Monday June 30th AM
30 June 08 - 09:56
Jim had a frightening incident yesterday. His trach became plugged & he could not breath - at all. The nurse tried suctioning to no avail. I was saying " pull the inner cannula, pull the inner cannula"! He finally did & it was completely stopped up. Jim's sats (saturation of oxygen) quickly came back to normal range, but the fright of the incident left him very tense & anxious for a while; I believe he had a panic or anxiety attack. He did not know what was happening, he just knew he was very tense & anxious. It took a while to get him calmed down; And it took a while for me to calm down, too. His kids arrived shortly & Michael gave him a shave. Jim told me he asked for the shave just then, knowing it would help him to calm his nerves. When this happens again, I will just pull the cannula myself. The doctor is perfectly agreeable with this, probably due to my years of working Pulmonary Medicine. ... (more)
Saturday Evening 10 PM June 28
28 June 08 - 22:01
Jim has had a pretty good two days. We have been focusing on Scripture & just talking with each other. We are allowing each other to see & experience the other's grief more openly. I continue to be amazed at the strength Jim has through all this. Yesterday he asked me to read from the Psalms & said he wanted to hear David's crying out to God. Just as I have been thinking about this, so has he.
I do need to make a correction. It was a card from my almost family - my sister-in-law, Sherry's sister, Joyce - that sent the note about crying out to God. Today in the mail was a book The Power of Crying Out from Joyce. I read the first chapter aloud to Jim & we are both wanting to learn more about what happened when God's people cried out to Him. We were wishing we could have a Prayer Meeting in his room to cry out to God.
One of the things we miss is the privacy we once took for granted. ... (more)
Thursday Evening
26 June 08 - 21:24
Spent all afternoon with Jim after working a bit. He was really tired today, said he had problems sleeping due to needing frequent suctioning & mucous plugs in his trach. Also, he said he thinks when he has a lot of company & he talks a lot it causes increased secretions.
Later this afternoon, he began to get cold & was shivering all over. I put 5 blankets on him & after a bit I asked him how he was & he said freezing. Then he broke down, saying this is really hard, everything that has happened, & he tries to maintain because he wants to be strong in the Lord. He said when he is feeling this way he thinks of Jesus on the cross & Paul & the other Apostles & what they had to bear, and he can't feel sorry for himself very long. (Of course, I cried like a baby & finally he said to me I had to stop crying because he had.) Then we talked about a card Sharon had sent that spoke of crying out to God. ... (more)
Thursday AM June 26
26 June 08 - 07:01
Good News! Jim was seen yesterday by a Psyiatrist(?) a specialist in Physical Medicine & Rehabilitation. He found that Jim has sensation - ability to determine where he is being touched - at a C5 level. His right bicepo is firing, but not the left. He still does not have any voluntary movement below the shoulders, except for the right bicep, but this is defifnitely good news. Also, he is being weaned off the oxygen, is at 33% now rather than 40%.
Jim had no pain meds Tuesday night - was usually getting 2 Percocet at 10pm & 2am - nor any all day yesterday. He also stayed awake all day & was just getting tired & sleepy at 6pm. His spirits were good & he was encouraged. Need I add we are all encouraged, too? I believe the presence of his kids & grandson in his room make a big difference. Daughter Joey & her son Michael are here as well as Michael & Tomo & 18 month old Zumi. (Little Zumi, the ... (more)
Tuesday Morning, 6 am
24 June 08 - 06:48
First, Chris your friend is so right - It it the Faithfulness of God not anything we do! Thank you.
Jim was up in the Cadillac Chair again yesterday for 2 hours & they rigged everything so he could be pushed outside his room to the doorwy. That was good for him to see something besides the three walls usually visible to him. He coughed, again with my help, almost the entire time. While that is good for him, it literally wears me out! I spent the morning with him, son Michael spent the afternoon. Michael reported he was not able to swallow for the Speech Therapist; not ice cubes or yogurt either. While she said some good days, some not so good, it concerns me. The mechanism of swallowing works, but the "food" sticks in the area (epiglottis) where the throat divides into the esophagus & the trachea. Improper working of this area can cause the liquid to drip into the lungs. When that happens that is called aspirating. ... (more)
Sunday June 22
22 June 08 - 06:53
I stayed at the house yesterday morning to do laundry, ironing, etc not arriving at the hospital until about 2 pm. While Jim & I had talked about this, and Miles & Tracey were there when I got there, he admitted to me later that he was very lonely and wants me to come earlier & leave earlier. It seems he had a "bad" night the night before, not sleeping & not getting his pain meds as ordered & when this happens it makes for a long, "bad" day next day. He was still having the wrenching spasms & this time admitted they are painful to his shoulders.
At one point yesterday he was "snippy" with me. Rather than get my feelings hurt, I made him open his eyes & talk to me. (When he is upset or angry, he closes his eyes & shuts me or whoever out. This is his way of "walking away".) He told me he was discouraged & was feeling he would be just like this, in a bed, forever. ... (more)
Saturday June 21
21 June 08 - 06:55
Jime was doing pretty good yesterday. Two concerns: He had a positive blood culture, which means he has infection in the bloodstream. Ordinarily this would be a BIG problem, but Jim is already on two very powerful antibiotics. We do not yet know what bacteria is in the blood as this takes a few days. Pray that the meds he is already on are effective against whatever bacteria is in the blood. His temp remained down yesterday, but he had a hard chill in the early evening. I put 5 heavy blankets on him & he was still cold. (It was 113 outside.)
Second concern are the spasms he has. Until a couple of days ago the spasms were usually in response to moving his legs or another part of his body. Since Thursday morning he is having spontaneous spasms all over & when he is touched, by hand or even the sheet he has severe spasms. These make positioning him a bit harder. ... (more)
Friday June 20, Morning
20 June 08 - 07:04
Jim had a good day yesterday. His temp remained down! The heel looks at least 50% better due to the "floating". Any & every part of his body is subject to pressure problems even though he is on a special mattress.
The sugars are still high. While we understand all the factors that can impact this, we are going to ask for an Endocrinologist to see him. His sugars were much better controlled at Osborn.
The chest xray was much improved yesterday, also. Pulmonary Doc said he thought Jim had pneumonia again, but now thinks it it atelectasis - collapse of portions of the lungs. Please remember that even though Jim is off the vent, his breathing and cough will continue to be a potential problem. We all aorked hard on coughing yesterday.
There are those who you never read about here who are providing help to us on a daily basis. Without names being mentioned, please join me in prayers of thanksgiving for their time & efforts. ... (more)
Thursday June 19
19 June 08 - 07:37
Jim's temp went over 101 so they have restarted two antibiotics - Vancomycin & a new one I have never heard of before. Because of previous reactions, he has to have Benadryl also which makes him sleepy. He slept much of the day.
The Speech Therapist came in yesterday & allowed Jim to have a small container of lemon Italian Ice. Boy, did he like that. About an hour & a half later he started coughing & coughed - with my assistance - for another hour & a half. I finally got Respiratory to help & then he had a mucous plug in his trach. That was a bit scary! The Pulmonary Doc came in & said this is a problem with trachs.
I suspected Jim had aspirated the Italian Ice, but when I suggested that, he got all huffy. I will make sure the Speech Therapist knows about the long coughing and suctioing session. Aspiration can be very subtle & this is what I fear happened. ... (more)
Wednesday, June 18th
18 June 08 - 06:05
Not a lot to report as far as Jim goes: The Infectious Disease doctor visited yesterday & he said there is no apparent reason for the low grade temps that he can find. He will continue to monitor chest xrays, white blood counts & other tests that would indicate an infection somewhere. All of Jim's doctors are from Phx. St. Lukes & I am impressed with the quality of care they give & the communication to Jim & me.
We contin ue with the cough assist & this really helps. Jim was up in the chair again yesterday for a couple of hours.
Let me share with you what is weighing on my mind: When Jim is stable enough, he will have to move from Promise. It is our hope he will go to Good Sam Spinal Rehab. My notes from the Social Worker at Osborn realy that Jim must be medically stable with no blood pressure drips, must be able to tolerate 3 hours of therapy per day and have a permanent airway. ... (more)
Monday, June 16 - Evening
16 June 08 - 21:28
Jim's trach was changed today to a smaller size. The change itself went very well & then I asked what the next step will be. The Doc said this is it for now that Jim will need the trach for a few weeks or months, maybe permanently. He is in no hurry to wean him off the trach due to the large amount of secretions Jim has & the weakness of his cough & muscles. The trach is for access to the lungs for suctioning, not for breathing any longer. I like this doc & respect what he has to say as does Jim.
The Respiratory Therapists are now on "order" to check with Jim hourly to see if they can help him cough using the cough assist technique. I was taught this at Osborn & have been using it a lot. It does help Jim cough better.
When I left tonight his temp was 100.8 again. Don't know where this is coming from.
I had a hard day today, feeling blue & sad. ... (more)
Sunday June 14
15 June 08 - 21:12
Progress today! Jim was moved from ICU to another room on the same floor, room 408. At first they moved him to a room on the end of the hall & he could not be seen, even from the doorway. We rigged up a suction for his mouth & they put a special call light he could activate by moving his head, but I was a bit apprehensive. If his speaking valve should dislodge as it occasionally does & if the call apparatus was not in the proper place, he would not be able to make his needs known. As he cannot swallow properly, he has to have his mouth suctioned very frequently. I left early, before Josh & Monika arrived, as a trial run of being alone, with the intent of returning & staying the night. It is his utter dependance for the simplest things that is so heart rending. Monika called a short while later & said the Pulmonary doc had been in & was not satisfied with the room & they moved him adjacent to the nurses station so he is ... (more)
Saturday June 14
14 June 08 - 05:23
Something of significance happened yesterday. Jim had asked that his cell phone be brought to the hospital. He asked me to check & return recent calls. Two of the calls were to subcontractors he had been working with when the accident happened. As I talked with them, back to back, and began to explain what had happened to Jim, I began to cry. These men were in such a state of shock & making comments such as, "Not Jim!" "Not my buddy Jim", "I can't believe this!", "Tell me this isn't true" and on & on. I tried to talk but was becoming overwrought due to their responses. One of the men began to cry also & I looked over at Jim & tears were streaming down his face. I hung up, went to him and he said "I'm grieving over what has happened. This is the first time I've grieved over this." I tried to comfort him as best I could & he said "I don't want to dishonor God by grieving". ... (more)
Friday, June 13
13 June 08 - 08:45
I spent the day with my Mom & Brother yesterday, and Monika was on hospital duty. Not really a duty, but time we plan so Jim is not alone so much. Sorry I missed you, April & Wes. Jim was in the Cadillac Chair again for a couple of hours & as of last evening his temp had remained down, below 100.
I will update tonight or early tomorrow morning. I am torn between wanting to be with Mom & Jimmy & being at the Hospital with Jim. I may ask him to let me leave early so I can have the time here at home. They leave early Sunday morning.
Continue to pray for the temps to remain down, the decub. ulcers, strong cough & Spinal Rehab as soon as possible.
"But those who wait on the Lord shall renew their strength; They shall mount up with wings like eagles, They shall run and not be weary, They shall walk and not faint." ISA 40:31
This is our Hope, this is our prayer. ... (more)
Thursday Morning, June 12
12 June 08 - 06:54
...
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Addendum: Special Need
11 June 08 - 07:44
We are in need of a Notary. My friend Judy K. is a Notary but is out of town right now. If any of you who read this is a Notary, I would really appreciate hearing from you. You can call me on my cell at: 480-231-5655. I need & Jim agrees, Power of Attorney.
Thanks, Marilyn
Tuesday Night, June 10
10 June 08 - 21:46
Several things to report:
Jim was up in the Cadillac Chair for 45 minutes early this morning before I arrived. Did well.
When Monika & I arrived Jim's right leg and foot were swollen. Around 11 he had an episode of tightness in the chest, wheezing & shortness of breath & his color was not good, lasting about 30 minutes. This same episode repeated itself later in the afternoon. The Pulmonary Doc came to see him & ordered a STAT Cat scan of the lungs, to make sure he did not have a clot to the lungs. Jim & I travelled to St Lukes by ambulance, Josh & Monika followed in their car, had the CT & returned back to Promise. The results were negative, no clot in the lungs. But, they will do a doppler of his leg tomorrow to make sure he does not have a clot in his leg.
The Infectious Disease doc examined him & since he is 6 days there at Promise on antibiotics & because he has a severe ... (more)
Monday Night, June 9
09 June 08 - 22:58
Jim has been off the vent for over 36 hours! His sats are good, cough pretty good. He also had another swallow test today. The Therapist gave him some yogurt she had dyed blue to see if he could swallow or would he aspirate. He said it stuck in his throat, but he did not aspirate. She assured us this was common in surgery approached from the front of the neck & so high on the neck. With time she is sure as the swelling from the surgery subsides he will be able to swallow. He is now allowed one ice chip at a time.
Jim ran a low temp today - 100.3 & said he was chilled. Please pray this is not a setback, but just a normal variant. Also pray for the skin breakdowns on his bottom. Pray also we can get the collar he has worn since the accident removed. What an ordeal this icollar business s turning out to be.
My brother, Jim - Jimmy, to me - arrives Wednesday to help get Mom packed and they will leave Sunday. ... (more)
Saturday June 7
07 June 08 - 10:40
Jim continues to be off the vent as tolerated during the day. Yesterday he was for 6 hours. They have put a speaking valve on his trach that allows him to talk. It is nice to hear him speak - most of the time! (Just a little humor.) It requires more effort & work for him to talk, so I encourage him to only say what really needs to be said.
Pray for his coughing efforts. While his diaphgram is working well, the intercostal muscles are not & that causes a weak cough. Coughing adequately is imperative in his recovery now & in the future. We have been taught the "quad coug" or "cough assist", which entalis pushing hard on and up in his stomach area when he coughs. We can see this makes a difference, but it also aggrevates the GERD - Reflux - he has. They are giving him two meds for the reflux, but the assist cough stills sends acid up into his throat.
Jim's son Michael is here until tomorrow night. ... (more)
Friday, June 6
06 June 08 - 05:50
Jim began weaning off the vent yesterday. We really liked the Pulmonologist who spoke with us & will be overseeing Jim's weaning process. He said Jim can be off the vent as much as he tolerates during the day, but on the vent at night. He told us not to get discouraged that it might take a couple of weeks.
He was also seen by Physical Therapy & they will be working with him, too. Everyone is very nice & the atmosphere is much less intense than at Osborn. That is the difference between Promise & Osborn. Promise is a Long Term Acute Care or LTAC Hospital. I felt much better about my own safety during the day. It is 40 miles from my door, all freeway once I get on Hwy 60.
Even though I have tried not to think about the future & just take one day at a time, I (we) have to think about practicalities. Jim is not working & may never work again. I have now been off three weeks. ... (more)
Thursday June 5
05 June 08 - 08:12
Jim was maoved to Promise Hospital ICU yesterday. The staff were all very nice & Jim was content enough for me to leave esrly - 7:30. It is located in a not very nice area, so pray for my safety. I did & will get Security to walk me to my car if it is dark.
Jim & I discussed some personal issues & he once again affirmed to me we must trust God, as He is in control of things, not us. It is so strengthening to me to have him continue to be the spiritual leader of our home laying as he is. God is so good!
Whenever someone uses the word "Quad" or "Quadraplegic" around him, it is like a punch in the stomach. I finally asked him if he was bothered by this & he said"That's what I am" & said it doesn't bother him. What a guy! He let everyonme know at Promise what his goals are: Get off the Vent, swallow properly, lots of therapy. They were happy to know he even had goals for himself. ... (more)
Wednesday, June 4
04 June 08 - 05:53
Much better day yesterday. Even with the PEG & the bronchosvopy being - at separate times - & the sedation from them, Jim was in his usual good mood & praising God. Good visits yesterday that strengthened our hearts & increased our faith.
He will most likely be moved to Promise today. All that is requird is that all the Docs sign off for him to go. I do expect this to happen unless there was something overnight I am not aware of at this time. Thie move requires TRUST on our part. Jim & I have not talked about this aspect, but new staff, new doctors, new philosophies of care, most likely out of ICU. Pray that I can trust that Jim will be taken care of properly. Since he cannot speak, the only way he can make a need known is clicking his mouth. Please pray he will be near to the nurse's station so they can hear him.
We read from the first 6 chapters of Revelation yesterday. ... (more)
Tuesday, Jume 3
03 June 08 - 06:32
Only time for a quick note today.
Jim got a new mattress that alternates pressure points. This should help with the areas of breakdown.
The fevers continue. They will put in a PEG tube today for feeding - see previous entires - and do a bronchoscopy at the same time. They hope to be able to get a sample of the fluids deep in his lungs to culture. He also had another CT scan of the lungs last night.
Jim slept all day yesterday & when I would awake him, he was disoriented & confused at times. I am not sure what to make of this, but will ask the docs today if I get a chance to grab them. Monika & I sat in Jim's room from 9:45 yesterday morning until 9:30 last night with a lunch & dinner break. Jim was not awake more than 45 to 60 minutes at the most the whole day & when awake, not always alert.
Pray for me, please. I am tired & weepy today. ... (more)
Monday, June 2, Jim Speaks
02 June 08 - 06:32
Jim Speaks: We request specific prayer for Infection (lung infiltrates), fevers, anything preventing leaving the ICU.
Thanks to all for your prayers. We can feel them, know when you are praying. We don't need to know the What, When, Why or How. We only need to know God has the answers to these questions & answers them in His time & to His glory because He loves us so much. Every week I pray , God speaks. I will try to keep you informed of what God shares with me. I ahd encouraging words from a visitor . Our neighbors, Bill & Amy, have a friend who was working near to me. He said he has seen full recovery in one year from an accident such as mine. This was someone in their 4X4 Club. More to come.......
From Marilyn: Jim & I had a wonderful time of Scripture & prayer yesterday. The discouragement of the last few days has lifted from Jim's countenance. ... (more)
Sunday, June 1
01 June 08 - 07:05
Not a lot new to report. Jim's temp over 103 last night. Jeff, Sue, Josh Monika & I were all wetting him down with ice, cool cloths & a fan. He has also developed a rash, probably from some medication.
Jim is a bit discouraged from what he views as slow progress. He is tired of the vent, tired of all the wires, and wants therapy. At this point all he can get is Passive ROM - range of motion - to keep his joints moving & prevent contractures. Pray for him to accept what is, not what he wants, right at this time.
I get conflicting messages about the move to Promise. Some say they won't transfer him with high fevers, some say the fevers are spinal or neuro fevers & he can transfer anyway. The staff at Scottsdale Osborn is wonderful & he has gotten excellent care. But, I too, am ready for progress, for Jim's sake.
The area of breakdown I mentioned previously is not healing yet. ... (more)
