Thursday, January 05, 2012

A Timeline. And Maybe Some Progress?

Okay . . . so the whole timeline went like this:

Dad got sick on 12/15.  The nursing home staff called.  They thought he had a stomach bug.  He presented with vomiting.  That's it.  The next day, he ate, slept and had a good day.

And then on the night of the 16th, he had more vomiting.  And a fall.   He went to the ER because he whacked his head.

And the next day, he ate and felt better and had a pretty good day, but felt weak.

So, on the 17th, he was admitted to the hospital for IV hydration.  And observation.

And he had some tests.  Where it was discovered that he had a partial small bowel obstruction.  He stayed in the hospital for observation and fluid.  The plan with small bowel obstruction is to wait, drag your feet and see if it clears.  But it didn't.

So, on Tuesday, the 20th, he was transferred from the little rural hospital where he was to a bigger hospital for a higher level of care.  

The official diagnosis came on the 22nd, when after several consults and much more testing, it was discovered that he had a chronic partial small bowel obstruction secondary to extensive scarring and adhesions from an appendectomy over 40 years ago.  When presented with the options (which were (a) have surgery or (b) never eat a normal diet again), he openly consented to surgery, stating, "Well, I can't starve to death.  That's no way to go."

Surgery was on the 23rd.  It was long and complicated.

On the 24th, the kids saw him.  He looked great and we all thought he would bounce right back.  He was laughing and joking with the kids and MOTH.

Then something happened on the 25th.  Mental vacation, I guess.   He stopped talking.  Started having a tough time swallowing.  No evidence of a stroke.

On the 26th, 27th, 28th, 29th, 30th, 31st, January 1st, 2nd, 3rd and 4th, he didn't speak.   He was exhausted.  He developed pneumonia.  He couldn't swallow.  Couldn't drink liquids.  Couldn't keep his eyes open.  He has been on IV nutrition.  Once in there, he slid markedly backward, began vomiting again and aspirated which made the pneumonia worse.  He began showing signs of renal complications (I hesitate to use the word failure).  He started looking yellow.  His liver enlarged.  His belly distended.

I'll be honest, I thought he would meet Jesus.

And today, I called his nurse to check on him and she said, "He's sitting up in the chair and eating lunch."

"Huh?", I said.  I repeated the name and room number thinking surely I forgot to mention that my dad was the one knocking on death's door.  

Instead, I heard her say, "Roy, it's your daughter on the phone . . . do you want to talk to her?"  And the most amazing thing of all, after no speech since the 24th of December, I heard him say, "Hello?"  He heard me on the phone, talked to me, answered a question or two.  I hung up absolutely stunned.  I had to pinch myself.  I still can't quite believe it.  

Now, it looks like things might be better.  Not out of the woods, but better.  He's speaking and he's more "with it".  He's tolerating a liquid diet.  Hmm.  Curious.

And I have this medical marvel to blog about.  If ever you have questioned the critical role of hormones in your life, let me tell you this:  My dad has been hypothyroid for many years.  He has been taking Synthroid for years.  Literally, as long as I can remember.  He's always been hypothyroid.  I did a case study on him once in nursing school.  I analyzed all of his meds and wrote about potential interaction.  Anyhoo . . . . round about the 30th or so, when the massive backward slide occurred, I spoke with a doctor and begged and said, THIS IS NOT HIM!!  Something has to be missing.  Hours later, she scoured his chart and discovered that his Synthroid had not been given since admission on the 20th.   So, for all of those days, his already slow functioning thyroid received no compensation.  Okay, medically minded folks, think of it this way.  Bowel surgery requires the bowel to be put to sleep.  In men who are 92, it's slow to wake up under normal circumstances.  Normal.  Add a severely hypothyroid state to that, and that explains the ileus.  It explains a secondary obstruction.  People who are hypothyroid sleep all the time.  They feel exhausted and overwhelmed and are difficult to rouse.

I'm not saying it was JUST that one thing . . . . but I'm saying his case is a case study in "I guess he really does need that med."  

So, to summarize . . . . a better day.  Not out of the woods, but a better day.

What an emotional roller coaster these last three weeks have been.  Lawd.

1 comment:

Winter said...

I am so glad that he is doing better. you both have pulled through this far..I will continue to pray that brighter days will be ahead!