Alert and Agitated

Alert and agitated best describes Dad’s mood over the past couple of days. Fatigue and a slow hospital network got the best of me therefore there has not been an update until now…sorry. For my sister-in-law Mary, the short & simple version: Dad is alert and acknowledges us, agitated with his circumstances, fighting an unknown infection, still having complicated dialysis treatments and probably missing the History channel.

The specialist attempted to perform the TEE or transesophageal echo http://www.heartsite.com/html/tee.html , on Tuesday, 2/10. He was unable to get the scope down the esophagus due to the balloon like inflation of the trach device, possibly due to the new trach http://en.wikipedia.org/wiki/Tracheotomy . The doctors still feel it is an important test to look at the heart valves, so they think they will attempt it again in a couple of days. Dad’s temp was down to 37.2* today. He was very alert all day. Mom held his hand and talked to him most of the day. She watched the Physical Therapist intently to know what exercises to help Dad with.


Courtney had class across the street at the GVSU/Cook Center so she stopped in to visit G’ma & G’pa for a few minutes on her way to Swing Dancing at the Grand Rapids Public Museum. My best friend Sandy had to come to GR so we arranged for her to meet me at the hospital. She was actually walking directly in front of me coming across the walkway! She won the ‘How Cold Can You Get?” contest. After about an hour, with a heavy sweater on, sitting with her left shoulder near the picturesque window overlooking the GVSU building she said her shoulder was throbbing. She told me the next day as soon as she got into her vehicle she turned the heat to high & flipped on her heated seats for the ride back to Belding! Dad was a little restless but as ICU nurse & friend Sandy suggested, try to interact with him as little as possible at night so he will sleep. With his alertness, I do not want to challenge him at night because he just gets agitated. You learn which beeps and bonks need stern attention. Earlier in the day I had called Courtney’s pulmonologist to ask if she could stop taking the Serevent diskus he had prescribed her 2 weeks earlier. Her heart had been racing ever since she started using it. Her last dose was in the morning, so he said not to use it at bedime. At about 1am I was chatting with her online and she said she couldn’t breathe. None of my bag of tricks seemed to work. It is a regular occurrence with Kelsey, but not Courtney! I called home to alert Dave and he had already heard her. I could hear her gasping in the background. He said he would call me back in a few. That was a long ‘few’! I was ready to head to St. Mary’s ER a couple of miles away, since that is where our new doctors are based. Not able to be the hands for her to hold during her ‘breathless’ attack, I sat here crying and praying until Dave called me back. She got back online and was feeling better so I stayed at the hospital. She went to bed knowing she can call me at any hour if she needs me. Even though the nursing care has mostly been excellent, there are times when Dad has coughing episodes or fidgets enough that he compromises his tubes and lines. Despite cameras & monitors, his nurse may be busy with another patient. He manages to maneuver himself how he wants to be even after they reposition him. Then he reaches for his tubes and he might be sleeping! Mostly, we are here so he knows we have not abandoned him. Nurse Jerri had a new admit that consumed much of her night but she still checked in on Dad, or arranged for another nurse to do so.

I was awake when ex-ray arrived at 6am. Sometimes I feel a thump and a heavier burden of weight. The techs will lay an ex-ray protection cape over me, which sends me stumbling out of the super recliner into the hallway. Dad finally began to rest after ex-ray left and I fell asleep somewhere after 7am. I felt something warm around my neck. I looked up and new nurse Maggie was tucking a warm blanket around me…sigh. I was already in a sweatshirt hoodie (hood on), wrapped in a polar fleece blanket and covered to my nose with a down blanket! It was around 8am. She said, “He’s resting, go back to sleep.” Mom arrived about 9:30am, after a foggy and very rainy drive. Nurse Gemma was just starting dialysis. She was brought up to speed with Dad’s case quickly, as his blood pressure will often spike, then bottom out. The proper amount of flushing and added dosage of Albumin is critical. She took 2.4 liters of fluid off. They needed to add 1 liter of fluid back in L .

When I got home Ruth Beyerlein had already dropped off everything for dinner. A large pan of chicken lasagna was thawing on the counter. She had brought a loaf of garlic bread and a whole cantaloupe. Then hiding under her instructions was a delectable brownie like dessert laden with chocolate & butterscotch chips, nuts and NO calories. Well, I’m not going to count them! Thank you so much!!! I slept hard from 1:30-4:20pm, got up and only had to turn the oven on and slide that pan in. I did cut up the melon, an easy and delicious task. Kelsey blew in from practice with the wind, snagged a ‘to go’ plate and left for youth group. She was singing so had to be there early. Dave, Courtney & I enjoyed dinner together. I laid down again for about 45 minutes, but couldn’t sleep. I had to pick up a few things from Meijer and called Mom to let her know I would be on my way but wouldn’t arrive until after 10pm. The nurse and tech were preparing to bathe Dad so she was going to head for home. She decided to try and sleep in Dad’s bed. Murphy did not approve. He kept coming in and looking at her. He prefers her sleeping on the couch next to his bed on the floor. Mom was able to do some housekeeping stuff at home before leaving.

This morning it was a lively place around here. Nurse Cindy came in and asked if I was ‘Mrs. Louie?” I was asked this once down on 7north also J. When I said I was his daughter she laughed and said when Mom arrived she would ask her if she was his daughter! She had two nursing students from GRCC doing their clinicals working with her today. Dad’s Respiratory Therapist also had a student from GRCC doing clinicals. Dad was very uncomfortable this morning. I had just got done talking to one of Dad’s doctors when his RT rushed out and exclaimed, “He’s alert, I mean really alert!” I said, “I know.” She wondered how long he had been like this. I told her three days! Apparently the doctors were just thinking we had ‘wishful thinking’ that he was coherent. Since he would be sleeping and wouldn’t react to them or he was being stubborn (NOT Louie…lol), they tell us his mental state is clouded due to the fluid, swelling, infection. We can agree with that but also know Dad is alert to his surroundings. One of Dad’s doctors was trying to determine if the dialysis port needed to be changed. They are thinking this might be the source of his unknown infection. They have identified the bacterium, but I forgot to write it down. It is one that can occur with dental break down also. I had informed the PA yesterday that Dad had his teeth cleaned 4 days before his surgery. Since it did not show up on other cultures, they are in the elimination process. We sure hope an exact source is found soon. Nurse Patti came in and got dialysis started. Dad’s blood pressure went up to 199/72! In true form it also dropped severely. With a call to the renal doctor, Patti stopped dialysis early. His critical care doctor was on the phone with radiology scheduling to have his port removed. He went down about 3:45pm. He is scheduled to have a new port placed on Friday. His next dialysis will not be until late Saturday.

After a simple supper with my family, Kelsey went to Poms practice, Courtney went to play for the MOPS dinner, then to the hospital to relieve G’ma. Dave saddled up with the dogs in front of the TV and I spent a fun 1 ½ hours with Halea, Sophia and Dillon filling in for Kelsey until she got done with practice. I even got to rock a sleepy Big D!

Dad’s night nurse doesn’t like him resting his leg up on the side of his bed. It effects the inflating action of his leg circulators. His previous nurses concluded he was going to put them there regardless of what they wanted, so they tried to make him more comfy the way he wants. Tonight he is really restless. Think of having the flu and only having one source of exit for all of the toxins. It is not all coming out in dialysis … I think that paints a ‘burning’ picture for you! Hopefully, the day ahead will bring us more affirming answers. We really hate the side effects of this infection. As mom wrote in her journal for Thursday…”Louie always says, You can plan for the future, but not the outcome.

”When you go through deep waters and great trouble I will be with you. When you go through rivers of difficulty, you will not drown! When you walk through the fire of oppression, you will not be burned up; the flames will not consume you. Isaiah 43.2