Doctor visit moved up a couple of days

What was scheduled as a visit to the knee surgeon for Wednesday was moved to Monday afternoon. The PA and physician at the VA Center phoned the orthopedic surgeon regarding my dad's knee and increased redness and fever. The surgeon asked to see him this afternoon. After making a mad dash to the Center and picking up my dad (complete with wheelchair) we kept the appointment.

Upon examination, the doctor discerned that it was cellulitis around his knee and incision. X-rays revealed the joint replacement is perfectly in place, pain medication was adjusted along with blood thinner, staples removed, and we were on our way back. The doctor stressed that my dad should be sure to keep the knee moving.

En route we made a quick Sonic stop for liquid refreshment. When we returned to the VA Center I suggested that he use the walker to get around and he would be more sure of himself. He did so without incident and made it out to the patio to smoke his pipe. Dinner arrived and I came home for a peaceful evening.

I'm headed for an early night to bed.

Patience, patience, patients . . .

My father's recovery is progressing now that he is back in residence at the Norman VA Center. The weekend has been a little bumpy but the staff has handled is beautifully. His blood pressure has been taking dips below 100 over the weekend and he developed a fever on Saturday prompting the medical director to give him IV antibiotics. The best of all is that he has been able to rest and sleep the past couple of days, hopefully making up for some of the sleepness and busy nights at the hospital.

His evening nurse (Mary) called me around 6 p.m. on Sunday stating that he had been asking for me and she promised to give me a call. We agreed that I would wait until Monday to visit unless his condition warranted me coming out. When I phoned her around 9 p.m., Mary indicated that he was "perturbed that I didn't rush right out to visit" but we agreed that this is precisely why I did not. Behavior change can be very difficult and he is having to re-socialize with others --- that is a very good thing.

The laugh for the evening was this. When I phoned her, she relayed that the staff had a busy evening. Just prior to my phone call, one of the other residents could not locate his call button so he called 911! Thankfully, the staff was laughing but it certainly broke up a somewhat routine evening. We must always remember to laugh at ourselves and with each other. We visit his knee doctor on Wednesday.

Discharged from Hospital . . . Back at VA Center

Thursday was a monumental day of sorts with my father being discharged from the hospital back to the Norman Veteran's Center to continue his recovery and rehabilitation. As with any process these days, it's never as simple as one would think and there is more than enough paperwork to cover our walls and everyone's backside! Daddy was very confused when I arrived at the hospital though he had been very clear, especially so with the neurologist, on the day before. Change is always difficult and brings on confusion --- I think much is triggered by fear.

We finally got to the VA Center and they were ready and available to check him in. The first order of business was getting him some lunch and me unloading his belongings and unpacking. Of course, the staff there was required to do a skin assessment, etc. and all was well. The CPM (continuous passive movement) machine was a source of anxiety as it had been during the stay in the hospital. When physical therapy came up to check it out and put him in the machine my dad's anxiety hit with a vengeance.

I was the brunt of his anger at bringing him to "this place full of strangers" and "pulling a dirty deed" in checking him in without explaining it to him, etc. etc. (None of which is true.) At this point, with four nurses, one physician's assistant, and two physical therapists, he continued to yell and I told him to "Stop", to which he replied "No, you stop." I did so; I walked out of the room and he has not seen me since.

In the meantime, the PA gave him an injection to calm him down and he cooperated with the staff and has done so ever since. I did speak with him by phone this morning and he was fine. My dad had requested that I try to locate a different room for him with someone who does not watch TV 24/7 plus the doctor preferred he be closer to the nurses' station. In speaking with the RN on the unit, one bed was open that is 3 doors closer to the station and a very quiet roommate. This room is in the very center and is closer for him to access the dining room on the unit as well as his patio balcony to smoke his pipe. The move was completed without incident or my presence on Friday.

His nurse this evening gave me a rundown of his status when I called to check on him. (The plan is for me to stay away for several days at the suggestion of the neurologist and PA.) His blood pressure dropped late this afternoon and an IV has been started with fluids and his vital signs will be checked every two hours. His BP has risen and all is well, though he did pull the first IV out and another was started. I've been assured that if his condition warrants, the nurse will notify me.

Pray for a continued transition back into life at the VA and continued healing. We visit the doctor again to recheck his incision on Wednesday, June 25.

Early Start to the Day

My day began at 3:45 a.m. with a call from my dad at the hospital wanting me to come up there right away, call Carolyn to come back from Kansas City, and get his doctor there who worked on his knee!! Not happening!! I received phone calls from him every few minutes afterwards until I unplugged the phone around 8:00 a.m. I made it in to the office close to 11:30 a.m., eating some lunch that immediately made me ill and nauseous. Did not bode well for my cranky pancreas the rest of the day.

Around 12:30 p.m. the neurologist phoned me regarding his visit with my dad. Suffice it to say, my father is functioning at a high level mentally and working in those fun little manipulation games. He is scheduled to be discharged from the hospital sometime Thursday, returning to the VA Center to complete his rehabilitation.

My bosses have been great and came up with a plan for me to work at home as tolerated for the remainder of the week, get some rest and take care of myself --- that is, after getting my dad out of the hospital. Tough love is going to be a bit tougher! Coping skills must be employed or developed and used to function.

My pancreas and system is still very unhappy and I'll pamper it as much as needed to regain some sense of normal. Rest is always the best medication for it along with gentle foods. I cannot thank my family and many friends for their loyal support, prayers, and words of encouragement. The saga will continue for a bit to be sure, but the damages can hopefully be minimized.

A big hug to each of you!

Dementia and Frustration

Tuesday evening late. Now I'm having trouble remembering which day of the week it is! As far as my father's knee surgery, the knee is healing very well and the crises for his overall health have seemed to work themselves out. Dementia on the other hand, is another story --- an ugly one at that. Dr. Moses has called in a neurologist for a consult to review and possibly adjust the medication currently being given to help battle the dementia. The confusion and frustration for my dad and his mental state has deteriorated in the past week.

He cannot remember for 5 minutes where he is and kept asking over and over today, claiming that no one else had told him. Though I firmly stressed that we had told him last night, he could always have an answer and then ask the same questions again. I was assured this afternoon and early evening that the neurologist would come by today but that never came to pass --- that is, as of 9:30 p.m. I left a detailed note for the neurologist asking him to give me a call. That the best I can hope for at this point.

The current plan (as of 1:30 p.m.) is to discharge my father to the VA Center on Thursday and allow him to work with the physical therapist there and accomplish as much as he can follow. I am mentally and physically exhausted and hope that after moving him on Thursday, my time can be lessened and the nursing staff at the VA will take care of him for a few days.

Thanks to everyone for your well wishes, good thoughts, and prayers on behalf of my father and our family. By the way, my four-legged patient is doing very, very well and is beginning to regain weight, purr for his mommy, and play a bit!

Monday evening late

You just never know what each day will bring. Okay, so it's not rocket science or an earth-shattering statement. Sunday evening was another wild adventure with my dad at the hospital with my sister Carolyn taking most of the "hits." We went through another day of anger and him uttering outright mean and hurtful comments for no reason. My morning was spent resting and trying to calm down a very nauseous stomach and angry, hurting pancreas. My results were more satisfactory and calming.

It appears that the rehabilitation unit of the hospital has accepted my father as an inpatient once they have available space this week. Carolyn leaves on Tuesday morning to return to Kansas City and I plan to at least be in the office on a part-time basis. At this point, his life is not in danger, unless of course we spend more time with him and take on or rather get our fill of childish behavior. Dementia is one thing but all behavior choices cannot be attributed to early stages of dementia. He was not too fond of my tough love approach, but verbal abuse will not be tolerated.

’Nough said!! Hopefully, diplomacy will rule.

(Thanks for all of the calls and messages of concern and prayers on our behalf. We couldn't do it without you.)

Wearing me out

It is Sunday evening after a long afternoon and evening with my dad and Carolyn at the hospital. While there has been no confirmation, all signs point to a mild stroke or TIA on Saturday evening. His speech is still difficult for him at times, though others it seems to be okay. We've pushed him to stay awake today and forced him to eat with us. Finally this evening, after ripping out the IV in his upper arm, he told me that he wished we would just let him die and get it over with. My response, was "No, that's not going to happen." At another time before this last statement, he asked if they were going to cut off his leg. There is still considerable confusion though he is not nearly as belligerant as was the case last week. His blood pressure is quite high for him today.

I'm home to get some sleep and try to settle my pancreas and stomach. It is no surprise that my body is reacting adversely. Carolyn plans to stay through Monday and we'll just take it day to day from here.

Thanks for the many offers of prayers and concern; it means a great deal. God is in charge indeed.

Late Saturday/Early Sunday Update. . .

On Saturday, we moved Travis from ICU back to the Ortho/Neuro floor of the hospital in one of the rooms closest to the nurses' station. For approximately 2 hours in the afternoon, all was calm and everyone rested a bit. Unfortunately, the doctor on call for the weekend decided to change his pain management medications after we had struggled this week to get him stable. Why do these guys do such foolish things, especially when dealing with dementia patients?! Carolyn and I made a quick run to my house to deliver dirty laundry and pick up some things she had previously left there for Father's Day. Late afternoon, he began shaking violently and cried that the machine (CPM -- continuous passive movement) was "getting him" and for us to help him and get it off. We turned the machine off and nurse gave him some Xanax to calm him. One of the changes made by the weekend doc was to extend the length of time for the pain med (Darvocet) from 4 to 6 hours which does not hold the pain, and he also added a muscle relaxer.

After a bite of dinner for me in the cafeteria, I made a run to Wal-Mart to pick up some things for Carolyn and work on laundry. While exiting Wal-Mart, Carolyn called and asked that I return to the hospital ASAP. As I returned to his room, he was having great difficulty talking which upset him because he knew what he wanted to say but could not speak it. After a while, he calmed down and bit and Carolyn went for dinner (10:15 pm). In the meantime, my dad began complaining of chest pains again and still had trouble speaking. I had the nurse come in and he added oxygen, checked his pulse, etc. My dad's heart rate began dropping again and his blood pressure up. Next, he complained of intense leg pain.

Just before Carolyn returned, he settled down again. As I began to leave around 11:20 or so the nurse called the "on-call" doc who further drew out the pain medication! Go figure this one when the nurse told him that he was having breakthroughs! We'll see come the morning. Carolyn in staying the night while I take care of laundry and get a bit of sleep.

Laundry calls. . .

pulmonary embolism confirmed...remains in ICU

It's 7 a.m. on Friday, June 13. A pulmonary embolism was confirmed by the CT scan. I've just spoken with his nurse and he pulled all IVs and other lines out last night. Confusion and dementia kicked in full force. Carolyn has been allowed to stay with my dad for a couple of hours this morning to calm him.

I am wiped out this morning as well as dealing with nausea. In addition, I apparently clenched my teeth rather tightly and my right jaw is killing me this morning.

When the docs make rounds in ICU, the nurse has suggested a more permanent IV line be placed in his upper arm. They will call me for permission and I can sign the forms later in the day. I'm hoping to lie back down for a couple of hours. Later. . .

Latest Update on Travis Cain (my dad)

Not everyone reading and receiving this blog knows my father's name, Travis Cain. It's nearly 2 a.m. Friday morning and this is the latest report. This morning around midnight he was moved to ICU (at Norman Regional Hospital) for a suspected pulmonary embolism. At approximately 10:30 p.m. Thursday, Carolyn phoned my and asked that I come to the hospital ASAP. His blood pressure had dropped to 55/38 and heart rate was around 35 with him complaining of difficulty breathing, chest pain, nausea and upset stomach; we had commented that his skin color was not healthy and deteriorated throughout the day. After I arrived, Carolyn again pleaded with the nurses to contact a doctor and the nurse finally obliged.

While she visited with the nurses, my father again complained to me of chest pain, it felt as if someone was standing on his chest, and he described that he was seeing pretty lights of many colors. Yes, it was difficult to hear and know what was going on yet try to comfort and stay with him. I finally left the room (when Carolyn arrived) to regroup and realized that I was not just upset but very angry. Thankfully, Jenny Wynn (youth minister) arrived about that time and became our angel and comfort.

The doctor assessed the situation and gave orders for him to be moved to ICU along with a CT scan to confirm or disprove his diagnosis. A heart attack had been previously thought to be the cause but pulmonary embolism is the more likely culprit as stated by the physician (a pulmonary specialist). After getting my dad settled into ICU, we were allowed to visit a short time and have a brief prayer with him, led by Jenny. My father was alert, talking and knew each of us and no longer talked of pretty lights, though the chest pain persisted. His blood pressure had raised to 80/40. The nurse strongly encouraged us to let him take care of him tonight and to get some rest, but Carolyn preferred to stay in the ICU waiting room and I came home.

My sisters and I have dealt with pulmonary embolism in the past --- that's how we lost our mother.

I thank each of you for your love, concern and prayers on behalf of my family. Regardless of the outcome, I rest assured that God is always in control and gives us strength for the journey. May God's Peace abide in each of us.

Successful Surgery

It's a day late for the report, but the knee replacement surgery for my father was successful, though I wish his recovery had “followed suit.” To say that it has been difficult would be a gross understatement. He has been extremely confused, agitated, irrational and totally out of character. To keep it brief and allow me to get to bed quickly, this evening we finally had to put on physical restraints and followed these with the third chemical restraint, finally using a large dose of Haldol.
Carolyn arrived on Tuesday evening around 7 pm, driving in from Kansas City. Though she had initially planned to leave on Thursday morning, she phoned her office and her husband and plans to stay until our dad is moved into a rehab unit. I will be staying at the hospital as well the next couple of days. Hopefully the doctor and nurses will narrow it down tomorrow as to what medication is causing the extreme confusion and agitation and we can help restore his mental state to a more normal level. The man we've been sitting with the last couple of days is not the father we know and love, but rather someone behaving as a child and caged animal.
Now for a bit of sleep...

Early June Sunday evening update

It's been a busy 10 days since the last post and I hope all is well with everyone. Last weekend my niece, Jeannie came to visit on Friday, leaving Sunday evening. Her granddaddy was surprised and very tickled to see her and touched that she took the time to come for a visit. We crammed as much as possible into the short three days: touring the OU campus, scrapbooking with friends, minor league baseball game, church, shopping, visits. Whew! Her visit was a breath of fresh air and mental break for me as well as boosting the spirits of her granddaddy.

This past week included doctor appointments and taking care of pre-op bloodwork, x-rays, etc. in preparation for his knee replacement sugery on Tuesday, June 10. On top of taking care of Daddy, one of my kitties needed dental surgery on Thursday to remove his canine incisors, thus leaving him with no teeth though he is not yet 6 years old. Unfortunately, he's had ongoing problems with stomatitis, a very painful condition in their mouth affecting approximately 2 percent of cats -- the only cure is removing their teeth. The bacteria from the plaque in their mouth causes the problem. Foster is a very sweet boy and is very good to take his medication without a struggle. (Foster is the kitty in the back, Tux is his buddy.)

This week promises to be very busy -- my Dad's surgery on Tuesday combined with a three-day training session Tuesday-Thursday on a new student system we are developing at OU. Naturally I will be missing the training session on Tuesday. Thankfully my sister, Carolyn from Kansas City, will be driving in on Tuesday evening to stay and help with my dad until Thursday morning. Today (Sunday) my dad and I made a trip to Target for last minute shorts, shirts, etc. which should help in his rehab coming up later this week. The doctor anticipates his stay in the hospital from Tuesday through Friday and he will then be moved to the rehab unit of the hospital for approximately 7-10 days.

My dad is looking forward to getting the surgery behind him and seems to be in much better shape mentally. We had a great conversation Friday evening discussing the VA Center as his new home and various financial details --- a conversation like I've not had with him in a number of years. I'm very grateful that he is responding positively. This last image is one taken last week with him on the patio outside his unit at the VA Center.

Tux seems to have decided that this post is long enough as he has positioned himself as a statue on the mousepad and storms are moving toward central Oklahoma. More later. Hope each of you has a great week!