Happy 34th Anniversary!

Surely each of those 34 years has been easy, right? 

Saturday mom and dad started off the celebration with a trip Brookshire, followed by lunch at a real restaurant, and finished it off with a movie date in Ganado.  That’s quite a bit of activity – all of which is outside of the house! Happy Anniversary to both of you!

Last week dad had another Dr.’s appointment which included a CT-scan, and everything looked good. He’s actually doing so well, that he’s going to get 1 free day each week where he does not have to be on TPN at night.  He used his “free night” on Saturday for his date!  The blog posts have been MIA, but he’s still recovering well.

 

HOME SWEET HOME

They made it home today.  We are so grateful for what Dr. Saggi and Dr. Hall were able to do for him; and thankfully healing can continue in El Campo.

THE FINAL LAP By: Marilyn Goerig

Help us to be grateful
Each day in our prayer.
Before we speak our petitions,
Let gratitude bring us there.

We say “In God’s Time”;
But we usually want more.
Our plans don’t always match
What God has in store.

Louie is improving
In all aspects of his care.
There is talk of going home;
To Louie an answered prayer.

His improvement is bittersweet;
It is difficult to rejoice
When they will no longer hear
Dr. Saggi’s reassuring voice.

Yes, Dr. Saggi is leaving
No doubt he will make history;
As a valued addition
At Tulane University.

Let us remember who’s really in charge
And let Him provide the map.
God has brought Louie this far;
He will manage his final lap.

So much has happened this week! The fever has subsided , Louie got 2 units of blood that definitely gave him a bit more zip, the wound vac is out and he's eating a bit of pureed(yum yum) food. The CT scan showed the abcess to be getting smaller and no new worrisome details were apparent. We are moving toward the door once again! The saddest bit of news, however, is that Dr. Saggi is leaving to go to Tulane in New Orleans. We are truly upset about this as he was the the perfect "fit" for us. He is a surgeon with tremendous gastrointestinal experience. We felt we had the best with Dr. Duke, who in turn recommended the best for the next phase, Dr. Saggi. We will definitely be looking to Dr. Saggi to recommend our next physician choice. We are doing fine, but long for El Campo more each and every day. In the words of one of our favorites, Dorothy, from the Wizard of Oz, "there's no place like home". (geez, where's a good pair of ruby slippers when you need them?). Thanks once again for all the prayers and support -----Love, Ruthie

The Good, The Bad, and The Grateful

The Good --Friday started off really well with Louie putting on real clothes in Occupational Therapy and venturing out of the room.  He looked so handsome!  Also, floor employees came around passing out Bingo cards. Patients were going to be playing Bingo at noon over the intercom.  They asked if we wanted to play--I quickly answered "of course we would!!!" ( Good thing I was there, right?   Louie may not have REALIZED  he wanted to play bingo)  They handed out the daubers at noon and the playing began.  Louie did well the first game needing only 1 number right away.  He didn't win but it really was a nice diversion. What does one win in a hospital bingo game?????  Your hospital stay is free?  Somehow I doubt it, but it was fun nevertheless.
The Bad--Louie had been having fever off and on . Dr. Saggi ordered blood cultures of the lines and a CT scan.  Saturday afternoon we got the news that there was something on the scan and we were moving back to the 9th floor.  We later learned that the scan revealed an abscess in the abdomen by the colon.  After another move, we arrived at 917. Honestly, in our almost 34 years of marriage we have lived in 2 places. That’s it-2!    During this 4 week hospital stay we have been in 6 rooms.  It  helps for keeping the clutter down but truly I think we enjoy a little more stability.
To assist in healing, a drain was placed by Interventional Radiology on Sunday.  We are not going home on Tuesday.  A real disappointment!!!!   Dr Saggi did say that the liver looks great.  Lets hear it for the liver --it seems to have gotten the memo that we want to go home and has not been acting up or causing trouble like some of the other parts of the body.
The Grateful---We have been really down by this recent turn of events.  In reality we know that this visit has not been THAT long and things could be so very much worse, but but we so looked forward to going home Tuesday.  We were on the Rehab floor---the last step before the car door!!  You know, Adios Hermann,  Hello El Campo.  We were out of sorts, praying for healing but not really having a good spirit. Depressed and irritated.  Today, however, I read in one of my books that Jesus says "your praise and thanksgiving are distinctly audible in heaven. Your petitions are also heard but it is your gratitude that clears the way to My heart. Practice praising and thanking Me continually throughout this day."  Hmm…  this is a good idea.  I remember Father Gary speaking once of adopting an "attitude of gratitude", choosing 10 things a day and thanking God for them.  Anyway to make a long story short (oops, it's too late for that) today we only want to speak of the many wonderful things we have to be grateful for.  The success of the surgery,  the possibility of Louie eating normally again,  Dr. Saggi. Dr. Hall, etc.  It will take us all day,  but I can't think of a better way to spend it.  Have a Happy 4th of July!!!
With gratitude to each of you---Ruthie

Could it be?

It's been mentioned that Mom and Dad may go home next Tuesday (4 weeks after surgery).  How awesome that would be if it proved to be true!  Dad would go home on TPN and continue to do rehab in El Campo.  Hopefully they will not go home on antibiotics or with a wound vac.  The wound vac appears to not be putting out anything!  Could it be that this fistula is actually healing (or already healed)?    Today he was able to start eating a couple of things- flavored ice and jello.  Continue to pray that all goes well; the prayers are working!  Another great day in Room 460.

Moving Forward
 
First full day on the rehab floor.!!! (Saturday is a light day and Sunday a day of rest.)The schedule includes 3 hours of physical/occupational therapy --about 2 hours in the morning and an hour in the afternoon. With help I will also get him up to the chair this evening.  So far so good---he is understandably tired but working hard to meet the challenges. They constantly include family members as we will be going home with the patient.  It's all very interesting. We saw Dr. Saggi on the weekend and he continues to say the fistula will heal.  In his words "It's just 4 steps forward and 1 step back".  When we think of it in those terms it helps us remember the very successful outcome of the surgery. We are blessed with wonderful doctors!!! 
Love to all
Ruthie

Visiting Pawpaw

Dad got moved to the rehab floor on Friday evening and started his "work outs" on Saturday morning.  He and mom are now residing in room 460.  Rehab is tough, but he's doing great!  They work with him 3 hours a day 6 days a week (Sunday is a day of rest).  He has a busy schedule, but luckily he was able to fit in a visit from the grandkids between occupational and physical therapy. 

The NG Tube’s History - Check out that handsome face!

Yesterday was a “test”.  The NG tube (the tube in his nose that pumps bile and such out of his stomach) was clamped off.  If the fistula did not leak much in the following 24 hours they would remove the tube.  Dad passed his test and the tube was removed this morning.  Dad never really liked the NG (possibly because his nostril formed a permanent crease in its place after having the tube there for so long in 2009).  This time the tube had fallen into that same familiar crease.  Now the tube its gone.  It’s amazing how much more photogenic one looks without a long straw sticking out of one’s nostril and a bandaid covering one’s nose.

Mom and Dad

Bonnie and Dad

A tentative plan for tomorrow – MOVE TO THE REHAB floor!  Cross your fingers (or better yet say a little prayer).  - Tracy

Patience 201 By: Marilyn Goerig

Enough already!
Is Louie’s cry I’m sure.
The thought of one more setback
Is extremely hard to endure.

For over two years now,
We’ve learned and practiced patience.
As far as content mastery goes,
Louis achieved all “A’s”.

When his present surgery went so well;
He began to see the light.
Could there maybe be
An attainable goal in sight?

No doubt that end is still there,
With total healing achieved.
God is only testing us
To see if we still believe.

“In God’s Time” is very hard,
When you are ready to be done.
We will continue to pray
And study Patience 201

The cause of the intermitten fever has been diagnosed. One of the central lines is infected.  This was not immedately evident but "grew out" over days.  To remedy this,  Louie made a trip to Interventional Radiology this afternoon where a PICC line was inserted in his arm and the infected line removed.. 
Dr. Hall came by today and took the staples out of Louie's leg. This area was the donor site of a "flap"  of skin, fat, and muscle that became the cover for the previously open abdomen.  As you can imagine, that leg is very painful because of the deep section that was removed.  It looks wonderful, and the doctors are very pleased. He also took the staples out of another area on his side--this patch was covered with a muscle flap---it also looks good. The stiches  of the larger abdomen area will stay in longer but it is amazing. Dr. Hall confessed to putting much thought all hours of the day and night into this procedure.  We essentially presented him with an open area  with three mounds of  leaking intstines outside his body and looked for answers.  It was nothing that either he nor his asociate expected calling it a "plastic surgeons nightmare". The morning of the surgery he outlined Plan A, Plan B, or Plan C.  We joined hands and prayed the Our Father togerther.  I am so impressed with these surgeons who use their skills acknowledging that it only comes from God.  He was able to put Plan A into effect with great results.
Louie was also begun evaluation to be consided for the rehab floor.. You must be able to tolerate 3 hours of therapy per day and meet other medical criteria.  We hope that this move will be in his future.
     As Tracy indicated,  we were stunned on Sunday to hear the word fistula from Dr. Saggi . After he said that word I don't think we heard anything else.  Our eperience with fistulas is so extreme!  Since then we have been able to process that it is small, it should close by itself ( really? really?--we do not have the capacity to understand this) and he is doing well. 
The NG tube in his nose will stay in for now, and the wound vac-these will both decrease the fluid of the fistula.  Still no food or drink.   He is hanging in there and I am really proud of him.  We have a plaque at home that states "Faith makes things possible, not easy". How true! 
Thanks for your continued healing prayers---Ruthie

First and foremost, Happy Father’s Day!  Bonnie, Suzanne and I have been blessed with such an amazing father.  We are so grateful for all that he’s always done for us and continues to do.  Even the day after this surgery when he was able to tell me to “be careful on my drive home and call someone when I got there”.  I guess even when you’re still a little “loopy” from anesthesia you still don’t lose the dad in you.

As happy as we are to have such a great dad, we still did not have the joyous Father’s Day that we’d hoped for.  Sunday morning Mom and Dad were told that Dad has developed a small fistula.  FISTULA – oh how we HATE that word!  This is a devastating blow!  Fistulas are what he had before and what we wanted more than anything to eliminate.  It’s thought to be very small and Dr. Saggi feels like it could heal on its own in 3-4 weeks.  That is our ultimate prayer right now.  Please continue to pray for the healing of this fistula.  - Tracy

The cause of the fever has not yet been determined.  New antibiotics have begun and yesterday Louie had a CT scan to check the appearance of the bowel. There is some leakage, however,we hope this has nothing to do with the intestines or anything major but rather may have another origin.  Dr. Saggi ordered a wound vac to draw out the fluid. The CT scan I believe showed nothing negative but was inconclusive. Today he went to Nuclear  Medicine for a HIDA scan.  This lasts for an hour in a tube like apparatus. . Louie was wrapped up in this velcro binder thing which made him feel in his words like a "burrito". Not fun, but done.
We will keep you posted if we find out anything.  Dr. Saggi has surgery now and a transplant later so it is a busy day for him . He is really fabulous and takes good care of Louie. Our prayer now is for the bowel to be doing well and the leaking to be a fixable issue.

The good and the not so good...

The Good
Currently mom and dad have a new "home".  He's been transferred out of ICU/IMU and to a regular room (RM 923).  This certainly means progress and I'm amazed at how quickly things are moving this time around.  I say "mom and dad have a new home", because this also means that Mom and Aunt Rose aren't sleeping in the waiting room anymore. :)  Dad was able to sit in a chair yesterday for 2 hours (not a regular guest chair, a neurochair).  It wasn't comfortable (and was painful), but he did it! 

Not So Good
Okay guys, your prayers worked wonders on the swollen arm so I'm coming here with another request.  This morning he has fever.  I guess this is his next hurdle, so whatever prayers you sent up earlier this week please send them again.  Maybe this has something to do with the central line, but hopefully it is doesn't mean that infections are setting into any of his surgicial sites.  Until later. - Tracy

The ultrasound showed a superficial vessel that may cause the swelling. This is not harmful, so no additional care is needed other than possibly a bit if heat. Thank you again for your continued prayers.

Bump in the Road

Hopefully this is just a small bump and not truly a setback.  Dad's right arm is swollen.  He will be taken for an ultrasound this morning to check for a blood clot or a problem with the central line.  A better case scenario would be fluid build up. Dad's really worried about this, so please pray that they determine the cause (and are able to fix it) soon. 

Touched By An Angel

Yesterday I started the day in the most wonderful way. I looked across the waiting room to see my dear friend, Judith. We hugged and greeted each other joyously. It was again more than a coincidence to see her because Judith was scheduled for housekeeping on the 8th floor. When she came in, her supervisor oddly sent her to Hermann 3--ICU.  If you don't remember Judith , I can only describe her as an angel sent to me at the most unusual times. She would comfort and reassure me when I was afraid and later celebrate with me when I was most hopeful. She confidently told me that Louie would indeed wake up (even though much time had passed with no signs of this). I only saw her a handful of times but she seemed to "know" things. Yesterday she reminded me that God always has a plan laid out for us. Sometimes we must wait paitiently to see that plan (as in our case) but it's always in place. I told her how much her kindnes and faith meant to me in those chance encounters. I called her my angel. She said that we all have someone in time of need that God,in his goodness, sends to us.

This may be difficult for some people to understand. You may not believe the odd circumstances that caused me to see Judith at random times in our previous 9 months at Hermann and again now. It doesn't really matter if you believe her to be an angel, as I do, or not. If we could all be a little more like her the world would be a better place. I'll tell you why I think this to be true. When I look into those beautiful brown eyes I see deep faith, love and acceptance. No matter what you believe, know this---------JESUS shines through Judith.

Blessing to you all, Ruthie

All continues to go very well. Dad said yesterday, "if visitors come tell them to wake me up; I don't want to miss seeing anyone."  We laugh at this, because back in the early part of 2009 hundreds of visitors came and he wasn't awake to see any of them!  We are just so thankful to be having such a different ICU experience.  I could go on an on about how different it is.  First and foremost he's awake!  He's not telling mom "to go get his other wife".  He's not insisting that the nurses are all drug dealers who stash weapons in his bedding.  He knows who all of us are and he speaks coherently! 
He's been watching TV and flipping channels.  His only complaint is that he doesn't get the channels that play "westerns" all day.  I personally don't even remember them having a TV in their previous ICU rooms.  I hear that they did, but it never once was turned on.  I guess  I didn't realize that people back there actually watched TV.  I thought everyone was in "our boat"; making brief visits with little activity.  He's asked to have his cell phone at his bedside, but apparently that's against the rules.  He has many friends that he's ready to call!
They've spoke about trying to get him out of bed sometime toward the end of this week.  Undoubtedly this will be painful, but its progress that far supercedes the timeline I had in mind.  Recovery is off to a great start!

Another good day
Today Louie reunited with a very dear friend-----the remote control.  He sleeps a lot but like most men happily flips the stations during his awake moments.  This is somenthing we women will never understand but I have to say, today I love it, because it looks so NORMAL.
    Yesterday he said he felt like an old dog--that had been run over. Today he expressed feelings akin to a butchered chicken.  These men with country roots certainly have colorful ways to express themselves!  The main thing is the pain is tolerable, his sense of humor is in place, and the doctors are happy.
     
With thanks to God, so are we................
 
Blessings to all of you,   Ruthie

The good news continues. He had a great night. We knew he would be weaned from the vent today, but were very surprised that he was already off this morning. He's groggy and sleeping most of the time, but he has opened his eyes and talked a little bit. To answer most questions he just nods, but it's easy to tell that he's coherent. It's so nice to have him already awake today. He squeezed my hand when I asked, and wow he's stronger than I remember! Mom is back visiting with him now. Unlike in the first go round, he does remember that he's married to her. :) Life is good!