Little things

Now that we've dealt with major things for Angela, the minor ones come up. She became very constipated, with a lot of pain, Tuesday. Her doctor couldn't see her, and we ended up in the ER that evening. After laxatives and pain pills there, we went home and the next day she drank the stuff that's used to prep a person for a colonoscopy. It did produce results, but she has continued to have pain and isn't sure she got all the way cleaned out. The pain has been preventing her from using the percussion vest and from deep coughing, so her lungs are getting congested again. It is starting to get somewhat better, and she's been able to use the vest today.

She saw her doctor today and was told that she is stable for the moment, but any little thing could upset her balance again. We still haven't heard any results from last weekend's tests.

Mike's grandmother passed away this week at 99 years old. Her services are Wednesday, so Mike is flying down here Tuesday, and we plan to drive home together afterwards.

We continue to praise God for the health she has and to pray that she can continue in it and improve it over time.

To San Francisco and Home

Friday morning we left Angela's house at 3:30 for California Pacific Medical Center in SF for her right heart cath and liver biopsy. According to the cardiologist, she does meet criteria for right heart failure and for pulmonary hypertension, but both are mild. He will give his report to her hepatologist who will figure out what this means to her liver, as well as analyzing her biopsy. So, we really did not get any answers yet.

The doctor who did her liver biopsy nicked the liver capsule - I think that means he went a little bit deeper than he had intended - and that increased her risk of post-procedure bleeding, so they kept her overnight for observation. They were able to put her in a private room so I could stay on a cot with her. That was a blessing in many ways.

We got another blessing in the form of a Respiratory Therapist who was able to figure out how to make Angela's mask straps work for her. She's slept with the mask for two nights, now, without any complaining!!

Our trip home was more eventful than we wished. I got a little lost trying to get to the Bay Bridge and went around in circles a couple of times, on the third go around figuring out that I needed to turn right instead of left. There was a lot of traffic getting on the bridge - which I guess isn't unusual. While we were fighting SF traffic, Angela started to get very sleepy, and the oximeter reading was in the 50-60's. I kept trying to get her to breathe deeply, cough, and keep her mouth closed while crossing the bridge, with only occasional success, so when we saw the Hospital sign somewhere around Berkeley, we turned in to the Doctors Medical Center ER. They were very good to us and tried to figure out what had happened, but by then Angela was back to herself and her sats were good. After some more labs and a CT scan to rule out bleeding from the biopsy site, and after about seven hours, they said her sleepiness was probably caused by ammonia build-up, since her level was high, and gave her something for that. They said she would be OK to go home. So I fastened her in her seat, put a pillow under her head, and drove with her sleeping and me not knowing her saturation rate. We got home around 2:30. She was almost too asleep to get into the house, but we managed.

Today, she has felt well. She went grocery shopping but otherwise took it rather easy. I'm going to call her hepatologist tomorrow and see if he'll discuss her results with me on the phone. She has an appointment with him on June 8, but I don't want to stay here that long.

We thank God for keeping us safe in spite of the unexpected duration of our trip.

Home, at Last

Angela had her sleep study last night. We ended up finding out that the mask she has been using has not been working - it has little nasal "pillows" that sit right at the edge of her nostrils instead of the full-face mask. The reason she has liked it is that it doesn't have a strap that goes behind her neck - those always seem to hurt. Unfortunately, it also allows her to have her mouth open so the air forced into her nose comes right out her mouth -- not good. She did get to sleep with a full-face mask at the sleep center, and they were able to figure out what were good settings for her. Tonight, it was very difficult to get her to use the full-face mask - it really hurts the back of her neck. I'm trying to make adjustments in the straps so that they hold the mask tight enough but not too tight and don't touch the sensitive area on her neck. It's not easy, but she is finally asleep with the mask on.

I'm becoming convinced that the majority of her problems recently may be traced to the lack of oxygen she was experiencing every time she went into REM sleep - that we weren't aware of. My guess is that this has not been doing her liver any good, either.

God continues to bless us with just what we need for the moment, and we are thankful.

Planning to go home

Looks like Angela will be leaving NorCal Rehab tomorrow evening for the sleep lab, where she'll have a sleep study and come home Wednesday morning. Her lungs seem to have recovered back to her normal. She had liver tests today and they were somewhat better - still not even back to what they were before this pneumonia bout, but I'll take better any day. We're still praying that God will heal her liver and planning to go to San Francisco Friday for more tests.

A long hike

Yesterday, Angela was told that Dr. Fredericks, her San Francisco hepatologist still wants to repeat the right heart catheterization along with the liver biopsy. She had assumed that since her pulmonologist here recently repeated the right heart cath that it wouldn't need to be repeated in SF. She got quite upset and said she won't let them do it because there's no reason. I tend to agree with her, but I'm also more compliant and since they are planning to do both procedures from one stick, I don't see how it will really hurt her more. Dr. Fredericks apparently doesn't trust the results done here - he's sure her liver troubles are caused by congestion from heart/lung failure, but the study doesn't show that. Anyway, I pray that either Angela goes along with the program or we see some other way.

This morning we went on a hike. There is a trail we had seen from the little park outside the rehab hospital that Angela wanted to check out. She walked to where it started with me pushing the wheelchair so she could sit if she got tired and to carry the oxygen. It turned out to be paved and wide enough for the wheelchair, so she decided to start up it and didn't stop until the end, even though it was quite a bit of up and down. I bumped her oxygen up to 3 L/min and she stopped a couple of times for rest. It was a very good workout, and she's had a little nap after lunch.

One of her doctors told us he's working on the sleep study, so I'm hopeful that something will be worked out.

Continued Improvement

Today, Angela & I went outside for a walk, but right then she had visitors, so we had an outside sit instead. She walked outside later with PT. We're still working on getting a sleep study, but she hasn't had any desatting episodes in a few days, which is encouraging. She's been on Lasix daily, and every day she gripes about taking it but then decides it helps her breathe, so takes it anyway. Today we talked to a PA who said she could take a day or two break and see how she does. That made her happy!

We're looking forward to her being released next week and thank God for her continued improvement. We're still praying for improvement in her liver to match that of her lungs.

Walking outside

Angela got to walk outside today and loved it. She tires rather easily but otherwise seems pretty much back to normal, except for being yellow. I'm glad she's getting rather intense respiratory and physical therapy. If she were home, she would have a tendency to be lazy, but that is not an option. We thank God for her recovery and are still praying that her liver will also be healed.