And on we go ...

The day after Jim's visit (Sept. 12) to St. Luke's ER he still had blood in the stool, but on the following day, Sept. 14, it was clear. Hallelujah! On that same day he also had an appointment with his primary, Dr. Butler, who determined more labs were unnecessary. Blood pressure still remained on the low side - for the nurse it read 70/40 and for the doctor it was 88/40. Dr. Butler requested a followup visit with Dr. Gerke in Gastroenterology at UIHC.

On Sept. 15, we received an email from Dr. Parekh's nurse, Joan Ricks-Mcgillen, who noted the CT scan done July 6 at St. Luke's - Cedar Rapids shows no recurrence of esophageal cancer. Great News! Another CT scan of chest will be done in late December.

Although we are no longer the pastor at Wilton Baptist Church, we continue to minister to its members, many of whom have become lifelong  friends. We attended the last WBC Senior Day of the year on Sept. 27 and were blessed with visiting with so many we hadn't seen for nearly a month. Sometimes 4 weeks seems like forever!  Pastor Appreciation Day is Oct. 16 and we plan to also attend those activities.

On Wednesday, Oct. 5, Jim had an appointment with Dr. Gerke in Iowa City re: the rectal bleeding Sept. 12. His weight is 137 pounds, blood pressure is 102/56 (good!) and temperature is 97.3. The doctor said he could have an internal hemorrhoid, but not necessarily - a rectal exam would not give an accurate picture - so recommends nothing be done unless another bleeding episode occurs.

Today - Oct. 6, Jim had an 8 a.m. appointment with Dr. Hoxie at PCI Urology - Cedar Rapids.
The ER visit Sept. 12 revealed:

• portion of right urinary bladder distended, recommends cystoscopy
• mild increased dilation of distal common bile duct in the pancreas, measuring 8 mm in diameter compared to 5 mm a year ago. IF there is concern of biliary pathology, a right upper quadrant ultrasound would be recommended.

Jim returned from the appointment at 9. The doctor did a scope and said everything was fine. Dr. Hoxie said sometimes CT scans indicate things are abnormal, when they really aren't.

Thank you Lord for every miracle.  

If it's not one thing, it's another ...

I updated the blog just Saturday, and two days later, I'm doing it again.

If this gets too graphic for you, I suggest you stop reading now. Otherwise, dive in.

Since the last time Jim had blood in the stool (that brought on the internal bleeding in October 2015), he has determined that if he ever had blood in the stool again, he would tell me.

So, this morning, guess what?! Blood in the stool. Lots of blood. He said there was a little Sunday morning, mostly on the tissue, but thought it could be because of straining. But this morning was a different story.

I called nurse friend, Lorraine (AKA Lori), who suggested we call our gastroenterologist (Dr. Gerke) in Iowa City, so I did. When the GI nurse returned the call, she suggested we go to the ER.
It was already late morning and I had appointments at 1:30 and 3, so we decided we'd go to St. Luke's after my last apointment.  Hence we became part of the sit and wait, go and do, and sit and wait some more crowd from 4:30 to 8:30 p.m.

Jim's blood pressure was actually high. Of course, medical staff was concerned over how low his readings were. The first reading was 80 over ? with an adult cuff, second reading was 88 over ? with pediatric cuff, and when he got his own room, a recheck showed it was 96/46.  It has never been this high in the 9 months he has been taking midodrine to raise his blood pressure. At least not that I can remember. He has gained another pound to boot, coming in at 137 pounds fully clothed.

Jim had the pleasure (NOT!) of having a rectal exam, then he had blood work, then a CT scan of his rectum.

At 7:50 p.m., Tina, physician's assistant, came in with the findings ...

• CT scan showed no obstruction 
• He does have constipation 
• The bleeding could be a tear as a result of straining
• There appears to be area of pancreatic duct that is dilated
• Prostate is enlarged
• Bladder is distended
• Hemoglobin count is 9.6 

Other details going forward ...

• The blood pressure was 102/54 when last checked at 8:07 p.m., and it was thought it was because he was getting fluids. So he still needs to drink more water than he does. 
• The hemoglobin count is near the point where a blood transfusion might be necessary. 8.0 is the magic number he doesn't want to reach.
• He took a capful of Miralax (a more gentle stool softener/laxative) at 9:55 p.m.
• Make appointment with Dr. Hoxie, his urologist, to follow up on abnormal bladder findings
• Make appointment with Dr. Butler, his primary, to see if bleeding has subsided and do a repeat of CBCs
• Call Dr. Gerke's office and advice him of details
• Return to St. Luke's ER if he has worsening symptoms, which includes dizziness and shortness of breath
  
  That's all folks. 

Thank you Lord for getting the answers we needed quickly, even though it seemed so slow and we are not very patient.

Thank you Lord for enabling us to go home, not having to spend the night at St. Luke's or have to drive to University Hospitals in Iowa City.

Thank you Lord for all you do for us. We are so undeserving, but without you, we would be thankful for nothing. 

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