fresheners to us so easily! Oh my heck it felt good to be in a shower. Little did I know time spent in an Appalachian holler using a wash basin would give me "experience" for the future. I am so grateful for the Tender Mercies that bless my life and for sweet words that bring hope to the day.

Today Has Been Good

Mike has continued to make progress thoughout the day! He is still on the BiPap ventilator mask but is maintaining higher O2 levels and number of respirations has been reducing slightly. He had an unexpected visitor today. :) Ron and his daughter, Kristen, drove in from Oklahoma to visit with him. Kristen stayed in SJ and Ronnie drove over for a visit. It was so good to see him and Mike loved seeing his dear friend. Tomorrow, Ron and Kristen both are coming over for a visit and it seems, Mark is coming to town, too. :)

Lab results started the day off good and it continued throughout the day. The picture above is pretty telling...not about the nose although that looks terrible. Note orientation of the image. Mike was sitting at the side of the bed!  Yep, yep, yep. About 8:30pm he was able to sit up, and with a nasal cannula. Believe me when I say that is quite an accomplishment.

We are so grateful for the love and support of so many friends and family. You've bolstered us when we needed to be uplifted and you've ministered to every need, expressed or otherwise. Our lives have been blessed. This has been a good day.

Look What I Got

Interesting, isn't it? The Director of the ICU seemed surprised too as she handed it to me. I got her sig and date on it, too. When she talked with me the other day, she indicated there was a policy in place and said, yes, she'd get me a copy when I asked for it. I don't think she was expecting a typed up note that didn't specify a policy or anything to be handed to her for delivery. At least that's how I felt about it when she handed it over. Very interesting...especially since the ONLY picture any of them were aware of is the one (first one) when I tried to get a picture of Mike's injured nose. Indeed. It is interesting.

Okay, and now it is time for all my health food friends to close their eyes. Just pretend the next picture  isn't even there. Afterall, I'm not permitted to take pics in this place. :)  Mischevious, aren't I? Taking pics of the letter telling me not to take pics and then goodies, too.)

When creeps make it tough, devour peeps! I know, they should be green for this special day. I did have corned beef and cabbage for lunch though!

Wishing all my grand-gremlins lots of green fun on this St. Patrick's Day. Love you sweethearts!!

The Power of Prayer

We've all read the testimony of others and heard their words on the power of prayer. I have witnessed this great power over the past few days. Today, Dr. Uhall smiled as she gave us a report on Mike's labs and progress. She even said the word "positive" which I've waited to hear so long. The past 48 hours I have seen miracles happening. As the doctors and others prepared me for more and more grim news, I saw the power of prayer working to help Mike gain strength and increase wellness. He still has such a long way to go but today, the news is good. He's making progress.

The only real number I heard in all this was WBC 13K. This is so amazingly good from where he had been just a few days ago. And, drum roll please - along with prayers of gratitude - Mike has officially been fever free since 6:00 last night!

Okay, so maybe there will still be an occasional picture. Like this one. Check out the numbers on weight. There have been such drastic changes day by day on his weight. Ths morning he is about 7.5k, or 16.5lbs since the same timeframe yesterday. That is likely all fluids. While he still has some serious fluid retention going on, his skin has become drier and drier over the past day. I hung the "top o' the morning" graphic and check out the cuties above there. Mike really enjoyed seeing pictures of the little ones. I'm glad I managed to get it in and up without a hitch.

Mike is still on the BiPap unit. He doesn't like it but fully realizes how important it is right now. In fact he helps with keeping the mask close while his mouth is being cleaned etc. His strength and energy is so low that he struggles to breathe on his own and even then, they aren't quality breaths. The BiPap assists him in breathing.

Today, physical therapy will be working with Mike. (They just started a session, in fact.)  On Tues & Wed he had a bit of therapy, just flex and stretch his feet, bend and straighten his arm at the elbow. Today though, he will go through a bit more motion. The bed he is on is hi-tech, it has a scale built-in, that's how they get the weight each day. The bed also goes through a transformer process and becomes a chair. They are going to try having him sit today. On the bed, not at the side of the bed or anything. He isn't able to sit on his own.

Today is good. Today there is progress. Thank you for your prayers and support!

No Pics

Well, what do you know...they don't want me to take pictures over here. Wonder why?

Note how the injury is below the mask's contact points which has a line above the injury. That's where the mask sits, not down in the middle of his nose. I saw this as it happened but had to wait to get a picture. There was a concerted effort to prevent me from seeing the results of the action and when I tried to take a picture earlier, the person responsible had quite a hissy fit about "no pictures" allowed. So for now, I am banished from taking pictures, for the most part.

That means I won't be able to take a picture of the sweet flowers that arrived today and I can't get a picture of the little collage of images I put together of the grand gems with a message for Grandpa to get better.  All in due time. For now, I'll just have to say thank you to Felicia and Jayden for the flowers. A huge thank you to Michele Sexton for bringing my clean laundry back from SJ (thank you, too, Jodie for taking care of the daily grind) and thanks to Delos and Carol for that special lunch yesterday. Yum!  Tremendous thanks to Alice and Teri for all you have done and are doing to oversee things in my absence.

Bear ye one another’s burdens, and so fulfil the law of Christ.                                      Galatians 6:2

I love you both so much, I love all of you so very much and appreciate all service being offered to Mike and I during this difficult time. Please keep Mike in your prayers that he will continue making progress in reclaiming good health.

Starting Off Good

After a restless night, Mike is off to a good start on this day. His blood results are continuing in the right direction.

Creatine 1.5
White cell 16000
Liver function good

Results of the echocardiogram should be in today and he had another chest x-ray this morning. Hopefully, the good news continues.

Last night, his glucose test was 118 - really good with all that has been going on with his pancreas. No shot of insulin. Whoopee!

Some Improvement

Our ward fasted and prayed for Mike yesterday. His name has been submitted to all three Arizona temples. Family and friends across the nation (and beyond) have been praying for Mike to regain his health. There have been many prayers and I am so grateful. This is the first day Mike has shown improvement. I know prayers are being answered.

A technician, Gabriel, did an echocardiogrm on Mike this morning. Dr. Memon, cardiologist, had ordered it so he could check blood flow and efficiency of his heart activity.

Today, I am praying the echocardiogram will confirm Mike has a strong and healthy heart, that there are no problems revealed in the imaging. I am praying, too, if they take Mike for a CT scan, that he will do well during all the transfers and will not experience excessive pain during the moves.

Dr. Uhall was just in and checked Mike over. She said his lungs sound good and his labs looked better this morning.

Blood Work

Mike's bloodwork is looking  a bit better this morning. His
Creatine 1.6
   Sat 1.7 | Sun 1.8 | Mon 1.7 | Tue 1.6
White Cells 18,000
   Sat 17,000 | Sun 31,000 | Mon 20,000 | Tue 18,000

His fever has not broke. Right now 38.5C; 101.3F

It was a difficult night. The nurse used soft restraint to keep Mike from pulling off the O2 mask. :( However. once they listened to me - once I could convince the Respiratory Tech (Bree) to adjust the amount of humidity, Mike settled down and had a good night's rest. He was no longer trying to tread water in the face mask.

AFib

Another doctor came in to check on Mike a short while ago, Dr. Menom. I wasn't so surprise. In fact, I thought he might be another hospitalist. He isn't. He is a cardiologist. Mike has a cardiologist, Dr. Sachs at the Heart Institute of Arizona. She's a top cardiologist and Mike has been seeing her for quite a while, she knows his history and, Mike likes her. I wasn't real happy when Dr. Uhall let me know they were contacting a cardiologist, other than Dr. Sachs, for cardio input.

After he told me why he had been called in to consult, I was even less happy. Apparently Mike has had several instances of Atrial Fibrillation over the past few days that they may have forgotten to mention to me. !!??!!

Dr. Menom has ordered an echocardiogram be done tomorrow.

Short-Lived Celebration

It didn't last long. Mike is back on the BiPap mask ventilaor and new blood gasses will be drawn at 11:00. In all likelihood, that is just a formality. Mike will be going back onto the ventilator today, shortly after those blood gasses are drawn. His body is laboring far too hard to breath with just a mask and the exchange of air is not sufficient to keep CO2 from building up. The ventilator would be the most effective on getting a good air exchange and also for protecting his lungs and keeping them healthy.

11:45 Update again: He will be staying on the BiPap instead of going on the ventilator. At least for now.

Current Status

Mike is off the ventilator. Whoopee! But, I suspect the happiness is short-lived. His breathing is rapid and shallow, not good for getting a sufficient exchange of blood gasses. :(  They drew arterial blood just a short while ago to test blood gasses.

Mike is much more aware of things today. He awoke from his deep sleep during the night and the more alert he became, the more he didn't like having that bipap mask on, at all. We were able to get the doctor to agree giving him a try without it, on just a regukar non-rebreather mask. That's the O2 mask with a bag attached below it. It's much more comfortable on him, which is good. Unfortunately, becase he is comforthable, he's not really taking deep breaths, which isn't good.

His mind tells him he wants to get up and move, that's what his words tell me, too. "I want to stand." Of course, standing requires a good deal of energy, whether or not we are aware of that need. Mike doesn't have the energy to lift his arm  for more than a few seconds.

His blood tests were looking a bit better this morning. White cell count has gone down to 20,000 from 31,1000. It isn't as good as the 17,000 from a few days ago, but it is a change in the right direction. The creatine, remember this is the one that may identify early problem with kidneys, had ben 1.7 a couple days ago, was 1.8 yesterday and today is back to 1.7. Tender mercies. So many prayers are being realized. Right now it does not appear Mike is heading for kidney problems. His red cell count was down slightly. He will get another unit of blood just to be on the side of caution.

Mike will need to go back on the BiPap, even I can see that by watching the monitor and watching his breathing. He got a break from it for just a little bit though. I hope he will realize how necessary it is and not raise a ruckus when it comes time. :)

Today, I am praying for continued good health in his lungs and kidney as his abdominal area contues to respond favorably to the antiobiotics. This is a dood day we have been blessed with.

Hospitalists

Hospitalist:
   –noun
       a physician who specializes in treating hospitalized patients; a specialist in inpatient medicine.

This has been such a learning experience! What the definition doesn't say is that the hospitalist is the on-call doctor who resides in the hospital and is available round the clock. They change often, too. I don't know who the doctor of the day is for day shift but Mike has had Dr. Chintis (from Scottsdale) who wrote his admission orders, Dr. Uhall (from this area) came next, Dr. Hinchman (from Phoenix) was here over the weekend until last night when Dr. Foote (places unknown, I didn't know there was a new one so hadn't met him) covered patients in the hospital, and now there'll be another today at 7:00am.

These doctors have been good, I'll give them that. They've stayed on top of Mike's care and each has been friendly and communicative. For someone who doesn't have a family doctor or primary care doctor, I can see they would have top rate physicians providing care for them. I guess I'm just whiney still that it has to be these doctors instead of our own family doctor. I don't think I'll ever understand why he has bailed on us like this. There's not a doubt in my mind he has been at this hospital during the past week. I know he is receiving reports and updates on Mike. Not once has he stopped in, not once has he contacted us. There's probably little that can compare with the feeling of abandonment a person feels when their need for professional response is so high, critical in fact, and the person you've turned to for years and years to provide those professional services just isn't there.

Quite honestly, I could easily accept and forgive an unintentional oversight. It's another matter though to accept and forgive abandonment. And, that's what I feel has happened. Mike has been abandoned by our doctor. It is my hope and prayer that I'll be able to forgive him if ever he asks to be forgiven. And I pray that I'll be able to let go of this anger that I have for him in the meantime.

There is also  prayer in my heart for the doctors, the hospitalists, who care for patients in time of need. My hat is off to them for their knowledge, compassion, and their service.

Friends & Family

I am so grateful for the friends and family who share my world, and especially grateful for those who are close to Mike. Craig and Lori came by to visit on Friday and it was so good to see them. Lori brought along a satchel...she knows me all too well. :)  She brought snacks and books and the "right" bottled water, and the "right" brand of soda. I love that gal! I appreciated so very much the blessing of comfort that Craig gave me before they left. The sweet words of that prayer linger in my heart.

Some friends from his work, and even his boss, have called to see how Mike is doing. Other friends, some going back many, many years have called to express love and concern. Ron and Terry have stayed in close contact, Mark has called on a regular basis. I sent a note to some of Mike's cousins, they had no idea he was so sick. Susan & Charlie, Patty, Craig's wife, Lisa, have all been in touch.

Candy and her daughter Jodie came for a visit and spent some time with Mike. Some of these friends go back many, many years. As Mike would say, BK (before Karen) and I've been around a long, long time. I appreciate their friendship so very much, treasure it, in fact. I hold some of these people nearest and dearest in my heart as though they too were immediate family.

All of us, as friends, have experienced much; births, deaths, gains, losses, fun and folly. We have been, and continue to be, blessed by their loving friendship. I honestly hope "families can be together forever" also covers those we love as family.

Creatine and White Cells

Creatine is used by muscles to produce energy. The kidneys (and liver) create creatine from amino acids. Mike's creatine levels (in his blood) indicate his kidneys are is not working as well as it should. Since Mike has only one kidney, confirmed by Dr. DeLange on the CT imaging, this is a serious complication. It's early in the diagnostic process right now, not sure what the game plan will be for monitoring or correcting things. For now, it's just something to be aware of.

Another bit of discouraging news this morning, Mike's white cell count has elevated again. He had been at 17,000 yesterday, today he is at 31,000. This indicated the antibiotics have not been effective over the past 24 hours or so. Not a good thing. Mike is on some of the most potent antibiotics available.

It is my prayer that the treatments will be effective, the white cell count will start on a downward trend again and remain in that direction until Mike is well again. I pray that his lungs will remain healthy and his kidney will remain strong and healthy.

BiPap

Mike's blood gases are out of sync, CO2 is elevated and his pH is acidic, so he is going onto BiPap. BiPap (bilevel positive airway pressure) is a ventilator, without the endo tube. It uses a mask, sealed on his face, that the ventilator tubes from the unit are attached onto. The mask reminds me of air systems used when going into confined spaces on the job (plant). Well, except for the fact the unit assists breathing, pushing a blast of air in on inhalation and preventing full emptying of the lung on exhalation. BiPap is a temporary fix.

When the doctors come in, they'll want to get another blood gases...that means another ordeal of trying to get arterial blood from his "woodpeckered" (their word) limbs. This morning, there were three different techs from respiratory who each tried multiple times to draw blood.

I'm not sure, other than gas levels being out of sync, what would cause the acidic levels. (Just confirmed it is out of sync gases that cause this - CO2 is acidic.) The CO2 levels would indicate he is not expelling the CO2 gases from his blood. There is good O2 exchange, just not dumping off the bad stuff when he exhales.

That is a problem. A serious problem. The BiPap unit is working for now, but it is temporary.

What A Day

Things change so quickly around here. Every event, every action, is dynamic and affects so many other events. At the end of the day yesterday, the plan had been to keep Mike sedated and on the repirator until Monday. Then try slowly waking him, reducing the sedatives, and gradually take him off the respirator.

I fell asleep, in the recliner in his room, somewhat late, about eleven o'clock, and slept pretty good until awakened by the sound of his nurse, Diane, calling out to Mike. "Mike, wake up. Can you hear me? Mike if you can hear me open your eyes. Mike. Mike."

Oh my gosh! What's going on? It was about quarter til two (1:45am) and Mike typically is responsive to simple commands while he's been under. They started a new medication, in addition to Propofol, so they could make sure he didn't have memory of any of this time he is out. Dr. Uhall explained that being sedated alone didn't ensure there would be no memory, and it would be far better if he didn't remember anything over this time. Mike had gone too deep asleep with the combination of these meds. He was not responding. Diane took him off both medications and worked with him over the next couple hours to get him responding again to simple commands. It was nearly seven when I dozed off in the chair again. Dang! I slept only 30 minutes, was awake again at 7:30am but missed Dr. Wehling's visit so didn't get to talk with him. Ugh.

A bit later in the day, they had decided to cut back both sedatives to 50% of what Mike had been getting and let him slowly wake up from his peaceful sleep. They would be cutting back on the respirator, too. Letting Mike do more of the breathing himself although it would be a bit like snorkeling, he would still be breathing through the endo tube. Well, as Mike started waking up a bit, he also started gagging on his endo tube and he ended up pushing it out as a result of pushing with his tongue. Everyone scrambled on that one!

Either way, Mike was off the respirator much quicker than expected. That meant, too, the sedatives ended right then and there. So now, several hours have passed and he is holding his own. He hasn't actually woke up fully just yet but his eyes are opening a bit more frequently and staying open a bit longer (only seconds in total, but still) each time.

His fever finally broke just a few minutes ago and his temperature is now at 37.6 (99.68) whereas it has been running 38s and up. The highest I noted myself was at 102.5, not severe but still problematic when dealing with infections over a length of time. They ended up using Tylenol to get the fever down. Other measures weren't doing the job.