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Thursday, September 29, 2005

Some big improvements

Here’s a long post covering two days, so get comfy, but not so comfy that you don’t want to jump up & cheer!

Top of the news is that Denise is doing better. Still critical (and in isolation... gown, gloves, mask needed when I'm with her), still not out of the woods, still weak, still dealing with some infection somewhere and resulting high fevers. But better. In fact one of the doctors described it as having "a different patient this afternoon than we had this morning." It's been encouraging to hear several people say that Denise can recover from this. So there's some pretty rapid things happening, and they seem to be in our favor.
The most dramatic improvements are a higher cardiac index (saw it go as high as 4.2, SVO2 in the 60s & 70s mostly) and increasing urine output. The ejection fraction according to the EKG was 10 (low... yikes!). But the doctor said that between judging the heart's condition based on the EKG (which I learned has some subjectivity in the reading) and the cardiac index & urine output (kidneys wouldn't work unless the heart can get enough oxygen pumped to them), he said he'd "listen to the urine." I just thought that sounded funny enough to quote. Anyway, her oxygen saturation has continued to be in the high 90s, heart rate still fast (127-152), blood pressure acceptable (I saw 118-127 systolic, PAP 52/31, CVP 15 for the nurses among our family & friends) with about 3 micrograms/minute of Dobutimine. I saw a drip for nitroglycerine as well. I could describe that bit of news as "Dynomite" but that would be horrible punnery.
As far as breathing, she's on 35% oxygen concentration & a PEEP of 5 from the vent (another one of those Servo-i vents that offered the bi-vent mode that was so beneficial earlier in her struggle). At times her breathing rate went to a nice 22.
She got 2 units of blood yesterday because the hemo count dropped to 8.? (sorry, don't remember the tenth). I don't know what any of the other hemo results were. Arterial line inserted yesterday.
J/G tube inserted, too. She already had the gastrostomy tube, but it was replaced with another one, then a tube inserted inside of that goes to the jeujenum. If I understand correctly, the hope is that putting food directly into the intestine(J-tube) rather than the stomach (G-tube) will reduce the vomiting. The feedings started today at 10cc to see how she tolerates the "food" (Novasource 2.0) that looks like liquid Silly Putty.
On Tuesday, Denise was injected with the isotope for a gallium scan, which they anticipted would be performed at USC. Turns out that this would be a last resort. Instead, (and I hope I remember this right) a scan with venous contrast might be on deck. She's already had an indium scan. But that was a nuclear medicine thing, and the venous contrast is apparently tracked with EKG equipment.
Yesterday they were not using Tylenol because of questionable liver function. Today it was used and it seems that the liver is doing somewhat better. The whites of her eyes look a little yellow to me, but hopefully things will progress toward healing.

The infection that’s causing the fever is quite the enigma. The fevers went up to 103.5, then an ice bath brought it down to 99.8. I’ve noticed that some of Denise’s skin is peeling off in places. I can’t help but wonder if the alternating heat of the fevers & then sudden harsh chill of the ice is blanching her skin, same as a peach or tomato. Anyway, throw everything you’ve got into lifting up the infectious disease doctor. These infections were/are the ultimate causes of the other problems. Once the infections are licked, the road to healing will have a smoother surface. He gave me a great deal of encouragement today. In spite of the cheerleading I’m doing when visiting Denise (which isn’t much, with all the times I’m turned away due to all the procedures), I started to crack a bit. The I.D. doctor said that pregnant women who have had disseminated Valley Fever (cocci going beyond a lung infection) have nearly a 100% mortality rate, and the cocci has gotten into the brain. Denise’s brain is uninfected, according to the spinal tap weeks ago and evidenced by her cognitive abilities & physical coordination when not loopy from sedatives & painkillers. That was a major boost to morale amid all the pressure of this ordeal. On a side note, the I.D. doctor has perhaps the best enunciation of anyone I’ve met in several years. If his gig as a doctor ever falls through (fat chance), he could make a living by narrating audiobooks.

I'm glad there's been a turn for the better. I (and I'm sure lots of you that are medically-inclined) would like to know what was done medically to help her out. Different meds, equipment, techniques, timings... what? I've heard of lots of switching around of meds (I've heard just about all the names before in our ordeal). I heard a suggestion that she may have been just pulling out of the trough of sepsis as she was handed off to USC. I heard that the p/a catheter might have been giving inaccurate readings. Indeed, while at Arcadia Methodist, that was suspected and they were planning to replace the p/a catheter but knew USC would just pull it out and put in a new one anyway, so it wasn't done. Actually, I heard many things that might have been the case in explaining why there's been such a rapid improvement in some of her numbers. I hope that as a few more days pass, there might be a definite answer. If not, I'll still be happy, of course.

It's been an adjustment at this hospital. Extremely busy, and as such, sometimes hard to catch someone to find out exactly what's going on (actually, it's so busy, I feel like I'd be bothering someone if I asked my usual number of dumb questions). There are uber-doctors teaching residents, fellows, interns... peppering them with questions at an astonishing pace. It's intense. I listen in whenever I can. I tried taking notes and then finally gave up because my writing was so sloppy, I wouldn't be able to read it. Now I know why doctors write that way. There are questions, suggestions, scenarios, facts and theories all jumbled together. So it was difficult for me to determine what exactly was going on with Denise. During one of these exchanges yesterday I heard someone ask when the gastrostomy tube was put in. I butted in and said that I have been recording such things on this blog, and they pointed out a computer & told me to find the g-tube insertion date. So I did, and it seemed to be something that mattered to them. I was elated that this web site might in some way help the doctors heal my wife faster. Later, a funny thing happened (read: I made a fool of myself). Amid fast & furious questioning & answering, I heard something about attempting bi-level ventilation. Emboldened by my previous perceived usefulness, I blurted out (as fast as I could, to keep pace with them) everything I could remember about Denise going from the "old" vent to the new Servo-i vent in bi-level vent mode, how beneficial that was, then attempting CPAP mode, how long she tolerated that mode, at what oxygen concentrations, PEEPS, and everything else I could remember. There was a short pause. Silence. Somewhere in the distance, a coyote howled. Then the "teacher" doctor said that he was asking that question primarily so that the residents could answer it, for educational purposes.
Doh!

What else today...
Oh! At one point Denise indicated that she wanted to touch my face & hold my hand without the gloves. That was a drag. But at another point, she had her forearms up. Usually she's raising & lowering her forearems repeatedly, but this time they were just up, perpendicular to the floor. I asked if she was exercising (shook head "no"), stretching (no), in pain or discomfort (no), trying to draw my attention to something (no), if it just felt good to do that (no), praising God (yes). That's my girl. Along these spiritual lines, I forgot to mention something that the chaplain from Arcadia Methodist brought up quite some time ago. I told him how, even though Denise was sedated, couldn't move, talk, eat, or do anything, even though she was near death, God was still using her to draw people nearer to Him. I told him that some friends have told me that their entire church congregations would pray for her during services sometimes. The chaplain said, "Across denominations... Wow, God's even using Denise to unite the Baptists! He can't do that alone." Just thought my Baptist buddies would get a kick out of that.

Tuesday, September 27, 2005

Getting hooked up at USC University Hospital

The ride to the new hospital went well. They let me go along (a rarity, apparently) and let Denise listen to some music through headphones on the way. She kept pulling one of the speakers out of her ear. We reached the hospital during the shift change and were not allowed into the ICU. They immediately began changing out all the tubes, hoses, needles, catheters, etc. to be compatible with their equipment, which was still going on at almost 11pm tonight. Denise's dad & I met the doctor that will be continuing Denise's care. We came away encouraged by some of the things he had to say... they only work on the sickest of the sick, Denise's age & previous good health is a plus, and they'll keep trying even if her heart stops again & again. He also reminded us that we can anticipate a long haul with progress and setbacks. He also said that he wouldn't anticipate anything earth-shaking until tomorrow, and we couldn't visit with her for several more hours, so we went home.

At this point, let me back up 24 hours to late last night. I was tipped off that a parent from the school I work at is a cardiothorasic surgeon at the USC hospital (I had no idea... all I knew was that he & his wife had great kids). Sensing that I was feeling discouraged, he felt lead to talk to me. He told me about a very sick patient with horrible stats that is probably going home soon. It sounded like it could have been Denise... same conditions, same failures, same meds, etc. He also said that Denise needs me to be a cheerleader. So I put on a skirt. Just kidding. She needed someone to rally for her, keep the fight up in her, and make her know that there's still hope. According to reading the blog, he thought that Denise's doctors from Methodist were right-on with their treatment, but perhaps the USC hospital might have some resources that might help Denise, even beyond what Methodist had already done. So I left a note for Denise's doctor late at night. First thing this morning, Denise's doctor said that the USC move would give her a better chance, USC had accepted Denise, and there was only insurance & red tape to work through on our end. Turns out that the parent, while working at USC, became critically ill and became a patient there (I know now what it's like to have coworkers taking care of me). Denise's doctor was at USC at the time and remembered the parent. Small world sometimes.

As far as stats & procedures today, the numbers looked about the same to me, and heart is very weak. There was a gallium scan on deck, and the need to change the p/a catheter in the heart. The gallium was injected (it's supposed to cluster at the site of an infection). But Denise was transported before any scan could be done. The doctor said that since everything would be changed out when Denise got to USC anyway, the p/a catheter would wait. Today was such a whirlwind, I can't remember much else (maybe because I haven't slept and I'm still sick). But I do recall that even though they were planning on moving Denise out, care was still going full bore, as if she were staying put.

Thank You
Somebody left a gift for Denise, with no card attached (gee... maybe it wasn't for Denise). Thank you to whoever left the little sculpture of the mommy angel holding hands with the little boy & girl. I'm not a knickknack guy, but that little thing was a tear-jerker, considering what we're going through. Definitely a hit.

THANK YOU, THANK YOU, THANK YOU!!!
I'm nowhere near eloquent enough to properly express my gratitude to Denise's doctors, nurses, and other staff in the Methodist Hospital CCU. I said it before and I'll say it again: You are the conduits through which God's been blessing us. Reading this blog, you may have noticed that I keep using "they" or "the doctor" or "a nurse." All along, I've wanted to name names and give credit where due. But I figure that there's probably a liability issue, privacy clause, or some other thing that might get someone into trouble if I got specific. I still don't know where all this is going. The doctor has made calls that have gotten Denise through some very scary situations. He's been at the hosptial on his "days off" after his wife had a baby to personally check in on Denise (Mrs. Doctor, thank you for letting us borrow your hubby so much). That hospital is incredibly lucky to have him. If I ever get into a scrape, I'd like this guy in my corner. Same goes for his colleagues. There's another doctor that got Denise's kidneys working early on when things looked bleak. I appreciate another doctor that put up with my frequent stupid questions about infectious diseases.
And don't even get me started on the nurses! I can't imagine a batch of nurses that could be any more caring. Toenail painting, hair styling, massaging, joking, encouraging... I feel like they took a personal interest in my wife, and for that I'm ever so grateful. I'm conviced that we would've lost Denise a few times during the last 2 1/2 months if it weren't for the nurses being so attentive and competent. Total pros.
I've probably had someone from every branch of hospital operations checking on Denise... payroll department, environmental services, floor managers, security, the brute squad (the ones that the nurses always call in to help turn Denise), food service, physical & occupational therapy, cashier... Sometimes I feel like just about the whole hospital cares about this struggle.

Transferring to USC University Hospital

Denise is being transferred to USC University Hospital, departing at 5:30pm. I'm riding along in the transport vehicle. I'll post more when I know more & have the time.

Monday, September 26, 2005

Heading toward cardiac arrest

It seems at times that we are fighting with God over Denise.
Things are still quite bad this evening. I had to come home to eat during the shift change. Earlier today my aunt asked the doctor what we can expect. It seems that the conditions and numbers are heading toward cardiac arrest. Could be today, tomorrow, a week... no telling.
The Dobutimine has had some positive effect, but I don't know that it would be enough to turn this around.
Denise is on Ativan and morphine now. She will wake once in a while for a few seconds. I did get some kisses & some important words with her. I asked her if she was scared and today she shook her head to indicate "no." I told her that her heart is weak, the deck is stacked against us (but there are always wild cards), and we might lose her. Our pastor from Lake Avenue Church came over (he's been coming over a lot during our ordeal) to pray. Even though she indicated days ago that she wanted serene, mellow music, I played one of her favorite Twila Paris albums that's a little upbeat. When asked if she liked it playing, she nodded "yes." The respiratory therapist snuck a little orange juice onto Denise's mouth swab tonight.
They were just about ready to finish dialysis when I left. They may take Denise for another fancy scan to try to find any infections. They're still throwing everything at her that they've got.

Heart deteriorating, should we do CPR if it fails?

Denise's cardiac status is deteriorating. The doctor called to say that if her heart arrests, it may not benefit her to try CPR, as the heart is so weak it may not be able to get enough oxygen to the vital organs, brain included. This is the same conversation we had last Sunday. He didn't know that we should get her out of the Morphine haze (no Ativan drip, that was a mistake in my last post) in order to ask her what her preference is. She's not a good candidate for any type of surgery that may be needed. But she probably can't handle another hit like she had a little over a week ago, cardiac status being what it is. In the mean time, they're trying to do everything they can, and being aggressive about it. But if the heart stops, we have to decide whether or not to try CPR. They might try using a drug called Dobutimine, but I haven't had time to figure it out. I just wanted to get this simple post out to you. I'm sick and do is Jacob, so I took the day off work. This is turning out to be one very stressful morning.
Pray that the heart doesn't stop, and that Denise can heal.

Sunday, September 25, 2005

Slow day, RMSF vs. Valley Fever

Slow day with not much new information (being a weekend) and not much change that I can see. Better than a week ago, not as good as just before that. Denise was "out" just about the whole time (Ativan & morphine). They also started an insulin drip again so they won't have to jab her whenever the blood sugar's too high from the TPN IV drip. That I saw, her fever didn't cross 103. Her oxygen concentration was turned up to 50% late last night, but was 40% the whole time I was there. Heart stayed at 132 bpm on average, higher during a coughing fit or obvious discomfort from turning. Breathing hovered all over the 30s. And again, I'm not feeling well, and will not be going over to the hospital tonight.

I just remembered a comment posted weeks & weeks ago asking why we started off with a diagnosis of Rocky Mountain Spotted Fever (RMSF) and then it changed to Valley Fever. Great question... one that we asked, with a great deal of frustration. The reason is that the doctors made the best guess at the time, based on symptoms (very similar) and where we had been (in Tennessee, trying to buy a house). RMSF is endemic to where we were, but difficult to diagnose, requiring tests with a time span in between. According to all web sites I checked, the treatment for RMSF starts before the diagnosis can be confirmed positive. That's what they did with Denise. Then, if I remember correctly, one culture of four started showing a fungus. The doctors thought it was probably just a fluke, but started antifungal meds just in case. It turned out that the fungus was cocci, the cause of Valley Fever.
Denise grew up on a farm in Illinois, then spent her JH & HS years in the central valley of California, where Valley Fever is common. We had been there to visit her parents many times, and the only problems we ever had was some congestion if we stayed too long. Many people are exposed to the cocci, and in healthy people the problem doesn't get beyond feeling like a bad cold or flu. Last winter was very wet for us in southern California, and according to one web site, the cocci fungus grew like crazy in the moisture. Then the heat came & dried it all out on the surface of the ground, being kicked up by wind, cattle, traffic, etc. In May & June, Denise went to visit her folks with the kids so I could do some home improvement projects without anyone under foot. About that time, Denise was at her third trimester of pregnancy (high risk group) and gestationally diabetic (diabetics also being in the high risk group). We may never know when the fungus first got into her system, how long it may have lay dormant, or what triggered the cocci to start making her sick. But it went beyond the usual infection of the lungs (causing the aforementioned cold & flu symptoms), and spread to other systems, which is called Disseminated Valley Fever. It's very rare to have it get that far (though we have received emails from people that have had Valley Fever in all stages), and it's got a high mortality rate. The last batch of cultures have not shown the cocci, but Denise would need to be on antifungal meds indefinitely anyway. The infections we're dealing with now are apparently common hospital-related infections, but just as devastating. If you'd like to really bone up on Valley Fever, check the link on the blog site for the Valley Fever Center for Excellence. Yes, the site looks a little bit goofy, but the resources link from that site is about as exhaustive as I've found.

In the mean time, keep praying/thinking/working us through this. Specifically, Denise needs comfort/rest/sleep, infections & fever need to go, heart & breathing rate need to slow down, heart needs to be able to squeeze out more blood with each beat, GI tract needs to work consistently (it's on-again, off-again), liver & kidneys need to function better (currently dialysis every few days is helping quite nicely), breathing/oxygenation needs to maintain or get better (so far, so good, considering she's on a ventilator). So everybody write that list down and tack it on the fridge.

Saturday, September 24, 2005

Tough conversations, Magna Doodle pen pals

As of today, kidneys & liver still not functioning. I'm told that it'd be unrealistic to expect them to "kick in" like they did weeks & weeks ago. It'll be a much more gradual process. So we're just expecting dialysis once in a while. After a few days of relatively low fever, she crossed the 103 mark again. The feeding tube has been stopped and IV nutrition started last night. She's had a couple bowel movements, so we're glad for that, but a few times she's vomited up water & Tylenol (that Flexi-Seal was reinserted today). Earlier today her heart rate & breathing rate started racing, and they had to turn the oxygen concentration up to 50%. So up to that point, things seemed just a tiny bit worse today than yesterday. Then just before dinner, they started her on a morphine drip & gave her some Ativan to relax her. Her heart rate was back to the 120 range, breathing still fast (30s), blood pressure holding about 117/77, with the help of 5 mics/min of blood pressure medicine, oxygen concentration 40%. At that point, she was pretty close to yesterday's condition. I'm not going back tonight because I've got a sore throat. It's a drag, not only because I can't see her, but also because tonight's nurse is pretty tight-lipped about what's going on, especially over the phone (those privacy regulations are in place for good reasons, but I wish they didn't exist right about now).

Yesterday was more interesting.
After Thursday's removal of 6 liters of fluid, her blood pressure dropped. This was to be expected, but it was still a bummer to see 89/57 on the display. Later in the day she stayed around 109/66. Heart in the low 120s. Respirations low-mid 20s. We got a good bit of news in that her hemo count was over 11, white count 10.8, plateletes a little low (apparently due to antibiotics?). These numbers are several days after her last unit of blood. So I believe that the marrow is chugging along OK.

But that wasn't the interesting stuff. Our "conversations" were. She wrote "So what happens." She wanted to know both what happened recently that everyone's been talking about (last Saturday's crisis), and what's going to happen next. I tried to explain things as best as I could understand them, in a way that wouldn't alarm her or cause her to lose hope. Speaking of hope, I had just finished the chapter on hope in the book I'm reading. That was pretty handy in talking to Denise since yesterday. She was also able to speak, saying "I love you" and "They leave it (the tracheostomy cuff) open sometimes." Given the vomiting, I asked a respiratory therapist to come check the cuff, and he said it was good... she was just getting enough air to force words out sometimes in spite of the cuff. Denise wrote that she had a dream wherein she was pregnant with twins. She also wrote, "If this don't go well I'll be stuck (here)." I asked if she was afraid of being stuck in the hospital for life, and she nodded. I asked if she was scared of dying, and she nodded. So I tried to pull it together once again for the pep talk about how well she's done already, there's a great team taking care of her, her fighting spirit's helping, how much prayer's going into this ordeal, how she's better now than she was 8 weeks ago, how she's a long way off from dead (she gripped my hand really hard as if to prove it)... I also made mention again that if she doesn't make it, we've got the hope of seeing each other on the flip side. Then I thought of something that was emailed to me by some neighbors of Denise's parents. In addition to the pep talk about not losing hope, and in addition to the reassurance that our faith provides in the event of physical death, the sick loved one may need "permission" to depart us; they need to know that we'll somehow be OK if they die. So I told her that, as eloquently as could be expected, bookending it with encouragement. Of course, it's just about impossible to feel like we'd be OK without her. These are just not conversations that I expected to have at this age. I received an email from a "friend I haven't met yet" that said they secretly wished their spouse wouldn't be around most of the time, because then everything would be so much smoother, but our ordeal has changed that thinking. Good. It ain't worth having someone gone just so you don't fight over squeezing the toothpaste from the middle or the bottom. By the way, Denise & I found a one-cent solution that licks that problem. As you use up the toothpaste, fold up the tube from the bottom, holding the folds in place with a large paper clip as you go.

Gracie has been asking if she can visit more frequently lately. I told her that mommy is still sick and needs more rest, so the kids can't visit right now. Overhearing us (me & Denise's folks) talk about what Denise had been writing, Gracie came up with the idea of drawing a picture on a Magna Doodle for Denise, then Denise could erase it and draw a picture for Gracie. So Gracie drew a ballet dancer. Denise erased it and drew a fox (Denise & Gracie love the movie "Fox & the Hound"), and wrote "I Love You." So I tote a Magna Doodle back & forth now for the Magna Doodle pen pals. Both seem to have their spirits lifted by having this form of interaction. Denise is drugged up and weak, and still a much better artist that I am.

Friday, September 23, 2005

16 Women Pregnant Moment Emergency Condition

Women pregnancy suggested that is not overanxious if its content experience of the light trouble. But pregnant mother very suggested that remain to alert to its content growth. Whether/What symptom which require to be paid attention to [by] that?

1. If experiencing of super stomachache and ride out the long time.

2. Happen blood or blood pock go out from vagina

3. Change of vagina Dilution, that is; stickier dilution, or mixed blood.

4. Feeling pressure of flank, ill in undercarriage back, or muscle-bound before pregnancy age enter the week to- 37.

5. Suffer decease at the (time) of urinating, and accompanied to by feel burned.

6. Urine choked up or do not go out at all.

7. Heavy puking repeatedly, accompanied by fever.

8. Trembling or fever. Body temperature reaches 38, 3 C.

9. Feel an itch -- what remain to -- totality body, especially if with of body husk turn yellow the, dark urine chromatic and pale fesses chromatic.

10. Experiencing of eyesight trouble sudden, like; double view, blur, or there [is] flash point felt dazzled if looking into something.

11. Defensive Excitement headache more than 2-3 clocks.

12. Swelling of effect of dilution gathering (edema) at hand, face and about eye, or heavy addition of body which sudden, about 1 kilo or more, what [do] not go together the pattern eat.

13. Cramps which remain at foot/feet or calf, what [do] not alleviate when pregnant mother genuflection.

14. Fetus movement decrease. As public guidance, if happen less than 10 movements in 2 clocks at pregnancy of week ke-26 or more, meaning of fetus condition below par.

15. Trauma or experience of to injure at stomach area.

16. Acute till faint.

If you experience of one of or some symptom which have been mentioned above, immediately phone the doctor. If there is problem, pregnant mother will get the help immediately? Even so in the reality just good content, hence mother will feel safe because have ascertained its pregnancy condition at one who precisely.

Thursday, September 22, 2005

Xigris stops, 6 liters drawn, Some better, Some worse

Denise finished her 96-hour Xigris drip today, then got a paracentesis which drew 6 liters off of her abdomen... you heard that right... 3 soda bottles worth of fluid. Denise was really tired today but indicated that she felt better after losing that fluid. That draw couldn't be done a couple days earlier while on the Xigris because of fear of complications from bleeding. By the way, the gal doing the procedure was someone that I remember from way back in elementary school.
Denise was doing pretty well on the gastro tube feeding at 40cc/hr until late this morning, when she threw up. Hopefully the lack of 6 liters in the belly will correct the bowel obstructions (that's been an "on-again, off-again" situation) and lessen the vomiting. By the way, for those that like to know, the g-tube is the better one with an umbrella to hold it in place instead of a balloon (I don't have a clue what this is supposed to look like, but that's what I'm told). Speaking of balloon, that fancy expensive fecal containment system was removed today. There was a note stating that it shouldn't be thrown away. Eeew.
Not all blood work was done today since several things are stable, and this saves some jabs for Denise.
Kidneys: The creatinine test is up a little to 2.2. We want it to go down to 1. But I guess this is to be expected with her renal function still so low. Urine output is still *very* low.
Liver: Didn't hear anything today, so I assume that liver function is still very low.
Lungs: Holding their own, respirations in the 20s, concentration still at 40%, still pulling good saturation in her system.
The blood pressure medicine was stopped today, and her blood pressure was about 98-110. Her heart rate was up as high as 130 at times to compensate for it. The challenge for the team now is to try to figure out what to do about this. If they give drugs to lower the heart rate, the blood pressure will also lower, and the liver & kidneys won't be as well supplied with blood. Denise needs the blood perfusion to those organs.

I've been feeling more ground down than usual since yesterday, the stress & chaos isn't bouncing off of me as well, and I think I might be fighting something. Either tha,t or this is what it feels like to turn 35. Anyway, getting sick and staying away from Denise for days isn't an option right now. So I'm trying to take it a little easier at night and get more rest. I didn't go to the hospital after the shift change last night and probably won't go tonight. That eats me up, as I havent' seen Denise much yesterday or today. I'm also feeling the stress of trying to cram a bunch of necessary computer lab projects that I'd intended to do over summer into the crunch time at the beginning of the school year. Fortunately, my ubergeek buddy from Tennessee has been putting in lots of hours to help me at work.

Wednesday, September 21, 2005

Much better since Saturday

Another day where nothing got worse, most things fairly stable, some things better, some much better! Very cool! She's not is as good a condition as she was before the shut down on Saturday night. But she's improving, and for that we're thankful! Here are the nuts & bolts:

The Xigris seems to be helping Denise fight the sepsis. That' stuff's been a life-saver twice now. We're hoping there will be no complications related to it so that she can benefit from the full regimen of it. It ends about 2pm tomorrow. Kidney function unchanged - still low. But her creatinine is down to 1.7 from 1.9 (we want it to get to 1.0). There's a possiblity that her kidney damage is here to stay and she'll need dialysis for life... or not. To early to tell. But as a buddy put it, dialysis for her life is a fair exchange. Her blood pressure is holding at 103-113 and the blood pressure meds were decreased again (down to 4 mcg/minute). Temperature stayed around 99.8-100 most of the morning, then increased to 101.2 after Ampho B was started... it has a side effect of fever. White cell count is down to 10.4. Again, those two bits of info hopefully indicate that the infections are subsiding. The infectious disease doctor says blood cultures & recent ascites fluid are not growing anything. Chest x-ray is unchanged, oxygen saturation is around 100% on a 40% concentration.
Great news is that her liver enzymes are *dramitically* improved (ALT 79, AST 155... both numbers were many times this earlier). We hope that the liver kicks in and starts working full bore, and real soon.
As far as blood goes, her hemoglobin is 10.2, DIC (that weird bleeding/clotting problem) seems to be improving (as based on a fibrinogen level being essentially normal in the DIC workup). She's got a Swan pulmonary artery catheter (this thing sounds incredible... it's threaded through the chambers of her heart... she had one in the beginning weeks). It shows the pulmonary artery pressure is getting closer to normal, pulse got as low as 106, high as 121... much nicer than those 150s-160s that we were seeing earlier. And her respiration continues to hover around 20 (much better than the 30s-40s that have marked the past two months.
The gastro tube feeding is doing OK so far, after some starts & stops. That would be great if she can continue to tolerate that. We heard that Denise had some vomiting episodes, but the nurse said that there was very little, and she thought it was mostly mucous causing a gag reflex more than anything.

Denise again wrote that she wanted to get into a wheelchair. When told that she has a big ol' Quinton catheter in her femoral artery for dialysis, and that it can't be bent by sitting, she wrote, "What about a walker?" That's my girl. My mother-in-law and my aunt also cut Denise's hair today... with bandage scissors. They don't cut hair as well as what you might find in a salon, nor do my mother-in-law and my aunt.

Correction: In the Monday September 19th entry, I stated that Denise's kidney output was 42-44 ounces per 8 hours. I meant milliliters, not ounces. Big difference. Those of you that are hip to nephrology probably caught my error & knew what I meant. Those of you that aren't probably thought Denise & I were having beer & pretzels or something.

Vitamin C and the Smoker Women was pregnant

Consumed vitamin C during the pregnancy period will really help the mothers who had the habit smoked during contained.

The team's findings from 'the Oregon Health & Science University' also suggested that the mothers of the smoker apparently stopped his habit when being pregnant.
Results of the team's research headed by Dr Elliot Spindel this proved that vitamin C could block the effect of the negative resulting from the activity smoked that was done by the mother was pregnant.

In the high dose, vitamin C could protect damage that was caused by 'nicotine` that was produced from cigarettes.'
Results of the team's research headed by Dr Elliot this was published through 'the American Journal of Respiratory and Critical Care Medicine.'
During his trial to the animal of Dr Eliot Spindel saw relations nicotine with the air current to the lungs.

Now to the monkey, the team of the researcher gave vitamin C to the mother of the monkey was pregnant and the monkey baby had the air current the normal lungs.
The success in the research to the animal made the team of the expert felt the team of the expert was sure that their discovery could achieve the similar success if being applied to humankind.

Nevertheless Dr Michael Gravet that became this research assistant continue to give the suggestion apparently a mother was pregnant must stop smoked for the sake of the safety the baby.

Tuesday, September 20, 2005

Nothing got worse, Map help

Denise is still very ill, we're still waiting to see what happens. Nothing got worse today, most numbers stayed about the same, some numbers got better. Keep pulling for us. Somebody posted a comment that I loved: " We have no pull of our own for Denise except our persistent tugging, even yanking it seems, on the Master's robe." Yup.

The temp went under 100 tonight, white blood cell count went down to 12.4. These might possibly indicate a subsiding infection (please, please, please). All the same antibiotics are going. Liver function still bad. Kidney function is about the same. She was on dialysis when I left tonight. Blood pressure medicine (Levophed?) was decreased to 9 micrograms/minute (was 50/minute Saturday night), and blood pressure is still holding at 103-115 systolic. Hemoglobin went down to 9.7, so she got another unit of blood tonight. Bowel sounds were good and they restarted her gastro tube feeding this morning at a slow rate. So far she's tolerating it well (yay!).

Denise wrote again that she wanted to get into a wheelchair. My aunt was brushing Denise's hair earlier, and Denise wrote "shave it" or "shove it." Being that both were plausible sentiments, and we couldn't tell which she wanted us to do, we did neither. Other than that, and showing off her leg strength during physical therapy, she was tired & resting most of the day.

Map Help for the Map Helpless
From my cousin (webmaster@stonebrew.com if you need more help)
"I've had a few times where the server is not responding due to the load. It usually comes up within a few seconds after hitting reload.

Here's my instructions on how to use it...
Drag the map back and forth until you have your location centered, then zoom in a little. Repeat this until you've found where you want to place a marker and click (give it a moment). It will popup a little form asking you to leave your name, a message, a link and choose what color marker you want to leave. The link field you can leave blank. You can click satellite mode in the top right if you want to be sure you're marking your house exactly. The hybrid mode is a mix of both views that will show you a satellite view with street names overlaid on the map.

If you're still having problems, let me know and tell me what type of browser you are using. I can add a pin for you if need be."

Guest Map is working... add your "pushpin"

A guest map has just been added to the web site. Look toward the right side of the web page under "Links" and you'll find the link to the map.

Once you're on the map, you can pan & zoom in & out by clicking the buttons near the top left of the map. You can also click & drag the map to move it around instead of using the up/down/left/right buttons on the map.

Using the buttons in the top right corner of the map, you can switch between a map view, satellite photo view, and hybrid view with both.

Depending on your area, you might be able to pick out your rooftop... I did.

To add your "pushpin" marker, just click once on the map. Type your name, a short message, pick a marker color, and then click the "Place" button. There's even a place for you to enter your own web site address if you've got one and want to share it.

**The Paypal link on the map does NOT send money to us or my cousin. It would go to the guy that made this Google-based guest map program (which my cousin then customized it for us). Contribute if you feel lead to do so.

Monday, September 19, 2005

Wait and see... still bad but stable

Things are still pretty bad, but stable. We have to wait & see what's going to happen.
Main points:

Heart: Denise's heart is a big concern. Her ejection fraction (heart output) is still low today (20-25%). She's got some catheter threaded through the chambers of her heart that give us all kinds of measurements. Her PAP (pulmonary artery pressure) is higher than they want but her cardiac index has stayed essentially what it should be for her size & age. A nice thing is that her blood pressure is acceptable while blood pressure meds are decreasing. She's still getting a lot, but not nearly as much as Saturday night. Her heart rate is slowing (got down to 100 while my aunt was rubbing Denises's feet) and oxygen saturation was still at 100%, so that's good.

Bowel not working: Today they put contrast in her gastrostomy tube to check placement and flow - it supposedly looked OK. They are putting meds down it now and are hopefully starting feeding soon (they're trying to avoid the IV feeding). She also has a tube down her nose to take the acid off of her stomach. Her tummy looks pretty big again.

Liver: Her liver also was affected by the shut down this weekend - it's not filtering as it should and her liver enzymes were way up yesterday & today - but today's is 1/2 of yesterday's. So we'd like to see that trend continue.

Kidneys: Yesterday she had 2 liters taken off with dialysis. Dialysis will be decided each day based on her electrolytes and fluid status. Denise is only putting out 42-44 ounces per 8 hours, but we are hopeful if the sepsis is controlled that the renal tissue that was damaged by this weekend's scrape will regenerate.

Thyroid test came back OK.
Lungs holding their own, Denise is able to get 100% oxygen saturation.
Fever only went to 100.8.
She's on Xigris (sepsis), Primaxin, Vfend, Vanco, Ampho B.
Labs show hemo count at 10.6, white cells 17.2, platelets 95, hematocrit 31.5.

We were sort of in the boat a bunch of weeks ago... organs shutting down, things looking scary, Denise on Xigris. The things going for us this time are Denise's ability to tolerate dialysis (that does some of her body's work for her), her ability to breathe more efficiently, even more of you pulling for us, and the knowledge that things were pretty darn bad then, and she was carried through it. Things against us this time are getting weaker after this long fight, different infections in different places, bowel not working... I think I'll stop there.

Today's non-crisis events: At times today Denise would reach out for hugs, especially from the respiratory therapist. She wrote "wheelchair" on a note pad in fairly normal-looking writing (she really wants to get around & maybe go outside). I was more anxious at work today than normal, probably because of Denise's condition. You might be wondering how I could show up at work in times like these. I wondered what I was doing there, too, sometimes. With all the family & friends around, I my heart felt at ease that Denise was getting emotional & spiritual support, on top of medical care that the CCU staff provide. I could worry by Denise's bedside, or worry at work. I thought as long as I'd be worrying, and Denise wasn't alone, I might as well be productive. Work is a short drive from the hospital, so that helped, too. We got a nice bit of lightning & thunder, then a whole bunch of rain tonight (the first of the rainy season). Know why? After not washing my car for 10 weeks, my buddy that came from Tennessee to be my right-hand man gassed up my car & ran it through the car wash yesterday. I think he brought some of the weather with him.

My cousin is working on a world map that we can all put pinpoints into. It's based on Google maps... you can zoom right down to street maps or satellite photos or a hybrid of both. Depending on what area you live in, you might be able to find your rooftop. There'll be a link to it as soon as it's all ready to go live.

Health Supplements For Women - Which Are Right For You?

Health Supplements For Women - Which Are Right For You?

Most women would agree that certain health supplements could be beneficial to your health, depending on the result you wish to achieve. There are many articles and news reports about the positive and negative attributes of healthsupplements. Due to the fact that individuals vary greatly in their particular desires and health issues, most women have chosen to make their own decisions about which health supplements are right for them. Many people, male and female, are taking several types of supplements each day.

Health supplements include any number of products designed to help with one type of health concern or another. You can find weight loss aids, vitamins, products designed to increase your energy level, and numerous others. Depending on the health concerns you have, there is most likely asupplement that is right for you. There is a large amount of information, both positive and negative, regarding different types of health supplements and their effectiveness. Some health supplement s carry risks of side effects. You should read the product information carefully to make sure you understand both the benefits and drawbacks of a particular product.

Used properly and safely, health supplements can be very useful in maintaining and enhancing your health. Research any products you are considering taking before you buy to make certain you understand the indications and risks associated with any healthsupplement. You can improve and maintain your health, your mind, and your body through the use of certain health supplements. Health supplements are available at reasonable prices and can be shipped directly to your door. Take a look at the wide selection of health supplements that are available and make your choices wisely. You can be on your way to a healthier, happier you.

Author:
HerHomeGym.com is a one-stop resource for getting fit and staying fit in the comfort of your own home. Visit http://www.herhomegym.com today!

Sunday, September 18, 2005

Very bad but stable

Denise is very bad off, but stable. There were so many procedures done today, I can't begin to remember remember them all. At one point this morning, the doctor said that her ejection fraction (how much blood can pump out of the heart) is so low that if her heart stopped, he didn't know if it could get going again. This flashed through my head: Last night there was a "code blue" for another patient as I was leaving the CCU. As I walked by, I saw people trying chest compressions on him. I found out later that night that he passed away, in spite of everyone's best efforts (the best effort being the norm in the CCU). I really don't want to leave Denise. But on the other hand, though I'm in no way squeamish, I hope I'm never in a position to see anyone working on Denise like that. Anyway, I told the doctor to do his best if the heart stopped, that we know everyone's been doing everything they can, and Denise is a fighter and she'll do her part to keep going. He & the team have been calling shots in such a way that Denise has come through some pretty bad scrapes already. After having turned the corner in a few ways, I feel like we're back at square one again.
I'm still trying to talk to Denise without cracking, telling her that she's come through a lot so far as a result of the medical team & what's available to them, her strength to fight this, and of course a whole lot of prayer. It's getting really hard to see her condition and find the positives to point out so she doesn't lose heart. I acknowledged that she's scared & admitted that lots of us have been scared sometimes. I've been avoiding it, but finally told her that even if she does die, our faith gives us hope for life beyond our time on earth. I told her that I wasn't strong enough to pick a woman to marry that didn't share the same faith I do; I couldn't stand the thought of life on earth with her being all there is, and when we're both done here, there's still heaven. I hope I didn't stress her, and I hope I didn't say the wrong things. But there was no way I could ignore that she's scared. Now I was a big chicken about all this, talking to her while she was too tired to open her eyes & look at me. By the way, she did move her arms & legs during the procedures, and she has move a little bit late this afternoon. She's opened her eyes a couple times.
Xigris has been started again to try to pull her out of sepsis. There are significant risks involved, as she also has DIC (simplified: bleeding/clotting problems) right now, and the Xigris combined with the bleeding makes for pretty bad news. But the alternative is to let the sepsis continue, shutting down her organs until she dies. So as the doctor put it, it's been nothing but full-court press this whole time, and so it continues. We don't want any bleeding problems to complicate things.
There are so many other things wrong, I can't remember them all. Fortunately, my R.N. aunt that's been explaining most of these things to me is visiting and she's going to talk to the doctors to find out what all's transpired since last night. That'll be in a future post. For that matter, my folks and a bunch of friends have rallied around us late last night & all day today.
Things that have gone positively:
The dialysis went well and lowered the demand on her breathing, so her breathing rate is approaching normal. The fact that she's "well" enough to tolerate dialysis is a good. I assume that since they can perform dialysis, there may not be the problem of her lungs filling with fluid that we had a few weeks ago. Her massive dose of blood pressure medicine was lowered about 40% and her blood pressure was still acceptable. I hope my understanding of that is correct. We'd like to see many more things go in a good direction.

Tonight I told Denise that we didn't need any excitement. I want the nurse to have a nice uneventful evening. Wouldn't that be nice if all the other nurses got jealous of Denise's nurse because there was nothing for her to do but sit & watch Denise get a little bit better tonight?

Understanding your body during pregnancy

Understanding your body during pregnancy
By MayoClinic.com

From conception to birth, your body is programmed to support the needs of your growing baby. The physical changes you'll experience may leave you marveling at the wonder of pregnancy — and perhaps looking forward to the day when you can reclaim your body.

An average of 25 to 35 pounds of weight gain aside, you may be surprised by pregnancy's effect on your body. Here's what to expect.

First trimester changes

Within two weeks of conception, hormones trigger your body to begin nourishing the baby — even before tests and a physical exam can confirm the pregnancy. Here are some common early changes:

  • Vaginal bleeding. Spotting or what appears to be a scanty period may be the first sign of pregnancy. A small amount of bleeding can occur when the fertilized egg, which has already undergone several cell divisions, implants into the lining of your uterus.
  • Tender breasts. Your breasts may become unusually sensitive and feel fuller and heavier. It may help to wear a more supportive bra.
  • Unusual fatigue. You're bound to feel tired as your body produces more blood and prepares to support the pregnancy. Your heart will pump faster and harder, and your pulse will quicken. Rest as much as you can.
  • Bouts of nausea. Many women struggle with queasiness, nausea or vomiting in early pregnancy. It tends to be worse in the morning, but some women feel nauseated throughout the day. It may help to eat frequent, small meals and drink plenty of fluids.
  • Increased urination. You may need to urinate more often as your growing uterus presses on your bladder, which lies directly in front of and slightly under the uterus during the first few months of pregnancy. The same pressure may cause you to leak urine when sneezing, coughing or laughing.
  • Constipation. An increase in the hormone progesterone, which slows the digestive process, may cause constipation — especially during the first 13 to 14 weeks of pregnancy. To prevent constipation, drink plenty of fluids and boost your fiber intake.

Second trimester changes

The second trimester is often the most enjoyable stage of pregnancy. The worst of the nausea has usually passed, and your baby isn't big enough to crowd your abdominal organs and make you uncomfortable. Even so, you may notice physical changes from head to toe:

  • Larger breasts. Stimulated by estrogen and progesterone, the milk-producing glands inside your breasts get larger. A small amount of fat may also accumulate in your breasts. The result may be as much as 1 pound of extra breast tissue.
  • Glowing skin. Blood circulation increases during pregnancy, including the tiny vessels just beneath the surface of your skin. Enjoy the healthy glow.
  • Nasal problems. As more blood flows to your body's mucous membranes, the lining of your nose and airway swells. This can restrict airflow and cause snoring, congestion and nosebleeds.
  • Dizziness. Your blood vessels dilate in response to pregnancy hormones. Until your blood volume expands to fill them, you may experience occasional dizziness. Avoid prolonged standing, and rise slowly after lying or sitting down.
  • Bleeding gums. Increased blood circulation can soften your gums. This may cause minor bleeding when you brush or floss your teeth.
  • Leg cramps. Pressure from your uterus on the veins returning blood from your legs may cause leg cramps, especially at night. Stretch the affected muscle or walk your way through the cramps.
  • Vaginal discharge. You may notice a thin, white vaginal discharge. This discharge consists mainly of cells from the vaginal lining and normal vaginal moisture.

Third trimester changes

During the last three months of pregnancy, your baby may poke you in the ribs as he or she practices uterine gymnastics. These exciting sensations are often accompanied by increasing discomfort and other physical changes:

  • Shortness of breath. You may get winded easily as your uterus expands beneath your diaphragm, the muscle just below your lungs.
  • Backaches. The increased weight you're carrying may be tough on your back. When you must stand, place one foot on a box or stool. Sit in chairs with good back support. Apply heat or cold to the painful area. Ask your partner for a massage.
  • Heartburn. Your growing uterus may push your stomach out of its normal position, which can contribute to heartburn. To keep stomach acid where it belongs, eat small meals and drink plenty of fluids.
  • Swollen ankles. Pressure from your growing uterus on the veins that return blood from your feet and legs may leave you with swollen feet and ankles.
  • Thick hair. Many women enjoy more luxuriant hair later in pregnancy. This is often followed by excess hair shedding after delivery.
  • Changes in skin color. Hormonal changes may make your cheeks, chin, nose and forehead darker than usual. Some women — particularly those with dark hair and fair skin — may notice a brownish darkening on the forehead, temples and central part of the face. Skin that's already pigmented — such as the area around your nipples — may get even darker.
  • Spider veins. Increased blood circulation may cause small reddish spots on your face, neck, upper chest or arms, especially if you have fair skin. The spots may seem to sprout tiny blood vessels that resemble spider legs.
  • Varicose veins and hemorrhoids. Veins throughout your body become larger during pregnancy to accommodate increased blood volume. This change is especially noticeable in veins near the skin surface, such as those in your legs. Elevating your legs and wearing support stockings can help ease any discomfort.

    Varicose veins in your rectum are known as hemorrhoids. To prevent hemorrhoids, include plenty of fiber in your diet and drinks lots of fluids.

  • Increased perspiration. Your baby generates heat by growing and exercising. In turn, you're likely to notice more sweating than usual. In hot weather, you may need to rest, drink cold liquids and take cool showers to keep from overheating.
  • Stretch marks. You may notice pink, red or purple streaks along your abdomen, breasts, upper arms, buttocks or thighs. Your stretching skin may also be itchy. Moisturizers can help. Although stretch marks can't be prevented, eventually the marks fade in intensity.

When to consult your doctor

Most physical changes you'll experience during pregnancy are normal. It's important to pay attention to your body, however. Consult your doctor if you experience:

  • Heavy vaginal bleeding or any amount of bleeding after the first trimester
  • Moderate or severe pelvic pain or any degree of pelvic pain that lasts more than four hours
  • Constipation that leads to more than two days between bowel movements
  • Persistent heartburn that doesn't respond to smaller meals
  • Persistent bleeding from the gums
  • Shortness of breath accompanied by chest pain or a cough
  • A severe or persistent headache, especially with dizziness, faintness, nausea, vomiting or visual disturbances
  • Vomiting with pain or fever
  • Strong-smelling, green or yellowish vaginal discharge or any vaginal discharge accompanied by redness, itching and irritation
  • Burning during urination
  • Rapid swelling, especially of the face and hands

If in doubt, make the call. Your doctor may want to do a physical exam to make sure you and your baby are fine.

Grave condition

Pray.
The doctor just called:
He said Denise is in very grave condition. Going back into septic shock, kidneys failing (no urine output), liver function off, high acid in blood, PA catheter going in to heart, another ab fluid draw needed. If she goes to surgery, there's a high mortality risk.

Here's what I typed before the doctor called:
The call that came as I was just finishing last night's post was for bad news. Denise's blood pressure was very low & not coming up. Procedures were performed to get her blood pressure up & stable... a groin catheter was put in and meds given, I'm sure there were other things, but I can't remember the details. The charge nurse that came out to the door to greet me & Denise's mom & dad said that Denise had given everyone quite a scare. The doctor told me that when he first saw her, she was ashen gray and he thought he should do chest compressions, but she was still conscious. He also said that usually they take great care to keep everything sterile. But he didn't have time, so he cleaned her up as best he could and put in the catheter to start the meds. One more life-threatening, time-crucial crisis in which we could easily have lost Denise. Her nurse said he's getting a really high dose of meds and only pulling a pressure of 103, "Cross your fingers," she said. They also took Denise for a CT scan because her tummy is really swelling (checking for blockage again), but as of this morning the CT scan was inconclusive. Denise again expressed that she's scared. So am I.
By 3am Denise was more peaceful & stable, and we left.

Saturday, September 17, 2005

VERY low blood pressure

First the downer stuff from today: I just left the hospital tonight and Denise's heart rate did lower to the 112-120 range. But her blood pressure is REALLY low, like 58/37 at one point tonight (about the best I saw today was 82/43). Very scary. The two meds that were administered to lower the heart rate (and increase blood flow) have been discontinued because the blood pressure is way too low. Denise expressed to the nurse tonight that she was scared. She's been saying that more over the past week. I must admit that while I try to be encouraging and point out all the progress and things to be optimistic about, I find it hard to be encouraged by what I'm saying to her sometimes. She got up to 103.9 last night and was about 102 when I left tonight. I heard from the nurse that the infectious disease doctor switched the antibiotic from Primaxin to something else because the pseudomonas infection is resistant to the Primaxin. For those that would ask, I forgot to get the name of the new antibiotic. So there are some pretty scary things going on right now.

Now for the good stuff: I turned 35 today. You might be asking why that's not listed in the "downer" paragraph. But it was really nice. They sent me out of the room to "clean Denise up." When I returned and opened the curtains, Denise had a teddy bear, a balloon boquet, and a couple cards. A bunch of nurses were in the room and everyone wished me a happy birthday. They deflated the cuff on Denise's tracheostomy and she was able to say "Happy birthday" to me. The card from Denise had writing that looked almost normal. The nurses also had a signed card for me. Denise was able to tell the staff to get my favorite pie & ice cream and organized a couple other things. Pretty impressive, I must say. She was fairly alert in the afternoon, which was also nice. Yesterday one of the teachers from work dropped off a goodie bag for me that all the other teachers & students put together. That was really helpful & encouraging to me (thank you all VERY much! I'm overwhelmed!). Today my friend from Tennessee that's visiting me invited a bunch of his friends over to my house (they happen to be my friends, too). So it was sort of a reunion for him, and a birthday party for me (I wasn't there most of the time because I was visiting Denise so much). At one point as the party was winding down, a car caught fire down at the end of my block. According to a witness, a drunk driver caused an accident, drove away, and finally got out of his car on my street as it was burning. Fortunately, it wasn't anyone from the shindig at my place.

I also had a few people go with me to visit Denise today. The support was good. On the way home tonight, one of my friends said that the blog was good for her & her husband. Each entry sparks a conversation about what they'd do if they were in my situation. The book I'm reading had a quote from Nietzsche that said "It is not so much the suffering as the senselessness of it that is unendurable." So hearing how the blog is helping a couple connect adds some sense to what Denise & I are going through right now.

I just got a call from the hospital to go over because Denise's blood pressure's low and not coming up. So here I go. Keep us in your prayers.

Friday, September 16, 2005

Heart function worse than previously thought

Here's the update as of about lunch time today. The official word on Denise's heart is that it's worse than what they thought (ejection fraction is 20-25%, not 30-35%). What she has is commonly referred to as congestive heart failure, most likely brought on by tachycardia (high heart rate for a long time). We're waiting to see how the two drugs they're giving her work. The drugs will slow the heart down, allowing more time for the chambers to fill with blood for the next beat. One drug is usually specifically for hypertension. As applied to the heart problem here, it dialates the blood vessels, making it easier for Denise's heart to pump out against an overall lower pressure. We're waiting to see what the latest thyroid check has to say (might have some bearing on the heart rate). The last thyroid panel came back essentially normal (thank you to family members that contacted me to contribute your thyroid histories). According to an outside-the-hospital opinion, this heart condition should get better once the infections, fevers, and breathing begin to come under better control, since Denise is young and was in great shape prior to going into the hospital.

By the way, have I ever mentioned that this is Denise's first hospital stay in her life? She's packing a lifetime of hospitalization into one long stay.

Fevers crept up to 103 since the last post, so I assume that there's an infection that's either new or getting worse, or one of the antibiotics or antifungals isn't as effective anymore (possibly related to yesterday's decision to switch the antifungal meds). Still waiting to find if the PICC line was a player in any infection. Pseudomonas still present in sputum. To fight the infection, the IV nutrition is either way down or discontinued. The thinking is that the very high sugar in the TPN that's going through the IV tube increases the risk of infection in diabetics (which Denise is dealing with at the moment... most likely temporary). So by cutting the sugar down, the risk of infection goes down, too. At least that's my overly-simplistic understanding. She still probably has a c. dif infection, but that's to be expected until the antibiotics are discontinued. Sounds weird, as I *think* c. dif is a bacteria, and should be whacked by the antibiotics. But then again I've been amazed by lots of things during this whole ordeal. The more I learn, the more I find out how much more there is to learn. Let me restate that... the more I learn, the more I realize how stupid I am.

Her bone marrow seems to be working, as she's still on procrit, and that can only work if the bone marrow's working. This is based on the reticulocyte count (a word I need to research, but my preliminary understanding is that it's basically an adolescent red blood cell, and used as an indicator of marrow function). Now whether her marrow's able to crank out enough cells to deal with her needs as related to infection-fighting and hemoglobin is something that is foggy in my mind.

And my mind is quite foggy right now, as Jacob was awake many times last night. The pediatrician says that he's got gingivostomatitis (sore throat w/white patches), caused by a virus, pretty common. Fortunately, he said virtually all adults have already had this and there's slim chance that I'll get sick, so I can probably still visit Denise. Also, the fever & contagious phase is short, and I got him into the doctor early on, so the meds they gave him should work great. The bad news is that Gracie is probably going to get it, too.
Oh, how I long for the days when if I took a sick day from work, it was because *I* was the one that was sick. Life's real different with kids!

Remedies for Asthma or Allergies

A lot people have asthma. My daughter, 41 years, included. She has suffered from attacks for many years. Recently I encounter three natural remedies that I asked my daughter to try. I have not yet received a report on these, so I would like to pass them on to you. Here is the first one.

Boswellia

Boswellia, an herb, is known for its anti-inflammatory abilities and its usefulness in reduces the effects of bronchitis, asthma, cough, laryngitis, and fever. It comes from the resin of a tree in India and made into a pill or cream. It is best known for use in arthritis.

Recommended dose is: 150mg three times a day.

Yamoa

Yamoa is an herbal powder treatment for Asthma, which is derived from the bark of an African gum tree. It is available in capsule and has been typically used to help asthma. It has a good history of helping asthma sufferers.

Minor Blue Dragon formula

The Minor Blue Dragon is a Chinese herbal formula. Another name for it is xiao-qing-long-tang, or XQLT. It’s a blend of eight herbal medicines used to treat asthma for centuries in Asia

The XQLT formula has been used effectively for bronchial asthma for centuries and it is said to have an even more powerful bronchodilator effect than prescription drugs.

This formulation contains ephedra, which has been banned in the US in diet formulas. However, ephedra in this formula is considered safe, since the formula only contains around 15% of this herb. The other ingredients in XQLT are paeonia alba, cinnamon, pinellia, ginger, schisandar, asarum, and glycyrrhiza. Nutritional Supplements That Help Reduce Asthma

Antioxidants

In addition to the above herbs it is also important to take a good supply of antioxidants - especially vitamins A, C, and E, carotenoids, and selenium. Taking antioxidants helps to reduce the irritating effects of airborne free radicals, which can activate an asthma attack.

Magnesium

Magnesium has been shown to reduce the risk of developing asthma and might also be helpful in reducing asthma. Magnesium is also good for asthmatics because it helps to dilate the bronchioles. Also, make sure that plenty of water is drunk daily, which thins mucus. The recommended dosage of magnesium is 200-600 mg/day.

MSM

MSM has also proven useful for asthma aside from being beneficial for arthritis, allergies, fatigue, back pain, sinusitis, carpal tunnel syndrome, autoimmune diseases, and many other conditions. Start with 2000mg of MSM per day but be sure to take 50 to 150 micrograms of molybdenum daily since MSM needs molybdenum to activate it properly.

I was able to find a product that already has the proper molybdenum in the MSM, which makes it convenient to take just one pill. Go to google and put in the words “MSM molybdenum” and you will find some web sites that sell this MSM combination.

Rudy Silva has a degree in Physics and is a Natural Nutritionist. He is the author of Constipation, Acne, Hemorrhoid, and Fatty Acid ebooks. He also writes a newsletter called Natural Remedies Thatwork.com For more information on his writings go to: http://www.asthmatreatments.info
source : http://www.newomen.com/displayarticle289.html

Thursday, September 15, 2005

Weak heart, Possible PICC infection, LTAC?

Top of today's news isn't great. Denise had an echochardiogram that showed no signs of infection in her heart, and no fluid around the heart. But it showed that her heart is weak. Her ejection fraction is only 30-35% (normal should be 60-70%). What this means is that her heart is not squeezing out enough volume per beat. This may be attributed to having such a high heart rate for so long. She's getting tired. So they're going to give her some meds (coreg & cardizen... I haven't had time to learn anything about them yet) to slow her heart rate down, thereby hopefully allowing enough time for the valves to fully open/close & get a favorable amount of blood volume flowing. Now since they're going to slow her heart down, that means that they need to get more hemoglobin into her system to accomplish the same amount of oxygen saturation with fewer heartbeats... they've gotta get more bang for the beat. So they're transfusing more blood tonight to get the hemoglobin count up. Other problems might be related to her current heart concern. Might be coronary disease, but not likely. There is an off-chance of a thyroid abnormality, so that'll be checked. There's also a possibility of postpartum cardiomyopathy (simplified, a weak heart muscle). But that's also not likely, since Denise probably wasn't far enough along into the third trimester for this to happen. Still, no stone unturned. I forgot to ask the doctor if this is something that's a new hurdle/crisis, or if it's been there for quite some time, and it's just the next thing to scratch off of the to-do list. Since the doctor has been so great about feeding me all the details regularly, I fear that it's the former.
The infectious disease doctor is planning to change up Denise's antifungal medication (though not showing up for a while, the Valley Fever fungus might still be lurking). The new med will be voricanozole. The reason for the switch is apparently to avoid having Denise build up resistance to the current antifungal med. The fever curve had been lowering over the last few days (at least when I was visiting) but tonight when I left she was at 102.6, which is higher than what I've seen with my own eyes. So the fevers seem to be creeping upward again. That reminds me, just before dinner tonight, there was what appeared to be pus where Denise's PICC line went into her arm. So they removed the PICC line and sent the pus and the tip of the line for culturing. Seems to me the other day, there was the thought that the PICC line might be a player in the blood infection.
The IV feedings and gastro tube feedings are still being adjusted. They're going to try to lower the lipid content of the IV feedings. There's some concern about dehydration, as evidenced by the increasing heart rate... at least that was the thinking this morning, before the echocardiogram. Also this morning, there was talk about getting the possibility of starting to look into a long term acute care (LTAC) facility if she stays stable and things continue to move in a favorable direction. That was also before the echocardiogram, which kind of blew that LTAC idea out the water for the moment. LTAC is something else we're not looking forward to, as none of us like the idea of Denise being gone for months beyond the two months she's already spent in the hospital.

And from the "When It Rains, It Pours" department, my dad started back on chemotherapy yesterday (maybe I should set up a blog for my mom & pop), and Gracie & Jacob are both running fevers tonight. The pediatrician on call (at 10 pm) said that from the sounds of things, Jake might have an ear infection, so we've got an appointment for tomorrow morning and we're praying that I don't have to go to urgent care later tonight.

Before The Baby Arrives

This article give you know what you do before your baby arrive. Congratulations - you're going to be a mom! Whether it's yourfirst or sixth baby, there are things to consider and plan for:
Do you have your birth-plan worked out with your
family and obstetrician (nurse-midwife)?

Do you have your suitcase packed (or things organizedif you're having a home-birth)?

Do you have your emergency contacts in case you go into labour at a less-than-convenient time?

Do you have the nursery ready for your baby's arrival?

Does your baby have a family?

That last point might seem odd, but inasmuch as we plan with such detail about every other aspect of our newborn's life, sometimes we overlook the most basic thing: your baby needs a family. I'm not going to delve in to the political hot-potato of single moms having kids, I'm simply going to advocate for a family for your baby. If you're married, this means a husband for you and a daddy for your child.

The goal of parenting is not to simply avoid excessive anxiety, but it is to create a world of confidence by what we do with each other as much as what we avoid doing. Weak marriages do not build strong families, nor do they infuse the hearts of children with confidence and security. And isn't that last phrase what we want most for our babies? The best years of parenting flow out of the best years of a marriage. Protect your relationship and you'll raise happy, healthy children as a
result.

Too often when a child enters a family (please note that you and your husband ARE a family even before you have children!), the marriage is set to the back-burner of the stove, be it due to exhaustion, lack of extra time, etc. The parents leave their
first love: each other. Isn't that the reason you married and decided to have children in the first place?

So before you begin parenting this new little one who will be so precious to you and your family, take some time to consider the state of your marriage. If you need to work on it, start now: your baby will sense and respond to stress in your home
and your body more than you might realize. You won't want to have your precious bundle of joy starting out life stressed, so do what you can now to eliminate that and keep your relationship with your husband on the front-burner. You won't regret it!


About The Author: Kirsten Hawkins is a baby & parenting expert
specializing new mothers and single parent issues. Visit
http://www.babyhelp411.com/ for more information on how to
raising healthy, happy children.

Wednesday, September 14, 2005

Not much change, Trach cheating, Party planning

Not much change between today & yesterday as far as fever, heart rate, breathing rate, etc. She was asleep most of the time. She managed to figure out how to cheat the tracheostomy... she pulls the collar to one side and can squeeze out a word or two. She's been writing quite a lot over the last day or two, and most of the time we're able to figure out what she's writing. The few hours a day that she's really awake & alert, her writing almost looks normal. They tried the CPAP mode of ventilation again today, but she didn't tolerate it well. It's been weird... one day she can go for a couple hours, the next day only a couple minutes. Her tummy looks a little more bloated today than yesterday, but that might be because the IV feeding is decreasing and the gastro tube feeding is increasing. There was a vomiting episode earlier, soon after administering some meds.
Denise looked at some party supply catalogs tonight and circled some items for me to get for Gracie's birthday party. One of the people at work took digital pictures from the party supply store for me, and I'll show those pics to Denise tomorrow when she has more energy. By the way, thank you for all the offers to help out with that! I'm overwhelmed & will hopefully get back to a bunch of you this weekend.
I went to wash my hands at the sink and my head knocked some chimes that are hanging from the TV set. Thank you to whoever got that for Denise. And while I'm thanking anonymous gift-givers, thank you to whoever left the daddy & baby sculpture & In-n-Out gift certificates on our front porch last week. And somebody got us a Boston Market gift card with no name. I'm sorry about being so bad about writing thank you notes to people... I like to express appreciation, but I'm dropping the "thank you note" ball quite frequently during this ordeal. Know that I truly appreciate all that's been flowing our way. Maybe I should do a post that's dedicated exclusively to thanking everyone... it'd be a long post!

Tuesday, September 13, 2005

Online Map?

I thought it would be a kick for Denise to see where all of you are on a map. I'm looking for a web site that has an online U.S. Map (maybe a world map would be needed) that lets each of us put a virtual push-pin (I'm thinking a red dot or something) onto the map where we live, based on city or ZIP code. I've searched but haven't found anything online. Anybody know of a site that offers what I'm looking for? If we can find a site like that, I can link it to Denise's blog. What an encouragement that would be for her to see a map with hundred (thousands?) of red dots all over the place, each one representing the location of someone that's been pulling for her.

Denise speaks, Kids visit

Starting 9 weeks in the hospital, and Denise spoke! I went by to visit Denise after school (it's murder sitting at work after being used to going to the hospital any time). The respiratory therapist (same one that painted Denise's nails) told me they had a surprise for me. So while I was copying numbers off of the machines, they deflated Denise's tracheostomy cuff and I heard Denise talk in a buzzy voice (one or two words at a time, like the kids in the wheelchair from Malcomb in the Middle). I was so shocked that I can't for the life of me remember what she said. But it sure was a welcome sound to hear her voice break into the the click, whir & hiss of the machinery.

I drove home to pick up the kids and drove back to the hospital, and got video of the kids hearing Denise talk for the first time in about 2 months. Gracie snuggled right up to Denise, hoses, wires, tubes and all. Jacob was once again very apprehensive, and at last kissed Denise on the forehead and gave her injections with a toy syringe. I was busy filming, but I think that every nurse, doctor, therapist, orderly, and all the other pajama-wearers that work in the CCU came in for a peek at what was going on. A few people had sweaty eyeballs. A while back, one of the nurses said that after so many weeks of taking care of Denise (and rooting for her), everyone there thinks of Denise as either their sister or their daughter. From what I've seen of the care, Denise is in a pretty good family. Good stuff! A great and welcome contrast to how scared I was last week at the thought of eventually losing Denise to a strain of bacteria for which there was no fix (it's turning out that it was margin of error from the lab & both infections are the same bug, and responding to antibiotic).

Earlier in the day I had gone to the hospital before work and Denise was asleep (not sedated, just "pooped-out-tired" asleep). Her numbers were very nice. Topping it all off, her color was pretty good. So I stayed out of the room so I wouldn't wake her (I have the squeekiest dress shoes in the world). While I was at work, Denise sat at the edge of the bed by herself (physical therapy crew on standby, waiting to dive into action if she fell) and sat in the cardiac chair for roughly two hours. She also had a luxurious shampoo and style (braided ponytail with Denise's super-curly, thick, boingy hair... a miracle!) from one of the nurses whose hobby is hair.

On the technical end, her hemo is at 9.1, they tried her in CPAP vent mode for a while (I believe that lasted about an hour), the infected lungs & blood seem to be responding to the antibiotic. Fever curve is lowering, two days in a row of lower heart & breathing rates with great oxygen saturation. They'll start feeding her a little bit through the gastro tube again. There are still moments that Denise is pale, clammy, and putting numbers on the displays that make me wonder how long this can go on. But that's because she's in critical condition. Some moments today didn't seem that bad for being critical.

Thanks for all the emails & posts offering to help out with Gracie's 4th birthday fiesta. Wow! There are so many emails... I'll start responding in the next day or two. I've got a crew taking photos and collecting party supply catalogs already!

Monday, September 12, 2005

Still waiting, Good signs, Tears, Party planning

I haven't heard any definite word from the infectious disease doctor about our latest scary situation with the infection (remember a few days ago we were encouraged to hear that the two infections are probably the same organism, and if so, there is medicine available). But there are some things happening that might indicate that Denise is whipping the infection(s). Her ab swelling has gone down a bit and it's softer to the touch, her fevers topped in the 102 range & were frequently hovering around 100. Also, white count lowered to 13. I guess that if it gets TOO low, that means that she's incapable of making the white cells. But lowering to the current range might indicate that fewer white cells are needed to fight infections. The doctor said that they were going to look into the possibility that the PICC line might be problematic as far as infection

Overall, it was a fairly uneventful weekend for Denise; more fine-tuning of her treatments. Her hemoglobin count has been low, so she's been given a couple units of blood. They're going to check to see if she's destroying blood cells (hemolizing... the new word I learned today). Fluid in the lungs has increased, but this is due to the IV feeding & doesn't seem to be a big worry at this point. The lovenox blood thinner has been discontinued (hmm... so when they start it up again, does that mean it'll be dishalted or disstopped or disdesisted or disceased?). She's got cuffs on her lower legs that inflate & deflate to keep blood from pooling & clotting now, and she hates them. She was able to get into a cardiac chair for about 3 hours today (sleeping much of the time). At one point today she was sleeping (not sedated) and had some of the nicest stats I've seens in weeks... fever at 99.8, heart rate 112, respiration rate 23, oxygen saturation 100%, using 40% oxygen concentration. But when I when I had to leave her tonight, she was back to sweating, feeling anxious, and having numbers to prove it. In my visit just before the shift change, she had tears dripping from her eyes (haven't seen this much). She indicated that she was scared & frustrated. I couldn't do anything to cheer her up, and I had to leave. That was tough. Real tough.

Today was my first "full" day back at work with the computer classes (my hours have been greatly reduced so I can be available for Denise & the kids). I was very anxious the whole time... I'd gotten used to being able to be at the hospital any time I needed/wanted to be there. Somehow, the CCU crew managed to get Denise through the day without me. First day for the kids in day care, also. We decided to go with a licensed home day care that one of the neighbors on our block runs. Close to home, and Gracie & Jacob don't have to be split up. Plus they'll get home-cooked Filipino food for lunch sometimes (I'm jealous... her pan de sal is legendary).

I was reading a section in "Where Is God When It Hurts" that addresses the way we treat suffering people. One thing that really stuck out at me over the weekend was a statement made by someone that was terminally ill (I guess we all are... one death per person, no ups, no extras), wherein they said that they hated the feeling of not being needed. We all like to think that we matter somewhere along the line; that if we weren't around, something would go wrong, and we'd be missed. It hit me that I could do better than just telling Denise how much she's sorely missed & how things aren't the same with her away from home. Gracie's birthday is coming up in October, and I got the idea of having Denise plan the party, just like she always does... however this time, she'll plan it from the hospital bed. She decided on a fiesta theme. I'm going to visit some party supply stores and take digital pictures of all the appropriate invitations & decorations. Then I'll show the pics to Denise & have her decide what to get. Actually, I don't have time to do this... anyone want to borrow our camera & take the pictures for me? Any suggestions for good and reasonably priced catered Mexican food?

Three minute beauty

Three minute beauty
By Kathy Miller-Kramer, from Lifetime magazine

You don't need to spend hours in front of the mirror to look great. Your free time is better spent doing things you love: hanging out with your honey, enjoying a day in the park or catching a great movie. After all, happiness is the most glamorous accessory a woman can have. But you don't want to feel completely exposed when you go out in the world. Here are four looks that can be achieved in three minutes or less, leaving you more time to go out and do your thing!

Look #1: In the pink
Nothing screams health like pink. Take a minute out of your morning rush to dab creamy blush on your cheeks and blend, then apply a pinkish hue on your lids. "A soft pink shadow works on all skin tones and brightens the eyes," says Los Angeles-based makeup artist Martin Pretorius. Finish with a glossy lipstick and people will be convinced you've been getting plenty of beauty sleep, whether or not that's true.

Our favorites for this look?
-Avon Ultra Color Rich Renewable Lipstick in Sheer Lily, $6.50
- M.A.C Cream Color Base in Fantastic Plastic, $14.50
- Cover Girl Triple Mascara in Black Brown, $5.40

Look #2: Drive and shine
It's a snap to look sun-kissed, even when you're on the run. Smooth on tinted moisturizer and apply bronzer where the sun hits you naturally: cheeks, the bridge of your nose, chin and hairline. To look legit, add a touch to your earlobes and collarbone. Swipe on tangerine shadow and lipstick or gloss and get glowing!

Our favorites for this look?
- Stila's Pivitol Sun, $25
- Shiseido Silky Eyeshadow Duo in Fire Sky, $25
- Laura Mercier Lipstick in Apricot Sorbet, $19
- Prestige Aromatherapy Lip Gloss in Skin, $3.25

Look #3: Working girl
To make the transition from work to play, give your daytime face some evening oomph to with a little desk-side tweaking. Emphasize your lips by applying long-lasting lipstick (we like a pearly red), then add just a bit of blush. Fill in brows with powder or pencil, dab on neutral-colored shadow and you're ready to have fun!

Our favorites for this look?
- Max Factor Lipfinity Lustre in Glistening, $12.75
- Prescriptives Mystick Swivel Cheek Color in Woman, $25
- Elizabeth Arden Dual Perfection Brow Shaper and Eyeliner in Sable, $16
- Clinique Quick Eyes in Blue-Grey, $15.50

Look #4: Party girl
Make him wait while you stew over shoes, not what to do about your makeup. Sweep blue shadow across the lower part of your lids, but keep your lips neutral. "You'll get a flash of color when you blink," says New York City-based makeup artist Mel Rau.

Our favorites for this look?

- Clinique Blush Wear in Rosy Blush, $14.50
- Calvin Klein Eyeshadow Duo in Mist Pacific Iridescent, $15
- Anna Sui Eye Color in No. 112, $17
- M.A.C Lipglass in Tittle Tassle, $13

Sunday, September 11, 2005

Laser Hair Removal New York

This information for laser hair removal new york. I hope this usefull for your information about laser hair removal washington dc, laser hair removal new virginia and other city.

We spend a lot of time waxing, cutting, shaving, plucking away hair from unwanted places like legs, upper lip, chin, arms, back, and other such areas, only to find it growing back a short time later.
In New York City, laser hair removal has become a very popular cosmetic procedure for getting rid of unwanted hair. Just try out the safe and economic process of new york city laser hair removal.
In this method, a low-energy laser beam is used to remove unwanted hair. I can tell you for sure that unlike routine hair removal practices, this procedure offers long-lasting results. When the laser beam moves across the treatment area, the laser energy passes through the skin and is absorbed by the pigment in the hair follicle.

You may have to pay multiple visits to the laser center to achieve that long term desired result. The cost of the treatment varies from person to person and is generally dependent on the size of the area treated as well as complexity of the case. The entire process is relatively pain free but improper treatment can cause lesions, burns and skin discoloration and irritation.

The result is the best if you are light skinned and have dark body hair. It must be kept in mind that lasers must be used very cautiously if you tan or have a darker skin tone.
New York city is perhaps the laser hair removal capital of the world. There are a host of centers offering new york city laser hair removal. Not only do you have the best specialists here, but you can also choose what kind of center you want to go to. Taking the decision regarding which center to visit is indeed difficult. For this you should talk to those persons who have undergone new york city laser hair removal. They will be the best to guide you and answer your questions. The internet is also a great resource in helping you to find out as well as decide which laser center in New York city will be the best one for you.

Several places offer new york city laser hair removal. There are even some centers which offer written warranties. If by chance you experience any re-growth of hair in the treated area within the specified guarantee period, you can receive additional laser treatments to the treated area absolutely free of charge.
So just walk in to any of these centers and get rid of all your hair from unwanted places.

Laser Hair Removal Discover laser hair removal information Articles and resources for prices, cost, and treatments of laser hair removal in cities like New York, Washington DC, Toronto, and Dallas. Visit this site for the best in laser hair removal! http://www.informationonlaserhairremoval.com/
Click Here To Download "Laser Hair Removal New York" E-Book

Saturday, September 10, 2005

Women's Health - 7 Tips For A Healthy Pregnancy

This is a simple tips for you healthy pregnancy.
It is always important to take whatever steps you can to be healthy, but while you are pregnant it is even more important:
not only do you need to take good care of yourself, you are also profoundly affecting the life of another person - your baby. Here's 7 tips to help you along the way.

1.If you smoke, one of the most important things you can do isto stop smoking:
babies born to mothers who smoke have a lower average birth weight, are more likely to be born prematurely, and are at greater risk of death from sudden infant death syndrome than babies of non-smokers. Sometimes mothers feel having a low birth weight baby could be an advantage as it will make the baby easy to deliver. This is not necessarily the case, as it may lead to an emergency delivery, which can result in all sorts of complications. Even if you are already pregnant, stopping smoking will benefit the baby for the rest of your
pregnancy. It is not only the baby who benefits. You are likely to suffer from less morning sickness, experience fewer
complications and have a more contented baby after the birth.

2. It is also important to pay attention to your diet.
Many women feel they should 'eat for two', but research has shown that women only need an extra 200-300 calories a day while
pregnant, and you may be eating those extra calories anyway. What is important is to ensure that you get the protein,
vitamins and minerals necessary to build another human being. Those extra 200-300 calories should not be squandered on
chocolate or crisps, but should be eaten as fruit, vegetables, etc. It is also important to increase your water intake, which
will help avoid constipation.

3. It is generally a good idea to take a good qualitymultivitamin and mineral supplement too.
There are now ones specially formulated for pregnant women. Ideally these should be started before you become pregnant, so that you are in the best shape possible for the pregnancy, and then continued throughout your pregnancy. An adequate supply of vitamins and
minerals is important right from conception. For example, a deficiency of one of the B vitamins, folic acid, in the first month of pregnancy may lead to the baby being born with a cleft lip, congenital heart disease or spina bifida. Omega-3 fatty acids (obtained by eating oily fish, flaxseed oil, walnuts, spinach and spirulina, or taken as a supplement) are important for the development of the baby's eyes and brain. Omega-3 also reduces the risk of premature birth and post-natal depression.

4. Nobody knows how much alcohol it is safe to consume during pregnancy, so many health experts feel it is better to avoid alcohol entirely for the sake of the baby. This can seem hard on the pregnant woman when everyone else is drinking, but it is important to remember that alcohol is a poison for the growing baby, and no caring mother willingly gives her baby poison.

5. Pregnancy is not a time to sit still. Although adequate rest is vitally important, most experts believe that healthy pregnant
women should be taking 30 minutes of moderate exercise everyday.

6. It is also important to minimise exposure to toxic chemicals while pregnant, so spending a lot of time painting the house and
laying new carpets is not a good idea, especially in the early stages of pregnancy when the baby is particularly vulnerable.

7. Many women find pregnancy stressful, and this can be a particularly good time to turn to safe, non-invasive options
such as Bach flower remedies, homeopathy, kinesiology and other therapies.

Making a new life is something miraculous. Doing the best you can for that new life starts long before you have the baby in
your arms for the first time.


About The Author: Jane Thurnell-Read is an author and researcher on health, allergies and stress. She has written two books for the general public: "Allergy A to Z" and "Health Kinesiology". She also maintains a web site http://www.healthandgoodness.com with tips, inspiration and information for everyone who wants to live a happier, healthier
life.

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