thyroid and trache

Last Thursday, mom had surgery to do the tracheostomy. They decided that they did need to remove the thyroid so they took it out first and then put in the trache tube.  The surgery went well.

She has to have a pretty big oxygen tube in through the trache right now, so she isn't able to talk, but they will eventually wean her off that and put in a smaller tube and she will be able to talk, which will be nice. For now, it is nice to be able to read her lips a little bit easier without the breathing tube in her mouth.

Other than that, things have been pretty much the same.  She has been able to sit in a chair for about an hour a day, which is nice.  She was able to spend some time with her grandkids on Christmas, which made her happy.  We are still just taking it one step at a time.

breathing issues

They still haven't been able to take the breathing tube out since last week's surgery.  This is a bit of a problem.  The breathing tube is meant to be a short-term solution.  It is not good for the lungs to have the tube in for a long period of time, not to mention the danger of taking it in and out.  So, it has become a very large priority to get the tube out.  Unfortunately, she cannot keep her oxygen levels high enough without it.  A couple of days ago, the doctors decided that the best course of action was to do a tracheostomy, cutting a hole in her throat, and inserting a breathing tube directly into her windpipe.   There are a couple of advantages to this.  It is much safer with less risk of infection in the lungs.  It is easier to allow her to breath on her own when she can.  With the breathing tube, the only way to get her breathing by herself was to take the tube out, but with the trache, they can hook it up to oxygen when she needs it, but plug it and allow her to breath on her own when she can.  This should theoretically make it easier for them to strengthen her lungs and eventually wean her off of it.  The other advantage is that she should be able to talk, or if not talk, at least we should be able to read her lips better than we can with the breathing tube in.  

We were all set to go, thinking that the tracheostomy would probably happen on Monday.  However, when the ear, nose and throat doctor came in to make sure everything was good, he found that her thyroid is swollen.  Because the thyroid is so close to where the incision would be made, they needed to find out what was wrong with her thyroid so that they could take care of it before doing the trache.  Today they did a CT scan to evaluate the thyroid.  When we left the hospital tonight, they were still looking at it and trying to decide the best course of action, but should know tomorrow.  The plan right now is that she will go into surgery tomorrow.  They are planning on either removing the thyroid, removing part of the thyroid, or if they determine there isn't a problem with the thyroid, just moving it out of the way a little.  Either way, they are hoping to do the tracheostomy tomorrow.  We will see.

Other than that, things are pretty much the same.  We are just waiting to figure out the breathing issue so that we can move on with the healing process.

Thank you for all of your thoughts and prayers.

sleeping

Well, the breathing tube is still in. Mom was really sedated and was pretty much completely asleep for two days. Today she was quite a bit more awake though, and doing pretty good. Now we are just back to our typical waiting game, waiting for the breathing tube to come out.

all closed up

Sorry, it has been a while since I updated. Mom is doing pretty good. She is still working on her breathing. She is only on the smaller oxygen mask most of the time, but at night, and occasionally when her oxygen levels drop, she has to be on the CPAP machine. A few days ago, they put her in a wheelchair and she was able to sit in it for about half an hour. She had been having a lot of pain though and hasn't been able to do that again. She was able to see the grandkids for a minute on Saturday, which made her really happy. They have been kind of concerned that she still isn't able to lift her right arm. The doctors did an MRI to try and figure out what is going on. They found a spot in her brain that they think might be evidence that she had a small stroke. Now we just have to wait and hope that her brain reroutes that section and that she gets arm control back. She had to have surgery today. They needed to go in to remove some dead tissue and see how things were going. Things actually looked good enough that they decided to close up the wound. That is a huge step. It means that they are no longer concerned about the infection and needing to get in to clean it up. It also means that blood flow is good enough in the area that they are no longer concerned about dead tissue. They said they were able to close up the wound pretty well, but that she will have a lot of healing to do. They said that it is now up to her and mother nature to heal the wound. It will take a while for it to heal, but once it does, it will be time to start getting her up and moving so she can start to feel better. Her surgery didn't end until this evening. They are going to keep her sedated for tonight. They had to put the breathing tube in for surgery, so they are leaving it in for tonight. It will hopefully come out tomorrow morning. We will see what tomorrow brings.

breathing tube is out

Today was a good day for mom. The breathing tube came out again tonight. She is doing well and is very happy that it is out. I went and visited her this afternoon, before the breathing tube was out. She was very awake and in pretty good spirits. She is getting really good at mouthing words so we were able to have quite a good conversation. They had told her that they were hoping the tube would come out and she was really excited to tell me. I thought that she looked better today than she has this whole time. Hopefully, now that her lungs are cleared out more she will be able to breathe more easily on her own this time. We are very grateful today and hope that things continue to move in a positive direction.

one step forward and two steps back

It has been a kind of rough couple of days. Yesterday was good for most of the day. Mom was breathing pretty well, and was talking quite a bit. She didn't have to be on the CPAP machine most of the day,so we could actually hear her. She still wasn't keeping her oxygen levels as high as they wanted them though. In the afternoon, they did a CT scan on her lungs to try and figure out what was wrong. They found that her left lung is full of fluid. They inserted a drain tube into her lung so that the liquid can drain out. Then they decided to reinsert the breathing tube. We had really hoped that the breathing tube wouldn't have to go back in, but she was right on the border line of needing it. They said that they would much rather put it in, in a controlled environment then in an emergency situation when much more could go wrong. So, they did it. It went in well and they didn't have any trouble. It ended up being a good thing that they put the tube in. They ended up doing sending a bronchoscope down the breathing tube. It allows them to see into the lungs and vacuum anything out that needs to come out. They found out that her windpipe was full of stuff too which they were able to remove. They were going to do the bronchoscope again tonight and will keep doing it until things get cleared out. They won't take the breathing tube out until they get rid of all the junk. The tube makes it safe and more comfortable to do the bronchoscope which is good. Hopefully, once her lungs get cleared out, they will take the breathing tube out and she will be able to breathe better on her own. Last time, when they had the breathing tube in, they kept her pretty sedated. Today, she was mostly awake though. They want to sedate her as little as possible. She was able to communicate pretty well with us today with nods, gestures, and mouthing words, and she seems to be handling the breathing tube pretty well. They said the the breathing tube will probably be in for a few days, so we are just hoping it can come out soon. Besides the breathing, things are going well. The wound is looking good, with no new signs of infection, which is great. She is moving her right arm a little bit more. She has had quite a bit of phantom pains (pain in the leg that they amputated.) That seems to me to be the most unfair part. It doesn't seem right that she should have to feel pain in the leg that is no longer there. But, they are working on finding the right medicines to decrease that pain, and it seems to be working pretty well. Even though the breathing tube was a bit of a setback, I think we are still moving in a positive direction. We have a long way to go, and there are going to be some bad days, but hopefully she will come out of this a little bit stronger and more ready to take on the next challenge.

ups and downs

I don't have a whole lot to report. Mom, and the rest of us really appreciated all your birthday cards and your love and support. Mom is having a little bit of a rough time. The breathing tube is still out, but she is having a bit of a hard time breathing without it. She just isn't keeping her oxygen levels high enough and her CO2 levels low enough. They have had to keep her on a CPAP maching most of the time, which has worked pretty good. They would love to only use that at night, so that she can sleep well, but want her breathing mostly on her own during the day. Her lungs just aren't quite strong enough for that right now. They are working on that though and doing everything they can to keep from having to put the breathing tube back in. One of the problems with the CPAP machines is that it is really loud. She still can't talk very well. She is really weak and her mouth is super dry (her swallow and cough reflexes are still not strong enough to give her water.) Because of that, she talks really quietly. It is almost impossible to hear and understand her over the machine and that is really frustrating to her and everyone else. She is also very, very tired all the time. Even just trying to say a few words wears her out. Although the last couple of days have been a little bit rough, we are still moving in a mostly positive direction. There will be bad days, that is just part of the process. We are just praying that her breathing can improve soon so that things will get a little more comfortable for her.

an even better day

Yesterday, the breathing tube came out!!  That is such a great step.

My dad was the only one who went to the hospital yesterday, so he was there with her most of the day.  She is able to talk a little.  Her throat is really dry and sore from the breathing tube, so she can't talk much, but a little.  She was also able to talk to me and Emily on the phone.  She didn't say much, other than that she loves us, but it was so wonderful to hear her voice.

She did have a bit of a rough day.  Mostly she was just exhausted.  They are making her work a lot harder now, making her work on her breathing and all sorts of other stuff.  Plus, talking makes her really tired.  There are still lots of concerns, but things are moving in the right direction.

She does know about her leg and seems to be handling it well.  At one point she asked the nurses to move it for her because it was aching, and they felt like they had to tell her the truth, so they did.  Right now, she just seems very grateful to be alive, so the leg is almost a minor thing to her.  I am sure that she will have a harder time with it later on, but for right now, we are glad that she is ready to fight and is doing well.

a pretty good day

Mom had a pretty good day today. She had surgery again this morning. She did really well in surgery. A couple of days ago, when they operated, they had to remove a lot of dead tissue. They told us then that they would have to operate every two to three days for a while. Today though, they hardly had to remove any tissue at all. Because of that, they haven't scheduled another surgery. They are just going to change her woundvac every couple days at her bedside. They won't operate again unless her body shows signs that the infection is back. Mom's temperature and white count were both down, which is good. Most likely, removing all that tissue on Monday took care of that. Because her body isn't fighting the infection so much, she was much more aware today. She is still very sedated, but today she opened her eyes quite a bit. She could make eye contact. She was squeezing our hands. She could shake her head yes and no to answer our questions. It was nice to see her interacting a little. She has made some progress on breathing. They said that she is only about two steps away from getting the breathing tube out. She is mostly breathing on her own, with only occasional help from the ventilator. They are really hoping that it will come out tomorrow. Once that comes out, they will decrease her sedation even more and she should be able to talk to us a little. So, all in all, today was a good day. We had a lot of good news. We are constantly being reminded that she is not out of the woods yet and that she still has a long ways to go, but it is always nice to get good news. We have started receiving some birthday cards today and her room is already looking more colorful and cheerful. We appreciate all those cards and your continued thoughts and prayers.

today's surgery

There isn't a whole lot to report today. Mom had surgery today. She was last on the list, so she didn't go in until about 6:30. She just got out a few minutes ago. The doctors said that she tolerated surgery well, which is good. They removed a little bit of tissue, which is expected, and cleaned everything out really good. They put a new type of wound dressing on. Basically it uses a sponge-like thing and a vacuum. It gets the fluid out and makes it so that they don't have to change the dressing a couple of times a day. They said that they will have to operate every two or three days for the next little while, to keep cleaning things out and to replace the dressing. Our next surgery is scheduled for Wednesday. Besides that, things are about the same. She has had a pretty nasty fever the last couple of days, sometimes getting over 104 degrees. They have her on some new antibiotics to take care of that. Because of the fever, she has been sleeping pretty soundly today, not really opening her eyes or responding much. They said that is just because her body is working on fighting the fever. They are hoping tomorrow to work on getting the breathing tube out. It will be really nice when that gets out. Then, they will be able to sedate her a little less and she can wake up a little. They reminded us today that this is a marathon, not a sprint. We have a long road ahead of us, but we are doing good We appreciate all of your thoughts and prayers.

birthday wishes

So, mom would yell at me for telling you all this, but Friday, December 2, is her birthday.

Her room, in the burn unit, is going to be home for quite a while, so we would like to decorate it a little bit for her. We would love to get as many birthday cards and well wishes as we can, to decorate her walls. Once she is awake, I think it will be a great comfort to her to see that so many people are thinking about her.

If you would like to send mom a birthday card, get well card, or well wishes, send them to me.  If you don't have my address, send me an email of leave a message here and I will get it to you.

I will get them up on her wall and let her know that you are thinking of her.

where we have been and where we are now

First, just a disclaimer.  I make no guarantees that any of the medical information here is correct.  I have had a lot of information thrown at me over the last few days and it is hard to keep track of everything.  Here is the situation as I know it though.

On Tuesday morning, at about 4:00 am, my mom was taken by ambulance to the hospital in Evanston.  She had been sick for a couple of weeks, with what she thought was the flu, but had gotten progressively worse.  She also had a sore on her leg. When she got to Evanston, they ran a few tests and quickly life flighted her to the University of Utah Hospital.

At the University Hospital, they did a CT scan and decided to quickly get her to surgery.  They diagnosed her with a necrotizing infection, in her leg, which is basically an infection which causes tissue death.  The infection makes it so that blood and oxygen cannot get to the infected area, which means white blood cells can't get in to fight it off.  It is very fast moving and had spread all over her leg and even into her abdomen.  They told us and her, before they went into surgery, that they would have to treat it very aggressively in order to save her life, and she would quite likely lose her leg.

She was in surgery for over 4 hours.  In surgery, they amputated her right leg, including her hip.  They were able to get mostly above the infection, and get most of it out.  She had surgery again on Thursday morning.  They went back in, just to clean things out and make sure they got all of the infection.  They will operate again on Monday for the same thing.

Mom is being operated on and kept in the burn unit at University Hospital.  They said that the infection and amputation wound act like, and need to be treated in much the same way as, a burn, so that is the best place for her.  We are very grateful for that. The burn unit at the University Hospital is one of the best in the country and her surgeon is one of the best as well, so she is in very good hands.

Mom has a long road ahead of her.  Right now, she has a breathing tube and a feeding tube. She is on lots of antibiotics. They are keeping her sedated, at least until the breathing tube comes out. They were hoping to take her breathing tube out for a couple of days now, but she just isn't quite ready yet. She opens her eyes a little bit sometimes, and reacts to sounds and things like that, but mostly she is unconscious, because of the sedatives.

The latest update, as of today, is that she is mostly the same. She has a little bit of a fever, which could just be from the wound, but could also indicate another infection somewhere or some that they didn't get. They are going to take her in for a CT scan today, to check for more infection so that they know what they are looking for tomorrow during her surgery.

We really know nothing about long-term plans at this point. We have no idea how long she will be in the burn unit, or in the hospital, or anything like that. We pretty much are working towards short-term goals. Right now, the goals are to get through surgery on Monday and to get the breathing tube out. They are hoping to take the breathing tube out on Monday as well, but we'll see. They want to be cautious with that and be sure that she is ready.  Once they take it out, they don't want to have to put it in again. We don't know how many more surgeries she will have, but they will keep doing them until they are confident that they have the infection taken care of.

We are very thankful for all of your thoughts and prayers.  We can feel your love and support and know that mom can to.

keep updated

We are starting this blog just to keep everyone updated on what is going on with my mom.  We know that there are a lot of people who are thinking about her and who want to know how she is doing.  It is difficult for us to keep track of who we need to update, so hopefully this will simplify things a little bit.

You are still welcome to call, email, text, or facebook us.  Don't worry if we don't answer your calls or texts immediately. Emily will have to get back to classes next week and my dad is often with mom or trying to figure out how to make the cell phone work. I am probably the easiest one to get a hold of. We will try to post to this blog as soon as we can, any time there are any updates or significant changes.

We truly appreciate all of your love, support, and prayers.  They mean a lot to all of us.