Life on Auto-Pilot

Sometimes when we are given more than we can handle, we go into auto-pilot.  But sometimes we do it out of boredom or habit.  While on auto-pilot, we can miss out on life.  Studies have revealed that most of us are 'mentally checked out' a good portion of the time.

Unfortunately, for me this week, there was more than I could handle and I spent much of the time in mindlessness or on auto-pilot.  And actually, at one point I found myself feeling quite depressed, something that rarely happens to me.

Laura Chang, M.A., LPC comments on the Pros & Cons of Being on “Automatic Pilot:”  She says it is good to experience being fully present in the moment without getting distracted by thought-based interpretations of that moment.  But she also said that it is difficult to live in complete engagement and awareness in every moment. 
"There is a tendency (for us) to be clouded by thoughts, feelings, and preoccupations a great deal of the time.  This lack of awareness can be experienced as being on automatic pilot or going through the motions.”  

Crane explains that "the term ‘automatic pilot’ describes a state of mind in which one acts without conscious intention or awareness of present-moment sensory perception.  There are benefits to being on auto pilot as well (e.g.  when performing routine tasks and problem-solving).  But, autopilot becomes harmful when it applies to our emotional experience.  When on autopilot emotionally, it is easy to “slip” into one mood after the other or to spiral into a state of depression and then wonder how exactly you got there.  It is in our best interest to be sensitively attuned to our emotional experience.  By being mindful of our ongoing emotional state, it is highly unlikely that we will become so lost in our emotions that we no longer know what we are feeling or why."

Mother's Day Sunday 5/13 - All I wanted for Mother's Day was to get Courtney home.  Early morning Patty and Britney noticed nothing moving along Courtney's stomach suction tube.  The nurse flushed it, getting saline and air in but could not get anything out.  He double checked the suction hookups and put a new canister on.  Dr Bowen came in shortly after that and she tried to get it going too.  Courtney has been having a decent amount of phlegm, so it was thought that was clogging the line.






Church was outside and it was a beautiful morning.  I came home to find a Mother's day gift from each of the neighbors.  This made me feel so blessed, in spite of my concerns for Courtney and Amiga.  Then I took a short nap and read on a lounge chair out in the sun on the back deck.  In that moment, life felt so good.

Can you see where the big trouble maker is?

Eventually I got up and planted my new flowers in this pot out front (photo taken on a later rainy day) and then I did more leaf and roofing debris clean-up.

Mid-morning back in Salt Lake City, Britney left to head back to Costa Rica.  It was a pretty quiet day for Courtney.  They did end up taking the NG tube out, much to Courtney's relief and delight, and her nausea seemed to get better.  She was awake and doing crossword puzzles for a little while and looking pretty good, all things considered.  It was better than Mike had seen her in a long time.

Later we got a report from Mike that Courtney was able to get into a wheelchair and take a short tour of the hospital.  He wheeled her to the lobby and went outside for a short time.

Courtney was still getting tired easily but getting out of the room for a bit seemed to have helped her a lot.  It was a great Mom's Day gift in my opinion.
Joe was at poker again and I went to bed at 7pm.

Monday 5/14 - The Mountain Laurel in back are blooming.  Britney didn't get home until 2am because of delayed flights, and she had an am meeting to attend. 

Courtney had a pretty good night.  She had two bouts of vomiting but the volume was very small, it passed quickly and with the NG tube out was less difficult.  There were the usual interruptions of sleep with vitals, meds, blood draws, etc. but she got back to sleep fairly quickly.  During this “back to sleep” phase her nonsensical talk was minimal and she settled into a more calm sleep.  

I skipped Ballroom Aerobics to work on my 5/6 blog post.  I had gotten so behind while in Salt Lake City.  I also finished defrosting and cleaning the garage freezer and got it set back up.  Then I ran to Patty's to water and Shirley happened to also drop by to care for Patty's cats.  I had to get a selfie of us to send to Patty.  I hit Food City on the way home.

Mid-afternoon I went to the barn, visited with Judy, and checked Amiga.  A short ride around the barn and I could not tell that she was (or had been) lame.  I brushed and fly sprayed Amiga and then did the same with Zorro.

After getting home and cleaned up, Joe and I went to Jan and Mike's for dinner.  It was a beautiful evening on their back porch, and so nice to be able to relax and catch up with each other's busy lives.

Courtney had had a good day.  She was waking to suction out her mouth (phlegm and mucus) and then took small sips of water which she said were “so good”.  She did get out and walk the hall in the afternoon and also got a shower.  Dr. Sossenheimer visited and said that things were looking good for a Friday operation to have the stent inserted.  The nausea continued to be an issue but there was no real talk of reinserting the NG tube yet.

I think everyone just wanted to make it through Friday's procedure and see how Courtney responded.

Tuesday 5/15 - Example of a room white board and notes by Patty:
May 14th -15th Monday overnight
09:10  pm- got Seraquel, Ativan, Metoprolol, Zyrtec,  drains flushed, back to sleep, compression socks on
11:15 got Zofran, back to sleep
12:30 suctioned mouth, sip water, compression socks off, vitals good
12:45. Vomited small amt. 10-15 ml
02:00 new ear patch, compazine, blood sugar done, bathroom trip
05:15 vomited approx 50 ml, got Zofran, back to sleep
07:15  bit of nausea but passed fairly quickly, blood sugar done
08:00  bathroom trip with a little bit of diarrhea, had compazine, Flonase, metoprolol,
08:30. Dr Bowen came in, no big status changes but wants to start using the feeding tube at a very slow rate.  Courtney's liver tests showed a small change.  Getting off the TPN IV and onto the feeding tube would help those numbers improve. 

Photo of the back of our house with Mountain Laurel in the foreground.  I was delighted to see them blooming, and this gave me renewed hope for them.  The rains moved in mid-morning and occurred off and on all day.  I was supposed to work 2-7 but the pool was closed for the day at noon.  I have no idea where the time and day went, I think because I was on auto-pilot all day.  I worked here at my computer on both blogs (from the past two weeks).  I also remember the refrigerator kept making a hissing sound (off and on) but when I would have Joe come listen to it, it would stop.  At some point I took this (video) of Monita fetching an ice cube while Stevie ran pass interference.


I love my bench in the woods, hidden by Mountain Laurel.  Now I just need to find time to go sit there.

Courtney's vitals, blood sugar, O2 saturation, and heart rate had been good.  She still had, at times, very short periods of nonsensical talking as she drifted in and out of sleep, but generally she slept okay.  Her episodes of being too hot and then too cold slackened.  Late morning she actually sat up in a chair, worked on Sudoku, and got up to brush her teeth.  And Aunt Patty braided her hair.

Internet photo of the front of the hospital, showing the nice garden area.

The nurses got Courtney's feeding tube started at the rate of 10 mL per hour, which she seemed to tolerate.  She got up for a walk and later went on a wheelchair outing.  She was looking for things to show tangible progress and PT was a good goal for her to work towards.  She was working SO HARD, and was so determined to get out of the hospital (and still is).

Wednesday 5/16 I convinced Joe to pull the refrigerator out and take a look behind it.  We quickly discovered the waterline to the ice maker had sprung a leak, so we turned off the water at the wall.  Feeling down on life, I decided to go to the gym for a change, hoping to perk up.  Ballroom Aerobics helped but then when I was lifting weights, I couldn't get into it, and was so zoned out.  My body has gone to pot in just a few weeks.  I kept thinking about Courtney and the shape she is in, her long road to recovery, and I just wanted to cry, right there at the gym.

When I got home I discovered more water and realized the valve to turn the water off at the wall wouldn't shut off all the way.  Joe made several calls, and the quickest we could get a repairman was in three days, so I had a melt down and just cried for a while.  I was beyond stressed out.  We had to empty the bucket every 30 minutes.  On top of Courtney being stuck in the hospital so far away, Amiga has been lame for over a week, Monita kept throwing up making messes everywhere, the SUV still wasn't out of the shop (It's been there almost three weeks), and now this water problem.  Joe made several more calls and finally got a plumber to come.

Unfortunately, this leak as been going on for quite some time and there was also evidence that it has leaked before.  There was old and new dry wall damage, wood floor buckling, and cabinet bowing.  And the house had smelled musty when we bought it.  After the plumber (seen above) got done (except he didn't have the right part to hook the existing refrigerator waterline to the new house line, and said it had been incorrectly done which was the problem in the first place), we had a water damage clean up company come out to give us an estimate.  Seen right, area behind the stove.  Orange dot shows how high the drywall was wet, you can see mold growing, and also damp cabinet and wood floors.

The sub floor (seen from crawl space) was saturated in about a ten foot stretch and up to two feet across.  Also while down there I showed him the old leak around the toilet sewer pipe (photo below).  He said that should really get cleaned up too, but he would price it another day.  
Well, after two hours, he gave us a nearly 2K cost to rip up tile in laundry closet floor and wood floor in kitchen under stove and fridge, take out damaged cabinet between stove and fridge and remove damaged dry wall behind stove and refrigerator.  He said it would take 4-6 days with heavy equipment running loudly to get it all dried up.  But he would guarantee no mold or mildew from the water damage.  

This company tears out all the wet crap but does not replace it.  We would have to find a contractor who would come in to do that.  It would mean new tile for the whole laundry area (because I had gotten the tile cheap since it was no longer being stocked), trying to match the wood floor in the kitchen, getting a new cabinet, and this place would be a mess for who knows how long.  This and the hole in the ceiling were frustrations that who knows when we would get fixed and what it would cost.
Looking on the bright side, at least now we have a new roof over our head, new plumbing to the fridge, and both are no longer leaking.  




I went to the barn to check on Zorro.  A  thunderstorm was threatening to hit, so I helped Kaylah bring the horses in kind of early.  I took and sent some photos of Zorro to Courtney.



I also watched Amiga come in with the mares.  She was at the back of the herd, but was running with them.  She looked a little off.  I could find no evidence of heat or swelling, but maybe the start of thrush on her hooves, so I treated those.  It poured while I was in the barn horsing around.



As I was leaving, I could see 'smoke on the mountain.'

The heavy rain had knock lots of flower buds off the azalea out front and some of the other flowering shrubs.  Joe was at poker again, so I had a quite evening at home.

Meanwhile, we got an up-date on Courtney.  During the day she got up, sat in the chair, and was on her phone and kindle.  She then brushed her teeth and washed her face, for a total out of bed time of 30 minutes.  Later PT came and they went for a loop of the Acute Care floor.  Courtney did it at a pretty good pace with fewer stops than the day before.  The feeding tube rate was also increased to 20 mLs per hour.

Thursday 5/17 - I worked 9-2 at the pool.  There had been rain in the forecast, but it ended up being a decent day.  I went to the barn to check on and treat Amiga again.  This photo of her eating hay was taken the night before.

While I was at work, Joe had the plumber back to finish repairing the water line hook up from the refrigerator (he had gotten the right part) and then fix the 1/2 bath toilet.  It wasn't even sitting all the way down on the wax ring.  When we had the floor in there tiled, the contractor didn't build the base up to the height of the new tile.  So unbeknownst to us, the toilet had been leaking some liquid under the sub floor with each flush.  Luckily, this toilet doesn't get used very often.  The plumber also replaced a new pressure regulator valve in the crawl space and reset the water pressure from 80 that it had been at, to the recommended 60.

We had chosen not to pay the company to do the water & mold clean-up, but to do it ourselves.  This was decided partly because there are old stains and evidence of water leaks before and I am sure the sub floor has been compromised with water in other places.  So we had heaters with fans blowing on the space behind the fridge, behind the stove, in the tool room off the garage, and in the crawl space.  We borrowed space heaters from Patty and Shirley.  Drying and then spraying the sub-floor under the toilet with mold killer/preventer would happen next.  We were also running the air conditioner and would look into getting a dehumidifier installed in the crawl space.

Update on Courtney from Mike:  Dr. Sossenheimer showed us the results of the preparatory CT scan.  The pseudocyst in her pancreas is about the size of a football and is compressing her stomach, causing the nausea.  During the day, Dr. Bowen, Dr. Gilroy, and Dr. Haseeb stopped in as well to check in and talk about Courtney's condition.  Her heart rate had been higher, probably due to anxiety.  She also spiked a small fever which resulted in her getting Tylenol to bring it down.  They also removed the PICC line to eliminate the possibility of any PICC line related infection.  She had her TPN stopped because of this and is now only on the feeding tube which had the flow increased to 25 mL/h. 

Two new IV lines have been placed to replace the removed PICC line.  Her left arm is so torn up from all the sticks they have done over the last month and her right arm veins aren't as good so that made things difficult to get the second line replaced.  Heparin continues.  Feeding tube and heparin will be stop at midnight in prep for the procedure tomorrow.  Dr. Gilroy and Dr. Haseeb were in the room while some of the action was taking place and they were able to confirm that these developments do not jeopardize the procedure happening tomorrow.  They expect immense relief for her after the procedure and described it as a "night and day" experience for most patients.  An x-ray was taken to confirm there is no pneumonia.  The x-ray and PICC removal are precautionary so at this point there is no cause for alarm or major concern.

Friday 5/18 - We got news late the day before that they could take Courtney first thing this morning.  At 8:30 am she was wheeled off to a different building for her stent operation / procedure.

Just after 11:00 we got word that the procedure went well.  The left diagram shows a stent from stomach to pancreatic pseudocyst, similar to what Courtney got.  1.5 Liters of fluid had been removed from the pancreatic pseudocyst, and unfortunately found to be infected, so they put her on antibiotics right away.  She had also needed a unit of blood, so got that and was sent to SICU post-op for closer monitoring.  The feeding tube had been removed during the procedure, so was expected to be reinserted later.  Her esophagus was irritated due to the vomiting and NG tube so they were going to let it rest and heal a bit.  

I was so excited about the good news of Courtney that I shared it with all my associates at the employee picnic.  Not the best lunch table conversation, but I couldn't help myself.  









I went to the barn to visit and check on Amiga and Zorro.  She still shows lameness issues which I don't know what to do about anymore.  I did treat for thrush again, just in case.

I'm not sure what else I did all day, except I did finish and post the blog from the first week of May.  I might have been in auto-pilot part of the time.  There was also time spent checking on damp floors and walls behind the refrigerator, stove, in the tool room, and under the crawl space.  I moved space heaters and fans when needed.

Joe went with me to the Moonlighters Dance.  We sat with (in order from left to center of photo) Dawn, Marie, Jimmy, and Kathy.  Joe left kind of early but we girls had a good time dancing till the 10:00 end.  It had felt good to let off some stress/steam.

Saturday 5/19 - Patty left for the airport at 3 am and reported that Courtney had had no nausea or vomiting since the procedure.  We had a real gully-washer of a rainfall shortly after sun-up.  Once it was over, I went out to photo and (video) the flooding.

Mid-morning Mike reported that Courtney was doing well, still no vomiting or nausea.  She had walked two laps of the ICU loop for physical therapy and sat in the chair for 30 minutes.  Her heart rate was still high but they have come to expect that from her as her "norm" while she is dealing with the inflammatory response.  She has esophagitis, which they expect to heal on its own, so are willing to hold off on the feeding tube and see how Courtney tolerates liquids by mouth. 

When Dr. Gilroy was in, she said that most of the pseudocyst was liquid and there was not much solid material in the cyst, which was a good thing.  She planned to talk to the team to get a consensus about Courtney trying other clear liquids by mouth, later in the day.  Dr. Nunez came in and confirmed they would be moving Courtney out of SICU and back to the floor.  So they seem to be satisfied with her progress thus far.

Patty's flight out of Denver was delayed 3 1/2 hours.  Joe’s flight out of Knoxville (the same plane) was delayed 3 1/2 hours too.  So he would not be able to make his connecting flight in Denver and Frontier doesn't fly on Sundays, so he had to scramble to come up with a different game plan.

Courtney's purple vase Patty had brought

home and put some of her peonies in.

I worked the 2-7 shift and had customers until closing.  It was a perfect day and I was so glad to be starting the pool season again.  I love my job.  Home, in my PJ's, and just starting my popcorn and beer, Joe arrived with Patty, returning from the Knoxville airport.  Patty filled us in on Courtney's status and the week she had spent with her.

Courtney would be spending the night by herself.  Later in the evening, she reported that she had 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.  This means my system isn't tolerating ANYTHING and I'll definitely be back on the feeding tube soon."  I felt so bad for her and wished there was more that could be done for her.  Healing just takes time and patience.  And maybe existing on auto-pilot might be best for her much of this time.