July 16. Dad was seen by the infectious diseases specialist, who (like Dr. Smith) wanted to take Dad off of the IV antibiotic. The lower strength of doxycycline, compared with the IV antibiotic he was taking, should help improve his kidney function. Antibiotics are tough on your system and can affect kidney function. Not surprisingly, when the doctor visited with him, Dad told him that he wanted to go home.
As promised yesterday, Adan stopped by with some thickened chicken soup for Dad to try. Dad wasn’t wild about the consistency of the soup, but Adan was encouraged that Dad was swallowing the soup without aspirating it.
Jennifer from PT arrived and Dad was ready to exercise. He immediately asked about her plans for him, and Mom wanted to know what he could do over the weekend. She didn’t want him “just lying in bed.” Although my parents were resigned to the fact that my father had to remain hospitalized until August 26, they didn’t want to stay there one day longer than absolutely necessary. Jennifer showed them a variety of exercises that Dad could do, and she encouraged him to sit in the chair at least twice a day over the weekend. Although he started out pretty unsteady, Dad was able to walk with assistance for about 250 feet. Jennifer was encouraged about how his mobility kept improving during their sessions.
July 17. The bad news was that it was Friday and Dad was scheduled for dialysis. The good news was that he’d have a two-day reprieve when today’s session was finished. Because it was dialysis day, he also had blood drawn. His lab results were very good. His WBC count was 6.5, his hemoglobin was 9.4, and his creatinine was 3.61. The hemoglobin and creatinine numbers weren’t good for the average person, but they were an improvement for him. They removed 2,877 ml of fluid, which was a significant increase over Wednesday. Although he was tired, he was still able to participate in some activities later that day.
Unfortunately, all of his physical therapy led Dad to believe that he could get out of bed by himself. He was reminded again by the nurse that if he needed anything, he should use the call button to request assistance.
Adan stopped by with some thickened tomato soup for Dad. It tasted as dreadful as it sounded, but he was able to swallow it. Adan was now cautiously optimistic about Dad’s prognosis. Mom and I were thinking ahead to Stan’s birthday the following week, and she asked Adan if he thought that Dad could eat a Jell-O cake (Don’t knock it until you’ve tried it.). Unfortunately, he said that the Jell-O was very slick and would be difficult to swallow. I was bummed. I had really hoped that we could have some sort of cake next week.
July 18. It was Saturday and the first weekend since May 15 that I stayed at home in Houston. When Mom arrived at the CCH, Dad was awake, but he said that he wasn’t feeling very well. He slept for another hour and felt better when he woke. Mom noticed that his feet stuck out of the bed when he slept. At 6’1”, Dad was taller that the hospital beds were long. According to the nurses, the beds were designed for 5’10” adults. Although she had asked before, Mom asked the nurse if she could find a bed extension for Dad’s bed. After searching for quite some time, she finally discovered an extension in the room across the hall, which had been occupied by a short woman. The extra foot enabled Dad to sleep with his feet under the covers.
The nurse started a new IV, but they had no plans to remove Dad’s PICC line until Sunday or Monday. I had sent Dad more flowers, and he surprised me by calling me at home to thank me for them. Although he was disappointed about how weak he had become and his extended stay, his attitude seemed to be getting more positive, and he was working hard to gain back the strength that he’d need to leave.
July 19. At 3:15 A.M., the night nurse woke Dad so that she could reposition him in the bed. When he objected, she reminded him about the importance of frequent position changes to prevent ulcers and to promote healing. He informed her that he didn’t need any help turning himself in bed and added that he did not want to be awakened during the night to turn. As you might expect, she asked him to show her, and he was able to fully turn on each side. She reinforced the importance of him turning, and then she left.
Rebecca, the day nurse, had a similar exchange with Dad when she reminded him that he had to turn himself in the bed every two hours.
When Dr. Ciceri saw Dad during morning rounds, he found Dad to be in good spirits and very conversant. If it wasn’t for the danged kidneys, you’d think that he’d be about ready to go home. It was now 75 days since Dad’s surgery. It had also been two days since dialysis, and Dad was feeling pretty good. With Mom’s help, he did lots of bed exercises and walked all over the CCH in his wheelchair.
July 20. It was Monday again, which meant a new doctor and more dialysis. Unfortunately, Dr. Douglas Anderson, our “favorite” doctor, was back. Before his 7:00 A.M. dialysis appointment, Dad was reminded once again that he had to use the call button and could not get out of bed without assistance. Dad’s pre-dialysis lab results were mixed. His WBC count was down to 5.4 but his creatinine level was up to 4.73, higher than they had been in weeks. Dad’s pre-dialysis weight was taken from the scale that is built into the bed. The down side of that nifty bed extension was that it added to the weight of the bed. According to the bed scale, which wasn’t recalibrated for the extra weight of the extension, he had gained 4.6 kg since Friday, which was highly unlikely. The dialysis nurse guestimated that he had gained 2.2 kg (5.5 pounds), and removed 2,872 ml.
Dad was pretty tired after dialysis—too tired to participate in swallowing trials with Adan. Adan said that he would follow up with Dad on Tuesday for a trial meal, and possibly diet advancement. That news from Adan was pretty promising, but even better than that was the news that Mom received from her neurologist. According to her latest MRI, Mom’s brain showed no signs of impairment from her stroke in May.
July 21. Dad’s day started out pretty well and he was in good spirits. Adan stopped by in the early afternoon and had Dad try eating some thickened chicken soup. He thought that Dad had made good progress in the past few days and would bring Dad a tray on Wednesday or Thursday.
Shortly after Adan left, Jennifer arrived for his physical therapy session. During his sit-stands on the edge of the bed, his heart rate increased to 140. Jennifer was a little alarmed, but the nurse told her that increases like this weren’t uncommon for Dad. Because he was a little dizzy and off balance, he required some assistance when he walked. His balance improved the more that he walked, but he required at least minimal assistance during the session. As she had done on previous visits, Jennifer ended the session by having Dad sit in the chair. All in all, Jennifer felt that he was progressing toward his goals.
A couple of hours after Jennifer left, Christopher, the occupational therapist, arrived to formulate goals with my parents. The occupational therapist had been monitoring Dad’s progress with physical therapy and felt that Dad was ready for OT intervention.
July 22. It was hump day for most people but dialysis day for Dad. It was also my husband’s birthday. Although Stan’s day would be better than Dad’s, he was scheduled to work during the day and then all night. As compensation for working 20 hours, Stan would get the day off on Friday, enabling us to get an early start to our weekend in Temple where we would celebrate Stan’s birthday with my parents.
When Dad arrived at the dialysis department, the dialysis nurse noticed that his lung capacity was somewhat diminished with crackles to the bases, although she said that his cough was productive. His WBC count was sitting at 5.6, so I wasn’t too worried about infection, although I wondered if the doxycycline was addressing the infection in his lung. His creatinine level was down slightly, but not nearly as low as it had been last week.
At 3:05 P.M., I was at the office in Houston and attending a meeting with Patrick and Michele, a couple of my coworkers. Whenever I was in Houston, I kept my mobile phone close by in case my mother happened to call. To date, all of my phone conversations with her were initiated by me. At this moment, my phone rang and my mother’s name appeared on the caller ID. I couldn’t take the call, but noticed that she left a message. I was able to end the meeting a little early, and then listened to the following message: “Melody, it’s Mom. I’m at the hospital with Dad and he’s not doing too well. He had a bad coughing spell during dialysis and they’re trying to bring his blood pressure down, but he’s got the shakes and delusions and all kinds of stuff. Call me on my cell, because I’m not going to leave him. Talk to you later. Bye-bye.”