Friday 28 Dec 2007

Well ! This is my first run at a blog, or journal of any sort. And, as any who know can vouch for, I am not a typist nor particularly gifted in the English language.

The doctor's follow up happened this morning and it was decide to continue my IV antibiotics. The redness, swelling, and the pain continues to present evidence that the infection is still active. I am able to walk a limited amount ( a few steps really) without the walker, and I can sit for a few minutes at a time. Cherished amounts of time since bed rest is really getting on my nerves ( and sore butt). While I feel much better on all fronts. there is still some residual effects from being in the hospital for two weeks.

On that note I have nothing but praise for the staff of Kaiser Sunnyside Hospital. Nearly all went the extra mile in their care of my health. The nurses and aides were phenomenal at anticipating my needs and catering to my conditions and my pains. I was treated with respect and dignity, even in the most embarrassing of situations. Long has it been since any other woman but my wife has seen any form a tan line, much less anything else. And I am quite certain my mother was the last to have to worry about the details of my bathroom visits decades ago. All in all I was measured, poked, prodded,bled and fed, bathed, wiped,rubbed, scrubbed, changed, dressed, undressed, slathered, lathered and pampered by a wonderful set of men and women. Thank you.

In that vain of thought there are many thank you's due from Myself and from my family. My next post will be to try and address all those who have helped and prayed and called.

Merry Christmas!

We have been blessed with the Magic of Christmas -- the miracle that Mike survived his illness and is home, recovering; the kindness of family and friends shown in so many ways; and SNOW ... a wonderful white Christmas for the first time in two decades.

Last Day of IVs

We're on our last few IV treatments of the antibiotics. We start another oral one tomorrow, in addition to the one he's already taking. Giving the drug is not difficult but I'm always concerned something will go wrong. The home infusion team is on-call 24 hours a day, so that makes us feel better.

On an up note, Mike stepped on the scale and has lost 26 pounds in the last two weeks. While this is NOT the way anyone wants to lose weight, hopefully that relatively small amount will help in his overall health.

However, on a more sobering note, I was reading on-line more about Mike's diagnosis and what we're actually fighting. The term the doctor used and I had typed incorrectly is Necrotizing Fasciitis ... also known as "Flesh-Eating Bacteria"! Now, they didn't say that!! WebMD describes it perfectly, exactly what is going on with Mike. Once again, we praise the Lord that he received treatment early on, because the potential was so horrid.

Please keep praying that these antibiotics work. While his redness and rash from the allergic reaction is going away, Mike is still in a lot of pain and can only be up on his feet for about 10 minutes before the pain is so intense that he must elevate it again and medicate. We don't have a follow-up appointment (with a new doctor) until Friday the 28th, so are simply following the course of treatment the hospital recommended and pray that's enough.

Can't think of much else to share. I did manage to find the tree and put that up but so far there are only lights on it, and I'm not sure when the wrapping will get done. However, at the moment I need to attend to the fire, prepare a balanced meal and get ready for the next round of meds.

Wishing you lots of rest and good cheer. Oh, and happy Advent Sunday!
-Shawnee

He's Home!

After lots of delays and waiting, Mike arrived home Friday afternoon! Yeah!!

The day began with a few bumps ... we started off with Frank's truck getting stuck in the mud while trying to retrieve firewood off the back acreage, but he called a friend who understood the miracle of four-wheeling and all was well (but that load is left for later). Frank did bring us wood from somewhere and I SO appreciate him. He also took a look at the furnace and under the house with inconclusive results. =) I do need to get some external foundation vents covered and that may help some with the frosty-house syndrome.

Mike's van continued to sound even worse when I took Tatum to YMCA care/field trip and we had to postpone the brake job when Mike was re-admitted so I ended up taking the Passat at Kathy's urging in order to prevent further damage. He wasn't as comfortable as he could have been, but it was workable.

We almost had a major setback Friday morning when results of an unexpected chest ray revealed that Mike's PICC line had moved out of place, over 5cm! So, it was partially pulled and is now a Mid-Line ... I just know that is okay for short-term usage and also means less risk, so we're fine with that. Praise the Lord for the x-ray ... could have serious consequences.

Once we were ready to be discharged, I had to check out with the cashier - thank you for wonderful insurance! Then, his discharge medication list was a page and one-half long! Family members have to go to the pharmacy on campus and pick-up (pay) for medications before the patient is released. Of course, it was complicated because I did not realize Kaiser had two pharmacies in two different buildings on their campus and I waited over 1/2 hour at the wrong one. Once I was apologized to and re-directed, it still took a little time, more money and then we found out that one was omitted - hence, a second pharmacy run was required last night.

Mike's hospital bed arrived while I was at the hospital picking him up, and Trevor and Teressa took charge of accepting it and setting up his space. They also were the first to greet the visiting nurse and refrigerate Mike's new IV medications because our check-out took hours longer than anticipated. Once we arrived home, we immediately had two hours of consultation and training from the Home Infusion Nurse, followed by a busy evening of medication administration and then I left to get Tatum from a field trip, made that second pharmacy run, trip to the grocery store, dinner and finally sleep.

Mike has seemed to adjust well to being at home with lay-man nursing care. Right now, we're trying to figure out a routine that keeps him happy and healthy. I made an Excel spreadsheet to keep track of all his meds and meals, which has helped me quite a bit today. We've had a second visit from a nurse and it looks like we're doing it right.

Teressa helped me get the van to Les Schwab, and it's ready for pick up after getting new brakes and rotors. We also received a wonderful surprise UPS delivery from the ESD of a huge Honeybaked Ham. Yeah - Christmas dinner is covered, since everyone can pitch in with sides. Thank you, Vicki, and all. My next goal is getting into our storage unit today or tomorrow and finding that darn Christmas tree and decorations. It's just NOT Christmas without a tree! You can't just stack gifts in a pile in front of the fireplace!! So, my "urgent" needs are a silly tree/lights and some wrapping needs done, too, plus a trip to Home Depot for ash bucket, ax and vent covers. As far as gifts, I still need something special for Tatum but I managed to work on a couple of gifts while sitting with Mike, and just have one more critical item to finish for Monday. Add in making balanced meals and snacks, and we've got enough to stay out of trouble I think.

Enjoy your weekend, and thanks for checking in.
-Shawnee

Quick Thursday Update

Just a quick note before I fall into bed. Thanks Trevor, for your sub-authoring -- I love your style. I'm happy to report that Trev will be staying at the house with us for the next month or so to help me out with Mike's care.

As for an update, yes, we had a bad experience in the Skilled Nursing Facility (SNF) Mike was transferred to, and yes he ended up back at Kaiser via ambulance. We called 9-1-1 when his blood pressure was 174 over 102 and rising, short of breath, etc.... the pressure just got to him. At one point, it was greater than 200/100. Mikey spent Tuesday night/Wednesday morning in the ER being tested and observed while we reiterated that we wanted to go home rather than try another SNF. While that option had been presented to us prior to the King City fiasco, the staff became nervous if Mike was medically stable enough for that and how quickly they could outfit our home. Plus, both Mike and I realized that we had no idea of what meds he is now to take and how in the heck to handle his newly-diagnosed diabetes. So, they decided to admit him overnight again and we would be trained today and have the equipment sent home.

Trevor and I showed up at the hospital today, again prepared to take Mike home once we had our IV training. However, Mike is now covered with a horrible lobster-red rash (welts really). They have decided he is allergic to the amazing new antibiotic, and he's been taken off of that one, started on a new drug and needs to stay ANOTHER night for observation to see if the red is subsiding and if there are any problems with another new med. My poor husband. All the horrible swelling and pain in his lower right leg, and now this horrible sunburn-like condition which is so itchy. We did get to watch videos on home infusion/IV treatments and he received diabetes counseling, along with another visit from the dietitian. There was also a scheduling mix-up and the bed/equipment actually did not get set up today so it's a good thing Mike was kept an additional night.

We are again very thankful that he was in the right place at the right time. I don't know if/how the rash would have been treated outside the hospital setting, and I'm thankful we haven't had to keep transferring him around town.

We have some dear friends coming by the house on Friday, Frank from our community gruop and Craig who volunteers with me in the nursery. They will transport some firewood that's on the property up to the house for us, and then take a look at the furnace to see if it is truly working properly. I look forward to getting Mike home and into some sort of routine in time for a quiet Christmas at home. I don't even want to think about my home to-do list but am looking forward to a different kind of celebration next week ... more about thankfulness and the true meaning of Christmas. It doesn't matter what decorations we do or don't have, if there are many perfectly-wrapped packages or even a traditional dinner. Being together IS what counts.

I hope this post finds you all well. Thanks for much for your care and concern.
-Shawnee

Fill-in author!

Hey guys, this is Trevor. I've pirated my mom's blog about my dad because she's tired. Actually, I'm tired too, so I guess that isn't really the point.

So today was a particularly grueling day, and I'm gonna go ahead and recount it for you as best I can. Here's everything that happened, to my knowledge (and I fully reserve the right to let Mom come back and correct me later).

So today, Dad was transferred to the King City facility around noon. Mom had gone and cased the joint to make sure it had all the necessary amenities -- big guy bed, appropriate drug regimen, cute nurses, etc. However, this initial scouting mission proved to provide... let's say faulty intel.

Here's the long and the short of it: the place was terrible. Nurses were taking forever to respond to even the most basic requests (pain meds, help using the facilities). This stressed out my parents to no degree, because of course then the concern becomes how they'll respond if something genuinely URGENT comes up.

When it became clear that this wasn't something that was going to be miraculously changing on Dad's behalf, he started requesting to be taken back to Kaiser. The nurses there were attentive and quick to respond to calls, and generally had their finger on the pulse of the situation (both literally and figuratively). But upon calling the hospital, we were met with the delightful news that it wasn't 'medically necessary' for Dad to be returned to the hospital. The King City facility (or King Facili-city, if you will) ostensibly had all the necessary requirements to care for Dad, and the doctors simply would not re-admit him under any circumstances.

This caused Dad to stress out even further, and understandably so: who wants to be stuck in a situation where they have to be constantly worrying about whether they will get the care they need when they need it?

When it became clear that the hospital wasn't budging, a call was made to the health care provider, who basically stated that they could not/would not override the doctor's decisions. So essentially, Dad was stuck there, and becoming visibly more agitated and upset because of it. Thanks, HMO! Way to look out for the little guy!

Finally, Mom became concerned about his well-being and asked one of the attendants to run a blood pressure check on Dad. When they finally got around to that (I assume it was Bingo hour at the nursing home and well, priorities are priorities), they found that Dad's blood pressure had (without getting into specific numbers that I can't remember) spiked to near-dangerous levels. Clearly, all the stressing about the situation was affecting him physically now. Again, the hospital was called, and again, Dad was denied re-entry.

Another call to the health care provider revealed that while they still couldn't get him re-admitted to the hospital, if Mom or Dad decided to call 9-1-1 of their own volition, that was their decision. And by golly, that's exactly what they did.

Sooo, another ambulance ride for my old man has him back at Kaiser in the E.R. And now we're re-assessing the situation with the goal in mind of getting him back home to Wilsonville right now. Because let me tell you, there's no way we're dumping him back in the old folks' home where they can't even bring him Tylenol in a timely fashion. No way, man.

Mom was by his side basically all day, from when he got to the King Facili-city at noon, to when he was ambulance'd out at seven, until they finally kicked her out of the ER to go home and rest around 1:00 am. She's sleeping, and I'm nodding off myself, having come to Wilsonville straight from work in NE Portland to help Teressa clear a spot in the downstairs living room for a bariatric hospital bed to come live at the house for a while.

We'll have more information in the morning, but that's what happened today. Technically, Mom didn't want me to post this. (She wanted editing rights, like it's her blog or something. But no Mom, this blog belongs to all of us.) Still, I think I kept it G-rated, no big deal. Just don't tell her I did it, okay? It'll be our little secret.

We now return you to your regularly scheduled bloggings.

Traveling Tuesday

Well, as they say, what a difference a day makes. The new antibiotic that Mike was put on Monday morning made a world of difference! The bright red on his leg has subsided greatly and the part that is red is only warm to the touch rather than burning hot. His temperature and white cell count have been stable for the past several days and Kaiser has determined he now only needs minimal nursing care.

So, today he was transferred via ambulance to King City Rehabilitation and Living Center. The current plan is that he will continue his IV antibiotics and oral pain medication through the 23rd with a tentative release date of Christmas Eve, the 24th. Before we agreed to the transfer, I went and checked out the facility to ensure they had all the necessary things for a big guy like Mike -- an appropriate-sized bed, big-boy "gowns" and the like. While it will not be like Hotel Kaiser, I think it should meet his needs for the short-term. And, if we need something, we'll ask.

I know the first thing he needs is a new phone. I ran into car, or rather tire, trouble while travelling from Kaiser to King City and tried to call Mike. However, his new room phone is broken and the other phone in the room wouldn't reach, so I think it was CNA that relayed the basics. I'm writing from Les Schwab's waiting area right now, waiting for the diagnosis of new tires or new tires AND brakes being necessary for Mike's van to be safe to drive. I like to play Pollyanna's Thanksfulness Game sometimes --- today, I'm thankful that the tire went flat during the day in a school zone rather than at 10pm on the highway. I'm also thankful that Les Schwab has free road-side assistance and they were pretty fast, too - OK, Kathy's follow-up phone call probably was a big help, too, relaying the sense of urgency I had inside but did not tell the nice dispatcher.

We had several wonderful visitors -- Kathy Morrissey and Pastor Jason Dick from church brought surprises and good cheer, along with a secret package that Mike conspired with Pastor Carr to get under the tree for me (I won't peek - promise). Carla and Herb Matter dropped by with a little Christmas tree and lots of upbeat conversation, plus Candie from TriMet came just before Mike was transferred. That means so much to him.

Oh, I almost forgot that Mike told me I need to put a medical disclaimer on this blog. I got the medical terminology wrong .... it's fash-ee-i-tus or something or other, not cellular necrosis. Whatever ... cells were dying is all I know.

One big request: In addition to good thoughts and prayers, if you have a minute, please drop Mike a get well card. I think that would really brighten his day, and I will check the post office box regularly.

Mike Halligan
PO Box 1326
Tualatin OR 97062

Blessings,
Shawnee

PS- Well, I guess it needs to be the cheaper tires ... we DO need brakes and probably an alignment, too.

News and Praise!

Sunday was an eventful and emotional day.

Mike was transported via ambulance to Portland Imaging for the comprehensive leg CT scan, heavily medicated both before and after but the ride was still painful. He said they took extra care to be sure they had clear images before returning to the hospital and his doctor was very quick about reviewing the results. The results were inconclusive, except that they ruled out lots of bad things: no cancer, no abscess just some swelling around the ankle.

So, his doctor brought in an orthopedic surgeon for a consult. Now, I was not happy to hear surgery mentioned. Mike asked why surgery would even be on the table since they don't know what's wrong: to remove excess fluid was the answer. Why risk surgery since he has such difficulty recovering from wounds due to insufficient circulation/venous insufficiency: how do you know you have that was the doctor's question. When Mike went briefly into his medical history, the orthopedic surgeon agreed that might surgery not be the best option but was not entirely convinced it wasn't appropriate; however, he decided a surgeon of his caliber wouldn't be necessary because there are no definitive leg/ankle issues and referred a general surgeon.

A general surgeon and his boss, the head surgeon, brought in the most shocking news. They say that Mike is fighting two different things. The bacterial infection that caused his initial symptoms is a particular devastating and fast-acting one, and because it seems very flu-like (nausea, vomiting, fever), it is not typically treated within the first few hours like Mike's was. The surgeons are usually called in after it's attacked a person for 24 hours or more, and by then the patient's only option is a life-saving operation. The doctor told Mike that if he had been called in on Saturday, they would have likely performed a surgery where they would have removed all the skin and tissue from his lower leg and it would have required months of skin grafts and recovery. He also told Mike there is usually a 50% mortality rate at that point.

However, Mike has received constant antibiotics and his body is actually responding to the drugs and leg elevation. How do they know it's responding, where I couldn't see it? Because of the pain! This infection typically causes cellular necrosis, and it kills the cells it attacks. Mike has horrible, deep red tissue that keeps climbing higher and higher on this leg, BUT HE CAN FEEL IT! They have never seen anyone respond like this, again because it's usually treated too late.

So, the head surgeon will be visiting Mike every 12 hours or less to review his progress. They will continue to pump in three or four different antibiotics trying to find the right combination in a multi-pronged attack. He will stay in the hospital for at least another week as of last night with constant monitoring and treatment.

I am so grateful that Mike was in God's hands during all of this, that TriMet dispatch called in medical assistance. Mike says he was so out of it, he couldn't have put together the thoughts to call 9-1-1 on his own. Thank you Lord for pain! As difficult as this has been, we could be going down an even more painful and life-changing path right now and are grateful that the tissue is alive and has feeling.

We pray for continued success of the antibiotics, that Mike be totally healed of this condition and that he experiences an overall healing of his body. Mike needs his own "Miracle on 34th Street".


On the homefront, thank you Pastor Jeff/Terra Mattson who offered to watch Tatum. She ended up spending the day with her best friend's family (thanks Kelley's!) but I so appreciate your call and Kathy for forwarding our request. Tess helped me Sunday AM before going to work, and then Tara spent the day at the session with me and then we went to the hospital. I couldn't have managed the cooking session without all their help, since I'm just on auto-pilot right now. Trev came out on Sat night and helped me unload the van from my TFF shopping, but we couldn't locate our Christmas tree, lights, etc in the barn -- Mike thinks they might be storage but isn't sure where the key is (the drugs talking) but decorating has dropped to the bottom of the priority list anyway.

I'm more concerned about where Mike will sleep once he is released ... I'm sure we can get a bariatric hospital bed since there is no way he can get up the stairs to our bedroom, but our rental farmhouse is cramped and very drafty (much to our dismay and PGE's glee). I can probably move out the sofa from the front room but it is freezing in there and we typically keep it closed up unless we're in there with a space heater. Oh well, a worry for another day. I'm going back to bed for another couple hours sleep until Tatum has to get up for school.

In Him,
-Shawnee

Saturday, Dec 15

Yesterday, his pain ended up going through the roof when they were a bit late with his pain medication and it took several hours to bring it back under control. They are concerned about what's going on in his leg and have ordered a CT scan. However, the machine at Kaiser won't work for someone his size, so he's being sent this morning to Portland Imaging. Pray for a pain-free and safe trip, clear read on his condition and excellent prognosis. He felt some pain in his bone right above the knee yesterday so that's a point they'll be looking at.

Mike was pleasantly surprised yesterday with several visitors. Pastor Dave Carr from Rolling Hills visited for a second time and that was very encouraging to us both. Then, fellow driver and long-time family friend George Brown stopped by - George is the one who encouraged Mike to apply at Trimet after Mike had been laid off from the high tech industry for 2.5 years. Mike and Trev's friend Rich stopped by, and he's coming back today with his wife Sunny. Finally, we ended up the evening with Trevor coming to spend several hours with his dad. Tatum was at a playdate/sleepover so I was able to stay at the hospital until about 10pm.

Thanks again to all my ESD friends -- Connie bought Mike a mocha, Sarah delivered it and then Cindy treated me to dinner from Baja. You guys make it easy for me to just be with Mike.

Mike's mom Karen and Luis are coming to spend time with Mike this morning since I need to shop for a cooking session on Sunday afternoon. Tess will help me get ready today before she goes to work, then Tatum and I will head up to Kaiser. I need to be at my Oregon City session by 1:30 on Sunday until about 4pm, and could use some entertainment for Tatum if anyone is interested in helping out that way. Tara is also coming up on Sunday so she might help with T or maybe she'll help me at the session ... we'll see.

We appreciate all your help and prayers.
Shawnee

Day 6 at Kaiser

Mike's been up and down as far as his blood infection. He's been alternating good and bad days, and yesterday was a good day: pain under control but only as long as his affected leg is elevated, although he still has a low grade fever. Blood pressure is the highest its ever been because of the pain but his blood sugar is staying stable on the new medication. Mike still doesn't have much of an appetite, again due to the pain and new meds, but they're providing tasty and varied meals for him to pick through. He was able to walk down the hall yesterday and we got him a quick shower, so that felt really good. His first bariatric bed kept shorting out, so he has a new bed and this one has lots of railings he can use for hand-holds to keep steady. Really, the nursing staff are amazing with him and we're very pleased with the care he's receiving through Kaiser.

We don't have a release date yet and I'm not sure what home care will look like ... he's got an PICC line (form of IV) inserted deep into his chest and is taking lots of antibiotics that way. They mentioned that the line has to be cleaned once a week at a medical clinic, and a home infusion nurse will come to Wilsonville once he's "out" to train us on his meds, etc.

Oh, most important, his room and room phone number is different, in case you need to reach me and my cell phone doesn't pick up or if you just want to chat with or visit Mike: Kaiser Sunnyside Room 321, phone 503-571-8875.

Thanks so much for your care -- warm emails, lunches(!), play dates for Tatum, prayers, calls, visits, FIREWOOD! -- the list goes on of the outpouring of love we're receiving. We're so grateful.

-Shawnee

PS - You can share this if anyone asks, no written release required due to HIPPA. =)

Day One

We would really appreciate your prayers for Mike. He's currently at Kaiser Sunnyside hospital being treated for an unknown infection.

He was driving TriMet bus yesterday and was suddenly overcome with chills, nausea, vomiting for half-hour straight, etc. during a break in Oregon City. He was able to contact his dispatcher who sent EMTs but was almost passed out when they got there. They transported him by ambulance to Kaiser and his temperature was 103.7 around 1pm. After trying to get in an IV for almost two hours, he finally got three bags of fluids in him by last night, his temp has been hovering between 99 and 101, plus was treated for an asthma attack during this time.

The physicians are a bit perplexed since it's not the flu/pneumonia but Mike's white cell count is extremely high. We have found a spot of severe swelling, redness and pain under his left ankle so they suspect cellulitis (deep tissue infection) and that the infection has somehow gotten into his bloodstream. They are worried are about the possibility septic shock and are still running tests. He's currently being treated with two high-powered antibiotics, fluids and medical monitoring. Mike's coherent now and in good spirits other than worried about the unknown. His nurse took an extensive medical history since we're new to Kaiser and was impressed with his overall general health. Even though his weight causes logistical problems and the potential for severe consequences, he has limited health issues all things considered.

We have great medical insurance through TriMet but I'm not so sure about sick leave/short term disability for lost work time. He will probably be off through tomorrow and then has regular days off on Tues and Wed. After that, we'll just see what happens.

The kids all made it up to the hospital yesterday; I think Tatum was the most upset because she couldn't see Daddy while he was in ER but he didn't get admitted into a room until after 9pm and the kids took her home by then. Trevor had just picked up Teressa from Pacific University for Christmas break, was going to take her to work and then help us get firewood when the call came in. Tara was sick in bed herself but drove up from Salem to be with us. Tess let Office Depot know her dad was in the hospital and she wouldn't be in. I'm so proud of my young adults.

Please pray that doctors locate the infection and it's cured quickly, that the details of his work settle themselves and that Mike is quickly on the road to total health. Thank you so much.

In Christ,
Shawnee