Passing

Today's theme is Passing.

Passover is today (I think?), when God spared the children of Israel right before His mighty deliverance from Egypt.

This morning, I caught the end of To Kill a Mockingbird on TV, including the immortal moment when everyone stands and the old black man says to Scout, "Miss Jean Louise, stand up. Your father's passing."

I am passing gas.

I am also passing through the contrast from yesterday's test.

Therefore, this morning, the doctor passed on the surgery option.

You read right. No surgery today. Hopefully no surgery at all.

The doctor said that my study looked normal. He even showed us the images. Neither he nor the radiologist nor I could see any dilation. Combined with me passing gas and contrast out of my system, he felt like surgery was not necessary for fear of opening me up, running his hands all over my intestines, and finding zilch. We're kind of relieved, since the surgery is a big deal, but also a little nervous that the food trial will yield the same result as last time. We'll take it slow, though, and pray that everything works fine.

Is this what we've been waiting and begging for? After months of prayer coming back seemingly answered with a 'no' or 'not yet', is God saying yes? The only thing that could have stopped the surgery was a clean study, and that's what I got. Will this last, or will it be only a moment of triumph? I don't know, but I'm going to flood God's inbox with e-mails asking that this be the end of my complications. So to speak. I hope you will do the same.

This, too, shall pass.

Pray for:

Successful food trial (no more need for hospitalizations or surgery)

Safe travels for Ashley (who is going back to school for a few days to pick up some much-needed clinical hours)

My release from the hospital by Easter

and thank God that I won't be in surgery in 4 hours as was thought.

The Surgical Option

After 2 weeks of trying to get rid of the bowel obstruction with NPO and an NG tube, it looks like this obstruction won't move without some surgical help. McGreeky ordered a test to be done today, but the resident who put the order in the system put the wrong order in. So, Dan had a GI test that showed part of his bowels, but not the part that is obstructed! I tried to convince the radiologist that McGreeky wanted something else, but he wouldn't budge. Of course, when McGreeky paid them a visit in radiology he changed his tune.

So, we're now waiting for the real test he wanted to be finished. The surgeon really wanted to make sure Dan needs this surgery before doing it, but he is fairly positive that he'll be operating tomorrow. The surgery is scheduled for 3pm tomorrow...but it could go earlier or later depending on the other cases in the OR. Basically, all we know is that sometime tomorrow Dan is having surgery. Considering his last operation took 15 hours, we're thinking this one should be shorter. :)

Prayer is certainly necessary. It is not a complicated surgery, but there are all sorts of things that they could find or that could happen. Obviously, we have no control over that at this point, but we can pray to the One who does have control.

Look for updates tomorrow.

Prayer Requests:
* A safe and successful short surgery...with no complications
* Rapid recovery...with no complications
* Wisdom and skill for the surgeons
* Ability for Dan to eat normal food from here on out without pain or problems
* Peace for the family and me
* Ability for Dan to come home with me very soon
* A night of rest
* NO COMPLICATIONS

Tentative Tuesday

Not much has changed since yesterday. NG is still draining, bowel sounds are still present but quiet, and not much is passing through. On a good note, Dan's belly pain is gone (unless an unruly resident presses too hard).

McGreeky came in and told us he has put Dan on the tentative surgery schedule for Tuesday. He still doesn't want to do surgery, but feels like it's nearly inevitable. The final decision will be made after the results of Dan's GI study (he'll drink some contrast and they'll take x-rays every hour or so to see how far the contrast goes in the small bowel) are seen. The GI study i scheduled to start ASAP today or tomorrow morning, but radiology is pretty slow on Sundays.

We've been told the surgery isn't complicated, but will still involve a new incision in Dan's belly and risk of infection and more adhesions. To date, Dan hasn't had a surgery without complications before, so we're hoping this surgery will be the first quick-healing-no-complication-fix-the-problem-without-making-more-problems surgery.

Obviously, our prayer is that Dan wouldn't need surgery at all, but the requirement for that is for Dan's GI study to be "stone cold normal." Accordingly, that would only be in God's domain of healing. God is powerful and can heal Dan in a second, it's just a matter of whether or not that is in His will to do. We cannot coerce God to do anything, but we can plead and plead until He gets tired of hearing us and grants our request. As there are probably hundreds of people praying everywhere, I'm hoping God is getting close!

Today we wait. My parents are visiting after church to bring me some more food for my "hospital pantry" and just to say hello for a while. Otherwise, we just wait.

Prayer Request:
* Completely normal GI study showing complete resolution of obstruction
* No need for surgery...miraculously
* If surgery: no complications, no infection, no muscle problems, no digestion problems
* A week of healing and successful recovery
* Ability for Dan to go home with me very soon...and not return to the hospital for A LONG TIME
*Lots of encouraging and excellent news to report this week

Alrighty then

After discussing it between ourselves, Ashley and I thought that surgery was a better option than trying to wait out my obstruction only to be obstructed again and need surgery. So we were going to wait for the doctor to come in and let him know how we felt. The only game-changer would be if my morning x-ray looked impeccable.

I did not get a lot of sleep last night. NG tubes do not let you get really comfortable. Just to let you know.

Well the doctor finally came in, fairly late since it was a weekend, and told us that the x-ray looked better, and that he didn't want to operate on someone who was passing gas and other things (that would be me). Well, so much for our opinion. After a long talk with him and him showing us the scans, we decided to give it 'til Monday like we had said last night. The biggest factor was his strong hesitation to do surgery. It is a big deal, and doesn't guarantee no complications. And especially for me in my condition, since I'm not in an ideal state for surgery, he wants to avoid it if possible, and he feels like there is objective data to go with his plan rather than a hunch, which is what our plan was based on. Hopefully this time, it will resolve with no surgery and will STAY that way. The interesting thing is, last night Ashley prayed that the doctor would be strongly opinionated one way or the other; though she was expecting him to be strongly for surgery. We'll see. We'll pray.

Please join us in praying for:

resolution of the obstruction with no surgery (quickly!)

NG out soon and eating soon (as is safe)

wisdom for the doctors

out of the hospital soon, at least by Easter

no more complications EVER

What next?

McGreeky and the team came in a little while ago with CT results. The obstruction is definitely back and not resolving well. Though the doctor doesn't want to have to do surgery, but he feels that the odds of the obstruction healing on its own are getting much smaller. His gut feeling (pun?) is that surgery will be necessary. He's going to do an x-ray in the morning to see how things compare to today, but he is willing to wait until early next week to make a decision.

After they left, Dan and I talked about what he wants. It seems as though we are simply postponing the inevitable. Dan could start to feel better and look better, but the last time that happened, we were surprised by a re-obstruction. Our fear is that that will happen again or that we will always be on the look-out for a recurrence of the obstruction. Dan's life has been put on hold for quite a while now, and he (we) would really like to work toward healing finally.

The surgery is not without lots of risk, especially considering Dan's state of health. It would be a separate incision to reach the distal part of the small bowel. It could be a simple surgery (removal of adhesions or whatever is blocking the bowel) or it could be complicated (resection of any part of the bowel that has become injured or has died). Those things will not be known until surgery has already begun. Additionally, surgeries involving the bowel could cause more adhesions and obstructions. Then, there are the normal surgery risks: infection, pain, malnutrition, etc.

Dan and I need a lot of prayer tonight to help us make a good decision. If surgery has to be done, we would rather it be done tomorrow rather than next week. Yet, there is no way to know whether or not surgery is absolutely necessary. Dan made the point that God could heal him and end this situation, but how long do we wait on God for a miracle? Perhaps, the healing we are seeking from God is coming through the hands of a surgeon. We really don't know.

Please pray that God will be very clear with us. Pray that the surgeon will stew on the situation tonight and make a firm recommendation in the morning. Pray that if surgery is required, it will be successful and the recovery would be smooth this time. Pray that we stay in the safest place in the world: God's will.

Stay tuned. The next few days may be more exciting than we would like.

Second opinion

The gastroenterologist walked in while we were watching Grey's Anatomy (Dan's uncle was on it again last night!). He and the team did a brief history and exam and then gave their opinion...the agree with what McGreeky is doing. It's nice to know that the second opinion is the exact same as the doctor we've been trusting so far.

Basically, the GI doc said it is completely the surgery team's decision regarding surgery. Some people heal and get passed obstructions without surgery, some do not. Looking at Dan's last CT, this doc was almost certain that this is not a medical issue (not paralysis of the stomach or bowels) and could not be fixed with any medications they could prescribe. Accordingly, he feels Dan is best taken care of by the surgical team. He will join McGreeky in looking at today's CT, but feels confident they will concur.

Dan's still working on the CT contrast. Pretty much a champ. After he finishes, he will wait for 90 minutes or so before getting the CT. This will allow the contrast to work its way through his intestines to give the docs the best picture.

Perhaps, this is a 3 update day.

Keep praying!

Out of control

The night went smoothly. We both slept, though I had to get the NG running every now and again. It hasn't put out much since last night, which is encouraging. Some of the belly pain has persisted, but it's gotten better.

McGreeky came in and said he had been expecting to operate on Dan today. Then, he looked at the x-ray from last night and was pleasantly surprised. The bowels are slightly distended, but there is air in the colon, which means things are still getting through. My favorite part of the conversation: McGreeky asked if Dan was passing gas, and Dan answered by doing so in his presence. Ha. (Hospital humor). At this point, the surgeon still doesn't think surgery is necessary. Though, he has warned us that if another trial of NG suction doesn't resolve the obstruction, surgery will be warranted.

Dan is currently giving himself contrast through the NG in preparation for the CT. So long as the CT shows improvement, we wait. Otherwise, this may be a bigger weekend than we would like. Also, the gastroenterologist is coming in eventually (possibly after the CT) to throw his advice in. We're not expecting anything different from the new doctor, but I suppose it won't hurt matters.

This will be another two-update day, though I am hoping the next update is nothing more than "things are looking better." We are definitely not in control of the situation, though God is.

Prayer Requests:
* Complete resolution of bowel obstruction without the need for surgery
* Encouraging news on the CT scan
* Wisdom for the doctors (McGreeky and GI guy)
* Bowel movements and passing of gas (such a weird thing to pray for, I know)
* Disappearance of belly pain
* Ability for Dan and I to celebrate Easter at home
* Peace and confidence in God's control

NG 2

Two updates in one day? That hasn't happened in a while. Today it is necessary.

Last night was awful. Thanks to exhaustion and 4mg of morphine, Dan slept until almost 1pm this afternoon. He obviously needed the rest. When he finally got up and moving, his pain kept him from walking around much. The belly pain got better as the day went on, but never really went away. The two meds he got put on ended up making him sick...so, we got the doctor to ditch those. We also convinced the doctor to order an x-ray for tonight instead of waiting for the morning. As we explained to McGreeky how Dan's symptoms had progressed throughout the day, he agreed with our thought that this was his obstruction returning. Accordingly, he wanted to get a jump-start on taking care of the problem.

While we waited, Jamie made a surprise visit since she was taking the exchange students to San Francisco. She brought us fruit and gifts from Israel. Very fun!

Unfortunately, the x-ray did warrant some concern. As the on-call resident is quite busy tonight, the only detail we got on the results was that his abdomen looks a little distended and the team wants to decompress the bowels before any obstruction gets worse. So, Dan got his 2nd NG tube inserted about an hour ago. The nurse was awesome and made the experience much less traumatic than the previous NG placement by the resident. We're awaiting x-ray confirmation of proper placement before Dan gets hooked up to suction again. Hopefully, this NG won't need to be in place as long as the last.

Luckily, Dan isn't feeling too bad tonight. Before the NG got placed, his nausea and pain were very minimal and sometimes, not even there. Perhaps, this will mean a quicker resolution of the obstruction, as the doctors caught it early. On the other hand, McGreeky is going to be even more cautious regarding advancing Dan's diet. Surgery is what we want to avoid.

Tomorrow, the plan is for a gastroenterologist to take a look at Dan's case (at McGreeky's request) to make sure nothing is being missed in his care. Also, Dan will have a CT to see the extent of this obstruction. Hopefully, by tomorrow evening we will have a more solid plan for Dan.

Let it be known, I have never seen a patient endure so much, have so many setbacks and still find the resolve to laugh and smile. Dan is honestly the most amazing man I have ever met, and no, I am not biased.

Prayer Requests:
* Complete resolution of obstruction without need for surgery
* Wisdom for the doctors
* Encouraging news from the CT
* Passing of gas very soon
* Short period of NG necessity
* Comfort and rest for Dan (despite NG)
* Wisdom for me to know when to go to school
* Ability for Dan and I to celebrate Easter at HOME

Back up

Approximately an hour after Dan blogged last night, we figured out something was going wrong.

His belly pain was coming back, his stomach felt full and he just couldn't comfortable. Over the course of a couple hours, Dan was vomiting and having terrible back and abdominal pain. The on-call doc got paged, she ordered an x-ray and checked him out. The x-ray came back mostly normal, though all his intestines looked a tiny bit distressed (mild ileus). The pain got worse and since the resident had ordered oral pain meds, he threw up any relief he might get. We called the nurse again, she saw how sweaty and miserable he was and came back with a large dose of morphine. Since then, Dan has been mainly sleeping. It was a terrible night.

This morning, McGreeky came in looking pretty disappointed, but not as much as Dan. He said it looked like the solid foods were a little much for his intestines and pushing it anymore could result in another obstruction. He wants to give the bowels a break today...thus, back to NPO and TPN. Dan was relieved that an NG isn't necessary today, though it's always a possibility if this continues. McGreeky and the team are pretty sure this isn't another obstruction but just distress on the bowels. He'll be starting Dan on a couple new meds (Reglan and erythromycin) to help the GI system get moving again, but we have to monitor him carefully. If he does have an obstruction, these meds would make it worse. If no obstruction, they help the situation. We're always walking a fine line here.

Dan will be watched today and if the pain continues, will have a CT tomorrow to make sure nothing is out of place. Additionally, the pain he is having in his back could be related to his pancreas, so he'll be having some extra labs to rule out pancreatitis.

This time yesterday, McGreeky said Dan could have his PICC removed and go home today as long as food stayed settled all day. Now, we're back to having no clue when discharge will be. As frustrating and disappointing as this is, I'm just glad it happened before we left the hospital. McGreeky told us that most obstruction patients go home when they can tolerate liquids, but with Dan, he wanted to be extra cautious and watch him progress through solids. Thank goodness, he decided to keep him a little longer than normal.

So, now we back up and wait a while. This could be only a set back of a day or two, or this could keep Dan here a lot longer. Only God knows what is in store for us.

After one of the best days we've had since January, that was one of the worst nights on record.

Prayer Requests:
* Dan's bowels calm down and do not become obstructed again
* That this is simply a matter of eating too much too soon
* That the meds help
* No more pain
* No need for more invasive procedures (NG, surgery, etc)
* Ability for Dan to be able to progress through a diet again soon
* Home for Easter (only a week or so away!)
* Creative clinical hours for me to make up this week
* Total healing for good!
* NO MORE COMPLICATIONS

More good news!

So two days ago I gave some good news: that I ditched my NG tube and was starting to eat. Well... things went well sipping, so I thought I would get upgraded to clear liquids (not just sipping). Wrong.

I got upgraded to full liquids, which is one step above. Hot dog. That's not what I ate; I had creamy soups and ice cream. Anyway, that went well, so today I went on regular diet. I mean... !

So that was nice to eat real foods. That has been going pretty well. I still have to remind myself not to eat too much. It's also been nice because they're holding off on the TPN tonight (to let me get more hungry) and they've also canceled my IV fluids, so I am currently wireless. Oh yeah.

If things keep going well while I'm eating, then I have no more reason to be here. Which means I get to go home. Oh yeah! So hopefully that will be soon.

Ashley got back last night and it was really good to be with her again. I got to kiss her for the first time in a while now that my NG tube was out, and it's really nice to cuddle with her on my bed. But it'd be nicer to cuddle with her on our couch. Soon. For now though, she's dealing with some belly pain that's just annoying.

Please pray for the following:

Food to go down well

Reduction/Elimination of Ashley's belly pain

Soon discharge from the hospital

Wisdom for doctors

Good news is good, you betcha

I like good news. Get ready for some.

There was zero drainage in my gravity-induced bag and my x-ray looked good, so this morning the doctor pulled out my NG tube! At first, my nose was extremely confused. My throat hurt a little bit, but that only lasted a while. I feel SO much better now. As of now, my new diet is sipping on clear liquids. If that goes well (which it is so far), I can drop the 'sipping' part. And advance as possible after that. It feels good to taste things again, and also to not be confined by my nose. Pray that things continue to go well!

Ashley is back at school. It's sad that she wasn't here for the gloriousness of the NG being removed, but there will be plenty more good times for us to share in the future. Unfortunately, tonight she is headed to the ER to check out some belly pain that has been off and on in the past months. Pray that nothing is wrong with her so she can make her scheduled flight on Tuesday night.

Well, I need to go because the battery's dying and I'm due for a walk around the unit. Keep praying-- I am encouraged by all of your prayers. Hopefully tomorrow I can give some more good news.

:) /\ |\|

Patience

So, we didn't blog yesterday. I was busy writing a paper all day, and Dan didn't really feel like it. However, don't feel like you missed a lot.

Dan had an x-ray yesterday and it looked a little better than the previous one. McGreeky came in and told us that a few loops of the bowel are still distended, but that the distention is decreasing (Thurs: 6cm diameter, Sat: 4 cm, Normal: less than 3cm). The obstruction is still there, but hopefully it is beginning to resolve. When we asked about what the obstruction is, McGreeky said there is really no way to tell just from a CT. However, the main options are still surgical adhesions or an internal hernia. Regardless, the plan of care remains the same: wait patiently for as long as possible. Though the obstruction could be fixed through surgery, Dan is not a good surgical candidate right now. Accordingly, McGreeky (and the other surgeons consulted) do not want to be hasty about making this a surgical issue.

(My blogging was interrupted by a victorious Dan announcing the passing of gas! Normally, we wouldn't post this, but it has been a prayer request. So, that means this is a praise!)

The NG drainage is still a lot, but is thin and light which encourages the doctors.

(My blogging is again interrupted by the doctors coming in.)

Between the NG output being light and the passing of gas, McGreeky has decided to put the NG to gravity with a drainage bag for a day to see how Dan does. If he can stay the day without being nauseous or vomiting, they'll start giving him fluids tomorrow. If not, they'll put the NG back to suction for a couple days. Once the diet keeps advancing, it will be the true test to make sure Dan can tolerate the food and that the food goes all the way through the system. An x-ray tomorrow will determine whether or not the NG gets pulled all the way out. So, it's a big day tomorrow.

I am unfortunately leaving for school today and won't be back until Tuesday night. Hopefully, I will be missing some exciting events so that when I get back, Dan will be eating a bit. It will be nice to get some school work done and to gather more clean clothes from home. It will be even nicer to get back to a happier, healthier Dan!

Luckily, Dan is able to talk better with the NG tube, so he can communicate to the nurses without me around. Also, he knows the signs to alert the nurses to quickly. He's a smart guy, so I trust he will be intelligent about his care. He wants himself to get better even more than I want him to get better! Though, somethings will be more difficult without me here--washing up, motivation to walk around, asking questions of the doctors, and remembering what the doctor says. It really isn't a matter of preference for Dan to want me here, it is actually very helpful for both the doctors and my husband. Sure, we can be apart when necessary, but when my professors are working with me so patiently and ensuring my graduation, why wouldn't I want to be with Dan?

Anyway, this has the potential to be a very exciting day or a very disappointing day depending upon what happens with Dan's GI system. We are hoping and praying this is indeed the turning point for Dan's recovery.

Prayer Requests:
* Complete resolution of the obstruction without the need for surgery
* Continuation of passing gas, bowel sounds, etc.
* No further complications!
* No nausea or vomiting or increased belly pain
* Safe travels for me (and the girls driving me down to school
* Peace and confidence in the doctors for Bob and Jamie
* Wisdom for the doctors to watch the progression
* Successful food trial this week
* Ability for Dan to come home with me very soon!
* Good news and encouragement for the rest of this hospital stay...may it be short!

Stuck

Things that prompted this title:

The NG tube stuck up my nose

The fact that I am stuck to the wall when the NG suction is on

Sometimes my NG tube gets stuck because of all the mucus

The fact that I am stuck in the hospital, with little progress

ESPN is stuck on March Madness right now

My bowels are stuck

I am really not a fan of this time. Not counting follow-up appointments, I have spent 41 days in a hospital this year, or 52.6%. And still, I wait. With a tube up my nose.

Granted, there is so much to be thankful for. I have made a lot of progress on other areas physically, but it's so easily masked by another setback that puts me in the hospital and not even able to eat the little cups of jello and drink the plain chicken broth. At least I get ice.

Before Ashley and I got a private room, I was in a shared room, and had 3 different roommates. The first was a guy with no legs who got transferred to a different floor and was later discharged. The second was a younger post-op who went home like the next day. Both complained about the food (because it is popular to complain about airplane and hospital food--I will never complain about either ever again). At least I have legs, right? My third roommate was an old Indian chap who was able to eat, but slowly. His wife and family were extremely nice and I felt really bad that I had to transfer out while rooming with him, for fear of seeming like we didn't like them. Whenever I walk by my old room, if I see them, I wave, and they wave back like I was part of their family too. They remind me of my Indian neighbors back at Biola. How I wish to see them again and eat their yummy chicken.

But really, I'm not obsessed with food. I think. The point is, 52.6% is too much. 41 days is too much. I'm done. I want to get on with my life and be normal again. I haven't taken a regular shower since January. I want to eat a home-cooked meal by my wife and gain weight and muscle mass back. I want to be at home for more than 2 weeks at a time and be with my friends and church family. And hopefully, I will soon. I'm hopeful that this will pass (and praying for it to not be surgically-induced). I'm praying that this will be the last complication, even for the upcoming second surgery in June. I've been on this ride too long, and it's time to get off. But wouldn't you know it, I'm stuck. Which is why I need God's help getting out. May He have mercy on my body.

Patient's Progress

Drum roll please...not much going on.

Dan is feeling a little better with more energy from the TPN. The morning has included getting cleaned up and an abdominal x-ray, which took forever because of radiology students.
Somehow, when Dan was here for a month, he only had one nursing student for part of a day. In just these past few days, he has had 2 nursing students (SN), a med student and radiology students. Good grief. Being a nursing student, I know we need to be nice and understanding since they are learning. Yet, I am also more aware of mistakes...(like dumping the NG canister down the toilet and never recording the output, causing the doc to think great strides were being made when nothing has happened). Today's SN is much better than last night's and has been very accommodating. What's more, she's not nervous and performs her tasks efficiently and well. Phew.

McGreeky came in twice this morning: once he was very excited because the intake/output record showed a very low NG output from yesterday and again with the x-ray results. After I explained the SN's mistake last night, he seemed a little disappointed. The x-ray showed not a lot of progress since Tuesday--maybe 20% more open. At this rate, Dan will be here for a LONG time. McGreeky told us we had to have patience and added a note of encouragement when he saw the look on my face that told him we have more patience than he does (patients, ha). He also reminded us that the possibility of surgery remains in the back of his mind.

Anyway, we're going to be up and walking a lot today to encourage his bowel to get past this obstruction. At this point, it looks as though Dan will have the NG for more than 3 days, which is not making him happy. The overarching goal: bowel sounds and passing gas. Seriously, without those...he's stuck here.

On the note of being stuck, I'm beginning to feel a little stuck myself. School is on break this week, but will resume next week. Dan feels pretty helpless since he is attached to the wall with the NG and has asked me to stay even if it means missing school. He hasn't asked that of me before, so I know he is serious. I have a lot of school work I can get done here (papers, readings, research, etc.), but there are some things I cannot make up while here. I'm becoming concerned that the grace my professors have given me is stretching a little thin. In the end, I know I need to choose Dan over school (and will), I just hope that doesn't prevent me from finishing school.

Speaking of school, I better start writing some papers!

Prayer Requests:
* Complete resolution of bowel obstruction with the need for surgery
* Quicker rate of progress (10% a day is too slow!)
* BOWEL SOUNDS AND GAS!!!
* Decreased NG output (less than a liter/day)
* No complications or further problems
* Wisdom for the doctors
* Wisdom for my decisions regarding school
* Ability for Dan to come home with me very very soon

Third time's the (Lucky) charm?

For the third time in 2 years, Dan got a PICC line placed today. Somehow, he got to the top of the PICC nurse's list, which means he'll be able to get TPN tonight. After a week of not eating (and losing 10 more pounds), some solid nutrition will do his body well. He has no energy and is pretty apathetic about getting out of bed. Such a bummer.

McGreeky came by this morning and reminded us that this is a "waiting game." Yes, we know, sir. The NG tube drained about 2 liters yesterday, which is still a lot. Additionally, Dan's belly pain has returned here and there. The surgeon says that is his bowels trying to overcome the obstruction. He doubts the blockage has changed much in the past day -- for good or worse. McGreeky might rethink the x-ray tomorrow if the NG keeps putting out so much fluid. So, now we just wait.

In other news, today is one of my favorite holidays...St. Patrick's Day! Of course, as a good (mainly) Irish lass, I enjoy the celebration of my heritage. Yet, I also find excitement in this day because it is celebrating a missionary! St. Patrick spread the Gospel using culturally relevant object lessons and stories--allowing the good news of Christ to permeat Ireland. Makes one wonder how many pubs full of people slamming pints tonight actually know what they are celebrating!

Usually, I make Irish soda bread on St. Patty's Day and watch The Quiet Man (classic John Wayne film that takes place in Ireland) to celebrate. As we are stuck in the hospital again, no soda bread will get baked today. Also, my movie is 500 miles away from me, so we had to switch to another great Irish movie: Waking Ned Devine (hilarious). I even forgot something green to wear, so I'm making due with a lime-green head band I found in my backpack. It'll have to do.

I hope everyone has a wonderful St. Patrick's Day and remembers what the day really is about...God working through a man to reach people for Christ. Though celebrating Irishness with a Guiness, corned beef and cabbage or wearing shamrocks is quite fun, too!

“Before I was humiliated I was like a stone that lies in deep mud, and He who is mighty came and in His compassion raised me up and exalted me very high and placed me on the top of the wall. What is more, let anyone laugh and taunt if he so wishes. I am not keeping silent, nor am I hiding the signs and wonders that were shown to me by the Lord many years before they happened, [he] who knew everything, even before the beginning of time.” ~ St. Patrick

Prayer Requests:
* Complete resolution of bowel obstruction without the need for surgery
* Miraculously quick healing of the obstruction
* Positive signs by today or tomorrow: bowel sounds, gas, etc.
* Improved nutrition status with TPN
* Quality rest for both of us
* Wisdom for the doctors
* My ability to get school work done in such a distracting situation
* Dan's ability to come home with me very soon
* Normalcy and a long period of good health in the near future!

And, here we go again.

McGreeky came in around 7pm to let us know the results of the CT. It definitely showed a bowel obstruction in the distal small bowel. Fortunately, is a partial obstruction meaning some fluid is still getting past the blockage. However, it is a very small amount. The doctor could only give a well-educated guess about how long it would take to resolve and threw out the number 3-4 days (at least). Dan will have the NG tube at least 3 days, which he is thoroughly unhappy about. He will have an x-ray on Thursday to see if there is any change in the blockage. We will also be watching for warning signs indicating worsening of the situation: increase in white blood cell count (WBC), fever, low urine output, abdominal pain, no bowel sounds or movements in the next few days. If these things happen, this problem may need to be surgically fixed. McGreeky said he is dragging his heels to avoid another surgery, but it is still a possibility. Surgery carries many risks, especially when Dan is already sick.

Unfortunately, we are embarking upon another "wait and see" type of journey. There really is no way to tell how long this will take to resolve. It's quite a bummer for all of us, but especially Dan.

Dan will be getting a PICC tomorrow (hopefully) or the next day for TPN. We asked the doctor to start him off with lots of calories to make sure he gets some heavy duty nutrition after so many days of nothing. We're hoping this PICC is definitely not needed for too long, as Dan should be able to eat normally after this resolves. We don't really know if he'll go home with TPN again, but I won't mind mixing to keep him "fat and happy".

Our lives have been seemingly put on hold since January 8th, and we are so ready to move past this. Dan misses how he used to be and I do, too. We need a little "us" time that doesn't involve meds and tubes and nurses and doctors and fevers and hospitals. We'll get through this, but we are weary and in need of joy and encouragement and normalcy.

Please be in prayer that something McGreeky said will be accidentally prophetic: "You'll have that NG for at least 3 days and be here a while unless something miraculous happens and the bowel opens up very quickly." So, pray for something miraculous! Pray that Dan's bowel opens up and the obstruction resolves very quickly...bowel sounds appear, gas gets passed, etc. Let 3-4 days be more than enough time for Dan to heal. Wouldn't it be great to point out to McGreeky that something miraculous did happen due to the prayers of the saints?

Prayer Requests:
* Complete resolution of bowel obstruction without surgery
* Miraculous speed of healing...which can only be attributed to God's hand
* PICC placement tomorrow
* Bowel sounds, movements, etc. in the next day or two
* None of the "warning signs"
* Comfort and rest for Dan
* Wisdom for the doctors
* Ability for me to stay with Dan throughout his healing
* Encouraging and joyous news in the next couple days
* Ability for me to get all of my school work and clinical hours completed for graduation (it's getting pretty tight)

Yucky stuff

Last night was pretty miserable. The NG did its job and drained nearly a liter from Dan's belly...that's a lot considering he threw up 1.5 liters already! Yet, as effective as it was, it also kept Dan awake because it kept triggering his gag reflex. A couple doses of Benadryl were in order just to keep him comfortable and sleepy. Then, we had a little scare when his pulse was running in the 150-160s. An EKG proved it was just the NG physiologically and psychologically speeding up his heart rate. After a bolus of fluid and some sleep, it's running in a normal range now.

At the moment, we are awaiting the CT. Dan has to have the contrast fluid pushed through his NG. Might be easier than drinking it, but it still fills up his belly too much. The CT will show how severe the obstruction is and what is needed to fix it.

When McGreeky came in this morning, he said he was putting in the orders for a PICC tomorrow due to how much fluid the NG was emptying. He believes this might take a while to resolve and doesn't want to Dan to keep going without nutrition. So, hopefully, by tomorrow night, Dan will have some TPN to get him going again. As this is another waiting game, none of us are sure how long he'll be on TPN this time. I guess it's nice to already know how to administer it at home, though.

I'm pretty nervous about the CT as it could mean more surgery. I just wish this would have been caught at one of the trips to the ER or at the follow-up appointment with McGreeky. (Oh, if wishes and wants were candies and nuts...I actually don't remember the end of that saying.) Honestly, I think McGreeky is a little nervous, too.

Alright, back to spending time with Dan. He has to keep this contrast down so the CT will show what it needs to. We cannot wait until he can eat and drink like normal again. Oh, and no more hospital stays. Good grief.

I will update this after we hear CT results.

Prayer Requests:
* CT that shows only a simple bowel obstruction (no twisted or strangulated bowel)
* No need for surgery to resolve the obstruction
* Quick and complete healing
* Smooth PICC placement tomorrow and starting of TPN by tomorrow night
* Understanding doctors and nurses
* Wisdom for the doctors
* Encouraging news today
* Comfort for Dan--he hates the NG tube

The Culprit

About 3 hours ago, I saw McGreeky walk in the room with the resident. Let's just say he has a terrible poker face.

Apparently the GI study Dan had today showed that he has a bowel obstruction (blockage). At this point, they aren't sure whether it is from surgical scarring (99% chance) or some other cause. A CT will be done tomorrow to get a better view of exactly how severe the obstruction is and exactly where it is. If it is from adhesions (scarring), it will most likely resolve on its own. There is a small possibility, however, that Dan will need another surgery to get rid of the obstruction.

The resident came in about 2 hours ago and placed an NG tube (through the nose to the belly) to help rid his GI tract of fluids and such. This will alleviate pressure on the bowels and help the obstruction to resolve. The NG placement was horrible, but very necessary. Over a liter of fluid has been emptied from his belly so far. Additionally, the pain that woke him up last Wednesday...gone.

So, we now know what the culprit is behind the nausea, vomiting and pain. Hopefully, it will resolve quickly without surgery. Dan will be NPO (nothing to eat or drink) with the NG until he can pass gas and bowel sounds return. That could take anywhere from 1 day to several. The CT tomorrow will be compared with the GI study x-rays from today to see how much improvement the NG tube has made. As the obstruction hasn't been visualized yet, the surgeon is hoping for the best but preparing us for whatever needs to be done.

Along with all of this, McGreeky has decided that we are done with the wound vac...for good. The wound is healing nicely, and is too small to need the vac. This would be very exciting news, but it is overshadowed with the terrible NG tube and the unknown concerns of the obstruction.

I have hidden myself away under the window ledge on a fold-out chair to update everyone. Dan seems to finally be asleep with the help of some Benadryl. Due to the nature of an NG tube, his gag reflex is triggered almost constantly until it gets used to the foreign tube. It will make Dan feel better in the long run, but he is positively miserable right now. I hope the next nurse lets him sleep. And leaves me alone, too.

All we ask right now is pray pray pray.

Prayer Requests:
* Complete resolution of the bowel obstruction without surgery
* Calming of Dan's gag reflex so he can be more comfortable
* Rest for both of us tonight
* Encouraging news from the CT tomorrow
* Grace for the doctors...they missed this at two hospitals and must feel crummy
* Peace and hope for Dan and I (and Bob and Jamie in Israel)
* Ability for me to stay with Dan throughout this ordeal (still no private room and no car)

Back on E3

The decision was made on Saturday night to transfer Dan up here because he just wasn't keeping anything down. Dan felt so weak and tired that he called and asked about going back on TPN. McGreeky said no for now, but told us to get Dan up to Stanford for more testing. It was getting too difficult to be around doctors who weren't sure about Dan's history (and new anatomy).

So, Dan got out of PIH...and got admitted to Stanford again. Our wonderful friends (Lise and Andrew) drove us up yesterday afternoon, and Dan got admitted to the floor he was on after his surgery. It's nice to know all the nurses and the staff. We don't have to play phone tag with McGreeky anymore--he just comes to visit in the mornings.

Dan is feeling a little better today. He had more energy yesterday and only threw up twice. He actually made it the whole car ride feeling fine! Since he threw up at midnight, he's NPO for more testing. He'll be having a GI study (he'll drink a contrast fluid while a radiologist takes x-rays to make sure his GI system is working appropriately--that food is going from his mouth through his stomach through his intestines and out) later this afternoon. If that comes out clear, he'll have another CT to make sure nothing is going on there.

McGreeky really does think this is just a bump in the road and that it will resolve itself. It doesn't make sense to him that he could be eating fine for 10 days and then his GI system would stop working. Luckily, though, he's willing to do all the testing necessary to ensure Dan's health. Hopefully, Dan will be able to hold more food down today or tomorrow. That will be the true test and will help avoid Dan getting another PICC for TPN.

Of note, also, Dan is supposed to be undergoing an embolization procedure this week. It will shunt blood to the left lobe of his liver to help it regenerate faster and to help the right side to atrophy before the next surgery. This was supposed to be an outpatient procedure scheduled for Friday, but I guess since Dan is here they might do it sooner. We'll see.

For now, I'm doing homework and trying to stay caught up on school. My professors came to visit on Saturday night at PIH and were very encouraging. I might have to scramble a bit at the end of the semester, but I'm caught up for now.

Please be praying for during this time. Also, pray for Jamie and Bob who are in Israel right now. I'm sure they are having a difficult time watching from afar, but hopefully they know we have a lot of help and support of here in the States.

Prayer Requests:
* Clear CT and GI study--proof that everything is working appropriately
* Dan's ability to hold down food and drink
* Wisdom for the doctors
* No more vomiting!
* Successful and safe embolization procedure
* Ability for us to go home to La Mirada very soon...this week :)
* Ability for me to be able to stay with Dan here at Stanford the whole time (It's not a private room, but we're on the list. Dan just feels a lot better when I'm here through the night. Also, I don't have a car to drive myself anywhere this time!)

Turning a corner?

So, the last blog was happy. This blog is crappy. Just so you don't get caught unaware.

Dan was feeling great up until early Wednesday morning when he woke up with abdominal pain. After waiting for a bit for it to recede, he began throwing up. So, we went to the ER where they did a CT and labs. The CT looked great, showing no obstructions, no fluid collections...nothing to be causing the pain. After the ER doc called McGreeky, they decided to just make sure he could drink something and then send us on our way up to Stanford as planned.

By 10am Wednesday, we were back at the apartment and Dan was starting to realize that he couldn't really eat much. I went to clinical for a few hours, came home, packed and then we headed up north.

We stayed Wednesday night with the Sizeloves and it was a miserable night. Dan threw up at least 6 or 7 times and could keep nothing down. The pain had also come back, so he couldn't sleep. We got up early and headed to see McGreeky. The appointment actually went well. The doc looked at the CT we brought with us and was very pleased. He could see nothing to be alarmed as far as the pain went. He pulled out Dan's last drain (yay!) and changed the wound vac, which will only be on for a couple more weeks. He told us to just wait out the pain and vomiting before getting too concerned. He gave Dan a prescription for anti-nausea meds and told us to call if anything happened.

We met my parents in SF for a little bit because Dan was feeling better. He drank some and looked better. By the time we left, though, he wasn't feeling good anymore. The drive down was miserable, with Dan throwing up pretty much everything he had drank all day. We called McGreeky again, who was confident that Dan's body is just readjusting to "new anatomy". He said to wait it out over the night and he'd call in the morning. I drove us home, we showered and went to bed.

The night was a little better with Dan only throwing up once this morning, though it was everything he had ingested. When the doc called, he said to wait until this afternoon to make a hospital decision. If Dan can keep some fluids down, he can wait this stomach thing out at home. If he cannot keep fluids down, we need to go to the ER for dehydration and another CT to make sure fluids are making it past the stomach and that there are no obstructions building up.
For now, Dan is playing video games and trying to stay distracted. He's had a half glass of water so far, and is feeling ok. I'm trying to straighten up the apartment and get my homework done without worrying too much.

It is good that the CT didn't show anything and that the drain is out. Those are very great things.

Yet, we are so tired. Dan especially needs to be able to eat and drink to build up the strength he has lost over the last couple months. After finally being able to live together again, this is such a discouraging event. We really need Dan to "turn a corner" for the better (as McGreeky would say).

For a week or so, good news was finding us. Now, it feels like good news is far off.

Please pray loudly that Dan will be able to avoid another hospital admission and just get better at home. Please.

Prayer Requests:
* No more vomiting
* Dan's ability to digest fluid and food today
* Disappearance of pain
* Another good CT (if he needs one)
* Rest for both of us
* Good news that sticks with us
* NO MORE COMPLICATIONS
* That Dan can continue to live down here with me in our home

Drain drain

Hi everybody. It really has been a while, comparatively (because if you compare January on with everything before, it really hasn't been that long). Just wanted to give you an update since there is news.

Ash and I are leaving tomorrow to go to Stanford again. This Thursday could be my last appointment in a while (we're talking multiple weeks). It's really early, but the Sizelove family continues to be awesome and let us stay at their place. What will happen are a few things: the doctor will remove my last drain because it is not giving out much fluid at all, even though I'm eating full-time (YES), he will look at my wound, and we will discuss future options. I'm really excited to be done with drains. Like, really excited. It's starting to smell really bad and it's always been a pain to lug around and sleep next to and it's just time for it to go. My wound is healing, but still has a way to go. There's a little problem because the wound is a little small for the wound vac, which means that sometimes the sponge inside spills over onto my skin and really irritates it, so we go back to dressing it with gauze until it gets better and there's just a long cycle. Right now, we're being cautious with the skin and dressing it with gauze. As for future options, there is some kind of procedure planned for maybe a couple weeks. It's outpatient, so not too big. They want to cut off the blood supply to one side of my liver, so the tumor-less side has to work harder and therefore grow more, while the tumor-filled side will shrink. It was supposed to be done in the first surgery, but if you remember from the beginning, the surgery took 15 hours and there was no time.

Otherwise, things have been really good. We went to the store today and got some food that I'm excited about, and I ran into a teacher at the high school where I did my observation during the fall. I've been trying to get back into the swing of things around the apartment, like doing dishes and little things to help Ashley as she digs herself out of her homework mountain. I have also been playing a lot of football on my PS3, which is fun. And my parents have just gone to Israel for a couple weeks. Anyway, life is good. I'm eating. God is good. There's a lot of journey left for us, and we're going to be leaning on Him for the rest of it. Peace to you all.

Dan

Birthday fun

So it's been a couple days since we've blogged--Ashley's been busy and I've been having too much fun doing other things. But don't worry, you didn't miss anything dramatic.

Things are really good. Wednesday was my 23rd birthday, and it was a good day. Lunch with my parents before they drove back up to Norcal, time alone with my wife, and a really fun game night with good friends. Yesterday, Ash was gone for a while at homeless clinic, so I played a lot of video games. When she got home, we got to spend some good alone time together and watch Jim and Pam from The Office have their baby.

I've been feeling better and better each day as I keep giving my body real food. My only real hindrance is my wound, which still interferes with my movement. But my wound looks better every time I see it, and it won't be too long before I'll be done with the wound vac. Right now, compared to weeks ago, it feels like drinking cold lemonade after being in the hot sun for hours. I'm so thankful that God has led me out of the sun, and I'm looking forward to healing even more.

Warning: blogs may become less frequent because there is less news. Maybe Ash will want to blog about things. We'll see.

Dan

Good news fills my stomach again

Right now, I am sitting at a table in my parents' house in Lodi. I was discharged from the hospital today--tonight I will be at my apartment. God has once again turned mourning into dancing- well, except I still can't dance THAT much.

Last night, after watching The Express and finding out that it is one of my new favorite football movies (and if it's accurate, Ernie Davis and I had the same number in high school), I slept pretty well as far as hospitals go. I just got woken up by people who felt like they needed to check my levels or whatnot. Interestingly, my nurse was an E3 nurse (I stayed my month on E3) that I had had before. Anyway, eventually the doctor came in and said that things looked good, so I could go home. Also, since the last two aides who had come in to empty my drain did not do so because it was EMPTY (aka, the drains... are... stopping?), the doctor did not do the painful procedure of pulling my drain another inch, but instead said he'd like to remove it altogether in about a week! I am all for that.

Not so long ago, I was not eating, I had two drains that were pumping out much too much fluid, I had a PICC line, and I had a painful wound. Now, I am eating, I only have one drain and it's barely doing anything, the PICC is gone (freeing up my arms), and my wound is less painful. I thank God for finally turning this around.

So yeah, my parents and I are headed down to LA tonight. There was an issue with the antibiotics prescribed; they are apparently really expensive, so most insurances, including mine, don't cover it. So we're waiting on the doctor to either write up an approval statement or prescribe something else. We'll figure it out.

Anyway, I'm just very glad I can spend my birthday tomorrow with my wife. :)

Pray for:

my body to keep accepting food and be able to recover weight

insurance issues to pan out

safe travel

no more setbacks

thankfulness for all the good news

Flowers

Looking out of Dan's window we can see the Garden Entrance to the hospital. As Spring is drawing near, the flowers are blooming beautifully. The colors are so cheerful that one cannot look at them without drawing some joy from the sight. Dan and I walked outside and the fragrance was amazing. (I'm wearing a little white flower on my shirt that smells so good, but I have no clue what kind it is!) I suppose the garden reminds me of God's goodness and beauty. Granted, He has allowed Dan (and lots of humanity) to suffer for His purposes. Yet, He is still good and working out good things in our lives.

I very much like the view out of this window, however, I will much prefer the view outside my apartment window when Dan is home with me. Which, by the looks of things today, will be on Wednesday :)

Dan began feeling dramatically better after a fluid bolus and antibiotics were started, not to mention eating. The night was alright, though neither of us got much sleep. Dan was able to keep his dinner down, which is a great thing.

The residents came in early and haphazardly redressed Dan's wound. (Dan stated that a boyscout could have done a better job). They gave us little news as it seemed we knew more of the plan than they did.

A couple hours later, Dan got some dilaudid and prepared for wound and drain care. The wound looked pretty good, but McGreeky decided the pull the sutures out to allow for less complicated healing. Dan said the wound vac doesn't hurt much at all today. Also, McGreeky pulled one drain completely out...OUT! Dan prepared for the worst as pulling on the drains usually hurts a tremendous amount, but he said pulling it all the way out wasn't bad at all. Strange, but good. The surgeon will pull the other one out a little more tomorrow morning, though it will be kept in as Dan continues to eat.

McGreeky told us that Dan's WBC count was 5.3--completely normal. We're still waiting on blood cultures to come back, but he's pretty sure the infection was in the PICC. He said Dan will likely get discharged tomorrow. Yay!

The plan is for Dan to spend the night Tuesday in Lodi and then to come home on Wednesday. Jamie will drive him halfway down and I'll drive up to meet her there. I really hope that plan works so Dan can celebrate his birthday at home with me!

I'm flying out this afternoon to Los Angeles to celebrate Lise's birthday and be back for a busy busy school day tomorrow. As my original flight got cancelled (such a bummer), I'm leaving a little earlier than planned. Hopefully, Dan has a good night without me around. Maybe some time to himself will be nice :)

Prayer Requests:
* Ability for Dan to be discharged tomorrow (no fevers, no complications, no scary labs, no suprises, etc.)
* Ability to keep eating and keep the food down.
* Resolution of infection and fever
* Continued healing of the wound
* Safe travels for me
* Birthday reunion in La Mirada on Wednesday!
* NO MORE COMPLICATIONS