Bozgratch

Good morning all. It’s in the 60’s outside and inside it’s… well…. confusing.

I dawdled a little getting in here this morning, anticipating that with the surgery I’d be here later in the day than usual. But things change.

Dad was sleeping when I arrived,  so I let him snooze for a bit.  Dr. Flickinger was around and so I had time to speak with him during the quiet time and it was one of those steady-state conversations… not up, not down.

The speech therapist came round to do e-stim and he kind of got roused out of sleep for that.  A little way into the therapy he asked her to stop the treatment.  Then he said he didn’t want ANY treatments. We talked about the surgery and he didn’t want THAT either.  He said he was in pain — on a 1-10 scale a 10, but then a few minutes later he said he was Ok. 

Pain can certainly make one say all sorts of things, so no one is jumping to any conclusions.  

Since then he has been fast asleep.  I mean fast!  Phlebotomists and pills and all sorts of things have come and gone and he’s still sleeping.

On a subjective level it seems as if he’s withdrawing — but how do you tell the difference between withdrawal and exhaustion.  Perhaps this extra sleep he’s been getting these last few days will make a turning point?  Or is his body just losing strength — there really is no way to tell and none of the professionals are doing anything other than just watching to see what happens.   He hasn’t even been awake enough to pray with. 

We’ll see what happens as the day goes on.

Good morning all,

Tomorrow is dad’s vascular surgery.  The “fistula” they plan on putting “in” is a movement of a major vein in his arm to the other side of the arm so that it can be grafted into the vein.  His other blood vessels will continue providing circulation to the lower part of the arm (thank God for human redundancy!).  Over the next couple months the vein/artery will increase in size to accommodate the greater volume of blood needed for the dialysis load and once it has strengthened it will be usable for over a year if he continues needing dialysis.

Two Darvocets last night knocked him out.  Unfortunately the catheter has traumatized tissue and he’s extremely sore at the entry point.  Darvocet seems a bit strong for the pain location, however he is so week that anything that knocks him out for a while and allows his body to sleep soundly and rebuild a little is a good thing.

Normally dad has been game for some elevation, either sitting more upright in bed or in a chair.  Over the past three days he has uncharacteristically NOT wanted to sit up OR be elevated.  He’s been out of ICU and his lungs are clear enough that the nurses are not pushing that as they had been before — for a while they would not let him recline less than 30 degrees — but now he’d rather lay flatter.  Not sure if that is an indication of anything other than just being tired.  Incredibly tired.

After much confusion this morning they took him down for dialysis today.  He will not have to do it before surgery tomorrow…  <whew…. sigh of relief>>  Dr. Flickinger’s associate had screwed up the orders writing them for dialysis tomorrow.  A few phone calls later she re-wrote them and transport arrived just as I was finishing his shave.  I’ll meet Phyllis at the hosp about 2, by then he should be back from dialysis and have had half an hour or so to sleep — don’t plan on trying to keep him awake, mostly just to be there if he is uncomfortable or needs anything — nurses, no matter how much they care, simply dont have time to check in on him often enough.

Bill and Kathy were up yesterday. While talking about Robt & Helen wanting to visit I said to them that with Frank being in this state that decisions about whether to visit or not really need to be made on the basis of the visitor’s need.

Frank IS incredibly weak, he is still having a hard time communicating, but he does appreciate visitors if they do not stay too long or are not too talkative. He is VERY mentally alert — however it takes him time to build up strength to speak, and to formulate sentences. If the visitor is talking AT him instead of having a conversation with him the conversation moves along too quickly for him to formuate what he wants to say and gets frustrated.  A few words, few sentences, and then time for him to process them and decide whether to attempt a sentence make conversations blossom.  Too much input and he gets overwhelmed.

If you have a cell phone with speakerphone and want other family members to have a chance to say hi, that works.  He has no problem remembering people, places, and things — so hearing someone’s voice on the phone is encouraging.

Frank CANNOT get to the phone

1. for one thing it’s too far away.
2. for another thing he doesn’t have much use of his arms (too weak) and he could not reach to the phone, pick it up, and find his ear, even if he could reach the phone.
   

If YOU need to see Frank then come.

You would be well advised to call ahead and find out his schedule for the day — while in dialysis he cannot be visited — sessions last supposedly 3-4 hours, but it’s not unusual for him to be away from the room 4-6 hours, between dialysis and therapy (when he is strong enough to participate).  As long as he is still in Toledo Hospital there is NO schedule until about 7am.  Calling the day before does not accomplish anything.  No one knows anything until the results are in from his 6am blood work. (7am or later), and things do change…. Good Lord… if we have learned anything we have learned that nothing is sure at the hosptital.

About discharge:

At this time the fistula surgery is the only thing we know is holding him back from discharge. Typically the surgery is performed outpatient.  How soon after the surgery they will discharge him depends on how he weathers the surgery.  We’re hoping it will be at least overnight to assure that he is stable before being transported — but we can only wait and see — also the availability of a bed at Arbors of Sylvania at that moment will affect his discharge we understand.

That’s it for now.