at least not by my dad. Because, you see, he's not coming home. The brain damage from the stroke is too extreme and the cancer is growing so rapidly, that his life expectancy is from four to six weeks.
Bud, Tom and I will meet with the Palliative care nurse in the morning. At that time we will decide our next step.
I will now close this blog, as there is no point in continuing.
Thanks to all of you that care, and have followed along. May God bless you all.
I can't say when you'll hear from me again, but if you want to try me through email, I think it's on my main FB page. If not, well..it's andrewnelson63@centurytel.net.
May God bless you all and thank you for caring.
Love,
Drew
Thursday, October 22, 2009
Wednesday, October 21, 2009
I wish I had the answers...
To open this evening's missive, I'd like to address a question that was posed the other day, and I'll not say by whom, but this individual asked, "Why are you blogging about this? Who the hell's gonna' read it anyway?"
A fair question, I suppose. The answer? Many. There are friends reading these words that have known me since I was six years old. Though I might not have seen or spoken with them in many years, they remain interested in friends and friendship. I thank them for that. Most of them also know Pop from years past.
Beyond that, when one is sitting alone in a quiet house, with no one to talk with, writing (at least for me) is cathartic. I made the choice to not post a bunch of "Dad updates" on Facebook for a reason. I wanted to give people a choice to read about it, or pass on it. Admittedly, I do alert when there's something new and if you so choose to read about it, it's up to you.
So, speaking of something 'new'. Pop had a massive thrombotic stroke last evening. Thrombotic, meaning that it was not a 'bleeder'. Simply put, he had a blood clot that entered the left side of his brain and, it has rendered him non-verbal, paralyzed on his right side and the right lung (the one with the cancer) has been rendered non-functional.
Ergo, it's no longer just about his cancer. It's two-fold now, cancer and a major stroke. The question is how will it, or can it, be treated? That is the $64,000 question. The answer to that question we do not know.
In detail, Pop has cancer. That we've established. Now, in addition, the following factors have come into play;
Thrombotic stroke, which carries the following side effects:
Ataxia-Loss of muscle coordination.
Dysarthria-Speech difficulty. He cannot speak at this time.
Dysphagia- Difficultly swallowing. He's currently on a nasal gastric tube.
Hemeballism-Involuntary muscle twitching. There has been a reduction since last evening.
Nystagmus-Uncontrolled eye movements.
There's also evidence of Miosis and Ptosis which are respectively, an involuntary contraction of the pupil and a drooping eyelid. Both were definite evidence of a problem last evening, whereupon I summoned the ambulance.
(Sorry, I've taken six family /friends phone calls since the end of that paragraph. I started this message at 7:15 if memory serves.)
When the ambulance arrived, Pop was still cognizant and communcative, he even got on the gurney without assistance. Later though, according to the EMT (about a block away from the house) he became unresponsive and they rolled red and siren the rest of the way to BMH-Desoto.
When I arrived at the ER, Pop was thrashing and in the above mentioned conditions for the most part. As of today, there is little change.
What happens next is up to God. If His choice is life, I'm on the front line. If not, well, Pops wishes are well known to me and they will be honored.
God love you all. I know I do.
Drew
A fair question, I suppose. The answer? Many. There are friends reading these words that have known me since I was six years old. Though I might not have seen or spoken with them in many years, they remain interested in friends and friendship. I thank them for that. Most of them also know Pop from years past.
Beyond that, when one is sitting alone in a quiet house, with no one to talk with, writing (at least for me) is cathartic. I made the choice to not post a bunch of "Dad updates" on Facebook for a reason. I wanted to give people a choice to read about it, or pass on it. Admittedly, I do alert when there's something new and if you so choose to read about it, it's up to you.
So, speaking of something 'new'. Pop had a massive thrombotic stroke last evening. Thrombotic, meaning that it was not a 'bleeder'. Simply put, he had a blood clot that entered the left side of his brain and, it has rendered him non-verbal, paralyzed on his right side and the right lung (the one with the cancer) has been rendered non-functional.
Ergo, it's no longer just about his cancer. It's two-fold now, cancer and a major stroke. The question is how will it, or can it, be treated? That is the $64,000 question. The answer to that question we do not know.
In detail, Pop has cancer. That we've established. Now, in addition, the following factors have come into play;
Thrombotic stroke, which carries the following side effects:
Ataxia-Loss of muscle coordination.
Dysarthria-Speech difficulty. He cannot speak at this time.
Dysphagia- Difficultly swallowing. He's currently on a nasal gastric tube.
Hemeballism-Involuntary muscle twitching. There has been a reduction since last evening.
Nystagmus-Uncontrolled eye movements.
There's also evidence of Miosis and Ptosis which are respectively, an involuntary contraction of the pupil and a drooping eyelid. Both were definite evidence of a problem last evening, whereupon I summoned the ambulance.
(Sorry, I've taken six family /friends phone calls since the end of that paragraph. I started this message at 7:15 if memory serves.)
When the ambulance arrived, Pop was still cognizant and communcative, he even got on the gurney without assistance. Later though, according to the EMT (about a block away from the house) he became unresponsive and they rolled red and siren the rest of the way to BMH-Desoto.
When I arrived at the ER, Pop was thrashing and in the above mentioned conditions for the most part. As of today, there is little change.
What happens next is up to God. If His choice is life, I'm on the front line. If not, well, Pops wishes are well known to me and they will be honored.
God love you all. I know I do.
Drew
12:30am Wednesday morning...
I'll just throw it right out there, last night at around 7:30 Pop had a major stroke.
Cancer and now this, good Lord, if this man can stand up to this and come out of it, I will forever call him the toughest fella' that ever lived.
What started as a routine day, ended in the hospital.
Truly, I'm too tired and too stunned to continue this right now. I'll do my best to fill you in later on today.
Cancer and now this, good Lord, if this man can stand up to this and come out of it, I will forever call him the toughest fella' that ever lived.
What started as a routine day, ended in the hospital.
Truly, I'm too tired and too stunned to continue this right now. I'll do my best to fill you in later on today.
Monday, October 19, 2009
Goodness, what a day!
Of course, with any OPS procedure you have to get up at the crack of dawn to be at the hospital by 7am and then...you wait. Wait, oh...until about 9:45 for the actual procedure to begin. Then again, there are plenty of sick folk's in the world. Truly ill, not just some nitwit with the sniffles looking for a day of from work so he can go drink beer and fish. (Save for the 'sniffles', a cold beer and fishing doesn't sound so bad to me.)
Anyway, in the word's of Gleason, "And away we go!"
The procedure performed today was a reasonably simple one that involved inserting a PleurX (r) catheter into Pop's right pleural cavity in order to extract any fluid that had built up in the past few weeks. And boy howdy, it certainly made its presence known as the pulmonologist drew off over two liters of fluid. That's a little more than half a gallon of fluid....a half gallon. Good Lord Almighty! It's no wonder he was having difficulty breathing.
Upon his return from the procedure the X-ray indicated pneumothorax in the right side pleural cavity. In other words, there was air in the cavity and it needed to be extracted as well. Shortly after that discovery, the surgical assistant came into the room with another PleurX setup and withdrew 250 more mL of fluid and, at the end of the process, the evidence of the pneumothorax made its presence know by emitting an audible air and foam effusion.
Somewhere around 3:00, after another X-ray, Pop was released and we made our way home, stopping for a burger and shake. He ate about two thirds of his burger and complained of feeling tired and weak. I put him to bed and me, well, I stretched out on the floor to watch a little TV. I promptly fell asleep, only to wake up after hearing him cough at about 5:15pm.
He got in his wheelchair and I rolled him to the table, whereupon he finished a half-tepid chocolate shake. He said he still felt pretty lousy, but would be OK while I went to the genetic bouillabaisse that is Walmart to pick up a prescription.
By the time I got back home, he was back in bed. This raised my level of concern, not to the panic stage, but to the 'check his vitals' stage. And so I did, taking three BP readings from each arm, I determined thaat he was in hypotension (low blood pressure) and that did raise my concern. To explain, after this type of procedure, hypotension is a potential side effect. That said, pulmonary edema induced hypotension is potentially lethal because, after reexpanding the lung and having drawn so much fluid off the lung, edema (more fluid) can effuse inside the lung, thereby causing circulatory failure. Keep in mind, Pop has experienced three MI's, two strokes and suffers from atrial fibrillation. So, my next move? Call the physician..
After my explanation that I had measured his BP in each arm three times, listened to his chest and back (yes, I own a good stethoscope), we reached the conclusion that this is most likely post-procedural side effects. After all, Pop is not experiencing any breathing problems (a little crusty, perhaps) but, overall he's not in any pain, nor is he in AFIB (a little tachy, perhaps) but not in AFIB, as the symptoms of that are quite obvious.
Pop's asleep now. I'll have an ear open all night, because with hypotension, there is the risk of 'postural hypotension'. In other words, if he needs to get up, he needs to do it slowly, otherwise he could get lightheaded which could cause a slip off the bed or, should he try to stand up, he could fall, which at 80 years of age, could cause further damage. I pray for a quiet night.
Tomorrow, Tom (my brother, of course Bud is too) will take Pop to the Cancer center at BMH. I think they are only going to do a CT, but they could go ahead with the radiation therapy. I don't know. As for me, I'm going to the park to decompress. But since I'm on LOA, I'm going to cold call and try and sell some web design. It's been a few years, but I've still got my chops.
But FIRST, I get to drain the pleural effusion. That should be interesting, but I think I've got a good handle on it. That's in the morning...
Right now, I think I'll go abuse any non-Bama, non-Saints fans over at Facebook. Tonight, I need a little humor.
Anyway, in the word's of Gleason, "And away we go!"
The procedure performed today was a reasonably simple one that involved inserting a PleurX (r) catheter into Pop's right pleural cavity in order to extract any fluid that had built up in the past few weeks. And boy howdy, it certainly made its presence known as the pulmonologist drew off over two liters of fluid. That's a little more than half a gallon of fluid....a half gallon. Good Lord Almighty! It's no wonder he was having difficulty breathing.
Upon his return from the procedure the X-ray indicated pneumothorax in the right side pleural cavity. In other words, there was air in the cavity and it needed to be extracted as well. Shortly after that discovery, the surgical assistant came into the room with another PleurX setup and withdrew 250 more mL of fluid and, at the end of the process, the evidence of the pneumothorax made its presence know by emitting an audible air and foam effusion.
Somewhere around 3:00, after another X-ray, Pop was released and we made our way home, stopping for a burger and shake. He ate about two thirds of his burger and complained of feeling tired and weak. I put him to bed and me, well, I stretched out on the floor to watch a little TV. I promptly fell asleep, only to wake up after hearing him cough at about 5:15pm.
He got in his wheelchair and I rolled him to the table, whereupon he finished a half-tepid chocolate shake. He said he still felt pretty lousy, but would be OK while I went to the genetic bouillabaisse that is Walmart to pick up a prescription.
By the time I got back home, he was back in bed. This raised my level of concern, not to the panic stage, but to the 'check his vitals' stage. And so I did, taking three BP readings from each arm, I determined thaat he was in hypotension (low blood pressure) and that did raise my concern. To explain, after this type of procedure, hypotension is a potential side effect. That said, pulmonary edema induced hypotension is potentially lethal because, after reexpanding the lung and having drawn so much fluid off the lung, edema (more fluid) can effuse inside the lung, thereby causing circulatory failure. Keep in mind, Pop has experienced three MI's, two strokes and suffers from atrial fibrillation. So, my next move? Call the physician..
After my explanation that I had measured his BP in each arm three times, listened to his chest and back (yes, I own a good stethoscope), we reached the conclusion that this is most likely post-procedural side effects. After all, Pop is not experiencing any breathing problems (a little crusty, perhaps) but, overall he's not in any pain, nor is he in AFIB (a little tachy, perhaps) but not in AFIB, as the symptoms of that are quite obvious.
Pop's asleep now. I'll have an ear open all night, because with hypotension, there is the risk of 'postural hypotension'. In other words, if he needs to get up, he needs to do it slowly, otherwise he could get lightheaded which could cause a slip off the bed or, should he try to stand up, he could fall, which at 80 years of age, could cause further damage. I pray for a quiet night.
Tomorrow, Tom (my brother, of course Bud is too) will take Pop to the Cancer center at BMH. I think they are only going to do a CT, but they could go ahead with the radiation therapy. I don't know. As for me, I'm going to the park to decompress. But since I'm on LOA, I'm going to cold call and try and sell some web design. It's been a few years, but I've still got my chops.
But FIRST, I get to drain the pleural effusion. That should be interesting, but I think I've got a good handle on it. That's in the morning...
Right now, I think I'll go abuse any non-Bama, non-Saints fans over at Facebook. Tonight, I need a little humor.
Waiting...
Arrived BMH at 6:45am. Still waiting for procedure to begin. Should take about two hours.
Sunday, October 18, 2009
A fairly quiet weekend...
The clindomyacin finally moved out of his system, and thank God for that, as we were up every two hours for most of the week. That stuff not only gets rid of the bad bacteria in your system, it also eliminates the good as well. It left him drained and dehydrated but, fortunately, with the change to Flagyl, he's finally starting to come around.
Tomorrow we begin the 'beginning', if you will, of this process. Though the Oncologist had already peformed the CT scan and 3d tomography, it has to be repeated. Why, you might ask? Seems that Pop has fluid (pleural effusion) on his right lung (the one affected) and it needs to be drawn off.
(Side note: The fluid was there while he was in the hospital, but they needed it to build up and then drain it, so that they could differentiate between fluid and tumor.)
So, at 7am in the morning, we will be at BMH-Desoto for a new bronchoscopy and the insertion of a PleurX catheter. If the pulmonoligist leaves it in place, it will be incumbent on me to perform the drainage procedure as necessary. (Note: Since BMH-Desoto has wi-fi, I will update this blog as the process moves along.
If everything comes out OK tomorrow, then Tom will take him back to the cancer center at BMH for a new CT scan and tomography on Tuesday morning at 10am. At that point, they should re-mark his skin in an effort to pinpoint the targets for radiation.
To Pops credit, he is eating better. Tonight I prepared 'skillet chicken' and brussel sprouts. He was a proud member if the "clean plate club", for the first time in a while. Additionally, he has put a few pounds back on, from 192 to 198. Granted, that's not much, but it's better than it was.
As mentioned, I'll try to add to this blog from the hospital tomorrow.
Tomorrow we begin the 'beginning', if you will, of this process. Though the Oncologist had already peformed the CT scan and 3d tomography, it has to be repeated. Why, you might ask? Seems that Pop has fluid (pleural effusion) on his right lung (the one affected) and it needs to be drawn off.
(Side note: The fluid was there while he was in the hospital, but they needed it to build up and then drain it, so that they could differentiate between fluid and tumor.)
So, at 7am in the morning, we will be at BMH-Desoto for a new bronchoscopy and the insertion of a PleurX catheter. If the pulmonoligist leaves it in place, it will be incumbent on me to perform the drainage procedure as necessary. (Note: Since BMH-Desoto has wi-fi, I will update this blog as the process moves along.
If everything comes out OK tomorrow, then Tom will take him back to the cancer center at BMH for a new CT scan and tomography on Tuesday morning at 10am. At that point, they should re-mark his skin in an effort to pinpoint the targets for radiation.
To Pops credit, he is eating better. Tonight I prepared 'skillet chicken' and brussel sprouts. He was a proud member if the "clean plate club", for the first time in a while. Additionally, he has put a few pounds back on, from 192 to 198. Granted, that's not much, but it's better than it was.
As mentioned, I'll try to add to this blog from the hospital tomorrow.
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