Everything is the same today. There have been no changes in settings or systems. He is still scheduled to be evaluated tomorrow to see when they might be able to do the tracheostomy.
Keep praying for protection of further complications and strength for Debbie to get through these long days.
As always they feel your thoughts and prayers and appreciate everything.
Sunday, September 30, 2007
Saturday, September 29, 2007
Saturday Update - More of the Same
Jerry's condition is virtually the same as yesterday. As Debbie put it, it will probably be the same tomorrow.
The weekend has been for trying to get him stable enough to do the tracheostomy. He will be re-evaluated Monday and she thinks that the procedure is a scheduled one, so it's not likely that it will happen on Monday. The are going to try for next week.
Debbie is asking again to pray that time will reveal itself and that the decisions being made about his care continue to be obvious. She is again thankful that all of the decisions thus far have been very obvious.
The weekend has been for trying to get him stable enough to do the tracheostomy. He will be re-evaluated Monday and she thinks that the procedure is a scheduled one, so it's not likely that it will happen on Monday. The are going to try for next week.
Debbie is asking again to pray that time will reveal itself and that the decisions being made about his care continue to be obvious. She is again thankful that all of the decisions thus far have been very obvious.
Friday, September 28, 2007
Friday Update - No Changes
There were no changes to speak of today. Jerry did not have the trach put in because they feared that he wasn't stable enough. They will try to get him more stable over the weekend and shoot for next week.
Debbie sounded really tired this evening. The days are very long and she is emotionally spent. Days with no forward movement are tough.
Pray that Jerry will be stable enough for the trach soon and pray for patience for Debbie.
Debbie sounded really tired this evening. The days are very long and she is emotionally spent. Days with no forward movement are tough.
Pray that Jerry will be stable enough for the trach soon and pray for patience for Debbie.
Thursday, September 27, 2007
Thursday Update - Small Victories Today
Jerry's blood pressure is doing a little better today. He's on the lowest dose of Lebofed that he has been on in several days. They are hoping to get him completely off soon. He needs to be off of that med to be trached tomorrow (so that is still tentative).
The sedation is a little less today because of his blood pressure being a little better. He is still on blood thinner and they are continuing to watch the blood clot and the lungs.
Dialysis continues with no problems, but the are still just keeping him balanced because of the hit his blood pressure would take.
Nutrition is another small victory. He has been able to tolerate feedings and has a little motility.
Specific Prayer Requests
The sedation is a little less today because of his blood pressure being a little better. He is still on blood thinner and they are continuing to watch the blood clot and the lungs.
Dialysis continues with no problems, but the are still just keeping him balanced because of the hit his blood pressure would take.
Nutrition is another small victory. He has been able to tolerate feedings and has a little motility.
Specific Prayer Requests
- Pray for Jerry to get completely off of the Lebofed.
- Pray that he continues to tolerate feedings.
- Pray for protection from additional complications.
Debbie sounds a little better. The doctors said that in the MICU small victories are what they are looking for. Let's hope this becomes a trend.
Wednesday, September 26, 2007
Wednesday Update
Jerry's medical picture is about the same. The overall picture is treatment for ARDS and sepsis.
He is back on the Lebofed as his body is still unable to keep his pressure up without it. They are working to get him off of it again today.
The vent settings reflect treatment for ARDS. He is a little less sedated today to see how he does. He will be on the vent for a while (weeks or months). The trach is still tentative for Friday. They are hoping that this will make him more comfortable and provide him a "turnaround" opportunity with regards to the pulmonary issues.
His hemoglobin level is better today and his red and white cell counts are reasonable. This is something to be thankful for. The leg clot is being treated with thinners and being watched closely. Amazingly, after 32 days of laying in bed, his skin remains in tact; another thing to put on the thankful list.
The dialysis continues without problem, but they are still not actively pulling fluid off of him due to the continued blood pressure problems. The fluid is staying balanced and the dialysis is supporting his kidneys until they decide to kick in again.
Specific Prayer Requests:
He is back on the Lebofed as his body is still unable to keep his pressure up without it. They are working to get him off of it again today.
The vent settings reflect treatment for ARDS. He is a little less sedated today to see how he does. He will be on the vent for a while (weeks or months). The trach is still tentative for Friday. They are hoping that this will make him more comfortable and provide him a "turnaround" opportunity with regards to the pulmonary issues.
His hemoglobin level is better today and his red and white cell counts are reasonable. This is something to be thankful for. The leg clot is being treated with thinners and being watched closely. Amazingly, after 32 days of laying in bed, his skin remains in tact; another thing to put on the thankful list.
The dialysis continues without problem, but they are still not actively pulling fluid off of him due to the continued blood pressure problems. The fluid is staying balanced and the dialysis is supporting his kidneys until they decide to kick in again.
Specific Prayer Requests:
- Stable blood pressure.
- Receive and process nutrition.
- Patience for a long journey.
The following is from Debbie:
Well, for certain our journey will be a long one. The move to the MICU has been a stressful one, more for me than for Jerry. He continues to receive excellent medical care which provides me with great comfort. I am thankful for that daily.
We have developed quite a "cheering section" from our team on the eight floor. We receive daily visits from 8th floor nurses, tech staff, housekeeping and doctors. It is wonderful to know that so many people are rooting for us. I'm thankful for that.
I find that some days are harder than others, I miss Jerry in so many ways, and find only comfort in being near him. I'm thankful for that. We receive your emails, cards, letters and voice mails and they are a treasure. Again, you have humbled and overwhelmed us, and we are thankful for all of you.
I ask God often to continue to carry us on this journey, however long it will be, and know he is doing just that. I ask that you continue to hold us in your prayers, as we surely need them, perhaps now more than ever. Please know, we feel your love.
Love, Deb and Jer
Tuesday, September 25, 2007
A Steady Day
Jerry's progress is slight, but he seems to be holding his own today. He's better, the same, and worse depending on which issue you are talking about.
Dialysis continues but there are no real positive or negative results. They are not pulling fluid off due to the continuing instability in his blood pressure. The good news is the edema is the same and not worse.
His blood pressure continues to need constant attention and medicinal support. He has been on and off of a combination of 3 blood pressure medications and is pressure is still borderline. He can't hold it on his own without the help of meds.
He may be developing a new pneumonia bacteria. There is a lot of talk about whether or not he is septic. The medical teams seem to be disagreeing somewhat on definitive diagnoses of sepsis and ARDS. One team says yes, another team says maybe not. Debbie seems to think the disagreement is because of he complicated nature of diagnosing each of those conditions. She is going under the assumption that he does have both after hearing from all of the teams and nurses. In addition, they are treating him for sepsis and ARDS.
There is a new and disturbing development. They confirmed with a Doppler scan yesterday that he has a blood clot in his left calf. This poses yet another risk to his health. He had to be put back on blood thinner to help deal with this. The blood thinner poses other risks like bleeding in the lungs.
The trach is still set for this week. Since he is in MICU he will not have to go to the OR. They will be able to do the procedure right there. That is good news since he is so sensitive to movement.
Nutrition is still a challenge. Debbie is hoping they get an OG solution to that problem soon.
She is very thankful that they are in MICU even though it has put extra stress on the situation. This floor is much different than CCU. He is very needy medically and they are able to provide more intense care.
Specific Prayer Requests
Dialysis continues but there are no real positive or negative results. They are not pulling fluid off due to the continuing instability in his blood pressure. The good news is the edema is the same and not worse.
His blood pressure continues to need constant attention and medicinal support. He has been on and off of a combination of 3 blood pressure medications and is pressure is still borderline. He can't hold it on his own without the help of meds.
He may be developing a new pneumonia bacteria. There is a lot of talk about whether or not he is septic. The medical teams seem to be disagreeing somewhat on definitive diagnoses of sepsis and ARDS. One team says yes, another team says maybe not. Debbie seems to think the disagreement is because of he complicated nature of diagnosing each of those conditions. She is going under the assumption that he does have both after hearing from all of the teams and nurses. In addition, they are treating him for sepsis and ARDS.
There is a new and disturbing development. They confirmed with a Doppler scan yesterday that he has a blood clot in his left calf. This poses yet another risk to his health. He had to be put back on blood thinner to help deal with this. The blood thinner poses other risks like bleeding in the lungs.
The trach is still set for this week. Since he is in MICU he will not have to go to the OR. They will be able to do the procedure right there. That is good news since he is so sensitive to movement.
Nutrition is still a challenge. Debbie is hoping they get an OG solution to that problem soon.
She is very thankful that they are in MICU even though it has put extra stress on the situation. This floor is much different than CCU. He is very needy medically and they are able to provide more intense care.
Specific Prayer Requests
- Pray for Jerry to get off and stay off the blood pressure medications. Pray that his body will maintain his own blood pressure.
- Pray for some nutritional success with the OG tube to get some motility going.
- Pray for Debbie to figure out the best way to deal with the long term nature of the situation.
Debbie is continuing to be thankful for the care he is getting. She continues to be inspired by people at Northwestern. She feels like they have a cheering section from CCU. Many of them continue to seek her our in MICU and follow Jerry's progress.
Monday, September 24, 2007
In the MICU
Yesterday's echo was about the same as the prior one. We're glad it wasn't worse, but we are getting the idea that the cardio team is more "cautious" as to what they think his heart will be capable of after all of this. He is back on the Lebofed (bp medicine). His blood pressure is unstable without it. They are trying to titrate it down. We'll wait to see how it goes.
Yesterday's bronchoscopy showed no further pulmonary bleeding and no obvious new infection. The early stains from the cultures do show bacteria that should be covered with his current antibiotic treatment. We'll wait to see what the cultures grow. We are probably are dealing with a sepsis picture and continue to try to combat that. His hemoglobin still remains low.
Jerry will be trached later this week. This means long term vent dependency. How long? We don't know. The trach is reversible and will probably make him more comfortable.
The dialysis seems to be functioning better. Because his blood pressure is unstable, we have not been able to remove much fluid in the last day or so. We'll wait to see when they will attempt it again.
The move to the MICU has been a stressful one for Debbie. It has definitely ramped up the intensity of his care and her stress level. But it is a necessary step.
As for Debbie: She feels like she is in hell, with no end in sight. She is frustrated and afraid. All of these "steps" seem to be with no choice and uncertain outcome, which is scary. The medical professionals tell her that all of these items are reversible, but no one can guarantee the outcome or estimate how long this will take. She is taking it day by day, but with each day that gets harder.
So we wait and pray for mercy, relief and an end to all of this.
Yesterday's bronchoscopy showed no further pulmonary bleeding and no obvious new infection. The early stains from the cultures do show bacteria that should be covered with his current antibiotic treatment. We'll wait to see what the cultures grow. We are probably are dealing with a sepsis picture and continue to try to combat that. His hemoglobin still remains low.
Jerry will be trached later this week. This means long term vent dependency. How long? We don't know. The trach is reversible and will probably make him more comfortable.
The dialysis seems to be functioning better. Because his blood pressure is unstable, we have not been able to remove much fluid in the last day or so. We'll wait to see when they will attempt it again.
The move to the MICU has been a stressful one for Debbie. It has definitely ramped up the intensity of his care and her stress level. But it is a necessary step.
As for Debbie: She feels like she is in hell, with no end in sight. She is frustrated and afraid. All of these "steps" seem to be with no choice and uncertain outcome, which is scary. The medical professionals tell her that all of these items are reversible, but no one can guarantee the outcome or estimate how long this will take. She is taking it day by day, but with each day that gets harder.
So we wait and pray for mercy, relief and an end to all of this.
Sunday, September 23, 2007
Moving to Medical ICU
Yesterday afternoon the medical team(s) started discussing moving Jerry upstairs to a floor with a higher level of care (MICU-Medical Intensive Care Unit) from the Cardiac Care Unit. That move is happening today. Medically, he is more needy.
It seems that most of his needs are pulmonary. There was a mechanical episode with the vent morning that has set him back further. He had been off blood pressure medication, but is now back on.
They suspect that he has more pneumonia. He will have another bronchoscopy today to 1) determine if he does have pneumonia, 2) determine if he has acquired ARDS, and 3) to assess bleeding in the lungs.
Today marks 4 weeks on this journey. Being on the vent for that length of time can introduce new issues with tissue breakdown, infection suceptibility, etc. His vent needs are going to be more long-term than short-term, so they will be performing in a tracheotomy. It will happen as soon as he can tolerate the procedure as it requires a trip to the operating room. That could be today, but most likely tomorrow or sometime this next week.
His sedation levels are increased because they have made some changes on the vent due to his needs and the morning episode.
Nutritionally he can't tolerate OG feedings (nutrition going directly into the stomach). They will reassess and may try NG feedings that will go directly into the small intestine. His nutritional needs are a continued source of concern.
An echo will be done today to check on his cardiac status. We're hoping that this will show that his heart is holding up under the new stresses.
We are thankful for the things that are holding up. His hemoglobin levels are a little better. They are still not great, but the are better. Dialysis seems to be working and his edema is marginally better. Dialysis continues.
Debbie is continuing to receive cautious reassurance that all of this is productive. She prays that all of the decisions about his care continue to be obvious. She is re-framing how she is dealing with things as this journey starts it's second month.
The move today is also creating more anxiety and stress for her. There are a whole new set of day to day caregivers to get to know. She is very comfortable with the quality of care he is and will be receiving, but this move will change the dynamics somewhat. The patients in Medical ICU are very critically ill and there is a higher level of intensity than the floor they are on now.
Specific Prayer Requests
It seems that most of his needs are pulmonary. There was a mechanical episode with the vent morning that has set him back further. He had been off blood pressure medication, but is now back on.
They suspect that he has more pneumonia. He will have another bronchoscopy today to 1) determine if he does have pneumonia, 2) determine if he has acquired ARDS, and 3) to assess bleeding in the lungs.
Today marks 4 weeks on this journey. Being on the vent for that length of time can introduce new issues with tissue breakdown, infection suceptibility, etc. His vent needs are going to be more long-term than short-term, so they will be performing in a tracheotomy. It will happen as soon as he can tolerate the procedure as it requires a trip to the operating room. That could be today, but most likely tomorrow or sometime this next week.
His sedation levels are increased because they have made some changes on the vent due to his needs and the morning episode.
Nutritionally he can't tolerate OG feedings (nutrition going directly into the stomach). They will reassess and may try NG feedings that will go directly into the small intestine. His nutritional needs are a continued source of concern.
An echo will be done today to check on his cardiac status. We're hoping that this will show that his heart is holding up under the new stresses.
We are thankful for the things that are holding up. His hemoglobin levels are a little better. They are still not great, but the are better. Dialysis seems to be working and his edema is marginally better. Dialysis continues.
Debbie is continuing to receive cautious reassurance that all of this is productive. She prays that all of the decisions about his care continue to be obvious. She is re-framing how she is dealing with things as this journey starts it's second month.
The move today is also creating more anxiety and stress for her. There are a whole new set of day to day caregivers to get to know. She is very comfortable with the quality of care he is and will be receiving, but this move will change the dynamics somewhat. The patients in Medical ICU are very critically ill and there is a higher level of intensity than the floor they are on now.
Specific Prayer Requests
- Jerry gets better.
- We have an informative bronchoscopy.
- The echo results are good.
- Strength and wisdom for Debbie.
Saturday, September 22, 2007
Up and Down Marathon Contines
Debbie sounded a little better today. They are making some changes and she is hopeful that the bridges they are providing for him will put him on a good path toward recovery.
The primary service team was officially switched to pulmonary from cardiology today. His cardiac numbers remain good. He has more fluid than last week and since his cardiac status is holding up well, the pulmonary team is now in charge of the day to day decisions for his care. In fact, it looks like they are leaning toward removing the Swan catheter which monitors his heart.
His pulmonary needs are great. This could be a very long road in that regard. He is also challenged nutritionally. His stomach and intestinal motility is very minimal. They are trying some more nutrition today.
The good news is there are still no obvious signs of infection. However, his hemoglobin levels are low (hovering around 8-10). He is getting more blood today. They are aggressively trying to identify the source of the problem. There are several possibilities. There is a delicate balance going on with keeping his blood thin enough with Plavix and aspirin and finding out why his blood count stays low. They are very reluctant to stop those meds since his heart is doing so well.
Specific prayer requests:
The primary service team was officially switched to pulmonary from cardiology today. His cardiac numbers remain good. He has more fluid than last week and since his cardiac status is holding up well, the pulmonary team is now in charge of the day to day decisions for his care. In fact, it looks like they are leaning toward removing the Swan catheter which monitors his heart.
His pulmonary needs are great. This could be a very long road in that regard. He is also challenged nutritionally. His stomach and intestinal motility is very minimal. They are trying some more nutrition today.
The good news is there are still no obvious signs of infection. However, his hemoglobin levels are low (hovering around 8-10). He is getting more blood today. They are aggressively trying to identify the source of the problem. There are several possibilities. There is a delicate balance going on with keeping his blood thin enough with Plavix and aspirin and finding out why his blood count stays low. They are very reluctant to stop those meds since his heart is doing so well.
Specific prayer requests:
- Pray for continued protection from infection and other complications.
- Pray that they can get some fluid off of him.
- Pray for each organ system to get up the hill.
It's been a very up and down week.
Debbie sounded a little better today. She's digging in for the long road ahead.
Friday, September 21, 2007
Friday Update - A Step Forward..A Step or Two Back
Today there is not much change. The upside...nothing is a great deal worse. Debbie feels like they move an inch forward and then move one or two inches backward. His health picture is very complex. Debbie is still very concerned.
Cardiac output numbers are pretty good considering everything that's going on with his other systems. He is still drug dependent to keep his blood pressure up and he is still sensitive to movement.
He had a CT scan of his intestines last night in the middle of the night which showed no obvious signs of bleeding or blockage. They are still trying to encourage motility, but feedings are shut off for now.
The pulmonary picture is worse today. Xrays show that his lungs are worse than yesterday. He has lots of fluid which is directly related to renal issues. There is possibly some new pulmonary hemorrhaging. They have changed vent settings to try and help that.
There are continued problems with dialysis. The longest block of time he has been on dialysis is 22 hours. The catheter is clotting and they have to readjust. It is currently off and they are going in a little different direction. This afternoon or tonight they will guide a catheter into his neck for dialysis. That means another trip to the lab...more movement...etc. This really needs to be successful as he has more edema today.
The infection status and hematology are all closely related. His hemoglobin levels are low in spite of the fact that he's been given some blood over the last week. They are wondering about a new bleed somewhere.
He's not on any other anticoagulants except for plavix and aspirin. They are unable to discontinue those because he needs them to keep the cardiac issues at bay.
Another possibility for the low hemoglobin is an infection that is not showing itself. He has no fever and his pancreas and liver numbers are fine. In fact, those numbers are trending in the right direction.
Specific prayer requests:
Cardiac output numbers are pretty good considering everything that's going on with his other systems. He is still drug dependent to keep his blood pressure up and he is still sensitive to movement.
He had a CT scan of his intestines last night in the middle of the night which showed no obvious signs of bleeding or blockage. They are still trying to encourage motility, but feedings are shut off for now.
The pulmonary picture is worse today. Xrays show that his lungs are worse than yesterday. He has lots of fluid which is directly related to renal issues. There is possibly some new pulmonary hemorrhaging. They have changed vent settings to try and help that.
There are continued problems with dialysis. The longest block of time he has been on dialysis is 22 hours. The catheter is clotting and they have to readjust. It is currently off and they are going in a little different direction. This afternoon or tonight they will guide a catheter into his neck for dialysis. That means another trip to the lab...more movement...etc. This really needs to be successful as he has more edema today.
The infection status and hematology are all closely related. His hemoglobin levels are low in spite of the fact that he's been given some blood over the last week. They are wondering about a new bleed somewhere.
He's not on any other anticoagulants except for plavix and aspirin. They are unable to discontinue those because he needs them to keep the cardiac issues at bay.
Another possibility for the low hemoglobin is an infection that is not showing itself. He has no fever and his pancreas and liver numbers are fine. In fact, those numbers are trending in the right direction.
Specific prayer requests:
- Pray that they can get dialysis going and keep it going for more than 1 day. A good 48-72 hours should help a lot of his other systems and get some of the swelling down.
- Pray that he continues to be protected from additional complications. We are thankful to have gotten this far without infection recurrence and hope that it stays that way.
Thursday, September 20, 2007
Thursday Update - Status Quo
We are thankful that nothing is worse today. All systems seem to be the same as yesterday. The picture is still muddy.
They made overnight adjustments to the dialysis hoping to help those issues progress a little faster. Heart wise his cardiac output is holding up but he is still on blood pressure meds to keep his pressure stable. There are still no signs of infection which is good news.
Last night Debbie was able to go to bed early and get a good night's rest. She feels a little better today, but is still very physically and emotionally tired.
Prayer requests for Jerry and Debbie are the same as yesterday.
- Pray that Jerry can fight his way through these complications.
- Pray that Jerry will be protected from further infection and complications.
- Pray for patience and strength for Debbie.
In addition to prayers for Debbie and Jerry, Debbie asked that you pray for a close friend who is dealing with their own health issues at the moment.
Progress for Jerry is and will continue to be slow. This is a marathon and not a sprint. Keep praying that the steps continue in a positive direction.
Wednesday, September 19, 2007
Wednesday Update from Debbie
Wed 9-19-07 1:30pm
From Debbie
Well the medical picture here is a bit muddy, some issues are good, which I am thankful for, and other issues are more concerning. In an effort to economize time and energy I will go system by system so all of you have a complete picture.
Heart: The output numbers are good, certainly better, for which I am thankful. He is having difficultly holding his BP stable and back on Lebofed, so that is a bit of a concern. We'll keep trying for stability there.
Lungs: We probably are not dealing with ARDS and that's great. Vent settings are low and Jerry seems "comfortable" with his breathing. The vent associated pneumonia is resolved, for which I am thankful. There is a risk of reinfection, which I am hoping will not occur. The pulmonary hemorrhage situation is not worse, for which I am thankful.
Kidney: We have had a problem keeping the dialysis going, today they have replaced and repositioned the catheter and are going to start again and I am hoping 48-72 hours from now we will see improvement. He does have some output on his own which is a good sign.
Infection: No clear signs of any current viral, bacterial or fungal infection anywhere. They will discontinue some antibiotic coverage, as the concern is resistance. This is all good and I am thankful.
GI/Nutrition: Currently, this is has moved into a "top priority" to problem solve. Nutritional status is low, as is motility. The team is strategizing on this right now. Nutrition is important in infection fighting, skin quality, as well as the obvious nutritional needs.
You can see why I say the medical picture is muddy. These complications are in the "norm" for this type of event and we are fortunate that we have not had to deal with them earlier in this journey.
Specific Prayer requests:
-Gratitude that we have come this far, and continued wisdom of the medical teams.
-Gratitude that we have all of you supporting us. It means more than you could ever know.
-Protection from further complications and positive resolution to the issues we are faced with.
-Rest. For Jerry and for me.
As for me: Thank you for your many birthday wishes. Needless to say, my birthday wish is a big one, and I still have hope that it will come true. I'm not sure if this made it to the blog last week-- When Jerry was extubated and talking, perhaps last Tuesday afternoon, he suddenly and slyly mentioned "I have bad news". To which I replied, half laughing realizing a joke was coming, "lay it on me, I've had a lot of that lately." To which he replied, "I don't think I will be able to do any shopping before your birthday!" Which of course, brought a big laugh (and a few tears) and my assurance that he had outdone himself with my birthday plans last year, so I felt comfortable skipping this year. To which he replied, "Well, there's always a belated gift and celebration", thus we struck that compromise to celebrate later.
Thank you friends and family for all you've done and continue to do for us. Continue to pray, as we need your prayer so much and know that we feel your love.
Love, Deb and Jer
From Debbie
Well the medical picture here is a bit muddy, some issues are good, which I am thankful for, and other issues are more concerning. In an effort to economize time and energy I will go system by system so all of you have a complete picture.
Heart: The output numbers are good, certainly better, for which I am thankful. He is having difficultly holding his BP stable and back on Lebofed, so that is a bit of a concern. We'll keep trying for stability there.
Lungs: We probably are not dealing with ARDS and that's great. Vent settings are low and Jerry seems "comfortable" with his breathing. The vent associated pneumonia is resolved, for which I am thankful. There is a risk of reinfection, which I am hoping will not occur. The pulmonary hemorrhage situation is not worse, for which I am thankful.
Kidney: We have had a problem keeping the dialysis going, today they have replaced and repositioned the catheter and are going to start again and I am hoping 48-72 hours from now we will see improvement. He does have some output on his own which is a good sign.
Infection: No clear signs of any current viral, bacterial or fungal infection anywhere. They will discontinue some antibiotic coverage, as the concern is resistance. This is all good and I am thankful.
GI/Nutrition: Currently, this is has moved into a "top priority" to problem solve. Nutritional status is low, as is motility. The team is strategizing on this right now. Nutrition is important in infection fighting, skin quality, as well as the obvious nutritional needs.
You can see why I say the medical picture is muddy. These complications are in the "norm" for this type of event and we are fortunate that we have not had to deal with them earlier in this journey.
Specific Prayer requests:
-Gratitude that we have come this far, and continued wisdom of the medical teams.
-Gratitude that we have all of you supporting us. It means more than you could ever know.
-Protection from further complications and positive resolution to the issues we are faced with.
-Rest. For Jerry and for me.
As for me: Thank you for your many birthday wishes. Needless to say, my birthday wish is a big one, and I still have hope that it will come true. I'm not sure if this made it to the blog last week-- When Jerry was extubated and talking, perhaps last Tuesday afternoon, he suddenly and slyly mentioned "I have bad news". To which I replied, half laughing realizing a joke was coming, "lay it on me, I've had a lot of that lately." To which he replied, "I don't think I will be able to do any shopping before your birthday!" Which of course, brought a big laugh (and a few tears) and my assurance that he had outdone himself with my birthday plans last year, so I felt comfortable skipping this year. To which he replied, "Well, there's always a belated gift and celebration", thus we struck that compromise to celebrate later.
Thank you friends and family for all you've done and continue to do for us. Continue to pray, as we need your prayer so much and know that we feel your love.
Love, Deb and Jer
Tuesday, September 18, 2007
Tuesday Update - Slow Progress
Jerry is making some moves in a positive direction today. Progress is slow, but it is progress. It wouldn't surprise me if even being sedated he knows that it's Debbie's birthday.
She sounded a little more upbeat on the phone today. The past two nights she has been able to leave the hospital in the evening and sleep through the night. Not surprisingly, she has gotten to know everyone from respiratory to housekeeping. Always making friends.
Here is Jerry's health update by system:
Respiratory status: Yesterday's broncoscopy showed that the pneumonia seems to be resolved for now. The preliminary staining shows no infection in the lungs. It also showed that he probably does not have ARDS. If he does, it is not severe. He does have quite a bit of pulmonary hemorrhaging which in part is due to his compromised renal function. His body is having a hard time getting the fluid out of his lungs.
Renal status: They started a very slow, gentle dialysis, and it seems to be doing it's job.
GI: He's now getting some nutrition and that is going well. It has potentially helped the pancreatitis situation as that has also improved. They don't think the pancreatitis is acute.
Cardiovascular status: His heart seems to be profusing better and his blood pressure is holding pretty well. This morning when Debbie arrived he was off blood pressure meds. He is very sensitive to movement, though and his blood pressure goes down some when he's moved. This afternoon he is back on some blood pressure meds for a little while, but they are already titrating that down.
The Infectious Diseases team is not changing anything with his antibiotic treatment. He has 3 more days on his current course of antibiotics.
Specific prayer requests are to get him out of the woods with the complications. The complications of the heart attack are what is causing him the most difficulty. His heart seems to be holding up well. It could take a while, but we're hoping that he continues to move in the right direction.
She sounded a little more upbeat on the phone today. The past two nights she has been able to leave the hospital in the evening and sleep through the night. Not surprisingly, she has gotten to know everyone from respiratory to housekeeping. Always making friends.
Here is Jerry's health update by system:
Respiratory status: Yesterday's broncoscopy showed that the pneumonia seems to be resolved for now. The preliminary staining shows no infection in the lungs. It also showed that he probably does not have ARDS. If he does, it is not severe. He does have quite a bit of pulmonary hemorrhaging which in part is due to his compromised renal function. His body is having a hard time getting the fluid out of his lungs.
Renal status: They started a very slow, gentle dialysis, and it seems to be doing it's job.
GI: He's now getting some nutrition and that is going well. It has potentially helped the pancreatitis situation as that has also improved. They don't think the pancreatitis is acute.
Cardiovascular status: His heart seems to be profusing better and his blood pressure is holding pretty well. This morning when Debbie arrived he was off blood pressure meds. He is very sensitive to movement, though and his blood pressure goes down some when he's moved. This afternoon he is back on some blood pressure meds for a little while, but they are already titrating that down.
The Infectious Diseases team is not changing anything with his antibiotic treatment. He has 3 more days on his current course of antibiotics.
Specific prayer requests are to get him out of the woods with the complications. The complications of the heart attack are what is causing him the most difficulty. His heart seems to be holding up well. It could take a while, but we're hoping that he continues to move in the right direction.
Debbie's Birthday
Debbie doesn't want to acknowledge it, but today is her birthday. I'm sure that she could use some cheerful greetings and to know that people are thinking of her.
Feel free to comment on this post or email her. If you don't have her email please send a message to me (Lynne) by clicking the button below and I'll forward them on to her. This should reduce the potential for her getting spam in her inbox.
Feel free to comment on this post or email her. If you don't have her email please send a message to me (Lynne) by clicking the button below and I'll forward them on to her. This should reduce the potential for her getting spam in her inbox.
Monday, September 17, 2007
Monday Update from Debbie
11am Mon 9-17-07
From Debbie
Surely this has been a trying weekend.
Regarding Jerry's current status:
We are dealing with a sepsis situation. Today he will be started on a temporary, continuous, gentle form of kidney dialysis. Obviously the more organ support he needs complicates the picture. These means of support can be viewed as "bridges" to better health, or "chances" for the various systems to recover.
We have lots of "eyes on the problem", cardiac, pulmonary, renal, infectious disease and GI/nutrition teams. As well as 24 hour constant nursing care. The quality of Jerry's care both in Bloomington and here at NW has never been a concern. In addition, Jerry's cousin, Dr. Ben Taimoorazy (from Bloomington) has been watching us very closely and has truly been a great gift, for which we are thankful.
Specific prayer requests:
- Gratitude for his medical treatment and continued wisdom for his team.
- Gratitude for the love, prayers and support of our friends and family. We need and appreciate all of you.
- Request that God carry this burden of Jerry's complicated medical needs, as it is certainly too big for us alone.
As for me, I have realized that one is not particularly born with the skill set to manage a situation like this. So, I am learning, adjusting, coping and reframing as we go forward each day. My Mom was here again this weekend and that was very helpful. My current "plan" is to be a the hospital, as always, 6:30-7 am and to leave (based on the days treatment plan) in the late afternoon. It is VERY hard to leave, but I have to do it, as we are now entering week 4. It is another step I must take on this journey. I'm experimenting tonight with friends at a real restaurant for dinner. Maybe this will be another positive coping tool. I'm sure it will be good in many ways.
I've said from early in this journey that I want to handle all of the facets of this situation in a way that would make Jerry proud, as I know that ultimately I will answer to Jerry for each decision I make. My selfish prayer is that I will have the wisdom needed throughout the course of his care. I ask God for this daily.
Lastly, I want to express our gratitude to all of you who love and care for us. We could not have come this far without you. Your prayers sustain us. Your constant thoughts, notes, cards, calls, messages humble and overwhelm us. Thank you. Simply said, we feel your love.
Love, Debbie and Jerry
Sunday, September 16, 2007
Sunday Morning Update - Many Concerns
This update is written with a very heavy heart. Jerry is facing many concerns this morning. There are indications of possible general infection or sepsis. They are running tests today to determine that. He is also in renal failure and possibly has pancreatitis. He continues to have pulmonary issues.
The good news is that the echo cardiogram from yesterday showed improvement from the previous one.
His treatment plan is as follows.
- A renal team has been introduced.
- They are putting in a Swan catheter again to more closely monitor his heart.
- They may do a bronchoscope today to give them better information on his lung issues.
Specific Prayer Requests
- God's will be done.
- Thankfulness for the teams of doctors & nurses giving him quality care.
- Strength & wisdom.
- Begging God to carry this burden.
- Thankfulness for the love of friends & family.
Saturday, September 15, 2007
Saturday Update - A Day of Resting
Jerry is resting more comfortably as he is sedated. He is still supported by ventilation and will be for a while. They are trying to get him through the pneumonia and the vent is the best thing for that right now. He was probably not completely ready to be off the vent the first time, so we're looking at this as a little extra time to heal before trying again. Thursday through Friday were pretty tough on him.
The teams are trying to get him through the pulmonary issues before they address his heart issues. He is being treated for ARDS. The infectious diseases team has done a good job managing his antibiotics and he hasn't had a fever in a while and cultures have been coming back showing no additional infections. This indicates that they are on target with the course of antibiotics chosen.
They performed another Echo today, but the results aren't back yet. We'll post those results soon.
Debbie is getting some rest today. Her mom is with her and they are out getting fresh clothes and a good meal. Debbie wants everyone to know they that they feel your prayers and support. She is very grateful for the cards and emails of support and especially the prayers coming their way.
Specific prayer requests are for Jerry getting through the pulmonary issues and Debbie's renewed strength for the road ahead.
The teams are trying to get him through the pulmonary issues before they address his heart issues. He is being treated for ARDS. The infectious diseases team has done a good job managing his antibiotics and he hasn't had a fever in a while and cultures have been coming back showing no additional infections. This indicates that they are on target with the course of antibiotics chosen.
They performed another Echo today, but the results aren't back yet. We'll post those results soon.
Debbie is getting some rest today. Her mom is with her and they are out getting fresh clothes and a good meal. Debbie wants everyone to know they that they feel your prayers and support. She is very grateful for the cards and emails of support and especially the prayers coming their way.
Specific prayer requests are for Jerry getting through the pulmonary issues and Debbie's renewed strength for the road ahead.
Friday, September 14, 2007
Friday Evening Update - More Support Needed
At 5pm Jerry was reintubated. It was planned and they were able to talk to him before hand to explain why this was necessary. They have started sedation again and hopefully he will rest better tonight.
He has severe pneumonia and they suspect that he may also have adult respiratory distress syndrome (ARDS). The short-term goal is for him to rest to try and fight the worsening pneumonia.
Debbie is struggling. She is emotionally and physically exhausted. Please continue to pray for both of them.
He has severe pneumonia and they suspect that he may also have adult respiratory distress syndrome (ARDS). The short-term goal is for him to rest to try and fight the worsening pneumonia.
Debbie is struggling. She is emotionally and physically exhausted. Please continue to pray for both of them.
Friday Update. . . More Prayers Needed
Jerry and Debbie are having a difficult day. Last night neither of them got much sleep. Jerry is miserable and can't get comfortable. Debbie is physically and emotionally exhausted. She has gone to get some rest this afternoon, but separation is tough for both of them.
The biggest concerns are pulmonary. The pulmonary team has taken over as the lead team in his care until they can get him breathing better on his own. Cardiology is secondary at the moment. He has ventilator-associated pneumonia. They are taking him for a CT of his lungs today to better assess the situation. Infectious diseases has a team involved to help with determining the best course of antibiotics.
He is coherent, but very weak and still listed as critical. He knows what is going on and is fighting and trying his best to tolerate the things that need to be done to get him well. They both need our prayers. This Sunday will mark 3 weeks and today his health is still very critical.
Specific prayer requests.
1. Pray for less misery for Jerry.
2. Pray for strength for Debbie. Lift her up as she walks through this with Jerry.
3. Pray for strength for Debbie to deal with Candace and pray for Candace. Her inability to deal with the situation is adding an extra burden to all involved.
The biggest concerns are pulmonary. The pulmonary team has taken over as the lead team in his care until they can get him breathing better on his own. Cardiology is secondary at the moment. He has ventilator-associated pneumonia. They are taking him for a CT of his lungs today to better assess the situation. Infectious diseases has a team involved to help with determining the best course of antibiotics.
He is coherent, but very weak and still listed as critical. He knows what is going on and is fighting and trying his best to tolerate the things that need to be done to get him well. They both need our prayers. This Sunday will mark 3 weeks and today his health is still very critical.
Specific prayer requests.
1. Pray for less misery for Jerry.
2. Pray for strength for Debbie. Lift her up as she walks through this with Jerry.
3. Pray for strength for Debbie to deal with Candace and pray for Candace. Her inability to deal with the situation is adding an extra burden to all involved.
Thursday, September 13, 2007
Thursday afternoon update
Jerry has been having trouble breathing on his own today as the pneumonia is getting worse. He has a temperature, nausea, and hasn't been able to eat much. More to come later, in the meantime, today's prayer requests are:
1. Please pray that Jerry's lungs can heal so that he can continue to breath on his own.
2. Pray for strength and protection from infection and other complications that Jerry is struggling with at the moment.
3. Continued strength and patience for Debbie.
1. Please pray that Jerry's lungs can heal so that he can continue to breath on his own.
2. Pray for strength and protection from infection and other complications that Jerry is struggling with at the moment.
3. Continued strength and patience for Debbie.
Tuesday, September 11, 2007
Continued Progress, Tuesday update
Jerry is doing great. He had a great overnight, he finally got his coke that he wanted. He is drinking water today, resting, and later today should be able to get something to eat. He's still a little weak which is to be expected but continues to make proress. Jerry and Debbie have been going over the many cards, emails etc. that you have all been sending. Keep 'em coming, it's all been very comforting for them.
Specific prayer requests continue to be for a positive MRI and for continued strength and improvement for Jerry.
Specific prayer requests continue to be for a positive MRI and for continued strength and improvement for Jerry.
Monday, September 10, 2007
More from Deb on today's progress....
Extubation day! Immediately after Jer was talking (albeit with a rusty voice) and asking for a Coke. He is hungry and thirsty and must wait perhaps the balance of today until he can have food. However, he has used his powers of persuasion on his nurse and scored some ice chips. Cognitively he's our guy.
Future plans: 1-3 days of PT and breathing and eating and talking and understanding all that has taken place.
Next plan: Go to the MRI see what the heart is like (we hope it is better than ecco suggests) and best case scenario will be a trip to the cath lab for a stint or two and we're outta here.
Prayer Requests:
Thanksgiving that we have come so far. And we are so thankful for all of you. Each of your prayers were heard and felt and appreciated. We feel your love. I truly feel that God holds us in the palm of his hand, never coming too soon and never too late.
Future plans: 1-3 days of PT and breathing and eating and talking and understanding all that has taken place.
Next plan: Go to the MRI see what the heart is like (we hope it is better than ecco suggests) and best case scenario will be a trip to the cath lab for a stint or two and we're outta here.
Prayer Requests:
Thanksgiving that we have come so far. And we are so thankful for all of you. Each of your prayers were heard and felt and appreciated. We feel your love. I truly feel that God holds us in the palm of his hand, never coming too soon and never too late.
GREAT NEWS!
Today’s third attempt at extubation was successful and Jerry is now off of all supports!! He is awake, alert, and asking for something to eat, all of which is wonderful news. More to post later, but I wanted to make sure you all had the good news.
Sunday, September 9, 2007
Sunday afternoon update....more waiting and a little progress.
We had hoped today would be the day for extubation but the doctors thought it best to wait again until tomorrow. However, the doctors did a trial run on the extubation (not sure exactly what that means, but that's what it amounted to) and Jerry did well. All of this means we're close.
Jerry is now off sedation and is awake and alert. He is nauseated, uncomfortable and needs rest, but he certainly did show signs of progress today. Overall, we should consider the day a success.
Please continue to pray for:
1. Patience and strength for Jerry and Debbie.
2. Pray for a safe extubation on Monday.
Jerry is now off sedation and is awake and alert. He is nauseated, uncomfortable and needs rest, but he certainly did show signs of progress today. Overall, we should consider the day a success.
Please continue to pray for:
1. Patience and strength for Jerry and Debbie.
2. Pray for a safe extubation on Monday.
Saturday, September 8, 2007
More waiting and praying
Today was a day for rest and waiting as the doctors thought it best to wait one more day to try extubation. They will try again Sunday. As I mentioned, this is a critical time in terms of the secondary risks and Jerry has developed pneumonia. The doctors are treating it and we hope for a successful extubation tomorrow.
Prayer requests continue to be:
1. Pray for protection from secondary infection and illness.
2. Pray for successful extubation for Jerry.
3. Pray for continued strength for Debbie.
Prayer requests continue to be:
1. Pray for protection from secondary infection and illness.
2. Pray for successful extubation for Jerry.
3. Pray for continued strength for Debbie.
Saturday morning update
Jerry is not ready for extubation. He is still in critical condition and not quite ready so we will try again tomorrow. The risks of being intubated this long start to mount now....infection, pneumonia, etc. So please pray for Jerry's continued strength to fight off secondary complications as we wait for further progress. Also, please continue to pray for strength for Debbie.
Friday, September 7, 2007
More progress, Friday afternoon update
I certainly have seen more of Jerry's brown eyes this morning. Sedation has been off since midnight and is gradually wearing off. I am constantly with him as I'm sure he is very foggy after 12 days of sedation, and don't want him to be afraid. He is breathing comfortably on his own and looks much better. Will plan for extubation tomorrow. The process of extubation occurs more slowly as he has been sedated so long. He is running a temp of 101- 102 and white blood count is up some. Something to draw concern not alarm. He is responding to my voice and turning to find me in the room, a very good sign. (he probably wants to tell me to shut the hell up as I have been repeating myself all day, "don't be afraid, the tube is awful and you are done with it, take your time waking up and we'll take it out, etc)
I truly believe that God has gotten him this far, and after extubation the picture will change dramatically. Your words of encouragement have helped us to carry this burden. One of you wrote me that "It takes great faith to patiently wait, believing God does not come too soon or too late" no truer words were ever said.
All our love, Deb and Jer
I truly believe that God has gotten him this far, and after extubation the picture will change dramatically. Your words of encouragement have helped us to carry this burden. One of you wrote me that "It takes great faith to patiently wait, believing God does not come too soon or too late" no truer words were ever said.
All our love, Deb and Jer
Thursday, September 6, 2007
Thursday afternoon update...MORE GOOD NEWS
Jerry's doing better! The goal for today was for extubation. He must be fully awake for this proceedure. So the doctors began shutting off the sedation about 10:30 this morning and he really tried to come around, but is pretty tired after 12 days of sedation. So we are going to give him a rest until tomorrow am and try again. Don't think of this as a set back, think of it as a "dry run" for the real thing tomorrow. I saw those brown eyes a few times today, that was great. Dr. Cotts actually made a reference about Jer "walking around" before we take him back to the cath lab in today's team meeting. Seriously, I almost sobbed, that sounded so good.
God is holding us in the palm of his hand and we are forever grateful.
Specific prayer requests:
1. That the extubation goes swiftly and safely tomorrow.
2. Continued protection from further complications, (today's white count is SLIGHTLY elevated and he is running a very low temp)
3. That the outcome is one that includes, using ONLY his own body to repair itself, a quick trip to the cath lab for a stint or 2 and we're outta here.
God is holding us in the palm of his hand and we are forever grateful.
Specific prayer requests:
1. That the extubation goes swiftly and safely tomorrow.
2. Continued protection from further complications, (today's white count is SLIGHTLY elevated and he is running a very low temp)
3. That the outcome is one that includes, using ONLY his own body to repair itself, a quick trip to the cath lab for a stint or 2 and we're outta here.
Progress!
Jerry has tolerated being off the balloon pump very well. He has now been off the pump for nearly 24 hours. He has been completely weaned off supportive drugs as well. This is all very good progress. He is still in critical condition but this is good progress. We are hoping for extubation today or tomorrow. Please pray for continued improvements and for a swift and safe extubation.
Wednesday, September 5, 2007
Wed morning, test results back
The doctors continue to wean Jerry off all supports a little more, which is good. However, yesterday's echo did not show the improvement we would like to see in Jerry's heart. The team will meet today for assessment of the current treatment plan. They are still looking to get off the pump (maybe today) and the vent (maybe in a day or two).
After 10 days of spending every minute in the hospital with Jerry, I left today. I was able to spend a night in the hotel, take a shower, eat at a sidewalk cafe, and sleep in a real bed. In some ways, it has been great. In other ways, it has been quite a challenge. But it's something I needed to do. Everyday is a struggle for both Jerry and me, but we're both doing our best. Many of you have offered to come and be with us, but my family is with me now and we may need you in the future.Thank you all so much for your continued prayers and loving support. Please continue to pray for us.
Love,
Debbie.
After 10 days of spending every minute in the hospital with Jerry, I left today. I was able to spend a night in the hotel, take a shower, eat at a sidewalk cafe, and sleep in a real bed. In some ways, it has been great. In other ways, it has been quite a challenge. But it's something I needed to do. Everyday is a struggle for both Jerry and me, but we're both doing our best. Many of you have offered to come and be with us, but my family is with me now and we may need you in the future.Thank you all so much for your continued prayers and loving support. Please continue to pray for us.
Love,
Debbie.
Tuesday, September 4, 2007
Tuesday 2:30 pm update....
It’s been slow progress to wean from supports. Still waiting for results from today’s echo which will further inform us as to how much of Jerry’s heart muscle is functioning. They took a sample from his lung, to check for infection and/or leakage. As soon as echo and tests results are back, I will post here. Check back in the next few hours.
Specific Prayer requests:
1. Pray that the results of today's tests will inform us and lead us to the best decisions for Jerry.
2. Please continue to pray for strength for Debbie to carry this loving burden
The cards, and flowers are very generous. Please send cards, flowers, etc. to Jerry’s Chicago office:
Jerome Mirza & Assoc
70 West Madisoin, Suit 2060
Chicago, IL 60602
Specific Prayer requests:
1. Pray that the results of today's tests will inform us and lead us to the best decisions for Jerry.
2. Please continue to pray for strength for Debbie to carry this loving burden
The cards, and flowers are very generous. Please send cards, flowers, etc. to Jerry’s Chicago office:
Jerome Mirza & Assoc
70 West Madisoin, Suit 2060
Chicago, IL 60602
Echo this morning
Please remember to pray for positive results from Jerry’s echo this morning. Also pray for continued strength and support for Debbie as she needs it very badly. More to come later today...
Monday, September 3, 2007
Monday morning
Still more slow but steady progress. We are in the home stretch of weening hom off supports. The process is a blanacing act, but as I say, progress has been made although Jerry is still very critical condition. The next 1-2 days will be dynamic. As Jerry is weened completely off all supports, alot can happen. You can see below from the prayer requests that Jerry needs to hit specific benchmarks over the next 48 hours.
Specific prayer requests:
1. Be thankful that we have gotten this far.
2. Continued protection from further complications or setbacks.
3. Pray that Jerry can get off the Dobutamine drug, reduce his depence on the pump w/normal oxygen levels (specifically with his PEEP steady at 5) and oxygen saturation at 90 or above, and pray for a safe reduction in sedation.
4. Pray for a safe extubation.
5. Continued strength and patience.
Specific prayer requests:
1. Be thankful that we have gotten this far.
2. Continued protection from further complications or setbacks.
3. Pray that Jerry can get off the Dobutamine drug, reduce his depence on the pump w/normal oxygen levels (specifically with his PEEP steady at 5) and oxygen saturation at 90 or above, and pray for a safe reduction in sedation.
4. Pray for a safe extubation.
5. Continued strength and patience.
Sunday, September 2, 2007
Sunday Update
Slow progress but more progress nonetheless. Weening Jerry off meds and all supports could take another 2-3 more days or more. He will have his echo on Tuesday, we'll know more then.
Specific prayer requests:
1. Patience and strength.
2. Jerry to be able to stop all blood pressure meds
3. Echo will show heart is rebounding from stunned reaction to heart attack
4. Pray that the only surgical intervention will be stinting
5. Continued protection from other complications
6. Be thankful to God that we have come this far
Specific prayer requests:
1. Patience and strength.
2. Jerry to be able to stop all blood pressure meds
3. Echo will show heart is rebounding from stunned reaction to heart attack
4. Pray that the only surgical intervention will be stinting
5. Continued protection from other complications
6. Be thankful to God that we have come this far
Saturday, September 1, 2007
More waiting, but good progress!
As I'm sure you can all imagine, this has become a grueling waiting game. Although Jerry remains critical, he is making small but positive steps toward progress. The doctors continue to ween Jerry off all supports with the goal that over the next 2-4 days, his body is functioning on its own. This will allow them to proceed with surgical intervention, stinting. Jerry will undergo another echo tomorrow or Monday, at that point, we will know more about how his heart is healing.
Keep praying! Specific prayer requests for today:
Be thankful to God for Jerry's progress and that he continue to be protected from complications.
Pray for positive results on the echo.
Pray that the weening process continues to go safely and quickly!
Pray for Jerry's heart muscle to heal from the trauma so he can be stinted.
Continued patience and strength.
Thanks to you all for your continued love, prayers, and support.
Keep praying! Specific prayer requests for today:
Be thankful to God for Jerry's progress and that he continue to be protected from complications.
Pray for positive results on the echo.
Pray that the weening process continues to go safely and quickly!
Pray for Jerry's heart muscle to heal from the trauma so he can be stinted.
Continued patience and strength.
Thanks to you all for your continued love, prayers, and support.
Subscribe to:
Posts (Atom)