Tom's Diary

Today’s Activities

• Shower.  DONE.
• Cat duty.  Sister Jojo performing this until I return home.

Log

04:00 AM: I woke up prematurely to find [Emmy] moaning in stomach pain.  Apparently the pain medicine she took last night for her hands did not agree with her.  She tried drinking ginger ale, but that didn’t help.  Then she ate a quarter-cup of Wheat Chex; still, no improvement.  After a half-hour or so, she threw everything up.  Now that helped.  I sat with her for another hour, and then we both went back to sleep.

09:00 AM: I’m up. 

10:15 AM: I’m walking to the hospital now to be with Mom.  Back later.

02:15 PM: Ate lunch at Panera Bread on Forbes Ave. with sister Christine, sister Jojo, and Jojo’s daughter Catie.  Had soup and a sandwich. 

03:15 PM: I’ve returned from the hospital and am back at [Emmy's].  Now I’m blogging, to record the information gathered in this latest visit. 

04:25 PM: I’ve finished typing in the information.  Nap time.

06:15 PM: I’m back up again. 

07:00 PM Ate cereal for supper and am now heading to the hospital.  Back later. 

09:10 PM: I walked both to and from the hospital tonight, and got caught in the rain.  Talked to sister Christine as I walked, as the Steelers scored a touchdown in their first pre-season game of 2010.  But as the strength and size of the drops increased, I got off the phone and put it in my pocket where it would stay dry. I only had five minutes more to walk anyhow, and it was a good thing that I brought an umbrella.

11:00 PM: I just hung out, either in front of the computer or the TV, to try and wind down from this very sad and stressful day for my family.  Off to bed now.  Hopefully tomorrow, we’ll start seeing some real decreases in Mom’s over all pain level.  Good night. 

Tom Hesley

Received Mail and Shipments

None today.

Related Posts

• Mom’s Status: 2010-08-14
• Today’s Diet: 2010-08-14
• Weight Loss: 2010

Summary

Mom in much pain today and last night, and demanding to be taken home.  Doctors say her heart does not function well; even if her valves were one hundred percent efficient.  But the antibiotics seem to be gaining ground on her infection, as her blood cultures have tested negative ever since she arrived in Pittsburgh.  They do not recommend surgery at this time to clear the spot in Mom’s heart; suggesting instead that we allow the antibiotics more time to work.  Though not likely, they may clear some of the spot if that spot is in fact vegetation. 

Pending Objectives

• Get council on results of the 2010-08-13 mid section CT scan and arterial doppler study. 
• Verify Mom’s code status.  DONE.
• Find out if that “flapping object” was present in Mom’s heart in her 2008 echo cardiograms.  DONE.  It was not present.  This is a new development since 2008. 

Log

10:00 AM: Talked to Kelly at Mom’s hospital.  They have received Mom’s medical records from Johnstown. 

10:45 AM: Leaving for the hospital.  Details of the visit follow:

• 11:05 AM: We arrived.  No results from yesterday’s tests so far.
• 11:10 AM: Mom’s records indicate a full-code response should her heart stop.  We’re talking with the doctors to make sure they honor Mom’s wishes in this matter.
• 11:15 AM: Nurse says that Mom had another painful night.
• She also said that they found some bleeding in the pelvic area but that this is a “stable” bleed.
• She received two units of blood overnight.
• 11:20 AM: Sisters Christine and Jojo arrive along with niece Catey.
• 11:20 AM: Cardiac surgeon stopped by. 
• 11:20 AM: Aortic valve working well.  But there is a spot above that valve that could either be calcification or a fatty deposit.  But it could also be the infection.  But they’re not sure which it is yet. 
• Blood cultures negative and Mom’s temperature is near normal.
• This doctor’s recommendation: Do no surgery to remove this spot at this time.  Continue treating with antibiotics and monitor progress over the next week. 
• He said though that Mom’s heart does not function well due to long-running and severe heart disease. Even if the valves were completely efficient, she’d still suffer symptoms of weak blood pumping by the heart.  So it’s likely that she would have experienced shortness of breath, even after her valve replacement in 2008. 
• 11:30 AM: Mom started waking up and experiencing more pain. 
• 12:00 PM: Mom started profusely calling for help.  We comforted her by helping her twist and turn and shift positions in bed.
• 12:30 PM: Her leg pain persisted, and she wants to go home.
• 12:30 PM: Palliative care personnel arrived.  They’re focusing on removing Mom’s delirium.  So they’re minimizing use of sedatives.  But must apply sedatives when Mom has the CT scan and other tests.  So hopefully, they can reduce the sedatives once all this testing is complete. 
• Antibiotics appear to be working, as her blood cultures are negative as of yesterday and her body temperature is near normal; only slightly elevated.
• Could be an abscess in Mom’s aorta. 
• Though the infection is disappearing from her blood, it is still contributing to her confusion. 
• If we opt for surgery, recovery could take three months or more.  Given Mom’s current strength level and delirium, she is not a candidate for surgery at this time.  Her ability to recover from surgery is compromised at present.
• The other option is to wait and see how the antibiotics do.  They could clear heart infection but typically, they do not; not without surgery.
• The spot in her heart they’ve been seeing is new since 2008.  That is: it did not appear in Mom’s 2008 EKG. 
• While we wait to see how the antibiotics are faring against the infection, Mom could be transferred to a nursing facility closer to her home.  But we’re concerned that she won’t receive the same level of attentive and responsive care that she’s getting here in Pittsburgh.
• Before she leaves Pittsburgh, we’d like to know that the internal bleeding and pain have been figured out and controlled as much as possible. 
• 03:00 PM we’re heading home.  I’ll go back in and visit Mom again tonight. 

07:25 PM: I arrived for the evening visit and the details follow:

• 07:25 PM: She was awake and calling out for help.
• 07:45 PM: I held her hand and helped her reposition herself a few times in the bed, and then she drifted off to sleep.
• 08:25 PM: Her evening nurse came in as she slept and changed her IVs.  She had no new information, as she just came on at 7:00 PM.
• 08:35 PM: Since she’s sleeping, I’m going to leave for tonight.  I will not say goodbye this time, because if I wake her, she’ll likely start crying and want me to stay. 

09:00 PM: More tomorrow.

Tom Hesley

Related Posts

• Today’s Business: 2010-08-14

I keep this food diary to stay aware of just how many calories I’m eating daily, with the hope that it decreases the likelihood that I’ll overeat.    It seems to work, so here we go with another day…

Today, I consumed the following items:

• Diet pop and herbal tea throughout the day. 0 calories.
• 12:45 PM: 1 strawberry cheese danish.  310 calories.
• 01:45 PM: 1 bowl of black bean soup.  500 calories.
• 01:45 PM: 2 rolls.  400 calories.
• 01:45 PM: 1 roast beef sandwich.  500 calories.
• 06:50 PM: 2 bowls of Cheerios, sugar, and skim milk.  800 calories.
• 10:00 PM: 1 bowl of cherries.  200 calories.

Total calories: 2710.

Tom Hesley

Related Posts

• Other Food Diary Entries
• Today’s Business: 2010-08-14
• Weight Loss: 2010