Procedure - Day 30

Jim called at 7. Dr. Yerkes was in and said time frame for the scope and possible surgery to take care of the blocked bowel is mid morning or first thing in the afternoon. Jim and I think that might be around 10 a.m. or 1 p.m.

I arrived at Jim's room at 9 a.m., Pastor Dan and Lily shortly before 10. Tentative hour for procedure changed to 11 a.m., but 11 o'clock came and went, with no sign or word from anyone in OR.

At 1:30 p.m., Jim was taken to pre-op on 5th floor and by 2 p.m. was heading to the Operating Room. That was the last I saw of him until 7:25 p.m., when he was brought back into his room on 4th floor. I learned he was taken to recovery at 5:40 p.m.

Someone from his team of doctors was to come talk to me and/or us about the procedure, but that didn't happen, so I cannot tell you exacts. I am hoping tomorrow morning I will have answers. I had heard the OR was a busy place today and Jim said the recovery area was filled.

When he came back into the room, good signs were he was alert and able to move from the bed surgery personnel brought him in on to the one in his room. He was glad to see me. The UIHC doesn't let families into recovery.

The J-tube has been removed, which he was glad about. The NG tube in his nose remains, but perhaps that too will come out in a few days. Also he is still under NPO orders (Nothing By Mouth). Can't be on that forever, or he'll weigh nothing. His nurse gave him a pain shot and anti-nausea medicine.

Among things he said he was looking forward to:

• sleeping in his own bed and sitting in his recliner
• not having the IV pole 
• being able to get up to answer the door without the IV pole falling over
• not having to cart nutrition stuff in a backpack everywhere

I did a lot of sitting. I was eating lunch when Lorraine came by and we had a nice visit. Many called, but I had no answers. 

I did my morning Bible study today at 5 p.m. The verse, from Luke 1:79, says, "To give light to those who sit in darkness and the shadow of death; To guide our feed into the way of peace." 

This is what I wrote, a prayer ...

May the Light of Jesus
guide us
our feet
our hands
our mouths
into the way
of His Peace

We cannot
be led
unless we are
focused
We cannot
be focused
unless it is
in Him
with Him
of Him
we believe
with our
every breath
and fiber
all He
proclaims

May the Light of Jesus
remove
the dark intrusions
that settle
on our bones
into our eyes
out of our mouths

May His Light
revive us
renew us
restore us
refine us
redefine us

May His Love
become our Love
His gentleness
His kindness
His Patience
all become ours

May His Truth
be shared
May His blessings
surrond us
transform us
through every trial
we face

May His glory --
the Light
of our Lord
and Savior
Jesus
forever shine

May we be
partakers
of that Light
and through our lives
lived
pass on
that Light
of His
to another
and another. 

(c) Cathy Orrick Luders

I left the hospital at 8:45 p.m., stopped at McDonalds for a fish sandwich, and headed homeward. Within 15 minutes I was near the North Liberty exit and the wind picked up and the rainstorms followed. It was not a good place to be caught in. Traffic slowed to a crawl and most of us put our emergency flashers on, often stopping alongside the interstate, under bridge overpasses for a brief respite. What is normally a 30-40 minute drive home, took an hour and 15 minutes. I talked to Jim during my stopping periods and he called once to tell me to take the 32nd street exit, not  42nd Street NE as it was flooded. I was glad when I arrived home. 

Set Back - Day 29

Jim called at 7. Said he woke at 3 when his roommate called for the nurse. Then later he had pain in his back, so asked for pain shot. At 4:30 he had x-ray of abdomen, followed by labs and vitals. He was waiting to see the doctor.

My Scripture reading this morning:
"My soul, wait silently for God alone, For my expectation is from Him. He only is my rock and my salvation; He is my defense; I shall not be moved. In God is my salvation and my glory; the rock of my strength. And my refuge is in God." (Psalm 62:5-7)

I write:

Is it the doctor
Is it the plumber
Is it the results
that we -- impatient --
wait
Perhaps
But more likely
it is God
alone
for whom we wait.

Silent
with tears streaming
down our faces
voices distraught
with the mess
of the day(s)
previous
and current
a moment yet to come
this day or another
God holds.

Our trust
does not waiver
It is with Him
He is the one constant
that stays

Our expectation
is for better
but better or best
comes to us
through God's strength
received
according to His will

The Lord is with us
every step
every direction
left or right
up or down
surrounding us

Remember Him
at the forefront
Do not be moved.
(c) Cathy Orrick Luders


Jim called again at 8:45 a.m. Dr. Jason Tcheng was in. The x-ray continues to show blockage. They were hoping the obstruction would resolve itself. Dr. Tcheng said they may do a scope tomorrow -  a small incision in the abdomen. Depending upon what is seen, it could turn into surgery, with a larger incision, to take care of the bowel obstruction. Jim hopes he will have some answers by the time I get there after work tonight.

A poem sent by my friend Lorraine - it is written by  Amy Carmichael, who died in 1951.

Thy Way Is Perfect 
Long is the way, and very steep the slope,
Strengthen me once again, O God of hope.

Far, very far, the summit doth appear;
But Thou art near my God, but Thou art near.

And Thou wilt give me with my daily food,
Powers of endurance, courage, fortitude

Thy way is perfect; only let that way
Be clear before my feet from day to day.

Thou art my Portion, saith my soul to Thee,
O what a Portion is my God to me.

~~~~~

Jim has lost his left contact ... in the hospital room's bathroom. Another has been ordered - probably be here Monday.

Nearly 1 p.m. -- Jim called a few minutes ago. Drs. Parekh and Yerkes were both in. They plan to do a scope Thursday, but at this moment don't have a time. They may be able to give him a better idea later today. If the obstruction is twisted, it can be untwisted via the scope. If it is more extensive, they will remove the small intestine and be under general anesthesia. He would be in the hospital another 7 days.

It is after 11 p.m. We still do not know a time. Perhaps tomorrow morning we will know something definite.

Set Back - Day 27

Today begins anew. Seven hours rested sleep - thank you Jesus - will give me energy for this day.

Jim called at 7. Slept pretty well. Did not have success, unfortunately, with last night's enema or suppository. There is some difficulty in knowing what to give him since he can't take anything by mouth or J-tube.

He is to have an x-ray of chest, I think, or stomach this afternoon.

Jim called at 8:30. Dr. Parekh was in and told Jim he may need additional surgery. Jim doesn't want more surgery. He wants a bowel movement. Said he is getting depressed. Was upbeat before the previous surgery, but now, he is going downhill.

Please pray .... call him, visit him ... if you can.

I arrived at the hospital at 10:45. Around 11:30 Jim and I took a walk down one hall of the wing and up the other. When we got back, he was weighed - he didn't like what it said - 137.5 pounds. He's lost 6 pounds! Shortly after noon he started receiving an antibiotic for the urinary tract infection - 400 mg ciprofloxacin through the IV. And then around 12:30 p.m. he was taken to radiology for an x-ray of his abdomen.

He complained throughout the day of cramping and while at radiology and afterward, chills.

Dr. Yerkes came by at 3:20 p.m. and had the first positive news of the day. He said the x-ray showed good things -- the bile in the NG tube is green yucky stuff, but that is good, compared to yesterday, when only saliva was coming through. Between the bile going out through the NG tube and other gunk going out of the stomach through the J-tube, the obstruction is dissolving. Another x-ray of the abdomen will be done Tuesday and if everything continues going good, it is conceivable surgery is unnecessary. But if surgery is necessary, so it will be.

Last night, when Craig, who is staying with us for a while, came home, he said water backed up after he flushed the toilet. Tonight, I really had to do some laundry and I guess I really should not have. Because the sewer is backing up and when I looked in the bathroom, the shower stall is filled with ugly dirty water. I don't know what to do. I don't think there's anything I can do tonight. I can't get it all done. I can't get up early enough to get everything done. I want a massage. I don't have time for a massage. 

Set Back - Day 26

Today did not begin well. Minimal tummy pain yesterday afternoon got worse by bedtime, and although he thought what appeared to be indigestion would go away by morning as it had in pre-surgery days, it did not.

He woke at 1:30 and got up again at 2:30 and by 3:20 this morning, woke me with complaints of severe cramping. I thought he needed pain meds, but he said he thought a call to the on-call thoracic fellow at UIHC was in order. So I called. The lady doctor I spoke with recommended an x-ray of his abdomen to see if there was a bowel obstruction. We elected to have that done here in Cedar Rapids at St. Luke's, primarily because it was raining heavy and lightening filled the sky. She also said if there was anything St. Luke's would consider doing, he should be transferred to UIHC, since he is a patient there.

We arrived at St. Luke's ER at 4 a.m. and got in right away. Took labs, urine sample via catheter, received through an IV anti-nausea meds (even though he wasn't nauseated) and pain meds - dilaudid, which is really hydromorphone - once every hour PRN. Also a CT scan of abdomen and chest x-ray were taken. Diagnosis showed a blocked bowel and urinary tract infection. The pain meds weren't helping his pain management very much, with pain levels only dropping from a 9-10 to a 7.

He was transferred to UIHC Emergency, leaving St. Luke's via ambulance, and got there around 9:20 - 9:30. I followed a little later and arrived at 10 a.m.

The UIHC staff  drew more blood, put an NG tube down his nose, did another x-ray of his tummy and took a urine culture. The NG tube was to remove air from his tummy which was causing it to be distended. Jimmy thought the problem was a result of what he was or was not eating, but Dr. Nick Yerkes (one of the doctors we saw on his previous 10-day stay) said not so. He wasn't eating anything wrong. He said the blocked bowel is a result of scaring from the surgery and anesthesia.

Dr. Yerkes said surgery was a possibility, but didn't think surgery was necessary at present. Jim is to stay in the hospital at least a couple of days to rest the bowels and hopefully it will resolve itself.

No food or drink or crushed meds to be given by mouth or through the J-tube. His meds all come through the IV, so the meds he has been taking since coming home that had to be crushed and given through his J-tube he won't be getting for now - that includes calcium, proscar, coumadin, melatonin and pravastatin. Of the four liquid meds given through the J-tube, only liquid benedryl is available through the IV, and that one he will be given at bedtime as a sleep-aid and allergy relief.

When I left the hospital at 5 p.m., results of the urine culture were still not available. The culture will give us more information on the urinary tract infection and with what antibiotics to treat it.

Jim called at 7:10 p.m. He was just given an enema - fun, fun - to get his bowels moving. Not working very well. Next step is a suppository.

Side Notes:

• Free parking today -- since Jim was transferred from St. Luke's to UIHC Emergency, that is where I drove to, and there is no charge for emergency parking. Yeah! 
• Jim had a bladder scan at 4 p.m., showing 400 ccs, but two attempts at catheterizing didn't work until Jim and I tightly held hands.... interesting... God gave us together the power to produce a flow. 
• Jim commented that his room (for 2) is hardly big enough to turn around in.
• When he and I want to be silly, we talk about dancing ... a real slow dance, standing in place. Of all things, there's a picture in the room called "The Singing Butler" by Jack Vettriano and a man and woman are dancing. How fitting. 

Room and Phone numbers: 

• Jim is back on 4th floor, Roy Carver, East Unit, Room 105, 1st bed
• Phone number is (319) 353-9193