Surprise - Nan is in a chair

Dear Friends,

I was surprised to find Nan sitting in a reclining chair this morning. Amy, her main nurse decided it was time that she get a chance to be in the chair so she made it happen. There has been a lot of discussion today about removing the ventilator. Nan has been sitting up in her chair a couple of times for more than an hour each time. However she remains very sleepy and just not alert enough to handle breathing on her own. Her cough reflex may not be strong enough to handle it so the plan now is to wait until tomorrow. When Nan wakes up she lets us know she wants the tube out but she does not stay awake enough to prove to the nurses that she can handle it. Why is she still so sleepy? Creatins and BUN which are both elevated way above normal and causes confusion and sleepiness. The tube needs to come out since it has been 14 days in yet it can't come out until she is more awake and she won't be more awake until the creatins and BUN come down. The nasty circle we are in right now. They will try to remove the ventilator tomorrow if she is more awake.

Roxanna arrived this morning and helped me get the rental car back to the airport, no problems and they lowered the rate to $109 per week from the prior $166 per week. Now I have no wheels to have to park every day or put fuel in. My commute back and forth is 2 blocks and there is every kind of food one could think of except Taco Bell nearby.

Roxanna is massaging her feet and legs right now and Nan seems to like that. Today she is mostly asleep though which is sort of a setback in a way. Our friends Roger and Carol just called and are about an hour out. It will be wonderful to see them again.

Since I first started this blog things have developed. We are even more in a rock and a hard place situation now. Nan is sleeping more and more and its caused by a BUN of 149 now and a creatin of 4.6. These factors keep her very sleepy, to drousy to let them take out the breathing tube. A decision will have to be made shortly about using dialysis again to get the creatins down so she can wake up and get the tube out. Otherwise they may go ahead with the trach.

If there was ever a time to pray for Nan this is it. Once again a time of decision and factors beyond human control. Her kidneys need to kick in soon on their own and start pulling toxins. They are putting out lots of fluid but not pulling the key toxins. We had hoped that a tiny trend down was happening with the drop from 4.6 to 4.5 but this afternoon it is once again 4.6 yet again. Her BUN jumped from 126 to 149 in a 6 hour period and that is a very serious jump. Meanwhile many of her liver numbers are now normal with only one or two being elevated now. That is great news. She is not running a fever, her platelettes are great now, the heart damage that resulted in her heart output at 15 has lessened and now her heart output is 30 which is nothing short of amazing in such a short time. Her lungs have a very heavy mucus that can be hard to suction out and that creates issues with breathing at times.

So to recap Nan has gotten to sit up in a recliner 2 times today for a total of about 2.5 hours. Many factors are better but she remains very sleepy which is caused by the elevated creatin and BUN levels. She has lost most of the extra fluid she was carrying but not all of it. She can be very alert and is aware of those around her. While she is no longer in as critical condition as she was until the kidneys do their thing correctly she remains a very sick woman. She looks good and when she sleeps the number of breaths per minute is good at about 25 and she is getting good air supply as well.

Roger and Carol are approaching so I will blog later.

Please pray for her kidneys. Thanks so much

tim