I showed up in the early morning today to an empty room. Mike was already up and sitting at the communal table eating breakfast. His first shower in a month had occurred two days previous and he now looks forward to them with a giddy pleasure-- even though they occur at 5AM. He proceeded to have a full day of therapy --although, he has figured out that claiming "dizziness" gives him a free ride back to his room even if the session is not done. We're hoping that the return of his regular OT and PT therapists will elicit a little more hard work. But there is solace in the fact that this is pure Clayton -- working the system as he is successfully doing.
Today was the first day I brought up household issues. He's clear enough to talk about things like Amelia's violin lessons and whether to keep two cars.
The kids are being delivered back to us tomorrow by my brother (have I mentioned my brother? My, what a stunning fellow he is...hand delivering those kids back to me and taking a few more days off to hang out and transition them smoothly). There should be some "re-entry" issues with them as they have undoubtedly been spoiled mercilessly by my sister for an entire week.
Mike's brother is due to arrive Wednesday and Mike's been looking forward to that.
Sunday, March 30, 2008
Friday, March 28, 2008
3/28
Oops. Speech tells me that they haven't given him the green light for water yet. Consider it noted. He might move off of "mechanical soft" foods tomorrow, however. Good news for me because I've been bringing him daily McDonalds cheeseburger Happy Meals to replace the food the hospital offers -- and eating (or enabling someone to eat) Happy Meals goes against my every fiber of being. But mechanical soft they are. You could eat them without teeth.
Mike's hitting his benchmarks. He is now expected to eat one meal at a table in a wheelchair, as opposed to bed. He started that today. He's being asked to hold more of his weight during bed to wheelchair transfers which he is doing. His fine motor skills are getting better. He can manipulate his remote control much of the time and bring small foods from table to mouth. He is a natural in the wheelchair (maybe all that kayaking helped).
As promised, Mike is starting to "wake up." He is taking a combination of drugs that is supposed to reorient his circadian rhythm and it's having a dramatic effect. We all feel like Mike is returning to us from a dark fog.
Mike's hitting his benchmarks. He is now expected to eat one meal at a table in a wheelchair, as opposed to bed. He started that today. He's being asked to hold more of his weight during bed to wheelchair transfers which he is doing. His fine motor skills are getting better. He can manipulate his remote control much of the time and bring small foods from table to mouth. He is a natural in the wheelchair (maybe all that kayaking helped).
As promised, Mike is starting to "wake up." He is taking a combination of drugs that is supposed to reorient his circadian rhythm and it's having a dramatic effect. We all feel like Mike is returning to us from a dark fog.
Thursday, March 27, 2008
3/27
The laughter I heard last night turned into a full day of uncontrollable cracking up. Between the vent and the stroke, Mike's laugh has turned into this insane, crazily modulated, very drawn out cackle and he spent much of the day amusing himself with reflections of a certain social gaffe I made earlier in the week and then progressed into just amusing himself with the sound of his own laugh. I'm sure we had people wandering by who suspected some serious frontal lobe damage. I did take some solace from the fact that he could control his laugh when absolutely necessary.
Mike had a great OT session early in the day. His OT claimed she had never seen a more flexible spine which led me to believe her other clients must be in pretty bad shape. In PT, he was harnessed into a waist support and stood for 2 ten minute sessions being coaxed the entire time to stand straighter, flex his muscles and do repetitions of toe standing. It's insanely hard work for him. Speech has graduated him to water drinking. Previously, he had been cleared only for "nectar" consistency drinks -- even water can be made thick in the hospital. All this is good news and means his swallowing reflex is coming back.
The kids are having a great time in San Diego. I was (cruelly) bombarded with pictures of Amelia and Winston running along the beach while the day started with snow for us in Portland.
Mike had a great OT session early in the day. His OT claimed she had never seen a more flexible spine which led me to believe her other clients must be in pretty bad shape. In PT, he was harnessed into a waist support and stood for 2 ten minute sessions being coaxed the entire time to stand straighter, flex his muscles and do repetitions of toe standing. It's insanely hard work for him. Speech has graduated him to water drinking. Previously, he had been cleared only for "nectar" consistency drinks -- even water can be made thick in the hospital. All this is good news and means his swallowing reflex is coming back.
The kids are having a great time in San Diego. I was (cruelly) bombarded with pictures of Amelia and Winston running along the beach while the day started with snow for us in Portland.
Wednesday, March 26, 2008
3/26
Mike is making strides in rehab. His OT, who has been particularly gracious and kind with him, tells us she is excited with his progress. The goals she set out for him have proven too easy and she's going to have to make some tougher ones.
Mike is working on centering his core when sitting up and was up in a walker for a few (assisted) steps today. He is also keeping his eyes open for longer stretches of time. This indicates his eye muscles are getting stronger and that the double vision is abating.
Dr. Hoeflich has agreed to try taking his off a feeding tube to see if we can get enough calories in him by mouth.
Tonight, Mike and I shared a funny moment and I heard a hearty laugh come out of him for the first time in almost a month (with all due respect to Dr. Baxter who claims to have heard a hearty laugh while Mike was on a vent -- but that could have been anything...).
We are hoping for a great night of sleep so he can continue his progress.
Mike is working on centering his core when sitting up and was up in a walker for a few (assisted) steps today. He is also keeping his eyes open for longer stretches of time. This indicates his eye muscles are getting stronger and that the double vision is abating.
Dr. Hoeflich has agreed to try taking his off a feeding tube to see if we can get enough calories in him by mouth.
Tonight, Mike and I shared a funny moment and I heard a hearty laugh come out of him for the first time in almost a month (with all due respect to Dr. Baxter who claims to have heard a hearty laugh while Mike was on a vent -- but that could have been anything...).
We are hoping for a great night of sleep so he can continue his progress.
Tuesday, March 25, 2008
3/25
The doctors are rearranging Mike's evening tube feedings because they are making him nauseous and interfering with his sleep. I told him a way to avoid this is to eat solids so they can stop the tube. Then a minor miracle appeared in the form of a bean and cheese burrito for dinner. The burrito is Mike's favorite meal, in or out of the hospital. It may have been the tiny, microwaved kind but it was beautiful compared with yesterday's tuna sandwich and other offerings which shall go unexplored in this blog. I was cutting it up into small, non-choking-hazard sized pieces when his hand reached through my cutlery faster than I've seen it move, ever. He grabbed the burrito and jammed half into his mouth. I proceeded to dance around the room screaming that he was going to aspirate and he tried to chew as much as he could before I returned to force him to give it back. I crouched down and looked him straight in the eye and asked, "are you having problems with impulse control?" to which he responded, "I was hungry." Oh, that makes sense.
Monday, March 24, 2008
3/24
We had a chance to watch a PT session yesterday and were impressed by Mike's strides. With a great deal of guidance and help, Mike sat up in bed, pivoted and made his way to a wheelchair. We wheeled him over to a stationary bike mechanism (he cycles and sits in the wheelchair) and did ten minutes on the bike. Then he wheeled himself around a bit more for fun.
The PT reminded us that when Mike "wakes up," which is to say when the swelling goes completely down and the lethargic state of mind lifts, he's going to be in a good place. He walked into this stroke physically fit and it will serve him well coming back out of it.
We are heading back out to watch and participate in another full day of rehab. It's a intense experience for Mike and he is understandably wiped out.
The PT reminded us that when Mike "wakes up," which is to say when the swelling goes completely down and the lethargic state of mind lifts, he's going to be in a good place. He walked into this stroke physically fit and it will serve him well coming back out of it.
We are heading back out to watch and participate in another full day of rehab. It's a intense experience for Mike and he is understandably wiped out.
Saturday, March 22, 2008
3/22
My forensic accountant (aka Mike's dad) went on a mission yesterday to find out more about the terms of the lease on one of our cars. He made an appointment with our salesperson, Kaz, and proceeded to lay out the bad news. Kaz wanted to know how old Mike was. He also wanted to know if we understood what the origin of the stroke was. When John told him Mike was just 38 and we didn't know where the stroke came from, Kaz leaned in conspiratorially to John and asked, "Was he having problems with his wife?"
Friday, March 21, 2008
3/21
Providence has filled Mike's schedule with Occupational Therapy, Physical Therapy and Speech appointments. He's been completely knocked out the times I visited today -- but did request I leave the computer behind so he could go through his email. I don't know if he can actually read the screen right now or manipulate the keys but I thought it was great he wanted to try. For those who know me, you can imagine the sacrifice of leaving behind my iBook...for five hours. I zipped by to retrieve it this evening and say goodnight and tried to swap him out for a less flashy computer.
The kids are going to San Diego for Spring Break to party it up with Kit and her family. We'll be able to focus on Mike with razor precision. I'm sure he'll appreciate that.
The kids are going to San Diego for Spring Break to party it up with Kit and her family. We'll be able to focus on Mike with razor precision. I'm sure he'll appreciate that.
Thursday, March 20, 2008
3/20
Mike was moved from the OHSU floor to Providence stroke rehab today. We were greeted by a very gracious nursing staff and Dr. Hoeflich. Mike tolerated the move but was wiped out by all the activity and wanted to sleep through the assessments.
OHSU removed Mike's sutures this morning. His ventricular drain looks good; there probably won't be much to admire there. But the occipital cranial decompression scar is really a thing of beauty. It starts low on his neck and stretches up nearly to the top of his head. It looks like Mike had some very dark days bar brawling.
Yet another shout out to all the people that facilitated the move. Tim has been particularly helpful the last few days guiding me through the next steps in this process. Thank you Tim!
Mike won't be ready for visitors for awhile. He will be at Providence for two to four weeks.
OHSU removed Mike's sutures this morning. His ventricular drain looks good; there probably won't be much to admire there. But the occipital cranial decompression scar is really a thing of beauty. It starts low on his neck and stretches up nearly to the top of his head. It looks like Mike had some very dark days bar brawling.
Yet another shout out to all the people that facilitated the move. Tim has been particularly helpful the last few days guiding me through the next steps in this process. Thank you Tim!
Mike won't be ready for visitors for awhile. He will be at Providence for two to four weeks.
Wednesday, March 19, 2008
Michael Love
This note goes out to all the Providence people who have been patiently waiting for Mike's transfer. We know you love him. He knows you love him. You know you love him. But we respectfully request that you hold off on visits until we give you the green light. Thank you!!
3/19 PM #2
Mike's case worker, Jen, has indicated that Providence rehab will take Mike early. He will transfer tomorrow AM.
3/19
Mike was less responsive to the physical therapist and family today. I think we are getting used to this being a cyclical recovery process. Sometimes he is up and going and sometimes not.
Dr. Clark came around to let us know they are almost ready to release him from OHSU. Because Mike is not ready for rehab yet (you must be able to work three hours a day), we're looking at some in between solution right now. Clark suggested skilled nursing. We would prefer to take him home for a week rather than have him in that kind of setting. Another option is to push him over to Providence earlier than anticipated. I'm waiting to talk to the case worker this afternoon.
Dr. Clark came around to let us know they are almost ready to release him from OHSU. Because Mike is not ready for rehab yet (you must be able to work three hours a day), we're looking at some in between solution right now. Clark suggested skilled nursing. We would prefer to take him home for a week rather than have him in that kind of setting. Another option is to push him over to Providence earlier than anticipated. I'm waiting to talk to the case worker this afternoon.
Tuesday, March 18, 2008
3/18
We got word today that the last few CT scans have shown amazing swelling reduction. And that has certainly been reflected in the improvement we've seen over the last day. We have been wowed by the progress Mike has made. He has been keeping his eyes open, tracking conversations and chiming in appropriately with much more frequency. The physical therapist had him up and walking (with much help) and thought the difference between yesterday and today was marked. Even today's ICU nurse commented that his sense of humor is coming back.
Mike has moved over to 10K and has a private room. It has a giant window for natural light. He's requesting ice cream and enjoying his iPod tunes. My sister and I brought the kids in today and he was more interactive with them. Winston tried to test every button in the room; only quick interventions saved Mike from certain harm.
Next, we'll get a schedule started for visits.
Mike has moved over to 10K and has a private room. It has a giant window for natural light. He's requesting ice cream and enjoying his iPod tunes. My sister and I brought the kids in today and he was more interactive with them. Winston tried to test every button in the room; only quick interventions saved Mike from certain harm.
Next, we'll get a schedule started for visits.
Monday, March 17, 2008
3/17 PM
Mike's cultures all came back negative (pneumonia gone) so he is off all the antibiotics (good news for his stomach!). And this morning he passed his swallowing test so he will be allowed water (for the first time in 2 weeks), yogurt, apple sauce, pudding and ice cream. There is not language ecstatic enough in English to convey the joy on his face when he was given a tiny plastic cup of orange sherbet this morning.
The physical therapists came around this morning, put him up in a chair and then got him up for a few steps. They would like to see him more interactive and less lethargic -- he's still exhausted.
Mike asked for an iPod for the first time today and was wearing it when we left his room. He'd previously felt too jangled to listen to anything so I consider that progress.
It looks like the non-ICU rooms are all booked up so he might have to spend another night in the ICU. No views but lots of nurses!
The physical therapists came around this morning, put him up in a chair and then got him up for a few steps. They would like to see him more interactive and less lethargic -- he's still exhausted.
Mike asked for an iPod for the first time today and was wearing it when we left his room. He'd previously felt too jangled to listen to anything so I consider that progress.
It looks like the non-ICU rooms are all booked up so he might have to spend another night in the ICU. No views but lots of nurses!
Sunday, March 16, 2008
3/16 PM
The ventricular drain is out so Mike is ready to move to the floor tomorrow, fingers crossed.
A visit late last night and earlier today yielded a Mike with much clearer speech. We were probably catching 10% of his words three days ago. Now, I think we're in the 50% range. He's talking about eating ice cream and cheese, pulled the (relatively obscure) names of a friend's parents out on the fly, and moving all around his bed in a more aggressive manner. He's ready to get out of the ICU to a room with a view.
If he is moved, we plan to take the kids for their first visit tomorrow.
A visit late last night and earlier today yielded a Mike with much clearer speech. We were probably catching 10% of his words three days ago. Now, I think we're in the 50% range. He's talking about eating ice cream and cheese, pulled the (relatively obscure) names of a friend's parents out on the fly, and moving all around his bed in a more aggressive manner. He's ready to get out of the ICU to a room with a view.
If he is moved, we plan to take the kids for their first visit tomorrow.
Saturday, March 15, 2008
3/15 PM
The gastric tube was placed bedside yesterday successfully and feeding has begun. The vent drain has been clamped and Mike is reabsorbing his own fluids well. The plan is to take the drain completely out tomorrow if he continues to do a good job.
Mike is conversing more. His speech has been difficult to decipher much of the time -- and it is clear he is exhausted.
We plan to have immediate family sit with Mike for some stretches once he has moved to the floor (nurse to patient ratio is much higher and we would like to keep a close eye on him). We'll set up a schedule for friend-sitting as soon as we are certain of the move.
Thanks to everyone who has emailed, called and posted. Mike will most certainly come back from this experience knowing that he is loved and appreciated.
Mike is conversing more. His speech has been difficult to decipher much of the time -- and it is clear he is exhausted.
We plan to have immediate family sit with Mike for some stretches once he has moved to the floor (nurse to patient ratio is much higher and we would like to keep a close eye on him). We'll set up a schedule for friend-sitting as soon as we are certain of the move.
Thanks to everyone who has emailed, called and posted. Mike will most certainly come back from this experience knowing that he is loved and appreciated.
Friday, March 14, 2008
3/14 PM
Mike has been very quiet today. Apparently he was up in his chair around 5AM (I missed that!) and is now napping in preparation for a (tentative) 1PM gastric tube insertion.
They are also readying to clamp his ventricular drain. Once the vent drain is out, he can be moved out of the ICU and to the floor.
My sister just forwarded a note from her friend Anke (also a physician) who helpfully noted, "the hardest thing for Mike now is to exercise patience with himself." I think that speaks volumes about where we all are right now.
They are also readying to clamp his ventricular drain. Once the vent drain is out, he can be moved out of the ICU and to the floor.
My sister just forwarded a note from her friend Anke (also a physician) who helpfully noted, "the hardest thing for Mike now is to exercise patience with himself." I think that speaks volumes about where we all are right now.
Thursday, March 13, 2008
3/13 PM
Mike was up and in his sitting chair this morning. The occupational therapists were hard at work getting him going. His speech continues to be difficult to decipher, perhaps as much for the vent and the drugs as for the stroke itself. We'll be back later this afternoon to check in with him.
Wednesday, March 12, 2008
3/12 PM #2
Wendy and I met with Dr. Bhardwaj this afternoon. Dr. Bhardwaj is the head of the ICU. He continues to be heartened by Mike's progress. Because Mike is still having a problem with swallowing, he requested we approve a gastric feeding tube. This will remove one of Mike's biggest annoyances: his nasal feeding tube. It will also reduce the chance of an infection associated with nasal feeding tubes. Mike may have this feeding tube for up to six weeks. The doctor seemed confident that his swallowing reflexes will continue to return.
I asked about tentative scheduling. The team felt that Mike will be in the ICU through the weekend. On Monday, he moves to 10K and could be on the floor for up to two weeks. He will then be moved to Providence Portland for in-patient stroke rehab.
Wendy and I both felt the meeting was optimistic.
I asked about tentative scheduling. The team felt that Mike will be in the ICU through the weekend. On Monday, he moves to 10K and could be on the floor for up to two weeks. He will then be moved to Providence Portland for in-patient stroke rehab.
Wendy and I both felt the meeting was optimistic.
3/12 PM
Mike was up in his chair for a visit today. He was speaking some but very tired by the end of our time together. We are waiting for a "team meeting" (doctors, social workers, etc) time today and will have more to report after that meeting.
Tuesday, March 11, 2008
3/11 AM
We left Mike agitated last night. He was experiencing what we are told is a pretty typical response to a long stay in the ICU. He would have bolted from the unit if he wasn't restrained from doing so.
We didn't know what to expect when we returned this morning. We found Mike calm and collected. His nurse got him up and in a seated position in a hospital chair. He continued on to have a busy morning -- physical therapy, occupational therapy, two teams of doctors, a stroke team member -- and he is tired. From my observations, he looks to have some problems with speaking (complicated by his long stay on the ventilator) and some vision issues. It's very early yet and he is on some serious medications so we are still not seeing his baseline.
Suffice it to say, today was dramatically better than yesterday. His PT threatened to get him up and walking tomorrow. That will be an amazing sight.
We didn't know what to expect when we returned this morning. We found Mike calm and collected. His nurse got him up and in a seated position in a hospital chair. He continued on to have a busy morning -- physical therapy, occupational therapy, two teams of doctors, a stroke team member -- and he is tired. From my observations, he looks to have some problems with speaking (complicated by his long stay on the ventilator) and some vision issues. It's very early yet and he is on some serious medications so we are still not seeing his baseline.
Suffice it to say, today was dramatically better than yesterday. His PT threatened to get him up and walking tomorrow. That will be an amazing sight.
Monday, March 10, 2008
3/10 AM #2
Extubated! Mike is off the vent and with less meds we anticipate he'll be communicating better soon.
3/10 AM
Good news on the tube -- they have dialed down the pressures on the ventilator to evaluate his ability to breathe on his own.
Sunday, March 9, 2008
3/9 PM
AM Nurse: Karen
PM Nurse: Doug (that "H.G. Doug" to Kit)
Mike had a stable day. No extubation but I think we can see that on the horizon. He is responding well to the antibiotics for the pneumonia. Dr. Baxter came by this evening to check in and made Mike laugh so hard that he set his vent alarms off and we had to all calm down.
PM Nurse: Doug (that "H.G. Doug" to Kit)
Mike had a stable day. No extubation but I think we can see that on the horizon. He is responding well to the antibiotics for the pneumonia. Dr. Baxter came by this evening to check in and made Mike laugh so hard that he set his vent alarms off and we had to all calm down.
3/9 AM
Mike's pressure went up overnight and he was given a CT scan at 4AM. The CT showed no new problems. They have readjusted his vent levels and the excessive pressure problem seems to be corrected for now. But that means more vent today.
Kit heads back to San Diego today and their will be a Weil changing of the guard. My mom arrives in time to get Amelia ready for another week of school. The kids will miss the abundance of chocolate chips in their pancakes and the endless patience.
John Clayton flies back to Palm Springs today. He will pack up their rental and return in his car to Portland later in the week.
John, Canterbury's Top Chef, whipped up a stellar pasta dinner last night for Amelia's birthday meal. She requested her favorites: pasta (plain), apples and salami. John managed to create a dinner with the spirit of all those requests and adjust it to palates that crave...shall we say...flavor. Amelia had hers plain; we did not. We will miss his ability to walk the fine line of Amelia's persnickety palate!
Kit heads back to San Diego today and their will be a Weil changing of the guard. My mom arrives in time to get Amelia ready for another week of school. The kids will miss the abundance of chocolate chips in their pancakes and the endless patience.
John Clayton flies back to Palm Springs today. He will pack up their rental and return in his car to Portland later in the week.
John, Canterbury's Top Chef, whipped up a stellar pasta dinner last night for Amelia's birthday meal. She requested her favorites: pasta (plain), apples and salami. John managed to create a dinner with the spirit of all those requests and adjust it to palates that crave...shall we say...flavor. Amelia had hers plain; we did not. We will miss his ability to walk the fine line of Amelia's persnickety palate!
Saturday, March 8, 2008
3/8 PM
Nurse: Karen
I'm visiting the hospital and can report that after taking down the dosage on the sedatives, Mike is communicating nicely with the nurse. She is offering him things (pain killers, body adjustments, pillows and blankets etc) and he is letting her know what he needs. I think it is the best I've seen him since before the swelling started.
The antibiotics are working nicely. Mike's lungs look better today than they did yesterday. Nurse Karen alluded to a possible extubation tomorrow. We'll see.
I'm visiting the hospital and can report that after taking down the dosage on the sedatives, Mike is communicating nicely with the nurse. She is offering him things (pain killers, body adjustments, pillows and blankets etc) and he is letting her know what he needs. I think it is the best I've seen him since before the swelling started.
The antibiotics are working nicely. Mike's lungs look better today than they did yesterday. Nurse Karen alluded to a possible extubation tomorrow. We'll see.
3/8 AM
Wendy, John and I met with Drs. Clark and Brambrink this morning to get an update. Mike remains on the ventilator and has developed some pneumonia. They are leaving him on the vent to protect his brain from any more stress and any more swelling. He seems to have plateaued with his swelling and we are happy to see that. So now, we let him rest in quiet and hope his body heals as quickly as possible.
We understand from Dr. Baxter that a visit early this morning yielded some animation from Mike. And maybe even a chuckle, although that is hard to tell from the vent. But he was definitely acknowledging his presence with some eyes openings and some eyebrows raised.
I will return to the hospital this morning -- we are launching Amelia for a birthday celebration. All of her favorite activities rolled in to one today. She will be playing a futsol (indoor soccer) game early this afternoon, then off to the ice skating rink with Auntie Kit, Julie, Hannah, Amy, Nora and Dahlia and then back home for dinner with Ethan and Maggie. She feels very loved!
We understand from Dr. Baxter that a visit early this morning yielded some animation from Mike. And maybe even a chuckle, although that is hard to tell from the vent. But he was definitely acknowledging his presence with some eyes openings and some eyebrows raised.
I will return to the hospital this morning -- we are launching Amelia for a birthday celebration. All of her favorite activities rolled in to one today. She will be playing a futsol (indoor soccer) game early this afternoon, then off to the ice skating rink with Auntie Kit, Julie, Hannah, Amy, Nora and Dahlia and then back home for dinner with Ethan and Maggie. She feels very loved!
Friday, March 7, 2008
3/7 AM
AM Dr. visit: Ansgar Brambrink, Anesthesiology
Nurse: Eric
Today we can report that Mike is responding to requests to squeeze hands, open eyes, wiggle toes and is nodding yes and no to questions appropriately. He remains intubated because he is currently lacking a gag reflex and the intubation keeps him from aspirating.
Mike's medical oversight continues to be excellent. A shout out to Joe Weiss for his numerous visits, vigilance and translations. And another to Brett Baxter who has helped us focus on the positive.
John and Wendy want to thank everyone for their prayers, love, positive energy, emails, offers of assistance and for being such great friends. She knows you are all keeping Mike in the forefront of your thoughts and prayers.
Nurse: Eric
Today we can report that Mike is responding to requests to squeeze hands, open eyes, wiggle toes and is nodding yes and no to questions appropriately. He remains intubated because he is currently lacking a gag reflex and the intubation keeps him from aspirating.
Mike's medical oversight continues to be excellent. A shout out to Joe Weiss for his numerous visits, vigilance and translations. And another to Brett Baxter who has helped us focus on the positive.
John and Wendy want to thank everyone for their prayers, love, positive energy, emails, offers of assistance and for being such great friends. She knows you are all keeping Mike in the forefront of your thoughts and prayers.
Thursday, March 6, 2008
3/6 PM
Mike is just back from a CT scan and the neurosurgeon came by to let us know that there is no more swelling and he just may, may be able to see a 4th ventricle. That would mean things have peaked and swelling is on its way down. He says we have every reason to be guardedly optimistic.
3/6 AM #2
Dr. Clark very helpfully stopped by to coalesce some of the information we've been given. He confirms that the stroke was much larger than they first thought and that it has affected the cerebellum. That being said, he is also confident about his recovery if he remains stable for the next day. He remains very concerned about the pressure on his brain. Even after the decompression surgery -- there's not a lot of room in there and, of course, the surgery itself causes swelling. He considers the next 24 hours critical and there is much vigilance.
We remain very confident about the quality of care here. Mike is getting CT scans every 12 hours. He has a dedicated nurse daily. This is extraordinary.
We remain very confident about the quality of care here. Mike is getting CT scans every 12 hours. He has a dedicated nurse daily. This is extraordinary.
3/6 AM
Mike had a bit of a rough night. We are told his pressures were a little off so they are going to continue on the ventilator today. They have removed sedation as of last night but added some pain medication for a headache so he's still not quite with it.
Nurse Lyndon starts a feeding tube today. Mike had been asking for food the last few days and was inordinately thrilled by popsicles so this should take some of the edge off.
Nurse Lyndon starts a feeding tube today. Mike had been asking for food the last few days and was inordinately thrilled by popsicles so this should take some of the edge off.
Wednesday, March 5, 2008
3/5 PM #2
The angiogram originally scheduled for tomorrow has been postponed. Dr. Burcheil advised waiting until Mike had more time to recover from the occipital cranial decompression. The angiogram might give us a clue as to the origins of the stroke.
3/5 PM
Mike will be on a ventilator overnight but is doing well. He's on some pain meds so he's not waking up fully but he squeezed my hand in acknowledgement. Tonight is going to be a quiet time for him to rest up and ready himself for tomorrow...
3/5 AM #2
Mike is out of the OR. The doctors said it went well. They have removed a small piece of bone at the base of his skull to relieve the pressure that was building on his brain. Believe it or not, you don't need that piece and they don't need to replace it.
This procedure sets back the ICU schedule a bit -- Mike will be in for another week, if not two.
As an FYI, Mike continues to get numerous CT scans to monitor pressure, etc.
This procedure sets back the ICU schedule a bit -- Mike will be in for another week, if not two.
As an FYI, Mike continues to get numerous CT scans to monitor pressure, etc.
3/5 AM
Pressure has been building up during the night. We have just given consent for an Occipital Cranial Decompression. Drs. Burcheil and Carlson will be taking Mike to the OR soon. It is a two and a half hour procedure. We will keep you updated.
Tuesday, March 4, 2008
3/4 PM #2
Neurosurgeons have elected to move ahead with a procedure we were anticipating -- Mike had a ventriculotomy to alleviate the pressure of backed up cvs. It went well and he now has an external ventricular drain on the right side of his head.
3/4 PM
A lot of us have spent the day worried about the amount of pressure in Mike's head. This is a worry that will hopefully abate after 24 or 48 hours -- the trauma the brain experienced during the stroke causes it to swell (with all due respect to the doctors out there; I'm speaking all layman here).
Waking Mike at intervals has been the primary method of determining whether the pressure has grown too great. A perfunctory squeeze of the hand and a question answered satisfactorily wins him another hour of rest.
I came back to the ICU this evening on an important mission -- to tell Mike that the war he had undertaken with the city was won. Two weeks ago, Mike declared battle with the city of Portland. They claimed we owed them $3000 for a poorly maintained sidewalk. He claimed on too-narrow streets where parking is not enforced and cars parked on sidewalks destroy the infrastructure, maintenance is the responsibility of the city. Today, in the mail, we received a $3000 bill with the words "CANCELED" written across it.
When I told Mike, his eyes flew open and he said "No way!" We proceeded to have an animated conversation for a few minutes. His speech is a little compromised -- but I was thrilled to see him fluid and cognizant. It is with a great sense of gratitude that I convey this story.
A giant shout out to my sister who has taken over motherly duties (some of them quite distasteful but that's between to two of us) of Amelia and Winston. Her husband, John, came up for a few days and built very impressive set of bridges out of Tinker Toys. I am indebted to him for dropping his life to help us. And another shout out to Noah who turns 13 today and who gave up his parents on his birthday for the greater good -- an amazing sign that he must be all grown up. And, hell, might as well round it out by saying that Wendy has been indispensable in her medical translations, putting to good use her years as a physical therapist. And John has kept us in the good food and has signed on as my forensic accountant. OK, I can't forget my dad who stands by at the ready to comfort and help out where needed. He is, of course, the original Rock.
Waking Mike at intervals has been the primary method of determining whether the pressure has grown too great. A perfunctory squeeze of the hand and a question answered satisfactorily wins him another hour of rest.
I came back to the ICU this evening on an important mission -- to tell Mike that the war he had undertaken with the city was won. Two weeks ago, Mike declared battle with the city of Portland. They claimed we owed them $3000 for a poorly maintained sidewalk. He claimed on too-narrow streets where parking is not enforced and cars parked on sidewalks destroy the infrastructure, maintenance is the responsibility of the city. Today, in the mail, we received a $3000 bill with the words "CANCELED" written across it.
When I told Mike, his eyes flew open and he said "No way!" We proceeded to have an animated conversation for a few minutes. His speech is a little compromised -- but I was thrilled to see him fluid and cognizant. It is with a great sense of gratitude that I convey this story.
A giant shout out to my sister who has taken over motherly duties (some of them quite distasteful but that's between to two of us) of Amelia and Winston. Her husband, John, came up for a few days and built very impressive set of bridges out of Tinker Toys. I am indebted to him for dropping his life to help us. And another shout out to Noah who turns 13 today and who gave up his parents on his birthday for the greater good -- an amazing sign that he must be all grown up. And, hell, might as well round it out by saying that Wendy has been indispensable in her medical translations, putting to good use her years as a physical therapist. And John has kept us in the good food and has signed on as my forensic accountant. OK, I can't forget my dad who stands by at the ready to comfort and help out where needed. He is, of course, the original Rock.
Bulk emails sent to date
For those of you that come to the site without knowing, here are the three emails sent previously regarding Mike's health. cw
3/2 First email out
> --- caitlin weil wrote:
>
> > Hello Everyone,
> >
> > I wanted to write and let you know that Mike had a
> > significant stroke today. We were playing on our
> > neighbor's sport court when he started feeling
> > nauseous and dizzy and eventually lost his speech.
> > He
> > has been transported to OHSU, Oregon's teaching
> > hospital, and has been admitted to the
> neurosciences
> > ICU. He has been given TPA and I thought it looked
> > like things were improving after it was
> introduced.
> > He
> > remains strong in his limbs although the doctors
> > know
> > now it has a left-sided origin.
> >
> > I have had SIGNIFICANT handholding by neighbor and
> > cardiologist Joe who has spent a few hours
> assuring
> > me
> > that he looks good and all indications are good
> > right
> > now. They will be moving forward in the next while
> > to
> > figure out the origins. We are, of course, looking
> > to
> > avoid anything more invasive.
> >
> > Mike's parents arrive this evening as does my
> father
> > and sister. We are in good hands. Amelia and
> Winston
> > are with neighbors and should be able to settle
> into
> > their own beds tonight with the help of family and
> > friends.
> >
> > There are many emails I do not have. Please
> forward
> > on
> > as you see fit. I will keep everyone up to date.
> >
> > Please keep Mike in your thoughts.
> >
> > Love,
> > caitlin
3/3
AM Email
NOTE CORRECTIONS THAT FOLLOW
> All:
>
> First of all, a big thank you to everyone who has
> contacted us and sent thoughts and prayers. How can
> that not be working?
>
> Secondly, a bit of a rundown on what we know for
> now.
> Mike had two CTs and an MRA. The CTs revealed that
> clot probably originated in the basilar artery and
> that gave off smaller pieces that affected a couple
> areas of the brain -- the cerebellum and the brain
> stem. There is not an issue of dissection or PFO as
> the doctors previously postulated. His most pressing
> problem right now is entering day two after the
> stroke
> and the swelling that accompanies the brain trauma.
> The neurosurgeons are next in line to talk about the
> possibility of drilling some holes in the skull to
> alleviate that pressure.
>
> Because of the locations of the stroke, upcoming
> challenges for Mike will be in the area of balance
> and
> coordination. Mike smiles along with my lame jokes
> and
> squeezes my hand appropriately -- his being is
> intact
> and for all of us blessed to know and love him, that
> is good news indeed.
>
> There is still not a firm consensus about where this
> problem originated.
>
> The CTs also revealed a dissecting aorta problem
> which
> may or may not be related to the strokes but which
> were an excellent find unto themselves. This will be
> discussion for upcoming bulk emails and another
> hospital stay.
>
> My father, Mike's mother and father and my sister
> and
> brother-in-law have run to the rescue. We will be
> taking turns at the bedside and juggling the kids
> who
> seem, at this point, no worse for the wear. We've
> got
> a hold on it now but for those of you who have
> offered, I'm sure we'll track you down at some point
> in the future for a little Winston quality time. Be
> sure to tie down your valuables!
>
> Love,
> caitlin
email 3/3
PM
CORRECTIONS
With apologies for sending out so many emails, I'd
like correct two important points:
1. "The CTs also revealed a dissecting aorta problem"
-- the aorta is NOT DISSECTING! Phew. It is an
aneurysm (which I happen to think sounds worse but am
assured it is not). And I do mean I apologize to those
that actually knew what the mistake meant and went
screaming down various hallways. The correction should
assure everyone this is not an urgent problem, just
one that will have to be taken care of eventually.
2. And, "The CTs revealed that
> clot probably originated in the basilar artery"--
not accurate. The clot did NOT originate in the
basilar artery. It just happened to end up there to
cause the problem.
And while I have your attention...a different team of
neurosurgeons swung by a few minutes ago and said they
did not see any pressing reason for their services. So
it looks like they will keep an eye on the
swelling...from afar.
Mike is looking better than we could have hoped this
evening.
Best,
caitlin
3/2 First email out
> --- caitlin weil
>
> > Hello Everyone,
> >
> > I wanted to write and let you know that Mike had a
> > significant stroke today. We were playing on our
> > neighbor's sport court when he started feeling
> > nauseous and dizzy and eventually lost his speech.
> > He
> > has been transported to OHSU, Oregon's teaching
> > hospital, and has been admitted to the
> neurosciences
> > ICU. He has been given TPA and I thought it looked
> > like things were improving after it was
> introduced.
> > He
> > remains strong in his limbs although the doctors
> > know
> > now it has a left-sided origin.
> >
> > I have had SIGNIFICANT handholding by neighbor and
> > cardiologist Joe who has spent a few hours
> assuring
> > me
> > that he looks good and all indications are good
> > right
> > now. They will be moving forward in the next while
> > to
> > figure out the origins. We are, of course, looking
> > to
> > avoid anything more invasive.
> >
> > Mike's parents arrive this evening as does my
> father
> > and sister. We are in good hands. Amelia and
> Winston
> > are with neighbors and should be able to settle
> into
> > their own beds tonight with the help of family and
> > friends.
> >
> > There are many emails I do not have. Please
> forward
> > on
> > as you see fit. I will keep everyone up to date.
> >
> > Please keep Mike in your thoughts.
> >
> > Love,
> > caitlin
3/3
AM Email
NOTE CORRECTIONS THAT FOLLOW
> All:
>
> First of all, a big thank you to everyone who has
> contacted us and sent thoughts and prayers. How can
> that not be working?
>
> Secondly, a bit of a rundown on what we know for
> now.
> Mike had two CTs and an MRA. The CTs revealed that
> clot probably originated in the basilar artery and
> that gave off smaller pieces that affected a couple
> areas of the brain -- the cerebellum and the brain
> stem. There is not an issue of dissection or PFO as
> the doctors previously postulated. His most pressing
> problem right now is entering day two after the
> stroke
> and the swelling that accompanies the brain trauma.
> The neurosurgeons are next in line to talk about the
> possibility of drilling some holes in the skull to
> alleviate that pressure.
>
> Because of the locations of the stroke, upcoming
> challenges for Mike will be in the area of balance
> and
> coordination. Mike smiles along with my lame jokes
> and
> squeezes my hand appropriately -- his being is
> intact
> and for all of us blessed to know and love him, that
> is good news indeed.
>
> There is still not a firm consensus about where this
> problem originated.
>
> The CTs also revealed a dissecting aorta problem
> which
> may or may not be related to the strokes but which
> were an excellent find unto themselves. This will be
> discussion for upcoming bulk emails and another
> hospital stay.
>
> My father, Mike's mother and father and my sister
> and
> brother-in-law have run to the rescue. We will be
> taking turns at the bedside and juggling the kids
> who
> seem, at this point, no worse for the wear. We've
> got
> a hold on it now but for those of you who have
> offered, I'm sure we'll track you down at some point
> in the future for a little Winston quality time. Be
> sure to tie down your valuables!
>
> Love,
> caitlin
email 3/3
PM
CORRECTIONS
With apologies for sending out so many emails, I'd
like correct two important points:
1. "The CTs also revealed a dissecting aorta problem"
-- the aorta is NOT DISSECTING! Phew. It is an
aneurysm (which I happen to think sounds worse but am
assured it is not). And I do mean I apologize to those
that actually knew what the mistake meant and went
screaming down various hallways. The correction should
assure everyone this is not an urgent problem, just
one that will have to be taken care of eventually.
2. And, "The CTs revealed that
> clot probably originated in the basilar artery"--
not accurate. The clot did NOT originate in the
basilar artery. It just happened to end up there to
cause the problem.
And while I have your attention...a different team of
neurosurgeons swung by a few minutes ago and said they
did not see any pressing reason for their services. So
it looks like they will keep an eye on the
swelling...from afar.
Mike is looking better than we could have hoped this
evening.
Best,
caitlin
3/4 Post 1
AM Nurse: Shawn
Dr. Visits: Dr. Clark
4AM catscan last night. another is scheduled for today at 2PM.
**NURSE SHAWN ASKS THAT EVERYONE CALL AT THE PHONE BEFORE COMING IN (EVEN YOU DOCTORS). SHE WANTS TO KEEP AN EYE ON EVERYONE COMING AND GOING, TRAFFIC, AND VOLUME. AND WE WANT TO KEEP NURSE SHAWN HAPPY BECAUSE SHE IS KEEPING MIKE HEALTHY.**
Dr. Clark tells us that he plans on scheduling an angiogram in a few days. This will determine whether there is a vertebral artery dissection. If there is a dissection, it's a matter of taking cumadin for a few months. Dr. Clark is still looking for the origins of the stroke.
Nurse Shawn is a prepare-for-the-worst kind of personality which helps in getting the straight dope. She is currently most preoccupied with the pressure in his brain. They don't want to see any more of it -- we have about 24 more hours of pressure building and then we'll be out of the woods on that one. Mike is awoken every 45 minutes or so and given a neurological assessment -- he is passing each one nicely.
Mike is responding to me and smiling at the thought of so many people getting in touch.
Dr. Visits: Dr. Clark
4AM catscan last night. another is scheduled for today at 2PM.
**NURSE SHAWN ASKS THAT EVERYONE CALL AT THE PHONE BEFORE COMING IN (EVEN YOU DOCTORS). SHE WANTS TO KEEP AN EYE ON EVERYONE COMING AND GOING, TRAFFIC, AND VOLUME. AND WE WANT TO KEEP NURSE SHAWN HAPPY BECAUSE SHE IS KEEPING MIKE HEALTHY.**
Dr. Clark tells us that he plans on scheduling an angiogram in a few days. This will determine whether there is a vertebral artery dissection. If there is a dissection, it's a matter of taking cumadin for a few months. Dr. Clark is still looking for the origins of the stroke.
Nurse Shawn is a prepare-for-the-worst kind of personality which helps in getting the straight dope. She is currently most preoccupied with the pressure in his brain. They don't want to see any more of it -- we have about 24 more hours of pressure building and then we'll be out of the woods on that one. Mike is awoken every 45 minutes or so and given a neurological assessment -- he is passing each one nicely.
Mike is responding to me and smiling at the thought of so many people getting in touch.
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