Passage Of Time

Looking back on former blog post titles, I realize I am rather preoccupied with time.  Our perception of time is interesting.  Time can seem to move so slowly, like when stuck in traffic.  Why do they call it rush hour when nobody is moving?  I guess because everyone is in a rush to get to work and then in a bigger rush to get home.  Time can even feel like it is standing still when we are waiting for an important call, or to fall asleep at night, or for a sick loved one to get better.

Time can also move very fast.  When talking on the phone with different people about Courtney this week, before I knew it, time had flown by.  Typing up-dates, researching medical jargon, answering questions, etc. all took a lot of time which went by in the blink of an eye or the stroke of a key.
"As time ‘marches on', there’s no parade or stomping of boots to alert you to its passing.  It tends to tip-toe by.  One day, you turn around and it is gone." Unknown

Saturday 4/21 - I have no idea where the time went.  We were quick to get in touch with the hospital and heard that it was a rough night trying to get the pain and vomiting under control for Courtney.  They tried different meds and thought they had found what worked best for Courtney, so she was doing better and finally resting some.

Joe and I were getting ready for our long awaited and planned trip to my sister Carol's, in addition to planning for the roofers coming while we were gone, pet care, and also monitoring Courtney's progress.  

Jean arrived at the hospital in Salt Lake City at 9:00 their time, and went to work taking care of Courtney.  She sent a photo which made us feel better just to see Courtney.  Jean did a fantastic job the whole time she was there, communicating with the medical staff and relaying that information to us.  She was a great comfort and mentor for Courtney.

She also went to Courtney's hotel, that Courtney had left Wednesday afternoon, and got her things packed up and Courtney checked out of the hotel.  What a shame that Courtney couldn't enjoy the conference and this beautiful room for the week.  Joe got Courtney's flight cancelled.

Back on the home front, Joe had sold the riding mower, but mowed first before the man came to pick it up.  Then he was off to golf.

I was busy with laundry, packing a suitcase, getting Maggie's stuff packed, and planning for pet and house care, while also keeping in touch with Jean almost hourly.  It was so sweet to hear that Jean had braided Courtney's hair.

Courtney was still dealing with a lot of pain and nausea.  She was in and out of sleep all day as the meds kicked in and then wore off.  They were really pushing IV fluids (the main protocol for treating pancreatitis) but Courtney was retaining a lot of the fluids, adding to the pain.   As each new issue arose, it was addressed and dealt with.







Once I took Maggie's crate, bedding, food, toys, etc. to Patty's house, Bo and Gilley were quick to make themselves at home.  Ha ha ha

I got all the furniture moved from the porch on our bedroom side to the one on the dinning side.  This was in preparation for the sky lights that were to be installed while we were away.









I watered all my plants and moved the un-potted ones inside, onto the porch.  Of course everybody had to check them out and maybe taste a few.








Jean gave us an update on Courtney before bed.  She continued to retain fluids which they need to keep pumping into her.  So they did a procedure to try to help with that.  The doc said that Courtney's pancreas is holding a lot of fluid too, which is why it is so swollen and painful and she feels nauseated.  This is how pancreatitis goes.  The other concern was her digestive tract, which was very sluggish.  They didn't want it shutting down.  They were also concerned about bladder and kidney function.  These are all known complications of the ERCP to remove the two gall stones. 

Sunday 4/22 - we were up and ready to roll by 8:00.  I drove my car with Maggie to Patty's house where we left both.  (We wanted the car out of our driveway for the roofers.)  Joe and I proceeded on the (over seven hour) long drive to Carol's sheep farm in Indiana.



Five minutes down the road we got this photo from Patty, saying Maggie was feeling right at home already.  As it turns out, during her four day stay, she did great with Patty's three cats and never had an accident.

The trip to Carol's flew by because I was on Facebook with Jean much of the time, and relaying information to others.  Several things developed with Courtney and her care during the course of our drive.  A CAT scan showed necrosis of the pancreas. (The middle half, neck and body, had died.)  It was acute and they would be treating it the same way as pancreatitis - giving lots of fluids.  There was also a blood clot in the portal vein which was being treated with blood thinner.  Courtney still had lots of dry heaves causing her pulse to spike and her resting rate was high too.  Blood was drawn for lactic acid to detect if there was infection or wider tissue damage.

By the time we reached Carol's at 3:00, Courtney had been moved to Surgical ICU, got a Foley catheter, was put on oxygen, and would be getting a nasogastric tube to drain the bile from her stomach and then a feeding tube to get nutrients down to her intestines.  Jean compared the hooking up of all the monitors and equipment to Dorothy in the Wizard Of Oz when she got all spruced up at the Wash and Brush-Up Co. before meeting the wizard.

When we first got out of the SUV at Carol's, Hercules came right over to guard his yard but when I said his name and talked to him, he quickly quieted down and started chirping to me (video).  I know he recognized me.

The stay at Carol's had been a lot like the dinner at Patty's last Thursday.  We were so pre-occupied with Courtney's care and progress, we didn't have much time for small talk or relaxing, but it was a relief to have Carol's medical knowledge and experience as the information came in and we had more questions and concerns.  Jean was great on her end with Courtney at the hospital.









Carol fixed great meals and we enjoyed fellowship around the table.

There was also time for sheep and lamb watching.  These photos and (video) were of feeding time the first evening, and our only day of decent sunshine.

 

I set up my laptop on the card table we had brought, right in front of the window so I could watch lambs and keep in touch with Jean while trying to do some blogging.

Jean sent one last evening up-date on Courtney before leaving for her Air B&B.  We summarized Courtney's day and sent it out to close friends and family: "Courtney showed improvement today.  The pain is more tolerable and the vomiting has stopped because of the stomach pumping.  She still has pain and is nauseated but the medicines were working better.  She walked and sat in a chair during PT which really wore her out.  She is on oxygen because it is hard for her to breath because of the swelling pushing on her lungs.  She was able to finally sleep some. It is going to be a long road."

Monday 4/23 - I did not sleep well the night before, looking at the clock every hour.  There were tears and then more praying all night long.  I got out of bed when I heard Carol up before dawn.  I had moved off the card table onto the desk by Carol.  Drinking tea, I waited for an update from Jean which seemed forever to come.  Time was passing so slowly. 

Rick sits watch at the chair.
This emulates us on the edge of our seat,
waiting to hear about Courtney.

The up-date: "Courtney is still in SICU and sleeping a little better, now that she is on two anti nausea meds.  They had  a shift change, and her new nurse said they will firm up today’s plans once they did rounds in the next couple of hours.  Both her GI Drs (Dr. Abdul Haseeb and Dr. Michael Sossenheimer) stopped in separately this am to check on her.  They are both great and say her case is fairly rare.  Giving her time, rest, and fluids are her best bet.  Her urine output has improved and she seems to be sleeping better, with maybe more manageable pain.  Dr S. still feels like some nutrients by tube will be beneficial since there is concern her digestive system will shut down.  He said it is a smaller tube, so hopefully less invasive than the stomach pump.  They will also give her more blood thinner for the clot and he wants to bring PT in to get her on her feet or at least moving some more.  Her respiration’s are still shallow, so they may work on that today too, with blowing into spirometer.  He said her kidney function has remained stable, but they are keeping a close eye on that as well.  She is in good hands here."

It was to be a day of working outside, since this is what we had planned so many weeks ago, and something I had been looking forward to since our February cruise.  I was feeling rather guilty for not going to Courtney's bedside, but was prepared to drop everything and go if she got worse.  Jean was doing a better job than I could do anyway.  She was booked to fly out Tuesday morning, and Joe would be flying in that afternoon.

This is a feed trough Joe built for Carol.  The dogs were inspecting it. LOL


Carol and I worked on pick up sticks, and Ike really wanted to help.  Joe did some other odd fix-it jobs and Carol and I got a bonfire going.  During our lunch break we checked in with Jean.



Rain came mid afternoon as predicted and eventually put out our fire.  We had called it a day and didn't want to worry about it anyway.




Hercules and I had more conversations during the day.  

Courtney's up-date:  "She showed improvement today.  The pain is more tolerable and the vomiting has stop because of the stomach pumping.  She still has pain and is nauseated but the medicines are working better.  She walked and sat in a chair during PT which really wore her out.  She is still on oxygen because it is hard for her to breath because of the swelling.  She was able to finally sleep some.  This is just going to take long so prayers are still needed and much appreciated."

Tuesday 4/24 - I don't recall how Courtney's night went, but things were hopping when Jean got to the hospital quite early.  We were all concerned about Courtney's shoulder pain, shallow breath, bloated and hard belly, vomiting and rapid heart rate.  Jean had to be chased back into Courtney's room again, as she had gone out looking for answers many times.  Patience is needed but hard to have when a loved one is so sick and the passage of time is so slow.

These lamb and sheep photos were taken Tuesday evening at feeding time.  Seen first, the ovine had no idea there was corn in the new feed trough. 










Then when they discovered it, there were too many to fit around it.

Dr Haseeb finally visited with Jean and Courtney.  He agreed with Dr. S. that the nasojuejeno tube was essential.  Courtney was nodding but half asleep.  Jean had to say goodbye, which made us all sad because Courtney would be alone when they do the tubing procedure.

With Carol driving we took Joe to the Indy airport and he was soon headed off to be with Courtney.

The feed trough works well as a seat also.

It was a rainy, misty, cold day, so once home we quickly finished up a few chores outside and then spent the remainder of the day inside.

We got word that Joe was able to catch an earlier flight out of Denver so got to the hospital sooner than expected.  Courtney had the feeding tube in and was really struggling to accept it, so they removed it.

Around dinner time we tried out the new feeding trough, then watched the sheep graze.  Carol's dogs helped herd them back to their pasture.

Courtney's up-date:  "Courtney had another long, hard day but she was doing and feeling a little better by the end of it.  They tried to get her some nourishment thru a nasojejunal (nose to intestines) feeding tube but her body  just couldn’t tolerate it.  The plan is to try an IV method called TPN using a PICC line.  She has been able to go to the bathroom so her catheter is out.  She was also able to take a short walk.  Hope and pray that tomorrow is an even better day."

Wednesday 4/25 - Brian sent this photo and a message that the roofers had started.  It had rained there all day Mon and Tue and still looked really overcast.

Joe touched base with us early, saying that Courtney had slept quite a bit overnight and that the pain and nausea were still under control.  She would be having the TPN line put in for nutrients and they would try letting her drink a little water to re-start  her digestive/GI activity. 

Also, Mike had worked with his teachers to get all his exams and papers done early, so his semester was over and he was flying to Salt Lake City.

I left Carol's a little after 8 am our time, and got home at almost 6 pm, making several stops along the way.  At the 2nd rest stop I happened to look at my gas gage and it was almost on empty.  I hadn't even thought to check it until then.  So I made another stop 20 minutes later.  I had also gotten a call from Steve the roofer saying part of a rotten board had fallen through our ceiling.

So I called Joe to give him the news and he called Patty to go check it out.  She went in the house and cleaned the worse of the mess, covered the TV, and took all of these photos.

The roofer showed Patty how rotten one of the sheets of plywood was.

At the TN border I tried lying down for a nap but after about 10 minutes got too hot.  I hadn't thought to crack the windows before lying down.  So once back up I just got back on the road.  Traffic around Nashville was not too bad yet.  At my last rest stop I happened to get another call, this time from Steve the sunroom contractor.  He had a question about sky light placement and Joe called to ask me to drop the SUV off at the repair shop.

 

I got lost in Crossville trying to find the car place.  Patty met me to take me on to her house.  We moved lots of stuff into Patty's car, dropping it off at our house before going to Patty's house to pick up Maggie and my car.  It had been a long day driving, but the book on CD Carol gave me really helped it go fast! 

Maggie charging out of the garage to greet me and do her business.

Back in the house, she showed me her favorite toy Aunt Patty had given her.  

It was good to get home, even to a mess.

This is a handful of the rotten wood I scooped up off the stairs - it was like sawdust.  And these are a sample of the under layer of roofing nails, some very rusted.

By the time I got home the roofers had left.  They had the second story stripped of the two layers of shingles.  They had new roof boards in place of all the rotten ones that had been removed and they had the felt paper over everything in preparation for another rainy day.  A large tarp was over the fireplace.  







Sunlight was no longer coming through the hole in the ceiling, as seen in Patty's earlier photo.  I had thought about having a can light put in our closet.  Too bad this hole wasn't about five feet over, it would have been perfect.  LOL



I needed to get some fresh air and exercise so took Maggie for a fairly long walk.  Coming down the hill on the golf course, I took this photo of the back of our house to get the roof.  Hard to see any detail unless you enlarge it.

Courtney continued making progress during the day and evening.  The PICC line was in and providing nutrients. She was processing her fluids well and her vital signs were steady.  We were anxiously waiting for the blood test to see if her pancreas and liver function had improved.  She was moved from SICU to SSTU - Surgical Specialty and Transplant Unit.
I was dead tired but couldn't sleep, so continued my CD book until too sleepy to follow the story line.

Thursday 4/26 - it was misting and rain soon started, predicted to settled on the Plateau for the day. 

We got an update from Joe: "Night was so-so.  Courtney did not sleep as well because of many trips to bathroom due to new med, but overall her condition was still improving slowly."  One day or even hour at a time makes time seem to drag.  They can’t make definitive projections cuz it varies so much.

It was a slow, quite, lazy, rainy, morning.  Most of the day was this way and I spent a lot of it on my computer.  I did do some laundry and go to the gym.



Computer time also included listening to the book on CD I was trying to finish.  I nodded off again.  There wasn't a lot new with Courtney.  We are looking at long hours and days of waiting as she rests, heals, and starts to feel better.  A feeding tube and  CAT scan were in the planning stages.  They were monitoring Courtney's blood sugar, due to the decreased pancreas function, and needed to give her some insulin.  This is not an indicator of anything long term and is only needed for now while her pancreas heals.

Friday 4/27 - I don't have record of an up-date on Courtney (think we switched those to once a day in the evening) so not sure how her night went, but know she went several nights in a row without any sleep to speak of.

Maggie has been having a ball with her new toy Patty gave her.  The roofers arrived at 8 am and started in on banging, hammering, nail gunning, etc.  Joe was flying into Knoxville at noon so Patty and I hit the road at 9:30 to go get him.  We left Maggie in charge at home.



Once in Knoxville, we started the River Walk and took some time to 'smell the roses', well these are azaleas.

Well, not far into our walk, we came across a quaint restaurant and decided to stop and have lunch.  Service was slow but the view was great, the sun warm, and ever so slight the breeze. 

 

Since we had used up more time than intended, we had to rush to get back to the car and get to the airport to
pick up Joe, the whole reason we went to Knoxville.

Coming home, we had to go all the way into Crossville to go back to Tenn Tech to pay them so they could get started on the SUV. 

The roofers had made great progress while we were gone.  Here is a before and after photo from when I left to when Joe and I got home.

I had taken this photo in the morning.  The roofers where photographing the rotten boards and I like how the light rays were caught and my reflection in the window.


This photo shows a rotten board in front, right above were there has been a leak in the office ceiling.


I tried to blog when I got home but was too distracted by the roofers and Courtney up-dates.  For stress relief, I decided to go to A Time To Remember - a dance at the Conference Center to rekindle memories of our prom days.  I had a great time both dancing and talking with a lot of fun and interesting people.

I was home by 9:15 and checked the Courtney up-date:  Sort of a roller-coaster day, starting with an elevated white cell count which could indicate infection, most commonly c-diff, so they put her on some antibiotics as a precaution.  They were able to get a stool sample, but it would take time to confirm or rule out c-dif.  On the plus side, they did another CT scan which did not show any further damage to pancreas.  She did a lot of sitting up and walking, brushed her teeth, and even some kind of "beauty treatments".   She said she was finally feeling human again and proved it by participating in some texting.  I think days and time were all starting to blend into one another for those of us involved with Courtney's care.

I like this quote by Natalia Sanmartín Fenollera:
"I have to admit that I've always felt burdened by nostalgia, by a desire to stop time, to recapture things that have been lost. A sense that everything, absolutely everything, is on a journey from which there's no return.”