Thank you all so much for the thoughts and memories you have expressed here.
On Sunday, the 17th, there will be a wake from 2PM to 4PM and from 6PM to 8PM at:
DeVol Funeral Home
10 E Deer Park Dr.
Gaithersburg, MD 20877
http://www.devolfuneralhome.com/
On Monday at 11AM there will be a service at:
Grace United Methodist Church
119 N Frederick Ave.
Gaithersburg, MD 20877
http://www.graceumc.org/
In lieu of flowers, we ask that anyone interested please make a contribution in Barbara's name to the Montgomery County Humane Society, http://www.mchumane.org/memorial.shtml.
Thank you,
David
Friday, August 15, 2008
Thursday, August 14, 2008
This is David, Barbara's brother. For those of you who have not heard yet, I'm sorry to post that Barbara passed away last night due to a blood clot which reached her heart. I know that throughout her struggle she greatly appreciated all of the well wishes that everyone posted here, and on behalf of her family we want to thank you.
A service will probably be held in Gaithersburg, MD this weekend or Monday, but all of these details have not been worked out yet. One of us will post here when we know more.
A service will probably be held in Gaithersburg, MD this weekend or Monday, but all of these details have not been worked out yet. One of us will post here when we know more.
Wednesday, August 13, 2008
back in the waiting room...
Because Barb is back in the operating room. But not as much this time. It's better than it could be.
They did do the CT scan and find blood clots -- actually, they termed it one single blood clot, running from her knees to her liver in a contiguous mass in her vein system, which is kinda big. There are two ways to deal with a blood clot like that -- you can feed a person anticoagulants, so her blood won't clot at all, and the clot will dissolve, or you can whack it with a hammer and break it up yourself. Sparing no expense, the doctors here decided to do both.
They started her on Heparin right away, which would prevent the clot from growing further. They then made preparations, and just now brought her into the arthroscopic surgery room. (I may not have spelled that right. I don't feel bad about it.) The procedure, which poses minimal danger, is to send a little robot scopey guy, named Albert, up the veins in the back of her knees. The robot has two tools attached, a high-pressure water gun and a vacuum cleaner. He will find the lower end of the clot, blast it with his gun to dissolve it, then vacuum up the dissolved bits. He will then continue up the vein, and repeat, until he has made his little robot way up to her liver, by which time he will have opened a pathway up for blood flow.
I am told that this description, while easy enough for me to understand, is not exactly technically accurate (e.g., the robot's name is actually Mortimer). However, it is correct in substance, and it will do as far as I'm concerned. The procedure, they assured us, is extremely safe. The more dangerous part comes afterwards, when they put her on blood thinners and anti-coagulants for a few months. They plan to monitor her for clot progress (the remnants of it should diminish over time without further intervention) and keep her on blood thinners until they can't find clot anymore.
Good news? Her liver's working great. Her kidneys are working great. She's put on a lot of weight through swelling, but it's all water and should go away quickly once circulation is restored. The operation today will leave at most two external wounds, punctures in the skin which can be repaired by a simple band-aid -- only a few millimeters in size. Things aren't too bad, and there are a lot of silver linings in sight.
But man, all these new clouds rolling in sure is starting to get old. We'll update as we can. Think positive thoughts.
They did do the CT scan and find blood clots -- actually, they termed it one single blood clot, running from her knees to her liver in a contiguous mass in her vein system, which is kinda big. There are two ways to deal with a blood clot like that -- you can feed a person anticoagulants, so her blood won't clot at all, and the clot will dissolve, or you can whack it with a hammer and break it up yourself. Sparing no expense, the doctors here decided to do both.
They started her on Heparin right away, which would prevent the clot from growing further. They then made preparations, and just now brought her into the arthroscopic surgery room. (I may not have spelled that right. I don't feel bad about it.) The procedure, which poses minimal danger, is to send a little robot scopey guy, named Albert, up the veins in the back of her knees. The robot has two tools attached, a high-pressure water gun and a vacuum cleaner. He will find the lower end of the clot, blast it with his gun to dissolve it, then vacuum up the dissolved bits. He will then continue up the vein, and repeat, until he has made his little robot way up to her liver, by which time he will have opened a pathway up for blood flow.
I am told that this description, while easy enough for me to understand, is not exactly technically accurate (e.g., the robot's name is actually Mortimer). However, it is correct in substance, and it will do as far as I'm concerned. The procedure, they assured us, is extremely safe. The more dangerous part comes afterwards, when they put her on blood thinners and anti-coagulants for a few months. They plan to monitor her for clot progress (the remnants of it should diminish over time without further intervention) and keep her on blood thinners until they can't find clot anymore.
Good news? Her liver's working great. Her kidneys are working great. She's put on a lot of weight through swelling, but it's all water and should go away quickly once circulation is restored. The operation today will leave at most two external wounds, punctures in the skin which can be repaired by a simple band-aid -- only a few millimeters in size. Things aren't too bad, and there are a lot of silver linings in sight.
But man, all these new clouds rolling in sure is starting to get old. We'll update as we can. Think positive thoughts.
Tuesday, August 12, 2008
Two steps back...
So, they moved her out of ICU and into a normal inpatient ward last night... and tonight, she's back in ICU.
A little frustrating, and we've been a little crazy today, so I hope you'll forgive if this is a shorter post. Basically, her swelling has recurred and gone a little crazy, so they are doing a CT scan tonight (in about an hour) to check very thoroughly for blood clots. If there aren't any, then she's got a Foley catheter (one of the things that she gratefully had lost yesterday), and they'll give her some diuretic pills until she loses all that excess fluids. If there are, then they'll give her blood thinners until they go away. (If there are and they're in the wrong place, there's the possibility of further surgery, but let's not even think about that, OK? Thanks!)
Anyway, you now know all that I do, and I'll post more when more happens. Sorry if I haven't been on the ball with this blog thing all the time, but oddly, internet access is much better in the actual ICU than in the lower wards. You get what you pay for, I guess. Next time, we're going to do this whole hospital stay thing in a GOOD hotel.
A little frustrating, and we've been a little crazy today, so I hope you'll forgive if this is a shorter post. Basically, her swelling has recurred and gone a little crazy, so they are doing a CT scan tonight (in about an hour) to check very thoroughly for blood clots. If there aren't any, then she's got a Foley catheter (one of the things that she gratefully had lost yesterday), and they'll give her some diuretic pills until she loses all that excess fluids. If there are, then they'll give her blood thinners until they go away. (If there are and they're in the wrong place, there's the possibility of further surgery, but let's not even think about that, OK? Thanks!)
Anyway, you now know all that I do, and I'll post more when more happens. Sorry if I haven't been on the ball with this blog thing all the time, but oddly, internet access is much better in the actual ICU than in the lower wards. You get what you pay for, I guess. Next time, we're going to do this whole hospital stay thing in a GOOD hotel.
Monday, August 11, 2008
Now, back to the star of our show...
My stuffed bear, Hope, and I are proud to announce that we made it through this endeavour together. Yes, surgery and all. The surgeon and anesthesiologist agreed that "special friends," as long as of the inanimate variety, were allowed in the operating room. He even got a hospital bracelet of his own.
After Del read me all the posts that he had written of the earlier stages of both surgery and recovery, I am pleased to say that I remember almost none of this. I remember some of yesterday and today, and the rest is a mystery (wrapped in an enigma) that can only be told to me by others who witnessed it.
My biggest accomplishment for the day was being able to have my catheter removed, and go potty all by myself! Mommy, WOW! I'm a big kid now! (Sorry, couldn't help myself.)
With all that said, I am woman, I am invincible, and I am TIRED. More tomorrow...
After Del read me all the posts that he had written of the earlier stages of both surgery and recovery, I am pleased to say that I remember almost none of this. I remember some of yesterday and today, and the rest is a mystery (wrapped in an enigma) that can only be told to me by others who witnessed it.
My biggest accomplishment for the day was being able to have my catheter removed, and go potty all by myself! Mommy, WOW! I'm a big kid now! (Sorry, couldn't help myself.)
With all that said, I am woman, I am invincible, and I am TIRED. More tomorrow...
Sunday, August 10, 2008
Middle of the night post
She's feeling OK, sleeping OK, and using push-button drugs (it's called PCA, or patient-controlled analgesic -- she gets a steady flow of drugs into her epidural, and she can push a button on a little remote to get a little more every so often; if you push the button eleven times in a row, it only works the first time, which seems unfair). She's probably going to move to a new room tomorrow. She had some clear liquids today, like broths, jellos, soups, and juices. She's feeling more and more human.
Human plus a big hack across the ribcage, but human nonetheless. I don't really have much news to update, but I didn't want anyone to get the entirely unlikely thought that I might ever forget to update the blog. (No, really, I'm not defensive!)
Did y'all catch that swimming relay race? It seemed like awesome competition, until you realize they're doing fencing, judo, and taekwondo today, and all three of those might get five seconds of airtime total. If anyone finds video of the judo online, let me know, OK?
Human plus a big hack across the ribcage, but human nonetheless. I don't really have much news to update, but I didn't want anyone to get the entirely unlikely thought that I might ever forget to update the blog. (No, really, I'm not defensive!)
Did y'all catch that swimming relay race? It seemed like awesome competition, until you realize they're doing fencing, judo, and taekwondo today, and all three of those might get five seconds of airtime total. If anyone finds video of the judo online, let me know, OK?
Quick update and non sequitur
Barb's feeling enough better that they're starting to wean her off her pain meds/epidural, which in turn is making her feel less better. It makes perfect sense, really. She did walk a few steps today, though, and they're planning on staging her out of the ICU into a normal room tomorrow. (Jeannie, they were discussing that this morning, which is why I told you I thought it better to hold off a day -- if you can come tomorrow and she's in her own room, it will be a little roomier, a little more private, and a little less noisy.)
There's a guy in the segment next to her in the ICU, just staged back here from the war. He got his face damaged pretty well by an IED -- or, if you prefer English to army talk, a bomb. He says that whenever he sleeps, he feels like he's getting blown up again. They're working with him, both to reduce the swelling enough in his face that he can open his eyes (I don't think he's outright blinded, but his eyes don't open at the moment) and to get him the meds and therapy to work with the post-traumatic stress disorder -- or, if you prefer English, to the shell shock.
He's hostile and angry, which seems understandable, and the nurses handle him well. He mostly has had males assigned as his nurses; when he cusses at them, they talk him down, help him focus, and try to bring him to a place with less hurt and fury.
This doesn't have anything to do with the InvinciBarb blog, or any of her medical issues -- she's been distracted enough with pain and discomfort that she may not have noticed that dude at all. I have, though, and I'm both moved by the sacrifices that people make in the name of love for their country and by the art and compassion of the medical professionals that try to repair them. When you're saying a prayer for Barb tonight, which I hope that you will, save a thought for those people, too...
There's a guy in the segment next to her in the ICU, just staged back here from the war. He got his face damaged pretty well by an IED -- or, if you prefer English to army talk, a bomb. He says that whenever he sleeps, he feels like he's getting blown up again. They're working with him, both to reduce the swelling enough in his face that he can open his eyes (I don't think he's outright blinded, but his eyes don't open at the moment) and to get him the meds and therapy to work with the post-traumatic stress disorder -- or, if you prefer English, to the shell shock.
He's hostile and angry, which seems understandable, and the nurses handle him well. He mostly has had males assigned as his nurses; when he cusses at them, they talk him down, help him focus, and try to bring him to a place with less hurt and fury.
This doesn't have anything to do with the InvinciBarb blog, or any of her medical issues -- she's been distracted enough with pain and discomfort that she may not have noticed that dude at all. I have, though, and I'm both moved by the sacrifices that people make in the name of love for their country and by the art and compassion of the medical professionals that try to repair them. When you're saying a prayer for Barb tonight, which I hope that you will, save a thought for those people, too...
What do you mean, I haven't updated?
There seems to be some belief out there that I haven't updated this blog all day. I deny this allegation wholeheartedly.
However, just to recap, I will say that Barbara looks much stronger today than yesterday, and that things are progressing well. She stood up and walked across the room with very little assistance today, and she seems eager to get out of the ICU, out of the hospital, and (most importantly) out of those annoying hospital gowns that fly open at the back. She hates those.
She's able to stay awake a little longer at a stretch now, although she can fall asleep pretty much at any time. She's taking more interest in everything, including the television. Her stomach's bothering her some, a little unsettled, but overall, she's doing pretty well.
There haven't been a whole lot of major occurrences, which is why you may not have noticed all my DOZENS of blog posts. I'll try to write louder from now on.
However, just to recap, I will say that Barbara looks much stronger today than yesterday, and that things are progressing well. She stood up and walked across the room with very little assistance today, and she seems eager to get out of the ICU, out of the hospital, and (most importantly) out of those annoying hospital gowns that fly open at the back. She hates those.
She's able to stay awake a little longer at a stretch now, although she can fall asleep pretty much at any time. She's taking more interest in everything, including the television. Her stomach's bothering her some, a little unsettled, but overall, she's doing pretty well.
There haven't been a whole lot of major occurrences, which is why you may not have noticed all my DOZENS of blog posts. I'll try to write louder from now on.
Saturday, August 9, 2008
Not much of an update...
But things are going well. I just realized I hadn't updated in 12 or 13 hours; sorry.
She's just gotten back in bed, after spending most of the day in a chair (the chair is a tricked-out cadillac of a chair, but it was still progress). She's been drinking ginger ale, which is a definite advance, too.
Still pretty tired and a little dazed, but we're showing more and more forward progress by the hour. More to follow...
She's just gotten back in bed, after spending most of the day in a chair (the chair is a tricked-out cadillac of a chair, but it was still progress). She's been drinking ginger ale, which is a definite advance, too.
Still pretty tired and a little dazed, but we're showing more and more forward progress by the hour. More to follow...
Milestone!
We had a coherent conversation! She is still distracted, uncomfortable, and very quiet, but doing much better.
The first thing she asked was if I had updated the blog. I allowed that I might have written a word or two. When I told her I was going to come in and update it to tell everyone she was awake, she told me to promise everyone that she'd call once she could talk a little more loudly. So, consider yourself promised. That will be no sooner than a few days, not just because her voice is weak, but because if we pull out her cell phone in the ICU, they're going to administer a prescription dose of beating to us.
Soon, though. Happy thoughts.
The first thing she asked was if I had updated the blog. I allowed that I might have written a word or two. When I told her I was going to come in and update it to tell everyone she was awake, she told me to promise everyone that she'd call once she could talk a little more loudly. So, consider yourself promised. That will be no sooner than a few days, not just because her voice is weak, but because if we pull out her cell phone in the ICU, they're going to administer a prescription dose of beating to us.
Soon, though. Happy thoughts.
She's a funny one...
The nurses decided to get her up out of bed and move her into a chair, which seems a good compromise between her burning desire to get out of bed and her utter inability to perform that athletic a feat. They bathed her -- which is when they threw me out, which was when I blogged earlier -- and then moved her over to the monster big chair that I've been snoozing in the past few days.
Once she got settled, she looked over at the nurse, and asked, "When's breakfast?"
The nurse looked alarmed. I said, "I don't think you'll be eating this morning, sugar. Maybe later on in the day--"
"Not for me," she said. She told the nurse, "He's diabetic; he needs to eat!"
I assured her it was still 3.30 in the morning, and I was going to go find a snack soon. After a bit, I did, and I kissed her cheek, telling her I was going to go find some food.
She said, "You'll meet me in the cafeteria?" Then she fell asleep without waiting for an answer.
The drugs will probably all have worn off soon. It's almost a shame; she's funny when she's loopy.
Once she got settled, she looked over at the nurse, and asked, "When's breakfast?"
The nurse looked alarmed. I said, "I don't think you'll be eating this morning, sugar. Maybe later on in the day--"
"Not for me," she said. She told the nurse, "He's diabetic; he needs to eat!"
I assured her it was still 3.30 in the morning, and I was going to go find a snack soon. After a bit, I did, and I kissed her cheek, telling her I was going to go find some food.
She said, "You'll meet me in the cafeteria?" Then she fell asleep without waiting for an answer.
The drugs will probably all have worn off soon. It's almost a shame; she's funny when she's loopy.
Rough night...
Barb's coming off the sedation, and it's hard for her. She's feeling a lot of pain, having trouble getting staying oriented, and she keeps wanting to get up, which isn't so good when you have an epidural in and can't feel your legs. But you know Barb; little things like that don't slow her down.
So trying to keep her calm is difficult, and trying to keep her flat is virtually impossible, and it's kind of a rough night for both of us. Keep us in your prayers....
So trying to keep her calm is difficult, and trying to keep her flat is virtually impossible, and it's kind of a rough night for both of us. Keep us in your prayers....
Friday, August 8, 2008
In progress...
Just wanted to throw out a quick update while I was eating a sammich. Barb's doing OK. Right now, as ever, it comes down to how well her kidneys can handle pushing out those excess fluids. They're overloaded right now, and a little fatigued, but still working.
She's annoyed with us, as she comes out from under her stoned state. The sedative they had her on for the past few days is a close chemical analogue to heroin, we were told, and she's still kind of loopy even though she hasn't been getting it for almost seven hours. (Your liver is really useful at filtering that sort of thing out of your system.) She keeps waking up, looking alarmed, trying to get out of bed, telling us she has to use the bathroom. When we explain that she needs to stay put and has a catheter in, she gets bored with the conversation and falls back to sleep. Repeat every ten minutes. Fun times.
John Hammer stopped by and visited for a bit, which was nice. Dan, Deb, and Don (and Del) are all still here and doing ok. (I'm ok. I've slept a couple hours here and there, and eaten a reasonably healthy amount. No diabetic incidents. No worries.) All of us grateful for your warm wishes and prayers. More to follow.
She's annoyed with us, as she comes out from under her stoned state. The sedative they had her on for the past few days is a close chemical analogue to heroin, we were told, and she's still kind of loopy even though she hasn't been getting it for almost seven hours. (Your liver is really useful at filtering that sort of thing out of your system.) She keeps waking up, looking alarmed, trying to get out of bed, telling us she has to use the bathroom. When we explain that she needs to stay put and has a catheter in, she gets bored with the conversation and falls back to sleep. Repeat every ten minutes. Fun times.
John Hammer stopped by and visited for a bit, which was nice. Dan, Deb, and Don (and Del) are all still here and doing ok. (I'm ok. I've slept a couple hours here and there, and eaten a reasonably healthy amount. No diabetic incidents. No worries.) All of us grateful for your warm wishes and prayers. More to follow.
Getting better...
She was extubated (a made-up word meaning the tube was pulled out, in her case, the breathing tube) about an hour ago. She's got a sore throat, but is now actually able to talk. Next goal: complete sentences.
We're actually doing a lot better than we thought we would be last night. The swelling has gone down a lot, and all of her numbers -- blood pressure, bladder pressure, breathing strength, oxygenation, pulse rate, price of tea in China -- are doing a lot better. She's losing the edema that was built up in her abdomen. They are thinking optimistically of moving her out of the ICU in the next day or two. Because of the swelling, they were thinking more like five days last night, but she really has turned the corner.
We're actually doing a lot better than we thought we would be last night. The swelling has gone down a lot, and all of her numbers -- blood pressure, bladder pressure, breathing strength, oxygenation, pulse rate, price of tea in China -- are doing a lot better. She's losing the edema that was built up in her abdomen. They are thinking optimistically of moving her out of the ICU in the next day or two. Because of the swelling, they were thinking more like five days last night, but she really has turned the corner.
Morning shift change
I'm writing this en route from her room to the caf downstairs, just because I don't know when I will walk past an unused computer again. She's doing well.
They just did turnover at the nurses station. Kerry, our nurse from last night, gave a really thorough status report to Stephanie, the nurse taking over for today. She reported that Barb is doing well, much better, and seems to be out of the woods. The swelling has gone down a lot; her bladder pressure and her airway pressures are much better than they were. They kicked me out and gave her a bath around 1 or 2 in the morning. (With nothing better to do, I called Kate and woke her up. Sorry, Kate.) An hour or so ago, Kerry removed a shampoo cap (think of a normal shower cap, only stuffed full of shampoo, so sort of inverted) and spent a while combing and brushing some dried blood out of Barb's hair. She now has two pigtails and looks like a blonde Pippi Longstockings.
(Incidentally, I'm not sure why so much blood got into her hair. I mean, it was a messy surgery, and they wound up giving her about five liters of blood, which is about as much as a full-sized human has available. But the incision was under her ribs; it seems almost careless to have blood flying all over that much. The surgeons weren't soaked in it when we saw them. A mystery.)
Most importantly for Barb's status now, her kidneys seem to be working really well, which is good for the problem of getting rid of all that fluid that was piling up in her abdomen. She's fighting off all the complications of this surgery, largely on her own.
Kerry said to Stephanie, sort of to wrap up the turn-over, that when she came in last night, Barb looked like "a train wreck ready to happen. I came in and said, 'What have I gotten myself into?'" I thanked her for at least pretending to be more optimistic than that at the time. She said that things looked about 180 degrees better than they were last night.
So the outlook's not so bad. Keep sending prayers and positive energy our way, though; we are not cancelling our subscription yet.
They just did turnover at the nurses station. Kerry, our nurse from last night, gave a really thorough status report to Stephanie, the nurse taking over for today. She reported that Barb is doing well, much better, and seems to be out of the woods. The swelling has gone down a lot; her bladder pressure and her airway pressures are much better than they were. They kicked me out and gave her a bath around 1 or 2 in the morning. (With nothing better to do, I called Kate and woke her up. Sorry, Kate.) An hour or so ago, Kerry removed a shampoo cap (think of a normal shower cap, only stuffed full of shampoo, so sort of inverted) and spent a while combing and brushing some dried blood out of Barb's hair. She now has two pigtails and looks like a blonde Pippi Longstockings.
(Incidentally, I'm not sure why so much blood got into her hair. I mean, it was a messy surgery, and they wound up giving her about five liters of blood, which is about as much as a full-sized human has available. But the incision was under her ribs; it seems almost careless to have blood flying all over that much. The surgeons weren't soaked in it when we saw them. A mystery.)
Most importantly for Barb's status now, her kidneys seem to be working really well, which is good for the problem of getting rid of all that fluid that was piling up in her abdomen. She's fighting off all the complications of this surgery, largely on her own.
Kerry said to Stephanie, sort of to wrap up the turn-over, that when she came in last night, Barb looked like "a train wreck ready to happen. I came in and said, 'What have I gotten myself into?'" I thanked her for at least pretending to be more optimistic than that at the time. She said that things looked about 180 degrees better than they were last night.
So the outlook's not so bad. Keep sending prayers and positive energy our way, though; we are not cancelling our subscription yet.
Thursday, August 7, 2008
switches and turns...
Another quick reversal, so this will be a quick post. Just after I posted my last, her surgeon came in and reported that, in the hour or so since we had last seen her, Barb's numbers were all looking better, the pressure was lowering, and her fluids seemed to be absorbing pretty well. The decision was thusly made to skip out on surgery for tonight and keep an eye on her. If things turn around again, they'll operate on her when the time seems right, but the time is not that now, so we wait.
Maybe having us in to talk to her had a positive effect.
Her three parentals just left the hospital, to stay at their hotels until the morning comes. It's been a long day; I can't say I blame them. I'm going to take things a little more calmly myself; I'm going into the surgical ICU to sit next to her bed, talk to her, and maybe even read my multicultural lit textbook. This will therefore be my last blog post of the night.
Keep us in your prayers. We're not out of the woods yet, but daylight is breaking through the branches...
Maybe having us in to talk to her had a positive effect.
Her three parentals just left the hospital, to stay at their hotels until the morning comes. It's been a long day; I can't say I blame them. I'm going to take things a little more calmly myself; I'm going into the surgical ICU to sit next to her bed, talk to her, and maybe even read my multicultural lit textbook. This will therefore be my last blog post of the night.
Keep us in your prayers. We're not out of the woods yet, but daylight is breaking through the branches...
Did I say breathe easy?
Maybe I was too optimistic. Things are not as bright as they seemed.
We had been hanging out for about two hours after the doctors all said, "We'll let you in to visit her in the ICU in about 30 minutes!" Eventually, we got tired of this and stormed the ICU to demand our Barb back.
"Things aren't quite what we thought," an exceptionally informative desk nurse told us. She then brought me and (the six-foot-eight and visibly tense) Dan back to Barb's area to talk to the surgeon.
The whole team was back there; at least six doctors and at least three nurses, including the surgical guys and the ICU guys. The problem, they told us, was that they had given her a lot of fluids over the last ten hours or so, including about two and a half gallons of blood. (I feel a distinct obligation now to donate blood about ten times.) The fluids have built up, causing swelling, especially in her abdomen. Looking at Barbara, the place was clear: right under her ribs, over her diaphragm, she was swollen pretty heavily.
The fear, the doctors told us, was that the excess pressure from that swelling would lay on her lungs and her kidneys. If her kidneys started to suffer, that was bad. If her lungs started to suffer, that was exceptionally bad. They described the fix, the necessity of which they were trying to decide: They would pull out the staples holding the original cut closed, open up her abdomen, and seal it shut with an airtight spongy draining device. It's a device they have a lot of experience with, because they often get soldiers and ground forces casualties in with open abdomen wounds. This device would drain the swelling off, and it would leave her abdomen essentially laid open for a few days until her fluid levels were normal again. (She would absorb the fluid more quickly, of course, except that it has to go through her liver, which is now missing 50% of its mass.)
The downside to that device is that she doesn't get to wake up until the weekend sometime, or maybe Monday. She's already expecting to wake up Thursday night, and the surgeons had already decided to push that to Friday afternoon, so any further postponement really risks throwing off her whole weekend schedule.
The other option, of course, is to leave her swelling. That will either lead to the fluids absorbing normally into her body overnight and into tomorrow morning, letting the problem solve itself, or it will lead to a crisis and decision point in another eight hours or so, when the swelling has increased to the point where the ventilator's function is impaired and she's not breathing the way she ought.
We weren't asked to make this decision. I am grateful for that, although I think I'd be brave enough to go the route where she's less comfortable now, in the hospital for longer, and doesn't run the risk of permanent lung or kidney damage. The doctors are going to observe her for a little while longer, and discuss their options a little while longer, and maybe they'll come talk to us again in a half hour or so.
We each talked to her for a moment before we cleared out of the ICU. I promised her that we were taking care of each other, Daisy was being well watched after, we were all saying prayers and thinking of her, and she should just relax peacefully and focus on feeling well. She was not conscious, in a traditional sense, but it's not at all unlikely that she was listening on some level.
Thanks for the comments y'all are posting. Sorry if I wrote The Brothers Karamazov. I'll keep you current as I can.
We had been hanging out for about two hours after the doctors all said, "We'll let you in to visit her in the ICU in about 30 minutes!" Eventually, we got tired of this and stormed the ICU to demand our Barb back.
"Things aren't quite what we thought," an exceptionally informative desk nurse told us. She then brought me and (the six-foot-eight and visibly tense) Dan back to Barb's area to talk to the surgeon.
The whole team was back there; at least six doctors and at least three nurses, including the surgical guys and the ICU guys. The problem, they told us, was that they had given her a lot of fluids over the last ten hours or so, including about two and a half gallons of blood. (I feel a distinct obligation now to donate blood about ten times.) The fluids have built up, causing swelling, especially in her abdomen. Looking at Barbara, the place was clear: right under her ribs, over her diaphragm, she was swollen pretty heavily.
The fear, the doctors told us, was that the excess pressure from that swelling would lay on her lungs and her kidneys. If her kidneys started to suffer, that was bad. If her lungs started to suffer, that was exceptionally bad. They described the fix, the necessity of which they were trying to decide: They would pull out the staples holding the original cut closed, open up her abdomen, and seal it shut with an airtight spongy draining device. It's a device they have a lot of experience with, because they often get soldiers and ground forces casualties in with open abdomen wounds. This device would drain the swelling off, and it would leave her abdomen essentially laid open for a few days until her fluid levels were normal again. (She would absorb the fluid more quickly, of course, except that it has to go through her liver, which is now missing 50% of its mass.)
The downside to that device is that she doesn't get to wake up until the weekend sometime, or maybe Monday. She's already expecting to wake up Thursday night, and the surgeons had already decided to push that to Friday afternoon, so any further postponement really risks throwing off her whole weekend schedule.
The other option, of course, is to leave her swelling. That will either lead to the fluids absorbing normally into her body overnight and into tomorrow morning, letting the problem solve itself, or it will lead to a crisis and decision point in another eight hours or so, when the swelling has increased to the point where the ventilator's function is impaired and she's not breathing the way she ought.
We weren't asked to make this decision. I am grateful for that, although I think I'd be brave enough to go the route where she's less comfortable now, in the hospital for longer, and doesn't run the risk of permanent lung or kidney damage. The doctors are going to observe her for a little while longer, and discuss their options a little while longer, and maybe they'll come talk to us again in a half hour or so.
We each talked to her for a moment before we cleared out of the ICU. I promised her that we were taking care of each other, Daisy was being well watched after, we were all saying prayers and thinking of her, and she should just relax peacefully and focus on feeling well. She was not conscious, in a traditional sense, but it's not at all unlikely that she was listening on some level.
Thanks for the comments y'all are posting. Sorry if I wrote The Brothers Karamazov. I'll keep you current as I can.
Surgery complete, but not quite all clear...
The surgeons just met us and let us know Barb's status; she made it through the surgery in one piece. Well, two pieces, but we were hoping to get one piece out and throw it away, so that's good.
Part of the FNH had gotten close to a hepatic vein. The hepatic veins (and arteries) are the primary vehicles for blood supply to the liver. Long story short, if you can't remove something without killing a hepatic vein, you should leave it in; otherwise, you risk the whole liver. Well, this FNH could be removed without killing a hepatic vein, but not too elegantly; the vein bled a lot and Barbara wound up needing about ten pints of blood. Blood transfusions don't make these surgeries pretty; apparently, she is swollen a bit, and they will want to keep her on a ventilator for a day to make sure that swelling doesn't impact her breathing.
That said, the mass is gone, the liver is not bleeding, and she came through without any blood pressure or heartbeat impact -- she was losing some blood, but they were refilling her, and she never noticed the loss. Still hasn't, I guess, because she is still asleep in the next room. They haven't let us in yet (which is why I'm blogging, instead of hanging with her).
When they do, she'll be doped up like Hunter S. Thompson on holiday, so hopefully, she won't be in too much discomfort. I'll post more when we know more.
But the bottom line for now: Surgery's complete, she seems well, and once we're sure that all the blood-loss controls took, we can all breathe easy. Say tomorrow morning. Until then, say a prayer for a speedy recovery, and keep sending happy thoughts.
Part of the FNH had gotten close to a hepatic vein. The hepatic veins (and arteries) are the primary vehicles for blood supply to the liver. Long story short, if you can't remove something without killing a hepatic vein, you should leave it in; otherwise, you risk the whole liver. Well, this FNH could be removed without killing a hepatic vein, but not too elegantly; the vein bled a lot and Barbara wound up needing about ten pints of blood. Blood transfusions don't make these surgeries pretty; apparently, she is swollen a bit, and they will want to keep her on a ventilator for a day to make sure that swelling doesn't impact her breathing.
That said, the mass is gone, the liver is not bleeding, and she came through without any blood pressure or heartbeat impact -- she was losing some blood, but they were refilling her, and she never noticed the loss. Still hasn't, I guess, because she is still asleep in the next room. They haven't let us in yet (which is why I'm blogging, instead of hanging with her).
When they do, she'll be doped up like Hunter S. Thompson on holiday, so hopefully, she won't be in too much discomfort. I'll post more when we know more.
But the bottom line for now: Surgery's complete, she seems well, and once we're sure that all the blood-loss controls took, we can all breathe easy. Say tomorrow morning. Until then, say a prayer for a speedy recovery, and keep sending happy thoughts.
Mid-morning update...
(Actually, I guess at 1130 that it's a little too late for a mid-morning update, and this should really be a very-stinking-end-of-the-morning-almost-friggin-noon update. However, so what.)
We got to Walter Reed about five this morning, and found Kate, Barbara's mom, her step-father, and (shortly thereafter) her dad waiting for us. In true military style, the order of the day was hurry-up-and-wait -- it was a mad dash to make it into the waiting room, where we waited for half an hour. We dashed to get her ready, changed, and her paperwork figured out, then waited in pre-op. We had a good mix of people, though, with a lot of banter and goofing around to keep the tension at bay. Around 7.30, we all exchanged hugs etc. one last time and sent her off with the anesthesia team, who promised to dope her up and keep her happy till we got her back.
When would that be? Well, we talked with two anesthesiologists, a resident, and her surgeon, and they told us that the only thing we'd know for sure is that it wouldn't be quick. Six to twelve hours is the estimate, and we'll probably get occasional updates during that time. They also said the first hour or so would just be prep time; she wouldn't really get started on the operation till 8.30.
So, it's 11.40 now, and no further news. Stand by to stand by. But we're in mostly good spirits, doing crosswords, reading classwork, and saying prayers. We're staying strong (Army strong, Barbara!), and hope you are as well.
More news later, if it happens.
We got to Walter Reed about five this morning, and found Kate, Barbara's mom, her step-father, and (shortly thereafter) her dad waiting for us. In true military style, the order of the day was hurry-up-and-wait -- it was a mad dash to make it into the waiting room, where we waited for half an hour. We dashed to get her ready, changed, and her paperwork figured out, then waited in pre-op. We had a good mix of people, though, with a lot of banter and goofing around to keep the tension at bay. Around 7.30, we all exchanged hugs etc. one last time and sent her off with the anesthesia team, who promised to dope her up and keep her happy till we got her back.
When would that be? Well, we talked with two anesthesiologists, a resident, and her surgeon, and they told us that the only thing we'd know for sure is that it wouldn't be quick. Six to twelve hours is the estimate, and we'll probably get occasional updates during that time. They also said the first hour or so would just be prep time; she wouldn't really get started on the operation till 8.30.
So, it's 11.40 now, and no further news. Stand by to stand by. But we're in mostly good spirits, doing crosswords, reading classwork, and saying prayers. We're staying strong (Army strong, Barbara!), and hope you are as well.
More news later, if it happens.
Wednesday, August 6, 2008
In Less Than 12 Hours
Just to update everyone, the arrival time for surgery tomorrow is now set for 5 AM. They expect the surgery to actually be underway by 7 AM. The whole thing should take approximately 6 hours, so Del will post something by early afternoon to let everyone know how I'm doing. The surgery will take place on the 6th floor at Walter Reed, Ward 67.
I'm not feeling real terrific at the moment, since I drank the Magnesium Citrate stuff to clean out my system a couple of hours ago. There are worse things in the world than that though. Although the surgeon said I could have a light meal of soup for dinner tonight, I have to say that drinking that stuff was really enough to kill my appetite for a while. I have until midnight to change my mind on that, so we'll see how it goes.
It's hard to believe that the surgery is now less than 12 hours away! The surgeon told me on the phone earlier that I should really try to get a good night's sleep tonight. I think he wouldn't have scheduled it for 5 AM and made me drink that abysmal stuff if he really said that with any thought that it would actually happen. Prescribing me some Valium or something might've aided me in that goal too. I will make an attempt and maybe the lack of sleep from last night will help.
Lesson plans are done, Daisy's sitter info has all been written and sent, many more boxes have been unpacked, and I think as many of our ducks that can be in a row before tomorrow are. Now I just need to pack a bag for the hospital and kill some time. Thanks for all of the prayers, kind wishes, and good luck that have been passed my way. Every little bit helps!
I'm not feeling real terrific at the moment, since I drank the Magnesium Citrate stuff to clean out my system a couple of hours ago. There are worse things in the world than that though. Although the surgeon said I could have a light meal of soup for dinner tonight, I have to say that drinking that stuff was really enough to kill my appetite for a while. I have until midnight to change my mind on that, so we'll see how it goes.
It's hard to believe that the surgery is now less than 12 hours away! The surgeon told me on the phone earlier that I should really try to get a good night's sleep tonight. I think he wouldn't have scheduled it for 5 AM and made me drink that abysmal stuff if he really said that with any thought that it would actually happen. Prescribing me some Valium or something might've aided me in that goal too. I will make an attempt and maybe the lack of sleep from last night will help.
Lesson plans are done, Daisy's sitter info has all been written and sent, many more boxes have been unpacked, and I think as many of our ducks that can be in a row before tomorrow are. Now I just need to pack a bag for the hospital and kill some time. Thanks for all of the prayers, kind wishes, and good luck that have been passed my way. Every little bit helps!
Friday, August 1, 2008
Mahna Mahna Mood-lifter
My friend Deb sent me a link to the Mahna Mahna video on You Tube earlier that brought a much needed smile to my face. I figured I'd share it with all of you. I don't think she even knew that, crazy people that Del and I are, we actually sang that song together on our first "non-date." :-D I embedded it in my blog page so you can share the smile if you'd like.
While I've been working on being "InvinciBarb" today, I'm actually achieving more of a tired and anxious Barb. I took the cashier's head off at PetSmart, where I had to take Daisy for a visit today, when it was taking her an inordinate amount of time to print a receipt and get me out of there. I can't even remember what other service or visit she wanted to schedule for next week or the week after, but I replied shortly with, "I'll be having surgery then, so if I could just pay and leave already, I'd appreciate it!" :-( Afterwards, I found myself thinking I must have been momentarily invaded by the pod people or something.
On a brighter note, the house is in a little better order now after Sally stopped by to visit and help out with some unpacking and straightening up this afternoon, so that does help. I'm trying hard to just have faith and let go. There's a lot that just won't get done before surgery no matter how much I insist on stressing about it. Del informed me of something that got past me in the doctor's office on Monday that actually sheds a whole new light on having just a week and a half notice before surgery. He told me that the surgeon had first said that he thought we could get this done by the end of the month (it was still July then). Del replied, "Which month?!" The surgeon answered matter-of-factly, "This one, July. Oh, it seems this Thursday is out, so what about next Thursday, August 7th?" So the surgery could've been yesterday, in which case none of these preparations I'm working on would've been of any concern and the world would've gone on just fine in any event. So with each extra thing I manage to cross off my long to do list, I remind myself...It could've been yesterday already.
While I've been working on being "InvinciBarb" today, I'm actually achieving more of a tired and anxious Barb. I took the cashier's head off at PetSmart, where I had to take Daisy for a visit today, when it was taking her an inordinate amount of time to print a receipt and get me out of there. I can't even remember what other service or visit she wanted to schedule for next week or the week after, but I replied shortly with, "I'll be having surgery then, so if I could just pay and leave already, I'd appreciate it!" :-( Afterwards, I found myself thinking I must have been momentarily invaded by the pod people or something.
On a brighter note, the house is in a little better order now after Sally stopped by to visit and help out with some unpacking and straightening up this afternoon, so that does help. I'm trying hard to just have faith and let go. There's a lot that just won't get done before surgery no matter how much I insist on stressing about it. Del informed me of something that got past me in the doctor's office on Monday that actually sheds a whole new light on having just a week and a half notice before surgery. He told me that the surgeon had first said that he thought we could get this done by the end of the month (it was still July then). Del replied, "Which month?!" The surgeon answered matter-of-factly, "This one, July. Oh, it seems this Thursday is out, so what about next Thursday, August 7th?" So the surgery could've been yesterday, in which case none of these preparations I'm working on would've been of any concern and the world would've gone on just fine in any event. So with each extra thing I manage to cross off my long to do list, I remind myself...It could've been yesterday already.
Tuesday, July 29, 2008
Movers and Surgeons and Sage, Oh My!
This summer has held no shortage of adventures in the Greer family! It all started out at the end of the school year/beginning of the summer back in June when I had a CT Scan done to investigate the cause of the strange abdominal and back pain I was having. Fully expecting to hear that they could see nothing abnormal and had no good answer, I was instead told that I had a large mass on the right lobe of my liver. :-O Testing and appointments related to this and the continual discomfort remained in the background of our other summer activities, changing our plans for a long road trip vacation entirely and leaving us pretty much at the mercy of the schedule of the military medical facilities. We did manage to fit in quite a bit of fun this summer in spite of all of that.
Sage was up visiting Del and I from Georgia from June 13-July 2nd, during which time we managed to teach her how to ride her bike without training wheels. This was quite the exercise for both Del and myself. I have to say that I now fully appreciate what my parents went through when running behind my bike when I was little. Whoever invented the little bar that attaches to the back of the kid's bike nowadays is a genius! At least our backs were saved as a result. It was great to see the pride on her face when she realized I had long since let go and she had ridden it herself for the first time!
While Sage was away on her beach trip in North Carolina with her mom, Del and I not only celebrated our one year wedding anniversary on July 7th, but the movers also came the next day to take our stuff over to our new 3 bedroom townhouse on base housing at Ft Meade (still in Maryland, near Columbia). We LOVE our new place which we took the time to paint in spite of all the other chaos. Having colors after years of only the white walls of rule-restricted apartments is wonderful and well worth the effort!
Sage was thrilled to meet all of the kids in our new neighborhood once she returned to Maryland from her beach trip on July 13th. She met twin girls that she immediately took a liking to and they were practically inseparable for the rest of her visit! She regularly came in requesting "ice pops for the girls" and other such "necessities." ;-D My mom and Dan also came for a visit to check out the new place and see Sage. She made sure to take them for a swim at our community pool to make their trip complete. We also had great fun when the twins came for a slumber party at our house during Sage's last week here; making our own ice cream and S'mores, playing games, and painting nails. Then Sage flew back down to Georgia on July 26th after we spent the day at a German festival as a family.
We then switched gears back to my health concerns for Del and I to meet again with the liver surgeon on the morning of Monday, July 28th at Walter Reed. Surgery is now scheduled for Thursday, August 7th. Yes, THAT fast! After having to practically push everything else through the system with both hands all summer long, he tells us that he can schedule surgery for next week already! During the surgery, the plan is to remove the mass along with some of the surrounding healthy liver tissue to ensure full removal and then get an analysis of the mass from pathology. The major indications are still pointing to benign causes, namely something called FNH, but they won't be certain until it is out and analyzed. I will be in ICU at Walter Reed for a day or 2 after the surgery and will be an inpatient at the hospital for at least 5 days in total. I can have visitors both while in ICU and in the room they move me to afterwards, so if you're in the neighborhood and want to drop in then feel free. They won't let you bring flowers in because of my asthma and the struggle the muscles over my lungs will already be having to do without an added asthma attack. Of course you shouldn't bring anything other than yourselves for a visit anyway, but I figured I better mention it in case anyone had any crazy ideas. ;-D I should add that they WILL check ID, vehicle registration, and possibly do a quick vehicle search if you're non-military and that parking is absolutely atrocious at Walter Reed. What's that?! I haven't scared you off yet?! We'll keep you posted on visiting hours just in case then.
Beyond surgery, the doctor also told me to expect to not return to work for 6-8 weeks, which means I unfortunately won't make it back for the start of the school year and no coaching middle school girls' soccer this fall either! :-( All of that will make behaving myself and resting at home harder to do, but it is necessary for that miraculous organ the liver to do its magic and regrow itself. Yes, regrow itself!!! Did you know that they can remove up to 80% of your liver and it will grow back!!! The human body is really a miraculous thing! While Del and I do feel that this is the right decision, considering the pain I've been in for quite a while and the need to find out definitely what it is, the whole thing is still a pretty scary prospect! It certainly didn't help when they handed me an "Advance Directive" packet to fill out, which I know is just protocol and all. But come on! Who wants to be asked about whether they want an autopsy and other such lovely stuff prior to going in to be operated on?!
With all of that said, we will keep all of you posted via this blog throughout the whole process. The postings will come from either myself or Del and you can leave messages for us and others if you feel so inclined. Keep it decent, I must request, as this is a PUBLIC forum and I am sharing this with family, friends, and colleagues (Not that I'd have anything to worry about I'm sure! ;-D). In the meantime, please keep Del and I in your prayers or if you're not one to pray then please send positive healthy vibes my way instead. Thanks so much for all of your concern and offers to help out so far! It really means a lot to us. Future posts should be much shorter than this one, but I just plain had a lot to say and we all know that I love to tell long stories when I get the chance. ;-D Please know that having such wonderful family, friends, and colleagues definitely makes times like this much easier! Thanks again!
Sage was up visiting Del and I from Georgia from June 13-July 2nd, during which time we managed to teach her how to ride her bike without training wheels. This was quite the exercise for both Del and myself. I have to say that I now fully appreciate what my parents went through when running behind my bike when I was little. Whoever invented the little bar that attaches to the back of the kid's bike nowadays is a genius! At least our backs were saved as a result. It was great to see the pride on her face when she realized I had long since let go and she had ridden it herself for the first time!
While Sage was away on her beach trip in North Carolina with her mom, Del and I not only celebrated our one year wedding anniversary on July 7th, but the movers also came the next day to take our stuff over to our new 3 bedroom townhouse on base housing at Ft Meade (still in Maryland, near Columbia). We LOVE our new place which we took the time to paint in spite of all the other chaos. Having colors after years of only the white walls of rule-restricted apartments is wonderful and well worth the effort!
Sage was thrilled to meet all of the kids in our new neighborhood once she returned to Maryland from her beach trip on July 13th. She met twin girls that she immediately took a liking to and they were practically inseparable for the rest of her visit! She regularly came in requesting "ice pops for the girls" and other such "necessities." ;-D My mom and Dan also came for a visit to check out the new place and see Sage. She made sure to take them for a swim at our community pool to make their trip complete. We also had great fun when the twins came for a slumber party at our house during Sage's last week here; making our own ice cream and S'mores, playing games, and painting nails. Then Sage flew back down to Georgia on July 26th after we spent the day at a German festival as a family.
We then switched gears back to my health concerns for Del and I to meet again with the liver surgeon on the morning of Monday, July 28th at Walter Reed. Surgery is now scheduled for Thursday, August 7th. Yes, THAT fast! After having to practically push everything else through the system with both hands all summer long, he tells us that he can schedule surgery for next week already! During the surgery, the plan is to remove the mass along with some of the surrounding healthy liver tissue to ensure full removal and then get an analysis of the mass from pathology. The major indications are still pointing to benign causes, namely something called FNH, but they won't be certain until it is out and analyzed. I will be in ICU at Walter Reed for a day or 2 after the surgery and will be an inpatient at the hospital for at least 5 days in total. I can have visitors both while in ICU and in the room they move me to afterwards, so if you're in the neighborhood and want to drop in then feel free. They won't let you bring flowers in because of my asthma and the struggle the muscles over my lungs will already be having to do without an added asthma attack. Of course you shouldn't bring anything other than yourselves for a visit anyway, but I figured I better mention it in case anyone had any crazy ideas. ;-D I should add that they WILL check ID, vehicle registration, and possibly do a quick vehicle search if you're non-military and that parking is absolutely atrocious at Walter Reed. What's that?! I haven't scared you off yet?! We'll keep you posted on visiting hours just in case then.
Beyond surgery, the doctor also told me to expect to not return to work for 6-8 weeks, which means I unfortunately won't make it back for the start of the school year and no coaching middle school girls' soccer this fall either! :-( All of that will make behaving myself and resting at home harder to do, but it is necessary for that miraculous organ the liver to do its magic and regrow itself. Yes, regrow itself!!! Did you know that they can remove up to 80% of your liver and it will grow back!!! The human body is really a miraculous thing! While Del and I do feel that this is the right decision, considering the pain I've been in for quite a while and the need to find out definitely what it is, the whole thing is still a pretty scary prospect! It certainly didn't help when they handed me an "Advance Directive" packet to fill out, which I know is just protocol and all. But come on! Who wants to be asked about whether they want an autopsy and other such lovely stuff prior to going in to be operated on?!
With all of that said, we will keep all of you posted via this blog throughout the whole process. The postings will come from either myself or Del and you can leave messages for us and others if you feel so inclined. Keep it decent, I must request, as this is a PUBLIC forum and I am sharing this with family, friends, and colleagues (Not that I'd have anything to worry about I'm sure! ;-D). In the meantime, please keep Del and I in your prayers or if you're not one to pray then please send positive healthy vibes my way instead. Thanks so much for all of your concern and offers to help out so far! It really means a lot to us. Future posts should be much shorter than this one, but I just plain had a lot to say and we all know that I love to tell long stories when I get the chance. ;-D Please know that having such wonderful family, friends, and colleagues definitely makes times like this much easier! Thanks again!