Everybody wants good news.
When Bill was brought to Emergency, he was not able to respond to anything on his left side.
The next morning, he had regular responses. Yeah!
Ida Louise Duchane Pitcher
2 months ago
Friday, July 12, 2013
Bill: levity
Hopefully this isn't inappropriate but it seems (to me) that this is a moment to be enjoyed when everything has settled down.
Ayn reports that the evening Bill fell ill, they were watching the Giants baseball game. Before Bill went in for a shower, the Giants were ahead by two points.
When Bill came out of the shower, the Giants were down by one.
Bill leaned over the counter, and Ayn thought "Oh, no, he saw the score."
We wish it were so.
Ayn reports that the evening Bill fell ill, they were watching the Giants baseball game. Before Bill went in for a shower, the Giants were ahead by two points.
When Bill came out of the shower, the Giants were down by one.
Bill leaned over the counter, and Ayn thought "Oh, no, he saw the score."
We wish it were so.
Bill, Friday July 12
Current status, what is and what is NOT:
Bill is sedated. So no, he is not awake. No, this is not an induced coma. Today they changed to a 'lighter' sedation medicine.
Bill has a breathing tube. No, he is not on life support.
His kidneys are stressed. No, they are not failing. No, he is not on dialysis. No, he does not need a transplant.
A cardio study was done through ultrasound, and there were no problems (no valve problems, no fluid around the heart).
A liver/gall bladder study was also done, and was clear (no problems).
He was taken off the drug study. If he was getting the actual drug rather than the placebo, then extra iron would be sent to the kidneys and they don't need that stress right now.
Technically, he had a hemorrhagic stroke, assumed to be from high blood pressure.
Fluid continues to drain from his brain. There is no timeframe on how long this will continue (yes, we would love to know too). Therefore, we have no idea when he will come off the various tubes, have less sedation, and "wake up." And we don't know what is function will be, although we're thrilled he has movement on both sides of his body.
Sure we all cry. (Me, his wife, his daughter, sisters...). The guys tend to be pretty dang quiet.
By the way, has everyone done an advance directive? Get on it!
Bill is sedated. So no, he is not awake. No, this is not an induced coma. Today they changed to a 'lighter' sedation medicine.
Bill has a breathing tube. No, he is not on life support.
His kidneys are stressed. No, they are not failing. No, he is not on dialysis. No, he does not need a transplant.
A cardio study was done through ultrasound, and there were no problems (no valve problems, no fluid around the heart).
A liver/gall bladder study was also done, and was clear (no problems).
He was taken off the drug study. If he was getting the actual drug rather than the placebo, then extra iron would be sent to the kidneys and they don't need that stress right now.
Technically, he had a hemorrhagic stroke, assumed to be from high blood pressure.
Fluid continues to drain from his brain. There is no timeframe on how long this will continue (yes, we would love to know too). Therefore, we have no idea when he will come off the various tubes, have less sedation, and "wake up." And we don't know what is function will be, although we're thrilled he has movement on both sides of his body.
Sure we all cry. (Me, his wife, his daughter, sisters...). The guys tend to be pretty dang quiet.
By the way, has everyone done an advance directive? Get on it!
Bill, late Thursday July 11
Christine is so anxious to have her dad wake up. He is her rock and the one she talks to when she needs to talk to somebody. Now she can't talk to him and have him reassure her.
Thursday, July 11, 2013
Bill, Thursday July 11
C wants everyone to know it's free Slurpy day (7 Eleven).
No big news this morning, but here is some catch up information. Late Monday, scan (CTA) was done where they inject dye in the bloodstream and scan as it enters the brain. They also wanted to do an angiogram (which starts at the femoral artery - thigh- instead of at the neck) BUT they kidneys were showing some stress. The kidneys weren't in danger, but the dye is toxic enough to not be used if the kidneys aren't "happy." Yes, a doctor actually used the word happy.
One of today's order is for a renal consult to have those experts evaluate the issue with the kidneys.
Another piece of catch-up: family medical history. As I mentioned, the doctors are not only treating his crisis, they want to know what has caused the situation. Long term high blood pressure can cause a bleed, but they say he's much too young. I could tell them my family side, with no young-onset problems, say age 40 or 50 or below.
But Bill's birth dad? Umm, well I haven't had contact in some 33 years? His dad was 20 or 21 when we divorced, so not history on him at that point, and I was guessing the other grandparents were about 40 with no known problems at that point. A great-grandmother passed away from a stroke right about those days, but she was about 70 I think.
I reached out through Facebook to see if I could find the right person, and his son, and asked if they would share any data. (My ex tried to friend me on FB a couple of years ago, which was just weird.)
We will see if there is any response.
No big news this morning, but here is some catch up information. Late Monday, scan (CTA) was done where they inject dye in the bloodstream and scan as it enters the brain. They also wanted to do an angiogram (which starts at the femoral artery - thigh- instead of at the neck) BUT they kidneys were showing some stress. The kidneys weren't in danger, but the dye is toxic enough to not be used if the kidneys aren't "happy." Yes, a doctor actually used the word happy.
One of today's order is for a renal consult to have those experts evaluate the issue with the kidneys.
Another piece of catch-up: family medical history. As I mentioned, the doctors are not only treating his crisis, they want to know what has caused the situation. Long term high blood pressure can cause a bleed, but they say he's much too young. I could tell them my family side, with no young-onset problems, say age 40 or 50 or below.
But Bill's birth dad? Umm, well I haven't had contact in some 33 years? His dad was 20 or 21 when we divorced, so not history on him at that point, and I was guessing the other grandparents were about 40 with no known problems at that point. A great-grandmother passed away from a stroke right about those days, but she was about 70 I think.
I reached out through Facebook to see if I could find the right person, and his son, and asked if they would share any data. (My ex tried to friend me on FB a couple of years ago, which was just weird.)
We will see if there is any response.
Bill, Wednesday June 10
In ICU, Bill has a nurse who is just assigned to his care. That worried Christine, his daughter. And while we told her flat out that it is serious, the nurse helps to monitor a whole lot of activity.
What activity? Golly, what activity is not happening?
Every hour, she (or he, there have been a couple of male nurses) turns off the sedation and they do a neurological evaluation: pupil reactions, does he respond to "squeeze my hand," does he react to sensation at his feet. IV bags empty and are replaced, and everything has to be entered in the record. The lift team comes every few hours to reposition him. The nurse clears the breathing tube and suctions the lungs, charts the brain drain and catheter outputs.
Every morning the horde, no excuse me, the team of neuro (this is a teaching hospital, so there are a lot of people involved) consults outside the room on his status and develops plans for the day. There might be new scans, or should his feeding tube diet be changed, or moving blood pressure meds from IV to oral.
Mid-day Wednesday, the drain stopped draining. A flush was done and they would wait for a bit to see if it cleared, which it did but much later.
Late Wednsday, two residents (I think, could have been a Neuro Fellow in there I guess) came in and announced he had a low-grade fever (101.6 if my conversion from Celsius was correct).. He was going to have a chest x-ray, cultures, blood samples so they could try to identify the source. Monday evening when all this started, he had vomited more than once, and some residual got in his lungs, so that was a worry. The x-ray showed some cloudiness and they started antibiotics. His temperature is back in an acceptable range.
But I have to comment here. The nurses have been super, but a few of the doctors/residents/fellows have not. The two guys I just mentioned, bringing the news about temperature? I asked about the drain problem, and got a dismissive response (almost "Can't help you there."). When they left I told Ayn I hadn't had the urge to flip someone off in a very, very long time.
What activity? Golly, what activity is not happening?
Every hour, she (or he, there have been a couple of male nurses) turns off the sedation and they do a neurological evaluation: pupil reactions, does he respond to "squeeze my hand," does he react to sensation at his feet. IV bags empty and are replaced, and everything has to be entered in the record. The lift team comes every few hours to reposition him. The nurse clears the breathing tube and suctions the lungs, charts the brain drain and catheter outputs.
Every morning the horde, no excuse me, the team of neuro (this is a teaching hospital, so there are a lot of people involved) consults outside the room on his status and develops plans for the day. There might be new scans, or should his feeding tube diet be changed, or moving blood pressure meds from IV to oral.
Mid-day Wednesday, the drain stopped draining. A flush was done and they would wait for a bit to see if it cleared, which it did but much later.
Late Wednsday, two residents (I think, could have been a Neuro Fellow in there I guess) came in and announced he had a low-grade fever (101.6 if my conversion from Celsius was correct).. He was going to have a chest x-ray, cultures, blood samples so they could try to identify the source. Monday evening when all this started, he had vomited more than once, and some residual got in his lungs, so that was a worry. The x-ray showed some cloudiness and they started antibiotics. His temperature is back in an acceptable range.
But I have to comment here. The nurses have been super, but a few of the doctors/residents/fellows have not. The two guys I just mentioned, bringing the news about temperature? I asked about the drain problem, and got a dismissive response (almost "Can't help you there."). When they left I told Ayn I hadn't had the urge to flip someone off in a very, very long time.
Bill, Tuesday July 9
Bill is sedated for two reasons. First, it helps keep the blood pressure down. Second, he has a breathing tube so sedation keeps him from reacting to the irritation.
He also has a "regular" IV, and a central line (through the coratid artery), and an "A-line" which gives constant feedback on the blood pressure. A feeding tube was inserted on Tuesday, and some "oral" meds are occasionally given through it.
Dr. Clark from the stroke unit came by and explained an investigational study that is going on. and of course he asked to include BilI in the study.
In cases of hemorrhage or brain bleed they are looking to use chelation to grab the extra iron from the brain blood and flush it out to the
bloodstream.
They don't want extra iron left because that damages the brain. It basically causes rust in the brain.
He also has a "regular" IV, and a central line (through the coratid artery), and an "A-line" which gives constant feedback on the blood pressure. A feeding tube was inserted on Tuesday, and some "oral" meds are occasionally given through it.
Dr. Clark from the stroke unit came by and explained an investigational study that is going on. and of course he asked to include BilI in the study.
In cases of hemorrhage or brain bleed they are looking to use chelation to grab the extra iron from the brain blood and flush it out to the
bloodstream.
They don't want extra iron left because that damages the brain. It basically causes rust in the brain.
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