It's Go Time Boys

The nurses are impressed with his night and they are seeing some personality come out from dad. He is flashing smiles their way and starting to bring on the "Gilbert" charm. When we call in the morning the night nurse says that he had a restful night with less medication. What a victory! I am just cringing watching all the meds they are having to pump through his traumatized body. Maybe they can lessen the versed to have him be more present through his days? I am afraid, though, that my mom is starting to seem like a little versed thrown her direction might be a nice thing. She is really having a terrible time sleeping, we both still just cry ourselves to sleep, and she continues to wake with hopes of a different reality. As she sleeps, she is allowed to be somewhere else in her mind, dream about him as her mind's eye remembers, but waking every morning with the wind knocked out of her sails as the reality of the day hits. We keep wondering if this is all a dream and maybe we will wake up from it. These days do NOT feel like our reality, we don't WANT them to be our reality! But, onward Christian soldier, dad needs us!


On the road again....I just can't wait to get on the road again! Too bad Willie, this just isn't true in our circumstance. The long stretch of highway is raw with grief, unbelief, sadness, fear, bits of hope, and a whole lot of tears. But the Lord knew our feeble hearts and soul needed a boost this morning! We see my dad sitting up in his bed as we walk into his room! Whoa,...where did you come from? They have taken out the screws from his head because his ICP numbers are down and looking great! They took off his neck brace once the screws came out and he is hooked up a couple fewer machines. Glory hallelujah!! I don't want to be a situationally happy Christian, but thank you Lord for allowing us to see this window of renewed health for my dad. He welcomes us back, is genuinely happy to see us and did I say that he was sitting up yet?!!! What a relief, I think we are on the right track now. We can all "talk" about how he is feeling today. He really seems good today, what a treat. We will see how this day progresses, but the phone calls I put out this day have a much better spin than the previous days.

The doctors are starting to look more carefully at his heart though. I haven't liked his blood pressure and his heart rate numbers the enitre time. They have been so high for him, but again the doctors were telling me to realize what his body has been through. I just wasn't liking what I was seeing! Now, they are seeing his heart rate is irregular. We get more questions of the quality of his heart. We assure the doctors that his heart has never been an issue, to our knowledge, other than it potentially being twice the size of other people because he is a lover not a fighter! :) They are seeing episodes of atrial fibrillation, where his heart is having irregular beats and is of concern because it can lead to blood clots the longer it goes (and blood clots are already an issue when you are laying in a hospital bed). There are people who are walking around right now with this problem, don't know it and will be fine, but my dad has experienced a significant trauma so it's a bit more risky for him. He is also showing signs of mild tachycardia (heart beating too fast), so they will be watching his numbers closely. Here we go with more numbers!

I also talk with the doctors about where we are with the ventilator. Do they have a goal on when they want to get him off? I know that WE want to get him off the ventilator as soon as possible. I know he can do it. The Respiratory Therapist thinks he can do it. She has been working him hard, enduring all the dirty glares he can give her. Maybe I should explain what "working him" really means. When they put him on a ventilator, they are using a machine to breathe for him. When they "work him", they pull back on how much work the machine is doing and require my dad's body to take over the gap. The problem is that he may resist working that hard or not be capable of it. In my dad's case , they are asking him to be in a certain range with his O2 Saturation. They are looking for numbers in the 90%tile preferably about 92%. But, I would be willing to bet he hasn't been in that range for the last 5 years at least. And they are still concerned with the amount of mucus coming from his lungs. But don't we need to remember that my dad is in the beginning stages of emphysema AND has been a smoker for most of his life. He has been coughing up mucus, productively, for quite some time and dealing "well" with it. I realize now that he has a trauma to consider as well, but he is strong and will fight to get out of here! He will do it. BUT, at the same time, his fight may have an expiration date to it...don't leave him too long on the ventilator because he may just give up on you. I know my dad and I am trying to be his advocate in this time since he can't speak for himself.

So, my dad fades in and out through much of the day. He is exhausted from the work and needs to rest a good deal. Luckily, we are able to slip out for lunch and dinner while he is resting rather than having to look him in the eyes and leave. We have been generously fed most meals by my mom's cousin (Bobo and Dolly, we'll let's just say that Bobo does all the talking and Dolly does all the working! :) They save us from eating out at random restaurants through this ordeal AND Bobo is funny! I am not sure if he thinks of creative things to talk about while we are there, but we never feel heavy leaving their house. It's refreshing to get out of the hospital and so nice to be with family who love my dad and care for us so practically. I will never forget the many meals we shared with them! At dinner, I talk about how great dad looked today and how I just know he is going to progress well in the next couple of days. We just have to get him off the ventilator. If he has the same sparkle in his eyes when we get to the hospital tomorrow, I might just have to suggest we give it a go! He looked ready this morning when we walked in, but it was the first day that he had given us that much cheer.

We drive home that night thankful for the events of the day. My mom even got to share a story about my dad, this time to the Respiratory Therapist. As we continually fight to give background on my dad to these health professionals who are caring for him, we feel desparate for them to really know him. We felt they should know how my dad treated his doctors after his knee surgery some 30 years ago. Only hours after his surgery, my dad begins to ask the doctor when he can go home (of course this is way before the in and out orthroscopic surgeries they have now) and his answer was "as soon as you can climb that flight of stairs." So,...my dad immediately gets up and starts to walk up the stairs, sweat just pouring off him as he struggles to bend the knee that has just been operated on, but determined that he was not about to spend the night in the hospital. The doctor was impressived with his drive, and maybe a little saddened by his "stupidity", but had to let him go. Needless to say, he recovered fine at home and the knee was ok, but my dad was stubborn!! He didn't want to do what other people told him because he always knew he could do it faster or they just didn't know his abilities. "Maybe other people need these guidelines, but somehow they don't relate to me," was his thinking. Unfortunately, he was so strong and athletically gifted, both physically and mentally, that it was generally true. Although taming his pride would have been a good lessen for him, he just had to learn in other ways.

Tomorrow is another day and I pray this night that God would make it clear for the doctors that they should go ahead and try to extubate. I LONG to hear my dad's voice again and as long as that trach is in him, this can't be a reality. And so, we "sleep"....

We get to the hospital the next morning to see my dad sitting up again in his bed with that glare / fight / love / "get me the hell outta here" look in his eyes. I go straight to his bedside and tell him of my plan. I ask him, "Are you willing to work today? Can you fight today to show these doctors and nurses that you are ready to be extubated? You want this thing out of your throat and you are going to work hard to breathe on your own, right? Don't make me a liar...I want to speak up for you and be your biggest fan, but are you sure you are ready?" He reassures me with his eyes and a firm head shake, and now it's on. I am talking to anyone who will listen about my dad's desire to be off the ventilator. They worked him hard yesterday and he did well with it. His mucus is still a problem, but it's always gonna be a problem until the good Lord takes him home. He realizes that not being able to kick his addition to nicotine is now playing a huge role in his recovery. As a sidebar...Day 2, we decided to start my dad on nicotine patches to help with the withdrawls his body might experience from lack of nicotine. I kept thinking this will be the way my dad stops smoking for good. Why don't we speed up the process for him and take this time to ween him from the addiction, plus won't his body respond better to the rest of the trauma without having to deal with a "cold-turkey" method?

(It might sound like I am running the show here, I realize that, but unless you have had someone in a Critical Care Unit, every piece of information is important and could matter. So, I was just trying to make sure they were well informed and we thought about all the angles of care my dad needed. I think the nurses and doctors were grateful for my active role, but who knows what they said about me behind closed doors!! I didn't care, it's my dad!! Oh yeah, a funny thing about my "active" role, the first time we met the Respiratory Therapist whom we came to adore, she came into the room and was asking all kinds of questions. The questions were directed at the nurse, but she had just gotten there and hadn't had much time to go through his notes. I chimed in to give her the answers she was looking for and you should've seen the look on her face...."Who is this girl and why does she know these numbers so well?" In case you haven't figured out, I like to learn and will ask lots of questions until I understand something. Plus, with my background in exercise science, I catch on to medical jargon pretty quickly. :)

As the morning progresses, I finally lay eyes on my prey, the team of 3 doctors who had been working with my dad (Doogie Howser doc included who has seen my "active" involvement the last 6 days). I walked straight to them, very matter of fact and said, "It's GO time BOYS!!!"