SAT-SUNDAY — routine functions

Saturday was a routine day, for a weekend.  There was some good food, some not so good food, and several visitors.  Nancy stayed in bed resting from her workout on Friday but she did – she claims – do some in-bed exercises.  I made her promise to get the Sunday morning staff to get her out of bed.

Sunday AM, and she did get moving this morning.  She was assisted into the bathroom (there is no bath there!  Do I call it a throne room?  [See below.] ), then into a wheelchair, and now she is having breakfast.  She was talking with me when they brought her tray.

On Saturday, with help,  I located that aisle and shelf in our friendly grocery store whereon they stash the nutritional drinks often marketed to diabetics.  There are several brand names but I wanted chocolate with high protein and as EBRG is a relatively small town I had a choice of one.  The package contains 6 – 8 oz. plastic mugs ($1.62 each) of a brown liquid composed of water, sugar, and about 74 other things listed in print too small to read by those of us that remember Bill Mazeroski’s series winning home run in game 7 of the 1960 World Series of Baseball (Pirates over Yankees).  Half of the selection was ‘high calcium’ and half was ‘high protein’.  Nancy is improving daily but frequently is disdainful of that part of her meals meant to supply protein.  The supplement I bought contains 12 grams of protein (about 24%) of the suggested part of a standard 2,000 calorie per day diet.

Having related the above I will say that as she has begun to move about more it appears to me that she is also eating more and otherwise improving.  Thus, I was very happy to hear this morning that she had used the bathroom and was in the wheelchair by breakfast time.

[About that term bathroom:  What she actually was in need of was a flush toilet.  Have you ever called the place a flush toilet room?  Me neither. Other names used include: can, commode, crapper, pot, potty, stool, throne, and my favorite ‘the john’

There is an interesting history regarding this device.  Read about it here:

Seattle was originally built on low ground and initially installed flush toilets would do a reverse flush when the high tide came in.  First they posted tide tables beside the potty in the throne room.  Later the device was put on an elevated platform.  The problem disappeared as the space around the buildings was filled in and street level was raised one floor along with the entrances, store windows, and the small out-of-the-way rooms containing the john.  You can find things to read on Seattle’s early history and their reverse flushing commodes or take a tour while visiting.  Search on ‘underground Seattle’.]

TUESDAY — Need a sign?

Today seemed somewhat like a Keystone Kops or Three Stooges movie.  Looking for an appropriate place to house Nancy just got silly.

Several of us believe she will progress very rapidly once she is out of the hospital environment and into a place that focuses on physical therapy (PT).  The fifth floor has a PT unit with doctors and nurses – and a reputation of “aggressive” action.  (No. I don’t know what that means.)   However they know Nancy is not ready for aggressive therapy and so have agreed to start her slowly.  This was thoroughly discussed and thought to be the best solution for the patient.  Great.

But the person in charge of giving the go-ahead at the insurance company is working only from faxed reports.  She doesn’t believe Nancy needs the 5th floor environment at this time.  She thinks somewhere else will be a good fit for a week and then maybe return to the 5th floor.

One of the suggested places has no rooms.  Another one sent a representative to the hospital.  The idea, I thought, was to talk to Nancy, nurses, and PT folks and decide if the facility would work for Nancy.  The representative came to the hospital and starting talking to people and asking to look at reports – but had no name tag nor credentials and, I think, the hospital case worker contact was not around.  Exactly what happened I don’t know, but apparently the on-floor head of the ACU objected to the visitor on privacy grounds, and “bingo” – Nancy was deemed not a fit for the facility in question.  Maybe I’m misinformed  about this but I think something went wrong.

At some point the surgeon and nurse came by, said hello, commented on how good Nancy looked, and went on down the hall.  Nancy has moved on from their rather substantial and expert skill set.

After I left the head of a rehabilitation place in Ellensburg came to visit Nancy.  We don’t know why he was in Yakima but the hospital case worker made contact and in he came.  Nancy and her music making friends visit his place once each month to entertain the residents.  So he and Nancy recognize each other by sight but are not very well acquainted.  He talked with Nancy (maybe others there) and thought his people could take care of Nancy.  He is to meet with his staff Wednesday morning and will get back to Nancy with his plan.  As we go into Tuesday evening, nothing is certain.

Well, the hospital did promise not to set her on the street corner with a sign asking for a ride to Ellensburg.  And I’m not going to be heading down the south-bound lanes of the interstate if she is being carted north.   I already have an “I’m stupid!” sign and don’t need another.’s_Your_Sign

SATURDAY — mirror, mirror . . .

Nancy weighed about 9 pounds less this morning than she did yesterday morning.  That’s what a double shot of diuretic will do for you.  Today she only got a single dose but tomorrow or Monday they will double dose her again.  It really showed in the lower legs, ankles, and feet.  They also want to keep her lungs clear so they are being aggressive about this.

On a lighter note, the head nurse of the surgical team and I were commenting on the natural color that has come back into Nancy’s eyes and face.  She had been a bit grayish.  We realized Nancy hasn’t looked in a mirror since Thanksgiving.  Unknown to us is that the over-bed food stand has a mirror hidden underneath the serving part.  I’m glad we didn’t know that a month ago.  She needs her hair cut and her face is thinner but she actually looks healthy.  As regards hair, she began losing a little with the endocarditis last May and she thinks she is still doing so.  Unlike someone being treated with chemicals and radiation for a tumor where hair loss is more rapid, this is a slow motion loss as her body seeks to repair other damaged cells and neglects the hair.  I think that is the idea as expressed to us today.  I’ll see if I can find any info on the Web.

The same nurse brought in the photographs from the surgery and they made copies for Nancy.  I was gone by then but via the phone Nancy claims that even on standard paper they are very good quality and I will be able to scan them.  I saw a few of the originals the day after surgery but I don’t know what all they have given us.

THURSDAY — escape !

It didn’t happen while I was there but there is a report that Nancy escaped to the fourth floor today.  Either that or when she started calling people on her cell phone they decided to throw her out.  Actually, the move is supposed to be going on as I write this so I do not know a room number.  I have a meeting to go to tonight and want to get this posted before I leave so I don’t have time to wait on more information.

They have a patient lifting machine (real name unknown) and Nancy can be sitting in a bed with feet toward the floor (or in a chair) and the machine is pushed forward and with straps and handholds she can be lifted into a standing position.  Then she can be moved from point A to point B.  Before today her legs and knees were so weak that this was more like strapping a sack of wheat to a pack saddle on a horse.  She could not help at all.  Now she can hold herself against the upper part and wait the few seconds for this thing to stand her up.  She can then lock her knees and be vertical.

Progress comes in small increments.

I don’t know what mechanism is hidden under the machine’s fenders but when in use it sounds like a small jet revving up to take off.  An interesting place – the ICU.

MONDAY — close, now

Nancy was in a good mood today and ate some real food.   Actually, I took the innards out of a ground chicken sandwich which she dunked in hot tomato soup.  Yum.  Mostly she stuck with the high nutrition drinks that seem to be marketed to diabetics.  Each has 9.9 grams of protein which she needs and hasn’t been getting in regular food.

Latest from “The Team” is that the operation to replace the valve(s) will be on Tuesday and currently scheduled for 7 A.M.

I suppose it is possible, but highly unlikely, Nancy could get bumped if there is an emergency because she is stable and she could remain so for a few more hours or even a day or so.

She can’t improve much, however, and the decision is to operate tomorrow morning.  We met the doctor that will be operating the heart-lung machine, he reviewed all the current readings, talked with the nurse of the day and visited with us – as did another (new) cardiologist on the floor for the day.  The surgeon visited Nancy during the late afternoon but I was home by then taking care of the horses and dogs.

We have read about and talked about this operation during the last four months.  Knowing it is dangerous for her we accepted this quite some time ago.  Still we did not count on the difficulties of the past month.

Your concern, hope, and prayers are appreciated.

SUNDAY — a day of rest

Well, not quite!  I left shortly before they were going to remove a sample of bone marrow from her breast bone. Ouch!  This might normally be taken from the pelvic bone but currently Nancy can’t be turned over.  Anyway, when taking a sample with a needle (or syringe) it is called aspiration.  I’ve confirmed that the sample was taken but results are not back in the ICU.

Apparently a rapidly inflating and deflating balloon in an artery can whack a few blood cells and over time decrease their number.  This is just one of the reasons why the balloon pump is not a long term fix to the profusion issue.  The examination today is meant to strengthen the view that the pause seen in the recent increase in Nancy’s platelet count is balloon-caused and not from any problem in blood production in the marrow.

Nancy and I visited with the doctor that had inserted the balloon pump and a team hematologist.  The latter’s view is of interest because Nancy’s blood cells reacted so strongly to the heparin and in the coming operation it will be the skill of the hematologist that balances the competing ‘clotting / not-clotting’ characteristics of her blood.

They did numb the area and gave her a pain pill and as I write this at about 5:30 she is sleeping.