Dialysis began around 1:30 and so far so good. She is tolerating everything well so far and is waking up a little more which is a good sign.
Their goal is to pull 3 liters of fluid off her body which is a LOT when you think of a 2 liter soft drink. They are almost at her goal. Her hands and feet are VERY swollen, so that should hopefully resolve soon. If she does not start producing urine tonight, they will do another dialysis tomorrow. Hopefully she will only need a round or two before they begin to function on their own. As her renal doctor told me, she has 84 yr. old kidneys and sometimes it takes them longer to wake up again.
Her surgeon came by and said he is very pleased with everything else and we just need to get this kidney issue resolved.
Pat, Melinda and Adri came up to visit during her dialysis and we've all been allowed to say in her room during the procedure (once the central line was in place). It's certainly been an education for all of us. It's amazing to see the amount of equipment that does the work for our two tiny kidneys!
Mom had a fairly uneventful night (in fact we both got about 4 hrs. uninterrupted sleep) and she was looking pretty good this morning. She even enjoyed a bed-bath including a shampoo which she said felt wonderful.
Unfortunately, the news shortly thereafter wasn't what we wanted...her kidney function isn't improving. She's still not putting out enough urine even on high doses of diruetics and the fluids are building up again. They've decided to do a slow dialysis today and possibly tomorrow to see if that will take the burden off the kidneys and hopefully they will "reset" and resume functioning on their own.
So, please say a little extra prayer for her today that her doctors are at their best and that her kidneys regain their full function.
Another busy day of lab work, pt, breathing treatments, etc. Back up in the chair this evening for a few hours and to eat dinner. Pat, Steve & Melinda all stopped by for visits, along with the Hospital Chaplain. While Pat & Melinda are there this evening, Jan is home for a shower, a change of clothes and dinner before returning for the overnight shift.
Hopefully Mom will rest better than last night.
Primary concern is still the kidney output which is low but they're adjusting meds to correct it. The drs. say this is somewhat normal, especially considering that she was having problems before the surgery and had been in the hospital 2 wks. prior. So, not time to panic just yet but she's still very swollen and needs to get the fluid off her body.
Other than that, she is in good spirits, good humor and managable pain. She doing her PT exercises and not complaining about anything. She's a real fighter and a trouper and a real inspiration to all of us.
Had a little bit of a restless night but finally settled down about 2:30 am. A little disoriented but nothing serious. The main concern right now is kidney function because her outputs dropped. I stayed the night with her just so she'd have a familiar face when she woke up during the night.
Up at 5:00 am for a bath and to sit in her chair. Much stronger today...she actually got her legs under her which was MUCH improved over yesterday when she had no strength at all. She's still sitting in the chair at 9:00 am and has had 1 1/2 slices of french toast a little fruit and a cup of coffee. And, she fed herself, unlike yesterday when we did everything for her.
She was also totally off oxygen for at least 1/2 hr. with great oxygen sats, so they've reduced the flow on her mask and she will only use the full bi-pap machine when she's sleeping. She's been doing a little range of motion movement and PT is supposed to come in later to start some rehab...baby steps.
The primary concern right now is her kidney function but the doctor has already been here and he's going to increase her diuretics to see if that will pull some of the fluid off her body. He said it's "of concern" but not to "be concerned" because he expects that she will respond nicely as she has in the past. Definitely keeping a very close eye on this right now.
Other than that, everything is looking very good and things are definitely moving in the right direction.
Next update will probably be this evening. Thanks for all the kind messages and words of support...we all appreciate it!
Thurs 11-18 8:30 pm Busy day....getting ready for bed
Journal posted on November 18, 2010
Things have been going well for first day post-op. Getting disconnnected from many tubes...allowed to drink fluids most of the day and even got to eat a little scrambled eggs for dinner.
Dr. Ryan stopped by again and is still pleased with her progress. They had her sitting in a chair from 4:30 to 8:00 which was her "exercise" for today. Still very weak and needed a lot of help moving from bed to chair and back but she sat there all that time without a problem.
Pat, Melinda and Aidry were here for a long visit this evening but have gone home.
The nurses are getting her situated for bed, back on the bi-pap, etc. so she can get some good sleep. I'll be staying the night with her since she's more alert just so she has a familiar face here if she wakes up and is disoriented.
Mom is fully awake and feeling good. Pat is here with Jan right now and they just let us feed us her a red Popsicle which she REALLY enjoyed and if she tolerates that well she may get a tray with something like to eat a little later.
Her short term memory is good and her first real smile was when I read her message from Tom B! I was afraid it might set off her alarms but all was ok.
She is sitting up in bed and even asked to be turned slightly so she's not flat on her back. She asked for the bi-pap machine because it helps with her breathing but everyone says she's doing extremely well
for just 24 hrs. Post op.
Mom is still doing great...in fact she is off the ventilator and on bi-pap to asset with her breathing until she's a little stronger. They said she did great all night and stats are good. She's been awake this morning and recognized me and even spoke to Chris and me. Of course she's still pretty sedated but responsiveness is a very good sign.
The staff here is wonderful and we know she is in the best of hands.
Will update later with any news or significant changes.
Still doing great....the doctors are very pleased with her stats. Of course she is heavily sedated but they are monitoring everything very closely tonight. She still has the breathing tube which will probably come out tomorrow morning. At that point, they'll start to wake her up and unfortunately she will become aware of what's going on. We are not looking forward to that part but we know they will keep her as comfortable as possible. Long day for everyone but we appreciate everyone's thoughts and prayers for her recovery. Will update as time permits.
We've all been in to see her briefly and she's doing great...still knocked out but responding to commands like "wiggle your toes". Probably wont be much to report this evening ....just consider no news is good news and well update if anything changes.
Dr Ryan just came put to let us know that Mom is out of surgery and doing well. We should be able to see her in an hour or so. He is very pleased so far and just need to keep things moving in a positive direction. Wil update later
Good news...bad news. Everything is going well but they are doing both the mitral and aortic valves so they had to do the full open chest surgery rather than the minimal procedure. The mitral valve is done and they are starting on the aortic now. About half-way through so will be another 2-2 1/2 hrs.
Just took Mom down about 15 Mins ago. She had a good night and was in good spirits this morning....except for wanting some coffee! Jan, Pat, Chris & Melinda were all here to see her off and Steve will be coming up a little later so she has her cheering section in place and knows all of younger here with her in spirit.
They expect the surgery to last at least 2-3 hrs and longer if they decide to do the mitral valve as well. They will call us when the surgery begins and then give us updates every 2 hrs or so after that. She will be brought back to her room after surgery and we'll all be allowed to she her as soon as she's stabile.
Will keep you posted throughout the day as things progress. Thanks for all the prayers.
Just left Mom at 10:00 pm...busy evening with dinner and then routine breathing treatments, bathing, finger pricks (for blood sugar) etc. Everything is still GO for first thing Wednesday. We are all planning to be there to see her beforehand.
With this universal care protocol, she will come directly back to her room and once they have everything stabile we will be allowed to see her 2 at a time for a few minutes. The nurse tonight gave us a good idea of what to expect post-op and it doesn't sound like fun but at least we are prepared.
She is receiving EXCELLENT care and we are all impressed with the level of nursing care she has already received and have been told that the post-op nurses are even better...at least better trained for the critical care needed for "fresh hearts" as they call them.
Thanks for the continued messages, prayers, etc. I'll update the journal as soon as possible after surgery as I know everyone is concerned.
Dr. Ryan's first surgery ran much longer than expected so they've put her back on the schedule for first thing tomorrow. Disappointing but we'd rather have a fresh surgeon than a tired one. So, she's resting comfortably and about to finally get something to eat.
Jan reporting in...finally arrived from Atlanta this afternoon and went straight to the hosptial. Things got busy shortly thereafter with transferring Jean from MCA Plano to Baylor Heart Hospital-Plano. Steve arranged with his wonderful dept. to transport her by ambulance (see photos), so she got the royal treatment and he got to ride with her as her personal Paramedic.
She skipped admitting and went directly to her "guest suite" which is what they call their patient rooms, and they processed her in there. This hospital treats only heart patients and is set up as "universal" care, which means that they bring the level of care to the patient, not the other way around. In other words, she will be in the same room for the duration of her stay, including post op ICU, x-rays, etc. Meals are ordered like Room Service at a 5-star hotel...tonight she dined on filet mignon, baked potato and cheesecake for dessert! Of course, from the diabetic, heart-healthy menu.
Dr. Ryan (the surgeon) stopped by and will review more of her tests tomorrow but said she is definitely GO for Wednesday. At this point he is still hoping to do the minimally invasive procedure that could change depending on her test results and what he determines needs to be done (one valve or two, etc.)
Tonight they inserted a pic line (sort of like a central line, except through the arm not the neck) rather than relying on an IV since they will have many meds to administer in the coming days. She was also having shortness of breath again, so they put her on a C-Pap machine which is supposed to help her breathe and push the fluids out of her lungs. She was undertandably very tired after all of today's activities, so Pat, Melinda and I said good night to let her get some rest.
I will be back up at the hospital in the morning to track down one more report that Dr. Ryan needs and spend some time with Mom. Chris is coming in from Little Rock tomorrow as well.
We are all very thankful that she is such a good patient and taking all of this in stride. We are most grateful that a bed was available at the Heart Hospital and that Dr. Ryan could perform her surgery. He is the valve surgery "guru" and definitely our first choice. We are very optimistic that things will continue to go well and once she recovers from the surgery itself that she will feel better than she has in years.
Thanks again for all the thoughts, prayers and well wishes. She may be on-line tomorrow but after that, it will most likely be awhile before she's feeling up to computer time.
Here's the hospital info:
The Heart Hospital
1100 Allied Drive
Plano, TX 75093
She's in Room 219. That's all for now...I'll update again when we have more news to report.
Dr. Ryan's office just called Pat and they've tentatively scheduled Mom's surgery for Wednesday, Nov. 17. The REALLY good news is that they are planning to do the Minimally Invasive procedure (barring any unforeseen complications). This procedure will be much shorter and require much less recovery and rehab time, which is fabulous!
Mom will most likely stay at the current hospital over the weekend and be transferred to Baylor Heart Hospital of Plano on Monday.
Thanks again for all your prayers and concern....they're definitely working!
Just spoke to Mom and unfortunately she had a tough night. Apparently the fluids started backing up again making it hard for her to breathe again. They have increased her Lasik to get things back in order. She is also going in and out of A-fib which isn't good.
Pat is going to take her records to the surgeon today. We hope and pray that he will agree that she needs surgery NOW, rather than wait 2-3 weeks. We are concerned that if she comes home before surgery, that she will continue to have problems and end up back in the hospital anyway.
We apprecate everyone's prayers that this is over soon and Mom can get on with the rehab and recovery phase.
Wednesday, November 10, 2010 - Angiogram Completed!
Journal posted on November 10, 2010
Pat just called to say that Mom's angiogram went very well. Once they finally came for her, it took much less time than expected...about an hour.
The doctor said they didn't have to use much dye (which is good) and were able to get a good view. The GOOD news is there are no blockages or other problems to prevent her surgery from moving forward. Only saw a small amount of plaque but apparently of no concern.
She is awake, although a little groggy but they are about to bring her back to her room from recovery. The worst part for Mom is having to lay flat on her back for 4 hrs, since it's hard for her to breathe in that position. Hopefully, she'll still be a little sleepy and it won't bother her too much.
Pat will take all her test results to Dr. Ryan tomorrow and hopefully we'll know pretty soon when they can schedule the surgery. Her cardiologist says that she will probably stay at this hospital for a couple more days to make sure there are no ill effects from the angio. We're hoping that they will transfer her directly to Baylor Heart Center and not send her home before the surgery.
It's been one week since being admitted to the hospital and still trying to get my kidney function leveled off before they will do the angiogram (which is hard on the kidneys). Still haven’t seen Dr. Ryan but as soon as they complete the angiogram, Pat will take my medical records to his office and then get things rolling.
The angiogram has been delayed until kidney levels stabilize. We also found out yesterday that I have a urinary tract infection so they are treating that as well. The pulmonary doctor came in yesterday and gave his “green light” for the surgery. So for now, it’s just waiting for the “green light” for the angiogram…which might be another day or two. They have switched me to oral medication now instead of intravenous.