WATER and Button downs

Banner Thunderbird must be in competition with other hospitals for the most fashionable doctors of the year award. The thing of it is, Dad has a healthy appreciation for fashionable button down dress shirts – especially brands you cant find readily or ones that are custom made, just like – you guessed it – the ones these doctors tend to wear.  He can be mid sentence and all of a sudden, “did you see that red shirt with the rolled cuffs?  Dr so-and-so said he gets them from xyz store…”  This morning as Dad was starting to regain consciousness, but still had the ET tube in place, he was trying to get me to understand something.  He kept pointing at me, then himself, then as I got closer he was specifically pinching my shirt. I had seen a Dr strolling around with a fancy shirt on earlier and thought I had started to see where this game of charades was going. Dad tried to write in the air with his finger and was getting more urgent about it. I brought pen and paper to see if that would help us out. Big bold letters:  W-A-T-E-R.  “Water?”  Yes, he nodded his head. “What do shirts have to do with water?” I asked. He scowled his face and shook his head No, then pointed to his mouth.  Oh. Dad’s thirsty. I’m an idiot… 

Fortunately, Dad has since been extubated and can now simply ask for the things he needs 😉  That process went smoothly. They check blood gasses and pressures associated with him taking deep breaths and exhaling forcefully. They were all satisfied with his strength and literally just deflated the cuff then pulled the tube out while he was conscious. Dad gagged a little then coughed up some phlegm and that was that. 

The surgeon is pleased with the outcome of his work and explained that once he could see Dads lung, he could tell that the infection had spread extensively from the upper lobe to the middle lobe. These sit sort of adjacent with the upper lobe hanging over and in front of the middle lobe in such a way that the CT was deceptive in suggesting only one lobe initially needed removing.  That being said, the surgeon is confident he took out all of the infection and from a standpoint of lung health, Dad is as good as he is going to get. Since the lung tissue was dead and useless, Dad wont even notice a difference. In fact, it may be easier now without the weight of the dead tissue compressing what was left of the good tissue.

Blood cultures finally came back and revealed a fungal infection had indeed spread to his blood. This was expected as they found yeast in the blood yesterday which is apparently indicative of fungus. Fortunately they recently changed his antifungal medication to one more appropriate for this, just in case. They are redoing some lines and placed a clean port needle. They will continue to watch the blood for changes and improvement. Should we need to switch medications again, we may be looking at Amphotericin B, which means literally nothing to all of us except that the doctor was concerned about the side effects and how hard it may be for Dad to tolerate. As with the surgery, we will embrace what we must to take another step forward.

Speaking of taking steps forward, Dad took several – literally! Less than 24 hours after having most of his right lung removed, Dad was standing and walking! Talk about being a go-getter! I have to admit, it looked uncomfortable at best. His Nurse is fantastic and very encouraging / borderline forceful, which happens to be perfect right now.  As he sat in his chair, he ate some soft foods and watched football. The doctor ordered speech therapy to work with dad on proper swallowing mechanics over the next few days with the goal of moving to a full diet and discontinuing TPN if his caloric intake supports it. 

It appears as though Dad will remain in ICU for a couple days until he is completely off certain medications. The upside is fantastic care. The downside is that I need a hall pass to go get food or use the restroom…  Bed sores are still trying to heal. These ICU beds have an auto rotate feature that rolls him from one side to the other and will help with the bed sores. The doctors are weaning him off medicines that keeps his blood pressure up. Dad is being encouraged to work on coughing forcefully. The structure and function of his respiratory system is in a period of critical change and adaptation. And that about sums up any noteworthy miscelaneous items. 
Hope and Love,

Richard