Friday, April 20, 2012

G is getting stronger

G has started making more of an effort to walk outside every day.  He has even gone with
me to the grocery store several times, and pushed a cart around the store rather than
riding in the electric cart.

His balance is much better, and he has started to get things for himself from the kitchen.
As I have waited on him for the last year, this has been a bit of an adjustment, for both
of us.   The reason I didn't want him getting up and down a lot previously was because he
had a catheter in his groin area for dialysis, and getting up and down increased the
risk of the catheter failing.   Of course now that is not an issue.

G's voice has also much improved.  The one side of his vocal chord is still paralyzed (from
when they hit the nerves during the carotid artery surgery), but the other side of the
vocal chords is compensating.   When he went to the Dr. a couple of weeks ago, the
Dr. let me look at the vocal chord, and you could see where the one side would
move past the center point, closer to the side which is paralyzed.  He doesn't get
as exhausted talking, and his voice is stronger, so we have decided to not risk
any type of surgical procedure to make it better.   Even with minor surgery there
is always a risk (witness what just happened to Dick Clark).

G has also taken an interest in writing computer programs again, and has been working
on a model diet based on all of the constraints he has due to renal failure, high blood
pressure and diabetes.

Just hope things will continue onward and upward!

Thursday, March 22, 2012

Dialysis at Night

G went on a machine called "the cycler" which does the dialysis at night when you sleep.

Well, that is if all goes well. If there is a problem it beeps, and let you know you
have to get up and check something.

There is a computer chip in the machine that we take in to the dialysis nurses who can
download info. The first time we did it there were 2 pages of alarms. They said many
people come in with print out of 2 alarms, not 2 pages of alarms.

So obviously things have not gone as smoothly as hoped.

It got so bad for a while that G started doing dialysis in the late afternoon/evening,
so it would be finished by 12:30 AM. It's been going better lately, but last night
alarm went off again.

G has gone on a "juice" diet, juicing fresh veggies. He did this in order to lose weight
and get his blood pressure down. It appears to have helped.

He is doing a great job staying on the diet, drinking juice and then eating eggs and
cottage cheese for protein, which he needs more of as the dialysis takes out protein.

He goes again next week for lab work, so we shall see what his blood thinks about
this new diet.

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Friday, February 10, 2012

Lots to update

My computer got a virus, so hence the lack of updates.

So, in the last month, G had surgery to remove the "omentum" in his abdomen. It was wrapped around the catheter, and the surgeon said that was why G had problems draining.

He had the surgery, but it still didn't solve the problem. G hit fluid overload in the hospital to the point he required oxygen the last night. The kidney Dr. didn't want to release him, eventhough they weren't going to do any surgery to fix the problem. What we thought would be an overnight stay turned into 3 nights..

Finally, G said "I am going to say I want released AMA (against medical advice). We told the nurse this, who advised us if this was done, then the insurance company didn't have to pay for the entire hospital stay.

So,..humm. Decided to ask to speak to the patient advocate. Luckily for us, when the patient advocate showed up, it was the guy who was the supervisor on that floor, whom I had complemented back in Oct. about how well run the floor was. He remembered us.

We explained we wanted to go home, G would do better at home, we would ensure he would
get hemodialysis if he needed it and not end up in the emergency room...etc.
I pretty much figured out the reason they don't want to release people is because they
get penalized by Medicare or Medicaid if a patient is readmitted within 90 days. The government is trying to force Drs. to address the underlying problem, and get support
in place so patients don't end up back in the emergency room.

G is not the typical patient. He will not let it get so bad he had so go to the emergency room for fluid overload.

Anyway, the patient advocate interceded, it was agreed hemodialysis would be arranged for 2 days from then, etc. etc.

G was released on a Thursday, he had hemodialysis on Sat., We still had problems with him not
draining, it sometimes taking 2-3 hours to drain when it should drain in 30 minutes or less. And, we had to do 4 exchanges a day, so all we got done was screw around with the exchanges. Finally, G decided to just lay in bed while it drained, and oddly enough when he laid on his right side, with the drain hose going up OVER his stomach (uphill), it started to really drain.

So weird, but at least we found the combination. And none too soon, because I was ready to throw in the towel at that point.

Then, last week G had a procedure, putting 3 stents in, to open up blood flow to his right leg, which was 90% blocked. He was in the hospital all day, but didn't have to stay overnight. That went well, so hope he can stay out of the hospital for some time now.

goverments s09r reetnandgem,,

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Friday, January 6, 2012

And more..

Two quick things.

The culture came back from the catheter is infected, they have changed the oral prescription, which I have to go pick up now.

Also went to the vascular Dr. today. Good news is the left carotid artery is not yet 80% closed, so they will check it in another 3 months. So, no surgery on it for the time being.

They will try to set up testing on G's right foot while he is in the hospital for the surgery next week. G doesn't have blood flow to 1 toe, so the VA podiatrist had suggested they try to do an angiogram and open up some veins to try to get some blood flow. After the experiences at the VA we decided going with this other vascular surgeon would be a bit wiser.

G needs to be sure and keep the blood flowing to his feet, or he will be in danger of losing toes, and then who knows what else.

We saw a guy yesterday who was at the VA same time G was in Feb. At that time the guy was having his leg amputated below the knee (this was his last leg..), and now he has to go back and have it amputated above the knee. But this guy still smokes, and has really bad diabetes.
Seeing him makes one want to be sure and take care of your feet!

Thursday, January 5, 2012

Back to the hospital

Wouldn't you know it. If something can go wrong, it seems to.

Apparently the "omentum" is attached or wrapped around the catheter. The surgeon
will have to make about a 3 inch incision, go in and remove the omentum, and at that
time he can also adjust the placement of the catheter, if need.

So G has to report to the hospital at 5:30 AM on Monday. They say he will probably
have to stay overnight...we hope not.

He is at hemo dialysis now. He will see if he can also get a session on Sat., so he won't have
to get one in the hospital...hopefully.

Here is the link to wikipedia if you want to know more about the anatomy of the Peritoneum.
click here

Also, G had a nose bleed this morning, so apparently the heparin which has been put into the
fluid for the dialysis has caused his blood to get too thin. He will have to quit taking the
blood thinners before surgery anyway, so hopefully his INR (which indicates how thin his blood is) will drop down enough by Monday that it won't be a problem for the surgery.

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Wednesday, January 4, 2012

Drainage problem NOT fixed

Spoke too soon.

After 2 really good drains yesterday, this morning the first one took 3 hours to get enough
to drain out...and that was with some walking around, pushing on the stomach, etc. After the
second one started out the same way, we called the dialysis center.

They set up an appointment for an X-ray which was done this afternoon, and
an appointment with the surgeon tomorrow morning.

The thinking is the end of the catheter in the abdomen has gotten turned up so it's above where most of the fluid is.

Assuming this is what is shown on the X-ray, they will put a guide wire in through
the catheter and reposition it.

Certainly hope that is the problem, and that it can be easily fixed.

Because G is pretty swollen, they are setting
up a hemo dialysis run, tomorrow afternoon after the Drs. appointment.

At least tomorrow is the clinic day for the Dr., and they got us in. I guess
it's good that the surgeon's staff knows us quite well by now. We certainly
have spent enough time at their office!

Fingers crossed.

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Tuesday, January 3, 2012

Drainage problem fixed

Long story short, the reason G was having slow drainage was because he has something
called "fibrin" which clogs up the line.

We went to the dialysis place today, and they gave him some heparin and showed him
how to put it into the bag with the fluid. This will break up the fibrin.

It is working.

Good thing, because G was getting way too much fluid build up. Hope in a couple
of days he should be back to normal.

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