Keeping on keeping on

Angela's strengthening program is coming along. She's also getting occupational therapy, to help with some adaptive tools and ideas for dressing (putting on socks has always been a challenge), etc. Her lungs are clearing up. She still has a few issues, none of them at all major, compared to where she's been.

She is still jaundiced. According to her doctor, she will need to have her gallbladder removed. He says it can be put off until she develops significant pain, which the doctor is surprised she isn't having. He said her jaundice and high billirubin readings won't damage anything if they are left for the time being. She needs to stay well hydrated to keep her gallbladder functioning as well as it can.

She is somewhat anemic. According to the doctor, this is not related to the gallbladder. Hopefully, it will correct itself. The doctor thinks this is likely.

Her blood sugars have been way out of control. Angela thinks she has this figured out and has cut back on how much she is eating. She says she feels better, and today she actually had at least one normal reading (on insulin). Again, I am told this is not related to her gallbladder issue.

Her feet and ankles have been quite swollen. This is at least partially due to the fact that she spends a large part of each day in her wheelchair, with her feet down. In the morning, after a night of elevating them slightly, they are better. She has been encouraged to stay up, but she thinks starting tomorrow she'll try to take half-hour stretches of being in bed and elevating her feet in an effort to lessen the swelling.

She continues to work hard at getting stronger. No one has said anything further about a discharge date, but I'm going to ask again tomorrow. I understand that they have a weekly conference regarding all patients' probable discharge on Thursdays, so I may get an approximate answer.

Angela's Bible study group is planning to come see her tomorrow evening, and she is very excited about that. She really has appreciated the visits of those who have come, and the cards, thoughts, and prayers of everyone who cares.

God continues to bless her and keep her attitude positive, and we're so grateful.

Getting Stronger

Angela's big accomplishment today was being able to stand up from the toilet in her room by herself. It is rather low, making it more difficult, and she is very proud of this new ability.

Yesterday and today she walked, pushing her wheelchair instead of her walker (which is a bit more difficult but necessary to carry oxygen) from her room to the lobby of the hospital. I'm not good with distances, but I'll bet it is over 300 feet.

She has continued with her physical therapy exercises in spite of the holiday and is looking forward to getting some new ones tomorrow.

Her jaundice is not improving, in spite of the IV fluids and discontinuing the Prilosec. There are two other candidate medications, and the doctor said he is considering stopping or decreasing them, but he was not certain yet that she did not still need them.

She is in good spirits and has been enjoying supper outside at a picnic table.

We continue to thank God for her recovery and to pray that the cause of her jaundice can be determined and corrected.

Jaundiced again

Angela is working hard at getting her legs stronger. She walked several times with the physical therapist and did sitting and standing exercises. She is doing well enough that they signed off on it being OK for her to walk with a nurse or aide or me. I am very glad for that because she won't be getting PT over the long weekend, except what I can do. So, I wrote notes about what she did today and will try to repeat that.

We have a first, tentative idea of when she may be able to go home - possibly the end of next week.

One of the hardest things she'll need to do is go up steps. When we were asked about her steps, I remembered that there were two, but I'd never really paid attention to the configuration, and I told the therapist that I thought they were right together, so that a walker couldn't be placed on one step at a time. When I got back to her house and looked, she has one step up to a 3-foot or so porch, then one step into the house. It will be much easier this way than what I had thought. Another example of God's answering our need before we even knew we needed it!!

Her jaundice appears to have returned, and no one seems to know really why. She'll be having more lab tests tomorrow, and I don't know what treatment may be suggested. She feels fine, with no pain, but her skin itches all over. That may or may not be related. It could be related to her not getting a shower for a while. She asked yesterday and was told she could have one today, but the floor got very busy and no one got showers. She was promised one tomorrow morning. I know it will make her feel better; whether or not it helps the itchiness remains to be seen.

This evening I took her out in her wheelchair to a picnic area just outside the hospital and we ate our supper there. She really likes being outside, and the temperature was just right. We enjoyed it a lot, even though we had to cut it short a bit becasue of mosquitos.

We continue to praise God for her increasing strength.

Out with the Foley

One more tube is out, one less thing to get in the way while walking, one more step back to a normal life. Without the catheter, she feels less like a patient and more in control.

More exercising, more walking, more wheeling the wheelchair with her arms. Hemoglobin started to go back up - 8.6 this morning, but so did liver enzymes. Angela has a new doctor today - I think he and the one she had yesterday and last week at Rehab trade off. This one rounds early and I missed him this morning. Tomorrow I'll try to be there at 7:00. This morning he said he wanted her to drink a lot of water today to help with gallbladder function, but nobody told me until around 7:00 this evening, so I didn't particularly encourage it. The staff here are friendly and competent but appear to be overworked. They are always running to someone who needs them, so I'm afraid "little" things like encouraging extra water may get overlooked. Anyway, I really need to see and hear for myself what the doctor wants and be able to ask any questions, so I'll get up early.

God continues to bless us and we continue to be grateful.

Back to Rehab

Angela keeps getting stronger in her legs, though slowly. Her lungs are also clearing, but again, slowly.

The liver and gallbladder studies were apparently normal, though I was not able to discuss them specifically with the doctor. Her enzymes are much better, though not normal yet, and she is no longer jaundiced.

Anyway, she returned to the rehab hospital this evening, so we're back to where we were about five days ago.

I am a little concerned that for the past 4-5 days, her hemoglobin has been dropping a little more with each test. Today's was 8.0. If it doesn't turn around in the morning, hopefully I'll be able to corner the doctor and at least ask why that might be and what they intend to do about it.

Other than that, she is progressing, and we are so grateful to God.

No Cholecystectomy

Angela's HIDA scan showed her gallbladder to be working fine, so she won't be having it removed. It is still unclear what has made her liver enzymes shoot up and her eyes turn yellow, but the eyes, at least, are better today.

I have found a gripe about Mercy Hospital - it is next to impossible to get Physical Therapy on Sunday. So Angela spent the day without walking. We did a little exercising of her legs and she stood, with help, a few times. Actually, she was able to have a regular chest x-ray, standing. Her first non-portable chest x-ray, I believe.

She had been kept NPO since yesterday afternoon because of the possibility of surgery, so the clear liquids that they allowed her this evening tasted quite good.

Maybe tomorrow we'll get some answers. In the meantime, her spirits are good, and she feels fine.

We continue to be grateful to God for the healing He is providing.

Setback

This morning Angela was feeling fine. She got a real shower, her first in ages. I took her outside in a wheelchair, and we walked around the rehab hospital. She really enjoyed it. After lunch, she got tired, so she went back to bed and rested.

But her liver enzymes have been consistently climbing since before she left Mercy, and this morning her eyes looked a bit yellow. So the doctor sent her back to Mercy to have an ultrasound of her gallbladder. They ended up readmitting her. Her new medical doctor said she has cholecystitis and needs to have a cholecystectomy - the sooner the better. But the surgeon said he wasn't sure if the gallbladder was the source of her troubles and has ordered a HIDA scan - a nuclear medicine study of the gallbladder. He says that should show if it is the gallbladder that is the source of the trouble. That should happen tomorrow morning.

God has taken such marvelous care of her so far, and I know He is still watching over her. That thought inspires me.

Standing Under Her Own Power

Yesterday, Angela was able to stand entirely under her own power. She used a walker and had people there in case she needed them, but her legs were strong enough to do the job themselves. She actually walked a shorter distance, but it was with a regular walker that requires her legs to do all the work and doesn't let her lean her upper body on it. This was in the morning; by evening she was again needing some help to stand.

She's also continuing to cough well, with lots of gunk still needing to get out.

At the rehab hospital they have a room with tables and patients can go there for their meals. Angela likes that and has been getting up into a wheelchair for that.

Her prednisone has been cut back to a quarter of what it once was, but she's still taking enough to make her a bit shaky, so eating is not always as neat as she'd like. Her blood sugar still increases, especially in the afternoon, but yesterday it was 200+ instead of the 400+ the day before.

Her spirits are good and she is determined to regain her strength.

We are so thankful to God for all the big and little blessings He has given and continues to give us.

Another big step

Today Angela was moved from Mercy Hospital to Northern California Rehab Hospital - the name may not be exact, it's from my memory. This is another step towards going home. She has been walking quite well with the physical therapist and the rehab walker. She was practicing putting all of her weight on her legs and now she will need to use a regular walker which will require that. When she feels energetic, typically in the morning, she does much better. By evening, her leg muscles are tired and she finds it harder to stand. She is to have physical therapy twice or even three times a day now. She will also continue her respiratory therapy. Hopefully, it won't be too long until she can go home!!

God truly is good to us.

Slow, steady progress

Today, Angela walked a little further - still with the walker and the physical therapist - and she went out the door onto the balcony. This was the first time she could breathe fresh air in many weeks, and she said it energized her.

Her lungs are clearing up. She still sounds very noisy breathing, but the respiratory therapists all say the sounds they heard in the bases are clearing up and what we can hear is stuff much higher up and much more easily coughed up. Angela is coughing quite well - getting rid of the gunk.

It may not be long before she is ready to leave the hospital for a rehab place, to keep gaining strength in her legs. This has not yet been determined but is likely.

We continue to praise God for his wonderful healing.

Continuing to Improve

Angela continues her respiratory and physical therapy - improving with both. She walked for - I'm guessing - about 40 feet with the walker and physical therapist today. She was up in the chair without a great deal of help on a couple of occasions, and has been coughing quite a bit. The doctor says her chest x-ray looks another 10% better from yesterday, and she is seeming quite like herself. He also started reducing her prednisone and theophylline. She may even be going home by the end of this week. Tomorrow, she should have her swallow evaluated again and will probably be allowed to drink thin liquids like water. That should make taking pills a little easier - she's been using V8.

We continue to marvel at the wonderful providence of God in bring her through this experience and ask for his continued healing and guiding in her life.

Out of ICU

Yesterday, Angela's doctor said she was to be moved out of ICU, but it didn't happen until this afternoon. She has a private room with a window but the view isn't as good. Before she could look out and see the helicopter land, and she enjoyed that. She's still getting the respiratory therapy like she was, and that is good because she still needs it. Tonight, she needed to have her IV replaced, and she had a tummy ache that we couldn't figure out what it was from unless it was constipation. Again, we are blessed to have nothing worse than this type of complaint.

God is so good.

A Few Steps

Angela walked a total of about 10 feet today, with a walker. She is getting stronger. Her cough is also stronger, and she is coughing up lots of gunk. One of her doctors believes strongly in positional percussion and drainage, meaning she is put on her side with her head down slightly and for 10 minutes the respiratory therapist moves this vibrator/percussor machine over her back, and the secretions drain out. It has worked very well. In fact this evening she is breathing oxygen at a flow rate of only 1 liter per minute and her saturation levels are in the high 90's. Before she got sick she was using 2 liters per minute and her sat rates were in the low 90's. I'm hoping we can learn some similar techniques that she can use at home.

Her diet was advanced to include solid food. She still can't have thin liquids like water until Monday. They get into the lungs easier than thicker foods. She is learning to eat slowly, finish one bite before starting the next, and stop frequently to cough. It isn't easy for her but she's trying hard.

The doctor said she doesn't have to stay in ICU any more, but when I left there were no immediate plans to move her. Her nurse this evening said that for some reason, people in the hospital seem to move around midnight. So, I'm not sure where I'll find her in the morning.

God is so good to us. The hospital staff are saying they love to see miracles like this. Of course, we won't argue. Many of them also believe that God answers prayers.

Coughing Better

Angela's cough is getting better. She is coughing up some nasty stuff, and the respiratory therapist was able to suction quite a bit of it out. She responds well to the percussion over her lung - so well that tonight they are even going to wake her up a couple of times for that, instead of letting her sleep. Today, she sat up in the chair for about three hours. She stood up for much longer - maybe a minute or so - with Physical Therapy and took some very small shuffle steps in getting from the bed to the chair.

The tentative plan is for her to move from ICU to a rehab hospital a couple of miles away some time next week.

God is continuing to bless her with healing and we are continuing to thank Him.

Eating Actual Food

Angela passed the swallow test today, at least well enough to have thick liquids. So, for lunch she had thickened apple juice, mushroom soup, tapioca pudding, and a strawberry shake. All serving sizes were small and she didn't even finish everything, so I didn't really think she had overdone it. But a little later she started complaining of nausea and just not feeling good. We decided she had put too much in her stomach after such a long time without real food. This evening, she ate less and I don't believe had similar troubles.

Her physical therapist was trying to get her to stand with his help, and she was refusing, and I couldn't figure out why. Finally, she got it out that she didn't want his help, she wanted to do it herself, which she isn't capable of quite yet. Anyway, he was very patient and helped her just enough so she stood for him three times, each only a few seconds. But tonight, with two nurses helping her to get from her bed to the chair to eat, she took about three baby steps. That made her feel great.

The respiratory therapy treatments are really helping and she is coughing quite a bit. Her lungs still don't sound great, but they are a lot better. The doctor said that yesterday her chest x-ray looked pretty good but today it was another 40% improved. I looked it and it actually did look like a chest x-ray, not all white like it was the last time I looked.

She is talking in short sentences now. Her voice sounds a little like she inhaled some helium - it is a bit high and soft.

She was using a regular nasal cannula with oxygen at about 5 liters per minute this morning, but the doctor wants her to use the high-pressure cannula because the extra pressure helps her lungs to open up better. She doesn't like the way it feels and complains that it is hard to breathe, so she uses it a little. When she sleeps, she is using the BiPAP, with settings only little higher than she was using before getting sick.

God is continuing to bless us, and we continue to thank Him.

Looking Better

Angela had a great day today. Her chest x-ray is looking much better and so is she. She still can't swallow, but she is starting to cough a little. And her respiratory therapist today had a couple of neat tricks. He has a machine called a cough assist that blows air into someone's mouth via a mouthpiece and then sucks it out, encouraging a cough. The hospital has only had the machine a year or so and not everyone is familiar with it or uses it. When he told us about it I was reminded of the Bible verse that says "Before they call I will answer". I was praying for some help for Angela's cough and there it was. Another machine he has does a percussion on her chest to loosen things. She thought it felt a bit like a massage.

She sat up a couple of times and tried to stand with Physical Therapy but wasn't entirely successful. Tomorrow they plan to try a special kind of walker that they said would support her in a way she would feel more secure.

Her voice is coming back. It is weak and a bit squeaky, but I am starting to be able to hear her, and she actually talked to Mike on the phone, a couple of words.

Most of the day today, when she wasn't sleeping, she was using just a plain nasal cannula - at around 5 liters per minute, rather than the high-pressure one she had yesterday or the BiPAP. She was on about 35% oxygen. This is getting into the neighborhood of where she was before the pneumonia and is making everyone very happy.

God has been so good to us and I feel very blessed.

Can't swallow yet - or cough

Angela failed the swallow test - she couldn't swallow the thickened water they gave her, or the applesauce. She will try again tomorrow or soon. I was told not to worry - she would regain her swallowing ability in due course. They put in another tube to feed her, so she is getting some nutrition again.

Her lungs are still not clear; they have a lot of fluid and thick secretions in them. She needs to cough, deep and often, and that is a real problem. Even when she's healthy she can't cough very well. Now she seems almost totally unable to cough at all. If she doesn't get the gunk out of her lungs, she is likely to develop another pneumonia, so they are mentioning the possibility of reintubating her so she can be oxygenated/ventilated while they do a bronchosopy to suction out fluids down deep. It doesn't sound good at all to me, but then neither does another pneumonia. Maybe tomorrow will tell.

She did get up again today. When I got there this morning she was sitting in the chair I usually sit in - I was surely surprised. She sat up again this evening, and stood a few seconds for physical therapy. It is amazing how much strength she has lost and will have to regain.

We continue to praise God for His healing so far and to pray that she will continue to gain strength and be able to get rid of the lung secretions.

Standing up

Oops - I forgot to write last night. Sorry.

Yesterday was a pretty much quiet day. The one forward step Angela made was to stand up. Physical Therapy got her to her feet for a few seconds. However, the effort tired her out and she slept for hours afterwards.

This morning a swallow study is planned to see if her swallow function is still working after all the time with the ET tube. If it is, she will get to start eating. You can imagine the smile on her face when I told her that!!

God has been so good to us and we are so grateful to Him.

Extubation day

Angela's breathing tube was removed today, and she is no longer on the ventilator. We were expecting this soon, but not necessarily today, so it was a nice surprise when the doctor and respiratory therapist both said she was ready. She is now on BiPAP, which is the same thing she sleeps with at home for sleep apnea. Tomorrow, she'll get to try some food and maybe be able to talk.

God has truly blessed us.

Treading Water

Today, Angela's respiratory therapists made some tests to see if she could come off the ventilator. Three of the four she passed fine - the one where she has to inhale as big as she can and then blow it all out was not easy for her. It's hard to tell, but she may have forgotten how to tell those muscles what to do. After the test she started practicing deep breaths and seems to have gotten the idea. We'll see what tomorrow brings.

She did more exercising with the physical therapist, much the same as yesterday, but they didn't come until after 4:00, and she was tiring easily.

Tonight she wrote me something on a piece of paper to bring in tomorrow. It was difficult for her, and hard to read, but nice to have that available. Tomorrow, I think I'll take her a large size tablet and a crayon.

We continue to thank God for His healing hand on her and everyone for their support and prayers.