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Earlier medical reports:
March-April
2013, Eunice broke a hip in Morocco, click here
2011 -history of Aortic
Dissection- CLICK HERE
Eunice has heart valve trouble, early 2014
Last note at bottom, Feb 26 about 7 PM, to go there click here.
We are now at our daughter Bev's home but just until Feb 19.
Address here is Eunice Ordman at
4407 West 77th Terrace, Prairie Village, Kansas, 66208.
Phone number here at Bev's is 913-649-0782
My cell phone at 901-634-7309 - takes voice messages and
records numbers - I'm not good at text messages so recommend against
them.
(sometimes late getting online, spotty web connection at the rehab
home.)
(Oh my, I should have been putting recent
news at the top, shouldn't I? Oh. Well, scroll down or use that
link!)
The most recent copy of this is usually at
http://inotherplaces.com/Eunice_Heart_2014.htm
which for some reason updates faster than ordman.net (ordman.net is
on fatcow, inotherplaces is on 1&1, for those who care)
We drove from Memphis to Kansas City to visit daughter Bev and
family around Christmas 2013. Late on Dec 27 Eunice was unusually
tired; when she was still tired the next morning I took vital signs
and we went to the nearest emergency room. The initial diagnosis was
severe congestive heart failure, with a great deal of fluid in the
lungs.
January 2, 2014 report:
We've known for some years that Eunice had severe aortic stenosis
(stiffening and narrowing of the aortic valve, the main valve
leaving the heart.) Whenever we've asked about replacing that
valve, her cardiologist has said "she is not complaining of
shortness of breath or chest pain; she is up and about and active
mentally and socially; let's not do elective surgery. It will let us
know when it needs replacing. Now, it seems, it has let us
know. Luckily Kansas City has one of the major heart hospitals
(St. Luke's) and Eunice was transferred there by ambulance.
Eunice's attitude toward this, as to a few previous incidents, has
been "I've had a wonderful, full, life. Life doesn't owe me
anything. But I'm having much too much fun to leave. What are you
(doctors) going to try next?"
Eunice is comfortable, in no pain, fluid out of lungs, on oxygen but
able to walk around with a long oxygen cord. There are plenty of
phone calls and family around.
The doctors have been spending a great deal of time testing,
discussing alternatives, explaining things to us. They say this is
not an emergency situation, they want to work out the best procedure
and best surgical team. They don't want to open her chest,
preferring to go in through a small hole and replace the valve that
way. (Eunice feels she's an old hand at this, having had a
stent placed in her abdomen, in the superior mesenteric artery, in
2011.) They don't think they can go up her aorta from her leg due to
the prior aortic dissection. They could enter between ribs or
by cutting a small hole in the sternum. But they prefer to use
instruments placed down the esophagus to get a good look at what
they are doing, and Eunice has had a constricted esophagus for years
(causing her to eat slowly, but it has not been enough of a
problem to justify surgery in the past.) So we are now awaiting an
angiogram to see what the arteries around the heart look like and an
upper endoscopy and possible biopsies and balloon stretch of the
esophagus to see if it can take the instruments the cardiologists
want to put down there. As of January 1, it sounds to me as if the
surgery itself may be one to three weeks in the future, assuming
they work out a method.
January 2 PM: Todaywe had high precision CT scans, pulmonary
function test, got more prior reports from Memphis, discussions to
plan work for tomorrow (upper endoscopy down to the duodenum,
biopsies if indicated, possible balloon stretch of the esophagus.
Instrustions on what she can and can't eat have been changing every
two hours, sometime before she can open the ice cream they just
delivered. We cannot complain of any lack of medical attention, and
have lovely discussions with the chaplain. They are still exploring
the possibility that the presenting cause was a form of pneumonia,
although that does not negate that the aortic valve is getting worse
and, by any usual standard, needs replacing. One problem is
that the muscles that push things down the esophagus are weak or
uncoordinated, so when she eats in a hospital bed (not fully
upright) things she eats or drinks don't go down properly and she
may get them into her lungs.
.It's after 5 PM and
we've been told to expect more doctors this evening.
January 2 at 7 PM - they did more pulmonary function tests, no
one has told us results. More past test results have arrived from
Memphis. They have cancelled the Friday angiogram and scheduled a
major endoscopy to look over the throat, esophagus, and duodenum,
biopsying and stretching as possible, then a swallowing test.
So she's on nothing-by-mouth for the next 18 hours or so, and back
on an intravenous. If they decide they still need the angiogram that
can't be done before Monday.
Jan 3 PM. It has been a very very busy day. An upper endoscopy
in the morning showed the esophagus sufficiently clear that they
will be able to put a doppler sonogram probe down the esophagus to
image the heard from that direction during surgery. No
narrowing of the esophagus was found but they have considerable
questions about her swallowing ability - perhaps malfunction of the
swallowing muscles (peristalsis?). They hope to do a
swallowing study Saturday morning. Reading of x-rays showed a
very fuzzy area near the heart and they don't understand it -
pneumonia? inflammation? aspiration? something related to heart? So
the pulmunologists want to do more before letting her out of the
hospital. Afternoon they did a coronary angiogram since they
had found no record of a recent one in Memphis. No arteries are
blocked, in fact they were in unusally good shape. The lower part of
the aortic dissection has healed remarkably, according to a cat
scan. But there is a substantial aneurysm (7 to 8 cm) in the aorta
just below the left subclavian artery (where the arch turns
down.) Cardiologist believes the odd appearance in the lung may be
something associated with that large aneurysm. So they need to
replace the aortic valve and stent the aortic aneurysm. They hope
they can assemble the rather large surgical team to do that on
Monday morning.
They cannot go up through the aorta
because one end of the stent in the superior mesenteric artery
extends out just enough into the aorta that equipment headed up the
aorta might snag on it. (It may not have projected out when it was
placed but the aorta has changed shape considerably since then as
the dissection has healed.) So they propose to go in between
the ribs under the left breast, run equipment into the bottom tip of
the heart into the left ventricle (if I understood correctly) then
run their tube through the heart and push the esixting valve flaps
aside and install a new aortic valve (bovine pericardial valve in
cobalt-nickel?), then continue to move their equipment through the
new valve to stent the aorta. The man says he has done this quite a
few times, most recently last week. (Dr Allen is the one talking
with us and is one of the surgeons who will be there.)
Risk
estimates? 10 percent risk of serious side effects or death
from the surgery; over 50% risk of death within a year if the
surgery is not done, given probable failure of the aortic valve or
probable bursting of the aneurysm.
Eunice came through both
major procedures today fine, recovered quickly, the anesthesiologist
was extremely nervous about the endoscopy and did terminate it a few
minutes before the gastroenterologist would have liked but the
gastroenterologist says he is happy with the results and saw nothing
that would require biopsies or a balloon stretch.
They are letting her have ice cream
and some other stuff this evening - "full liquids but no actual
liquid", in other words soft foods, after about 28 hours of
nothing-by-mouth. She is a bit confused by all the goings on
but speaks loudly and demands explanations appropriately. She
helped convince the reluctant anesthesiologist that yes, she really
wanted this done.
January 4, 9 PM. The only remaining tests today was a swallowing
test, with the speech therapist. She found no impediment to Eunice
swallowing either thick or thin liquids. This was just an exam
in the throat and neck, not a full barium swallow as I had expected,
so it tells us no more about any muscle problems in the
esophagus. But it had one wonderful side effect: She is niow
allowed to eat or drink anything she wants, as long as she sits
fully upright to so so. After over about 40 hours of
nothing-by-mouth, she is reveling in having a choice of foods and
feeling much livelier and enthusiastic.
Her cardiologist who seems to do the "admitting
doctor" job became concerned at her lack of exercise after a week in
the hospital and sent in a physical therapist to do an evaluation
and tell us which of her hip exercises she should resume, as well as
take her for her first significant walk on a walker in the hospital
corridor. No major tests are scheduled for tomorrow (Sunday) -
it is a day to eat, exercise, rest, and be ready for the big surgery
which they hope to do just before noon on Monday (assuming the
surgery the team is doing before hers that morning goes as planned.)
Carl and Bill have returned to
college, so Bev and Heidi now have the night sessions at the
hospital - Heidi tonight.
Sunday morning Jan 5 10 AM
I'm at home (Bev and Bob's) with a bad cold and productive cough.
Eunice is fine. The doctor who came on morning rounds said that a
doctor essential to the surgery was unavailable Monday and that the
next day they could hope to assemble the surgical team in Thursday
January 9. This is not a big surprise as we had been
told last Monday that Thursdays were the normal day to do this sort
of surgery, given the large team needed.
Wednesday morning Jan 8 10 am
Nothing exciting has happened in the interim. Eunice is her usual
cheerful self, they have a physical therapist or two session for her
daily getting her to walk up and down the corridor. They
offered to let her come home for a day or two but given my bad cold
(cough still occasionally productive), sub-zero temperatures and a
lot of snow on the ground, that seemed a bad idea.
Surgery is scheduled for Thursday morning - I think she is second on
the schedule and of course this sort of surgery is of rather unknown
duration - they hope to start in the 8 to 9 range and take 90
minutes to 2 hours, so she should be out of post-op around
noon. I'll get a notice up here as soon as I can after that.
I understand they will movbe her to a different room after surgery
(I'm unclear on whether that is intensive care or simply a post-op
special follow-up corridor) so the room phone number will change. I
hope she'll be ready for phone calls Friday or Saturday. My cell is
901-634-7309 and if I'm not with her I'll refer you to the cell
number of whichever of the Skrukruds is with her or a room phone
once we have one.
Our mail is now arriving at Bev's so she has Christmas cards and the
like to read. Address things to Eunice Ordman at
4407 West 77th Terrace, Prairie Village, Kansas, 66208. I have
no idea yet how long we will be there but I'll be startled if we get
back to Memphis during January.
Thanks for all the phone calls and e-mails.
Love, Chip (and Eunice!)
Monday Jan 9 about 1 PM. Doctors say the surgery went fine but
she is still under anesthetic. The stent went in fine, the new heart
valve went in satisfactorily with a small but acceptable amount of
leakage (small backflow when valve is closed). The only
problem encountered was that after surgery her heart rate (pulse)
was slow. They had her on a temporary pacemaker during surgery
and phasing her off of it left the rate too low (e.g. 40 rather than
60). So they have decided to put in a pacemaker while she is still
in the surgical area. The conjecture is that the stent and the
new valve are very close to an electrical/nerve circuit in the heart
and may be affecting it. Since the wires for the temporary pacemaker
have worked well for a few hours now, making it a permanent
pacemaker is a minor operation and the batteries won't need
replacing for ten years. But it means it will be another two hours
more or less until she is conscious again. I get to go in
occasionally to hold her hand.
Jan 9 3:30 PM all the surgery done, including
putting in a pacemaker. Still asleep, and they say it may be another
hour and a half or so before she can open eyes. It seems to me that
is the third time at least they have said "another hour or
two." I'm not sure if they move her to the ICU before or
after she wakes up. I've had Bob, Bev, Heidi, Jilana with me
at various stages, right now Jilana is here. Lots of e-mails and
phone calls but at this hour the waiting room is quite noisy. Good
support and contact by hospital staff.
Jan 9 Monday 7:30 PM. They have had trouble getting her
blood pressure and body temperature up to normal levels. As of
now the nurse says that body temperature is OK but that they are
going through change-of-shift and that the doctors who did the
surgeries are now off duty. They may lighten the anesthesia to
test reflexes this evening and may not. The nurse guesses that
they won't try to seriously wake her up before 8 am or so tomorrow.
But she suggests I stay here another hour or so to talk to the night
shift of doctors, then go home to get a night's sleep and come back
in the morning. I may well not make another report before noon
Tuesday unless there is
an exciting change.
Jan 9 10:10 PM. The breathing tube is out, breathing on her
own with some nosepiece (canulla) oxygen. Some responses (raise your
left hand, squeeze my fingers.) Vital signs all
acceptable. Lightly sedated, letting her sleep for the night.
We've gone home to go to bed also.
Jan 10, Friday, 8:20 AM. She is awake, smiling, recognizing
people, talking quietly, still a bit confused about date and current
events but happily remembering children and grandchildren. No
sedation. Blood pressure and pulse a bit higher than they want
but not alarming. They have stood her up briefly. They
hope to get various tubes (surgery drainage) out later today and if
her vitals are stable enough they may move her to a normal room
(with a phone) by this evening, or that may be tomorrow. I probably
won't report again until she is moved. Phone calls are rather
inconvenient in the intensive care unit.
Jan 10, 1 PM. She has been moved, after a bunch more tests and
doctor visits. She is sitting up in her new room,
Room 529. The room phone number is 816-960-4402. She is
still tired and still rather confused, The nurses say her confusion
is much less than typical given that she was anesthetized or sedated
for so many hours.
One nurse practitioner gave a rough estimate of five
days in hospital, come back for checkup five days after that, then
probably cleared to travel to Memphis. Don't use left arm
today (due to incision for pacemaker), don't lift over 10 pounds
with left arm or raise left arm overhead for six weeks.
Possible release from hospital to nursing home for a few days for
physical therapy but physical therapy will start today or tomorrow
in hospital. The pacemaker is a new new Medtronic model that
allows MRI's. Her lung capacity at the moment is lowered, she
is on 3 liters of oxygen and doing breathing exercises (this doesn't
worry me much - at one point in April she was on 5 liters.)
January 11, 10 AM. The hospital internet access has been
down yesterday afternoon and overnight, still questionable
now. E-mail is questionable at the moment. Web works. Eunice
is dramatically improved, bathroom functions fine. Still suffering
from some anesthesia aftereffects but is starting to distinguish
dreams from reality much better than yesterday. (Nurses say that at
89 and after 14 hours under, this may take three or four days.) A
physical therapist is with her now but Eunice is having a bit of
trouble remembering not to put weight on her left hand (due to the
incision for the pacemaker.) She's enjoying reading National
Geographics (we have plenty). She's making progress on the
deep-breathing exerciser. They are not letting her use her walker
yet since they are afraid her short-term memory is still weak enough
that she will put too much weight on the left arm.
(I took a day off from the internet)
January 13, 9:30 AM. Eunice's memory is now very normal except
for a bit of mental blocking on medical issues and events of the few
days after the operation. She is standing up easily but has
only walked about 20 feet at a time. Lungs still are not fully
expanded, and her blood count was low enough yesterday that they
gave her a unit of blood in the late afternoon. So she is
still on oxygen and itwill be at least a few days before we can go
back to our daughter's house. (One prediction on Jan 10 was hospital
until the 14th to 16th, then maybe a rehab home for a few days,
followup appointment Jan 20, then further plans.) Phone calls
have tapered off so by all means give us a call at 816-960-4402
(hospital room) or 901-634-7309 (Chip's cell)
Jan 13, 9 PM. I'm afraid this has been one those
two-steps-forward, one step back, days. Lungs and blood oxygen
were a bit worse, appetite and activity level much lower.
Mentally she is still fine, although a bit depressed at the
setbacks. Lots of diuretic today to try to get fluid out of
the lungs and they'll do some more detailed x-rays in the morning,
then bring in the pulmonologists if necessary. The nurses say this
sort of setback is not uncommon and are being very helpful and
supportive.
January 14, 4 PM. As predicted, they did x-rays and
called the pulmonologists, who decided to use a needle and drain
fluid that had accumulated between the lung and the chest wall,
especially in the upper left back (if I understand the x-rays
correctly). They did that about 3:30 PM, withdrawing about 1.3
liters of fluid. Eunice's voice sounds much better already,
but I suspect it will take a night's sleep and a meal (in which
order I'm not sure) to see how much improvement it brought.
The hope is that this will let them slowly wean her off oxygen (now
at 4 liters.) In the absence of further setbacks, we'll probably
leave the hospital Thursday or Friday and spend the weekend in a
rehab home near Bev's house, then see the doctors for followup next
Tuesday +/-.
January 15, Wednesday, 7 PM. It was a much better day today -
obviously the lung drainage worked. There is still a biyt of fluid
left there, she is still on Lasix (diuretic), but is maintaining
good blood oxygen levels (95) on only two liters rate in the nose
piece. She is more talkative, standing up by herself more
easily, and walked 20 feet for the first time in several days. I
took four or five hours off today, with daughter Bev staying with
Eunice and granddaughter Heidi helping me to run errands (refill
prescriptions, shopping for snacks, bringing more changes of clothes
to the hospital.) I'm beginning to gather copies of radiology
and other interesting details. The stent they put in her aorta
measures 3.1 cm in diameter by 15 cm long - in layman's language,
they have reinforced her aorta with a piece of fat garden hose about
6 inches long! The estimates of opening in the aortic
valve before surgery were an opening of .34 cm-sq and a pressure
differential exceeding 51 mm-hg; I haven't seen the estimates for
after surgery yet but presumably the opening should exceed 1 cm-sq
and the pressure differential should be very low.
Jan 16, Thursday, 10 PM. Eunice is still being very sleepy a
lot, but she is eating somewhat better and walked aboput 18 to 20
feet twice today. Oxygen down to 1 liter rate. The present
plan is to release her from the hospital and move her to a rehab
home after lunch on Friday. We've agreed to a rehab place within a
few miles of Bev's house and they say that I (or Bev or Heidi) can
spend nights there in her room. So we are on the way back to
normalcy! I'll get the phone number and such at the rehab home
posted within a few hours of getting there.
January 17, Friday, 1:30 PM. They are planning to release Eunice
from the hospital between 3 and 4 PM today.
She is off oxygen experimentally for the last hour or so and
symptomatically is fine, they haven't tested blood oxygen level
yet. Walking is still slow and short - about 20 feet at a time
- and she still gets sleepy, so we will go to a rehab home probably
for a few days to a week. The doctors are suggesting followup
appointments about Jan 29, so we'll probably still be in Kansas City
for granddaughter Heidi Skrukrud's birthday on Jan 30th, and I hope
then we'll go to Memphis.
The rehab home is "Brighton Gardens of
Prairie Village" but mail should still go to Bev's house, address in
the Jan 8 note above. The phone number in room 173 at Brighton
Gardens is reputed to be 913-236-9354 but I doubt we'll be
settled in for phone calls before about 6 PM Central time this
evening. (Yes, it is a different area code - the Hospital is in
Missouri and the Rehab home is maybe five miles away, in Kansas.)
January 17, 8:15 PM. [not posted promptly, poor internet
connection at rehab home] We've made the move, phone works, she is
asleep. Blood oxygen however fell back to about 86% so I suspect
she'll be back on oxygen for awhile longer. She is still not
doing well at deep breathing exercises (rarely above 500 ml on the
standard suck-machine test, rarely up to 600). She is standing
up easily without assistance when needed.
January 19. 3:15 PM. We are very happy with the rehab
home, getting phone calls, I can sleep in the room and eat meals
with her. Bev Bob and Heidi are in and out (and spelling
me so I can go shopping or home for a shower) but her blood
oxygen still falls to the 80's if she is off oxygen too long or
walks 20 feet. So progress may be slower than I'd hoped.
We'll get there! Mentally she is fine when oxygen level is OK,
but very tired when it is low. I'll probably report less
often, unless there are changes to report. She does enjoy and
respond well to phone calls, 913-236-9354, we tend to be out of the
room for meals for roughly two hours starting roughly 7:45 AM,
11:30 AM, 4:30 PM Central time. The room phone does not take
messages or record caller numbers. My cell phone at
901-634-7309 takes voice messages and records numbers - I'm not good
at text messages so recommend against them.
January 21, 8:45 PM We are not spending a lot of time in
Eunice's room. Physical Therapy (=below waist), occupational
therapy (=above waist), speech therapy (deep breathing and avoiding
swallowing down windpipe), shower. Daughter Bev was in for
three hours or so today while I ran errands with granddaughter
Heidi's help. The very minor bleeding around Eunice's
incisions seems to be subsiding (the nurse says no bras for awhile,
maybe the bra is rubbing one of the incisions), and her blood oxygen
level is coming back a little better after exercise. She is
still on oxygen while resting or sleeping but can manage two to four
hours of activity while off oxygen. Monday she walked 80 to
100 feet on her rollator, a little less Tuesday but that was after
all the other exercise! We are usually out of the room for
meals for about 90 to 120 minutes starting about 7:55 am, 11:55 am,
4:55 pm Central time.
January 25, 11 am. Eunice is still improving and
getting visibly stronger, and enjoying long conversations both in
person and on the telephone. Incision bleeding seems to have
completely stopped. She still tires and naps a lot, which the nurses
say is very normal after such major surgery. Unfortunately her lungs
are not expanding as much as we'd like; blood oxygen level still
drops briefly as low as 81% to 84% when she's been exercising
and off oxygen for a few hours.
In the rehab home she gets
physical therapy (hip and leg and general strengthening exercise),
occupational therapy (coping with her limited use of left arm for
six weeks following surgery that involved multiple left-side
incisions), and speech therapy (deep breathing and some tendency to
swallow down her windpipe) at least five times a week each, and
oxygen is readily available when needed. So she is tolerating not
coming back to daughter Bev's home (and then Memphis) as fast as
we'd both like. She sees the surgeons on January 29 for the
post-surgical checkup, so I should get a report up late on the 29th.
I've been out of
the loop for most of two days with upset digestion (it may simply
have been exhaustion). daughter Bev, granddaughter Heidi, and
son-in-law Bob have been taking turns caring for me at Bev's
house and being with Eunice at the rehab home.
Wednesday, January 29, 1:30 PM. I'm fully recovered
from the digestive bug,and granddaughter Heidi, who got it shortly
after I did, is largely recovered. We went back to the
surgeons' office for a followup this morning.\, by wheelchair van
from the rehab home. The doctor felt that the incisions were
in good shape, everything sounded right with a stethoscope. He
wanted us to stay around Kansas City until Feb 12 unless there is
some urgent reason to leave sooner, and then wants to do a more
complete followup, with x-ray, sonogram, EKG, I think. In the
meantime Eunice's lungs continue to have fluid in and around them,
so she is getting Lasix 40mg/day. Right now they have her on oxygen
2 liters/min constantly, hoping it will make her more active, build
up muscle strength, and that will make her breathing
stronger. It certainly is making her more
interested in more things, so in that sense things are looking up.
We are still doing multiple therapy sessions per day (Physical,
occupational, speech).
Saturday, February 1, 7:45 PM They are giving Eunice an
Albuterol inhaler 4 times a day, which is supposed to help open
bronchial passages and I suspect lungs. It seems to be helping
considerably. On Friday morning they lowered the oxygen rate from 2
liters/min to 1 liter/min. Her oxygen level is mainly staying 90 -
93 % even during exercise; if it briefly drops to 88 it comes up to
93 within 2 minutes of rest. She is walking 100 ft+ several times a
day, and is able to stand and work with her hands for 5 or 6 minutes
at a time before tiring. On the "suck on this" test machine (which
I'm told is called a spirometer) she is now hitting 750 ml a few
times a day - she was stuck at 500 or less for a week or two.
If she continues this well, she may be able to go off oxygen all or
part of the time by Monday or Tuesday.
The other obstacle to getting out of here
is where to go - Eunice would love to spend a few days at Bev's
house, a mile from here, which makes excellent sense, but Bev's is a
split-level and to live normally there Eunice would have to manage
seven steps. As yet her left hip isn't up to that. Recall she broke
that hip in Marakesh, Morocco, in March; she was doing a flight of
steps with no trouble by June, but a few weeks in bad with the hear
issue has cost her muscle tone there, So the therapists here
are starting her up-and-down one step to work her back up to ability
to do stairs. Of course in Memphis we can live without stairs
(on one floor) if necessary, but that raises the issue of whether
she is up to that 500-mile trip without a few extra days
recovery.
We had a small birthday party here at the
rehab for granddaughter Heidi Skrukrud on Jan 30, and grandsons Bill
and Carl Skrukrud have come down from college in Minnesota to visit
for a few days, so we have plenty of extra entertainment. The
other people here at the rehab are giving us fascination
conversation; among others, there is one lady whose father was an
officer in the Estonian Army in World War One, a man who has been on
25 medical mission trips to Haiti starting in 1982, and the director
of the Kansas City World War One Museum is a frequent visitor (his
mother is a patient here.).
February 6, Thursday, 8 AM. We had a rough few
days. Sunday she had no appetite and was listless; Monday and
Tuesday she had some sort of digestive flu (fever under 100, but
plenty of symptoms at both ends; could not even keep pills
down.) Wednesday, stopped up with immodium, she felt like a
new woman - some appetite, doing slaloms in the hall on her walker
during physical therapy. We had a major blizzard here Tuesday and
some of the volunteers and staff couldn't get in Tuesday and
Wednesday (several of the nurses and others worked 16 hours instead
of 8 when their replacement couldn't get in or they couldn't get
out) and the "entertainment" people in particular were in short
supply. So I did a story-telling session for the residents and Bev's
family turned out in force to do musical performances (family
folk-sing with Bob and Carl on guitars, Bill on mandolin, Heidi as
well as the males on vocals ... then Bill on piano.)
Then they went home (about a mile away) and cooked an elaborate
dinner and brought it back and we had a family dinner for seven in
the very fancy private dining room / board room here.
We don't know how badly the flu will set
Eunice's release bak - they put her back on 2 liters/min on oxygen,
and she hasn't made progress on the inhaler (incentive spirometer,
Carl calls it), still topping out at 750 ml. The latest x-ray shows
a reduction in fluid in/around the lungs but I don't know how to
quantify the improvement and I haven't been able to get the disks to
compare the pictures - this is one of the extremely few things I've
been unhappy about here, the place has generally done a fantastic
job. We'll see the surgeon(s) again on Feb 12 and no doubt get
a clearer discussion.
February 7, Friday, 5 PM. Dramatic progress in muscle
work the last two days - now going up and down 7 steps on a flight
of stairs and walking slalom courses on her rollator (4-wheel
walker). But her blood oxygen level still drops quickly to
about 86 to 88% if she spends time off oxygen (e.g. getting
dressed, when the nose piece is off so she can pull a dress
over her head.) They are experimenting tonight with 1
liter/min instead of 2 to see how it goes. The local doctor in
the rehab feels that the pleural effusion at the base of the left
lung (I take it this means fluid around the lung, rather than in the
lung) is not resolving as rapidly as it should and has suggested a
pulmonologist look at it. So we are going in for a pulmonology
appointment at St.Luke;s Hospital (the attached medical buildings)
on Monday afternoon Feb 10, and then going in for a full round of
tests with the cardiology surgeons for essentially all day Wednesday
February 12. We very much hope that after that Eunice will be
off oxygen, or only need a whiff occasionally, and that we will then
be able to arrange to return to Memphis. The present thought
is that we will fly (minimizing travel time, and airplanes have
oxygen available) and that Bev will drive our car back to
Memphis. But of course we'll see what the doctors say on
Monday and Wednesday.
February 10, Monday, 7 PM. Very Good News! The
pulmonologist says that the remaining pleural effusion (fluid around
the base of the left lung) is relatively small and slowly
decreasing. He estimates that it will go away in a month, more or
less, faster with more activity on Eunice's part. As far as he is
concerned we can get out of the rehab home, fly, go home, and resume
as normal a life as Eunice is able. We still need to see the
cardiologists on Wednesday, but expect they will say much the
same. Among the tests on Wednesday (when we expect to spend
all day with doctors) will be a CAT scan, a Doppler sonogram, if
needed x-rays and.or EKGs, and an altitude tolerance test (to tell
the airline how much oxygen to give her at any given altitude or
cabin pressure.) After that we still have the logistics of
making travel arrangements, arranging oxygen equipment where we need
it, etc., so exact date of return to Memphis is still very much
open.
February 12, Wednesday, about 4:30 PM. We spent the whole
day with doctors- Caridiologists for CT scan of chest, Doppler
sonogram of heart, EKG, all looked great, doctors are impressed by
how she has healed; then to the pulmonologists for a test of
altitude tolerance. She needs 1 liter/min of oxygen on the
ground but at flight altitude needs 3 liters/min. After about
seven phone calls I found a place that will lend us the portable
oxygen concentrator needed for flying. We now need to arrange
to get out of the rehab home to go to our daughter Bev's house near
here (lots of paperwork, getting prescriptions written and filled),
arrange for oxygen at Bev's house, make flight reservations, arrange
for oxygen on the flight from Kansas City to Memphis, arrange for
oxygen at home in Memphis. Present guess is that we'll move
from Rehab to Bev's on Friday and fly to Memphis next Wednesday.
(Part of the constraint here is figuring out when Bev can drive our
car to Memphis and come help us get settled in there.)
February 14, Friday, 5 PM. We have escaped from the
rehab home and are at Bev's house. After about 48 hours of utter
chaos organizing prescriptions and oxygen, we left there after
lunch today and now have a stock of prescription medicines, oxygen
at Bev's house, and oxygen equipment for flying to Memphis Weds. Feb
19 arriving early evening. I'll add more when I get more time.
[added the 18th: The rehab home did a fabulous job while we
were there. Getting out was absurd. Two examples: The fax
machine at he rehab and the fax machine at Walgreens had
incompatible margins. So the faxes Walgreen's received cut off the
first two letters of "Ordman" and the first two letters of each
prescribed medicine. So when we called Walgreens, they said they had
not received any fax about Ordman. When finally got the origibal
from the rehab home and carried it, the problem ot identified but
Walgreen's still couldn't correct it and give me pills based on my
copy since my copy didn't have the doctor's signature...
(etc.) Then we needed an order for the oxygen system at
home. The oxygen company told the rehab home to do an Oxygen
Desaturation test on Eunice and fax the results. Apparently the
words "Oxygen Desaturation Test" meant different things in the two
organizations; the rehab home kept saying they had send it and the
oxygen company kept saying they had sent the wrong form... In both
cases, very minor differences in procedure that the human beings
involved seemed completely incapable of resolving without 7 or eight
faxes, ten phone calls, and eventually a personal visit.
February 18, Tuesday 1:30 PM (note added material in the
paragraph above also.) We are doing fine at Bev's, therapists
have come to the house a few times to check that things are doing
well. Eunice is going up and down stairs (half flight - split level)
and clearly can get around by herself (but we stay beside her). The
doctors still hope she'll be off oxygen in a month or two (she hit
850 on the inspirational spirometer twice yesterday - a month ago it
was hard for her to get to 500.) We will fly to Memphis
tomorrow (Wednesday) afternoon - daughter Bev is driving our car to
Memphis, granddaughter Heidi is driving us to the airport.
Delta Airlines has approved our oxygen arrangements for the flight,
the oxygen company here is talking with the oxygen company in
Memphis to set us up there. We have Thursday appointments with
Eunice's internist and cardiologist, a caregiver coming in Friday
afternoon so I can go shopping, an orthopedic appointment next
Tuesday. I hope that by about 5 PM Friday we'll be settled in enough
to manage phone calls on our home number (901-327-9735).
February 19, 2014, Wednesday, 8 PM. We are home in
Memphis! The plane ride had several minor problems
(Delta Airlines slow at wheelchair help and some of their
staff being bewildered about oxygen) but the glitches were
very minor in the scheme of things. Bev and Bob left Kansas
City at daybreak and drove our car and theirs to Memphis (theirs to
go home in) and were here at our condo cleaning out the
refrigerator, going shopping, etc., and ready for us to
arrive! The oxygen company arrived within an hour and had us
set up and off the portable oxygen. We are exhausted.
Doctors appointments tomorrow Thursday at 11 and 12:30,
numerous errands to run. Help lined up in the home for Friday
and Sunday afternoons.
February
26, Wednesday, 7 PM. It has been a week. We are still
unpacking and sorting papers, and trying to figure out how to move
projects from my old computer I had taken to Kansas (thinking of a
one-week trip) after it is two months out of synch with my home
computer. Eunice has seen her internist, cardiologist, and hip
surgeon, and will start physical therapy (outpatient) tomorrow.
We've been to church, out to lunch with friends, and to a League of
Women Voters meeting. I am getting in home help a few times a
week so I can run errands et cetera without leaving Eunice alone,
and one of those helpers drove us to and from the League of Women
Voters meeting. Eunice is still on oxygen (1 liter continuous
at home, 2 liters pulsed when out), walker at home, wheelchair in
public, but is now active at her desk and on the phone and very much
herself, with a bit of extra short term memory weakness - but if the
first time a husband notices that is when his wife is 89 and a half,
he has little reason to complain. The cardiologist and hip surgeon
are talking to figure out how to coordinate heart rehab (stress
training, typically on a treadmill) with hip rehab (on a walker) ,
and the cardiologist is planning a pulmonology consult in case the
pleural effusion does not clear up smoothly.
As our life is now returning remarkably to
normal (well, we aren't auditing classes on campus yet!) I may well
not update this again unless something unexpected happens. Do
send us e-mails (edward@ordman.net, as eunice checks hers too
rarely) or phone us (901-327-9735.)
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