Ready for Visitors!

I would like to let everyone know Dad has said it is Ok to come visit him. He still sleeps a lot, and it's always possible he will be taken away for some test randomly.

If you bring food or snacks, please follow his diet restrictions: very low sodium, no red meat, no dairy and no saturated fat. We don't have anywhere to put flowers, so abstain from that tradition please.

Besides my wife Joycelyn and myself, Catherine is our first visitor! Thanks go out to her for stopping by. She just happened to get in touch with me right after dad told me to let people know. It's like finding a sale they haven't sent the fliers out for. 

Belpharitis

We were just visited by Dr. Hollenberg's weekend substitute. She examined dad, poked, prodded, and asked him questions to test cognition. He passed all with flying colors. He even knew he was at the Cornell part of New York Presbyterian, nor the other part.

He has a new, very serious condition. Robert Ryan Berbec, at the tender age of 71, has Blepharitis. It's when you get gunk on your eyelashes. Everyone's had it at one point: that crud that sort of sticks your eyelids together when you blink.

Treatment? Johnson &  Johnson's baby shampoo and some cotton balls.

If only all of our troubles were so simple!

Lunch

They have dad on this no-salt, no-saturated fat diet. So no red meat, sodium or milk products. He ate all of his cream of mushroom soup, his lemon ice dessert, but the tuna sandwich was just to crappy. No mustard, no mayo, no salt.

His appetite seems to be returning, but he still won't eat horrible food!

Cardiology Visit

We just had a visit from dad's cardiac team. They poked and proded him, asked a few questions and told us the plan for the weekend.

The MRI is still a go. This gives them a better look at the heart compared the previous echocardiograms. This appearing, disappearing thing in his heart will be discovered or disproven.

There is also a cardiac catherization planned. The will insert a tube into one of dad's blood vessels in his groin area and snake it up to his heart. Coronary angioplasty, the specific type of catherization they will be doing, allows the team to check for blockages in the heart's blood vessels.

If there are blockages there are a few options, bypass surgery being among the most well known. A vein would be transplanted from another area of dad's body and would be used to skip over the blockage.

Balloon angioplasty is a less invasive procedure that produces similar results. They go in with a catheter, just like for the exploratory process, but the catheter is inflatable to allow the blockage to be pushed out of the way.

The hope, of course, is there are no blockages. We want the reason dad's heart is weak to be related to activities, it lack thereof, not buildup in his veins.

Whatever the reason and test results, I'm sure we are in capable hands.

RN update

Dad's nurse came by to give him his pills and heparin shot. I get an update.

He had an uneventful night, and no MRI was done. They usually don't do MRIs over the weekend, so it may be slow until Monday. She hasn't heard about the catherization, so I'll try and find a MD to ask about it.

Robert is still tired, so he is sleeping now that the nurse left. I'll try to get him some breakfast when he wakes up if it isn't lunch time by then!

The Waiting Games

I'm here with dad thus morning. They have delivered breakfast, but he still wants to sleep. We had to wake him for his morning EKG, and it was right back to sleep after that.

I'm waiting for a number of things now:

To see if the MRI was done overnight
If not, to find when it is scheduled
To talk to his nurse about how he did overnight. The day shift RNs get a report from overnight, so they know as much as anyone
For dad to wake up and eat breakfast
To find out about the cardiac catherization his MD was hinting at

Dr. Hollenberg told me last night the cardiologists were thinking of doing something involving his heart. I'm not sure what catherization is, and I plan on asking his RN when she shows. If snooze does know, please explain in the comments!

Time goes slowly when you are worried about a family members health. The only thing that really helps is good news, but any news is preferable to no news.

On the Road

The nurse came and helped dad to the bathroom. When he got back to bed, he looked at the TV (CNN of course!), and asked what country we were in. For some reason, he thought we were in Scandinavia watching a USA CNN feed. This normally would distress me, but this time he recognized his confusion for what it was and asked for help. This is a big step forward.

That's it for my visit today. Tomorrow I hope for the MRI results and maybe (hoping!) a transfer for him back to the regular part of the hospital, out of ICU.

Dinner and Waiting for Radiology

We had a few blood draws. Some IV vitamins. Lots of CNN.

We are still waiting for the MRI of dad's heart. We don't know when it is going to happen.

Dad is not a big fan of hospital food, so we talked to nutrition and asked if and what we could cook. We were told anything Joycelyn makes is Ok, just keep it low salt. Joycelyn is vegan, so there are no saturated fats to be found! Perfect for cardiac patents. She made lasagna and chili. I served the lasagna and dad ate half and a cookie. This is the most dad has eaten so far. I'm going to refrigerate the rest for later.

Update from head MD in charge

Dr. Hollenberg called my dad's room just now and gave me an update on his condition.

The contrast echocardiogram did NOT show the "something" the previous echo showed. The new echo also couldn't find evidence of the hole my dad has between two ventricles. They are sending him for a heart MRI to get a better look.

He confirmed has blood work is looking better which was the reason they took him off the heparin. They also removed his IVs because the goal is to get him on all his medications in pill form. His lungs are totally clear, so they have taken him off oxygen as well.

If all goes as planned, we should be back to the 11th floor gen-pop, and will get started on discharge plans soon. Then we find dad's inpatient physical therapy location.

Cardiac Diet

We just got a visit from Nutrition. Because of the concerns involving dad's heart, they are switching his diet.

The cardiac diet they are putting him on focuses on low sodium and low saturated fat. We already had dad on low sodium for his blood pressure, but previously I was unconcerned about his saturated fat intake.

The main sources of saturated fat are animal products: whole-milk dairy, cheese, butter, sour cream and red meat. This will take some getting used to as margarine, chicken, turkey and fish are the new normal for dad. Occasional beef, pork and lamb is possible, but I plan to be fairly strick.

You only get one heart!

Occupational Therapy & Cognition

The OT lady came by. She always asks dad the day and where he is. He knew right away today, which is good news. Since Robert has gotten here, he has had bad memory and focus abilities.

He would often wake up confused, not knowing where he is, the day, or why he was in the hospital. He told me he was in Baltimore once because that was where the statue in liberty was. He woke up once and took his IVs.

Father and the OT walked together, dad got up and, using a walker, walked to the bathroom and brushed his teeth. He hadn't done that in a while. Robert had been. His teeth in his bed. After teeth, he walked back and sat in the chair where he got his elbuterol treatment for his lungs.

I'm still waiting for news from his MDs. The RN took him off the heparin. It seems his clotting factors are normal again.

Woke up late

It's funny how waking up two and a half hours late, due to traffic, can get you to your destination less than two hours late.

Dad is sleeping calmly and had a quiet night. The aide watching him said he ate most of his breakfast! He has had no appetite his entire stay and this us great news. He has daily physical therapy, and his caloric intake was around 500 a day, previously. That's just not enough to have any energy for exercise or muscle growth. This is great news.

I await the RN and MDs to get my questions from last night answered.

Goals for Friday

I've got a few things to learn or get done at the hospital tomorrow:

1. Get dad his appetite back
2. Find the results of the contrast echo
3. Get dad to do some exercises in bed
4. Make sure the physical therapist comes
5. Find out if there is another heart scan. CT? MRI?
6. Bring dad a real knife and fork
7. Bring dad a cocktail mixer to get the Ensure cold, hoping he will drink more of it then

Heading home

Joycelyn came by and we got dad to eat some chicken. The "unofficial" (by the tech, not the doctor) sonogram results was no clots found in dad's legs. We stuck around for the ward's resident vampire's nightly feeding and are getting home. (also know as the phlebotomy drawing blood)

Sonogram

Just got a surprise: a tech showed up to do a sonogram on my dad's legs. They are checking for blood clots.

Physical Therapy

We had the PT person come by just now. She worked with dad: got him to stand and walk. It was only 40 feet, but it is difficult now. He also is quite worried about falling, understandable. She was very nice and said she will be back and get him moving!

Echo of an Echo

Dad just came back from his second echocardiogram. He is in good spirits and seems less confused. I await the doctors interpreting the results.

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Cardiologists

I just met with dad's GP and his team (like six!) of cardiologists.

The first concern is dad's heart being relatively weak. It pumps significantly less than it did three years ago. Like all muscles, it atrophies when not used. Just like his leg and arm muscles, being sedentary has affected his hearts ability to do its job. Physical therapy and exercise for the rest of his body will help his heart just as well.

The second concern comes from the results of yesterday's ECHOcardiogram. I has the acronym right but he meaning wrong. This is the same tech for a sonogram of a baby in a pregnant mother. The echo showed a mass in dad's right ventricle. They are unsure what it is, but it is 99.999% NOT cancer.

As some of you may know, dad was born with a small hole between two parts of his heart. They call it a ventricular septal defect.  It is small enough that it never affected his life, and would have required major surgery to fix with a non-negligable risk of his heart stopping with all the negatives that comes with. One idea the doctors have is the piece of his heart that was supposed to cover that hole came loose and is flapping around. This would take major surgery to fix, and dad is not health enough for that.

That is why they are treating him for the other possibility brought up: the mass is a blood clot. A clot could have started small and gained size over time, reaching it's current size. The treatment for this is simple: IV heparin, an anti-coaggulant.

The cardiac team is planning a second echo with contrast. They inject dad with a sort of dye to allow a better view. As you can imagine, since even a resting heart beats sixty times a minute, figuring out what something the size of a small marble is in a blurry black and white picture is very hard.

The best case is a clot that is smaller on the second echo, being reduced in size by the heparin. Next would be a flap of heart tissue that is attached firmly to the rest of the heart, so they can just ignore it. A clot that doesn't respond to heparin would be worse and a heart piece just about to separate would be bad.

The added concern for a clot, if that is the issue, is it dislodging from his heart and going somewhere bad, like the brain, causing a stroke. If it does dislodge, the neurologists can go in and break it up into small pieces, minimizing damage.

This is all supposition. It is possible for the blur to be one or none of these.

The team overseeing his care is top notch. New York Presbyterian has been ranked as the #1 hospital in the state fourteen years running. I trust the people here to get the best information, make the best decisions to get the best outcome possible.

Dad is in the best hands he could be.

Swallow Test

Tuesday, dad had difficulty eating a soup with mushrooms in it. He started coughing and said it was caught in his throat. I told the nurses and they put him in line for a test to see how his swallowing was.

He only had issues that one time, but once you say something is wrong in a hospital, it MUST be checked out. He passed with flying colors and I feel sort of stupid for bothering because it never reoccur. Better safe than sorry, I guess.

ICU

Dad has been transfered, finally, to the cardiac ICU. I haven't seen his nurse or doctor yet today. He had an easy night according to the his aide and was sleeping when I arrived.

I'm still waiting to hear from his doctor about the results from his ECG. I will keep everyone updated.

Travel

Subway transfer to bus was one hour. I'm going to try strange subway only route tomorrow

Morning

The day begins. I've been taking cabs to get to the hospital the last few days, but the traffic on the east side Highway is horrible. It takes over an hour to get from my location (187th) to the hospital (70th) an 8 mile trip. Today I'm trying mass transit.

Due to quirks of the system, there is no way to get to the east side of Manhattan via subway without insane convolutions. Best route is a subway to the west side and a bus. We will see what's faster.

End of day

I managed to get dad to eat some chicken and potatoes. Now to home for me. They say they will transfer him to cardiology overnight.

O²

They took dad off the fancy sleep apnea machine around lunch time, but left him on oxygen. They didn't put the machine back after lunch and his oxygen levels have stayed high. It seems they got the fluid out of his lungs!

His remains in good spirits and has no pain.

EKG

Last night the doctors suspect dad had an incredibly mild heart attack. He showed no symptoms of a heart attack, but there was a blood test he took that showed results similar to those who just had a heart attack.

For that reason, dad just returned from the fourth floor cardiac ward where he got an ECG. His doctor is expecting the results within the hour.

Dad is also on 24-hour watch by someone. He wakes up confused some time and has tried to pull out his IV. It's for his safety for someone to remind him where he is if he is a little disoriented.

They do have CNN here, so he may not want to leave!

New York Presbyterian

Robert was admitted to the hospital Sunday, May 24th around 3am. He had fallen and the EMTs took him to NY Presbyterian hospital. His strength is so low he is unable to walk, even with a walker or cane, unassisted. His appetite has been very low, leaving him without energy, so he doesn't go out of his apartment much, so he doesn't get any exercise, so he doesn't get very hungry, repeat.

The long-term plan is to transfer him, after stabilization, to an in-patient physical rehab faculty to regain his strength. He would speed weeks, not months, there before being released.

Dad took a slight turn for the worse last night.

His O² stats hit the floor (low 70s) last night. The x-ray of his chest showed fluid build up in his lungs, so they have put him on diuretics to drain his lungs. They have put him on a bypath (spelling?) machine to push more air into his system, assisting his kidneys to work harder so the lungs drain faster. It's basically a really Damn expensive sleep-apnea machine.

An endocardiogram is also on the list to check for heart blood vessel blockages. They have him on IV heparin to clear any possible blocks. They believe he may have had a extremely mild heart attack overnight.

They are not concerned, currently, that any of these issues are even close to life-threatening. He will be transfered into the cardiac ICU for closer monitoring, that said.