Sunday, March 27, 2011

Terrible Tuesday, or Sweet Pea's ED Adventure

We stayed late at the hospital.  Finally the the Wife took the kiddos back to Mom and Dads house to get them tucked in.  I stayed around for a little while longer.  My brother arrived from St. Louis.  There was talking and wondering and worrying.  I honestly don't remember much of it.

I do remember thinking about what the next few days might hold.  There would be trying to get him off the vent and extubated.  If he woke up, there would be tests to see how much his mental status had been changed.  It could very well be that he would be a vegetable.  They had him on the hypothermia protocol.  Which means they had put a cooling blanket on him and were lowering him to around 33 degrees Celsius, or about 91 degrees Fahrenheit.  This was to help give his brain the best chance at survival.

I wondered how good the CPR had been.  Whether it had been enough.  I had more questions than answers, and all I could do was wait.  At some point I went and joined my wife and kids to get some sleep.  It did not come easy, nor was it of any quality.

The next morning as we were getting ready, our little Sweet Pea approached us and proudly said that she had taken her medicine.  This was slightly alarming since she was not on any medicine.  I asked her to show me where the medicine was.  She marched right into Grammy's room and handed me Grammy's morning pill box.  OK.  A little more alarming.  I had mom go through her meds and tell me if any were missing.  Everything was there, except for the Sunday section.  She couldn't remember if there was Clonadine or Bystolic in that part or not.  With this being unknown, the decision to take her to the ED for a check was not a hard one to make.

Honestly, I was not too concerned.  The kid won't chew anything that doesn't taste like chocolate, cheese or chicken.  Those pills would not have had that flavor.  But about half way to the hospital, she became very lethargic and sleepy, and sounded quite drunk when she talked.  I hit the hazard lights and ran the red lights the rest of the way there.

The doctor in the ED was the same one that had been on when Dad the Code came in yesterday, and our nurse was a high school classmate of mine.  After a brief check, it was decided to admit us to the children's floor for observation.  The medicines she may or may not have taken were for lowering blood pressure and heart rate.  So she spent the day sleeping and being drowsy.  But everything turned out well.  We had a room to crash in and still could go visit Dad.  He spent the day sedated and tubed and literally chilling.

I can't say that everything was rosy that day.  My father was still in rough shape, and I worried about losing him.  My daughter had taken Grammy's meds, and I was stressed about her.  By noon I was emotionally empty.  I rarely spend time thinking about what might have been, but now I was numb from the thoughts of "what if".  What if Dad had died.  What if Sweet Pea had taken more of those meds and coded or died.  The possibilities were miserable to think about, and I was too tired to shut them off.

My sister in law had mentioned to my brother that I seemed to be holding up really well.  I love her for thinking that, as I was apparently able to function.  In truth, in my head I was just in an endless fog where every turn led to unimaginable and horrific outcomes.  I was on autopilot, just hoping not to crash.

I don't even really remember the end to the day, other than Sweet Pea was fine and they were going to try a "weaning trial" with Dad in the morning.  They started by stopping the paralytic that was stopping his breathing so the vent could do it, and re-warming him to human temperature.  Later they would cut the sedative and see how he was when he "woke up".  We stayed until they stopped the Versed, a long acting sedative, and started him on propofol, which is much shorter acting.  They decided to keep him sedated until the morning to give him time to get the Versed out of his system, thereby making the wake up period a bit shorter.  I went back to the house and crashed, thankful that everyone had survived Tuesday.

More Later

Friday, March 25, 2011

The Day

Monday, March 21.  It was around 4 in the afternoon.  I was sitting on the living room floor, playing catch with Sweet Pea and the Wife.  Laughing and having a good time.  We had this day and Tuesday off all together and were talking about things to do on our free day Tuesday.  The phone rang.  I was sitting on the floor and didn't feel like getting up.  The Wife was in the chair and sitting comfortably, but she had worked a night shift the night before and was darn near exhaustion, so she didn't feel like jumping up to answer either.  Until we heard my sisters voice. 

Usually when people leave a message, it is a little breezy.  Not so this one.  We could tell by her tone that something was terribly wrong and she commanded us to call her immediately when we got this message.  Of course by then we were both up and to the phone.

My first thought was something had happened with my mom, as she has been having health problems this last year with her kidneys and dialysis and such. 

"I'm on my way to pick mom up from dialysis.  Dad apparently had a heart attack and is headed for the hospital."

Everything sped up and slowed down at the same time.  With only that information I thought perhaps he had some chest pains and someone called 911.  I've picked up symptomatic people before.  Maybe it wasn't too bad.  Still we started packing up for a rushed trip to Cedar Rapids, three hours away.  I got online and found the phone number for the ED down there and gave them a call.  There was no answer.  That seemed strange, as even in my hospital there is always somebody around to answer a phone.  Within ten minutes my sister called back.

She had talked to a fire medic that had been on scene and been working with the medics on Dad.  The information passed to me was that he had dropped mom off at dialysis and gone to the cardiac rehab gym to do some exercising when he collapsed.  All the fire medic could tell her was that CPR had been started, the medics arrived in just under ten minutes.  CPR was continued.  Dad had been in ventricular fibrillation, or V-fib, and a shock was administered.  One round of epinephrine and amioderone were administered along with a second shock.  An endotracheal tube, or ET tube, was placed down his throat and into his lungs to help him breath.  He was loaded and transported with CPR still in progress.  The fire medic was not too optimistic about his chances.

With that information, the kiddos were loaded in the car, along with the dogs and some hastily packed bags, and we headed out.

As a paramedic, I have been on calls like this.  We get someplace with CPR in progress, work the patient and do what we can.  If we transport at all, we have usually regained some organized heart rhythm, or seen something that makes us think perhaps they have a chance of survival.  But if we've administered the drugs and the shocks and nothing is working, we usually call it in twenty or thirty minutes or so.  ten minutes of CPR before the medics arrived.  They had worked him for another ten to fifteen on scene, and CPR was being continued on the way to the ED.  I was starting to try and wrap my mind around the world without my father in it.

We stopped at a gas station about twenty minutes down the road.  I stepped outside and got hold of the ED.  Mom gave them permission to tell me everything.  My own heart was heavy, as I knew that by this time he was either alive or he wasn't.  And from what I had heard, I did not think he would be alive.

Much to my relief, they had a rhythm back.  He was critical but stable and headed for the cath lab to find the problem and fix it. 

When we arrived in CR, we headed straight for the cardiac intensive care unit.  Dad's room looked like a movie set.  All of the various life support paraphernalia was there, and there was my father.  He was pale.  The vent was pulsing rhythmically, keeping him breathing.  The vitals looked OK.  He was heavily sedated and unnaturally still.  And my heart broke.  It is cliche to say it seemed like a bad dream.  But there is no other way to describe it.

As the day went on, we heard more of the story.  He had collapsed while on the exercise bike.  CPR was started within a minute.  Much of the staff at the dialysis center worked on Dad, doing good quality CPR.  The medics did everything just right.  The ED nurses and doctors did everything just right.  It was a textbook case.  A textbook save for a sudden cardiac arrest event.  The medic in me was proud and thrilled that all had gone well.  But the medic in me also knew that just because we get a pulse back doesn't mean everything will be all right.  The brain dies pretty quickly without oxygen, and sometimes even with good CPR the end result is a person who loses some of their mental faculties. 

I will be forever grateful to those that saved my dad so that I could make it to his side in time to say goodbye if that was the case.  And now it was a waiting game to see if he would wake up, and if he would be close to the same man he was before the day.

More Later

Wednesday, March 16, 2011

Training Days

Yesterday I went for a run outside.  First outside run this year!  Temp was almost 50 degrees and there was a little breeze blowing.  In all a very pleasant run!  It rained later in the day, so I was thankful to get the run in at all.  Otherwise it would have meant the treadmill. 

And as I ran, I thought about the treadmill.  I don't like to run on the treadmill.  I think it is because my running pace is not that perfectly constant that I can just set a speed and go.  I end up running too fast or too slow for the spinning belt, and spend a great deal of time futzing with the speed controls to try and avoid running into the control bar, or worse yet, sliding right off the end like those idiots you see on YouTube all the time.

But outside I can run as randomly as I want without worry.  And I tend to go farther and faster than I do on the treadmill.  Perhaps because I like being outside so much.  With 81 days until my first triathlon of the year (or roughly 1900 hours) I've still got a lot of training to do.  But I feel like I'm much farther along than I was training for my first tri last year.  And I have extra weeks this year to train!

I found a place to swim indoors that doesn't cost an arm and a leg, which is good, because swimming with only one arm and one leg would be much more challenging.  It is our local Rec center, with an Olympic sized pool broken down into two 25 yard/8 lane pools.  Plenty of space, and open late for family guys like me!  It felt good to be in the water again.  I think for this next year I'm not going to stop training between seasons.  It is so draining to "get back into it".  So I have a place to swim over the winter months.  I'll have to come up with some ideas for the running and biking in the cold though... Hmmm....

As for the bike, if the weather is reasonable, I might go for a ride this Friday!  Just a short six or seven miler to see how it feels.  But I am looking forward to getting back into training mode, and even more so to making it a part of year round life instead of just being seasonal.

More Later

Sunday, March 13, 2011


Again.  With the snow.  And the cold that comes with it.  Seems that spring is far, far away.  Even the dogs are tired of the cold and snow.  Holly used to frolic.  Now she goes out, does her thing, and races back in.  Often with a leg or two raised away from the cold.  But I know spring is on the way.  I'm just impatient for it to get here.

I hope it gets here soon.  Triathlon training is so much more fun outside than on the treadmill.

More Later

Thursday, March 10, 2011

Lenten Miracle

My biggest goal for this Lenten season was to try and purge myself of sitting around and doing nothing.  So I decided that the Kitchen and Living Room would both be clean before I went to bed every night for the next 40 days... at least.

I am happy to report that I am off to a great start!  The Wife just finished three night shifts in a row, and that really takes it out of you.  So I want her to wake up to a clean house. 

I am also up and exercising again.  Not exactly easy when you are coughing up a lung.  But I struggled through it.  And will again today.  I am in the process of compiling a list of Things To Do for this season.  I have a sneaking suspicion that it will take longer/last longer than 40 days.  So, while I am list making and pondering and planning, I am also very aware that the habits I have that are good, I need to keep at and find motivation and encouragement to keep going.  The bad habits I need to change.  Slowly but surely for some, and just cold turkey for others.  Wish me luck!

More Later

Tuesday, March 8, 2011

Skinny Wednesday is Tomorrow

I've never been big into Mardi Gras, Fat Tuesday, that whole scene.  Not that I have anything against those who do celebrate, of course.  My brother and his family seem to do it up right.  But those just weren't traditions I grew up with.  The Wife didn't either, although she did acquire a taste for giving things up for Lent some time ago.

Today she asked me what I'd be giving up tomorrow.  It got me to thinking.  What could I give up?

Now, I'm no saint.  But there isn't much for me to actually give up.  Some people give up swearing, but with two kiddos under six, I don't have the opportunity to swear much anyway.  Stop drinking or smoking?  I don't do those.  What about caffeine?  Some people give up pop.  I had a root beer a couple weeks ago.  Nothing carbonated since.

Finally it dawned on me.  We've been fighting the crud that's been going around here for the past few weeks.  This has led to an extreme case of frustration with not being able to do much of anything but cough, wipe noses, administer medications, and cough some more.  So for Lent tomorrow I'm giving up sitting around and not doing anything.  Tonight I am putting together a list of forty projects.  Each should only take an hour or two.  Some more complicated ones, like working on stained glass or knives, will be timed portions.  But I am going to get up, get showered and DO SOMETHING every day for forty days.  My days will also include some sort of physical fitness, since I've got 89 days until the Pigman Triathlon, my first tri this season.

So... gotta go.  I've got lots to plan tonight.  And starting tomorrow, I'm giving up living by default because I don't feel good.  Time to get some stuff done!  Exercise and projects!  I'll bet I'll be losing weight along the way, too.  So Skinny Wednesday starts in the morning.  I'll let you know how it goes.

More Later

Monday, March 7, 2011

Close Encounters

We've been talking as a family about what kind of vacations to take this year.  One of the places I'd like to take my family is the Mt. Rushmore area.  And by area, I mean including such places as the Badlands, Custer state park, Crazy Horse Monument, and Devils Tower in Wyoming.

The Boyo had no idea what Devils Tower is, so we looked at some pictures and told him the legend, and he agreed that we should go there some time.

That night we had our favorite Mexican food for dinner.  During this, our little Sweet Pea channeled her inner Richard Dryfus and started piling her beans and rice into a little mound...

The Wife and I were amused as it was right on the heels of talking about Devils Tower.  But since we haven't watched Close Encounters as a family, and have never told the kiddos about that scene, we were amazed when we asked her what she was doing and she said, "Making a picture."  I guess we have to go to the Tower now, just to meet the visitors!

In other news, last week the Boyo and I went out in a new fallen snow and built a snowman.  The Boyo thought he looked lonely, and decided he needed a snow friend and a dog.  The Boyo built the friend, and I threw together a little dog, too.

Fun in the snow.

More Later