Wednesday, December 30, 2015

A December we'll remember (even if we try to forget!)

We were congratulating each other at how smoothly our transition to settled life had gone.  Our "to do" list shrank steadily during the months of July, August, September and October:
  • house shopping, check;
  • house purchase, mid-July (after only 2 days of shopping!);
  • buying necessary furniture, 2 weeks in late July and early August;
  • closing on house, mid-August;
  • immediate possession (house clean!);
  • furniture deliveries begin day after we move in;
  • we begin exploring the neighborhood;
  • we trade the Ram truck for a Honda CRV in mid-September;
  • we locate needed health care professionals and make "get acquainted" appointments;
  • we sell the fifth wheel to a lady who lives near our son in Athens County, early October;
  • we begin to enjoy the joys of the area such as the bike trail, local restaurants, the hometown symphony, plays at the local university, line dance classes, etc.
  • we manage to keep up our routine of exercise walking 2 to 3 miles each morning;

In November, we enjoyed sharing Thanksgiving with family for the first time in ten years.

Then December arrived!

Bruce has known since the early 1980s that the aortic valve in his heart was not working properly. Over the years since then he has been very diligent about having it checked by a cardiologist at least twice a year.  It has become steadily less efficient as the opening has progressively narrowed.

Echocardiograms and cardiac catheterizations have been done regularly.  They show the problem but doctors did not want to do the corrective surgery as long as Bruce was having no symptoms of cardiac distress.  When the cardiologists questioned him about symptoms, he would say, "No, no shortness of breath, no chest discomfort, no weakness or dizziness even when I walk several miles each morning and dance a couple of hours several nights a week."  Invariably, a shocked expression would spread across the doctor's face and he would say, "Oh.  Well, let's just keep an eye on it then. See you in six months."

Bruce's new cardiologist here in Westerville responded in exactly the same way.  He did, however, schedule a new diagnostic test for early December.

Then the first day of December with all its unexpected surprises, arrived.  It was cooler than we were used to -- but not really cold --, as we went for our morning walk.  About halfway along our route, he said, "I'm going to have to slow down a little.  I feel a little light-headed."  We did slow down (for which I was thankful!) and he voiced no more complaints.  Later, as we were walking home from Line Dance class, he said, "I had the strangest little spell of weakness during class.  But it went away; didn't last long."

We had a conference call on the phone that afternoon.  We had adjourned and I had gone off to do something around the house while he continued in phone conversation with a friend.  Suddenly I heard him call my name.  When I reached his side, he said, "I'm sick." I helped him to our bedroom to lie down on our bed while I took his vital signs: blood pressure low, pulse weak and rapid.  He reported the discomfort he had in his chest was easing up now that he was lying down.  "Shall I call 911?" I asked.  He nodded his head "Yes."

I don't know where the emergency squad had to come from but they were here in a matter of minutes.
They very respectfully and efficiently went about assessing Bruce who was now feeling a bit better.  In about 20 minutes, they had loaded him  into the ambulance and were on their way to the hospital.  Our dear neighbor had come out to see what all the excitement was about and she carefully gave me directions to the hospital, which was only 2 miles away.

I arrived and found him comfortably settled in a cubicle in the emergency department.  He was having no discomfort but announced to me, "They are going to keep me at least overnight."  I was relieved that he would be under professional observation for awhile, but my intuition was already signaling that it would be longer than just overnight.

He was moved upstairs to a very comfortable and impressive private room and was scheduled for a cardiac cath the following day.  I finally found my way to the cafeteria after asking directions of at least half a dozen people.

I stayed with him into the evening, silently patting myself on the back for staying so calm.  However, when I left to go home, I had to spend 45 minutes wandering around the parking lot.  I couldn't find my car!  I could not remember where I had parked it and I was surrounded by acres of parking lots!  I finally found it with the help of that handy-dandy little push button on the key fob that causes the headlights to flash!  By the time I got home, I was exhausted!

The next morning, while Bruce was undergoing a cardiac catheterization, I was sitting in the office of an attorney.  We had made that appointment planning to meet with him together.  He was quite understanding, but asked many questions I could not answer intelligently.  So, of course, we will have to continue that consultation in the future when both of us can be present!

By the time I got back to the hospital, Bruce informed me that he was scheduled for surgery the following day.  His faulty aortic valve would be replaced with a valve from animal tissue.  I stayed late at the hospital hoping to have a chance to speak with the surgeon.  However, he came to Bruce's room just after I left to go home.  We did have a phone conversation which I found very reassuring.  Throughout the afternoon we had received e-mails and phone calls from many friends who were already holding us up in prayer.

Surgery morning I arrived at the hospital early even though his surgery was not scheduled until early afternoon.  A friend from our local church family surprised us by coming to the hospital and staying with me until Bruce was taken to surgery.  We were grateful for his presence and his prayers.

The surgery is apparently painstaking and, to those awaiting news, seems very long. Bruce left for the operating room at 1:15 pm and I got only brief reports until 7:30 pm. Then the surgeon came out and gave me a more complete account of the procedure. Bruce had tolerated the surgery well and there was no evidence of any damage to the heart because of the faulty valve.

Shortly after that brief conversation, I was allowed into the cardio-vascular intensive care unit to see Bruce myself.  As I expected, he looked awful!  He was being assisted to breathe by a ventilator connected to a tube down his throat, about which he was quite restless.  He was connected to several IVs, a cardiac monitor displaying his vital signs constantly, and had tubes coming out of both known and unknown holes in his body!  I called his name, kissed him several times, and headed home to collapse.

The Westerville Street Department, however, was in the middle of a major repair project at the intersection where I had to turn left to get home.  In consideration to daily traffic, they worked on that project only between 7 pm and 5 am.  On this night, when I needed to get home as quickly as possible, they would allow no turns at that intersection at all!  So, I went straight, as the policeman insisted, knowing that was not the way home!

I thought I knew where I was, but in the dark I couldn't read the street signs, and before I knew it, I was lost!  But before I hit downtown Columbus, I had the presence of mind to turn on the GPS, and that "know it all" lady directed me straight home!

He progressed well and and had amazingly little pain (because of the approach the surgeon had made for the surgery which did not require splitting the breast bone.)  So, on Saturday, two days after surgery he was moved out of ICU to a room in the cardiac step-down unit.  I stayed to see that he was well settled and then headed home.

My phone rang at 1:30 am, an ominous sound!  The nurse informed me that he had experienced a sudden and serious drop in blood pressure so they had moved him back to ICU.    About 2:15 am, the ICU supervisor called to report that Bruce's condition had stabilized and he was resting well so there was no reason for me to come to the hospital at that time.  I did not sleep much the rest of the night.

Next morning, Sunday, I was so groggy I could hardly find the alarm clock to turn it off!  However, I knew I wanted to get up and go to church so I could get the signatures of our friends there on a birthday card for Bruce who would turn 73 the following day.

I made it to church and actually stayed awake during worship!  I got a card-full of signatures and well wishes to deliver to Bruce on his birthday.  I left church, and just as I reached my car, my phone rang again.  Bruce's blood pressure had dropped suddenly and seriously again, but he was now stabilized.

I headed for the hospital immediately.  Force of habit took me to my usual route instead of a more direct but unfamiliar way.  But, as I exited the outer belt. the main street was totally blocked off with barriers, orange cones and police cars.!  Now what?  I followed the car in front of me looking for an alternate route.  Suddenly a big, angry-looking policeman was frantically motioning for me to stop.  I did, and he proceeded to shout at me for "trying to get around our roadblock."

I apologized, but added that I was looking for a way to get to the hospital as quickly as possible.  He calmed down, directed me back to the beltway and the first exit to the west to get to my destination.  Then he stopped traffic so I could get out of my predicament and on my way.  I got to the hospital a few minutes later and found Bruce sitting up in a lounge chair totally unaware that he was having any problem!

 When the staff realized that Monday was Bruce's birthday, they gifted him with a birthday balloon and a greeting card they had signed.  Another "gift" -- an un-birthday type -- was the result of observations of a skilled nurse.  She became concerned that he was still having so much trouble swallowing four days after surgery.  She insisted on a consult with a speech therapist who immediately scheduled him for a swallowing evaluation X-ray.

I went along down to radiology to watch the process as I had never seen it before.  It was interesting, and discouraging!  He took a small swallow of barium which outlined his throat and upper swallowing passageway.  Every time Bruce tried to swallow clear or thickened liquids, they would go down just a short distance and then hit some invisible "brick wall."  There they would lie, causing him to choke and cough.  He was immediately ordered to have "nothing by mouth" and alternative forms of nutrition were discussed.

Two days later the swallowing evaluation was repeated in hope that there had been improvement.  There was no change so, on Thursday, one week after his heart surgery, he had a feeding tube placed directly into his stomach.  Tube feedings were begun and we were both instructed in the technique.

He was kept in the hospital for two more days.  I was eager for him to come home but those extra days gave me time to arrange for all the supplies and equipment we would need: tube feeding solution and equipment to give it, dressings for the feeding tube site, portable suction machine to help him handle his secretions and saliva, getting prescriptions for medications filled, buying several gallons of distilled water to go with the tube feedings, getting a "pill crusher" so the medications could be given through the tube, and arranging for the services of a home health nurse (to draw blood to monitor his "blood thinner" medication level), and a speech therapist to work with him on strengthening his throat muscles.

Soon after he got home, we had to increase the number of his
"tube meals" because he was losing weight.  

We now check his weight daily and adjust the number of cans of "goodies" accordingly.  

Our schedule is controlled by his "meals" every 2 1/2 to 3 hours
and the visits of the home care professionals.

Christmas was spent quietly at home enjoying the company of our son for the day.  Dad watched as the other two of us enjoyed a modest "feast" for the occasion.

Bruce is gaining strength every day.  Whenever the weather is tolerable, he walks outside several times a day around our little condo community.  Against the advice of the speech therapist, he is tolerating small sips of water without choking or coughing (we think that's progress!).

And suddenly, it is the end of December and of 2015.  December has, indeed, been a month we'll remember.  We are so grateful for that new heart valve that we are making the best of all the surprises that have come with it.  For the most part, our spirits are good and our senses of humor intact.  But where did December go?  We can't remember -- but neither can we forget!