Thursday, February 16, 2012

The Joys of Parentheses. Or - I Cause a Ruckus

Well, we got back from Indy after 4 weeks of John being in IU Methodist hospital - got home last Friday (Feb. 11th). John didn’t get the mitral valve replacement we'd hoped for, because the radiation from 1974 that damaged the valve had caused so much calcium to collect at the base of the valve that there wasn't enough good tissue to sew a new valve to. But after a permanent pacemaker (to stand in for the conduction tissue the radiation damaged), an EP study and 4 ablations (to stop irregular rhythm caused by damaged tissue), and a stent (to deal with a blockage caused by - you guess it - radiation), he was on new drugs and in much better cardiac shape that he was before (when he passed out at work and started all this ruckus).
Thanks be to God for parentheses; I couldn't talk without them.

The last few days before he came home, he came down with bronchitis. He got 24 hours of IV antibiotics and came home on oral ones. But by Sunday he was very short of breath, went in to the Goshen Hospital ER, and was admitted with severe pneumonia. Then more ruckus started, set in motion by me. Hard to imagine that.

He's been in ICU since, and is quite sick. The doctors disagree about what to do with him. The intensivist wanted my permission to let him go, since he had obviously been disabled for a long time. The oncologist wanted me to let him go because the problem was a rapid worsening of lung cancer (also caused by radiation). The cardiologist wanted him to be treated aggressively because he had pneumonia. Having power of attorney, I told all of them that:

  1. Ten days ago he was walking in Indy without assistance and not needing oxygen. Then he started coughing up brown stuff. He does have pneumonia.
  2. After the cardiac work in Indy, he was doing fine with the new meds.
  3. When all of this started he was at work, not severely disabled at home.
  4. This current crisis came on quickly when he started coughing up stuff; cancer doesn't spread that fast, but pneumonia does.
  5. John & I have talked extensively about what he wants done in what circumstances. He wants everything done if he has a problem that can be gotten over.
  6. This isn't the 19th century. Pneumonia is still fatal at times, but it can be gotten over.
  7. Here's what we're going to do: aggressive antibiotics, aggressive nutrition through an NG tube, Bipap to support his respiratory system, and some sleep.
So that's what they did. And he's making small steps in the right direction. And now they all agree that it really was pneumonia after all. (I used to work with cardiothoracic surgeons; I can tell off any physician that I need to.) His blood gasses on Monday were catastrophic, Tuesday's were merely horrific, and Wednesday's and today's were normal. This chest X-ray is improving. He's getting stronger and feeling better.

There's a long way to go. "Stronger" means able to sit on the side of the bed for 2-3 minutes at a time. But he's alert, laughing at jokes, and rolling his eyes at the right political news (No, I won't elaborate. So don't ask.). He is sleeping a great deal, which he needs after 4 weeks of trying to sleep in a hospital. I'm glad to be back at home, with my own bed and fridge and dog.

After 4 weeks without any income and with the expenses of being in Indy, I'm back at work. It is also great therapy for me - a little bit of normal life. I'm not spending a lot of time in the hospital room because John tries to stay awake if I'm there, and he needs to sleep right now. In the morning I run errands, go see him, go to work, see him after work, run more errands, and try to get home within the limits of the puppy bladder (successfully, so far), then look after the house. I've had a few times of emotional decompensation, but am generally doing well. Father Matthew is taking good care of both of us, and I have a wonderful support system here.

Two out of 3 docs - including the first one that wanted me to let him go - now think he may live through this. I think he has a decent chance. But nobody knows, of course. Your prayers are welcome, as always. I'll try to do better keeping you all updated. So much has happened so fast, that by the time I was ready to tell you about one thing, there were 2 or 3 others that needed to be covered. So I got myself hopelessly behind. And in Indy I was spending about 10 hours a day at the hospital - if I wasn't there, I was generally asleep.

As always, any of you that are on Facebook are welcome to look me up. Though I haven't been very good at communicating, you're all in my mind and heart. Love you all!

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