Wednesday, September 30, 2009

One Breath at a Time

That's how we're taking it these days. Last night Alex managed to keep his temperature down, and his oxygen saturation improved bit by bit. Today his temp was still around 99 until about 5 when it started to come up again. Could just be his body fighting the inflammation; we don't yet know if the fluid in his lungs is growing any "bugs". (That's the term the doctors use, really!)

They were able to adjust the pressure setting and the oxygen flow setting on his ventilator today, lowering them as he became better able to oxygenate his blood. Will see what things look like tomorrow morning... it's a roller coaster.

This morning's xray showed less fluid in both lungs than what they found yesterday. This is great news and we hope that trend continues!

His heart, kidneys, liver, and digestive system all continue to function well, thank heavens. If we can put this pneumonia in its place, we can get the trach tube in; if we get the trach tube in, we can start to wake him up and wean him off the ventilator; once that happens, he can get up and walk and finally get well. They say once they get up, patients improve immeasurably.

Looking forward to that day...

Tuesday, September 29, 2009

Just Breathe

I keep telling Alex that all he has to do is keep breathing...

That's a little harder for him to do now that he has fluid inside his lungs. The "pleural effusion" they drained yesterday was fluid between the lung and the chest wall. We weren't happy with the fact that draining that stuff out didn't result in a marked improvement in his oxygen saturation levels. Dr. O'Mara ordered a full contrast CT scan to see what was up inside our boy. We found no blood clots, no internal bleeding, and no abscesses. What we did find is that he now has fluid inside his lungs, a.k.a. pneumonia. Now, this fluid doesn't necessarily have any bacteria growing in it, yet, but its presence does make it harder for Alex to breathe and oxygenate his blood.

They can't suck the fluid out because the procedure is more invasive than his present oxygen saturation levels can tolerate. So the best we can do is give him an antibiotic known to kill the bugs most likely to want to grow in his lungs, give him a blood transfusion to help replace the blood they draw daily for tests, stop the blood thinner he was on when we worried about clots, and rock and roll him in his bed to get the fluid to break up and shift. Once it has broken up, he'll be able to reabsorb it into his system, like a sponge sucking up water instead of trying to suck up jello.

All of this will take time. Once his oxygenation levels are better, we can think about doing the tracheostomy and start waking him up and weaning him. But his system can't handle the shock of a surgical procedure, even a minor one, right now, so we have to let his body kick this thing.

The good news is, his heart is still strong, his kidneys are still working, his digestive system is kicking in, and his fever this afternoon was the lowest it's been since this whole thing began 3 weeks ago. This guy just keeps on fighting. He is double-tough.

Alex's brother Martin, who went through a horrendous accident and equally horrendous recovery, says that "Every thought is a molecule." Thank you for all your thoughts and prayers.

Monday, September 28, 2009

A New Doc in Town, and No "Trach" Today

The wonderful Dr. Tiru, infectious disease specialist, is on her way back to her hospital in NYC and won't be back until December. Today Alex has a new doctor, Dr. O'Mara, who is a pulmonologist (sp?) or lung specialist. Perfect timing!

Alex's oxygen levels and fever continue to improve since the draining of LOTS of fluid from his chest, but Dr. O'Mara decided to wait on the tracheostomy until he's slightly stronger. Works for me. I don't really need to see my husband go into respiratory arrest this week...

I keep telling myself that these little setbacks are just that, and that he will be turning the corner soon. I hope I'm right!

Sunday, September 27, 2009

Next On the Menu...

Pleural effusion with a side of blood clots... Yum...

They inserted a tube drain into Alex's chest and drained 450ml of fluid out of his left side. That's a lot. They're culturing it to see what's growing in it, but in the meanwhile he's on broad spectrum antibiotics that should handle the most likely suspects.

They were expecting that his oxygen saturation levels would improve after the drain, but they didn't. The next most likely problem is a blood clot in the lung, so now he's on blood thinners to help with that. They'll stop the blood thinners 6 hours before his 10am tracheostomy.

I keep saying that Alex doesn't do anything "small." I'm ready for "small" now... this illness just keeps growing arms and legs. It's going to be a long recovery indeed.

Thanks for your support, everyone! Special thanks to Ken and Carol for coming with me to the hospital and helping me think of all the right questions to ask tonight. It helps to have medical professionals amongst your "nears and dears." We are truly blessed.

Saturday, September 26, 2009

One Door Closes, Another One Opens

They have tried a few gentle ways of waking Alex up today, but now that they've found some fluid in his right lung, they're going to let him rest. This little wrinkle is often referred to as "hospital pneumonia" and happens to people who have been on ventilation for a long time. The surgeon will do the tracheostomy either tomorrow or Monday, depending on his schedule. The "trach" should actually help with the fluid and the labored breathing associated with it. With the shorter tube, his throat and lungs will be less irritated.

Once you have one complication, it opens the door to the other possible complications. Luckily Dr. Tiru is right on top of things and is going after this lung fluid with everything she's got. At this point he's in no great danger from this fluid, it's just another delay in his healing process. They're culturing it to see what kind of bug it is, but the culture will take days. In the meanwhile he's already on a broad-spectrum antibiotic that is known to kill the most likely bacterial culprits.

The awesome news is that the original infection, the sepsis, is under control and is waning. This is very good news because that means 1.) He's getting better and 2.) He's getting better and 3.) He has more energy to fight off the pneumonia.

It's hard to get a picture of what this recovery is going to look like. No one can know for sure because we never know when something like fluid in the lungs is going to present itself. It's safe to say that Alex may be in the hospital for another month, and after that, the at-home recovery will take months.

People have asked about visiting Alex. You are more than welcome to, but there are some things to think about: First, you may want to call the ICU ahead of time and ask if/when he can have visitors. Be prepared for the nurses to tell you that "now is not a good time." They also can't give you medical information about his condition; it's the law. They have to safeguard his privacy especially while they're doing certain procedures, and they have to safeguard his rest. If they do let you in, they'll only let 2 people in at a time, and only for a short time. If you have a cough or the sniffles, or know that you have been exposed to someone with the flu, PLEASE wait to visit him. His body can't take the risk of exposure to any more bugs. After he first wakes up, these rules will become even more important for them to enforce.

Thank you all for your support, generosity, and prayers. We're on a long road, and it helps so much to have such great fellow travellers.

Friday, September 25, 2009

I'm Still Waiting...

The docs have decided to try a slightly different approach to weaning him this weekend before they give up. There are some kinder gentler ways they can adjust his medications to wake him up. If they feel like they're just aggravating him and wearing him out, they'll stop ASAP. And if it looks like he can't "wake up and wean" through this process, they will do the tracheostomy on Monday.

This poor guy has been through so much. For someone who's been sleeping for 2 weeks, he is DEFINITELY going to wake up exhausted!

Fingers crossed. I found a 4 leaf clover on the hospital lawn. If only luck were that simple...

Thursday, September 24, 2009

Every Breath You Take...

Apologies to FaceBook readers for the duplication of information...

I'm hoping that the doctors are going to ask for permission to give Alex a tracheotomy tomorrow; putting in a trach tube will mean we can take out the full throat tube and relieve a considerable amount of discomfort. Then waking him up will be much easier to do. THEN he can start the ACTIVE part of the healing process, getting his muscle tone back, etc. There's little risk of any sort in doing the tracheotomy, and it may save him a lot of stress that will only serve to delay the healing process and wear him out. As stable as he is at this point, there's only so much he can do at this point without some kind of intervention. The current ventilator tube is triggering his gag reflex, so now that he's less sedated, he feels like he's choking all the time. What a nightmare. Luckily the sedative that's in his system may be enough of an amnesiac (?is that the word I want?) that he won't remember, but the less he has in his system, the greater the chance is that he will remember and be traumatized.

Breathing's pretty important, but it sucks when you feel like you're constantly choking and your vocal chords are getting abraided. Fingers crossed for the docs to decide that he's had enough!

-Nancy

Wednesday, September 23, 2009

Weaning Woes

They've started weaning Our Boy off his sedatives, so he's becoming more aware. They have to do that in order to wean him off the ventilator. He has to basically consciously exercise his lungs again because the machine has been doing the work for him. This all means that he has to go through the discomfort of being awake with a ventilator tube shoved between his vocal chords and down into his lungs. It's very uncomfortable, especially after over a week. There's a balancing act that the doctor has to do with keeping him comfortable enough not to stress him, but uncomfortable enough to wake him up and get him off the ventilator as soon as possible...

It's like watching a mother cat wean her kittens... it seems so cruel, and yet it's good for them, and they're crying piteous little cries. Alex isn't crying (yet) but he's grimacing and wincing. It was stressful enough that I felt stressed; I didn't want him picking up on my stress, so I came home to try and relax and let the wonderful CMC staff help him through this. Cindy and Anne (2 great nurses) said that was a very smart choice, so I'm trying not to feel guilty. Ugh.

Weaning sucks.

Sorry, bad pun.

-Nancy

Tuesday, September 22, 2009

Poo is a Beautiful Thing

Parents remember that relief the first time their toddler actually made it to the potty and proudly announced their accomplishment.... Alex can't speak right now, so I'll say it for him: Alex made doo-doo in his colostomy bag. Yes, I'm punchy; 2 weeks without sleep will do that to you, but yes, this is a big deal. It means his digestive system is working. It means he's absorbing nutrients, which will help him heal and will help him reabsorb and flush out all the fluids that are trapped in his "third space."

Whew. Toilet training is over. Now for the hard part.

They lowered his sedative to start to wake him up a little today; when he stirred, he opened his eyes and grimaced, then choked on his ventilator tube. Doesn't sound too comfortable, so they increased his pain meds a little but kept the sedative where it was. Slowly as the pain abates, they'll be able to lower both, and start to wean him off the ventilator. Waking up is the hard part. It hurts like the devil, and it's very disorienting. Please keep some good vibes going Alex's way during the next few weeks. They're going to be hard.

Thank you all for the outpouring of support and care you've shown us. We are truly grateful to know such excellent good friends.

Monday, September 21, 2009

Slow Cooling

Another day of a sub-101 degree temp. This kiln is densely packed and taking a long time to cool! Seriously, we still run the risk of Alex developing abscesses in his abdomen, in which case his temp will spike again and they will have to go in again. If we get through the next few days, we may just make it through with a nice smooth matte finish... ok, enough of the pottery imagery.

My boy is still fighting and we're still here.

Sunday, September 20, 2009

Another Great Day at the Solla Ranch

My hubby's temperature has dropped considerably since yesterday's procedure - 99.2!!! Which means he is on the way to kicking this infection without having to struggle against anymore toxic goo in his body cavity...Wow. It took a week, but we're on the road now. This is going to be a long process, especially when it comes to physical therapy. They cut through all of his abdominal muscles, and he relies on them to help get up out of chairs and beds without straining his bad back. We are all breathing a little easier, but we'll feel even better in a week or so... A big thank you to the staff at the ICU at Cayuga Medical Center. They are the finest kind of people imaginable.

-Nancy

Saturday, September 19, 2009

"Fetchez Lavage!"

(Apologies to those who aren't Monty Python fans... that's a random reference for sure.)

Today we saw Alex go back to surgery for a procedure called "lavage," which is the French word for "washing." The doctors suspected that the reason Alex still had a fever despite all his antibiotics was that there was still some toxic goo left in his abdominal cavity. So they went back in, and literally washed his internal organs. This is not an uncommon thing to have happen to peritonitis patients, and we may have to do it more than once. It's not seen as any kind of set-back; on the contrary, it's helping him get over the hurdle so he can stop fighting so hard to get well.

Every day I learn things I didn't know - and maybe didn't want to have to know - about the human body. Who knew you could take someone's bowels out, sanitize them, and put them back in?

After surgery Alex had a small period of a VERY fast heart rate, but they were able to stabilize him and they're rechecking his heart's condition just to make sure it's ok. They're being extra cautious with him, and I certainly appreciate it.

Tonight our former apprentice Dana is arriving from California to spend a few days with us; I hope she brought warm clothes because we're taking Aurora to hockey practice Tuesday night! Tomorrow Dana and Aurora are baking cookies for the fabulous ICU staff. They work so hard and deal with such difficult situations. They need to know they're very much appreciated.

Thanks for all your good vibes and prayers.

-Nancy

Friday, September 18, 2009

Another great day for Team Solla

Every day has been a day of small improvements for Alex in this recovery process. Today they removed his IV painkillers and then tested his awareness. He was able to open his eyes on command, but wasn't able to squeeze the nurse's fingers. It could be he was too weak to do that, or that he wasn't awake enough to process that more difficult task, but it doesn't really matter: the fact that he could open his eyes when asked is a great step in the right direction!

The doctor ordered a CT contrast scan today to check A's belly for abscesses, an unfortunate possibility in this scenario. No sign of any today, but they may yet develop. The scan will be repeated on Monday, but for today we'll celebrate the lack of abscesses!

Aurora came to visit her dad for the first time since his emergency surgery on the 14th. Terri, the RN assigned to Alex's care today, explained all the tubes and needles sticking out of Alex and gave her an idea of what his next challenges are. Granny VanWormer (Nancy's mom) is here until tomorrow night to hang with Aurora and I, and then Dana, an ex-apprentice, is coming in for a few days.

Thanks for all the good vibes. It helps more than you know.

Our saying has become, "It's All Good."

-Nancy

News from the Hospital

Hi folks -
Alex's wife Nancy here. Alex is still in the hospital after complications arose post-surgery. He has peritonitis and is very seriously ill, so it may be a while before he's back at a computer. At this point he is still in the ICU and has been kept fully sedated. He has made small improvements every day, and we are hoping for a full, if long, recovery. Many people have asked how they can help. I'm in the process of figuring that out; as his proxy I have had to focus on decisions his healthcare during this very critical time and haven't had much time to think ahead. I will certainly let folks know what I need when I have the time to think about it! I feel so lucky that we belong to such wonderful communities; the clay community, the community of Ithaca/Trumansburg, and the Cornell University Library community. Everyone has been so supportive and helpful during this difficult time.

Please keep Alex in your thoughts and prayers during this challenging time, and thanks for your support and care.

-Nancy

Wednesday, September 9, 2009

Treasures Found in a Week's Time



A week ago, I bought my first Nikon Speedlite SB-600, and life has not been the same since. Today I found another one via Craigslist. Here are the rest of my treasures from this past week. We found a killer Manfroto tripod with a sweet ballhead. My lightstand and shoot-thru umbrella arrived. Together, all of this fun stuff, combined with a 85mm f1.8, and a TTL patchcord... all of this has made my week a TON of fun. Like a kid in a candy shop, I have spent the better part of the week trying new ideas with flash every chance I could! Next up: during my recuperation, I aim to study up on the "Strobist" method of lighting so I can push my lighting skills to the next level. Should be fun.

Sunday, September 6, 2009

A Bug Flew Up My Nose



Well, not really, but this image sure looks like something went up her nose! We spent the afternoon outside playing with flash. Trying to figure out how to deal with background lighting vs. subject lighting. So much to learn!







Saturday, September 5, 2009

Glazing Up a Storm










As I get ready for surgery, I am faced with a mountain of bisqueware. I have tried for weeks now to get enough pots made to keep this place flush with pots. Tonight, all I saw were pots covered in glaze on every surface in the studio. Now that the boards are all put away, tables cleared,... it's time to fire. Tomorrow our toaster will finish firing and by breakfast it will begin cooling. Monday morning, while everyone else is celebrating Labor Day, we'll be unloading pots, packing pots and getting orders ready to ship out. No rest till the surgeon calls for "lights out".

Friday, September 4, 2009

Trying to Get Ahead
















Getting ahead is oftentimes a pointless endeavour. During the Winter 2008-09, I tried my darndest to get ahead. I figured if I threw enough pots, we would have enough to carry us through the Summer and into Fall. We did great. We have consistently had mountains of bisqueware just waiting for an open kiln. And yet we never got ahead.

Inevitably, something goes awry. First it was an acute case of diverticulitis that way-laid me back in June. Tuesday I go in for surgery to resect my colon. No fun. It means I will be down and out for 4-6 weeks. For the first two weeks, my mom will be here (from Miami!). R&R is such an uncommon thing around here. The concept of actually relaxing and recuperating is such an anomaly. But I am going to be a good patient, and I am going to utilize my time out of the studio to work on other non-clay things.

I have decided to dive feet first into the Strobist-world. Just in case you've never heard of Strobist, check out David Hobby's blog. If you make images with a camera, you'll find his blog an endless source of information and insight.

I also aim to begin working on articles I promised myself I would write during the winter. I think this will also be a perfect time to pull together various ideas for classes I would like to teach. Writing a curriculum always stirs up writer's block in me, so this is a fine opportunity to reach around the subject from the other side.

Until I am back in the studio, Hannah, Nancy and Aurora will have to make do without my throwing. I have made a pile of pots this past week, and hopefully will see many of them glazed before the end of the month. Here's a quick shot of what's been happening in the studio this week.