TUESDAY — doubly amazing today

[Tues. was the 9th; this was posted on the 10th]

At noon we left for Yakima Regional Medical Center to visit the fine folks of the ICU.  I was simply amazed. As we entered the parking lot John spotted the nun that floats around the wings, wards, and operating rooms offering support to all.  She showed up in the operating room just before my open heart surgery to see me off.  I couldn’t get out and run so John had to maneuver around rows of cars, other visitors, and a few in wheelchairs and caught up with the lady just as she was crossing a grassy strip and leaving the grounds.

Then, back at the front entrance, John dropped  me off, unloaded the 4-wheeled walker, and left to park the car.  I made it through the large double automatic entry doors to the front desk and there found the young woman that delivered all the e-cards ya’all sent.  After she paged the ICU Director for me I turned and encountered 3 of my caretakers. One had just delivered a patient in a wheelchair to a family’s van; the other two were just passing through.

Before we made it to the elevator we met my early morning blood drawer – she showed up and poked a needle in me most mornings at 5:30 and so John had never met her.  We had an elevator cage to ourselves but when I stepped into the hall we got an echoing “hello” from way down the hall from the mom  of one of my former students.  She is the nutritionist that keep me fed via a tube for many days and then kept after food services to see that I was served proper meals.  At the phone outside ICU where one has to call to get “buzzed in” a male nurse was pushing through the doors on his way out. He had been with me for many 12 hour days when I was in my worst condition and was always cheerful and helpful.  He meant so much to John and me through the stay.

Finally we made it through the doors.  This is a difficult place to “just visit” because every bed is occupied by a very ill person and those on duty are committed to keeping them alive.  Knowing this, we were amazed to find folks squealing with glee to see me walking again.  I got many hugs, and even John did.  It was a special day.  The on-floor doctor was about the only person that did not know me and he seem amused at all the fuss.  Nurses came out of several of the rooms, gave me a hug, and quickly went back to their patients.  We stayed no more than 15 minutes because we didn’t want to take folks away from caring for those needing the care as I got while in there.

Back in the hall we headed for the elevator.  A person had just turned into a door way, backed up, and addressed me with —  “Nancy, is that you?”  Well, I was in street clothes, up right, and walking – none of which she had seen from me before – and it has been 6 weeks since I was there, and still she knew me.  We met another nurse outside the big doors with a freshly emptied wheelchair and a flipped over name tag so I couldn’t see her name.  She knew me though and gave me a hug, remarking how good it was to see me walking.

Off to grab a milkshake for me and a hamburger for John, and then on to my surgeon’s last check up on me after the Dec 29th surgery.  It was another great meeting when my progress was noted as “exceptional”.   I think the surgeon and the nurse are exceptional too, but they are professionally through with me.   They will now pass me back to the cardiologist – that visit is for April 14th.  After that I should be released to our family doctor (in Cle Elum), also known as my primary care provider.

Finally, we hit the road for home with no further events, except a stop to get some lemonade for me.  Arrived home just about 4:00 p.m.

There I had a phone call reminding me about a play date, so we left for town again at 6 for me to play music with The Connections.  It is mostly singing (& playing) religious music, plus sing-alongs by the residents with anthems from a book that has the words.  Tonight someone chose The Old Rugged Cross, and Leaning on the Everlasting Arms, and others.  I still do not have a singing voice, but the others did fine and have strong voices.  I played my violin on all songs.  It was great to be back.  We ended with Amazing Grace.

Nancy

MONDAY — Nancy says . . .

Today was a most frustrating day all day from the initial contact with my insurance company until 5:00 p.m. with another call to them to check on what supposedly had been changed on the referral to Physical Therapy.

I’m not allowed to use the words on the blog that emanated from my mouth several times today.  I’m sure this is a test of my stress level and I guess I passed it.  I’m still alive.  I do not know how truly “sick” people deal with the system.  It stinks big time.

Started at 8:00 a.m. with a call to my principal insurance provider about an incorrect facility in the referral for outpatient physical therapy.  I was put on hold for 20 minutes while the agent checked on it to be sure, after I asked if a new referral with the correct place needed to be sent from my doctor.  She returned to say that it was the only facility they would pay for because I was no longer a resident of the Rehab center.  She said my doctor could request a change but it would likely be denied and the appeal process would take 30 days.  I won’t need it after that, most likely.

Then I called my doctor’s nurse to explain what happened.  The accountant in charge of such things called my provider and put in a changed location for the provider.  I didn’t hear until 4:00 p.m. today that it was approved, but we have nothing in writing, and only an authorization number.  I called the insurance company again and gave them the authorization number and was told it was still to the old facility.  So back on the phone to my doctor’s office and the woman who had just called to report nothing had changed.  I wanted to know before I made another appointment at the Rehab center that I would have to break.  She called again and found the paperwork had apparently not been updated in all the right places.  Now we await verification.

Let’s see .. what else today?   I spent loads of time on the computer responding to folks all over.  John took the 3 horses to get them their flu shots.  The wind started blowing again, fiercely all day, but that did not affect his getting them into our trailer and taken down for their appointment.

Oh, another call this morning to the HEBB (health benefits for the state), satisfied them that our wedding date was indeed July 12, 1969.  I never heard the other date they had.  He actually said the correct one before I had to tell him.  Also they were asking for his and my Medicare cards, which we thought had been submitted with the application.  Sure enough, they were in the file.

Finally, I made another call to the provider of my 4-wheeled walker which may not get delivered until I no longer need it.    They didn’t have any in stock with 8” wheels but no one thought to call me since last Monday when I refused to accept the 5” wheeled version.  First, the person contacted today said 2-3 weeks and he’d have to order; then he found they had one with 7.5” wheels and perhaps I will get it as late as this week.  Wow.. more frustrations.

Did I say ?  Something is wrong with this system, and I wonder how others are treated.  Certainly they don’t get any better “customer” service than I have experienced.

Actually, there is good news with my eating ability.  I managed to eat ½ piece of pizza john made for himself for dinner.  That was before my bowl of soup.  So I’m improving a little.  Not fast enough for John’s wishes, however.

Nancy

[from JFH:  Have you ever noticed how things seem troubled when the wind blows?]

SUNDAY — recumb & fly at the same time

We started the morning filling the pill box, our second time.  We have seen pictures of folks going through this routine.  One pill is only once-a-week, on Monday morning, and likely only for a month or two.  Some I’ll take for the rest of my life.  Some are twice a day.  Some need to be broken in half because I don’t want to try and swallow the big ones whole.  Some are tiny.  One is dark green.  One is bright yellow. One is chewable.  One says don’t chew or break. Others have to take many more than we are currently dealing with.  Sorry folks!  And some folks have very expensive pills to pay for.  Sorry again, but these are relatively inexpensive.

Today brought long distance phone calls from family and friends. Otherwise, the day was uneventful. I made time for leg exercises and to eat 3 meals (I’m still a light eater), and take my pills.  Then we worked on some ‘Thank You’ stuff.

So while we were at home basically on cruise control a friend went flying for us – into the winds of an approaching storm. John wanted an air photo of the location of the weather station – it’s so new it wasn’t there when currently available photos were taken.  We asked and she said she had to fly anyway – but whether that “had to” was a required time-in-air thing or a psychological thing she didn’t say.  Late afternoon she called to say that despite getting jostled about some she got a batch of photos.  Now she will export to her computer, create a CD (because of large file sizes), then John will upload, resize, crop, and annotate.  Then one will become part of a public (viewable on-line) weather station atlas.  The technology is as amazing as that found in intensive care hospitals — even if what transpired today hasn’t saved my life I’m still impressed.

I’m still working through the batch of emails that have piled up since November, and responding to current ones.  John goes in and out but returning frequently to see what I need.  I’m spending time in a recliner chair and while I can get down and up, I can’t make the thing lay back in the recumbent position and a recliner isn’t much good if it won’t recline.  John is the power unit that makes the silly thing recumb.

Nancy

SATURDAY — frayed edges

If I was still healthy and teaching, today I would have participated in a GIS workshop with 9-12 year olds from around the region.  I and other CWU folks (including, in my case, students, graduates, and a mom of a graduate) host the visitors in a program called Expanding Your Horizons.  It is to introduce “science” to these kids by having them participate in what we do at the university.  It’s a great program that I have participated in for many years (even back to being involved at the University of Idaho before coming here in 1988.  That I choose to tell you about it says that I missed doing it.

It was a wonderful night and I slept well.  My appetite is not the best though, and that is causing concern, especially to John who, when he fixes it, has to eat what I don’t.

Breakfast and lunch were late, but John was working much of the day on the newsletter he puts together for our Kittitas Valley Trail Riders group.  Their meeting is next Thursday night at 7:00.

This was supposed to be a non-eventful day; however, we still had to deal with crazy paperwork things.  Problems of the day meant writing correspondence to insurance companies and  Friday’s mail brought additional misunderstandings from Medicare, the State Health Board, and my primary provider of insurance.  Referral for physical therapy was approved at the wrong facility.  The first time we can straighten this out will be Monday morning.  One agency has different dates for our marriage. How that happened we cannot understand.  We don’t know if we have to prove this or just state the date (July 12, 1969), which neither of us would have filled in wrong on a form.  What a mess is all the paperwork associated with health care. We sure hope someone thinks of a way to simplify this but that doesn’t seem likely.

John also had to go to town to mail the newsletters and while there picked up the correct Iron Supplement I was supposed to be taking. The system somehow spit out 27 mg rather than the 325 mg the doctor wanted me to have.  John caught the under dosage by comparing notes and pill bottles – explained his find to the doctor – and now it is fixed.  Moral: check everything.  So, I have had an under dose for the past week, for my anemia.  It’s no wonder I’m anemic with all the frequent tests and their demand for blood.  One young cute female tech told John it only looks like a lot but isn’t – and he believed her!

I continue to try to catch up on all the emails that came to me — and John saved. Thanks to all of you who were supportive all those many weeks and continue to call and check up on me.  While I was in Yakima and EBRG my cell phone worked well, but not now from home. The best telephone line to use now is the land line (509-925-3304) because our cell phones don’t work well in most of the house.  The nearest tower is about 12 miles away through most of the house and the trees to the south.  Our best reception is in the middle of our 7-acre pasture, but that is uncomfortable in bad weather and won’t do for me now.  Standing by the window in a storage room on the correct side of the house often works and often doesn’t.

After John bought his first cell phone in December he got a letter from AT&T from a vice president saying how much they loved him and how willing to serve him they were.  So he wrote back with a few comments, including a suggestion of a small hill in our neighborhood where they could place a tower.  The letter was returned as undeliverable.  Either the address or the man or both are bogus.  Go figure!

Carry on and we’ll talk soon.

Nancy

FRIDAY — close wouldn’t do

Today started with leaving at 9:50 a.m. for Cle Elum for a doctor’s visit.  We spent a long time with him, seeing a change in some meds, review of my bettering condition, and finally more blood drawn for lab work there.  We stopped afterwards at the accountant’s office for John to ask questions about Medicare A & B and changes, if any, to our relationship with the Clinic beginning April 1 when the group health policy via the University will no longer be our major provider.

My weight is holding steady and my body parts are healing nicely – they are all in good shape for the shape they are in.  Still, finding a good place to stick a needle to draw blood  took a bit of searching.  I’m thin where I haven’t been thin since the mid-60s.  My lower legs are attractively thin but not pretty – the peeling or scaly sun-damaged look is gone but the flesh tone is more red than bronze.  There are reasons for that and we’re working on them.

I might as well have been in a cave for the past three months, so, short term, I’m taking a mega dose of vitamin D, extra calcium, and iron.  Those are in addition to the several other things related to the heart issue.  We bought a 4-times by 7-day multi-chambered plastic pill box.  Now John and I can fill that once a week and cut down on sorting through the containers and the strange names.

This next isn’t part of my story but it almost caused me to pee my pants which I would have done 10 days ago – progress.

John wanted to find the waste treatment facility because they have recently installed a new set of instruments to report weather data.  An on-line atlas of weather stations is being completed by volunteers and this site, operational only since last September, has not yet been included.  The place, though easy to see, is behind a gate and the protocol is to have permission.  Getting permission was easy enough but took a little time.  Across the road but within sight was a store.  The lady inside didn’t know what to do but she did know whose land one had to cross to get to it.  She called Andy (names are changed to protect the … just kidding).  Andy said the gate appeared to be locked but usually wasn’t and, anyhow, the combination was WXYZ.  So the lady called the Chamber, which we visited by driving back across town and the ladies there said they didn’t control it but to see Bill in city hall.  Bill was eating lunch but Jane called Tom at the sewage treatment plant.  She held the phone up and Jane, Bill, Tom, and John discussed the issue.  It is a small town – John was the only stranger.

Soon we were headed back across town, opened the gate, drove in, closed the gate, signed in, took notes and pictures, back in the car to the gate, opened the gate, drove out, closed the gate, and headed to the nearest gas station/mini-mart because the Subaru and I were very thirsty.  Almost as soon as we passed the “leaving town” sign I knew I had to go.

John said if I started to do so in the car he would reach across, open the door, and roll me out.  He didn’t say he would stop first.  I’ve already told that I made it home.

Just one more little accomplishment on the road to recovery.

THURSDAY — in the range

Slept in again, but won’t get to tomorrow a.m. because I have an appointment in Cle Elum at 10:45 to see my regular doctor, or as current jargon has it – my primary care physician.  John and I both go to Cle Elum because when I first arrived in Ellensburg the office being touted as the place to go wanted $25 just to have me complete a survey and still would not commit to seeing me.  We like our doctor and so have never thought of switching.  We keep telling him not to retire.

Today, I played the fiddle at a skilled care facility called Royal Vista with the Kittitas Valley Fiddlers and Friends.  We had a lot of people there:   guitars, violins, accordion, flute, clarinet, bass fiddle, and banjo.  One of our group works at Royal Vista and she joined us with both a flute and a guitar but not at the same time.  We interspersed Irish music as we are practicing a few tunes we are not familiar with.  In a prior post I mentioned we have been asked to play at Briarwood, four days before the “wearing of the Green.”    [For fun:  http://www.history.com/topics/st-patricks-day-symbols-and-traditions ] We actually worked on Danny Boy twice because of a resident’s request.  It’s a favorite of many, but seems sad nonetheless, although the meaning and history are somewhat muddled: http://www.karlsenfineart.com/article-Ireland-song.htm

Afterwards I had to go to the Kittitas Valley Community Hospital for a blood draw (supposed to be a standing order) to check my INR for Coumadin dosage.  Of course, when I walked to the laboratory, they had no record of a request, so my wait time increased while they contacted my doctor.  Now I know what to say the next time.

Came on home and never took a nap, but we caught up on emails.  Also had a phone call from my doctor reporting on the blood draw showing an INR of 2.4 which is in the good range of 2.0 to 3.0 for a person taking an anticoagulant and so I continue the dosage of 2.5 mg of Coumadin.

[ This link explains about the test and INR:

http://en.wikipedia.org/wiki/Prothrombin_time

the next one explains about rat poison, er.,  Warfarin, and Coumadin:

http://en.wikipedia.org/wiki/Warfarin

and the history section in this is interesting.   JFH ]

John’s cooking supper (meat loaf) as I write this.

So for me, each day shows some improvement.  Hope you all are well.

Nancy

WEDNESDAY — start slowly, work hard

We had light rain all last night but lovely weather today, becoming sunny with billowing puffy white clouds around the blue sky.  The drippy and gray early sky made for a great morning to sleep in so I did.  Then I had a late breakfast, followed by pills, and then I worked on the laptop awhile still catching up on emails on a couple of accounts.  I still need to check all those messages saved by John in my absence.  Also, they keep coming in to nancyh@ellensburg.com — still the best contact for us.

We skipped lunch during the noon hour and headed to out-patient physical therapy for an hour.  Did well, happily.  I completed several walks around without a walker and then climbed high-riser stairs.  While resting from that, my therapist set up an obstacle course.  It had things to step over, then I had to walk on a foam cushion (springy) the size of a single bed, step up on a high stand, and then over another circular piece and finishing via a serpentine route through a set of cones.

After that I rested again to stabilize my heart beat, and then I went to a recumbent bike-like machine that includes both arm and leg (stepper) functions.  Legs first for 5 minutes and then another 5 with using my arms.  Finally, after resting from that, I did one more balance with my eyes closed and the therapist pushing my body in different directions and I had to regain (sustain) my balance.  I did well on that.  Then he had me raise one foot and stand only on one.  That is a bit harder, but I was doing better on the hard foam pad than I had last Friday on the hard floor.  So, I’m making improvement.  [Unlike some others there with whom improvement is barely noticable and, sadly, seems destined to continue as such.  JFH]

We came on home for a late lunch and spent the rest of the afternoon catching up with a backlog of things, especially online.  John was sorting through a stack of papers and found letters to each of us from Medicare that had arrived a few days before Thanksgiving.  They had a form they wanted filled out and returned within 10 days.  Oops! I called and worked through a phone-tree to a real person.  Then we answered the questions.

I’ve been getting an afternoon nap but it didn’t happen today with the late morning start and the trip to physical therapy.  We’ll have lights out early tonight.

Nancy

TUESDAY — Moving on out . . .

. . . of the University requires a bit of work. Retirement activities were on the schedule today.   We had an appointment at the office of Human Resources. This ended up involving two employees; one for over two hours and the other an hour.  I (Nancy) had to be present because . . .

Building a retirement for me has meant putting in a “defined contribution” from each pay period through a plan called a 403(b)-7.  This code comes from the federal law establishing the ability of an academic institution to set up the process.  In the non-academic world this is done via section 401(k) and seems to be the commonly used term for writers when they write about such retirement programs.

The university will send my contribution and its matching dollars to any or all of three major financial companies. The part with the match is restricted to only certain funds but I have the option (taken) to contribute more in a non-restricted set of funds, but not matched.  I’ve sent $$ to all three companies via both options.  The “contribution” part is ending and the “withdrawal” part has to be established.  Before that can happen each of the three companies has to be notified that I am being retired or “terminated.”  Then, because the State of Washington assumes the retirement funds are shared resources, a spousal signature is required to acknowledge said spouse knows what is happening and agrees to it.  And the six different sets of funds under the thumb of the university have to be “rolled over” into an individual retirement account (an IRA) that is controlled by me, independent of the university.

John thinks the term ought to be “roiled”, not rolled over, because there are several different things that can be done and, as I have six components, and the three company’s forms are unique to them, there is considerable paper work.

Now back to the “I had to be there” part:  To make sure we had all the correct and latest forms, plan numbers, signature pages and so on, we wanted to call and talk to a retirement specialist at each of the firms.  That requires my presence to answer questions (the usual stuff) while being recorded to assure that all is legitimate.  Once the fund rep had that assurance and my statement that my spouse and human resources person could participate in the conversation we could proceed.  Thus, three hours later we had a stack of forms half and inch thick and more on the way.  They are partly completed but there are still nitty-gritty details to be added.  In early April, the flow of $$ will reverse and we will be fully retired.

Some of the time today was also spent on making sure of the transition from the university group health provider (primary now, secondary soon) to Medicare (secondary now, primary soon).   More forms.

I owe a huge thanks to the folks for helping us sort out the details.

MONDAY — A curse on the land …

This will be fast as John forgot to recharge my laptop battery. (forgot? — jfh)

Today was a comedy of errors with the health care system.  We arrived at the Rehab center for out-patient physical therapy only to find out it had not been approved.  (They called home but we were already on the road.)  So off to Super One for a shopping trip and walk around using my walker.  I stopped several times.  Last stop was at the cashier when my phone rang.

It was my doctor’s nurse saying they could not get the referral through the system (my insurance company), as I was not recognized in the system.  Go figure?  I have been there since 1988.  Never occurred to me to ask what she had fed in and perhaps the numbers were wrong ?  So I came home and called my employer to be sure I was covered and for how long – till April 1st was the first answer, and she said she would call the company and see about my being in the system.  She did, but then got busy and didn’t contact us.  Mid-afternoon I called and she said I was.

I then called the number where a few hours before I was not in the system” – Morning  linkage went from  Rehab to Primary care nurse, to insurance company and then reversed and eventually to me.  With me having verified my ID number was in the system the request went round again – me to Rehab, etc., etc  I had a phone call that it was done, and they would call the rehab center.  I had already called.   Unbelievable.  We suspect someone mistook a 7 for a 1, or a 2 for a 5, or just maybe a nerve impulse didn’t jump a synaptic cleft and a finger that should have hit one key, hit another.  At some point one has to let go of the need to understand what went wrong.

Now I’m approved for 15 visits through September– and the first will be this Wednesday.  However, on April 1 (an appropriate day for this) the insurance company will be demoted to ‘secondary provider’ and the Gov-ment Medicare program is elevated to ‘primary provider.’  Even now Medicare has been billed by someone for something and we got a long form wanting information they can check to decide if fraud is, has been, or might be going on.

Thus another day of frustration.  It won’t be the last.  A curse is upon us all.

Nancy

SUNDAY — a RECAP, mostly by Nancy

Happy days !   Loads of quiet sleep last night.  I even slept through the coyotes yelling.  Was awakened twice by Brittanys wanting to go outside, but John let them out.  Breakfast (non-leather fried lightly egg and a sausage link), tomato/V8 juice, and then pills.  We had bought a pill container allowing spaces for Morning, Noon and night for all meds for the week.  It took us awhile to fill the box. Today for lunch we went to our neighbors, who ordered in Chinese as their oven/stove quit working.  Yummy and a nice visit.  I was so happy to be able to join their family again. Came home and slept hard for 2 hours !

Okay… after being on-line on my laptop again today, and calling some people by phone, I realized that many of you had not heard the entire story.  Even those reading the blog would have missed on the beginning of this because John didn’t get it started till Dec. 4th.

So, here is a list of events starting in June that culminated in what happened.  John will have to add and make corrections, but here you’ll have the whole story and not have to sort it out.

In June 2009 I went to the ER when my doctor in Cle Elum could not see me because the clinic was closed to participate in a funeral for one of their own.   My Doc listened to my symptoms and told me to go in immediately and ask for all the doctors in ER to take my case.   I was very run down and had red spots on my lower legs, indicating internal bleeding.  They examined me, took an X-ray, and so on and the lead doctor decided to take blood for a culture.  The lungs appeared to show “a bit of pneumonia” but nothing jumped out at them as to what was wrong.  He admitted me to the hospital for further testing.

Two days later, the culture results indicated my bloodstream was full of bacteria – introduced, we suspect, in a late April dental cleaning.  The  “a bit of pneumonia” was fluid leaking into my lung from damaged cells.  When infecting the heart this is called endocarditis. The bacteria grew on the valves of my heart — the mitral valve was the worst, and I had known for years I had a heart murmur and was advised early to take a high dose of antibiotics before any teeth cleaning or anything that opened my blood to potential infection. I had done that in April, but apparently I was run down and the antibiotic did not protect me.

I was very ill and had much fluid build-up which, along with my heart issues, made me have difficulty breathing.  These symptoms were treated. I received a non-targeted or general antibiotic while cultures were done to determine the exact nature of the bacteria.  There were four – all treatable with Rocephin – and as by then I was no longer in imminent danger of dying I could leave the hospital. I had to go in as an outpatient for 28 days for infusions of Rocephin that lasted ½ hr.  This was done via a tube or PICC line from my elbow to just above my heart.  That solved the bacterial infection.

Afterwards, I visited both an internal infection specialist and a cardiologist in Yakima.  Visits continued till it was determined I had made enough progress to teach in the fall.  Our classes begin in late September.   I managed until the morning of the day following Thanksgiving – I woke at 3 A.M. with chest pains.  First time, so I told John I was having a heart attack.  We dressed fast and he drove me to ER in Ellensburg.  They took me in and called an ambulance, sending me off to Yakima Regional Hospital.  Once there I had my first operation (for which I was awake), to watch them search for a blood clot that lodged in an artery across and leading to the front of my heart.  This was accomplished in the cardiac catheterization room where a long thin tube, called a catheter, was threaded into a blood vessel and then guided to and dislodged the blockage.

That was Friday about 6 A.M.  I seemed to be fine on Friday but by noon on Saturday all my systems were shutting down.  By late afternoon I was taken to the intensive care unit and I was put on life support.  Tubes and wires and things I didn’t know about.  It looked like I was dying.  6 days completely sedated.  Two more of partial sedation –  still with breathing and feeding tubes—but I was aware of my surroundings.  The exact reason for my cardiopulmonary collapse remains a mystery.

At some point they found I was deathly “allergic” to Heparin, the major blood thinner used for all operations and even to flush PICC lines. An initial test for this came back negative – it was suspected in the shutdown – then later, a second test showed the very serious reaction.  [This reaction is called Heparin-induced thrombocytopenia (HIT) and I discussed it earlier.  JFH]

I started to improve and was moved to a different floor.  Then my heart missed a few beats and I was back in the ICU, picking up a temporary pacemaker on the way.  There were a couple of days of watchful waiting and plans to insert a regular pacemaker but my blood clotting ability wasn’t cooperating.  While the wait went on I wasn’t eating well and started to deteriorate again (or more).

The death spiral was halted by inserting an intra-aortic balloon pump (IABP) to assist my heart pumping functions. [This too, I covered earlier.  JFH]  The IABP resulted, just a few hours later, in my general improvement.  This was the expected result and it also indicated a good result from a mitral valve replacement.  First I would have to live through an open heart operation – that probability was not real high. I was in intensive care with 24 hr supervision as they worked to improve my health.  It wasn’t happening.

John and I and the doctors talked.  This is the definition of between a rock and a hard place.  I would die without the operation.  I might die during it. Take your pick!  John sat at home with the dogs and they took me from the ICU at 9 A.M. on Tuesday, 12/29/2009.  The heart surgeon’s nurse called John at 3:30 to say she left the operation as they were closing my chest back up, that I was alive, and doing well.

The actual procedures – two by-passes and one valve replacement – normally take this team about 3 ½ hours.  Because of being on a non-standard blood thinner the operation was extended another 4 hours – 3 hours with an open chest to visually monitor how I was doing, another after initial closing to watch the equipment that was watching me.  I spent 2 ½ days sedated and intubated and closely watched.  John spent one day away as I was aware and wanted to communicate and the nurse wanted me as quiet and still as I could be.

I was in intensive care until I left Jan 20th for a rehabilitation facility in Ellensburg.  Had there been a room available in the care unit called “advanced care” I could have been moved.  That floor remained full and none were sicker than me so I stayed put. That changed on January 18th and I was booted upstairs with little warning.  I stayed for two days in that room.  Then I came to Ellensburg.

I had to be in a skilled care facility.  I lost much muscle mass and could not get up from bed on my own, nor walk once up.  So, my leaving the facility hinged on my being able to get out of bed on my own, get to the potty on my own, and walking with the aid of a walker.  I had physical therapy 3 hours each day.  Even my tongue had lost muscle and I had trouble swallowing, food and pills. Some say that for each day of being down a 2 to 3 day recovery is required.  I’m not there yet but I progressed enough to make it home.  The great day arrived for my departure (as you heard in Saturday’s blog), and now I’m home and getting better each day.  I will go back to outpatient physical therapy 3 times/week at the rehab center.

Thanks for caring and asking.

Nancy