Tuesday, March 31, 2009

MaryAnn Status 3/31

Well the time has finally come!!  She's coming home tomorrow.  We're not totally sure of the exact time, but it will probably be later morning or early afternoon.  Obviously she's in sufficiently good shape to be home.  I have been working to get things ready.  For local folks we'll be in touch about help needed.

I am going to stop the daily updates unless something significantly changes.

Hopefully MaryAnn will be able to personally do the next update

Sunday, March 29, 2009

MaryAnn Status 3/29

Progress is being made.  Her doctor told her that her white blood cell count was 13000 yesterday - a drop of 2000!  If that trend continues it is good news indeed.  I'm sure the infectious disease doctor will weigh in on Monday.  Our Aaronic Priesthood youth came and gave her the sacrament today.  She certainly appreciated that.  She had another workout from the physical therapist and is making progress there.  Her spirits are great.  She had quite a bit of company today.

Tomorrow should be a day with lots of information and potential decisions.

Saturday, March 28, 2009

MaryAnn Status 3/28

We saw two of her three doctors today.  Her internist is concerned that the antibiotic that she is on is not doing the job they would like, so they will probably switch her to a different one. She still runs a low temperature occasionally.  The orthopedist looked at her shoulder and noted that she is healing well from the surgery and the swelling is less.  She continues to walk and do her right shoulder exercises.  Her movements seem to be definitely improving.  She really enjoys phone calls  so take a few minutes and call.

I am going to stop predicting departure days.  When I get told she is going home tomorrow I'll let everyone know.

Friday, March 27, 2009

MaryAnn Status 3/27

Things went well today.  The doctor came in and removed the drain and talked to us for a while.  Everything still looked good.  He feels that it will just take time for the antibiotics to work. He gave an order for her to start physical therapy and that started today.  She did various motions with her right arm for about 10 minutes, which she was able to do without a lot of pain. That will go on every day.  She also went walking for a while today.  The main thing that seems to be keeping her from being discharged is high white blood cell count.  It is still hanging around 15,000 (less than 10,000 is considered normal).  They want the count to start going down which it hasn't yet.  Right now I think the earliest day she could go home is Tuesday.

Thursday, March 26, 2009

MaryAnn Status 3/26

The surgery happened today, rather late.  She actually got back into her room at about 7:30.  However, she had a great appetite and ate most of her dinner.  I talked with the surgeon a little while ago and he said everything went as expected.  He cleaned out the shoulder and found a small amount of cloudy liquid, but no pus deposits and no evidence of anything that would require orthopedic surgery.  He put in a drain as planned, which he will take out tomorrow.  She will have her arm in a sling for the next few days, but that is somewhat academic as she had very little use of the right arm anyway.  Physical therapy will start in a few days.  As I've said before the IV antibiotics will go on for quite a while and everyone feels that eventually that will fix the joint problems.  I think we're getting close to discharge, but we'll know better tomorrow.

Wednesday, March 25, 2009

MaryAnn Status 3/25

This is what the PICC line looks like.  
Decisions are being made!!  She got a CT scan on her hip today, which did not show anything.  However, finally something is going to be done on the shoulder.  After consultations with some orthopedists in Providence and Boston the medical team decided on a procedure to make an incision in the shoulder and go in to inspect it and clean it and to put in a drain.  If there is anything that indicates that something is seriously wrong she will go somewhere else for surgery.  She will be put under light anesthesia for it, but it's a pretty minor surgery that will provide information to determine how to move forward.  In the best case the procedure itself will make things significantly better.  In the worst case they will know exactly what is going on there and will be able to inform surgeons in either Providence or Boston.  The doctors are hoping the procedure will be done Thursday morning.   Her glucose levels continue to go up and down and probably won't be steady until the infection is totally gone.

MaryAnn Status 3/24

Well we learned a bit more today.  The MRIs came back negative.  So far the culture from her shoulder is negative also, but they will keep that going another day.  She thinks that the joints have improved a little bit.  Tomorrow we're going to start walking the halls a couple times a day.  The joint pain may be the way it will have to be for a while until the antibiotics have finished doing their thing.  Unless the orthopedist comes up with something I think we're going to push for getting home by the end of the week.  Her glucose levels do need to be stabilized a bit more before she can come home.

Tuesday, March 24, 2009

MaryAnn Update 3/23

Today was a tiring day for her.  The orthopedist came in and poked into her shoulder and looked for pus to drain, but found none, but it was still pretty painful.  Later on in the afternoon they did an MRI on both the shoulder and hip which lasted for about 2 hours.  Still through all that she is still cheerful and has a good attitude.  

I have no idea now as to what is going to happen next and when she might be going home.  Obviously the orthopedist needs to look at the MRI results.  He will be looking at the bones to determine if there is infection there.  That probably wouldn't be good.  So we shall hopefully know more tomorrow.

Sunday, March 22, 2009

MaryAnn Update 3/21 and 3/22

Here are the last couple days of news

3/22
Today was another good day.  She really enjoyed getting phone calls.  Elder Wood called which was nice.  We got another bit of medical news today.  The internist stopped by and mentioned that the echo cardiogram that was done on Friday revealed that she has a dilated aorta.  This is one of those "watch items" that can get worse and when it does it becomes an aneurism.  She is on a beta blocker which keeps her blood pressure down and will minimize the danger from this.  This has absolutely nothing to do with the infection or blood sugar, but probably has been present for a long time.  We look at this as a "tender mercy"  that gives us a heads up that we never would have had if she had not been hospitalized.

They will probably be draining pus from her shoulder tomorrow.  if that does not help they may have to do some type of surgery on it.

We expect that the next few days will be full of information and training on what we will need to do when she goes home.

3/21

Today was a big day.  She has moved to a regular room!! She is quite tired because she was sitting up most of the day waiting for a room to open up.  They didn't move her until about 7:15 PM.  She started eating solid food today.  As you might suspect it is a low-carb, low-sugar diet, but she was quite happy to have it.  The surgeon that removed the gallbladder came in and checked her out and removed the drain.  She has had no discomfort or complications from the surgery.  The shoulder and hip are definitely infected.  They are saying that she will have to have IV antibiotics for another 4 weeks, so that obviously means that we will be doing it at home.  The focus over the next few days will be on getting her ready to go home.  They stopped the insulin drip and started with injections.  That will require adjustments to get the right amounts. 

Friday, March 20, 2009

MaryAnn Hospital History

For those that don't know MaryAnn has been in the hospital since Wed. March 18.  Here are the status e-mails that I have been sending to the family:

3/20
She continues to do well.  She has had no problems whatsoever in recovering from the gallbladder surgery, in fact the nurse reported that she slept very soundly last night.  She had her first hospital food today (broth, jello and herb tea), nothing to get excited about, but she wolfed down every bit of it.  Her last real food was on Tuesday.  The doctors were concerned about the heart getting infected so they did an echo cardiogram and that looked good - no hint of infection.  The orthopedist took tissue samples from her shoulder so hopefully they can get to the bottom of what is causing that problem.  She also had a PICC line inserted today.  For the non-medical types this is basically a semi-permanent IV line.  It is easier on MaryAnn and easier on the staff.  No more sticking her to put in yet another IV.

I do want to clarify something about her glucose levels.  They are down to normal levels, but that is because she continues to get an insulin drip.  Until they get the infection eliminated and determine what the pancreas is doing they do not know what type of diabetes she has and what treatment will be required.   They are proceeding one step at a time.  There is a lot that has to happen before she can get home.


3/19
The big item today was that she was operated on to remove her gallbladder.  This was done at about 6:30 tonight.  Earlier today they did a test where they found that the gallbladder was "dead" and was considered a definite possibility of causing the infection.  The operation was successful and I saw her at about 8:30.  She was fairly groggy, but doing well.  The surgeon said the gallbladder was definitely infected.  Her sugar level was down to about 120 so that is good.  She will definitely be in ICU through Friday.  Tomorrow an orthopedist should be taking samples from her shoulder and hip to find out what exactly is going on there.  The "jigsaw puzzle" pieces are coming into place so hopefully by tomorrow we'll have yet more info.  By the way I'm doing fine.  I had a nice dinner at the Mellos tonight and will be eating at the Baileys tomorrow and of course I'm working.

3/18
Some of you have probably heard, but I wanted to send a note out to everybody that Mom/Memere/MaryAnn is in Newport Hospital right now. She has been having severe joint pain for the last few days and today was much worse so after a visit to the doctor it was decided to send her  to the emergency room.  The main finding is very high blood sugar (over 600) along with an infection that they are still looking at.  Right now she is in the ICU and resting comfortably.  They are giving her insulin and antibiotics by IV.  They wanted her in ICU to ensure that they could watch everything very closely.  I'm sure that she will be in the hospital for at least Thursday.  I'll keep everyone informed after I see her tomorrow.