Saturday, May 26, 2018

Going Through The Motions

This week I did life by pretty much just going through the motions.  I basically kind of moved along, step by step, but with no real clear direction.  I was feeling lethargic and emotionally numb and seemed to have little interest in the usual things.  I haven't slept well or felt well rested in over a month, and I have become absent minded, struggle to think straight, and can't remember things.  I don't know if this is the effects of stress or depression.  I feel like I can't fully return to normal until Courtney is home and getting back to normal herself, and I can't relax and fully enjoy life until this house is fully put back together again.  Even when life hits you hard, it still moves on and somehow you need to keep movin' too.  So I went through the motions.

Sunday 5/20 - We weren't really sure how Courtney's night went because no-one was there with her.  Joe had removed all the screens and door from the porch off our bedroom in preparation for the sunroom construction to start.  We moved building materials into storage in the crawl space.  Then Dan arrived mid-morning.  We met Patty and had lunch at Stonehenge.







We got an up-date on Courtney.  Her night went fine.  She was still receiving meropenum, vancomyacin, and fluconozol; and had been given the go ahead for clear liquids as tolerated.  She was also cleared to move back to Acute Care once a bed became available.  All good news.

We went for an hour pontoon ride at St. George.
It was nice to relax and enjoy the day with each other.  

Mid-afternoon Dan left with Joe to take him to the airport in Nashville.  Joe was originally going to fly out of Knoxville the day before, leaving Patty's car there for her to drive home.  But with a cancelled flight, that plan didn't work out.  I was getting tired of things not going smoothly.  With the SUV still at the School of Technology, getting fixed, we needed Daniel for transportation.  

I was off to the barn to check on our two horses.  Zorro always wants attention and I sent his photo to Courtney.  Amiga showed lameness on both front legs, especially when turning on them.  I no longer know what to think or do for her.  Maybe some benign neglect was best, for both of us.  I just didn't want to deal with another problem.

Meanwhile, back home, I continued checking on the four heater/fans and drying condition of the subfloor.  Progress was being made.  And I was so excited to see a post Courtney actually made:  "No vomiting at all since surgery, I'm pretty alert except when I'm about to fall asleep.  I feel a lot better but still have some pain and fullness.  They're letting me have ice water and it's wonderful.  I actually slept a ton in ICU."  

But then just before I went to bed she posted:  "I had a setback.  I was on a clear liquid diet so I decided to try some Italian sorbet, after having lots of success with ice water.  About halfway through the Italian ice, I threw up everything... lots and lots and lots of green bile, plus my sorbet.  My system isn't tolerating ANYTHING and I'll definitely be back on the feeding tube soon."  ☹  I went to bed feeling so sorry for Courtney.

Monday 5/21 - Joe had arrived at Courtney's bedside shortly after midnight.  He reported in the morning that Courtney had a pretty peaceful night, sleeping except for blood draws and vitals checks.  She had some nausea but no vomiting, so the doctors may wait awhile longer for feeding tube.  They want to see how she tolerates liquids today.  She has drank some apple juice and chocolate milk. So far, so good.






I went to Ballroom Aerobics, and had difficulties staying with the routine several times.  I was going through the motions, but not really engaged, so kept messing up.  At least lifting weights went better than last Wednesday.  

I had lunch at home and then left for the dentist at 1:30.  With nice clean teeth, I went shopping (to five stores) and puttered around so much I didn't get home until almost 7pm. 

Blooming Mountain Laurel, even prettier than last week. 

Courtney had been moved to a room on 6th floor.  She had been attempting to eat to avoid having the feeding tube and was experimenting with what her body would tolerate.  She was taken off of the antibiotics and had been working with PT and doing what she could to get stronger.  She really wanted to get home and was working so hard to do so.





By evening, Mike reported that Courtney had been able to consume a little more by mouth.  She had some pudding and Jello successfully, and then some chicken broth, which did not sit with her quite so well.  They were going to try some Ensure later in the evening.

I kept hoping and praying for Courtney as I drifted in and out of sleep most of the night.


Tuesday 5/22 - Courtney had an uneventful night, but started the day vomiting, even before trying any liquids.  Her team of doctors agreed the feeding tube needed to go back in and they wanted to figure out why she was throwing up.

Before going into work at 2 pm, I blogged, did household chores, neatened up around the place, and took two naps.  I don't know what my problem was, although I had been up for two hours in the middle of the night.



We got a few little rain showers during the day, barely getting the concrete wet.  But with the clouds, I only had four customers all afternoon.  Then around 5:30, a nasty storm blew in.  That cleared the pool decks and golf course.


These two ducks were my only other customers, until I closed early (at 6:30) because of the weather.  The male did enjoy a swim/bath (video)  before settling in for a nap on the deck beside his lady.

A rainy evening made walking the dog a challenge and miserable.  I went to bed extra early.


Courtney had the feeding tube re-inserted in the afternoon, placed by radiology to make sure it went to the correct spot.  The doctors were trying to determine whether the stomach, small intestine, or pancreas was causing her persistent vomiting.  They suspected that it was her stomach, just not pushing food through correctly, given how long it had been compressed.  The feeding tube empties into the small intestines, after her bile duct, so it bypasses the stomach.  The inflammation of the stomach area needs time to heal to allow for the stomach to work properly again.  This is going to take time as she struggles controlling her gag reflex, but also  needs the nutrition to help her heal.  The daily battle continues.

Wednesday 5/23 - Courtney did not have the best of nights.  She hadn’t slept too well because she threw up twice.  They had tried a new anti-nausea med, Merinol and new blood thinner, Coumadin so there was some waiting, to hear what the doctors had to say.







I had my regular own ducky visitors down back. 
The doctors had decided to stop all oral input and just use the feeding tube and IV until nausea subsided.  The nurses used just Zofran at regular intervals and encouraged Courtney to sit up and move around as much as possible.


After blogging and getting caught up with Courtney up-dates, I went to Ballroom Aerobics and also lifted weights.  Rain was expected, so  I went out and got these flowers (which I bought in April) planted.  There was plenty of weeding to tackle in the process.

Courtney spent a lot of time out of bed during the day.  She went for a walk with PT and Mike was able to get her to sit in a chair and knit for a lot of time.  The possibility of removing the drains was being explored.  The heparin IV had been ordered to be discontinued, in favor of a subcutaneous injection until oral meds (a pill sent down the feeding tube) take hold.


Having gotten the kitchen floor/sub floor completely dry, I continued the 'clean up project' for mold removal and prevention behind the stove.  Sherwin Williams sold me a can of special spray paint they highly recommended for mold prevention, so I used that on the dry wall, as high up as it had gotten wet.








Courtney reached the goal of having the 35 mL/h of food through the tube and was tolerating it well.  If that continues she can possibly get off of the IV fluids.  That is the last IV left for her to get off of at this point.  While not entirely ideal, she can travel with the drains and the feeding tube still in.  We felt like we were getting closer.


Thursday 5/24 - I had little time to sit at my desk with the cats, and watch the birds (like this duck) come and go.  I was at the administration building at 6:50, ready for my CPR recertification class.

They removed the drains from Courtney's abdomen and made tentative plans to release her from the hospital Friday or Saturday if no issues were to come up.  Hallelujah!





My pool shift was from 9-2.  Patty came out to enjoy the sun and water.  And I asked the pool ladies to help me make this video for Courtney.




I was pretty tired by the time I got home from my pool job, and couldn't get motivated to work on the house or yard, or go to the gym.  A nap helped and then I took the dog on a nice long walk, before sitting at my computer to get caught up on blogging and Courtney.  She'd had some occasional vomiting (not much volume) during the day.  They suspected gastroparesis (partial paralysis of the stomach) which will just take time to resolve.  Her feed was still going at a rate of 35 mL/hr.  She had also been up and about several times during the day.  Good progress.


Friday 5/25 - I started the day with an early morning walk before the golfers got on the course.  I took this photo looking at our back yard from the 17th green.  I love the Mountain Laurel (with white flowers) interspersed with the Dogwood, which had white flowers a month ago.















Looking down #14 fairway while the sun was getting higher in the sky.  I was hoping to see the new waterfall feature, but when I got to the bottom of the hill, it was still turned off from the night before.










Courtney had a pretty good night, although had some anxiety.  Mike and Joe talked her thru an episode about 9 pm but at 3:30 am she needed help to be able to get back to sleep and was given a Valium.  The good news she got earlier, gave her a lot to think and worry about.  She was very emotional when she heard she might be going home in a day or two.  She has been stoic through this whole ordeal, so I think it was good to let her emotions emerge. 


But then Friday morning, more bad news came.  The doctors detected a new abscess where fluid was collecting in Courtney's abdomen.  To be safe they needed to go in and drain it like they had the other two.  They didn't want to chance symptoms developing while Courtney was traveling.  We hoped this would only delay her release by 2-3  more days. 

Hobo has been hanging around, begging for food (especially in the morning) when I come and go with the dog.  The cat has gotten quite brave and even let me pet him.






I was feeling awful for Courtney.  Since Joe was not going to be coming home over the weekend, I knew I had to mow the lawn, and it gave me something to do without thinking.


At one point I accidently ran my hand into the edge of the deck while turning the mower, and got a splinter under my fingernail.  I pulled it out, but man did it hurt.  This was nothing compared to what Courtney was dealing with.  

I got half of the yard cut before running out of gas.  A call to Joe during a late lunch break confirmed which gas tank to use, and later I finished the mowing. 



Courtney was back from surgery, and had another drain in her abdomen, similar to the two she had before.  But she had vomited and was feeling miserable again, and really wanted me to come be with her.  But it just wasn't feasible and I truly thought she would be home in a few days. 

worked in the crawl space spraying a 75% bleach solution on the very dry (but stained) subfloor/ceiling, seen right.





Then I moved the heater and fan over to the space under the guest bathroom toilet to dry that subfloor out. 


I cleaned (with disinfectant) the encapsulation plastic floor (seen right) that had stains (running eight feet long down hill) from the toilet leak.  None of this was easy to do crawling on my hands and knees.  I was feeling pretty good about all I had accomplished and came inside to rest.  Then I got a call from Karen.  Amiga had come in from the field really lame.  Karen and Jan looked her over, saw nothing remarkable, and gave her a Bute.  I was too tired to do anything, and thankful for friends who were willing to help out with my horse. 

I have felt so numb lately, burying my emotions and just going through the motions needed to get by, and not really thinking or functioning in any significant capacity.  I can't even imagine how Mike is dealing with this after spending four weeks at Courtney's bedside.  It is so draining.


Sat 2/26 - am update:  Courtney had been struggling with persistent vomiting.  When Dr. Gilroy stopped in, she said it may be due to some pooling of tube feed in abdomen resulting in some “back pressure.”  She said sitting up more may help.  She thought Courtney looked fine, said the drain site would be tender for a couple of days, and thought a Tuesday release still looked very doable.






I went to the barn to check on Amiga.  I brought her in from the pony pen and she didn't look too bad walking.  I treated her two back hooves for thrush, applied fly spray, and returned her to pony pen.  Bill and Celia were out there grooming their two Icelandic's and Amiga decided to go over and get in on the action and treats.


When I got home, I continued the kitchen 'clean up project' working on the floor, wall, and cabinet behind the refrigerator.


I went to the pool for my 2-7 shift, and Patty came out to visit for awhile.


We heard from Courtney that she had been doing a lot of sitting around but also kept vomiting.  They took an x-ray to check the feeding tube placement and look for any new issues that could be causing nausea.  Courtney also reported that they gave her a bed bath so at least she didn't stink.


I left the pool 30 minutes early because of rain.  My two evening dog walks were quick for the same reason.  
I finished with mold removal and prevention behind the refrigerator, emptying the rest of the can of special spray paint on the drywall. 

Courtney's x-ray showed that the tube had worked its way out of the intestine into the stomach.  They discontinued the feeding for the night so the nausea would subside and planned to re-position the tube Sunday.