Hello from Tom (Not dead yet!)

I am emerging from this medical nightmare.  My strength is much better (I'm writing this note, something I couldn't have done a day ago), spend more time out of bed than in it, and instead of struggling to make four circuits around the "Huntsman Highway" have already made the walk seven times today.  I get myself out of bed, and am able to walk without assistance.  Basically I am now in a waiting game, waiting for the leak to close so I can go home.  The current strategy is to have my catheter connected to a vacuum, the theory being that will encourage urine to flow in its normal route rather than through the leak.  How long?  The doctor said two more days minimum.

For the record...being able to watch endless movies, Twilight Zone re-runs and football games gets old fast!

Ruth Ann just walked in and the room has brightened!  Thanks to all of you for your love, prayers, and concern.

Love,

Tom 

Happy New Year??!! A big yes...

  Some might call this past three weeks a creeping catastrophe (definitely not a long drought) in Tom's case. It's pretty obvious that what we all want is for him to get better, as Bishop Whiting said on Sunday night,  but it takes time for the body to heal and in the meantime his incisions are pretty well there and he's a few days out from having the cath withdrawn. Dr. Willis and Dr. Foot, urologists with Dr. Bob Stephenson dropped by and explained the suction on the cath and putting the other gravity drain back on after seeing today's CT scan that shows less fluid below the bladder, which has less in it than Sun. and Mon. and there is a granularization process with tissue as it heals that takes time. One of the other patients we have visited with has been in longer than Tom. She has had her whole throat and mouth rebuilt because of cancer. They can shave off skin and muscle tissue from a leg and refashion it into all that's necessary for her throat. Pretty spectacular sculpting! Everywhere I turn, I see others whose place I wouldn't want to be in. We continue to appreciate your prayers----Love, Ruth Ann

(Tick tick tick tick...)

Pappy had a better day. He looks more and more like himself. They're trying an "experiment" to see what effect clamping the abdominal drain will have - hopefully sending the urine out the right way, through the foley catheter. Rashes still persist from the aforementioned frost, but all indications are that we'll be outta here this week! Stay tuned. We're hoping to be out on Wednesday. - Nathanael

A delay in routing---

   Tom is a little grouchy today. Hmmm. Maybe more energy to feel that way. The docs were thinking seriously about releasing him, but thought of more to check out before they do. They found the labs to be seriously lower (yes!) and the flow still mirroring the input. He has a bad uremic frost because of toxicity over the last 15 days...it's the body's way of ridding itself of poison and it's dang itchy, so we wipe him down with aloe wipes and he has vetoed the benadryl they gave him yesterday. Wade the nurse is watching the flow from the JP drain in the lower abdomen and comparing the outflow from the Foley cath to see if it will help the healing process on the urethra.  We are doing a dance again, called cause and effect. He'll be here tomorrow I guess.  Ruth Ann

Saturday, Dec. 27, 2008

Tom's kidneys are working at a better rate than yesterday----blood labs and urine are looking better. Possible return home tomorrow depending on the labs tomorrow morning. He will have his lower drain in abdomen and the Foley catheter which will both remain until Dr. Stephenson decides otherwise. The kidney docs have signed off on going home. Heart and lungs look clear and strong. It looks like a renal diet for him on low sodium, and less phosphorous. I will be getting more info from the diet tech.  He is walking some today, but I anticipate that he has a ways to go towards normal activity---- we have our Davenport nurses lined up, but we might have to call Sadie every now and then, or some of the nurses in our ward! 

The clouds are lifting!

Good things are happening!! Last evening when we got back to the hospital after a wonderful dinner at the Hardings, his flow had increased significantly and along with that, today his blood and urine labs took a turn downward. What a relief----so no dialysis! He has an infection they're treating with an IV, but he ate a little more than he has in the past week and they'll do some CT scans this afternoon to verify what's happening to the leak. More later... Ruth Ann

I just erased a bunch of info about Christmas eve and morning: we ate dinner at the hospital to be near Tom and watched a Christmas Story together. We were glad to see the Whitings for a cheering visit. Then we headed into the hospital early to have Christmas morning together and watch Esther and Ezra open their presents. Several caroling families have graced the time here. The normalcy is a pleasant reprieve...Later that night we watched It's a Wonderful Life. Compared to many of the other patients here, Tom has a lot less to worry about though I doubt we sense his pain level accurately.

On Christmas day the nephrologists came by with the same news about the kidneys as the day before: kidneys working at 60% of normal and the peritoneal cavity still absorbing fluid from the lower pelvis, with a quantity also being drained on the right side. Little was coming from the catheter. They wanted to do another dialysis on Friday because the creatinine number is high. But last evening, more urine was coming out the cath and this has continued through the night and this morning, over a liter. He's restricted to one liter of water to drink in 12 hours along with juices, milk at meal times. No IV. We'll see what they say this morning about dialysis. Ruth Ann

Christmas redefined indeed

Sometimes I hesitate to write anything, because the opposite can happen. Going home was possible, but not probable. The nephrologists thought better of the idea so Tom's here for a bit longer. It will be a White Christmas for my knight, who is in better spirits every day. We've decided the renal diet has it's advantages, one being that there are far less choices. He doesn't enjoy making mundane decisions. So jello, broth, and popsicles here he comes.

    Today he's getting a drain replaced in the lower abdomen, and they have removed the other drain on the left. Yesterday's dialysis has relieved some peripheral swelling and helped the toxicity in the blood. The flow continues low.  Looking back to Dec. 11, it didn't occur to us that recovery might be delayed, but this year will end with a deepened love for life because of your quiet gifts to Tom and all. It gives us both heart!

Many thanks for the bright, cheerful greetings from the Primary in the Forest Park Ward where Tom teaches every other week. He lit up like a Christmas tree when he read your heartfelt wishes----I think he misses the excitement and challenge!  Thanks to all the children, teachers, and leaders! 

This evening Tom had a visit from Dr. Bob Stephenson after receiving dialysis all morning and having a cystogram to check for a leak (s) from the bladder.  The upshot:  they might release him to go home for Christmas tomorrow afternoon.  The surgeon and nephrologists feel that his complications that were causing problems have become less impactful:  heart and lungs have improved markedly, the JP drain will be removed tomorrow very likely, and the other drain will remain for some days, also the catheter. He will be coming in for blood labs and checks for healing. The leak isn't 'communicating' as much fluid now and his peritoneal cavity that is very vascular has been reabsorbing a quantity of fluid from the abdominal region. This has baffled them on the blood electrolytes, which is looking better for now but will have to be monitored. Most all leaks are typically healed by the body.

   He's been a model patient and deserves some time off for Christmas!!  In other words, your kind prayers and positive thoughts have helped him improve and I hope this continues tomorrow and day to day. I'm so grateful for the blessings that he's received---- what healing power is possible from Heavenly Father!

Dialysis went well this morning, next is a cystogram test to try again to determine where the internal leak is. Esther would like to leave everyone a message:uhyyyyyyyyyyyyyyyyyyyyyyyyyyyttyyttyttttttttttttyyttttttttth uuu8uyyy7yyyyyy

Which, interpreted, means: happy birthday cake and toys! 

Love you all!

Abby and Esther

Dialysis

Tom is in dialysis again this morning, and we are just waiting to hear from the doc's what is new today.

Pathology Report - Doctor's Analysis

Dr. Stevenson just appeared tonight and gave us the pathology report on their analysis of the removed prostate. The report is favorable, there was 20% coverage of cancerous cells on both sides of the prostate, and analysis of the surrounding fat tissue tested negative for spread of cancer. As far as the kidney problems go, the opinion of the nephrologists and the surgeons is that they are functioning quite well, but there is definitely a leak in the connection between the bladder and the urethra. Dr. Stevenson said that it WILL heal with time as the tissue builds up strength again, but sometimes it just takes longer with some patients. He said he has never seen a situation where the leak did not repair itself - but surgery is an option if it seems the leak is not healing fast enough. They will do some more specific x-ray tests tomorrow to determine the specific location and size of the leak. So good news.

Allergies?

We continue to be confused. The trio of nephrologists came in to tell us that they think there is the potential for an allergic reaction to the drugs from the antibiotics he was prescribed. They also believe there may still be a leak between the bladder and the urethra. However, one of Dr. Stevenson's residents came to check on him and says she doesn't agree with the nephrologists on a leak - that there is definitely something wrong with the kidneys. They are definitely going to do some more tests, but what ones are still on the cards. The consensus is that they have not seen anything like this and can't explain why his kidneys aren't kicking back into gear. On the positive side, they all doubt the possibility of complete renal failure. They hope to have him home healthy by Christmas. 

He is more lucid today, and while he is still extremely exhausted and still has bowel and bladder spasms (which are very painful), he talks more and looks better than he did last week. So things are slowly looking up.

12/22/08 for Tom

Three nephrologists visited with us this afternoon and have this update. He has two drains that continue to gather more fluid than the Foley bag which seems to indicate a leak in the abdomen and he has had a reaction to an antibiotic in his kidneys. They will likely do dialysis tomorrow. Thanks for those prayers!! Ruth Ann

Renal Scan

Tom is preparing for a renal scan this afternoon. We will post the results when they happen.

Getting up to Speed

Tom was diagnosed with the beginning stages of prostate cancer and enlarged prostate in October. He elected to have a Da Vinci prostatectomy over radiation therapy. The procedure took place on December 11th, and under normal circumstances, would have only stayed for one night to convalesce from the surgery. 

The following day, however, complications arose with the kidneys and his electrolyte balance. He became edemic over that weekend.  By Monday, three kidney doctors ordered a special test be done and the following morning, dialysis was ordered. He had it done twice that day and once the following day.  His lungs were also filling with fluid and his heart became enlarged from edema. 

The next few days he was on a diuretic and it helped for several days. By Saturday 12/20 he was having problems voiding. The doctors are still scratching their heads about how to balance the electrolytes and finding out more about the kidney functioning.  Thanks for all your prayers and positive energy!! He feels it---as do we all! We'll post updates daily.