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Wednesday, August 31, 2005

Mixed bag, Writing, Jake's vist, David Hasselhoff

Mixed bag between yesterday afternoon and tonight.
I had to start back at work today for teacher orientation. While I was there, the nurse called and said that Denise wanted to see Gracie & Jacob, the staff arranged a visit, and Denise got to see both kids. The kids had a big morning at the park with Denise's dad, and Jacob was a little tired & clingy to grandpa. Gracie was wide awake and gave Denise about a million kisses. Unfortunately, I didn't make it for the visit, but I hope to be there for the next one. And again, many thanks to everyone that dabbled with the rules and allowed the kids to visit.
Yesterday Denise went from PRVC vent mode to CPAP, in which she gets to call the shots as far as how often to take a breath, and how deeply. That lasted 5 hours. Not bad. They tried it again today, but she was only able to go for about an hour. Yesterday her oxygen concentration was only 30%; today I saw it as high as 60%. Late yesterday afternoon, she was able to write fairly legibly for the first time in over a month. When she got too tired to write (couldn't complete the sentence), she rediscovered how to use the TV remote (well on her way to becoming either an author or a vidiot).
Unfortunately, yesterday's indium scan didn't reveal anything helpful to us in the fight. That was disappointing, as I thought that it might shed some light on what's going on to cause the ab swelling & fevers. Today they gave her a bunch of contrast and did a CT scan to see if they could find anything. Her heart rate was also in the 150 range much of the day today, so they gave her some more sedative and morphine in addition to cranking up the oxygen to try make her relax.
While I was getting caught up on Denise's condition at the nurse's desk, there was a "code blue." When I saw everyone run toward Denise's room, my heart sank, thinking it was for her, but it was for the patient in the next room over, in a corner room. Fortunately, they were able to revive that patient.
And today's bit of frivolity: I parked by David Hasselhoff. He was getting to his car as I was getting out of mine. I've actually seen him there several times over the last few weeks, but I don't think I've mentioned it before in the blog. The first few times I saw him, I thought he looked familiar (school parent, someone from church, old high school teacher...), then a nurse reminded me that he was on Knight Rider and I made the connection. Anyway, I guess his folks are fairly local and his mom's been in ICU. Even though he drives a nicer car than me (well, who doesn't?), the waiting room for ICU/CCU is a great equalizer... no distinctions due to fame, race, money, college degree, or much of anything else. Everybody's in the same boat: worried about, weeping over & praying for a loved one. I guess I only mention this now because I'm re-reading "Where Is God When It Hurts?" and that point about waiting rooms and death both being equalizers came up in what I read today. Anyway, he seems like a nice enough guy, but no, I won't pester him for an autograph for you.

Tuesday, August 30, 2005

Nerve conduction normal, vent weaning beginning

I just got a call from the doctor with mostly good news. Here's the good stuff:
No sedative for over 24 hours; she's really awake & alert this morning. Any time she's asleep it's just that: she's exhausted & sleeping. They're changing her over to a vent mode that allows her do more breathing on her own, so I guess the weaning process will officially begin later today. The neurologist's opinion is that Denise's nerve conduction is normal, and her muscle strength should come back after extensive rehab (but at least there's no damage detected, and we can chalk up one more miracle). The extreme muscle weakness is perceived as being due to meds, breaking down muscle for protein since she can't absorb protein through the gut, and maybe just completing six weeks in the hospital.
The concerns:
They tagged her blood cells yesterday and should perform the scan today to find where the mystery infection is located. Still vomiting, dealing with colitis (and the goodies that go along with that). Some electrolyte imbalances, nutritional problems, frustration at inability to move, speak, use the restroom, etc. I need to fall asleep (sleep aids knock me out for way too long). And of course, there's a long, long time away from home & family ahead of us.
Thank you, family, friends, professionals, prayer warriors, and happy thought thugs... I'm glad you're all in our corner!

Monday, August 29, 2005

Active day, Gracie got to visit mommy

Denise had no sedative at all today, and was very active. She ran the daytime nurse ragged in the morning. They had her in the cardiac chair again (Denise, not the nurse), and she tried her best to stand up in it, pushing against the foot plate. During the time I was home for dinner, she tried pulling herself out of bed, so they had to strap her down. She has a belt around her torso and cuffs on her wrists with tie-downs attached (she can't stay away from that pesky breathing hose into her throat).
We got permission to take Gracie into Denise's room this afternoon. She wore her custom-built nurse's cap, brought her toy doctor kit, and behaved with a great deal of maturity. Denise was pretty tired, but lit up when she saw Gracie (Gracie lit up, too). We were able to let Gracie sit on the bed, where she stroked Denise, listened to her heart, pretended to give her an injection, looked at books with mommy, and even got to snack on cookies & juice that one of the stafflings brought in. Quite a few nurses came in to watch the reunion. I took video of the visit, and Gracie & Jacob wanted to watch it over & over at home. Truly one of the best days we've had in the last six weeks. The rules at the hospital CCU say that nobody under 10 years old can come in. Many thanks to the nurses that magically turned the rules into mere suggestions for us today.

If You're A Woman Over 25, You Should Eat These Foods To Prevent Diseases That Claims Most Women's Lives

By : Naweko San-Joyz
Do you keep your health care plan in the fridge? It's not a bad idea actually because if you pick your foods the right way, you can pack heart disease, colon cancer, osteoporosis, and diabetes prevention all in a day's worth of groceries.

Heart Disease
It kills nearly 500,000 women a year. The American Heart Association warns that heart disease, including stroke, claims more women's lives than the next six causes of death combined. Yet few women realize their risks for heart disease.

Hip 30-something singer Toni Braxton thought her chests pains were just from parenting stress before she discovered that she had heart disease. While the singer is OK now, she's getting the word out about heart disease as the spokeswoman for the American Heart Association's "Go Red For Women" campaign.

If you want to be heart smart, you need to be food wise. For example, according to the Tufts University Health & Nutrition Letter, a diet loaded with whole grains may lower your risk of developing heart diseases.

Another clinical research from the Archives of Internal
Medicines found a link between increased dietary fiber and reduced blood pressure. In short, more fiber may reduce hypertension and thus lower the blood pressure.

Where to get fiber and whole grains:
Apples, grapes, celery, whole grain bread and cereal (make sure that sugar is not a main ingredient), whole-wheat pasta, popcorn, barley, oats and oatmeal, rye, corn, brown rice, bulgur or cracked wheat, and wheat germ.

Colon Cancer
The fiber gleaned from a whole oat rich diet also reduces the risks of developing colon cancer. Similarly in animal studies, selenium has shown anti-cancer benefits. Researchers from the Harvard School of Public Health noted that calcium limits the development of rectal lesions, which could become cancerous.

Where to get calcium and selenium:
Broccoli, bran, brown rice, cottage cheese, garlic, onion, Brazil nuts, molasses, eggs, yogurt, celery, tahini, kidney beans.

Osteoporosis
Are you going to scream if someone else tells you to drink your milk to make your bones strong? While calcium has hoarded the spotlight for osteoporosis prevention, Dr. Alan R Gaby points
out in the Townsend Letter for Doctors & Patients, that magnesium, manganese, and zinc are just as important in the fight against osteoporosis.

Where to get them:

Magnesium:
Almonds, bran, oat, hazel nuts, pecans, lentils, sunflower seeds.

Manganese:
Avocado, walnuts, pineapple, buckwheat, parsley, spinach

Zinc:
Cheese, raw cashews, egg white, sunflower seeds, macadamia nuts, wheat germ

Diabetes
Christine Gerbstadt, M.D., R.D., spokeswoman for the American Dietetic Association suggests limiting your risks for diabetes by consuming orange and leafy green veggies. Adding on a high quality fiber rich cereal can also limit your risk for diabetes.

Where to get orange and leafy green veggies:
Spinach, yams, papayas, peppers, rich green varieties of lettuce, lemons, parsley, cilantro

Here's a final reason to stash your health care plan in the fridge. A finding presented at the Annual Scientific Session of the American College of Cardiology that analyzed the records from 2,857 heart attack survivors treated at Michigan hospitals found that men had a better chance of surviving after treatment
than women.

One reason for this could be that the women receive less one-on-one sessions with the doctors or nurses before going home. The lesson here is to put health in your own hands before you even need to use your health insurance.

Increase your chances of beating heart disease, colon cancer, diabetes, and osteoporosis now. It's as easy as buying apples, beets and carrots. I'll see you in the produce section.

Indium scan on deck

Yesterday was fairly mellow. Denise was sedated or asleep most of the time and we didn't interact much. I did a lot of reading. Last night she finally started to wake up and asked about the baby. I told her the usual response "Don't worry... he's doing perfect, very well taken care of." She indicated that she wanted me to leave her and go visit the baby.
The doctor called earlier this morning with the latest. Fevers are still high and they don't know why. So they're going to do an Indium scan. They will take some of her white blood cells, tag them with Indium (radioactive), put the cells back in her, and the cells will accumulate at the site of infection. They can then scan her body and find where all the white cells are hanging out. Then a proper course of action can be determined.
She's back on IV feeding (TPN); feeding through the gastro tube has been halted for a while. Between the protein/nutrition problems and vomit problems, IV feeding seems to be a better bet for now.
Chest x-rays have been showing some more improvement. As far as the vent, the oxygen concentration has been between 28 & 35, PEEP set to 5. When she's not stressed & anxious, her breathing rate is in the mid-teens. There's talk of making changes in the coming days to begin allowing her to assume more of the work of breathing on her own.
There seem to be no indications anymore of DIC (that weird clotting problem). The concerns of SPT (septic pelvic thromboflibitis) are also fading, however she's still on preventative doses of Lovenox.
Blood cultures for all infections (cocci, pseudomonas aeruginosa, c. dif) have been coming back negative the last 3 times and the latest paracentesis also came back negative (yay!). But she still has to be on the meds for a while to wallop the infections (like when you're on antibiotics, the bottle says to take all the pills until they're gone, even though you don't have the symptoms anymore). For those that like to hear the play-by-play, she's on Diflucan for the valley fever (cocci), Flaggyl, Vancomycin, and Xifaxan (rifazimin) for the c. dif, and Amicacin and Zyvox (linezolid) for the pseudomonas. Throw that stuff in a Martini glass with an olive, because it sounds like quite a cocktail, doesn't it?

Sunday, August 28, 2005

Kidspace Museum, anyone?

I've heard lots about the Kidspace museum in Pasadena, and I'd like to send the kids. If you have a family pass and you'd be willing to take the kids, please contact me. Gracie's going to be 4 in October, Jacob is about 17 months. You can use our van if seating is a concern.
In fact, if you have a family pass to anyplace and you'd like to include my kids on your family field trip, let me know (thank you to the families that have taken them to the library for story time, park, zoo, aquarium, and Huntington Library... they love those places!).

Biting, frustration, cardiac chair, video, dad update

I almost got bit today (well, yesterday, since it's now the wee hours of Sunday morning). Denise kept pulling the tracheostomy hose off. She was about to do it agiain and as I was prying her fingers off, she tried biting my fingers. She put up a pretty good fight, too. She's really angry with having to be in bed, having all the tubes, not being able to use the restroom, unable to speak, too uncoordinated to write (though her scribbles are getting finer). She's pretty loopy much of the time, so it's always like the first time, having to tell her about all these hoses, how long she's been in the hospital, etc. I had to tell her that if she kept popping the hose off, she'd get sedated or tied down (and then she'd really get mad).
The absorption of nutrition continues to be problematic. She's thrown up a few times over the last few days (nothing aspirated). As far as meds, there's been a change from Primaxin to Flaggyl (to try & nail the colitis). Amicacin is also on deck or already started (I can't remember for what, though... I'll have to ask again).
Denise was moved into a special chair for about 45 minutes today... a "cardiac" chair or a "stroke" chair. Her bed back raises and feet lower, but apparently not to the extent of today's chair (which can lay flat at the same level as the bed for moving a patient). I wasn't there for that, but my guess is that she appreciated the change of position.
I've been showing Denise footage of the kids on a camcorder. She loves that. I also showed the kids some positive footage of Denise in the hospital (awake, smiling, able to wave & make kissy lips for the kids). They wanted to watch it over & over.
Earlier Gracie said she wants to be a nurse. Word got out that I tried to get her a nurse's cap from the gift shop, but they don't have any. So someone from another part of the hospital made some caps out of card stock for Gracie to wear until the real cap that I ordered comes in the mail. Gracie's been using her toy doctor kit to check us all, including her dolls, and Chloe the dog. Gracie tried putting the sphygmomanometer on Chloe's tail a while back, but it was wagging too much.
An update on my dad... My dad's been dealing a recurrance of cancer (colon, liver, lung, lymph) since last November (sorry to those of you that didn't get Christmas cards from us last year, by the way). His inclination was that he'd rather live six month without chemo and feel OK most of the time than string along for two years with chemo and feel too lousy to do anything he likes. My dad just came back from a Southern Gospel quartet convention in South Carolina (he visited the area of Tennessee that Denise & I were looking at, too). He had a great time. At the most recent oncology appointment, the doctor suggested that he do another series of chemo treatments so he stands a chance of going to the convention again next year. Those of you that know him will not be suprised that this line of reasoning helped to persuade him in his decision to follow the doctor's suggestion.

Friday, August 26, 2005

Sedated vs. Alert, Mirror, Sneakers

Been a rough couple days since the last post. Denise has had some more sedative a couple times, and when she starts coming out of the stupors, she's still asking about the baby & we're reliving the bad news over & over. At this point, I just show her the picture of her holding Danny & say, "Don't worry... he's being very well taken care of right now." I'm a little discouraged, because I kind of thought we'd be beyond all this after bringing her to full-throttle alert and telling her about the baby a couple days ago.
The more Denise becomes alert, the more uncomfortable and aggitated she gets. Yes, it's good that at least she's well enough to be awake sometimes & be able to know she's miserable. But I don't like seeing it. I'm also having to explain the tubes & hoses once or twice each day. I finally brought her an unbreakable mirror (a baby toy) so she could see herself. Her eyes teared up and I reassured her that she's getting better and stronger, and eventually all the hoses will be gone. On the light side, she'd complained over the years that as she gets older, her jawline gets broader like her dad's (who has no neck whatsoever... he's built like a fire plug). So I reminded her of that gripe, and said that she doesn't have that problem right now. She raised her eyebrows & nodded.
The gastro doctor called to say that Denise's isn't tolerating the tube feeding very well. Today they did a third paracentesis and drew off about a liter (the previous one drew 1.7 liters... think of that... almost a 2-liter bottle). They're going to test the fluid for infection. Speaking of infection, my last post stated that we're dealing with only cocci and clostridium difficile (c. dif). I forgot to mention the pseudomonas aeruginosa. The cocci (Valley Fever) didn't show up anymore, but there are still those other two infections that are causing quite a bit of trouble. And we can add vancomycin to the current arsenal of meds. Same story with raging fevers, colitis/diarrhea (eew!), nutrition problems (especially protein... she looks to me like she's pretty bony lately), and need of transfusions (to those offering, they say there's not much point in directed donations if she's not scheduled for a surgery), and a few other things that I can't even think of.
On the positive side, she got her hair done, legs shaved, feet pampered, and some other nice things yesterday, courtesy of the nurses. She really liked that. She also has an unlikely medical apparatus: classic Converse Chuck Taylor high-top sneakers, black (trivia: that's what I and the groomsmen wore to our wedding). They were needed to prevent ankle problems, and the inflating boots they had were too big.

Movie Note: Parking yesterday was a royal pain in the bohonkus during the movie shoot. Denise's dad saw a stunt double for Tom Cruise get out of a car & jump over some shrubs. Funny, I thought Scientology might enable Tom Cruise to do that, too. Oh well. For those of you that plan to see Mission Impossible 3, the Arcadia Methodist hospital will have "Virginia Regional Hospital" on the doorway and parking lot banners, and the sign for the building will say "McGrath Medical Tower" (in real life it's the Nor & Fran Berger Tower). That's the entry way that we rolled Denise through 5 1/2 weeks ago when this nightmare started.

Thursday, August 25, 2005

Women Health - Fourteen Simple Things You Can Do To Reduce Your Risk for Breast Cancer

1. Increase your consumption of fresh, organic fruits and vegetables.

2. Avoid using any pesticides or chemical sprays in your home. Try to avoid new carpet.

3. Avoid drinking tap water.

4. Decrease alcohol consumption.

5. Start an exercise program.

6. Increase consumption of organic whole grains and fiber.

7. Decrease meat, poultry and fish consumption.

8. Stop smoking.

9. Increase consumption of phytoestrogens from organic sources.

10. Decrease or stop consumption of processed foods.

11. Avoid trans-fatty acids found in margarine and some vegetable shortenings.

12. Take two capsules of organic flaxseed oil daily or just add a teaspoon of flaxseed oil to your daily organic salad.

13. If you are pregnant definitely breast feed.

14. Gets lots of sunshine as breast cancer is less prevalent in areas where there is ample sunlight unobscured by fog or smog.

Discussion:

As a retired diagnostic radiologist who read way too many mammograms I am excited because I finally have a path to try to connect to so many women who are having and have had mammograms.I was always chagrined since we would really torture and radiate many breasts but it was as if these breasts were not connected to a human type person. It bothered me that so many mammography programs make no effort at all to educate their clientele about what "they can do" to reduce their risks of breast cancer. I would suggest to the directors of these programs that we try to educate the patients and their response was 100% predictable. They would always first deny the relationship between diet and breast cancer and then add that their patients would not listen anyway.

Increasing your consumption of fresh organic fruits and vegetables has been shown to reduce the risk for breast cancer.

"There is strong evidence from epidemiologic studies that eating more fruits and vegetables decreases a woman's risk of developing breast cancer. This conclusion is strengthened by the similar results obtained from animal studies and experiments using isolated breast cells." Quoted from the Cornell University Program on Breast Cancer and Environmental Risk Factors. They go on to recommend uncooked fruits and vegetables. The reason for this is the heating damages some of the beneficial nutrients in the fruits and vegetables. Carrots, squash, sweet potatoes, broccoli and spinach top the list for being most protective. The Cornell study however does not stress the fact that these need to be "organic." Non-organic commercial fruits and vegetables besides being largely nutritionally bereft are also heavily sprayed with a wide variety of toxins.

The relationship between pesticides and other toxic chemicals such as benzene and toluene and cancer has long been established. There are better ways to rid your house of undesired guests than using chemical sprays. It sounds difficult but even if you can't get rid of all your pests you will live a longer and healthier life if you refrain from spraying. New carpet is another source of extremely toxic chemicals that "off gas" for at least a year or so after it is installed. Try to avoid new carpet especially in children's rooms.

Avoid tap water unless you live either in Lake Tahoe or Ithaca, New York. The tap water here in Tucson is CAP water that travels in an open trough from the Colorado River. It is loaded with fungicides / herbicides not to mention all the chlorine added once it gets here. While bottled or filtered water may not be perfect,you will considerably reduce your risk for any cancer by avoiding most tap water.

There is a little debate about the link between alcohol consumption and breast cancer. However, the consumption of any simple sugars such as occur in most alcoholic beverages is associated with decreased T-cell mobility and thus some immune compromise. I still have an occasional beer but that is the only sugar I ingest. The general consensus however, is that it is best to reduce alcoholic beverage consumption as much as possible.

Exercise has been proven in multiple studies to enhance the immune system. In order to be beneficial I would recommend thirty minutes at least three times a week. This should be exercise that elevates the heart rate and keeps it there for the thirty minutes. Running is good if you are not biomechanically impaired. Cycling and swimming are also good alternative and or exercise machines.

Increased consumption of organic grains and fiber has been shown to reduce the risk of breast cancer.

Decrease your meat, fish, poultry and dairy consumption. Animal protein has been linked to all the big three killers in this country as well as osteoporosis. For more on this see the "China Study" by T. Colin Campbell and "Diet for a New America" by John Robbins. Stop smoking is really a "no brainer" here. Smoking is associatedwith a variety of cancers and there is now strong evidence that cancer of the breast is one of them.

Consume more phytoestrogens from soy products like tofu. "Women with diets rich in phytoestrogens also excrete more estrogens into their urine, and have lower blood estrogen levels. Some studies have shown that women with a diet rich in phytoestrogens have longer, and hence fewer, menstrual cycles. All of these factors may contribute to reduced breast cancer risk. " This quote from the Cornell University Program on Breast Cancer and Environmental Risk Factors. Please be sure that any soy products you consume are organic.

In conclusion there are many ways to reduce your chances of breast cancer. I have presented the above from a more subtle point of view. When my wife (now ex-wife) developed a lesion in her left breast back in 1995 we put her on an organic vegan diet. Soon we cut out all sugar and increased her running mileage. She still has her left breast although there is still some skin retraction. My good friend and world class flamenco dancer Carmen Heredia died in her early forties from breast cancer and its treatment. Best not to get breast cancer at all.

For more information on the relationship between diet, health and exercise please go to: http://www.drmericle.com/

For more information on cooking and food preparation without animal products please go to: http://www.drmericle.com/fscook3c.php
Copyright J. Mericle M.D. 2004 All Rights Reserved

http://www.drmericle.com/ is devoted to achieving optimal health and peak performance through diet and lifestyle change. Dr. Mericle brings together a unique blend of formal medical education, 29 marathons, 3 Hawaii Ironman competitions and a lot of practical real life experience.

Article Source: http://EzineArticles.com/

Click here to download "Fourteen Simple Things You Can Do To Reduce Your Risk for Breast Cancer" E-book

Wednesday, August 24, 2005

Valley Fever Whipped? Hug! Mission Impossible 3

Topping off today's post is a public service announcement. If you're signed up to receive the email version of these updates (see link to the right if you haven't already signed up), please don't respond to those updates if you want to write back to me. They go back to my cousin that set up the emailing capability, and then he has to forward everything to me. Instead, either click on the COMMENTS link under each post or send an email to me at the email address in the box at the top of this page.

Much more good than bad news today!

THE GOOD: Latest tests for the presence of cocci (the Valley Fever fungus) came back empty. So it looks like that infection may finally be whipped. I assume they will keep her on the meds & do another culture or two in the future, just to be sure. The only other confirmed infection that we're currently dealing with is clostridium difficile, which has been detected in the stools (those of you sitting in chairs need not worry, I guess). I got the impression that it is something that can be dealt with and is not life-threatening at this point, as Denise is in no danger of dehydration. If I understood correctly, the only things she's currently taking for the infections are Amphotericin B and Fluconazole. The fancy ventilator that Denise was on has done all it can for her... she's been changed over to a more conventional vent mode (PRVC) on a different ventilator and so far is doing OK. This evening I was told by the respiratory therapist that today's arterial blood gas workup was perfect (essentially normal, as in a reasonably healthy person). The chest x-rays have improved. We can focus on rehabilitation and weaning from the ventilator. It's not currently thought that she has septic pelvic thromboflibitis (SPT). The fluid & ab swelling is most likely from lack of protein (think of what we've seen with starving children in Africa) rather than SPT. Someone from the Los Angeles County Health Department paid a visit to our house today. What's dealing with a government entity doing here among the good news? The rep was very, very nice. We were trying to pin down specific dates & places in relation to contracting the Valley Fever. The financial counsellor at the hospital said that it looks like we're covered 100% (Whew!).
My favorite thing: I got a hug! Denise flopped her arm over the side of the bed and was trying to hang onto me. I asked if she was trying to get a hug & she nodded. Pretty awkward with all the hoses & wires, but I was happy!

THE BAD: A couple of blood transfusions (while the blood gas was good, the blood composition is still very low in hemoglobin). Same colitis. Same massive protein requirements. More coughing than usual (it gets the crud up & out of her lungs, but it's really uncomfy for her). And of course, we still have months to go in the hospital.

On a side note, a movie scene will be filmed at the hospital overnight. They have palm trees in the parking lot, but the movie crew tied pine trees to them (a worker said the hospital is supposed to look like it's in Maryland). They also covered the hospital's sign at the car dropoff with a fake sign (I didn't see the name... it's covered). A volunteer told me that the movie is Mission Impossible 3 (hardcore fans of the TV series may be wondering why I didn't include this news of this movie sequel with the "bad news" paragraph above).
A nurse indicated that Tom Cruise would be there.
Filming starts at 4am Thursday.
Shhhh... don't tell anyone.

Tuesday, August 23, 2005

Denise knows about losing the baby

Yesterday afternoon we told Denise that we lost baby Daniel. Denise was fully awake/aware, was definitely asking about the pregnancy & baby, and was getting mad that everyone was giving her evasive answers (some of these great nurses would also make great politicians). The ObGyn explained what happened to Denise while I, Denise's mom, and a chaplain were there. Denise did better than I did. I've been worrying about Denise's health so much during the past weeks that it was almost as bad as my first time hearing the news. Denise started to cry and heave her chest, but she mostly coughed and set off the alarms on the ventilator. The ObGyn also told made sure to tell Denise that Denise didn't do anything wrong; she made the best choices possible for herself and the baby. But at a point when it came down to Denise or the baby, her body went into spontaneous labor, and losing the baby was a bittersweet event that added to Denise's survival thus far.
Everyone left us alone, and I asked Denise if she wanted to see the pictures of the footprints, the and pictures of us holding Daniel all bundled up (we have some other pictures that are more somber that I don't really want to see again for a long time, much less show to Denise right now). I put her glasses on and she looked at those couple of pictures for probably 10 minutes. I wiped away lots of tears for her, as well as myself. She wanted them taped up on her bed rail with the pictures of the rest of the kids, so I did that. She also wanted to hear everything I could think of relating to the birth & everything else. So I told here everything I could think of. I have some good news relating to the worry I had about deciding casket vs. cremation without Denise's input. I explained that it was a tough decision to make, but since we didn't know how long Denise would be in the hospital, I thought it best to do a cremation and decide what to do later when she gets home after we pick up his ashes from the mortuary. She was OK with what I'd decided, and indicated that she'd like to bury his ashes along with the planting of a tree, more than scattering at sea. So now I have the relief of not having to keep losing the baby from Denise, and knowing that I made an acceptable call with the cremation (insert sigh of relief here). After that, our pastor from church came in and read two perfect verses for the situation and prayed with us (I wanted to post the verses, but can't find where I wrote them... I'll try to remember to post them later). Since yesterday, I've seen Denise looking at the pictures frequently, and many times I've let her know that she brought 3 beautiful babies into the world. She cried the first few times, nodded the next few times, and today she smiled, nodded, and raised her eyebrows. We know he's being taken care of better than we could take care of him, and we'll see him later on when we're done here.
Obliquely related theological thoughts: One of the first conversations we got into before we started dating was trying to figure out any biblical preferences toward or against whole body burial or cremation (weird pre-dating conversation, I know). In the end, Denise kind of thought the casket would be nice, based on most Bible references to whole body burial, but didn't feel any strong pull either way. I leaned toward cremation, but if somebody wanted to shell out more than I'd spend to embalm me & pay more for a casket than I'd pay for any car I'll ever own, it wouldn't matter to me. I sort of felt that these things were our final futile attempts at vanity & status symbols. However if Yugo built a casket, I'd think that'd be pretty funny to be buried in one of those, as opposed to a more reliable and well-appointed casket, say one with the Eddie Bauer trim package (you laugh and think, "How silly," but we do it with cars & baby strollers all the time, don't we?). Anyway, Denise & I both agreed that the end results were the same... absent from the body & present with the Lord, it's all going to decompose eventually, God'll figure out a way to restore & raise it all up again, and He probably doesn't need our help, whether we attempt to delay the decomposition process or speed it along.
Thanks for pulling for us through the medical concerns and the emotional concerns. I know that most of you that have been following along share the same worldview we do (all you "Prayer Warriors") and many don't (our friends coined the term "Good Thought Thugs" and "Happy Thoughters" for all you wonderful people). Either way, I've felt and appreciated all your support all through this ordeal. Your prayers & thoughts especially manifested themselves yesterday when we told Denise what happened. It went much better than I'd envisioned, and we've felt more peace, and faster, than I'd thought possible. There's still sorrow when we look at the pictures of Danny boy, but somehow it's not as bad. I really can't explain it. Truly, we're experiencing the "peace that passes understanding."

Monday, August 22, 2005

Error AGAIN... Ativan, not Avastin

It was just brought to my attention that in the post made earlier today, I stated that Denise's sedative was Avastin. It's Ativan. I made this mistake earlier in my August 11 post, to which I posted an error alert as well.
(Denise *did* receive some Avastin a few days back, but to help boost her red cells).
Ah, the joys of being mildy dyslexic! Good thing I'm not giving Denise her meds, huh? Guess I could never be a nurse.
:O)

Women Health - Top 10 Foods for Women

Beans and Pulses

Beans and pulses should be included in everyone's diet, but for women they are especially important. They are highly nutritious, low in fat, and an excellent source of vegetable protein. A fibre-rich diet is one of the first components to colon cancer prevention, and with more women dying of colon cancer than breast cancer every year; it makes sense to eat plenty of beans. This group of foods also contain phytoestrogens, the natural plant hormones, which are also protective against cancer, as well as being important for bone health.

Kale

Kale is an often-overlooked vegetable that happens to be loaded with folate (folic acid), an important B vitamin for women. Having a deficiency in folic acid during pregnancy may cause neural-tube defects in babies. In the UK, all women of childbearing age are now thought to need 400 micrograms of folate daily. Kale is also an excellent source of vitamin C and calcium, too.

Orange vegetables

Orange squashes (and tubers) like pumpkin, butternut squash and sweet potatoes are a girl’s best friend when it comes to nutritious, comforting food. All these foods are filling, low in calories, and rich in beta-carotene, a precursor to vitamin A, which will work plenty of it’s antioxidant magic in your body. Antioxidants are important in the anti-ageing process, helping to repair and regenerate skin and other tissues. Beta-carotene is also thought to help reduce the risk of breast cancer.

Linseeds (flaxseeds)

Flax seeds (or linseeds) and flax seed oil have so much to offer women. For starters, flax is full of “essential” Omega 3 fatty acids (EFA's), which help to balance a women’s hormones, protect a woman from heart disease (the leading cause of premature death among women) and the pain of arthritis. The dietary fibres in flax are called lignans, which contain phytoestrogens, currently being researched and showing promise in cancer prevention. Lignans are also thought to have antioxidant properties. The best way to get the benefit of the flaxseeds fibre and oils is to grind them in a clean coffee mill, used just for this purpose. Alternatively use a pestle and mortar, and sprinkle them onto cereal in the morning or add them to a bowl of natural yogurt and fruit. The essential fatty acids are very fragile, unstable, and liable to oxidation if exposed to light and air. Within the whole seeds, the oil is protected. So buy fresh, organic seeds if at all possible. You can eat them whole; just chew them thoroughly!

Iron-rich foods

Women need to eat more iron-rich foods. Getting iron from food (as opposed to a supplement) is by far the best way to get the correct amount of iron the body needs and can absorb. Lean red meats and dark poultry are the ideal food sources of iron. Unfortunately that doesn’t help much if you are vegetarian or one of the many women who avoid red meats. In this case, think about eating more of the following iron-rich foods… lentils, dried apricots, beans, spinach, enriched wholegrain cereals, pumpkin seeds, and oysters! If you do need to take a supplement, the best choices are Easy Iron (Higher Nature Ltd), which is an organic, food-form of iron, and Floradix, an herbal-based iron-rich tonic. Increase your intake of vitamin C too, which helps to absorb non-haem sources of iron.

Soya

Soya foods (including beans, tofu, soya milk & yogurt, soy sauce, Tamari and Miso) are the richest food sources of phytoestrogens (and of course soy protein). The natural plant substances – phytoestrogens - are now thought to be beneficial in maintaining bone density, as well as being the best “alternative” to HRT when many women need hormonal support as they enter menopausal years. Tofu, milk, and yogurt are also great calcium sources. All these foods can help a woman significantly lower her bad cholesterol (LDL) and raise the good (HDL) cholesterol. Tofu is a great source of low-fat, vegetable protein, best used in a vegetable stir-fry with soy sauce, and brown rice. Try Cauldron Foods, firm tofu.

Brocolli

Broccoli is not only a good source of calcium and B vitamins; it contains plant substances called sulphurophanes. These plant chemicals are cancer-protective and help the liver process and clear any excess oestrogen. Nowadays we don’t just produce oestrogen internally, but we are exposed to it in the environment in the form of oestrogen-like chemicals found in plastics, tap water and other insidious places. Excess oestrogen causes weight gain, hormonal imbalances, night sweating, and presents an increased risk of fibroids, breast cysts, breast cancer and endometriosis.

Calcium and magnesium - rich foods

Women of all ages need enough calcium in their diets to build and maintain strong bones. Calcium-rich foods that are also good sources of magnesium (and other nutrients) go a long way to supporting bone, and heart health. Magnesium is the nutrient that plays an important role in the creation of new bone; so think about seeds and nuts as healthy additions to a wholegrain cereal. Calcium, magnesium and potassium are alkalising minerals. Bones serve as a reservoir of these highly important alkaline minerals, which are released to help neutralise the acids in your body. If your body is overly acidic (this happens if you eat a lot animal protein, smoke or drink too much alcohol, or become highly stressed), your bones must donate their minerals to restore your pH balance. This can deplete the bones, leaving them brittle and weak.

The UK RNI for calcium is 700 milligrams a day, but many experts feel it should be more like 1200 to 1500 milligrams a day. When you take into consideration the epidemic of osteoporosis and heart disease among women, it is wise to include or increase your intake of the following foods… plain natural yogurt, which is not only a source of beneficial bacteria for good colon health, it is also much easier to digest than other dairy products), parmesan cheese (again, easy to digest), ricotta cheese & goat’s cheese, tinned bony salmon, freshly grilled sardines, kale, almonds and sunflower seeds, tofu, fortified “SoGood” soya milk (20% more calcium than cow’s milk) and “Provamel” soya yogurts. Replacing dairy with soya milk and yogurts in the diet provides all the benefits of soya protein while reducing the amounts of animal fats in the diet. A 100g serving of tofu or 125g pot of plain yogurt both provide 200mg of calcium. An ounce of Parmesan provides a whopping 390mg of calcium, and 100g canned pink salmon 300mg. Don’t forget your fruit and vegetables… latest research in bone health shows that women who have more fruit and vegetables in their diets, tend to have higher bone density. Fruit and vegetables contain an array of micronutrients such as magnesium, vitamin C, and boron. We now know that these play an equally important role in bone metabolism.

If you feel you need to supplement with calcium, remember that calcium should be taken with magnesium in a 2:1 ratio. This is because calcium and magnesium require each other for proper absorption, and utilisation in the body. So, if you supplement with 500 mg of calcium, you need to take 250 mg of magnesium at the same time. Most reputable companies now formulate supplements that take this into account, as well as the synergistic “need” for the other nutrients involved in the entire process of bone metabolism. Choose carefully.

Water!

Water is a nutrient and the fact is, we need it... and plenty of it. Certainly, water may be one of the best tools in the weight loss game. It not only suppresses the appetite, but helps the body metabolise stored fat. Water keeps the body’s tissues well hydrated, so if you want smooth, line-free skin for as long as is naturally possible… drink!

Salmon and other oily fish (in moderation)

Salmon was at one time avoided in favour of white fish or sole, due it’s higher fat content. However, once we understood the value and benefit of the essential “Omega 3 fatty acids” present in salmon and other oily fish, it was back on the plate. The time has arrived however, that food-conscious individuals are steering away from oily fish again (or at least cutting down), not because of the fat content, but because of the presence of harmful chemicals and metals. Fish such as mackerel, salmon and swordfish are known to contain high levels of potentially carcinogenic chemicals, and others, including shark, marlin, swordfish and red snapper contain the highest levels of mercury. These larger, long-lived predatory fish and mammals tend to accumulate more mercury from the environment than shorter-lived fish. The Food Standards Agency (FSA) recommends that we eat 2-4 portions of fish a week, and 1-2 at least should be of an oily variety. Pregnant mothers are the only group that need to limit oily fish intake to 2 portions a week, but not to avoid fish altogether. Omega-3 fats are vital for the baby’s brain development. Many people often prefer to take an uncontaminated fish oil supplement, or stick to flax seeds as a source of Omega-3’s. Nutri’s Eskimo oil is one of the best un-contaminated fish oils on the market, and contains the fat-soluble antioxidant vitamin E to ensure the fish oils do not oxidise in the body. Remember Omega-3s ARE essential to good health, and freedom from diseases such as Alzheimer’s, cancer, depression, diabetes, heart disease, and rheumatoid arthritis… so as I say, don’t avoid fish altogether, as fish oil is clearly the richest source of Omega 3’s we know. Important omega-3s are DHA (docosahexaenoic acid), and EPA (eicosapentaenoic acid) - from fish oil and algae - and alpha linolenic acid, usually from vegetable sources such as flax seed oil. In a healthy person, linolenic acid can be converted to DHA, and EPA, provided the correct enzymes are present. However, only 2% of the alpha-linolenic acid found in flax oil is actually converted to EPA… far less than we find in fish oil. EPA and DHA substantially lower your risk of heart disease by lowering LDL cholesterol and triglycerides, prevent blood platelets from becoming sticky, and can lower blood pressure. They also promote good bone health, heart health, and breast health. DHA is particularly important during brain development, so is a popular and useful supplement during pregnancy.

Re: CANNED FISH - During the canning process of tuna, all the fat is lost, so tinned tuna does not count as an oily fish. The canning process of other fish (salmon, sardines, pilchards etc.) is different to that of tuna, and does not affect the oil content of the fish. How the canning process affects the stability and integrity of the delicate fish oils has not been fully elucidated. The possible presence of mercury and toxic chemicals I would imagine is no different in canned vs. fresh fish.

Eating fruit to offset mercury absorption?

To enjoy fish while minimising your mercury exposure, eat some tropical fruit for dessert… eating antioxidant-rich tropical fruits, such as mango, pineapple, banana, and papaya, may help reduce the amount of mercury that your body absorbs, according to research published recently in Environmental Research (2003). This particular study was a 12-month prospective dietary survey, carried out with 26 adult women from a fish-eating community in the Brazilian Amazon. They found a strong relationship between fish consumption and mercury (Hg) levels in hair. Not surprising you may think…. What was surprising and very interesting was the finding that this strong relationship was significantly modified by fruit consumption: for the same number of fish meals, those who ate more tropical fruits had lower hair mercury levels. The findings of this study indicate different ways of maintaining fish consumption while reducing Hg exposure in the Amazon. A number of phytochemicals and nutritional fibres present in fruits might be interacting with Hg in several ways: absorption and excretion transport, binding to target proteins, metabolism, and sequestration. More research on larger worldwide populations would further elucidate the extent, and public health implications of the use of fruits to counteract the toxic action of methylmercury.

Try this tasty fish dish… with minimal mercury exposure!

Fresh Tuna Steak with Mango Salsa (Serves 2)

Ingredients: 2 fresh Tuna steaks, marinated in olive oil and chopped garlic

For the salsa: 1 whole mango, peeled, sliced off the stone and chopped A small piece of finely chopped fresh ginger root Handful of chopped fresh coriander 1 tablespoon of balsamic vinegar and 1 tablespoon of olive oil, mixed Juice of half a lemon or lime Ground black pepper to taste

Method: Place the steaks into a frying pan. Pan-fry on a medium heat until opaque on the outside and a little pink in the middle. While the fish is cooking, combine all the salsa ingredients in a bowl and mix thoroughly. Serve the fish alongside the mango salsa and a large mixed green salad.

Lucy-Ann Prideaux MSc BSc RNutr Registered Nutritionist http://www.simply-nutrition.co.uk

Article Source: http://EzineArticles.com/

Women Health - Top 10 Trends in Healthcare

America is undergoing a dramatic shift in healthcare. Actually, ten distinctly different shifts. Although the changes are unsettling, and will cause dislocations in our economy, the overall trends are positive and will help us all be healthier and wealthier when it all shakes out.

Western Medicine Costs Continue to Rise


It's hard to imagine, but the cost of going to a regular MD or hospital is going to get more and more expensive. This is not because doctors or hospitals are getting greedy, but instead because their own costs are rising every year. Malpractice insurance for risky surgical procedures, pharmaceutical drug reactions and deaths with accompanying lawsuits, complex medical equipment for diagnostic testing – everything is rising dramatically in cost. Pharmaceutical drug costs will continue to escalate also, leaving consumers holding the bag, because...

Health Insurance Opt-Outs Surge

For many years, corporations and small businesses have provided health insurance as an employee benefit. Often, employees would choose a job based on who offered the best health insurance. No longer. Small businesses have almost completely opted-out of the insurance game, and large corporations are not far behind. General Motors complains that health insurance costs them more per year than steel for their cars. In a few years, health insurance through your employer will be only a memory. Everyone will be buying health insurance the same way they buy home insurance or car insurance – independently.

Because of this shift, consumers will begin treating health insurance the same way they treat car and home insurance. Which is to say, they will treat it like INSURANCE.

Today, many Americans run to their doctors for even the smallest maladies, and they expect their health insurer should pay for everything. In fact, they're incensed when they don't. “What, you're not paying for this bottle of antibiotics for my kid's ear infection? How terrible!”

This is opposite of how we treat car insurance. Imagine expecting your insurer to pay for oil changes, car washes, pockmarks in the paint job, a broken cupholder. Can you picture it? Of course not. It would be ridiculous.

Yet, with health insurance, it's been okay. Why? Because the employer is picking up the tab. Not anymore, they're not.

As a result, Americans will pay more attention to preventive healthcare, like regular exercise, good diet and meditation, etc. They will also do more cost comparisons between all their healthcare options, including a trip to the doctor, or...

Alternative Medicine Becomes the Dominant Healthcare System in America

I feel bad calling this a future trend, since this has almost already occurred. Alternative medicine, including naturopathy, hypnotherapy, Chinese medicine, chiropractic, yoga, etc. is fast overtaking Western medicine (drugs and surgery) as the dominant healthcare system of America.

Several studies have shown that Americans spend more out-of-pocket on alternative medicine than on Western medicine. They've also shown that people are making more trips to these alternative practitioners than they are to regular MDs. These are positive developments. The downside is that people are reticent to mention their alternative therapies to their doctors, because they're afraid of disapproval by their doctor.

But the trend is clear. Alternative medicine is often less expensive (especially outside of insurance), equally effective and produces less harmful side effects, as was evidenced by the flurry of pharmaceutical drugs this past year that were removed after being prescribed to hundreds of thousands of patients.

People's trust in Western medicine is diminishing, and their relief in finding alternatives is rising.

Major institutions are now doing large numbers of studies on alternative medicines, including herbal remedies, bodywork, meditation, dietary changes and many others. Randomized, controlled studies are available on almost every type of alternative healing practice, and they typically show good results.

The rise of alternative medicine and the opting-out of employer-funded health insurance has led us inevitably to an era of...

Consumer-Driven Healthcare

People are making their own choices in healthcare and health insurance. They want to make their own decisions.

This is extremely positive. One study after another shows that hospital patients who are disruptive, picky, nosy and non-compliant are the ones who fare best with any surgery or recovery from illness. The patients who are compliant and put their fates in the hands of their doctors are the ones who fare most poorly. Taking charge of one's health is part of consumer-driven healthcare.

This term also refers to how people are deciding to use whatever treatments they think will work best, based on their own research. Fewer people simply accept their “doctor's orders” and instead they find out for themselves what is available and make informed choices. This also means they are deciding to use a different kind of health insurance, which is more compatible with their free-will healthcare style...

High-Deductible Health Insurance and Health Savings Accounts (HSA)

As corporations drop their employees' health plans, the employees are choosing to buy high-deductible health insurance policies, which are much cheaper.

In fact, a high-deductible policy ($2,500 deductible or higher) is almost always so much cheaper, that even if you had to pay the entire deductible yourself every year, you'd still save thousands of dollars. The monthly premiums are reduced MORE than the amount of the deductible.

Along with high-deductible policies, people are choosing to use the Health Savings Account (HSA), introduced in 2003. This is a tax-deductible savings account that can be used for any medical treatment (Western medicine, actually), which is basically a tax savings for everyone who buys their insurance independently.

High-deductible policies and HSAs allow people to have Western medicine waiting in the wings when they have serious health problems that require expensive drugs, tests and surgery. But until then, they are able to use alternative medicine as the best service for prevention and small day-to-day health problems.

Alternative medicine provides a “first line of defense” while Western medicine provides the expensive, dangerous, but necessary backup.

Since alternative medicine has taken such a major role in healthcare, the state and federal laws have had to adjust, which has meant...

The Rise of Health Freedom Laws

Health freedom is a term applied to a particular kind of legislative bill. It is a bill that allows alternative medical practitioners to practice their healing arts, as long as they stay out of the areas where extensive Western medical training is required:

- performing surgery
- prescribing pharmaceutical drugs
- administering injections (like vaccinations)
- knowingly contradicting an MD's orders

If alternative medical practitioners are caught doing any of these, they can be arrested for practicing medicine without a license. But otherwise, they can use any other type of healing art, including bodywork, dietary changes, movement therapies, hypnosis, etc. to help their clients.

This bill is needed in many states, because current laws state that no one can practice medicine except medical doctors, and the definition of practicing medicine is anything that helps people with their health! This means that if someone has a cold, and they go to a massage therapists who recommends echinacea, that massage therapist is breaking the law! Ridiculous? Practitioners have been shut down in many states for doing less.

Health Freedom laws are common sense. They've been passed in four states already – Minnesota, Rhode Island, California and Idaho. These states have had excellent results from these bills, including patients from neighboring states making trips to their states to seek relief from health problems. Can you say “boost to the economy?”

For more information about Health Freedom initiatives, visit the National Health Freedom Website.

With Health Freedom information, and alternative medical options available, it is only natural that people turn to...

The Internet As a Healthcare Information Resource

The Internet has become the first stop for someone who has a health concern. Feeling low? Do a search on depression remedies on the Internet. Just been diagnosed with cancer, and the doctor says it's chemotherapy or die? Jump on the Internet and see what your other options are.

Of course, the Internet has its benefits and its problems. There is a tremendous amount of misinformation about healthcare on the Internet. Much of it comes from well-meaning entrepreneurs who have been sucked into a multi-level marketing (MLM) scheme and are trying to pitch some health elixir or other. A second source of health misinformation comes from the Western medical establishment, who seek to discredit alternative medical therapies that could take significant revenues away from their invested therapies. A third source of misinformation comes from the anecdotes of individuals who experienced relief from one therapy or another, but who do not (and cannot) actually represent a proven cure to a particular health problem.

Even with all these caveats, the Internet's influence in healthcare decisions will gain momentum. People will understand the “good sources” and “bad sources” of information and new portals will crop up that separate the wheat from the chaff.

The reason people are turning to the Internet in such numbers is due to a lack of trust...

Distrust in Existing Medical Institutions

At one time, you could hold no position of higher trust than to be a doctor. My wife's father was a doctor in a small town in Ohio. When he died, the funeral was packed with his patients over the years. People appreciated his caring and his dedication to keeping them healthy.

Now, doctors are viewed with suspicion. Will my doctor let me die by not revealing an alternative therapy that could help me? Is my doctor getting kickbacks from the cute, young, female pharmaceutical rep who visits him twice a month?

The system has gained the pallor of corruption, even when it's not really true. Big medicine has become big business, and the number one concern is no longer the patient, it's dollars and cents.

But hospitals and doctors are not the only things that Americans distrust...

Distrust of Socialized Medicine

People in government and in society seem to feel that some brand of socialized medicine will be the magic solution for America's healthcare problems. The “single payer system” of healthcare, successful in other countries, must be implemented here, they say.

But America is a different kind of country, from its very beginnings. Americans praise the independent spirit, the entrepreneur, the underdog.

Socialized medicine will not work in America. And Americans know it. They do not want a government-run system. What is the least efficient organization you can imagine? It's the government. Do you really want a government worker making decisions for you about healthcare?

Yes, America needs to find a way to insure every single person in this country. But socialized medicine is not the cure for this illness. Having been born in Canada and living there for the first twenty-eight years of my life, I can say that Canada's socialized medicine program leaves much to be desired. It does cover every person, but in a way that benefits no one.

I understand that the person in the middle of this entire crisis, the professional who has the most to gain or lose, is the doctor, the general practitioner. They will be devastated by a socialized medicine system, and they will also be affected greatly by the other trends in this article.

Because of this, I see the emergence of a final trend...

Doctors Incorporate Alternative Medicine Into Their Practices

Doctors will have no choice but to use pieces and parts of alternative medicine in what they do day-to-day with patients. “The customer is always right,” as they say, and the customer definitely wants a choice.

Although doctors are increasingly using alternative medicine in their own practice, and hiring alternative practitioners to work in their offices, the independent alternative practitioner will still be the rule, not the exception. There are just too many alternative practitioners (massage therapists, chiropractors, yoga instructors, etc.) for doctors to absorb everyone. And people will want a choice. A Western medical experience, or perhaps an alternative medicine experience.

And a choice they will receive.

The Western medical practitioners who are clearly leading the way are nurses. Nurses are much more open to alternatives than doctors, and they are increasingly opening their own offices, as nurse-practitioners sometimes, and treating patients with a wide variety of healing methods. Patients appreciate the nurses Western medical knowledge, and also their openness to a new set of options.

Overall, the outlook for healthcare is extremely positive for everyone involved. Tremendous change, yes. But upheaval can create some wonderful new circumstances.

Daryl Kulak is the author of Health Insurance Off the Grid, a book that provides a simple, effective plan to reduce insurance costs for the self-employed and underinsured. The book puts the new Health Savings Account (HSA) together with alternative medicine to create a workable, cost-effective plan for many Americans. The book is available at the Website http://www.healthoffthegrid.com

Article Source: http://EzineArticles.com/

5 weeks in, memory better, asking about baby

Things have been progressing slow for the last couple days. Overall, her breathing continues to get better, her blood, nutrient absorption, infection & high fevers continue to be in the limelight as concerns.
Denise looks very frail... bony hands, tiny wrists, etc. Not chewing & talking make her cheek bones very pronounced, cheeks sunken in & jaw line not as square. In spite of that, she's still giving it all she's got when she's alert, moving her legs & arms. Yesterday I think she was able to bend her knees on her own a tiny bit, and she was able to raise her arms at the elbows with great effort. She even accidentally batted the tracheostomy tube and it popped off for a second.
There was another change in antibiotic, as one of her infections (pseudomonas something or other) was resistant to it. They started Amikacin. She has mild DIC (disseminated intravascular coagulation), related to infection. It's a weird condition that I haven't researched enough to understand. But for the time being, I *think* it's a situation in which blood coagulates within the circulatory system (not at a wound), and uses up coagulants & platelets. She also has disproportionately low count of lymphocytes, which are part of white blood cells. 20% should be normal, she's been 15% on a good day, 5% on a bad day.
She had the best blood gas results yet (encouraging). Yesterday she was about as alert & active (and aggitated & anxious) as she's been since waking up. She could remember most people in photos and last night's nurse said she's definitely asking about the baby. Denise is only taking sedative (Avastin... with an "i" is the official hospital spelling) as needed, in small amounts to mellow out, not get knocked out.
We finished reading "Purpose Driven Life" the other day, which we started the day before Denise started feeling sick (40 days). Today marks the end of 5 weeks in the hospital. So on we go into week 6. And off I go to the hospital. Thanks for caring, all!

Saturday, August 20, 2005

Coping, Amnesia, Blessings Counted, Music

Today has been fairly uneventful, as far as major news goes. Transfusion, antibiotic switch (Vancomycin to Tobramycin), physical & occupational therapy (Denise has expressed that she likes to move). There might be another organism found in the fluid from the paracentis (a gram-negative bacilli possibly). As usual, there is a waiting game involved with the cultures. I should have asked if this might be the same organism that was found from the swab that the ObGyn did a while back, in which they found p. aeruginosa, but I forgot. I remember from bio way back that a bacilli is a rod-shaped bacteria, and I read that p. aeruginosa is gram-negative (can anyone explain "gram-negative" within the 300-word limit of a comment?). No word on the CT scan for neuropathy causes yet. Still have the usual infections, fevers, weakness, blood concerns, ab swelling, etc.

I talked to someone that gave me an idea of helping the kids cope. I was already going to get video of the kids to show to Denise. It was suggested that I take video of Denise while she's very alert & can smile & be expressive facially (have this happy footage at the beginning of the tape, and at the end). Also get video of her sleeping. Show the room so that Gracie can see the pictures on the walls that she made. Show the bed (Gracie was comfortable with pushing buttons on the bed when Denise was in a "regular" room). Even get video of nurses taking blood pressure, using the stethoscope, and doing other "regular" procedures that Gracie is familiar with (Gracie has a Fisher Price doctor kit with these items, and she uses them all the time). I can show these things to the kids to reassure them that mommy's still OK ("OK" being relative, of course).

Today, the temporary amnesia that can result from the sedative (Atavan) really hit home. Again, she mouthed that she wanted me to take her home. Again I explained that she's been in the hospital for 4 weeks and has Valley Fever, not Rocky Mountain Spotted Fever (she DOES remember coming into the hospital), she's got chest tubes, feeding tube, tracheostomy, etc. etc. etc. ad nauseum (ad nauseum, for those of you that don't know latin, means "getting sick of seeing the same commercials over & over). She had a look of disbelief on her face. She didn't remember visitors from yesterday. I took photos off of the wall and asked if she recognized the people in the pictures. In many cases, she did not. Fortunately, she recognizes me. That's encouraging, since she'll pucker up for a kiss. Don't want her doing that for just any guy, you see.

Denise's regular doctor (the one that just became a daddy) indicated that he would be less involved. I met another doctor this evening that has been following Denise's case. He showed me the chest x-rays and pointed out the improvement between August 2 and today. Lungs are still bad, but much better than they were. He stated that earlier in this ordeal, nobody expected Denise to survive with the ARDS (Advanced Respiratory Distress Syndrome... the critical lung issue a couple weeks ago) that bad, on top of the other vital organs shutting down (remember she was going into septic shock and they gave her Xigris to combat the sepsis). He also said that he could think of one other person that was in the state that Denise was in that survived, and that was about 15 years ago. Hearing these things made me count my blessings again!

In addition to reading to Denise, I've been playing music she likes, too. She's usually been asleep for that. Today was the first time she wanted to hear music while alert. We played a whole bunch of songs on the iPod. Some highlights: She started rolling her head side-to-side, just about in time with Fleetwood Mac's "Hold Me." During "Teach Your Children Well" by Crosby, Stills, Nash & Young she smiled & turned her head to look at a family picture taped on the bed rail, raising her eyebrows a couple times. "I've Got To Walk That Lonesome Road" by the Stamps has a part where the bass singer dips *really* low, and at that part Denise made the same face she always makes at that part ("Did that sound come from a person or a whale?"). My favorite moment: During Cyndi Lauper's "Girls Just Wanna Have Fun" she was moving her legs and shrugging her shoulders, shaking the bed so much that a portable oxygen tank was rattling in the bracket. That's pretty fitting for her, I think.

Thursday, August 18, 2005

2 days of news, and jury duty

Today was our one-month anniversary for this ordeal. Denise went into the hospital the 18th of July. Sorry for not posting yesterday, and posting so late today. Here's the scoop:

Yesterday: CT scan of abdominal area & pelvis, with contrast. Contrast... I guess it's like paint or something so the organs show up better. Denise is an artist at heart, so I hope she appreciated the contrast. Anyway, that showed lots of fluid buildup around bowels. The question is: why? Also, they drew blood to do some blood cultures. I learned that they have regular tubes for adult blood samples. And they have child-sized tubes as well. They've been using those pediatric-sized tubes for Denise all along, because they don't want to take much blood from her if they can help it. Fever crept up to 103.4. She vomited yesterday. Nothing was aspirated, though. The vent mode that had been serving her so well (bilevel) was down to a very low level of help (40% oxygen concentration, 0 PEEP, 18 cm/H20 pressure, for those that will ask) and they tried switching over to a different mode called CPAP. I rushed home. I looked it up. I learned a lot. But then Denise started doing poorly in that mode, so they switched her back to bilevel again. Oh well, at least they thought she might be far enough along to try.
Yesterday she was asleep most of the time. When she was awake, she was sort of catatonic... eyes open, mouth open staring at the ceiling. But then between about 3 & 6 pm, she became more alert. At one point the nurses washed her hair & braided it, then tilted her bed up & feet down (like a recliner... this bed is so cool!). They were joking about how it's almost like going to a spa or salon, and Denise seemed to be getting a kick out of that. I had to leave to get home for dinner with the kids and she did big puckery kissy lips, so as to lure me back for another smooch. I fell for it, easy. When I got home, there was a jury duty letter for Denise in the mail. I had to have the doctor fill out the form to be excused. I *did* hesitate, though... given some of the verdicts we've seen over the years (Blake, Jackson, and let's not forget "The Juice"), I started to think that maybe, just maybe, Denise was exactly the type of juror they were looking for to sit on the next big celebrity case. Anyway, the doctor wrote in that her condition will remain for 6 months, she'll be well enough to serve on a jury in 8 months. The other stuff that the doctor filled in on the form is completely illegible (can someone please post a comment that explains why this seems to be a common trait among doctors?).

Today: As is typical, some things get better, some get worse. High fevers (they're lowering the heparin to see if the fevers will get knocked down). Brutal Valley Fever infection still going on, plus the p. aeruginosa, and some other fungus that's yet to be identified. We were really hoping to not find any more nasty things to deal with.
Electrolytes are doing zany things due to the meds, so that requires a balancing act.
For those asking, albumin is at 2 (should be 4). It's "a
protien made in the liver that assists in maintaining blood volume in the arteries and veins. If albumin drops to very low levels, fluid may leak into tissues from the blood vessels, resulting in edema or swelling."
Hemo went down to 7, so she got another transfusion (she has developed what they call "minor antibodies"). But white count went up to 15 (neupogen stopped) and platelets went up to 108. Really, somebody should assign ticker symbols to these things... I *am* watching them closer than any stocks right now.
There will be another paracentesis today or tomorrow. There was also a CT scan of the head and some other neurological tests to try & find out why her nerve conduction is so weak. Which leads me to the next topic...
When Denise is alert, she can move neck, face, mouth, and shake her legs some... that's about it. She's *very* weak. Can't give a thumbs-up or wiggle fingers. So they need to find out if it's caused by the steroid & other drugs, or from "Critical Care Neuropathy." When we find out results from the CT scan, then I'll know where to even begin asking questions about getting her strength & movement back.
On the good side, they again lowered her vent pressure (down to 15), still has 40% oxygen, still maintianing about 97% saturation. Cookies and gift certificates to In-n-Out Burger appeared in Denise's room (THANK YOU!). And we finished "To Kill A Mockingbird" tonight. If you've never read this great story, now I've got a copy you can borrow. I was thinking of bringing in some books that Denise hasn't had time to read and let her pick what to hear next. One of the nurses said I should bring in a romance novel & read it, and the nurses could hang around the room and listen in. Maybe I'll buy a great big Fabio poster to put up in the CCU instead.

Tuesday, August 16, 2005

Less Vent, Less Critical

This morning's news is short & sweet. Denise's dad & I went in at about 9 am to watch the physical therapy. Denise did pretty good. We learned a lot of things that we can do with her. Much of the work was passive, but some was active, requiring Denise to apply a little force on her own. She was *really* tired when therapy was done. Not that she's ever really been a morning person, but she was already starting to fade in & out by 10 am. I still got a smile, though! :O)
The ventilator pressure went from yesterday's 20 cm/H20 to 18 today. So once again, here's another day with the machine doing less work, Denise doing more, and her oxygenation remaining adequate.
The doctor indicated that they're going to discontinue the med that boosts white blood cell production, as her marrow seemed to start cranking out acceptable amounts again. Yay!
There's another increase needed in the protein department. The fevers persist. Infections persist.
Ray of sunshine: doctor indicated that if things continue to slowly get better, Denise may be graded into a category that's less critical or even just plain serious. When patients are in serious condition, they don't really like to hear jokes. That'll be a tough phase for me. Still, I'm glad to hear that all the decisions, meds, skill, equipment, hard work, and prayer is all working together to keep Denise on the road to recovery. After all that's been going on for a month, it's nice to hear the positive things.
By the way, Denise's doctor became a first-time daddy yesterday. He's "off" for a few days to hang out with his wife & new son. But he's still been coming in to see Denise anyway. That kind of dedication has been typical of him and the nursing crew.
:O) Phil

Monday, August 15, 2005

Physical Therapy Starting, Less Vent Pressure

I didn't hear from the doctor until very late today. This is good. Usually, the earlier I hear something, the worse things are. OR I may have heard from him late today because he just became a daddy this morning. One of the nurses said she thought she saw him early this morning. Then his wife had a baby. Then he called to touch base with me later in the day. Wow. That's dedication.
Things are fairly stable today. The same problems are still being problematic. She needed another unit of blood to get the hemoglobin count back to acceptable levels. Still battling colitis & infections. Still needing ultra-high amounts of protein. Still very, very sick.
But on the good side, a physical therapist started Denise's first session today. This will be no surprise to those of you that know Denise's love of dancing, but her strongest movements (really the only movements) were in the legs & feet.
The vent pressure was lowered a little bit more. So Denise is doing the work of breathing a little bit more on her own and still maintaining decent oxygenation.
The ascites looked to me like it was going down a little. Then again, it's hard to notice the change. Kind of like watching grass grow.
Denise liked hearing the emails read to her today. They don't get printed out on the weekends. There's an avalanche of them on Mondays. They put smiles on her face. They're weak smiles, but that's the best she can manage right now. Thanks so much for them! Keep them coming! Thanks also for the emails sent to our home account & for the phone calls, too. While I'm not as good as I usually am at responding, know that I'm getting them all and being encouraged.
:O) Phil

Women Health - Pregnant Women Don't Just Stay At Home; Go Shopping !

Most women like to go shopping. However, sometimes pregnant
women reluctant to go out because they are afraid could harm
them. That's not true! Go and have fun. You don't have to spend
any money; just get out and window shop. Try on shoes; check out
the new fall purses or sample a new cookie at the corner stand.
Shopping is very therapeutic for women, and it gives you a
chance to clear your mind.

If you are feeling ambitious, though, or cannot justify taking
an afternoon off to shop, give yourself a chore, like deciding
on nursery room colors or selecting a crib. Then, you will feel
like you are accomplishing something as you go.

Do not get stressed out, however, if you do not find what you
want right away. Remember, you are just looking now. There is
no hurry to immediately find and/or buy everything, especially
since friends and family will want to help by bringing gifts to
your baby shower.

If you would rather shop for clothes, purses or makeup, though,
that's also fine. Sometimes, it is good to step away from the
"mommy" world and remember that you are also a woman who has
her own needs and wants. Don't feel guilty if you need some
"you" time or if you need a little something to perk up your
spirits. A new maternity outfit or a sweet scented lotion may
be all you need to feel de-stressed and reinvigorated. You
might also feel good just trying out new perfumes and seeing
what those strappy sandals look like on (even if you know they
would kill your feet!).

Just remember that while you are out shopping, you need to be
relaxing. Treat yourself to an ice cream cone or catch a new
movie if the mall has a theatre. Any of these activities will
help you let go of your stress and refresh your spirits. Then,
you will be fully ready to be Mommy again!


About The Author: Sara Jameson writes her experiences in "The
Very Happy Pregnancy: Avoiding Stress and Depression." Check
this out http://www.sign-of-being-pregnant.info and
http://www.pregnant-woman-101.info

Links


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Sunday, August 14, 2005

Error Aug. 11: Ativan, not Avastin

There was an error on the August 11 entry, which stated that the sedative was Avastin. That is incorrect. The sedative is Atavan or Ativan (I've found both spellings). Avastin was on my mind because my dad was on it for cancer treatment, and all these drugs are starting to sound the same. I received a couple email from alarmed nurse-types that knew the difference. Thanks for bringing this to my attention.

Breathing better, Blood worse, Reading Lips

The doctor just called with the usual good news/bad news/neutral news update.
Denise's lung mechanics are going well enough that they're going to turn down the vent pressure and let her assume more of the work in breathing. The holes in the lungs have closed up. Chest tubes will stay in for the time being, however.
Last night she was responding fairly quickly to news of how long she'd been sedated, what the date was, and much of what has happened. She expressed disbelief. Can't remember a thing. Good.
A therapist will be coming to start working on muscle movements. She's very weak from the severe sepsis and the meds. The neurologist will also be coming in to do some more evaluations.
Her fevers haven't spiked beyond 102 for the past 24 hours. As mentioned numerous times, some part of the fever is her fighting infection, some part is brought on by the meds (I believe Abelcet or Albecet, used to fight the cocci fungal valley fever). That med also causes problems with potassium and magnesium. During this whole crisis, I've often wished that I took chemistry instead of physics throughout school.
An anti-clotting med is going in (Lovenox) to treat the SPT mentioned on Thursday.
Blood numbers have drifted downward. Hemoglobin count is down to 6.8. Earlier I mentioned that 7 is currently the limit if oxygenation isn't an issue (and that's been going well). There have been issues with her creating antibodies to the blood from other people, so they don't want to do too many transfusions. White count is 1.7 (normal would be 8, they say). So they're starting her on a drug to boost that (Neupogen). Denise & my dad have that in common now. For those that don't know, my dad's been dealing with cancer in colon, liver, lung, and lymph since November... indeed, I thought I'd be sitting by *his* hospital bed by now, not by Denise's.
They are also treating Denise for colitis (inflammation of the colon). The situation was described as having tons of antibiotics killing almost everything off. But the really resistant bugs are just having a big party in the colon. I imagine that this is how the phrase "party pooper" originated. But I digress...
I was encouraged to hear the doctor tell me that overall, she's better now than she was a week ago. So I'm off to the hospital to visit with her. At this point, let me toss up a small prayer request for me. I've got to learn to read lips FAST. She's too weak to write anything, and may be lacking in the fine motor skills department at this time, anyway. It was tough to see her completely sedated. I don't know if it's much better to see her awake but unable for us to communicate so I can understand her needs. The most frequent things are pain/discomfort and thirst. But she's trying to say a whole lot more to me that I can't understand. Some of the biggest arguments we'd get into over the years were over me doing something but not stopping to look at her when she talked. Don't get me wrong, we'd focus on each other most of the time, but when I didn't actually look at her, I fully understood what she said and certainly was listening. It's just that I interacted with her while still carrying on with whatever else I was already doing. Computer guy that I am, I tried to explain to her that I was just "multitasking." She wasn't amused (men, your wives aren't amused, either). Right now, I wish I'd watched her so I could get practice at reading lips. Any of you adept at ASL and lip reading, let me know some pointers.

Saturday, August 13, 2005

p.aeruginosa found

The culture from the fluid draw they did the other day (paracentesis is what it's called) showed nothing of concern so far (let's hope it stays that way). But the swab that the ObGyn did showed growth of the p. aeruginosa bacteria. The "p" stands for "pseudomonas." The "p" also stands for "pretty darn resistant to antibiotics." Apparently there's currently only one antibiotic (Primaxin) that can lick this bacteria, so they'll try that. I just now looked it up and saw that it's got Imipenem as a component. I remember that name because I already joked in an earlier post that Denise likes Stan Getz doing "Girl from Ipanema" and Denise had become the "Girl on Imipenem." Why it was apparently tried before and we still have this infection to deal with, I don't understand. Then again, I don't understand most of the work they do in the CCU. By the way, television E.R. has nothing on the CCU.
I'm waiting to get more info on the SPT (mentioned Thursday August 9) that we may be dealing with as well.
Fevers tickled 104 again last night (hadn't gotten that high in a couple days), and were down around 99 by the time I left earlier this afternoon.
Blood workup is still not great, but stable. My understanding is that additional transfusions could be counterproductive to fighting the infection(s). So they're giving Denise iron instead of red cells to help with the oxygenation.
They also stopped the SoluMedrol steroid drip. Apparently it works against one of the antibiotics. Since the steroid was primarily given to reduce inflammation in the lung to improve oxygenation, and the new ventilator is taking up that slack in accomplishing that end, they felt it was the wisest move to discontinue the steroid for now. That'll give the meds the best chances to hammer the infections.
The Tygacil was also stopped, as it apparently doesn't combat what was anticipated to be the problem.

Denise's overnight nurse went to Pasadena Christian School from kindergarten through 8th grade, graduating in the year that I started teaching there (1994-1995). All the old PCS teachers reading this can be proud of Michelle Gower. She took real good care of my wife.

Yesterday, Denise was waking up again, and I was reading all of the emails to her that were received that day. One of them was from one of Denise's friends. The email described a dream in which our friend saw Denise well and happy. I read that aloud and then related a dream I had a few weeks ago in which I was a kid, walking down the school hallway, and everyone was laughing and pointing at me. When I sat down in my desk and got my books out, I realized that I had forgotten to put on all my clothes and was only wearing my underpants. Denise opened her eyelids, rolled her eyes, and shook her head a little. Without moving her lips, she said, "Honey, you're a buffoon." For this, I was happy.
Needless to say, I hope that our friend's dream comes to pass, and mine does not.

Friday, August 12, 2005

New lung hole, more sedation, infection concerns

Well, Denise has indeed developed another pneumothorax (lung hole) according to the x-rays. It's smaller than the first one, but they still had to sedate her again to put in another lung tube to allow the air & fluid to drain. So she's sleeping again. Still, yesterday was a nice bit of encouragement!
The doctor told me that there was something found in the fluid taken from the pelvic region yesterday. The standard bacteria/virus/fungus waiting game still applies: gotta wait 48-72 hours for cultures. Preliminary word is that it might be something that's pretty resistant, though I didn't get the specific name. Hopefully, the infectious disease doctor will have spoken to Denise's main doctor by the time I get back to the hospital and I can report to you all what she might be dealing with later tonight.
I haven't heard anything about Denise's blood workup today. I assume that it might be stable (but still bad and cause for concern, treatment, and of course, a whole lotta prayer.
Oh, yesterday I said the brand-spankin' new antibiotic that they were trying with Denise was Tygracil. I accidentally added an "r" that didn't belong. The stuff is Tygacil. Still pretty new, though, approved just June 15th.
Denise is going to be moved to a room with a view later tonight. It's still in the CCU. They want to start to get her on a schedule... "awake" during the day, sleeping at night. One change is that even family will have to clear out by 10pm or so. As much as we've loved having someone there for her 24 by 7 for a few weeks, this should be a good thing. Denise won't be tempted to stay awake in the middle of the night if one of us is there. And the rest of us will get some much-needed sleep (and we'll finally be on a schedule as well). I know I'll be making fewer 1am stops at In-n-Out Burger. As hard as it might be, this will help us take one more step toward normalcy. Speaking of visits, I should probably state again that they really only want family visiting for a while. If you show up to visit without one of us with you, or without me calling ahead to clear you, they will likely politely turn you away. That said, we're all humbled by how many of you have come by to visit. She's well-loved, as evidenced by the many cards, entries in the guest book, and goodies left for her in the room.

Thanks for so many suggestions via email for how to handle any questions about losing baby Danny. The O.B. thought it best to wait until Denise is fully awake before discussing this, as we don't want to traumatize her repeateldy through the amnesia caused by the sedative. Just once would be better. Last night she sort of pulled my hand to her tummy and hit my hand against it. I explained that she had a bunch of new tubes, including one to her stomach, and there was a bunch of swelling, so things don't feel right. I need some wisdom, people. Hard to figure out what to tell the kids and Denise to keep the trauma to a minimum.

On a *very* positive note, I was thinking this morning of how good I have it when it comes to where I live. Last night, one of Gracie's toys fell and broke the only phone jack in the house that we can use with our DSL modem for internet access (to my partners in geekiness who will ask... we've got a weird/special setup... none of the other jacks will work). Anyway, I've got a neighbor that does electrical stuff. Turns out he does phone stuff, too. And at odd hours of the night. Thanks to him, we can do this update today. Another neighbor brought dinner unannounced on just the perfect night. I can't remember what day it is, and another neighbor knows that, as evidenced by my trash cans always being by the curb when they need to be. The lawn is not only not dead, it's been mown & edged a few times. We were treated to some fine black cherry ice cream, deliverd to our door a while back. Quiche for breakfast, delivered hot. When our van pooped out, it was repaired by a friend of a neighbor (who I would consider a bona fide neighbor any day). Lots of "How's she doing?" being asked when I drive to or from the hospital. "Love thy neighbor" has been put into practice on my block in a way that's not to common in most neighborhoods. I wish everyone had neighbors like I've got, and I look forward to returning the good deeds. Thanks, neighbors.

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