Error AGAIN... Ativan, not Avastin

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

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Women Health - Top 10 Foods for Women

Beans and Pulses

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

Kale

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

Orange vegetables

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

Linseeds (flaxseeds)

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

Iron-rich foods

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

Soya

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

Brocolli

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

Calcium and magnesium - rich foods

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

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

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

Water!

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

Salmon and other oily fish (in moderation)

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

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

Eating fruit to offset mercury absorption?

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

Try this tasty fish dish… with minimal mercury exposure!

Fresh Tuna Steak with Mango Salsa (Serves 2)

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

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

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

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

Article Source: http://EzineArticles.com/

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Women Health - Top 10 Trends in Healthcare

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

Western Medicine Costs Continue to Rise

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

Health Insurance Opt-Outs Surge

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

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

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

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

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

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

Alternative Medicine Becomes the Dominant Healthcare System in America

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

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

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

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

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

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

Consumer-Driven Healthcare

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

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

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

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

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

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

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

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

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

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

The Rise of Health Freedom Laws

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

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

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

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

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

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

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

The Internet As a Healthcare Information Resource

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

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

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

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

Distrust in Existing Medical Institutions

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

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

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

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

Distrust of Socialized Medicine

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

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

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

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

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

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

Doctors Incorporate Alternative Medicine Into Their Practices

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

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

And a choice they will receive.

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

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

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

Article Source: http://EzineArticles.com/

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5 weeks in, memory better, asking about baby

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

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Coping, Amnesia, Blessings Counted, Music

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

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

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

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

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

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2 days of news, and jury duty

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

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

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

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Less Vent, Less Critical

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

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