Home after hand surgery

Dear Janet made it successfully through her 2 1/2 hour outpatient hand surgery at OHSU.  She went home after the procedure this evening and was sound asleep at about 9 tonight.  Please just continue to keep her in your prayers.  Pray for her pain control especially these first few days.  Janet doesn't do well with pain medication; it makes her feel really sick and loopy.  The surgeon took the tips of three fingers to her first knuckle (her pinky, ring, and middle fingers on her left hand) as well as a little bit from her pointer finger.  We continue to lift her up in prayer as she navigates all this physically, emotionally, and mentally.  Her family will be surrounding her over Christmas, so we will step back a bit in helping out just the next week and half or so.  Starting in January, we will be providing meals.  I have many of you on the calendar.  Let me know if you want to add your name to the list.  I hope you all enjoy your families this Christmas.

Surgery bumped to December 19th

Just wanted to let you all know that the surgery scheduler called Janet last week to let her know they would have to bump her hand surgery to December 19th.  Please continue to pray for Janet... she was emotionally and mentally ready to have the surgery Dec. 12th.  She was glad that she'd have some time to recuperate before Christmas.  Pushing the surgery out another week was definitely not what she wanted.  There is a possibility she could get in sooner if there is a cancellation of some sort.  Please just keep the Dickens in your prayers as they wrestle through this.

Hand surgery scheduled for December 12th

Just wanted to let you know that Janet's hand surgery with Dr. Solomon is scheduled for December 12th.  Please be praying for Janet as she faces this.  We all take so much for granted with our health and our ability to function.  We get a papercut or a headache and we complain.  At least, I know I do.  We don't realize how much we use our hands and our fingers until something like a papercut calls attention to it.  Janet losing several tips of her fingers on her left hand is a really tough challenge she has to face.  She is facing it with grace and strength, but just keep her in your thoughts and prayers as she works through finding a new normal.  Even just the waiting to get this surgery behind her could be really tough as it is one more hard step looming ahead of her before she can get down to the business of healing.  Janet is our miracle and we are so grateful for her.  I know that many of us would lose a finger tip with her if we could, just so that she didn't have to do this alone.

Thank you to so many of you who are helping out with meals and cleaning and shopping.  It's crazy to realize that Thanksgiving is next week. We have help set up through the first full week of December.  Please contact me if you are willing to provide some help through the rest of December and/or anytime in January.  We want to continue to provide support for the Dickens while Janet is recovering from her hand surgery.  Just email me at praying4janet@gmail.com with whatever help you are willing and able to provide.  Thanks so much!  

I hope each of you has a wonderful Thanksgiving and that we all hold on to our loved ones a little tighter this year, remembering to be grateful for the moments that we have.

Note from Janet...

Just wanted to send out a little update after yesterday. The dr. found two kidney stones following the stent removal, so he got those out. Because of all that activity my kidney was quite inflamed, so he had to place another stent. It will just be in til next week and removal will be at a simple office visit. I slept alot the rest of the day, and Mike and Jeremy took good care of me. It was really nice to come right home afterward. I will rest a lot this weekend, and just keep getting my strength back.

Thank you for your prayers for my family and I.

Love, Janet

Pray on Friday!

Janet is scheduled to get her stent taken out of her kidney this coming Friday, November 9th in an outpatient procedure.  It should be fairly straightforward.  During the procedure, the urologist will also deal with whether or not Janet still has another kidney stone and will hopefully take care of that as well.  So please be praying!!!  Even though it shouldn't require a hospital stay, Janet will still have to deal with undergoing anesthesia and all the risks and side effects that go along with any procedure.  Pray that she gets good rest and recuperation this week so that she is feeling strong.  Also, Janet sees the hand surgeon on Thursday.  She will schedule her surgery for her left hand at that point.

Thank you!

Looking so great... still two surgeries ahead

Janet is continuing to be our own walking miracle.  She has gone to several follow-up appointments with doctors such as the hand specialist and the urologist.  Each of them has commented (as they just shake their head in wonder after reading her chart) on the fact that Janet is even here with us... that she looks so good, that she's talking and walking and... alive.  It has really helped give Janet such a grateful perspective in understanding the gravity and magnitude of what she has gone through and survived.  She is handling her recuperation with such grace and thankfulness. 

A huge blessing is that Janet was referred to Dr. Joel Solomon at OHSU for the treatment of her hand and fingers.  He is THE hand specialist in the area and is considered the most experienced brachial plexus surgeon in North America.  Here is an excerpt from his biography:

Dr. Joel Solomon is the chief of the hand surgery service within the Department of Surgery and the program director of the hand fellowship. Dr. Solomon is board certified in plastic surgery and holds a certificate of added qualification in surgery of the hand. He is broadly trained in the techniques of plastic and reconstructive surgery and has particular expertise in the surgical management of nerve injuries, reconstructive surgery of the hand and upper extremity, reconstructive microsurgery, brachial plexus, and occuloplastic surgery.

 

You can read more at http://www.ohsu.edu/xd/health/services/providers/solomojo.cfm. 

        

Janet will see Dr. Solomon again in two weeks and will schedule surgery for her hand at that point.  Unless she were to wake up to an utter miracle (which she is totally up for!), Janet will be losing some tissue from the tips of her fingers.  Although this is not what any of us wanted for her, as I mentioned before, Janet is handling this with a lot of grace.  Dr. Solomon is waiting as long as possible so that the viable tissue in her fingers is clearly demarcated from what is not viable anymore.  We are so grateful Janet feels at ease with this surgeon and is confident that Dr. Solomon has the experience and expertise to do what's absolutely best given her situation.  So definitely keep praying!!!

 

Janet still has the stent in her kidney that will be removed in an out-patient surgery sometime after her hand surgery.  Once she gets beyond these two procedures, I know she will feel a huge relief in being able to just fully concentrate on healing and getting well.
 

Thank you to all of you who volunteered so willing to help out. We have shopping, cleaning, and meals covered through December 12th. Yea! If you volunteered, I will try to send out a reminder email when your date come closer. As we know more about Janet's hand surgery, we will keep you updated on ways you can help. We will probably need to continue to have volunteers through January at least.

Blessings!
 

In the process of organizing help...

Thank you to all of you who responded and are so willing to help out Janet while she is continuing to recuperate! We are in the process of putting together a schedule of volunteers for things like errands, meals, cleaning, shopping, etc. (It isn't too late to add your name to the list! You can contact us at praying4janet@gmail.com.) Anyway, expect an email of a tentative schedule by Thursday, October 25th. You can let us know if it will work for you; it will probably be something like once every other week.

Janet is continuing to do well at home!  She went to her follow up appointment with her urologist last week and found out that the procedure to remove the stent in her kidney is a straight-forward outpatient procedure.  Also, she won't have to have this procedure done for a couple months.  This is good news since Janet will have some good time to regain her strength.  Please continue to pray for her recovery.  She has been so amazingly upbeat and grateful and positive through all of this.  I just know that sometimes trying to find a new normal over the long haul can be a daunting process... physically and emotionally.  Please remember to pray for her spirit along with everything else. 

Blessings!

Home sweet home! 

Just a quick post to let you know that Janet is now recuperating at home, away from all the distractions and interruptions of the hospital.  Hooray!  (If any of you have been in the hospital lately, you know it's a terrible place to try to get any rest).  In the next week or so, we are going to be putting together some sort of plan/schedule for how we can help now that Janet is home.  She won't be driving for a while, and definitely still needs to rest while her body continues to recover and regain its strength. 

If you are interested in helping out in some tangible way, please let us know by replying to praying4janet@gmail.com or you can also call or text Kris Esau at (360)798-6144.  I will be visiting with Janet tomorrow and hopefully will get more of an idea of some sort of plan that would be helpful for their family.  Please think about whether you want to provide a one-time meal or maybe you can donate a specific chunk of time to help out once a week until Janet gets on her feet again. 

Right now, we are thinking we can be helpful by:
*Providing meals or homemade goodies or even Subway or pizza gift cards
*Running errands
*Grocery shopping (you would shop and the Dickens would reimburse you)
*Cleaning
*Staying with Janet for chunks of time whenever Mike goes back to work

I understand that Janet and Mike's home church (Kessid) will be providing dinners at least through October 25th or so.  I'm sure dinners will continue to be appreciated! (I will be asking Janet what her family's favorite foods are!) 

I think if we all just pitch in together to provide what we each of us can easily offer, it will add up to a huge blessing for the Dickens.  They have come through this acute-ICU-hospital phase of this journey, but we want to continue to support them as they work toward getting back to normal.

Mike is off work for now and will be taking Janet to her follow-up appointments.  Again, keep praying for those appointments and especially for her left hand and arm.  Pray that she finds the right doctors and that she receives the very best care.

Plan = HOME!

Janet was transferred out of PCU yesterday to room 301.  This should be her last step before being discharged today sometime.  Janet's whole hospital journey started exactly two weeks ago.  In some ways, we can hardly believe it's been that long; in other ways, it feels like the days before all this happened was a lifetime ago.  I know we are all inexpressibly grateful for the miracle of Janet's recovery.  Please continue to pray for her and her family in the coming days as she continues to rest and recuperate and gain her full strength back.  Also pray as she follows up with her hand.  Janet has some decisions to make as far as which doctor to listen to and trust.  She will also have to follow up with the urologist.  Pray for that as well.  Thank you!

I just put the compilation of emails together in one letter for Janet to read.  Thank you for your thoughts.  If you didn't get a chance to contribute, I'm sorry!  You certainly can still email a note, and I will make sure she gets it.

Still lookin' good! Transferred to the Progress Care Unit

Janet had her PICC line taken out yesterday (the line used for IV medications and lab draws) - Yea!  More tubes out!  Even though they wrote the transfer order yesterday, Janet had to wait until six this morning before a room finally came available in the PCU.  She's all settled in her new room now though and will hopefully be able to get some better sleep tonight away from the chaos of the ICU.  The doctors are looking to discharge Janet on Sunday.  She is SOOOO ready to be done with the whole hospital scene.  That is always a good sign that the patient is recovering!  She will follow up with the hand specialist after she discharges.  Keep praying for those fingers!

She's doing well!

Janet is continuing on a good course.  She is losing her tubes and wires and beginning to reclaim her body back to herself.  Oh boy, has it been a long ten days for the Dickens!  It looks like she will be transferred out of ICU today as soon as a regular room becomes available.  They are continuing to just watch her and her lab work as her body mends itself; everything looks pretty stable at this point.  No invasive procedures look like they are needed right now.  If all continues to go well, Janet could be discharged as soon as Sunday or Monday.  From there, it's just going to take time for her to regain her strength and stamina and continue her full recovery.  Janet's left hand and fingers are continuing to look better; the doctors are still cautiously watching to see how that goes.

Doing much better

Janet looks so wonderful today.  She said that she feels perky and has energy.  Her color is great after the blood transfusions.  She's a little sore from everything, but generally feels really good.  She is eating regular food, and she's making lists of foods she wants to eat after she gets out of the hospital.  I told her to make her lists and we can bring the food to her - hospital or not! 

They are just continuing to monitor her blood count today.  She may receive more transfusions depending on her lab work.  They are waiting to decide if they need to do more tests on her bleeding issue.  We can all pray that the internal bleeding completely stops and heals on it's own and that her hematocrit stablizes.  Janet had an echocardiogram yesterday that showed improvement in her heart. Cardiology has signed off and is no longer following her in the hospital.  It doesn't look like Janet will have to be on any long term heart medication either.  Good news!

Keep praying for Janet's fingers on her left hand.  There has been some improvement in the color the last few days.  Janet doesn't want to lose any of her tips!  Let's keeping praying that she doesn't!

Anyway, it so good for our hearts to see Janet's beautiful self so courageously shining through the tough stuff she is facing.  Let's continue to pray for her heart and mind and spirit.

It wasn't the other kidney stone causing the issues...

Janet is okay, but she had a rough night.  She and really everybody could use your prayers for strength and stamina as this is the beginning of hospital week number two. 

After talking to the nurse and trying to put all the pieces together, here is what I know so that we can continue to pray and not take anything for granted.

About midnight last night, Janet's blood pressure and heart rate began to drop.  They did labs in the middle of the night that showed her red blood cell count had dropped as well.  Janet had had some right abdominal/back pain that was increasing.  The nurses were becoming more concerned after they saw the lab results when Janet became non-responsive.  They couldn't find a pulse and called a code blue.  It was quite a flurry of activity as they worked to find out what was causing her to suddenly decompensate.  They gave her medications for her blood pressure.  Janet quickly responded to the medications and awoke to the nurse standing over her beginning chest compressions.  Very scary for poor Janet.  After that, they started blood transfusions, and that is when things began to even out and Janet's heart rate and blood pressure came back into a normal range.

Janet is back in ICU and is receiving more blood transfusions today.  Part of what they have been watching for from the beginning is that Janet is not bleeding anywhere she shouldn't be.  She was at risk for this due to the heparin therapy she has been receiving.  Last night, as I said, her abdominal/back pain increased and her blood pressure and heart rate dropped.  Basically, after a bunch of tests, a CT scan showed that Janet was bleeding from a pelvic vein that burst.  The blood pooling near her ovary was mimicking the kind of pain she had with the kidney stone.  (She does have another known kidney stone that they have been monitoring).  At this point, they are thinking that the bleeding has resolved itself now that she is not on the heparin drip and that the pooled blood will naturally be absorbed without surgical intervention.  The blood transfusions should make her feel a lot better and have more energy.  They are closely monitoring her blood count to make sure it stays stable.

Janet is really tired today, but she is awake and knows everything that happened last night.  I found some hospital earplugs for her.  We're hoping she can find some good sleep somewhere tonight.

This is all I know for now.  Janet has a ton of different doctors rounding on her, each giving their own two cents worth.  Keep praying... Pray that the doctors have wisdom as they tweak her medications and her treatments.

With love and prayers for Janet,
Chandra

Keep praying

Janet was transferred to the progressive care unit yesterday evening, but had to go back to ICU in the middle of the night.  A second kidney stone has been trying to pass, causing more issues.  She had to get a blood transfusion last night as well.  This is all I know for now.

Totally herself...

Janet is completely back to her normal sweet and funny self.  It's fabulous to see and hear.  It looks like she will be moved today to PCU (the progressive care unit) once they get a room opening for her.  That will be nice for everyone since there won't be all the restrictions that are required in the ICU. 

The most pressing issue at this point is Janet's hand.  The vascular surgeon is going to wait until Thursday before they decide if they need to surgically remove some parts of her fingers.  At this point, it looks like Janet is in danger of losing the tips of several of her fingers on her left hand.  Although we are all so relieved that Janet is alive and just herself, this is still a huge thing.  So please pray for healing in those fingers, and for Janet personally as she copes with the stress in all this...

And oh, by the way, her white blood cell count dropped today for the first time since her admit.  Just thought I better mention that!  

Now that she's awake...

Sweet Janet.  Can we even imagine how hard her body and mind are working right now to heal and begin functioning again?  She is continuing to make great progress, but of course, it's going to take time.  Now that she's awake after losing a full week of consciousness, Janet is beginning the hard process of putting all the pieces together of what exactly happened.  Her mind is still clearing a bit, but she is definitely sweet and funny Janet.  She noticed Mike got a haircut!  We have told her about this blog and about how so many people are praying for her.  We asked her what she wants prayer for, and she is really worried about her left hand.  Of course, waking up to the tips of her fingers being purple and learning that she could lose some parts of her fingers has been pretty distressing.  We told her we would definitely ask people to keep praying about that!  As we have been.  I think she is a little scared in general.  Please pray for her heart and emotions as she has to move forward in all this.

For a more clinical update, Janet's lab work is continuing to improve, but it isn't all perfect yet by any means.  Her white blood cell count has been a little higher everyday.  I talked to her night shift RN about that.  Although we want to see it start coming down, it definitely is a reflection of how sick she has been.  In some ways, her continuing high white blood cell count does show that she is responding to this attack on her body appropriately.  That is what our immune systems are designed to do: fight back when there is an attack.  Again, it is going to take some time.  She is receiving the appropriate strong IV antibiotics.  Janet's blood coagulation has been all out of whack and they are still watching different factors in her blood pretty closely.  They found a blood clot on ultrasound at the intersection of the splenic and portal vein near her liver.  In light of the big picture, this is not a huge issue and isn't causing problems but they are giving her medication to keep the clot from getting bigger.  The body will naturally break down the clot, it will just take time.  Janet's platelet level has been low though so they are watching her very carefully to make sure they don't make her bleed.  It's a delicate balance.  Janet's liver enzymes are continuing to come down which is good.  They are starting her on a medication for her heart (a beta blocker) to protect it and help her heart pump more effectively.  This medication is something she will continue to take after she goes home.

Janet, unfortunately ended up with a bad intestinal bug called c. difficile.  This definitely adds insult to injury - poor girl!  So you can definitely pray that it clears quickly from her system.  They started IV Flagyl (another antibiotic) for that.  On the positive side, they did a CT scan of her brain and found nothing abnormal.  They did a chest x-ray yesterday, and the little bit of fluid at the bases of her lungs is improving.  As I mentioned, being on ventilator puts her at huge risk for pneumonia.  Continue to pray that her lungs stay healthy.

They did not get Janet up in the chair yesterday as she was too exhausted, understandably so.  Physical therapy will be working with her today though.  She has been a little nauseated and only tolerated a clear liquid diet yesterday.  She is swallowing fine, though, and I'm sure they will begin to advance her diet soon.

Ok, I think that is the full update.  Just keep her in your prayers as she continues this new phase of her healing.

Sometimes a picture IS worth a thousand words...

Take a look at the collage with pictures from today at the hospital. 
I promise to write more soon.  Keep praying!

Celebration!

Oh wow, what a difference a day can make.  Janet has most definitely turned another corner.

It started early this morning when she began nodding her head and squeezing on command in response to questions.  She began focusing better and just being more and more alert.  At one point this morning, the day shift nurse asked Janet to give a thumbs up sign and she wasn't able to do it.  It wasn't long, however, before the nurse asked her again and this time he got the sign he was looking for.  To the nursing staff, this meant that Janet was ready to have the ventilator taken out.  Woo hoo!

The vent and the feeding tube came out about eleven this morning.  Janet has just continued to respond more and more as the day has gone on.  She is talking!  Her responses are short as I'm sure her throat is sore and her mind and body must be exhausted as it works to sort through what has happened.  This evening as the night shift nurse was asking Janet questions about her name and the month and the year, etc. - poor Janet looked really frustrated when the nurse came to the question asking about where she was and Janet started to respond "hospital."  The word "hospital" seemed to get stuck in her throat and she made a face...  I don't think Janet had this scheduled in her day planner.

Clinically, Janet's liver enzymes are markedly improving and her ammonia level was normal today!

It's so wonderful to see Janet's family rallied around her as she becomes more and more coherent...

The nurse tonight was going to let Janet try to get some good sleep.  They will do a swallow test to make sure she's ready to eat and drink.  They will be getting Janet out of bed tomorrow and at least into a chair.  I think Janet is quickly going to be graduating out of the ICU to a regular hospital room... probably not tomorrow, but soon. 

Our dear Janet is back.  I think we can all cry, laugh, celebrate, and most definitely thank God together.

All this healing takes more time than we want...

I must head to bed, but wanted to write a note for all those who are anxiously waiting on news of Janet.  She continues to be stable, and her labs (liver enzymes, etc.) are slowly getting better.  She is not off the ventilator yet though, and is not responding to commands yet.  Janet's body has undergone so much with the overwhelming storm of events that occurred during her septic episode that it is just going to take longer than we want for her body to mend... Part of that process of healing is waiting for the fog in her brain to lift.  Some of this is due to medications still in her system; some of it is due to her liver enzymes and ammonia level being high...  They don't want to remove the ventilator until her breathing gets a little stronger and she starts responding to commands.  The doctors are confident that Janet is moving in the right direction.  We will just continue to support her in prayer!

Quiet day

Janet is continuing to show good progress.  She took a lot of steps forward in her recovery yesterday, so today has been more quiet to just allow her body to catch up with itself.  All of Janet's treatments and medications right now (i.e., the ventilator, the tube feeding, the antibiotics, the IV fluids, etc.) are really aimed at supporting her so that her body can regain strength and stamina.  Her body has a lot of hard work to do as it repairs itself and comes back into balance.

For those of you who are interested in a more clinical update, here it is.  Janet became much more responsive yesterday as some of the sedation and other medications cleared from her system. 
She is not alert or responding to commands yet, but she is definitely not liking all the tubes and wires that are attached to her (this is all a normal part of the process when someone has been totally sedated on a ventilator).  Last night, Janet was able to pull out her feeding tube.  Oops!  Thankfully, she only pulled out the feeding tube (which is relatively easy to replace) and did NOT pull out her ventilator.  The nurses are now watching her closely and soft wrist restraints are keeping her from pulling anything else out.  Although Janet did respond well to the ventilator being turned off yesterday and was breathing on her own, they did end up turning it back on on a low setting so that she can rest a little more before they take it out completely.  They will probably allow her to just rest tonight with the ventilator as is and do another trial with it off tomorrow.

Janet is tolerating her tube feeding without any problems, so now she is receiving nutrition around the clock, and this will also help her heal and get stronger.  Her lab work looked a little better today.  Her white blood cell count is the only thing that still isn't coming down yet, so continue to pray that the IV antibiotics start kicking in.  Her vital signs and kidney function are good.

Janet's fingers on that left hand are looking a little better.  While they were worried a couple days ago that she may lose her index finger in this process, it is now looking like she may only lose the tip of her finger and maybe the tip of her thumb... The vascular surgeon said that they will just continue to watch it.  It is possible that she could get enough blood supply to those areas where she may not lose anything.  They don't know.

So just continue to keep her in your prayers as I know you are.  Janet is definitely loved by so many!

Improvement!

 

Dear Janet has made some very encouraging improvement today - even just in the last 10 hours.  I know that so many of you are praying for her, and we believe she is feeling your prayers!  The nurse today was able to completely wean Janet off the four different medications (vasopressors) that were giving her a blood pressure.  Yesterday, each time the nurse would try to titrate the vasopressors down, Janet's blood pressure would also drop, and so they would have to turn the medication back up.  This is no longer the case.  Janet is maintaining a very healthy 110/60 blood pressure now completely on her own.  Now that the vasopressors are turned off, her stomach is beginning to wake up.  They were able to turn her tube feeding back on, and now she is digesting it as she should.

The other great news is that the respiratory therapist was able to do a trial of turning off the ventilator, and Janet responded by breathing on her own!  The ventilator is still inserted, but she is no longer depending on it.  The sedation is beginning to clear from her system and she is starting to wake up a bit and is responding to irritating stimuli.  She hates the ventilator, and has tried biting it and pulling at it.  These are all very good things!  It will take some more time before Janet responds to commands and is alert to people and her surroundings, but this is a great start to the process.  Hopefully the ventilator will be able to come out soon.

They will do blood work again in the morning.  Hopefully, the labs will show the same improvement that we are seeing in her vital signs and behavior.

 

Not much change...

As far as an update for today, not a lot has changed. Janet is still fighting a severe infection. She is not conscious right now due to being sedated. They are turning down her sedation and her pain medication in hope of getting her to wake up a bit. She is on a ventilator and is not breathing on her own at this point. She is continuing to receive IV antibiotics, but her white blood cell count has not started coming down yet. Her heart and her liver have been pretty stressed and there is some damage to both. She isn't really digesting the tube feeding (through a tube in her mouth to her stomach) at this point, which just means that her gut needs to wake up a bit. Janet's left arm has some dark purple mottling from a previous lack of circulation. Her arm looks like its going to be okay, but they are doing ultrasound tests on her fingers... they are worried about her first finger on her left hand which is very purple and cold. There is a possibility that she could lose it...   They are also working to wean her off the medications that are keeping her blood pressure high enough to perfuse everything as it should (internal organs, etc). Janet's electrolytes and blood work is still a little off as well and they are working to get that back in balance.  Her platelets and blood clotting ability is low, so they are continuing to make sure she isn't having any active bleeding anywhere.  Her chest x-ray looked fine today which is a good thing since there is a very high risk of pneumonia when a patient is on a ventilator.

The big picture is that Janet's situation is very serious. Her body has undergone a major storm of events from septic shock which started from infection overwhelming her body. Janet is stabilized at this point, but she has a LOT of work ahead of her to recover from all of this. This isn't going to be over in a few days with Janet just bouncing back to normal life. Today, they are beginning to turn down the ventilator settings a little at a time.  As I mentioned, at this point, Janet is totally dependent on the ventilator to breathe for her. It will be a process to wean her off, hopefully in the next day or two.

I know for so many people it is really tough to wrap our minds around how very sick Janet is right now. Please keep praying for her!  Pray for her family as they process all of this, and as it is going to be a long haul for all of them.