July 12, 2009

Email exchange...

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-------Original Message-------
On Fri, Jul 10, 2009 at 11:13 AM, Dr. Lisa Earle wrote:

Just read your latest entry on the blog, my heart goes out,I know exactly how P. Feels, pain wise and otherwise.
You said you expressed yourself (at that Mexican restaurant) how tired YOU are of it -when sickness comes into our life, we all feel that way, Darling. I have been through it many times myself, through Simon, through Susie, my own Cancer surgery and now the Heart sugery...I believe, so many of us go through our own personal holocaust...Life is very tough so often- philosophically there must be a reason for it...At that Mexican restaurant, to WHOM did you "express " yourself thus? I just wonder...

Hang in there, Darling, no matter what, Life still has wonderful moments and IS good!(Ann Frank).

I love you, MOM




-------Original Message-------
From: Dave Ruden
Date: 7/10/2009 3:32:31 PM
To: Dr. Lisa Earle; dave.ruden@gmail.com
Subject: Re: I understand...

Hi Mom,
It was at dinner with Pam. That's what made it so cathartic. I can express this with friends and family, but it's not quite the same as doing so with her as it's about she and I. Was a small short conversation on that aspect, but meaningful.
Done with the worst of this last round now. Only one more infusion to go!
Love you.
---Dave.




-------Original Message-------
From: Dave Ruden
Date: 7/10/2009 4:04:09 PM
To: Dr. Lisa Earle
Subject: Re: I understand...

She teared up a bit cause she knows I'm almost as tired of it as she is. But it was a good reaction, not one of those that says "I take offense". Pretty well balanced gal! That's why I felt comfortable saying so, and why it was such a quality moment. It was about comisserating, not feeling at fault.

Sorry to hear you feels so tired. Julie tells me that the fibrilation not happening anymore.
How goes the physical-therapy?
---D.





-------Original Message-------
On Fri, Jul 10, 2009 at 3:59 PM, Dr. Lisa Earle wrote:

How did she react, when you expressed your feelings in that fashion?(.Only if you want to share it, but I just wonder)....
My day today is rather flat myself, hard to describe, Doc gave me new Med, I guess, to make the newly fashioned heart slow down (Pulse averages 111 beats a minute, shouldn't be over 80 or 90...I am so tired.)

Rough days for all of us, I am afraid...Wish my message would be more uplifting, but...
No matter what, I love you lots, stay strong and take care of yourself!

Love, MOM




-------Original Message-------
From: Dave Ruden
Date: 7/10/2009 4:04:09 PM
To: Dr. Lisa Earle
Subject: Re: I understand...

She teared up a bit cause she knows I'm almost as tired of it as she is. But it was a good reaction, not one of those that says "I take offense". Pretty well balanced gal! That's why I felt comfortable saying so, and why it was such a quality moment. It was about comisserating, not feeling at fault.

Sorry to hear you feels so tired. Julie tells me that the fibrilation not happening anymore.
How goes the physical-therapy?
---D.





-------Original Message-------
On Fri, Jul 10, 2009 at 4:27 PM, Dr. Lisa Earle wrote:

Therapy is helpful. Fibrillation(to me is questionable - why does the pulse stay at 111 and more, I wonder...Doc gave me"Digoxin( also known as Digitalis to slow it down, I guess, but now I have no appetite, which slowly had come back...

Well, I shouldn't burden you with this, forgive my bitching, you have enough on your plate!
You DO have a lot of inner strength throughout this bittersweet experience, DAvid, God bless you!

LOL, MOM

Jul 9, 2009

On Thu, Jul 9, 2009 at 5:13 PM, Dr. Lisa Earle wrote:

Sharing...

-------Original Message-------
From: Steve Hirschhorn
Date: 7/9/2009 3:07:34 PM
To: Dr. Lisa Earle
Subject: Re: Fw: Update

Dearest Lisa
we're thinking of you all the time and wishing you to be well as soon as possible. we think you've done wonderfully so far and are willing you to get better and better..

love from both of us to you and Julie
s&a


-------Original Message-------
2009/7/9 Dr. Lisa Earle

My dear, caring friends and Cousins, who seem to want to know...

"They" say, I am doing better, day by day -I still feel congested and we will see the cardiologist today -hopefully, he may be able to help me a little -I don't expect wonders :(((

I am telling myself, that the new addition -the new valve - for my heart, is trying to get used to its new position...therefore the occasional pain, the fatigue, lack of energy, "heavy" leg movements, rough nights and sleeping problems etc.

However, I am still among the living and enjoying my wonderful family (you loving, caring guys) -it seems, this was not my time to join the angels... As Jim always said, you won't go until your time comes...As it must come for everyone, sooner or later, I guess...Let go and let God...

I am trying to be patient, patient, patient -it is sooo difficult for me...My great daughter, Julie, helps me to uplift my spirits -she is so positive and wonderful!!!

I love you all,
Lisa

Jul 9, 2009

On Thu, Jul 9, 2009 at 5:09 PM, Dr. Lisa Earle wrote:


-------Original Message-------
From: Irene L Clark
Date: 7/9/2009 2:38:26 PM
To: Dr. Lisa Earle
Subject: Being a patient patient

Dear Aunt Lisl:

I well understand your impatience with not feeling perfectly well and would react
that way myself. But we impatient patients must learn to be patient patients--
somehow!

Remember that when someone undergoes a procedure, the recovery usually
requires six weeks, at least. Bill has a very painful shoulder for which he finally
went to the doctor and learned that he has either tendonitis or a small tear in the
rotator cuff. To get back motion and reduce the pain, he has been going to a
physical therapist, has to do painful exercises,ice the shoulder twice a day, and he
was told that recovery will take SIX MONTHS TO A YEAR!

Needless to say, he is not happy about this and growls through his exercises with
great irritation..

Please keep up your spirits! We are all plugging for you!

Love,

Irene
.

Jul 9, 2009

On Thu, Jul 9, 2009 at 9:52 AM, Dr. Lisa Earle wrote:

Dear David,

I finally managed to get into your blog pages - I am getting the complete picture now (practically a nightmare) about my surgery and what you two had to go through emotionally too...

"They" say, I am doing better, day by day -I still feel congested and we will see the cardiologist today -hopefully, he may be able to help me a little -I don't expect wonders :(((

I am telling myself, that the new addition -the new valve - for my heart, is trying to get used to its new position...therefore the occasional pain, the fatigue, lack of energy, "heavy" leg movements, rough nights and sleeping problems etc. However, I am still among the living and enjoying my wonderful family (you loving, caring guys) -it seems, this was not my time to join the angels...! As Jim always said, you won't go until your time comes...

I am trying to be patient, patient, patient -it is sooo difficult for me...

2009 has been a very bad year for us and hopefully, will get better, slowly, but surely, concerning your situation, Pam's and mine -I will pray for this!!!

BTW, hope you received the requested check -do NOT cash till Monday and then, try to negotiate those totally unreasonable, undeserved fees- Simon would offer half!!! -Cash TALKS!!! Do NOT be timid about it, my dear, dear Son!

I love you all soooo much!

Hugs and Kisses, MOM

Saturday June 20

Ariane and Walter send an email to Julie and me to say hi during this time.
I answered a bit in German, followed by explanation of Mom's status in English...

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---------- Forwarded message ----------
From: Dave Ruden
Date: Sat, Jun 20, 2009 at 12:08 PM
Subject: Re:
To: Walter & Ariane Roy


Hallo meine lieblich Familie,
Danke fuer deine Email. Ich bin derzeit mit neue Arbeit und Kuemmern-nehmen(?) fuer meine Freudin, sehr beschaeftigt. Ich habe zu wenig Zeit meine deutsch zu ueben. Julie ist jetzt zurueck von Hotel. Ich schlief gut gestern, und folglisch kann ich Heute wenig Arbeit tun.

Also, nur eine kleine Brief auf deutsch "Hallo" zu sagen.
Bitte, kanst du mir die Email-addresse fuer Horst und/oder Florian schicken. Ich moechte gelegentlich ihnen schreiben. Ich hoffe dass Florian ganz-geheilt wird!

Als die bestimmten Daten ueber Mom's Bedingung kompliziert ist, ich beschreibe es fuer Euch auf englisch...
Chuess!
---Dave.

---------
Mom's doing really well. She slept through the night with only a couple short exceptions. As I've been taking the 'night-shift' while she's in ICU, I'm much better rested this morning than I was yesterday :).

Starting to get some of the IV's and probes out today. She sat up in the chair yesterday for more than an hour. Complaint about pain is much reduced. Complaint about difficulty breathing has subsided as well this morning. Eating easily. Still pretty sleepy, but when she's awake she is very awake. Also her feet, which almost always feel cool, feel luke-warm - and that's not wearing socks! Still in Atrial-Fibrillation (mostly in the 70 to 100 bpm range), yet they are less concerned about that, given that it is not in a life-threatening status - blood pressure is still good, and she doesn't feel badly from it. Still, they're likely to prescribe some kind of anti-fib medication for it. I really hope we get her moved to private room today. Would hate to leave tomorrow while she's still in ICU. Dr just came in and said he'll keep her in ICU for another day. Going slow to be cautious. So it's not today but she's real close to getting out of ICU.

Doctor also said that she's got a bit of fluid in her right lung ("odd cause they didn't do anything there"). They're watching it, getting up and down - being a bit more active - might very well help clear that up. If not, they'll aspirate it maybe tomorrow. Mom hears about fluid in her lung and she starts thinking fatalistic again. I was in for my collapsed lung operation 25 years ago, and similarly had fluid in my lung and a chest-drain tube for a good handful of days afterwards. So fluid is not what we want, but it isn't the sign of the beginning of the end like she can sometimes be looking for. I relay my experience to her, and she asks the nurse and doctor about it. Everybody is telling it straight, and they're saying that it's related to having such surgery and being in bed for several days, and it should clear up on its own. And if it doesn't the aspiration will take care of it. So after chewing on this for an hour or so, she starts to feel more up beat.

She also finally had a bowel movement, on her own, this morning. That's really good. Unfortunately, the exertion subsequently had her feeling very fatigued. That coupled with thinkng again about the doctor's note of fluid in her lung started her thinking fatalisticly again. So we keep reminding her that it is part of the process. Julie is good at forcing her to stop talking in fatalistic terms. I'm good at giving he time to express herself, ask questions and giving her answers at a technical level that she appreciates - she is into "explanations". Also, I can give her insight that comes from my own very similar chest-operation experience.

So she's back in bed now and resting. In a couple hours or so, she'll get her energy back and be more cheery.

Love to all.

ICU recovery

We went in to see Mom Wednesday early evening. She was sedated and not awake. The nurse said she'd be that way until morning. So given that there was also no place in the ICU room for another person to stay overnight with her, we went to the hotel for some much needed rest. We walked around the grounds, and then sat outside the restaurant again for dinner.

Before turned in at Midnight, Julie called the hospital to check on Mom's status. The nurse said she let her come out of sleep briefly to check on her mental state - do you know who you are, where you are, what's going on. The nurse said she was cogent enough to respond by hand squeezes.

Julie planned to be at the hospital by 7am Thursday. I pretty much knew that wasn't going to happen. Too much sleep needed to wake that early, and too much to do getting dressed and checked out. We finally made it to the hospital at 10am. Mom was no longer intubated (breathing tube was removed), and she was fully awake and communicative, albeit in small amounts.

She was in significant pain, and getting jolts of morphine to help. It only dulls the pain down, but it's good enough for a little while. She was also talking fatalistic, saying "she shouldn't have done it", it was too painful, too much trouble. Julie tried to help by pointing out why she'd done this, what the decision process was, how she was getting better. It wasn't very helpful. Julie doesn't understand, or more than this, when it comes to Mom, she can not back away from pushing for optimistic attitude.

At this moment, Mom needs to be able to express the pain, be acknowledged and validated, and that's all. No offering of solutions or positive argument/reasoning.

Also, when Mom needed some help with something, like shifting her posture, or adjusting the bed or pillows, she speaks slowly with breaths inbetween her words. Julie is so focused on immediately helping that she tries to finish her sentances for her, and then do the adjustment she finishes - without waiting to hear confirmation or correction. It was frustrating to Mom because Julie was often wrong. It was frustrating to me to sit there and witness cause I knew Julie was wrong and overly eager. I also knew that my jumping in and trying to resolve the aggitation would result in even more aggitation.

So eventually, Julie went out for a smoke break while I remained behind. We decided not to leave her alone, and she asked us to be sure to have one of us there as she found it difficult to get the staff's attention sometimes.

While Julie was out, I listened to Mom and gave her that simple, pure validation of discomfort and pain. It really helped. I was also able to 'relate' real well to her discomfort by reminding her that I had gone through very similar pain when I had my operation in '82. She appreciated that.

Julie arranged for another hotel a little further away, but half the price of the nearby one. Later, she went down for dinner, and after her, I went. While there, I spoke to Lenny and to Pam. My conversation wtih Pam was nice and long. It was well past 9pm by the time I finished. I had sat outside for dinner, and it turns out they lock the doors at 9pm so I and 3 other people were locked out. We managed to waive down someone inside to unlock it for us and I headed up to ICU again.

I took the night shift at ICU, and Julie went to the hotel for the night. I was awake until around 3am, and Mom was up and down until then as welll. Then she fell asleep until 6:30am or so.

Heart-Valve Replacement Surgery

Mom went in for the valve replacement surgery this morning. They went back and forth on what time frame it would be, from 10am to 1pm, to 10am again to 1pm again. Finally, they came at just after 10am.

Julie and I went with her to the pre-op prep room. There we consulted with the anesthesiologist. Shortly after that, he began his work getting her ready. Julie and I gave hugs and kisses, and 'checked into' the waiting room. Then we went to drop off into the car-trunk all the 'stuff' we had from the hospital room. Whew, now we were a less encumbered and could walk more freely.

Julie was very tired, and very much wanted a bath. The night before was difficult because of the errors the nurse-staff kept making, so Julie was pretty frazzled. Still, she said she just couldn't leave the hospital while Mom was in surgery. So we stopped of for lunch in the cafeteria, and then settled into the waiting room.

Tea, coffee, smoke break, computer working; tea, coffee, smoke break, computer working... Over and over again. At around 2:30ish, someone called us on the phone at the front desk to tell us that they were proceding to put the valve into place.

Tea, coffee, smoke break, computer working; tea, coffee, smoke break, computer working... Finally at around 3:30pm, Dr Guyton came out to update us on the progress. Mom was finished with the surgery, it went well, and they were 'closing up'. They said that due to her age, they had to be extra careful with the closing.

At 4pm, Dr. Thourani came out to discuss the same stuff with us. Surgery went well. There is slight leakage around the new valve, but that's to be expected - probably permanent. The flow through the valve is way better than it was before. They decided not to use the groin aortic artery for catheter observation, and instead went in through an artery in the upper right shoulder. In closing their heart incision, they removed a small portion of one of the ribs in order to have access for the closure. The rest of closure continued and should be done soon.

At 4:30pm, the pager went off, and I took the call at the front desk. Mom was all done with surgery and in the ICU on the 4th floor. Julie was out on a smoke break, so I waited until she returned, and then we moved up there to wait another hour or so for her to get comfortable enough and conscious enough to go in and visit with.