When I get there, he is laying almost on his back.  Knowing that is very uncomfortable for him, I raise his head up and ask him how he is doing.  He says he has bad heartburn.  I ask if they have given him anything for it.  He says the food sucks and they gave him some Maalox earlier but it's not having any effect.  He also is trying to cough up phlegm and says that he still does not have a suction tube.

I go out to the nurse's station to talk with his nurse.  She says they gave him Maalox.  I tell her he is still having bad heartburn and the Maalox isn't helping. 

Is there something else we can give him?  Maybe some Zantac? 

Well, they have to have the doctor's okay to do that. 

Well, how about calling the doctor and see what he says, I suggest. 

She says she will try to find him. 

Is he in the facility or not?

She's not sure.

While I wait for her to find out, I ask about the suction tube and am told that someone from Respiratory has to evaluate him.

I go back to his room.  A few minutes later, a young woman comes in.  She is the Respiratory Therapist. 

I explain that he needs a suction tube. 

She asks why. 

I tell her that he is weak and has a hard time coughing up all the phlegm.

My hand to God, she tells me that we have to "stop babying him".  She has worked in many hospitals and she knows that all they do there is baby their patients.  Now that he is here, we have to stop babying him and get him strong enough to be able to go home.  

I tell her that is all good and fine but that he had surgery barely a week ago and is still very weak.  A suction tube would help him cough up phlegm.

Again, I am told to stop babying him.

She says she will do an eval, consult with her Supervisor and let me know what they decide.

Fine, do the eval, I say.  The sooner, the better.

She listens to his chest, his lungs, takes his pulse, asks him to cough.  He does so weakly, complaining of heartburn.

Serena comes in and I explain what has happened.  The Respiratory Therapist leaves but not before telling us that she will be back to let us know what they decide.

I go in search of the nurse to find out if they can give Dad some Zantac.  The nurse says they are still waiting for the Doctor to call back.

Serena offers to go to the near-by 7-11 and get Dad some Zantac.  It seems the fastest solution.

While she is gone the Respiratory Therapist comes back to say she was right.  No suction tube is needed.

I bite my tongue.

She leaves.

About 15 minutes later another Respiratory Therapist comes in.  She performs the same eval as the first one.  Her reaction, however, is very different.  She says that Dad needs to be moved to another wing with oxygen portals on the wall.  She rushes out to the nurse's station to find out if there is a bed available in the right wing.

Serena returns.  We are both concerned by the very quick turn of events.  The second Respiratory Therapist comes back in and says there is a bed and he has to be moved NOW!  Two other nurses come in and they try to move the bed.  The bed won't move.  The wheels are stuck in the immobile position.  Another nurse comes in.  For a few minutes they are more concerned about the bed than Dad.  He is now complaining his chest hurts. ALOT.

While the comedy of errors about getting the bed to move continues, the Doctor shows up.  He listens to Dad's chest and lungs and pronounces Dad in congestive heart failure.  The Paramedics are called.  Serena tells Dad not to worry, the Paramedics are coming and we will be going back to the hospital.  The Charge Nurse scolds my niece, telling her that only the Doctor can make that pronouncement.  Serena tries to explain that she is trying to keep Dad calm.  The Charge Nurse continues to scold her.

The Paramedics show up and get him hooked up to oxygen.  I explain that he had come from Valley Hospital just yesterday and we would like for him to go back there.  They tell us that it is doubtful that he would survive the trip across town.  Desert Springs Hospital is just around the corner.  We are going there.

They get Dad on the gurney and we all fly out the door.  From the car, I call Mom and tell her we are on our way to Desert Springs Hospital and why.  I call Jon and tell him.

All I can hear in my mind is that Respiratory Therapist telling us to "Stop Babying Him".  In less than seventeen hours in this facility, they have managed to undo the last month's progress and Dad, again, is fighting for his life.

Over the weekend he continues to improve.  Unfortunately, his white count jumps to over 40,000 on Monday.  They give him some heavy duty antibotics to combat it.

I am surprised by the middle of the week when they are talking about sending Dad to Harmon Rehab Hospital.  Dr. Ahmed feels that with his white count coming down, that he can be moved.  We are reminded that it puts him closer to coming home.

Barely a week has passed since his surgery and he has orders to be moved to Harmon on Friday.  I call Jon and tell him I will be home on Saturday.  I want to be sure that Dad gets moved properly.

Medi-Car transportation finally comes to get Dad at 6:30 pm and I follow them across town.  We get to Harmon Rehab and he gets taken to his room.  I explain to the Charge Nurse, the nurse and the respitatory therapist that Dad needs an air bed (it was in Dr. Ahmed's orders) and a suction tube would be good.  I am told that the Wound Therapist will have to evaluate him to see if he needs an air bed.  I am told that Dad will get a medical evaluation as well as a Respitatory evaluation.

I settled back waiting for all of this to happen.  Dad and I are watching television and talking.  Serena and her husband, Rob, come in and wait for us.  By 10:30, no one has come through.  I decide to call it a night and Serena and Rob say they will stay with him awhile longer.  While they are still there, the staff comes in to try and weigh Dad.  Unfortunately the equipment is not working right. 

It is a sign of things to come. 

I changed my plans for returning home until Saturday so that I could follow Dad over to Harmon and be sure he got set up in his room alright.  

I spent most of Friday afternoon with Dad waiting for the orders for him to be moved to be signed.  I had to go over to the State Museum for an exhibit opening.  I told Dad I would be back by 7:00.  I wasn't gone more than 90 minutes.

When I got back, Dr. Holland walked in.  He looked over Dad's chart and his latest blood work-up.  He canceled the move to Harmon.   His reasoning was that Dad's white count was very high, over 20,000 (less than 10,000 is where it should be) and Dr. Holland didn't feel he should be moved until they could find and treat the source of the infection.  I asked him what he thought the source was and he said it was likely Dad's other foot.  That foot was bandaged and Dr. Holland, doning gloves, took the bandage off and we could see that Dad's foot was looking pretty grim.  After replacing the bandage, Dr. Holland said he would call and have the Ortho surgeon come in and take a look.  His prognosis was that Dad would likely lose that foot as well.

I called Jon and told him I wouldn't be home just yet.  I went over to my Mom's and told her the news.  We had all been so hopeful and this deflated our good moods.

We had to wait until Monday for the Ortho surgeon to come take a look.  But Dr. Holland had called it.  Dad was going to have to have surgery to remove his left foot.  Surgery was scheduled for Wednesday, Sept. 13th.

On Wednesday morning, because he was having surgery, Dad was not allowed any food or drink.  Surgery was scheduled for late afternoon, 4:00 pm.  I got there in the afternoon to sit with him until they came to take him downstairs.  The afternoon dragged on.  By 3:00, he was thirsty and hungry and there was no one from the Pre-Op coming to get him.  By 4:00 we were getting concerned.  Our nurse finally called down to the OR to find out what the delay was.  By then, Dad had not had anything to eat or drink for almost 24 hours.  Word came back from the OR that the surgery had been canceled because the surgeon had been called to an Emergency at Sunrise Hospital.  Dad's surgery was rescheduled for tomorrow evening, Thursday, at 6:00 pm.  

Needless to say, I was irritated.  No one had called up to the third floor to tell us that the surgery had been canceled despite them knowing for awhile.  We quickly got Dad some water and ice chips to quench his thirst.  I thanked the nurse for calling.  I went down to the OR/Pre-Op to find out what happened.  They told me that the scheduler from Nevada Orthopedic should have called us.   I then called Nevada Orthopedic to find out why no one had called us.  I was told that the scheduler was gone for the day. 

The next morning my first stop was Nevada Orthopedic.  I wanted to talk to the scheduler myself.  I tried to explain to her that Dad had gone the day without food or liquid, that he had spent the day worrying about the surgery and that the least they could have done was call us and tell us that the surgery had been canceled.   She explained that the Pre-Op people should have called us and told us.  It was the classic Catch-22 so prevalent in healtcare these days.  I was very understanding about the Emergency surgery that had called the surgeon away, I was just upset that they had left Dad worrying for hours when a simple phone call would have let us know.  Dad has been through enough and the worrying about the surgery didn't do him any good.   Rather than apologize for the oversight, the scheduler basically shrugged and said it wasn't her problem.

When I got to the hospital I was glad to hear that they had given Dad a bit of breakfast since his surgery was scheduled for the early evening.  The nurse, Lise, asked how it gone with Nevada Orthopedic's scheduler.  I explained what had happened.  Lise, like the people down in Pre-Op, said the phone call should have come from the scheduler as soon as she was made aware of the need for the surgeon at Sunrise.  She had to rebook any other surgeries and call those people to let them know.  We, more than likely, fell through the cracks, thinking that someone else would handle it.

Dad tried to belie that fact that he was nervous.  Mom and Serena came up to sit with us while we waited again for Pre-op.  This time they showed up on time and took him off to the Operating Room.  We went downstairs to wait.    Less than an hour later the surgeon came in to tell us that everything had gone alright.  He was able to give Dad a "matching pair" of legs.

Once out of recovery, Dad would go back upstairs to his room.  He didn't think Dad would spend too long in recovery.  I waited.  I finally saw them taking Dad back upstairs and followed them in the elevator.  By the time I got up there, Dad was resting.

I told him I loved him and would see him in the morning.   

For the first time in a month, we are hopeful.  We have been in the same room (the one nearest the automatic door) for almost a month.  The nursing staff has all but adopted us, it seems.  Now that Dad seems to be doing better we ask if it is possible to move him to another room away from the door.  Every time the door opens or closes he wakes him up or commands his attention.  There is a room on the other end from where we are.  The Charge Nurse, Tessie, and the Nurse Manager, Michelle, both agree it is a good idea.  We all wonder why didn't think of it sooner.

He gets set up in his new room.  He even comments on how much quieter it is.  Go figure.  The things you don't necessarily think about when you are surrounded by medical crisises.

On Monday, the doctors start to come through and talk about moving Dad down to MICU, which at Valley Hospital, is considered step down ICU.  It is on the third floor.  We have been there before after his stent replacement and after his carotid surgeries.  The Doctors say if all goes well they should be able to move him by the end of the week.

We finally begin to believe that we have caught that long hoped for break.  Dr. Takiyudden, his Kidney doctor, believes that Dad's kidneys will recover.  He is the only Kidney doctor willing to say that and we respect him for that.

I call Jon and tell him I am planning on coming home for Labor Day weekend.  I haven't been home since my trip home for a weekend in June.  I will have to come back right after the holiday because of an event I have at the Las Vegas Springs Preserve but I think I will be home for good right after that.

Life, of course, will have different plans for us.  But for now, Dad does get moved to MICU and begins to recover.  We say goodbye to the nurses in ICU who have treated us with kindness and who have worked so hard to keep Dad alive.  We owe some of them a debt of thanks that we can never repay except with kindness.  Dad is awake, alert and talking to us.  His memory is still quite foggy but considering all the medication he has been on, we take this in stride.

For a few days, I am able to return home to my husband.  The first night home, I sleep with the phone at my side, praying it never rings.  I get up in the night and in my grogginess think to myself "Why is it so dark?  Where are all the nurses?".  It takes me a few minutes to realize that I am home and not in the hospital.  I tell Jon about it the next morning and we have a laugh together. 

I talk to Mom and Serena and the news is good.  If Dad continues to do so well, they will move him to the Harmon Rehab Hospital by the end of the week.  There he will get his physical therapy, fitted for his prosthetics and begin his journey to coming home.

We wallow in the good news not realizing that it is too good to be true.

Dad is still there and we are still standing.  The only thing different is that Dr. Ibarheem is not there.  As the day goes on, I realize that he has not come through and ask about him.  I am told that Dr. Ahmad, the original primary doctor, is back from vacation so he is taking over.

We will miss Dr. Ibarheem.  He was like our guardian angel willing to step out on the limb and do what was necessary to keep Dad alive.  He sensed that Dad was a fighter and was not going to let him down.  If we had had a doctor that was not willing to go the extra miles that Dr. Ibarheem was willing, Dad would probably not be with us today.

Which makes me think about faith.  Many people I know live with faith in their every day lives.  Faith was never a big component in our family when I was growing up.  Though for a few years we did attend United Methodist Church.  When my brother was younger, my family also explored the Church of Latter Day Saints but to say that we are a faith based family would be pushing it.

I found my faith that Saturday afternoon that Dad was bleeding out.  Losing 3,000 ccs of blood in one hour will do that.  I prayed from the top of my head to my toes.  I went to the Quiet Room, what passes for a Chapel at Valley Hospital, and prayed.  It was one of the most non-descript rooms I have ever been in.  No furniture, the walls were painted white sans one that had a scene of the ocean as if painted from a Greek window sill.  Not my idea of a Chapel or a Quiet Room but at that moment it didn't matter.

There I prayed and bargained with God like I have never done before.  And there I learned that you do not need to bargain with God. All you need is to believe and pray.  I don't know that it was an epiphany but I do know that Dad overcame tremendous odds and remained alive.  Many people were praying for him in various cities around the country.  They all contributed to Dad beating the odds and the doctors and staff that had written him off hours before.

That Monday morning, his vas cath (dialysis catheter) clogged and they had to put in a new one. 

As the week progressed, the various doctors made their  rounds each day and each day I was there asking questions about how well he was doing.  There was good news and bad news.

The good news, they are able to begin weaning him off the vaso-suppressors.

The bad news, his right foot does not look good.  As we were told, the vaso-suppressors constricted the blood vessels in his legs and his feet as they sent all the blood there to his chest cavity to keep him alive.  To complicate matters, he is diabetic.

His left leg and foot look alright but his right foot continues to go downhill.  We are told they might have to amputate. 

On Aug. 15th, he pulls out the PICC Line.  Annabel thinks that it was not deliberate but that it causing him to scratch and in his sleep he pulled it out.  His oxygen mask is replaced by nose tube.  He is alert, asking questions, beginning to  remember.  He wants an Orange drink, a ginger ale, and a 7-Up.   He is thirsty.

I walk in to see two unfamiliar nurses prepping his right arm (the one with the Blood clot).   I ask them what they are doing.  They tell me they have to put in a new PICC Line.  I ask them why they are trying to put it in the right arm.  They tell me it is because the previous PICC Line was in his left arm.

I tell them he can't have a PICC Line in his arm because he has a blood clot in it! 

The nurse says "What blood clot" 

"The one in his right arm". 

"What's that from" 

"The first PICC line" 

"How long ago?  A long time?" 

"Three weeks ago" 

"Here" 

"Yes, here!!!!!"

"Oh." 

They stop prepping his right arm and move to other side of the bed and begin prepping his left arm.  If I had not walked in at that moment, they would have put a PICC line in his right arm.  The problem with the blood clot in that arm is that it can break free and move towards to his heart causing him to have stroke.  The right arm should not be used for blood pressure readings, IVs, PICC lines or anything that can cause the clot to break free.

Which makes me wonder why people do not read his chart before attempting procedures?  But the sad truth is they don't.  They are too busy, too many patients to treat, you name it there is a reason.  Never mind that it might cause the patient more harm than good. 

As the week progresses, we learn that his right foot cannot be saved.  The cardiologist, Dr. Holland tells me this on Friday afternoon.  I ask what do we do next.  He says he will ask Dr. Morris, an orthopedic surgeon, to come take a look but he his almost certain the foot will not able to be saved.

My Dad is sleeping.  I cannot tell this wonderful man myself that he will lose his foot.  It is one of his worst nightmares come to life.  He knows he is diabetic and has had trouble with infections and sores on that foot for years.  But every time, he has been able to beat the odds.

Today, his luck runs out in that regard.

Dr. Holland offers to come back in the morning and tell Dad the news.  I thank him and tell him we will be here as well.

I go home to tell my mom the bad news.

Things I learned from this:

1)  As hard as it is, you have to be there as much as possible.  

    A)  To talk to the doctors and chart your loved one's progress.  Leaving notes in the chart for the doctor's to call you
and give you an update is most likely not going to happen in timely manner.

    B)  You have to be there to make sure that anyone that comes in to do a procedure, change a PICC line, do anything
has a full understanding of your loved one's condition and problems.  One wrong move can have catastrophic consequences.

2)  Never underestimate the power of prayer and the power of faith.  It can provide you with a sense of calm and help
ease the sense of helplessness.

3)  Listen closely when they tell you side affects of medication they are giving your loved one.  We were prepared for  
what the vaso-suppressors could do because Annabel and Dr. Ibarheem took the time to explain it to us.  If they
hadn't this next part of our journey would have been much more difficult.

4)  Healthcare in America today demands that you be as hands-on in the situation as you can afford to be.  Sacrifices
will have to be made if you want to ensure that your loved one is getting the proper care.  Having someone there at
their bedside during the day to talk to the doctors is a financial, but necessary sacrifice, because of the information
you learn will help to you to make the tough decisions.  It is one that I felt I had to make during all this to help keep Dad alive.
 

"Yeah, that's a man" Ridley replies

It is Saturday morning, Aug. 11th and the little bleeder that could has become an engine that won't stop.  My conversation with Judith, the Charge Nurse, spooks me enough to race to the hospital.  Serena meets me there.  My Dad's catheter bags are filled with blood.  As quickly as they transfuse him with blood, just as quickly it seems to pour out of him. 

His nurse, Annabel, answers our questions.  Another nurse is pushing us to give Dad some morphine to make him more comfortable.  Annabel tells us that morphine will lower his already too-low blood pressure.  We are in a race to get his blood pressure up.  We say no morphine.

We are scared.  Dr. Ibraheem explains how difficult it can be to detect a bleed in the bowel The Radiologist, Dr. Batiste, took his time and tried to find it, to no avail.  It must be a tiny, but, potent bleed.  We ask what can be done as we realize that he is bleeding out and if the bleed is not slowed or staunched, he will die.

Dr. Ibarheem explains to us about vaso-suppressors.  These are strong drugs that will constrict the blood vessels in his legs and feet as the blood is sent to his chest cavity and his blood pressure can stabilize.   As my Dad is diabetic, there is a very real likelihood that the vaso-suppressors will damage the circulation in my Dad's feet.  We are between a rock and hard place with no real alternative but to make the devil's agreement and concentrate on keeping him alive.

Doctors come through and evaluate him.  The Gastro-Intestinal doctor evaluates my Dad.  We step out into the hallway, Dr. Ibarheem, the Gastro doctor, Serena and me.  The Gastro doctor tells us it looks grim.  My Dad is not a candidate for surgery so they can't find the bleed that way.  The Gastro doctor tells us he can do nothing more and walks away and out the door of ICU.  We turn to Dr. Ibarheem.  Without blinking, he calls for a second opinion.  Luckily, we never see that particular GI doctor again.

By now, my mom has arrived.  Serena's husband, Rob, went to pick her up.  She uses one of those small four wheeled carts to help her keep her balance while she walks.  She looks at Dad and the shock registers on her face.  However, she quickly regains her composure and starts to talk to him.

By now Dad has lost 3,000 cc's of blood in one hour and has had 12 units transfused.  Even without medical backgrounds, we realize this is not the norm. 

Within 15 minutes, the other Gastro-Intestinal doctor, Dr. Banich, has arrived.  While he evaluates Dad, we explain the situation to my mom.  If they cannot find the bleed, her husband, of forty-four years, will die.

Dr. Banich comes out and tells us what we already know.  Dad is not a candidate for exploratory surgery.  We ask what else can be done.  He asks if an angiogram has been done.  Dr. Ibarheem explains that two have been done with no luck.  Dr. Banich says "Do another angiogram".  It is our only hope.  Before he leaves, he takes me aside.  He wants to be sure that I understand what an outside chance it is to find the bleed.  I tell him I do but that we have no alternative.  I tell him Dad is one tough hombre.  He agrees and says that he will keep Dad in his prayers.

Dr. Ibarheem makes the call to the two Radiologists that have performed the angiograms.  The first one refuses to do another, quipping "I've been in there, didn't find it, probably won't find it this time".   The second one, Dr. Batiste, agrees to assemble his team and give it another go.

The problem:  it is Saturday so it will take sometime to assemble his team.  We start praying. 

I call Jon and tell him that Dad is dying.  He asks if he should come.  I tell him 'not yet', afraid if I tell him to come, Dad will die.  Jon says that Mary and Arlyn from work are praying for Dad and Arlyn has said a rosary.  I start to cry.  Afterwards, I call a few friends and ask them to pray for Dad.

The vaso-suppressors have helped stabilize his blood pressure and the bleeding has slowed.  Annabel explains to us how difficult it is to try to find a bleeding blood vessel or artery in the bowel.   We wait for them to come from Radiology.  It is the longest afternoon of my life. 

Dr. Ibarheem waits with us, checking Dad's vitals every 15 minutes.  The ICU staff and nurses, even the people in the hallway and in the waiting area are wishing us luck.

Finally about 4:00, they come from Radiology to take Dad downstairs for his last angiogram.  We follow him down, tell him we love him and go to the small, quiet waiting room.  Dr. Batiste comes out and tells us that the test will take some time.  As he did the angiogram the night before, he feels he knows Dad's insides a little better today and says he will do all he can.  We tell him that he is our only hope.

We wait.  An original Star Trek episode comes on.  The one with John Fiedler.  It makes good background noise.  Serena, Rob and I talk, we try to take our minds off what seems like the inevitable.  Through it all, Dad has not given up.  He could have slipped away when so much blood was oozing out of him.  But, as we say, he is one tough hombre.  We pray he will be one again.

An hour passes and we are still waiting, convincing ourselves that this is a good sign though I don't know that we actually believed it at the time.  I turn the channel looking for anything to take my mind off the waiting.  

Suddenly, there is Jack Bauer.  24 is Dad's favorite show.  He got me hooked on it last season (season 5).  Tonight is a rerun of Season 5.  There is psycho President Logan, the great Gregory Itzin and his humane wife, Martha (the wondeful Jean Smart) but most of all, there is Jack.  I take it as a sign that things might not be so bad.  If Jack Bauer is here, surely there is hope.

About 20 minutes later, Dr. Batiste comes out.  He looks tired but he tells us he did find the bleed.  It was a small bleed as everyone suspected and it was only by luck that he found it.  It took 8 coils to cauterize it.  He explains that 8 coils are alot.  We hug him and thank him with tears streaming down our faces.

He says the team will take Dad back upstairs to ICU.  He cautions that Dad has lost a great deal of blood and is not out of the woods by a long stretch.  We go back upstairs.  Dr. Ibarheem is waiting for us.  We hug him and tell him thank you for everything.

I turn the channel to 24.  When they wheel Dad back in from Radiology, there is Jack Bauer on screen.  Jack becomes my talisman and will, in the weeks ahead, prove to be a worthy one. 

By now, Dad is resting comfortably as possible.  We have been at the hospital for almost 12 hours and all of us are exhausted.  We tell him that we love him and that we will see him in the morning.

As I head back to my mom's house, I stop at the light at Jones and W Charleston Blvd.  Our old church, United Methodist has a modern LED/LCD sign.  All it says is "Practise Hope". 

I burst into tears. 

Dad is slowly oozing away as the blood continues to leave his body.  The nurses continue to give him transfusions and plasma (looks like frozen orange juice) but still the bleeding won't stop and they are all at loss to explain it.

Finally, the radiologists are called in.  This is a special team that specializes at finding bleeds like this.  On Thursday, I sign the consent for the radiologist to go in and try to find the bleed.  We are hopeful.  After all, this is the A-Team. 

They will do an angiogram.  They will inject a "dye" through a thin, flexible tube. It will then be threaded nto the bowel  from an access point.  This "dye",  properly called contrast, will make the bleeder inside the bowel visible on an x-ray.  It is intricate work and with 20 feet of bowel, the odds are not on our side that the bleeder will be seen.

I call down to the hospital late that evening and ask about the results.  They could not find the bleed.

The next day, Friday, Dad is slowing bleeding away.  I call Jon and tell him he should prepare for coming home as I don't know if Dad will make it.

Dr. Ibarheem calls in another radiologist to take another look.  We hold our breath.  He, too, cannot find the bleed.

The blood keeps oozing out but Dad refuses to give up.

We are in limbo not knowing what will happen next . 

The call came at 5:50 am.  It was the night time charge nurse.  She was calling about my Dad.  Something had happened.  I was scared he was dead.  She said that he had been stable since I had left just after 11:00 pm.  That is, until about an hour ago when his blood pressure and heart rate crashed.  Was he okay?  Yes, he was okay but they had to put him on ventilator. 

I woke my mom up and gave her the update, throw some clothes on and head down to the hospital. 

He was, in fact, on a ventilator and he was still bleeding.  Not nearly as much as yesterday but he was still losing blood.  The shift change hadn't happened yet and his nurse said that one minute he was doing fine, waving at her and talking with her.  She went to check on another patient and when she got back 15 minutes later he was in duress. 

As we wait for the doctors to come through, the two respiratory techs answer our questions about the ventilator.  One by one, throughout the day, the doctors come in and evaluate him.

The kidney doctor, Dr. Takiyudden, tells us that Dad's kidneys are in shock due to the blood loss and the fact that donor blood is high in potassium.  They will start dialysis in the morning.

The gastro doctor wants to run a series of tests to see if they can pinpoint the bleed. 

The respiratory doctor, Dr. Stuart, understands our concerns about the ventilator and wants to ween Dad off as soon as he is stable and ready. 

Dad's previous primary doctor is on vacation and we meet Dr. Ibarheem, the doctor who will be the primary doctor for the next ten days. 

It's not easy seeing Dad on a ventilator.  He can't talk except through eye signals and hand squeezes.  He is scared.  It is his worst nightmare come to pass.

On Saturday, we think the bleeding has almost stopped.  The catheter bag is not filling with any blood.  The Dialysis tech comes.  Dialysis takes about 3 hours.  It is late in the day when we discover a kink in the catheter line.  Dad is still bleeding, though it has slowed down considerably from Thursday.

Saturday night, he spits up blood.  Serena and I sit with him all night, praying and holding his hands. 

The ICU staff is getting to know us, partly because we are there so much.  I take the day shift and Serena takes the evening and night shift.  She is often there until midnight.  We talk to him, explain what is going on, tell him that we love him.

We become familiar with the other families in the ICU.  A father and daughter from Australia stop by whenever they are going for coffee or food to see if we need anything.  The wife had a heart attack while they were visiting Las Vegas.  I refuse to leave because I am afraid I will miss a doctor or something will happen while I take a break.  They bring me food and Diet Coke and I am grateful for their kindness. 

On Monday, the begin taking x-rays and I begin signing consents for exploratory procedures.  Dad, hating the ventilator, takes the situation into his own hands and excubates himself.  This is not the usual way to be taken off a ventilator.  However, Dad is able to breath on his own and they put an oxygen tube in his nose.

Over the next few days they will do an endoscopy, the longer endoscopy, a colonoscopy and a myriad of x-rays trying to discover where the bleed is coming from.  In the process, they discover that Dad has eight, previously undiagnosed,  ulcers in his stomach, dueduodum and colon. 

But by Wednesday evening, he is still bleeding and they don't know why. 

Things I learned:

1. Ventilators are scary.  You are not prepared for the first time you see your loved one hooked up to one.  But, DON'T be intimidated by them.  Ask the Respiratory techs to explain the numbers so that you can tell how many breaths your loved one is taking vs how many breaths the machine has to give them.  This ratio is important.  The more breathing your loved one does vs the machine is good.
2. Get to know the ICU nurses and staff.  Get to know the Charge nurses.  This is very important.  Most work 4 day, twelve hour shifts (with time off for lunch) so the nurse you have, you will likely have for four days at any given time.
3. Not all nurses are created equal.  The sad truth is that in today's modern medicine, not all nurses are there because it is a calling.  To some, unfortunately, it is just a profession.  For others, they may be having a bad day and their attention may not be on the patient.  You need a nurse who knows to leave their private live on the other side of the ICU doors.
   
4. Don't be afraid to ask for another nurse.  This is very important.  If you don't feel the nurse is giving your loved one the care and attention he needs, speak to the Charge Nurse and ask for another nurse.  Don't be shy about speaking up.  Your loved one's life depends upon it.
5. Be kind.  Say thank-you.  Alot.  Every time someone comes in take a reading, do an x-ray, whatever, be polite, ask how they are and be sure to say thank you.  Courtesy goes along way and you have no idea how long you will be in ICU and dependent upon these people.  We had no idea we would be there for a month but we tried to be as polite as possible to everyone.

A note to Charge Nurses, Nurse Managers and Nurses everywhere:

When calling the patient's family: 

If our loved one has not died, please lead off the conversation with the fact they are still alive and then proceed to tell us why you are calling.  Any call we get from the hospital, our first reaction is Oh my God, he/she's dead! even if we don't say it out loud.  You can help everybody's anxiety level by letting us know if they are still with us!