The Binary Biker

Pseudomonas aeruginosa

This post won’t be terribly long.

It’s been a while since I updated everyone on mom’s status.  There really hasn’t ben a lot to tell until now.

Mom has been in ICU for over two months now.  If you remember from my last post, Mom suffered a setback when the vac on her belly, meant to help close the wound, caused a rupture in her intestines.  She was doing great until that point.

She has been recovering from that ever since.  She has been in and out of consciousness, uncomfortable, scared, and not really retaining any memory from day-to-day.  She’s had a rough ride but, thankfully, she doesn’t remember most of it.

Last month they put a tracheostomy tube in her throat to help with the breathing.  She’s been bedridden so long that her weakened lungs were having a hard time feeding her body oxygen and she was stressing herself even further as she struggled for breath.  With the tracheostomy tube, the ventilator can breath for her and she can still be relatively awake and aware.  Before, she had the breathing tube inserted directly into her mouth and that forced the doctors to keep her sedated.

The longer my Mom is in the hospital, the greater the risk of her getting an infection.  So, not surprisingly, she got an infection about three weeks ago.  With a fever spiking over 103 it was serious.  When your body has an infection, the healing process for other wounds, like the wound on her belly, essentially stops as the body battles the infection.

Mom was put on three power antibiotics and an anti-fungal.  The cultures came back and the infection mom had was called pseudomonas aeruginosa.  According to Wikipedia, “the symptoms of such infections are generalized inflammation and sepsis. If such colonizations occur in critical body organs, such as the lungs, the urinary tract, and kidneys, the results can be fatal. Because it thrives on most surfaces, this bacterium is also found on and in medical equipment, including catheters, causing cross-infections in hospitals and clinics.”

You guessed it – Mom went septic and the infection was in her blood.  She’s been fighting that for three weeks now and it finally looks like she is starting to cross over on the other side of it.

Yesterday was her best day yet.  She was awake, aware, and able to communicate.  She is in considerable pain from her surgeries still, confused about why she has been in the hospital for so long, and irritable.  She wants out.

Her surgeon said that if she continues to stay infection-free, next week they will probably perform the skin graft necessary to complete her healing process.

Once that is successfully completed, she will essentially be healing and recovering her strength to go home as soon as she is able.  She’s still very weak, and is not out of the woods yet, but she is a fighter and she is slowly but surely fighting her way back to us.

Thank you all for asking, praying, and wishing her well.

Mom and Dad in Hawaii

It’s been a month since Mom went into the hospital.  I wrote a blog many of you enjoyed – describing her plight and why this dangerous surgery was necessary.   Since then, the ubiquitous Facebook updates I was posting have slowed down, but Mom’s care has been a constant roller coaster of good days and bad days.

Many of you have reached out to me, my father, sister, brother, and uncle for status updates.  Others of you have offered support, prayers, and well-wishes for her speedy recovery.  Thank you all for caring so much about my mom.

The last month has been, as I said above, a roller coaster of ups and downs.  I’ll take a few moments and give you the high level history and current situation.  I’m going to keep it very dispassionate, though – this blog isn’t about the roller coaster of emotions the entire family has been through – it’s just a status update.  You can imagine the emotional strain this has put on the entire family and this isn’t the forum to share those emotions with you.

After her original surgery, Mom went right to ICU for recovery.  The surgeon removed most of her colon and attached it directly to the rectum, made room in her body cavity, and completely and 100% closed mom up.

We were so excited when we saw her that evening in ICU.  She had such a flat belly and, once recovered she would have easily been as flat as she is in the picture above.

Unfortunately that wasn’t how she ended up.  The pressure inside her body cavity was too great.  Her body cavity was too small to hold everything because her liver is enlarged and her body cavity had shrunk in the past 8 years.  Her kidneys couldn’t function and the surgeon was forced to go back in three days later and “open her up” to relieve the pressure.

Opening her up immediately relieved the pressure and her kidneys began to function again.  She was still 5 times smaller in the belly than she had been before the surgery and she still looked great.  We were very happy.

A series of synthetic mesh and skin grafts were placed over her abdomen to close her up.  A “vac” was put on her abdomen to, through pressure, close her remaining open hole and force the healing process to proceed.

While that was happening, mom had some issues with her blood pressure and respiration.  It took a week or so for the doctors to find the perfect mix of medicines to stabilize her blood pressure.  Mom was sedated most of this time.

Finally, Mom started waking up.  She was hallucinating a lot.  She was in terrible pain.  The doctors had removed the breathing tube and she was breathing on her own.  Because she was breathing on her own they could only provide so much pain relief –  too much pain management would force them to put her back on the breathing tube; she would be too sedated to breathe properly on her own.

So Mom battled the pain, and it was unlike any pain she had ever had.  She was brave, she endured, but her pain was so intense that often she slipped into hallucinations.

But she was getting better!  The physical therapists were coming in daily to help her move on her own.  They got her out of the bed and into a chair for a couple of days.  They started feeding her again – she was drinking nutrient shakes and ice chips and drinking water.  Her bowels were working.  She was talking, making phone calls.  She was so so very weak and the pain consumed her, but in her better moments she was lucid and able to interact with us all.

It looked like mom was well and truly on the road to recovery.

And then the worst happened.  The pressure from the “vac” was so great that it pulled her intestines into the mesh and caused them to rip – creating a small fistula which put stool and bile into her body cavity.

She got an infection.  Her breathing started suffering.  The surgeon quickly removed the vac, cleaned her up, and put her on heavy duty antibiotics to combat what looked to be an onset of sepsis.  Yes, if you read the original blog, this is VERY familiar to you.

Fortunately the infection was caught early and handled effectively.  Her breathing, however, did not get any better.  The issue is the fact that she has to clear the congestion from her airways and lungs.  In order to clear the congestion,she needs to cough.

You try to cough without using your abdominal muscles.  You can’t; it’s impossible.  And therein lies the problem.  Mom has been on her back for so long, with no ability to clear her airways or lungs, that she is very congested and at high risk for pneumonia right now.

If mom gets pneumonia, there is a very real chance that she won’t have the strength to fight it.  That leads us to today.  Today, the surgeons decided that the only way to avoid pneumonia is to insert a tracheotomy tube into mom.  With a trach, they can clear her airways and remove the congestion.

So, mom has had the breathing tube put back in again – they need it for the small surgery to insert the tracheotomy tube.  As soon as the surgeon is ready this afternoon they will perform the procedure to insert the tube.

The tube is the only thing that will enable her to breathe easily and avoid further complications.

How long will mom be in the hospital?  We don’t really know – but it’s a good guess that she’ll be here at LEAST another month and probably more.  I’ll be surprised if she is home by Thanksgiving.

She’s going strong.  She’s a fighter and she is the strongest woman I have ever known.  I know you are all worried about her; I am too.  Take heart in knowing that she is getting the best medical care she can possibly get, that she wanted to do this, and that she stronger than anyone ever suspected.  That’s all I’ll say about that – this is not supposed to be an emotional blog.

I’ll continue to blog and post updates on Facebook.  Thanks, everyone, for the well-wishes and prayers.