Saturday, June 28, 2008

Update Still making progress

Tuesday June 23rd: Joy took Barb to the Cardiac rehab assessment. I am told it went fine. They measured her, did fat and body mass calculations and took her blood pressure. Barb says they are very nice and not at all militaristic.
They have sit down (with a back) bicycle machines. They put a monitor on her and had her do some leg and foot exercises. They decided to do two sessions per week (Barb says to cut down on travel). After that they went to Marshalls to do a bit of shopping. Barb could only handle about 20 minutes there.

Wednesday night. We tried sleeping in our bed for the 1st time since surgery. It did not go well. Barb was very uncomfortable and her breathing was shallow. In retrospect, we should have gone back downstairs after the 1st half hour, but stayed the night there.

Thursday Night: We are back to sleeping downstairs on the recliners.

Friday June 27th: Donna took Barb to her 1st regular rehab. Barb says it went well. They tell her it will be four months before she will do any arm based exercises. Toward the end of each session, Barb is supposed to call out "One more minute" then the person monitor wakes up from their nap and actually watches the monitor for the last minute. (Really I don't get what this step is about.). Once Barb stops exercising she waits till they say "OK Barbara, you're cool!". Then she can leave. I guess they are doing their part to avoid un-cool people roaming the streets.

Now, when Barb goes upstairs she typically pauses for a very brief time after three steps. She does not have to sit and rest on the landing any more either.

Friday, June 20, 2008

Not much new

Barb is still making progress and moving about a bit more and a bit faster. She has an appointment on Tuesday for an assement as a first step to start cardiac rehab.

Tuesday, June 17, 2008

Tuesday June 17th

Barb was home alone today. When I got home from work she had squirted chocolate all over the walls. (Just kidding about the chocolate).

She's feeling well enough to start noticing things like I need a haircut.

Monday, June 16, 2008

Update for the last x days

Sorry, I've been a bad blogger. Time keeps on drifting into the future.

Barb keeps getting better. I can see the difference between any two days. Sometimes from one day to the next she feels a little worse, but between any two days it's always better.

Her sister Beverly flew in from Florida last Sunday. Barb & I dropped her at the airport yesterday morning to go home. Bev was a huge help last week. We are extremely grateful and will miss her. Hopefully we can visit again soon under better circumstances.

Tuesday, June 10, 2008

Tuesday June 10th

Barb was feeling low and moving pretty slow this morning.
Dr Hamman looked at the incision and said the little bit of weeping of fluid happens and is nothing to worry about. We discussed the effects of the varios drugs: Furosemide will not make one cough. It is OK to move the timing of drugs around. None of them have to be taken at the same time as others. As in, we can move the Carvedilol and Enalapril to be an hour apart. That way they will not affect her so much. In trying to asses how she is doing, Dr Hamman asked her if she could walk 100 yds (No way). He says as bad off as Barb's heart was (congestive heart failure) prior to surgery it will take her longer than usual to fully recover. He says she should start Cardiac rehab in about one week. We will have to figure out how to get her there and back home three times a week.

On the way West, we came across Stavros (Greek restaurant) on Northwest Highway and had lunch. Barb and Bev had a Greek salad. I went for the heart healthy ( yeah, right) Gyros plate.

This evening, Barb is again feeling better.

Monday, June 9, 2008

Barb's progress since getting home.

Since getting home Barb has progressed rather nicely. She walks up and down the stairs to the second floor for showers. We are both sleeping on the recliner couch in the living room as it slightly elevates so she sleeps better. (Last night she had me lower it as far as it goes which is also progress). Barb has had several good nights sleep and is feeling stronger each day. When we first got home she needed help getting off the couch as it is a bit low to the floor. Now she get up on her own. She still needs help with the putting on / taking off walking socks and her brace plus taking showers.



A little recent history:

Thursday / Friday: Home but exhausted. I picked up one of those plastic lifts for the commode as otherwise it is too low to the floor.



Saturday: Donna, Howard, Angie, Brent and Joy, Rob, Austin visited



Sunday:

We started paying more attention to which meds have affects on how Barb feels:

Hydrocodone makes her a bit tired.
Furosemide seems to stimulate her to cough a bit and of course stimulates the expected trips to the bathroom.
Carvedilol makes her feel like she is floating. Combined with Enalapril... She goes to sleep for at least half an hour.
Lipitor: She does not seem to notice an affect.



Joy picked up Bev at the airport (Bev is staying the week to help Barb) Rob, Brook, Austin, Angie, Brent, John, Casey, Peyton, Jack came for a visit and cooked steaks, fish tacos and made salads. (The kids had frozen pizza). Our next door neighbor Kim brought us wonderfully tasty roast beef and Rosemary baked potatoes. (As you can see there is no risk we will go hungry)

Barb had some issue with constipation over the last 4 days which is no longer an issue.



Today:

We noticed a little (light orange) drainage on Barb's incision. I called the doctors office and left a message. We are timing Barb's meds around their effect on her. She also switched from hydrocodone to Tylenol for the pain med during the day today. Stacy from Dr Hammond's office called back. We will go see him at 10:45am tomorrow. She said it could be the beginning of an infection, but she doubts it. I had planned to go to work tomorrow, but will go with her instead. We started a list of questions for the Dr.



Barb, Bev and I went for a drive to get my car's registration renewed. Then we went to Dairy queen for grilled chicken sandwiches. Barb also directed a driving tour to show Bev some houses and property for sale in the area. Barb is in a great mood and feeling energized. :)

Thursday, June 5, 2008

Drugs

Twice a day:

Carvedilol - 3.125mg is a beta-blocker
Beta-blockers can be used to treat some types of heart disease. Beta-blockers improve the heart's ability to relax, decrease the production of harmful substances produced by the body in response to heart failure and slow the heart rate. Over time, beta-blockers improve the heart's pumping ability.

Enalapril - 2.5mg is an angiotensin converting enzyme (ACE) inhibitor
This drug belongs to a group of medications called ACE inhibitors. It is used to treat high blood pressure (hypertension) in adults and children. It works by relaxing blood vessels, causing them to widen. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.
This medication is also used with other drugs (e.g., "water pills"/diuretics, digoxin) to treat congestive heart failure.
Vitamin C 500mg


Once a day:
Lipitor 40mg Atorvastatin Pronunciation: (a-TOR-va-STAT-in) is used along with a proper diet to help lower "bad" cholesterol and fats (e.g., LDL, triglycerides) and raise "good" cholesterol (HDL) in the blood. It belongs to a group of drugs known as "statins". It works by reducing the amount of cholesterol made by the liver. In general, atorvastatin is prescribed after non-drug treatments have not been fully successful at lowering cholesterol (e.g., diet change, increase in exercise, weight loss if overweight). Lowering "bad" cholesterol and triglycerides and raising "good" cholesterol decreases the risk of heart disease and helps prevent strokes and heart attacks.

FUROSEMIDE 40mg - Pronunciation: (fyou-ROW-seh-mide) Furosemide is a "water pill" (diuretic) that increases the amount of urine you make, which causes your body to get rid of excess water. This drug is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.
This medication also reduces swelling/fluid retention (edema) which can result from conditions such as congestive heart failure, liver disease, or kidney disease. This can help to improve symptoms such as trouble breathing.

Klor-Con M20 POTASSIUM CHLORIDE Pronunciation: (poh-TASS-ee-um KLOR-ide) This medication is a mineral supplement used to prevent or treat low amounts of potassium in the blood. A normal level of potassium in the blood is important so that your cells, nerves, heart, muscles, and kidneys work properly. Normal blood levels of potassium are usually achieved by eating a well-balanced diet. However, certain situations cause your body to lose potassium faster than you can replace it from your diet. These situations include treatment with certain "water pills" (diuretics).

Enteric Coated Aspirin 325mg
This medication is used to reduce fever and relieve minor to moderate pain from conditions such as muscle aches, toothaches, menstrual cramps, and headaches. It may also be used to reduce inflammation and swelling in conditions such as arthritis. Aspirin is known as a salicylate and a nonsteroidal anti-inflammatory drug (NSAID) that works by blocking a certain natural substance in your body to reduce pain and swelling.
Aspirin is also used in low doses, alone or in combination with other medications, as a blood thinner to prevent blood clots after surgery on clogged arteries (e.g., bypass surgery, carotid endarterectomy) and to reduce the risk of stroke or heart attack.
Multivitamin


As needed 4 to 6 hours:

HYDROCODONE / ACETAMINOPHEN 5-500 Pronunciation: (hye-droe-KOE-done/a-SEET-a-MIN-oh-fen)
This combination medication is used to relieve moderate to severe pain. Hydrocodone is a narcotic pain reliever (opiate-type) that acts on certain centers in the brain to give you pain relief. Acetaminophen is a non-narcotic pain reliever.

Thursday Barb is at home

Barb was released from the hospital this afternoon and is at home. We were greeted by Kim our next door neighbor with a hug and freshly planted flowers at the entrance to our house.

I went and picked up the prescriptions ordered for her and she has a follow up appointment with Dr Hamman on Tuesday June 17th.

Earlier today, the Physical Therapy folks worked with Barb and she walked up a flight of stairs and back down.

Joy, Angie, Brent and Rob cleaned the house for us and went shopping for heart healthy food. Angie and Joy said they were quite enlightened by reading all the labels. (They also seemed to enjoy throwing away our old food and had a contest to see who could find the item with the oldest sell by date. (I think I heard Sept 2007)

I need to organize the drugs and vitamins a bit. I'll post what they are later.

Wednesday, June 4, 2008

Tuesday night and Wednesday

Barb had a pretty good night. She slept well and was awaken only at 1AM for a breathing treatment. We started trying to time the requests for pain meds at the 4 hour mark.

Pain Meds = less pain.
Less pain = more able to handle needed coughing to avoid pneumonia.
More able to handle needed coughing = More able to do deep breathing exercises which opens up the lungs, helps avoid shortness of breath and also helps avoid pneumonia.

Dr Hamman stopped by and said she will probably go home tomorrow.

Barb just had another breathing treatment and should be getting breakfast soon. I'll be heading to work shortly.


Wednesday afernoon & night
Joy P dropped Donna off and Donna stayed with Barb all day. Barb says Donna has a talent for patient care. They also had a very nice visit together. Robert came by and visited and was Barb's coach on her afternoon walk. After work and drove Donna home.

Tuesday, June 3, 2008

Tuesday

John and Joy were here at 7AM. Barb is doing OK, but not great. I left for work around 7:30. The plan s for Joy to stay with Barb until Joy DiGiavoni comes in the afternoon. Angie was here after I left. Angie and Joy (P) went with Barb for a lap around the nurses station. After lunch Barb got a breathing treatment which helped a lot. Joy D and Barb did a lap around the nurses station. Barb is really having trouble with her right foot turning out because it is so weak.

One of Dr Hamman's PAs came by (Don't know her name) and answered our list of questions: Results of X-Ray / pertaining to the knot on top of chest incision = OK. Barb can only use her cane for ballance, not to lean on. Breathlessness = breathing treatments and back on a little O2. Neck pain should go away.

They are going to have someone come in the A.M to fit Barb for a brace for her foot.

I got back from work around 5:30 and Joy D headed home around 6. Barb says she really enjoyed her visit with Joy D. Barb had another breathing treatment and did another lap around the nurses station. I went to Walgreens and picked up an ankle brace for Barb to use temporarily. She says it helps a little.

She's sleeping now. I hope she gets a good nights rest, but she is scheduled for another breathing treatment around 2:30 AM.

Monday night

3:30 PM ish: Barb did another lap arond the nurses station. She did not feel whoosy.

Barb was weened off the Oxygen and is no longer using it

7:30PM Barb was feeling a bit "whoosy" this afternon, so the nurse (Kathy) wanted to be careful about her walking. Checked her blood pressure and it was 91 over 66. She wanted to wait an hour and check it again.

8:30PM Kristin checked Barb's blood pressure ... 95 over 65. She and Kathy discussed it. Apparently Kathy said to go ahead and walk with her. They said they would get her walk in as soon as they could.

9:20PM Barb is really getting sleepy and still has not had her third walk of the day. I went down the hall and snagged a cart and tried to talk her into letting me help her walk. Of course Barb does not want to "get in trouble". After some more discussion, I changed tactics. I asked / told Kristin I was going to help Barb myself. She called Kathy and they asked if I had walked with her before. (Yes, I hope following Barb and a nurse around counts). They OK'd it. Barb did another lap and headed for bed.

Maybe around 11:00 Pm? Barb is wide awake and feeling a little short of breath. Kathy checked her stats and they were Ok. She said it might help to get a little Oxygen. She set it to 1. I suggested a sleeping pill and Kathy gave her "Resterall" . Over the next half hour, Barb said she was feeling better and fell sound asleep.

Monday, June 2, 2008

Sunday Night / Monday morning

Barb had a good night sleep.
After breakfast (around 9AM) she did one lap around the nurses station. She was a bit woozy as she had a hydro codone for pain. She was feeling rather anxious which just might be the situation or maybe another effect of the Hydro-codone. We decided that she will just take two Tylenol during the day and hydro codone at night after she goes to bed.

Noon til 2pm : She's feeling stronger than yesterday and is in much better spirits. After lunch the IV nurse removed the Central line in her neck and added a new IV in her right wrist. They have to take the IVs out after three days therefore the one in that was already in her wrist has to come out. She's has to stay in bed for 30 to 45 minutes after getting the Central line removed and is sleeping right now.

Sunday, June 1, 2008

Sat night and Sunday Morning

Saturday night.
Unfortunately the patient in the room adjacent to Barb passed away last night. We do not know the details of his age or prior condition. Dear Lord, please be with his family in their time of loss.

Sunday morning / afternoon.
RN = Jim and PcT = Adrienne.
Barb is feeling stronger today. Her voice sounds stronger too.

Jim worked with Barb and she got up and walked in the hall twice. In between the walks she was given another unit of packed RBCs (transfusion). At some point while Adrianne was in the room the IV for the transfusion came loose and blood was getting all over. Adrianne was trying to reconnect it , but was having trouble. Jim came in & said "What are you doing girls?" . This was apparently quite funny somehow, but I think you had to be there, (Thankfully, I was home taking a shower and doing a few quick chores. )

Barb is pretty tired right now ad I think she will sleep soon.