Hi all. A further update on Daddy here. Today, as we all know, was Mama's 83rd birthday! Happy Birthday Mama!
I picked her up this morning and we proceeded to St John's hospital to see Daddy. He woke up shortly after we arrived and was surprised to see me there, too. He realized after a while that today was Mama's birthday and mouthed Happy Birthday to her. He next wrote me a note to tell me to go buy her a birthday present from him to her and that she should write a check for it. I showed the note to Mama and she laughed and told him loudly in his right ear that she needed no birthday present from him except that he should cough up all the crud in his chest, get better, and get back home with her. Sixty-one years of married bliss showing up in all its glory there.
The nurse told Mama and me that Daddy had had his last dose of morphine at 9:40am and that he couldn't have another one until 1:40pm. Daddy was complaining of pain in his belly, throat and chest. This was at 10:00am. Daddy and Mama told everyone who entered his room that I was his daughter and that I was a nurse, to which they replied "we know." Mama expounded telling each of them that another daughter had taken off work and spent the last 2 days with them and that they didn't know what they would do without her. I told them that there were four of us daughters and that we'd each be taking turns being with them and making sure that they were ok. Mother was concerned about Shari's schooling obligations and told everyone proudly that she is working toward her Master's Degree and is very busy every day. In short, our parents are extremely proud of their children.
Daddy has thrush in his throat making sipping virtually impossible. He silently screams out in pain when attempting to do so. He has no voice. A first for our Daddy! He can whisper, which comes out in puffs of breath and I must lean my ear into his mouth to "hear" it and finally can understand it after several tries. He tries to write down what he is saying, but his handwriting is wavery and his strength is slight. We eventually understand what he is trying to communicate, but it is very taxing. He falls asleep often in the middle of an exchange and then awakens a few minutes later looking a bit surprised by his surroundings.
He was wearing a diaper, had an IV going with fluids in it, and sleeping with his mouth open and a gurgly sound coming from his lungs. At about 11:00am, Dr. Patel, an associate of his oncologist, Dr. Kovitz, came to visit him. Daddy became alert and answered Dr. Patel's questions, with me interpreting, throughout his stay. Dr. Patel explained that Daddy was neutropenic, meaning his white cell count is very low and that is why everyone in his vicinity must wear masks to keep from breathing germs on him. Also, that he thinks Daddy had a partial bowel obstruction because at some time during the night he passed a "semi-normal" stool. So, he believes that the constipation Daddy had experienced prior to his hospitalization was due to a stool that would not come out and then he had diarrhea passing around that and thus he became dehydrated. He said that all of these things were due to the last chemotherapy Daddy received a little over one week ago.
Also, he has the yeast infection, or thrush, in his throat, which is terribly painful, and it appears that he also has pneumonia. Daddy has been coughing up phelgm all day, greenish and sometimes bloody. Also, his liver tests are up, meaning that his liver is not working properly. Daddy's abdomen is swollen, although his arms and legs are skinny as can be. This is probably from his inflamed liver. Dr. Patel said that his liver problems are a combination of the tumor, which has grown from 5 cms. to 10 cms. and also from the assault of his latest chemotherapy treatment, which his liver is trying to rid from his body and fighting a tough battle on.
Daddy was still breathing room air at this point in the day and his oxygen saturation levels were about 95% which is ok. Dr. Patel said that Daddy would remain hospitalized throughout the weekend at least and that he would be the one to come in on Friday and that Dr. Kovitz would be back on Saturday. He was a kind and caring man, just as Dr. Kovitz is. I felt relief that Daddy is in his care. Daddy's legs are hurting him and I asked Dr. Patel if he needs TED hose, which are those tight leggings to help prevent blood clots from forming in the legs from too much lying in bed. He said that he would order them, but they still haven't been placed on Daddy. I will follow up on this in the morning.
Soon after Dr. Patel left, the tech (nursing assistant) came in the room to take Daddy's vital signs. His blood pressure was 80/44, which is very low, and his heart rate was 123, which is very high. These are signs of dehydration. The nurse was called in and she called a "rapid resonse team" meeting which consists of a nursing supervisor, the bedside nurse, a respiratory therapist, and the internist doctor. They came in and checked his oxygen saturation, which was still good at 93% and the doctor then said to give him a fluid bolus. So he squeezed Daddy's IV bag until 500 ccs went into him and then his blood pressure came up to about 120/60 which is good, but still low for Daddy. His heart rate went from 123 to 89, so that was good too. I wrote notes to Daddy throughout this time to explain to him who the various people were in his room and what they were doing. The nursing supervisor asked if Daddy was a "full code" meaning that everything that can be done for him would be done in the event of his heart stopping or his breathing stopping. So, Mama said that yes it should all be done. The doctor and nurse acknowledged this and later in the day, the nurse gave Mama back the copy of Daddy's "living will" that he had signed back in June, which states that he wants no heroic measures.
The internist also said that he thought that Daddy should have a PICC (Peripherally Inserted Central Catheter) line implanted because his veins are shoddy and he has already been stuck several times for peripheral IVs. These lines go into the inner elbow area and are very long and can last a long time and they can give fluids and medication in them and also draw blood from them. Mama said yes and Daddy agreed to have this done. Daddy's next possible dose of morphine was due at 1:40pm and so Mother and I decided that after he received that, that we would go out to lunch at Luby's. At 2:00pm, the nurse finally showed up to give him the morphine. We told him that we were leaving for lunch and he said ok.
Then the dietician met us in the hallway and we talked to her for a while about his not being able to tolerate anything by mouth because of the pain in his throat. Then, a delivery person showed up at the door with a beautiful vase of flowers for Daddy and a wrist corsage, smaller but made of the same flowers for Mama for her birthday, both from Beti and Herb. We brought them in to show Daddy and he was delighted, as was Mama with her gorgeous corsage. Meanwhile, the doctor told us that we no longer need to wear masks at Daddy's bedside because his white blood cell count had increased to half that of normal. So, good news there. Before we could leave, the PICC nurse arrived and said that she'd be putting in his line and that we would have to leave during the procedure. So we went to lunch.
Mother had shrimp and fries with a combination carrot/cheese cake for desert. She had me share the cake which was delicious and she took most of the shrimp dinner home with her in a styrofoam container to finish later. She said that with everyone's cards, gifts, and well wishes that she was having a happy birthday even though it was also very tough with Daddy's condition happening at the same time. When we got back to the hospital, Daddy's bed had been removed from the room. We found the nurse who explained that it had been difficult for the PICC nurse to get the line in him so they were doing it via fluroscopy in the fluroscopy suite and that Daddy understood that and had signed the consent for it himself. After about ten minutes they wheeled Daddy back into the room with oxygen in his nose via nasal cannula because his breathing became rougher during the procedure. The line is in his left elbow. After a while, the nurse finally got a Fentanyl patch for pain, which the internist had prescribed for him.
Daddy urinated 350ccs after no urine for 2 days. His blood pressure continued to be good at about 120/60 and his heart rate maintained at about 90. After spraying chloraseptic spray in his throat Daddy drank a big sip of his Juice drink and ate one or two bites of a popsicle from his dinner tray. To backtrack, when we first came back from lunch and found Daddy gone to fluroscopy, it was time for Mother's appt with Dr. Winfield about the abcess on her face. So we went over there and Dr. Winfield said to keep taking the antibiotic she is on and call him Monday for an appt if it hasn't gotten better.
At about 6:00pm, Mother and I were very exhausted and Daddy was able to sleep a bit so we told him that we were leaving for the night. He had his nurse call button, his suction apparatus, his chloraseptic and his pad and pen within reach and he mouthed that we should "go." We kissed him goodbye and then stopped by the nursing station to let them know that when he pushes the call button, to go to him rather than talk over the intercom because he cannot hear anything. The secretary said she would pass this on to the night shift. We will return in the morning. More updates later...
I picked her up this morning and we proceeded to St John's hospital to see Daddy. He woke up shortly after we arrived and was surprised to see me there, too. He realized after a while that today was Mama's birthday and mouthed Happy Birthday to her. He next wrote me a note to tell me to go buy her a birthday present from him to her and that she should write a check for it. I showed the note to Mama and she laughed and told him loudly in his right ear that she needed no birthday present from him except that he should cough up all the crud in his chest, get better, and get back home with her. Sixty-one years of married bliss showing up in all its glory there.
The nurse told Mama and me that Daddy had had his last dose of morphine at 9:40am and that he couldn't have another one until 1:40pm. Daddy was complaining of pain in his belly, throat and chest. This was at 10:00am. Daddy and Mama told everyone who entered his room that I was his daughter and that I was a nurse, to which they replied "we know." Mama expounded telling each of them that another daughter had taken off work and spent the last 2 days with them and that they didn't know what they would do without her. I told them that there were four of us daughters and that we'd each be taking turns being with them and making sure that they were ok. Mother was concerned about Shari's schooling obligations and told everyone proudly that she is working toward her Master's Degree and is very busy every day. In short, our parents are extremely proud of their children.
Daddy has thrush in his throat making sipping virtually impossible. He silently screams out in pain when attempting to do so. He has no voice. A first for our Daddy! He can whisper, which comes out in puffs of breath and I must lean my ear into his mouth to "hear" it and finally can understand it after several tries. He tries to write down what he is saying, but his handwriting is wavery and his strength is slight. We eventually understand what he is trying to communicate, but it is very taxing. He falls asleep often in the middle of an exchange and then awakens a few minutes later looking a bit surprised by his surroundings.
He was wearing a diaper, had an IV going with fluids in it, and sleeping with his mouth open and a gurgly sound coming from his lungs. At about 11:00am, Dr. Patel, an associate of his oncologist, Dr. Kovitz, came to visit him. Daddy became alert and answered Dr. Patel's questions, with me interpreting, throughout his stay. Dr. Patel explained that Daddy was neutropenic, meaning his white cell count is very low and that is why everyone in his vicinity must wear masks to keep from breathing germs on him. Also, that he thinks Daddy had a partial bowel obstruction because at some time during the night he passed a "semi-normal" stool. So, he believes that the constipation Daddy had experienced prior to his hospitalization was due to a stool that would not come out and then he had diarrhea passing around that and thus he became dehydrated. He said that all of these things were due to the last chemotherapy Daddy received a little over one week ago.
Also, he has the yeast infection, or thrush, in his throat, which is terribly painful, and it appears that he also has pneumonia. Daddy has been coughing up phelgm all day, greenish and sometimes bloody. Also, his liver tests are up, meaning that his liver is not working properly. Daddy's abdomen is swollen, although his arms and legs are skinny as can be. This is probably from his inflamed liver. Dr. Patel said that his liver problems are a combination of the tumor, which has grown from 5 cms. to 10 cms. and also from the assault of his latest chemotherapy treatment, which his liver is trying to rid from his body and fighting a tough battle on.
Daddy was still breathing room air at this point in the day and his oxygen saturation levels were about 95% which is ok. Dr. Patel said that Daddy would remain hospitalized throughout the weekend at least and that he would be the one to come in on Friday and that Dr. Kovitz would be back on Saturday. He was a kind and caring man, just as Dr. Kovitz is. I felt relief that Daddy is in his care. Daddy's legs are hurting him and I asked Dr. Patel if he needs TED hose, which are those tight leggings to help prevent blood clots from forming in the legs from too much lying in bed. He said that he would order them, but they still haven't been placed on Daddy. I will follow up on this in the morning.
Soon after Dr. Patel left, the tech (nursing assistant) came in the room to take Daddy's vital signs. His blood pressure was 80/44, which is very low, and his heart rate was 123, which is very high. These are signs of dehydration. The nurse was called in and she called a "rapid resonse team" meeting which consists of a nursing supervisor, the bedside nurse, a respiratory therapist, and the internist doctor. They came in and checked his oxygen saturation, which was still good at 93% and the doctor then said to give him a fluid bolus. So he squeezed Daddy's IV bag until 500 ccs went into him and then his blood pressure came up to about 120/60 which is good, but still low for Daddy. His heart rate went from 123 to 89, so that was good too. I wrote notes to Daddy throughout this time to explain to him who the various people were in his room and what they were doing. The nursing supervisor asked if Daddy was a "full code" meaning that everything that can be done for him would be done in the event of his heart stopping or his breathing stopping. So, Mama said that yes it should all be done. The doctor and nurse acknowledged this and later in the day, the nurse gave Mama back the copy of Daddy's "living will" that he had signed back in June, which states that he wants no heroic measures.
The internist also said that he thought that Daddy should have a PICC (Peripherally Inserted Central Catheter) line implanted because his veins are shoddy and he has already been stuck several times for peripheral IVs. These lines go into the inner elbow area and are very long and can last a long time and they can give fluids and medication in them and also draw blood from them. Mama said yes and Daddy agreed to have this done. Daddy's next possible dose of morphine was due at 1:40pm and so Mother and I decided that after he received that, that we would go out to lunch at Luby's. At 2:00pm, the nurse finally showed up to give him the morphine. We told him that we were leaving for lunch and he said ok.
Then the dietician met us in the hallway and we talked to her for a while about his not being able to tolerate anything by mouth because of the pain in his throat. Then, a delivery person showed up at the door with a beautiful vase of flowers for Daddy and a wrist corsage, smaller but made of the same flowers for Mama for her birthday, both from Beti and Herb. We brought them in to show Daddy and he was delighted, as was Mama with her gorgeous corsage. Meanwhile, the doctor told us that we no longer need to wear masks at Daddy's bedside because his white blood cell count had increased to half that of normal. So, good news there. Before we could leave, the PICC nurse arrived and said that she'd be putting in his line and that we would have to leave during the procedure. So we went to lunch.
Mother had shrimp and fries with a combination carrot/cheese cake for desert. She had me share the cake which was delicious and she took most of the shrimp dinner home with her in a styrofoam container to finish later. She said that with everyone's cards, gifts, and well wishes that she was having a happy birthday even though it was also very tough with Daddy's condition happening at the same time. When we got back to the hospital, Daddy's bed had been removed from the room. We found the nurse who explained that it had been difficult for the PICC nurse to get the line in him so they were doing it via fluroscopy in the fluroscopy suite and that Daddy understood that and had signed the consent for it himself. After about ten minutes they wheeled Daddy back into the room with oxygen in his nose via nasal cannula because his breathing became rougher during the procedure. The line is in his left elbow. After a while, the nurse finally got a Fentanyl patch for pain, which the internist had prescribed for him.
Daddy urinated 350ccs after no urine for 2 days. His blood pressure continued to be good at about 120/60 and his heart rate maintained at about 90. After spraying chloraseptic spray in his throat Daddy drank a big sip of his Juice drink and ate one or two bites of a popsicle from his dinner tray. To backtrack, when we first came back from lunch and found Daddy gone to fluroscopy, it was time for Mother's appt with Dr. Winfield about the abcess on her face. So we went over there and Dr. Winfield said to keep taking the antibiotic she is on and call him Monday for an appt if it hasn't gotten better.
At about 6:00pm, Mother and I were very exhausted and Daddy was able to sleep a bit so we told him that we were leaving for the night. He had his nurse call button, his suction apparatus, his chloraseptic and his pad and pen within reach and he mouthed that we should "go." We kissed him goodbye and then stopped by the nursing station to let them know that when he pushes the call button, to go to him rather than talk over the intercom because he cannot hear anything. The secretary said she would pass this on to the night shift. We will return in the morning. More updates later...
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