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 28

I woke at 6 this morning. Jim called at 7 - he had an x-ray of his abdomen at 5:30, which still shows some blockage. The doctor will compare today's x-ray  with yesterday's and go from there.

I called Kenway Service and Drain Cleaning at 8 and they will squeeze me in to check out our sewer issue.

From one blockage to another blockage.

Plumber just called - 8:15 ... they're coming now! Thank you Lord!

8:50 a.m. - the line is open! Just everyday stuff clogged in the drain. And the price was reasonable! Now to turn on the air and get some bleach to get rid of the smell.

Thank you so much Don and Carol, Lorraine and Bob and so many more.

I didn't get up to see Jim until 2 this afternoon. Dr. Yerkes never came back after this morning's visit - believe he was in surgery most of the day. The only order that came in was to re-insert the foley catheter. He apparently hasn't been able to void on his own since Monday morning and I guess it was decided might as well put the foley in rather than doing a straight cath.

Bile has stopped coming out of the NG tube, his stomach doesn't cramp as much, he doesn't need the anti-nausea or pain medicine as often. It looks like things are improving, but .... he will more than likely have another x-ray tomorrow of his abdomen.

I am working tomorrow, so won't get up to see him until closer to 7 p.m. I will try to update when we visit via phone.

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

Recovery At Home - Day 25

Today was quiet for Jim, busy for me.

He had 2 teaspoons of cream of wheat this morning and later a tiny glass of apple juice. Sometime between the two, his stomach started hurting, but it didn't seem to be bothersome for him. Since we were getting groceries later today, I suggested maybe some warm 7-Up or ginger ale would be good, and he agreed.

He had pain meds at 3 p.m.

By the time I finished work at nearly 7 p.m.!, he had 2-3 teaspoons of cream of chicken soup, and after we finished grocery shopping at Fareway, where he got his walking in for the day, he decided to have some ice cream.

It's now 8 p.m. We're going to watch a movie.

Well, the ice cream seems to play havoc with his tummy, so he may not be having it so much. Perhaps it is too sweet for now and can try it again later as his tummy gets used to having real food.

Recovery At Home - Day 24

Friday. It seemed like Saturday all day long. I had errands to do before I could start Gazette work, so I got up earlier to do all the usual things. The errands included filling a prescription for pain meds and getting melatonin that was crushable. We bought melatonin the other day, but neither one of us realized they were geltabs until last night. Ugh! As for the liquid pain medicine, CVS Pharmacy on Center Point Road NE didn't have anywhere enough, so I asked them to track down someplace close that did. CVS on Mount Vernon Road had almost the correct amount, so I drove across town to have them fill the prescription. On the way, I discovered 19th Street was pretty much closed.

Today Jim could start eating/drinking all liquids, so he had 4 teaspoons of cream of wheat, a tiny glass of apple juice, 2-3 teaspoons cream of chicken and 2 teaspoons ice cream.

He got his evening walk in when Christina and Austin were over for supper and we all went to Walmart to check out baby things.

Recovery At Home - Day 23

Little by little Jim is getting stronger. However, as long as there are stitches in the area around his J-tube, he will have discomfort, because the stitches pull. I could see how the stitches pull against the skin this morning, when I changed his dressing. So until he gets the J-tube out, I guess he'll have to deal with the irritation as best he can.

and now for my venting ...
This afternoon someone from the doctor's office called - I say someone, because she didn't give me her name. Jim's doctor is on vacation this week, and apparently his nurses as well, so someone else called from the general office.  She asked for Jim, because you know, Jim is the one who gives himself the medicine, crushes it, the whole nine yards. She didn't tell us what his INR reading was after blood was drawn earlier today. She just rushed through saying this is how much Coumadin he'll take Monday, Wednesday, Friday, and something else Tuesday, Thursday, Saturday, Sunday. What happened to slow down and speak calmly?! And then I asked her about an appointment for Jim, because on the discharge information it said within a month he should see his primary care physician. And she says, what discharge ... oh, you mean from the hospital?   Really!?

It's nice that Jim appreciates me .. he's always saying I go above and beyond... I don't know that I do, but as long as he thinks so, I can muddle through the mess of talking to medical personnel who lack commonsense and understanding.

We took a walk after work ... us and the bugs that is. It was a bit longer than the day before,  a full block plus some.

Tomorrow Christina and Austin are coming over, bringing supper... and for dessert, we can have vanilla ice cream, because Jim can eat that!

Tuesday afternoon Jim had a chest x-ray, but we haven't heard results of it yet.

Our frustration continued into the night between Jim and I and the syringes ... we struggled with getting the meds to flow down the tube - they wanted to spurt out instead of in, so about the same time we decided to use the anti-clogging gizmo, we also prayed, and then of course, it worked. We should pray everytime we flush with water and put in meds ... at least twice a day just for this little activity..   

Recovery At Home - Day 22

Jim had apple juice this morning. Has not had any pain meds yet today .. not since 9:50 last night. Nearly 12 hours. He is trying to wean himself off them. Still very tired.

Jim slept most of the day. He didn't take any pain meds until 7:50 p.m. and that was because the J-tube was bothering him. He had jello for lunch and chicken broth for supper. He's not eating very much because the tube feedings keep him full. After supper, we drove to Barnes and Noble and HyVee and got some walking in. Also bought a package of small ice cream cups, which Jim can have beginning Friday.  Yum, yum.

Timeline

Summer 2014 _____complained of digestive issues (again)

October 7, 2014 ___ Endoscopy scheduled with Dr. Weinman at St. Luke's Hospital, Cedar Rapids. Tissue sample sent to lab at University of Iowa Hospitals & Clinics, Iowa City.

October 21, 2014____Results of tissue sample showed high grade dysplasia related to Barrett's Esophagus. Jim's local doctor mistakenly told us he had cancer.

October 27, 2014___Met with UIHC gastroenterologist specialist, Dr. Henning Gerke, re: endoscopy procedures; indicated there was no cancer, just a greater chance for it to develop

November 18, 2014___Endoscopy with ablation (tissue burning)

February 16, 2015___Endoscopy with tissue cut (tissue sample sent to lab)

February 19, 2015____Received call from Dr. Gerke - Jim has esophageal cancer

March 3, 2015___ PET/CT Scan  ... results show cancer has not spread to lymph nodes. Met his surgeon, Dr. Kalpay Parekh (pronounced Pare-ek), and nurse Joan

March 15, 2015 ___Jim provided pulpit supply at Wilton Baptist Church in Wilton, Iowa ...  Message: "Our God is Able," from 2 Timothy 1:12

March 31, 2015___Endoscopic ultrasound ... results appear to show no tumors  present in area of esophagus

April 1, 2015___Surgery date scheduled for May 5

April 22, 2015____Pre-Op ... lab work, chest and neck x-rays, answers to questions

April 30, 2015____Complained of right jaw pain

May 3, 2015______Jim provived pulpit supply at Fairview Baptist Church near Anamosa.

May 4, 2015_____Dental x-ray reveals major infection; Jim needs root canal,  which was scheduled for 3 p.m. that day; Cancer surgery was rescheduled for May 12

May 5, 2015__Original date for surgery

May 11, 2015____Colonoscopy prep, surgical shower

May 12, 2015_____New date for surgery, 8:15 a.m. ... 6-hour procedure followed by 2 1/2 hours in recovery. NO CHEMO /NO RADIATION / NO MORE CANCER

May 14, 2015____Acquired Afib, a complication of the surgery

May 15, 2015____Moved into a new room, one with a view; started J-tube feedings; tentative release date Sunday, May 17

May 18, 2015_____Final pathology report indicates no cancer; swallow study shows no leakage

May 19, 2015_____Chest tube removed; appears more positive Jim will be released May 20

May 20, 2015 _____Was not released. Bubbles found around lungs; pigtail drain put in; started on Coumadin, a blood thinner. Doctors said Friday would be earliest Jim might go home and suggested we not travel outside the state

May 21, 2015_____Tube with a "whoopie cushion" in it is attached to pigtail drain. Jim was released from the hospital today ... we left at 6:33 p.m., got home at 7:15 and met home health nurse at 7:30 p.m.

May 24, 2015______Attended morning services at Immanuel Baptist Church.

May 26, 2015 ______Complained of left jaw pain

May 27, 2015______Called dentist - 2:40 appointment rescheduled to noon showed lower left molar was internally dying and needed to be pulled

May 28, 2015______Called Morgan & Morio Oral Surgeons ... consultation scheduled for June 16; 11 a.m. appointment at UIHC ... pigtail drain removed as well as sutures, had EKG and chest x-ray, looked at J-tube area and how to bring Jim relief

May 31, 2015________Attended morning services at Immanuel Baptist Church.

June 1, 2015______Visitied UIHC without appointment due to extreme discomfort of J-tube. Nurse Joan snipped one of the four stitches holding the J-tube in place - and replaced the duoderm tape with gauze and paper tape. Feels much better.

June 2, 2015______Grape Juice test - Jim drank a full glass of 9 teaspoons over the course of 20 minutes to test see the neck incision was holding. There was no leakage. On to clear liquids. Had lime Jello and apple juice today. Complained again of left jaw pain - called Morgan & Morio and rescheduled consultation from June 16 to June 9; had chest x-ray at St. Luke's Hospital, Cedar Rapids, per orders from UIHC

June 7, 2015 _____ Jim awoke with intense tummy pain; I got up at 3:20, called on-call thoracic fellow at UIHC, went to St. Luke's ER for x-ray of abdomen. Transfered via ambulance to UIHC by 9 a.m., and later admitted. Left messages with dental offices to cancel upcoming visits.

 June 8, 2015_____10:30 a.m., Permanent filling on tooth repaired by root canal with Dr. John McGrane - CANCELLED, to reschedule

June 9, 2015 _____9:15 a.m., Consultation with Morgan & Morio Oral Surgeons re: removal of lower left molar - CANCELLED, to reschedule

June 10, 2015 _____ Ordered new left contact with Klauer Optical as Jim lost it somewhere in his hospital room's bathroom

June 15, 2015_____2:45 p.m., Appointment with primary care physican, Dr. Todd Butler - CANCELLED, to reschedule

June 17, 2015____ 7:50 p.m., Arrived home after 10-day stay at UIHC for bowel obstruction

June 18, 2015____ Picked up left contact ordered with Klauer Optical

June 22, 2015____8:30 a.m., Appointment scheduled with Dr. WeiWei Li, PCI Cardiology, Cedar Rapids, per orders of Dr. Parekh. Includes EKG

June 22, 2015 ____11 a.m., Appointment Rescheduled with primary care physician, Dr. Todd Butler

June 29, 2015____ 11 a.m., Permanent filling on tooth repaired by root canal Rescheduled with Dr. John McGrane. Includes cleaning

July 1, 2015_____2:30 p.m., 4-week clinic visit with Dr. Parekh

July 7, 2015 _____ 2 p.m., Pulmonary Function test @ St. Luke's Hospital

July 9, 2015 _____ Appointment re-scheduled from July 14 with Dr. Logan Hoxie, PCI Urology

July 13, 2015 ____ 11:30 a.m. to 1:30 p.m., Part I of nuclear stress test @ PCI Cardiology
July 14, 2015 ____ 10:30 a.m. to 12:30 p.m., Part II of nuclear stress test @ PCI Cardiology
July 16, 2015_____Dr. Li's office called, saying stress test results were abnormal

July 21, 2015______1 p.m., Colonoscopy with Dr. Henning Gerke scheduled at UIHC per orders of  Dr. Parekh - CANCELLED; Rescheduled for Oct. 27

July 23, 2015_____10:30 a.m., Cardiac Catherization / Coronary Angiogram @ St. Luke's Hospital with Dr. Hajj. To check for blockage - if warranted, will put in stent. NO BLOCKAGE. Praise the Lord!

August 3, 2015 ____ 9:45 a.m., Follow-Up Appointment with primary care physician, Dr. Todd Butler

August 4, 2015 ____12:45 p.m., Consultation Appointment re-scheduled from June 9 with Morgan & Morio Oral Surgeons re: removal of lower left molar

August 27, 2015 ____9:20 p.m., Appointment follow-up with Dr. Li @ PCI Cardiology following heart catherization July 23

August 31, 2015 ____2:30 p.m., Appointment with Dr. Morio @ Morgan & Morio Oral Surgeons to remove lower left molar

October 5, 2015 ____11:30 a.m., Appointment with Dr. Butler

October 27, 2015 ____ 10:30 a.m. (check-in), Colonoscopy Appointment re-scheduled from July 21 with Dr. Henning Gerke @ UIHC per orders of Dr. Parekh.

November 2, 2015 ____ 9:30 a.m., Dental Appointment with Dr. McGrane

December 23, 2015 ____ 10 a.m., ReClast!/ Dr. Michael Brooks @ PCI Rheumatology

Recovery At Home - Day 21

Jim had pain meds at 4:10 this morning and was back to feeling hot and clammy, hence the ceiling fan was turned on and windows opened. We got up for the day around 7.

Today is the first day of drinking clear liquids. First he did the grape juice test - I gave him a full glass of it -- all of 9 teaspoonsful, which he drank over the course of 20 minutes. If there was leakage, we were to call UIHC immediately, but alas, there wasn't/there is no leakage, so he can move on to clear liquids as tolerated.  Five to six meals a day - that's like every 2 to 3 hours he can have a little bit -- broth, popsicles, apple juice, jello, etc.

He will stay on a clear liquid diet through June 4 and if everything continues well, on June 5, he can start all liquids.

 At noon, I gave him a little lime jello in a bunny mold and he's ate half of it. Going good ... just still tired.

Since he has less post-surgery pain, now the jaw pain has resurfaced. I called Morgan & Morio Oral Surgeons to see if Jim could get in earlier for consultation and managed to move appointment up a week, from June 16 to June 9.

Jim's sister, Dianne, came for an afternoon visit, and since I had the afternoon off work, we went out for lunch at Zio Johno's -- all 3 of us, except Jim didn't have anything to eat. Food was tasty - Dianne and I were hungry. Then we stopped at the credit union to make a deposit - Dianne needed something sweet, so Jim got her a sucker... LOL. Then on to St. Luke's for Jim's chest x-ray to see if the air outside the lungs has resolved itself, and lastly, we came home. Not an exciting afternoon, but we got lots of visiting done inbetween all the activity.

It's after 5 p.m. now and Jim is having a tiny glass of apple juice. A little bit later we plan to take a walk up or down the street.