Saturday, June 26, 2010

Saturday, the 26th of June

Today might be the first day I haven't seen a ton of improvement. He's been tired today and he's still not eating a lot. He has a hard time getting comfortable in bed so he has trouble sleeping. I think he's settling for a series of naps. Tonight he was still able to stand up briefly and get in his wheelchair. I think he could use some encouragement, so if you have his cell you might drop him a line. I'm heading home tomorrow, so this will be my last first person update.

Friday, June 25, 2010

Friday, the 25th of June

Today at physical therapy Dad took 12 steps. He says his ankle is what gave out so he had me bring his work boots. He thinks tomorrow he can go farther. Later, he went against orders and got into bed himself from a wheelchair. I saw him try yesterday and he wasn't even close so this was quite an improvement. Tonight he said he had a tummy ache this afternoon but he's better now. Sadly, I think he's going to miss the drag races this Saturday. He insists the Camaro is ready, after all he drove it to Trinity Center last week and "rattled Glenn's windows." In a car that gets 5mpg with $8.50 gas.

Thursday, June 24, 2010

Thursday, the 24th of June

Today Dad can scoot around in a wheelchair. He can slowly feed himself, but needs help about halfway through. Last night at physical therapy he finally learned that he can't walk. He needed help to stand between the parallel bars and he could only take two steps. We caught him watching NASCAR this morning.

Wednesday, June 23, 2010

Wednesday, the 23rd of June

We showed up at breakfast time. He wanted to sit up on the side of the bed. Personally, I think he was trying to bolt! He couldn't do it so they just raised the back of the bed. He got both pieces of bacon to his mouth by himself and several bites of eggs with assistance. It was the most I've seen him move his arms so far. He will be transferred to rehab as soon as his doctor comes by to discharge him.

Dad was transferred to Northern California Rehabilitaion Hospital at 12:30. While waiting, he tried to talk me into helping him split. When we called back later he was out of the room. He had completed his first physical therapy session which consisted of sitting up and pivoting. I guess after that he was allowed to sit in his room in a wheelchair. He was pretty pleased. Later the nurse found him half out of his chair on the floor. He claims he was just looking out the window and doesn't know what happened. I call BS. He now has alarms on his bed and chair.

Monday, June 21, 2010

Monday, the 21st of June

We walked in on Dad's physical therapy. He stood up the first time almost on his own. The second time he wasn't even close. He can now raise his hands pretty high even if they are a little shakey. He's getting a little confused about time. This is the second day he claims to have been at home "yesterday." He keeps asking us to get the video camera so we can take it to the track tonight. He wants proof that the front end of the camaro will come off the ground. I try to gently remind him he won't be racing for a while. He thinks he's already balanced and mounted the tires and wheels. I'm pretty sure I saw the front wheels in front of the T.V. before I left the house this morning. He's talking up a storm, though.

He developed a small dvt in his left leg a day ago and they've decided to insert a filter into a large vein in the lower back just in case any piece of it breaks off. The procedure was very quick, but afterwards Dad became pretty agitated. Mom was pretty sure he was going to try and sneak out. On the advice of the nurse we just split early so he could calm down.

Sunday, June 20, 2010

Sunday, the 20th of June (Father's Day)

Complete sentences and clear speech! I've sounded worse with a cold. He still doesn't exactly rattle on, but when he talks even Mom can understand him. Until today I had to act as translator. He even read his Father's Day card. His blood pressure is back down a bunch. He said he wasn't tired... right before he fell asleep...

Physical therapy went about the same as yesterday. He said he stood up. The nurse said someone was holding him up. He also thought he was at home yesterday. According to him he's walking out tomorrow. Maybe later. :-)

Saturday, June 19, 2010

Saturday, the 19th of June

Dad can talk in whole sentences now. He has to speak them about five times before we can understand. He sounds like a sleepy drunk. Or so I'm told. He asked if I wanted to take out the 'skis. He's not moving as much, but that might be because more coughing is involved. Plus I think we caught him as he was napping. He has fewer tubes today. He's down to insulin, potasium, saline, and electrolytes/sugar. And monitors are down to heart rate and blood oxygen. His physical therapist said today would be more fun today without all the teathers. Then we had to leave and miss the fun.

The physical therapist says they had Dad sitting up on the side of his bed. He was wobbly but managed to stay up. They've been working on range of motion. Mom and I are supposed to help him move his arms and legs several times per day. I guess that means at the beginning and end of each visit.

Now that he's not on a lot of other meds one of his doctors decided to start his blood pressure meds again. I guess they no longer need a lot of brain profusion.

Friday, June 18, 2010

Friday, the 18th of June

The best news we got this morning is that he's been breathing on his own since last night. The machine gives a tiny assist to overcome the resistance from the long tubes, but each breath is initiated by him. His mobility is greatly increased. We just got kicked out for his physical therapy session. And we're still waiting for the tube to get pulled out. Oh, and the hospital has a strict "no pictures" policy for the ICU. :-(

At 1:30 one of his doctors showed up to verify that he passed the parameters for getting his tube out. Flying colors. They pulled the tube and now they'll just monitor his breathing by checking blood gasses every few hours. Dad likes making sound now. We were asked to go easy on talking to him for a few hours.

I moved his arm around to get one of the monitor alarms to shut up and got his first words: "Thanks, Don."

Thursday, June 17, 2010

Thursday, the 17th of June

Moments after we entered Dad's room we could tell he was more alert. His eyes were open and he was scanning the room. Mom had called earlier this morning and found that the nurse had gotten Dad to respond to yes/no questions by blinking. We asked him if this was true and he nodded his head. Show off. He then proceeded to lift each arm about an inch and wiggle his legs a bit. He's turned his head a little also.

They changed a setting on the vent so he could breathe on his own for a while. I could see that tired him out a lot. Once in a while I'd have to remind him to breathe deep. After that they did tests to see if it was time to pull the tube. Not yet. They'll try again tomorrow morning. He looked pooped after that so we told him to nap and snuck down to the cafeteria to eat and update.

Evening visit yeilds nothing new. He still has his humor, though. I started singing a lullabye and he bugged his eyes out. He also looked ticked when we said we had to go. Hopefully the tube comes out tomorrow.

Wednesday, June 16, 2010

Wednesday, the 16th of June

We visited a little later today because we knew Dad was having a CT scan this morning. It will be a while before we hear the results. Everything looks much the same as yesterday except...he opened an eye! I thought maybe it was just open a crack from the last time someone was hitting him with a flashlight. But no! He closed it and reopened it a few minutes later. Mom likes to get real close and chat with him and try to get him up. We use words like Camaro and salami. At least twice he has scrunched up his eyes and moved his lips. So far it's only been the one eye, and it's just a sliver, but it's a start.

The nurse came in to reset some lines, get his food going, and turn him. Dad's really coughing when he gets his mouth vacuumed out. His doc is supposed to pop in around 2 so we're going to lunch so we can be back by then.

At three the doctor still hasn't been by. But the nurse just hollered at Dad to look to his right and he turned his head about an inch. Somebody's home now, baby!

The doc showed up just after 4:00. He kicked us out for a while and removed the bolt and staples from Dad's head. He put in a few new staples and put on new bandages. Dad now sports a cool beanie just like a newborn. The doc said his CT's look better and better every time. Mom was worried that Dad's taking so long but he said there is no reason to believe he won't wake up fully. That's what I wanted to hear! We went back in and caught Dad making yucky faces. Seriously, he looked like Justin did at two days old. He almost constantly has both eyes open now. He looks at different things in the room, but he doesn't track or seem to focus. We finally ended our morning visit at 6 p.m.

Tuesday, June 15, 2010

Tuesday, the 15th of June

We walk in and notice the EEG is basically going crazy! His brain is active enough that the EEG tech has to come in and change the impedance on the leads to basically change the scale of movement. To us, that just meant the bumps got a lot smaller, but on a new scale. General swelling is way down, even in the left arm. If you didn't know him, he would pass for normal. The nurse says he sometimes coughs when they are messing around with his vent tubes. Good sign. The doc is leaving the bolt in until Dad wakes up more so he can see that the pressure isn't inhibiting normal functions.

During the evening visit, nothing changes. The nurse says they're going to run cultures on everything to verify there are no infections. He's had a slightly high white blood cell count, but that's normal for the steroids he's on.

This is where I realize I could save Mom several hours a day on the phone by posting all this stuff in a blog and passing out the address. She likes talking to people, but 10 or 12 want updates every day, and that's a little too much. She's skipping her naps and that's just not right!

Monday, the 14th of June

We walk in to notice that there is substantially more brain activity on the EEG. What had been tiny squiggly lines are now bumpy lines. We try to see if he responds to words like bacon, but to no avail. His ICP is back up to 20, but they expected it to rise when they took him off the pheno. They have dialed back the ventilator from 19 to 16 breaths per minute to normalize his blood gasses. He no longer looks like he's panting. He's also beginning to create small amount of back pressure on the ventilator which is a tiny precursor to breathing on his own. Again, the puffiness has decreased, except maybe in his left arm.

Nothing new on the evening visit except we bump into his doctor. He's pleased with the progress so far. He plans on maybe removing the bolt (pressure meter) maybe tomorrow or the next day. Dad's pupils were responsive to light.

Sunday, the 13 of June

It turns out that when a doctor says three days he means after three days not including the day of surgery. On our Sunday morning visit the first thing we noticed was that Dad's ICP was down to 8! This was after three days of hovering around with really no downward trend. At 11 a.m. they stopped his phenobarbital to begin the waking process. Apparently, pheno has a half life of around 40 hours, so they aren't expecting him to get up and dance any time soon. In addition, they gave him some drugs to increase his pee output and dialed back his fluids so he could dry out some. Kidney function had returned to normal range a few days ago and he seemed quite willing to help out. At this point he's hooked up to an EEG for constant monitoring.

By Sunday evening only two things look different: his ICP is back up to 12, and he's noticeably less puffy.

The Coma

For the next three days we visited twice a day to see how things were going and to generally get in the way. We learned that Dad's ICP may have been in the 40's for "some time" before and during the surgery. Normal is 10 (mm Hg) while lying down. While asleep he's on several meds, including one to keep his blood pressure artificially high. This allows more blood profussion to the brain. In addition he is given extra fluids for basically the same reason. This extra fluid, as well as laying around in bed, causes his body (hands, feet, and face esp) to get pretty swollen. I begin calling him Sta-Puff. During these three days his ICP is around 25. He also has a clot in the vein of his left arm. The unusual thing is that is extends almost from the shoulder to his wrist. This may have happened while he layed in surgery for an extended period of time. The normal procedure would be to give him anti-coagulants, but that is out for the time being. Turns out that's not a good thing to give a guy just out of surgery. The decision is to just wait it out.

Surgery

On Wednesday, the 9th of June, my dad underwent surgery for the removal of a tumor. I was planning on driving down the next day after work as it would be the final day of the school year. I was doing laundry that evening so I would be ready to go when I got a call from Mom. She said there were issues and Dad had been put in a drug induced coma. She also asked if I could come right away. Thirty minutes later I was on the road for Redding, where I arrived at 2:30 a.m. At this point I knew nothing about his condition except that he had high intracranial pressure or ICP.

The Beginning (Almost)

On Monday, the 7th of June, Dad went in for an MRI to see how a brain tumor had responded to radiation therapy. The tumor was not smaller, and may have actually grown since its discovery. There was no fooling around...surgery was scheduled for two days later.