The doctor's discourse...

When we arrived at the hospital this afternoon, we discovered that Dad had had a busy morning: today's consultant had decided to do an endoscopy after all - just to see if they could get any further insight into the cause of the blood in Dad's stoma bag. The camera didn't reveal any source of bleeding, other than a little irritation in the stomach lining, and so they are continuing to treat him for gastritis for the time being. The doctor asked to speak to us, as it had been quite a while since we'd been given an "official" update by one of the consultants. He said he wanted to speak to us to give us the current prognosis on "the risks" to Dad and to the whole family at this point in time. So he took us off to a little private room where he spoke to us for more than half an hour...

He began by saying that he, and all the medical staff on the ward, are amazed that Dad has made it this far. Just a few weeks ago, most people felt that he wasn't strong enough to survive and that he probably only had a few hours left to live. Today, the doctor's position was that, "Now he has a much better chance of ever coming out of hospital than he had three weeks ago." Just about everything is heading in the right direction now and Dad might be on the way to recovery, "as long as there are no further steps backward." There's hope that they might be able to wean him from the ventilator within the next couple of weeks, and then the main challenges would be waiting for the wound to heal, for the infection to clear totally, and for Dad to start building up his strength again.

The doctor told us that it is very unusual for someone to be in intensive care for as long as my Dad has been (although they do have one patient at the moment who has been there for nearly a year!) and so there are very few families who have had to face the sort of long-term uncertainty and trauma that we've been through over the past few weeks. He proceeded to give us a rather long speech about research that had been done on the longer-term consequences for family members who have had to live through the roller coaster ride of having a family member so close to death for such an extended period of time. Exhaustion, depression, sleeplessness, mood swings and poor nutrition were among the things that have been documented, and he wanted to encourage us, the other family members, to consider seeking  a GP's help if we noticed that we were suffering from any of these symptoms. (When I think of all we've experienced as a family over the past month, I can understand that family members of long term ICU patients could be affected in this negative way, especially if they don't know the Lord and can't draw on His peace and strength during such a difficult and uncertain time. I can see how incredibly hard this time is for my Mum, even though she knows she is being upheld by so many people's prayers.)

The doctor also spoke to us about the possible long term effects on the relatively few patients who manage to survive what Dad has been through. (Fewer than 20% of patients survive multi-organ failure caused by severe sepsis, and that statistic is even lower for the very young or the elderly.) Some struggle to come to terms with the long term weakness and tiredness that they experience; it can take up to a year to get your strength back, and patients will never totally be as strong as they were before the toxic shock. Some patients may lose interest in life and struggle with depression, with post-traumatic stress or with flashbacks like those known by Vietnam war veterans. Some may have memory problems or may struggle with confused memories of what they have been through.

In fact, Dad has already spoken to us about how painful and terrifying the hallucinations were. He said it was so frightening that he thought he was going out of his mind, and he couldn't understand why people were coming and were doing terrible things to him. In some of his memories, he was on a boat (one nurse told us that many patients report this, and that it may be caused partly by the movement of the air mattress they are on) and was being chased and attacked by wild animals. "You were there too," he told my Mum.  "Was I chasing you?" she asked. Then he smiled and quipped, "Oh, you stopped chasing me a long time ago!"  He's not having any flashbacks, though, and seems to be fully aware that what he experienced wasn't real. His main struggle is with the tiredness and the constant discomfort. Tomorrow is his 83rd birthday, and I so much hope that he can have some relief from the pain on that day.

As things stand at the moment, doctors are not yet at the point where they'll say that Dad will definitely recover and will ever come out of hospital. But they are saying openly that they are all amazed that he managed to survive those first weeks and that he has come this far and managed to make so many improvements in recent days. The two main sources of concern at the moment are:

• that Dad has no appetite and hasn't really been eating for more than a month now. (He's being fed by a tube through his nose.) It would be really good to see him begin to eat one or two things over the coming days.
• that he is still so very weak and doesn't yet have use of his arms and legs. He's having physiotherapy every day, but is making only slow progress because he's so weak. We pray that he will begin to get more control of his arms and legs and perhaps even be able to stand up (with help) over the coming week.

The other things that still need to happen are:

• for his wound to heal (this will take a long time, because it couldn't be stitched closed and has to heal slowly from the inside out.)
• for the underlying infection, and any hidden source of bleeding to clear up completely. Doctors were giving him another blood transfusion tonight because his haemoglobin count is still low, and that's a source of concern.

We don't know what lies ahead for Dad or for us... and it sounds as if the doctors really don't know either. But what we do know is that God is good and can be trusted in every situation. If you are one of the people who has been praying for Dad and for us during this time, we want to tell you how thankful we are for your support, and we pray that the Lord will also bless and encourage you in whatever situations you might be facing in your own life during these last weeks of 2011.

Scotland and Spain: hospital, home and hotel...

The weather in Spain can be very unpredictable at this time of year: sometimes we get bright sunny days, but often we get days on end of strong winds and torrential rains. So when we planned to hold our KKI leadership conference this week in a beachfront hotel, it gave no guarantee at all that the weather would be conducive to taking walks on the beach during the conference's mealtimes and coffee breaks.
Well, despite the fact that this morning's weather report said Torremolinos was only one degree warmer than Falkirk, the overall weather picture is quite different this week. Here in Scotland, where we're commuting daily from home in Falkirk to the hospital in Larbert, it's raining non stop and our temperatures are dropping from daytime "highs" of 13 to night-time lows of 4 degrees. In Torremolinos however, our international guests are enjoying bright sunny days of at least 19 degrees and, when weekend temperatures soared to twenty eight, some of our conference attendees from Latvia even went into the sea for a swim!
After working all year to prepare the conference and liaise with the hotel, it seems very strange to me to be here in Scotland and not actually to be in Torremolinos to welcome our group of youth workers from all over Europe. With my Dad's condition not being stable yet, I felt it was important for me still to be here with my family. The conference is is good hands, however, as it's being led by three or four of our other KKI Europe leaders, and we're trusting God that the group will have a fruitful week together.

As the conference draws to a close, I was supposed to be house-sitting for friends in Spain: looking after their dog and cat while they went to Canada for three weeks. My being in Scotland meant that they had to begin searching for someone else to stay in their house while they were gone. For four weeks, they couldn't find anyone at all, and I was praying so hard that someone could be found to take my place. Praise God, at the eleventh hour (they leave today) they have found a young man, a friend of a friend, who will be able to stay with Brandy and Simba during December.

Upstairs, downstairs...

We had a double hospital visit this afternoon: while Mum was upstairs visiting Dad in intensive care, I was downstairs at accident and emergency. I have absolutely no idea what I did - whether I jerked my back opening the garage door, or whether I twisted it when leaning back to pick something up in the car. But somehow I had given my back such a twist that I couldn't move or even sit without gasping at the stabbing, excruciating pain. It felt kind of similar to when I had torn a disc in 2006 (and had to lie flat on my back for six weeks) so I went into the minor injuries unit to find out if it was another disc injury (which would mean that I wouldn't be allowed to sit for weeks.) Turns out, however, that it was simply mechanical back pain, probably caused by jerking or twisting something in the area where I already have lumbar degenerative disc disease. It's incredibly painful at the moment, but the doctor in the hospital said that the pain will probably last around two weeks (as opposed to two months with a damaged disc.) He sent me off with a bag full of pain killers and anti-inflammatories. As I hobbled into the hospital this evening, and my brother limped in on his stiff knee, we must have looked like a bunch of old crocks.

Dad, however, continues to improve slightly from day to day, although he also complains of having aches and pains nearly all the time. He chatted to us this afternoon, and it was nice to see that he was getting his sense of humour back. In the evening, though, he was tired and sleeping again. He often asks us if we think he is looking any better, or if we think that there is hope for his recovery. Feeling tired and achey much of the time, he can't see his little steps of progress as much as we and the nurses can. So tonight he asked us to take a photograph - so that we can show him later what he looked like when he was propped up in bed and surrounded by machines. 

Slowly moving forward...

After six very exhausted days, where Dad simply slept all the time and didn't have any energy to speak to us when we visited, he finally looked just a little brighter yesterday and was able to talk to us in the afternoon. He was sleeping again by the evening, and it's obvious that his body still needs a lot of rest. He can't really move his arms and legs yet, and he says that all his limbs feel as if they're laden down with lead.

I spoke this week with the surgeon who did the original operation, and asked him how things are going with the various infections (wound, lungs and abdomen) that Dad has been battling over the past weeks. He said that the wound is doing okay on the whole: because they couldn't sew it up after the third surgery, they're waiting for it to heal from the inside out, and that's going to take a long time. As for the underlying infection in Dad's abdominal cavity, infected pus is still draining from it, but blood tests for infection indicators seem to suggest that Dad is doing just a tiny bit better from day to day. The sore lungs and cough are still a trial for him, but hopefully will also continue to improve as Dad gets a little bit stronger. He's not really eating yet, and so his nutrition is coming mainly through a feed line through his nose to his stomach. He's lost quite a bit of weight.

As for me, I can hardly believe that I've been here in Scotland for nearly a month. It will be four weeks this weekend, and some of those weeks were rather traumatic ones. I'm so thankful to see Dad making some small steps of improvement now but, with things not yet being very stable, I haven't yet made any plans to return to Spain.  I spend my afternoons and evenings at the hospital, and I spend my mornings and later evenings answering phone calls and catching up on computer work for ministry. The leadership training course that I should have been working with in Malaga is drawing to a close this weekend; I've been helping out (over the internet) this week with filling in the paperwork for the University and with the grading of the students' assignments that were written in French. As the strategic leadership school comes to an end, our KKI leadership team meetings and the biannual leaders' conference will begin in Torremolinos this weekend. After working all year to liaise with the hotel and communicate with the conference participants, it seems very strange for me not to be there to host the fifty or so people arriving for a leadership summit in "my" part of Spain. This morning I'm working to complete the last of the admin and paperwork that I'll need to pass on to the others who'll be leading the conference in my absence.

Tired, but turning the corner...

Dad has continued to feel weak and exhausted today. It's so hard to see him looking worn out and hear him complaining about being in pain all the time. (Dad's not usually the complaining type.) He's been so tired lately that he has no appetite and doesn't want to eat anything, although he seems to be thirsty all the time. Trying to persuade him to take a few spoonfuls of yogurt, Mum said, "It's not like you to lose your appetite." Dad just shook his head weakly and said, "But I'm in a bad way this time." It's heart rending to watch him like this. He keeps saying that his lungs, chest and back hurt (and having had pneumonia four or five times myself, I can see that some of the symptoms he describes are very typical of an acute lung infection.) Physiotherapists are helping him bring up loads of infected phlegm every day.

The doctors who told us last week that he had no hope of making it have been giving us a wide berth this week. I think Dad's amazing comeback has surprised everyone, but no one is really sure whether he's strong enough to sustain it. During the first two weeks, doctors spoke to us every day, so one of the hardest things about this past week is that we've seen Dad make a few steps of progress, then sink into fatigue, and no doctors have been coming any more to give us an update on how he's really doing.

Today we met one of the doctors who had been there four weeks ago when my Dad first checked in for his operation. Mum remembered him because he had been so kind to Kasey and had answered a lot of her questions about Papa's operation. He came up and introduced himself to us again, and then he said, "We thought that we were losing the war... but now he seems to be coming out of it."  Our hearts leapt: this was the first time that any of the medical staff had given us any indication that they believed Dad might survive the things that had happened to him.

I asked the doctor about all the exhaustion and pain Dad has been experiencing - whether it was a bad sign or an indication that he was losing the battle with the underlying infection in his abdomen. He replied that it's normal for Dad to be so tired, and to be stiff and sore after all that he's been through at his age... but the blood tests and other indicators for organ recovery and healing are beginning to head in the right direction now. He still has a long haul ahead of him, but this doctor was hopeful that the antibiotics will continue to help him overcome the infections he's been battling.

As for us, we continue to pray with Dad every time we visit and we're trusting God to keep touching him with strength and healing too.

Week four in intensive care...

Tomorrow it'll be a month since my Dad first went into hospital for surgery, and this is the beginning of his fourth week in the intensive care unit. In case it's been a while since you heard an update, let me summarise where things are at.

This time last week, after fifty one heart stoppages over the previous four days, doctors were basically telling us that Dad had only a few hours left to live and that we could expect him to go at any moment. Although it was now established that the brachycardia had been caused by a drug they had given Dad to regulate his heartbeat, there was concern that having his heart stop more than fifty times would just have weakened him too much and that he wouldn't be strong enough to fight the underlying abdominal infection. One doctor even told us rather bluntly that there were nine consultants on the ward and none of them believed that Dad would ever leave the ICU alive. I asked whether there was any chance that Dad could come off the ventilator so that we would be able at least to speak to him before he died... and the consultant replied, "I very much doubt it."

Well, three days later, the heart episodes had stopped, Dad was off the ventilator for a while, and was sitting up in a chair, eating ice cream and talking to us about what he remembered of his experiences. He has been off the kidney (dialysis) machine for a week now, and blood tests show that his kidney function is improving slowly but surely. One day he was even off the ventilator and breathing on his own for nine hours.

Since then, however, he has been feeling exhausted and in quite a bit of pain. Nurses tell us that he was doing so well after his dramatic turnaround, that perhaps medical staff tried to take things too fast and didn't wean him from the ventilator slowly enough. He's been feeling so tired that he hasn't been eating again over the past few days, although he still keeps asking for things to drink. Yesterday they decided just to let him have a day in bed to sleep and rest, rather than working to help him sit up or breathe for too many hours on his own. 

The plan now is to take things a little more slowly: to put him overnight on a ventilator mode that will really give his body a good rest, and to continue working during the day to give him some hours of breathing on his own and sitting up in a chair. He'll continue to have line feed overnight, but they'll stop that during the daytime to see if he'll start eating a little soup and yogurt again. He'll continue with physiotherapy for his lungs and limbs, and he'll get morphine for the pain whenever needed.

The difference between last Sunday and this Sunday is nothing short of miraculous, and we know that we have been held up by the prayers of many of you around the world. As we begin week four in intensive care, here are the things we are all praying for:

• that Dad will begin to build up strength again and will not feel so weak and exhausted all the time.
• that he will know relief from the pain and discomfort which contribute towards his feeling so exhausted.
• that the antibiotics will continue to do their job and that he will be able to overcome the underlying infection in his abdominal cavity.
• that his kidney function will continue to improve from day to day.

We are incredibly grateful to God, and to the many people who have been praying, for the amazing improvements we've seen in my Dad over the past week.

A tired day today...

Dad was breathing on his own for more than nine hours yesterday, only going back on the ventilator around midnight. Today, however, he was feeling very tired and weak, and experiencing quite a lot of pain and discomfort. So he wasn't speaking to us much today, but was sleeping on and off while we were there to see him. Medical staff say that perhaps they need to take things a little more slowly, as even the simplest of everyday tasks - breathing, eating, sitting up, etc - are quite exhausting for him. Concerned about his constant pain today, they prescribed a little more morphine this evening, and a sleeping pill that will hopefully help him to have a deep, pain-free sleep.
The good news, however, is that blood tests are beginning to show a decrease in Dad's underlying infection, and we pray that this trend will continue. Tonight, though, we're especially praying that he can get a really good night's sleep and not feel so weak and exhausted when he wakes up tomorrow.

Needing rest and relief...

Dad was feeling kind of tired and weak when we saw him this afternoon, as he'd had a sleepless night due to some pain and discomfort. He looked a little brighter when we popped in to see him this again evening, but he fell asleep shortly after this photo was taken. (That's my Mum, my brother, Graham, and my niece, Kasey, by the way.) Now that he's breathing on his own, talking through the passy-muir valve, and sitting up in a chair now and then, he gets tired quickly, and we're being careful not to tire him out.
Dad's appetite is continuing to pick up (he had soup and juice today, as well as his current favourites of yogurt and ice cream) but a special powder needs to be added to his food and drink to make them a thicker consistency, so that he doesn't swallow too fast and choke on it.
Despite Dad's tiredness and some ongoing discomfort, the medical staff had some good news for us today: blood tests show that his kidney function has improved slightly, and surgeons said this morning that his external wound is beginning to look a little better. We continue to pray for the healing of the internal infection that caused this life-threatening illness in the first place.

I thought I wasn't going to make it...

Dad continued to look a little better today: he was sitting up in an armchair for a couple of hours, and he's begun to get a little food (ice cream and yogurt) by mouth. While we were there, he kept asking for spoonfuls of ice cream, and he also seems to be thirsty all the time. He had the passy-muir valve again this evening, so he was able to speak to us and tell us what he can remember of the past three weeks. In some of his memories, he is aware that he was in hospital, while other memories are confused recollections where he thought that people were doing something to him with computers.
"I wouldn't want to go through that again," he said. "Did you think I'd had it?" When we told him that he had given us quite a scare last week, he replied, "There were times when I thought I wasn't going to make it. I felt like I was just waiting to die." It was so strange to give Dad some yogurt and actually hold a conversation with him, when only a few days ago we were holding his hand as his heart stopped beating.
Under the surface, though, there is still concern about the infection in his abdomen, which hasn't started to heal yet. That's the big change that we really need to see over the coming days. Thank you, once again, for taking time to read these updates and for standing with us in prayer.

Amazing changes...

When we went in to see Dad in hospital this afternoon, we were astounded to see that they had taken him off the ventilator and he had been breathing on his own for about five hours. They had fitted something called a passy-muir valve, which meant that we could actually hear him speaking to us, instead of having to try to lip-read. "What date is it?" he asked. "Have I had my operation yet?" (We didn't tell him that he'd actually had three operations since going into hospital three weeks ago?) 
His day nurse was encouraged to report to us that he is beginning to absorb his feed (which enters his stomach through a tube in his nose) and is continuing to produce urine, even though his kidneys aren't actually working properly yet. What an encouragement it was to hear his voice for the first time in three weeks. One of the first things Dad said was, "When do I get something to eat?" Nurses explained to him that he's not allowed to have very much today, because his stomach hasn't been working for such a long time, but they did give him a few sips of a thick drink called Fortisip. "That's good," he said, but when he asked for more, they told him that he couldn't have any more for now. Dad turned round and spotted me drinking from my water bottle. "Can I have a wee sip of that?" he asked.
At that point, two nurses came along to weigh him (in a rather complicated procedure that involved weighing the whole bed.) I joked with the nurses, "Are you checking whether he's put on weight?" Dad turned towards us and quipped, "Not a chance!" (In fact, he had lost about a stone / 14 pounds / 7 kilos.)

The doctor in charge asked to speak to Mum and myself, and he admitted being amazed that Dad had made it this far and that he was suddenly beginning to make some small steps of progress. The brachycardia (heart slowing or stopping) is happening very seldom now, and only time will tell whether it will stop completely. However, the main concern for the doctors is that all the infection in Dad's abdominal cavity is not healing yet and is still producing black, infected pus. Unless that situation changes, unless the infection begins to heal properly, their fear is that it will simply get worse and worse until he sinks back into sepsis again and this time he wouldn't be strong enough to survive it.
We were encouraged to see Dad looking a little brighter, to be able to hear his voice and his sense of humour again.... but the doctors say he's "not out of the woods" yet and still won't be able to make it through unless the infection in his abdominal cavity starts to heal. 
Thank you once again for your prayers.

"The patient's confusing us..."

Well, Dad had a good day yesterday, followed by a settled night. With only two heart-slowing episodes yesterday, and none at all during the night, it's beginning to look as if the amiodarone is finally working its way out of his system. Generally, it seems that doctors are predicting he's dying and that it's only a matter of time now - perhaps a few more days. The two main sources of concern are that his kidneys haven't really started to work after the sepsis, and the wound from his surgery is still infected and slow to heal.
This morning, the night nurse reported a confusing and slightly paradoxical picture: there's no evidence his kidneys are starting to work, and yet he produced a lot more urine overnight than she would have expected; Dad's wound is still infected and becoming smelly now... yet his blood count for infection indicators is down, rather than up. We'll see what doctors feel should be done, when they come around the ward this morning.

I was supposed to go into hospital myself today - for my appointment with the arthritis specialist who was going to assess what could possibly be done about the constant pain in my feet. Despite phoning the Spanish hospital more than forty times last week to explain my situation and cancel the appointment, there was always either an engaged line or an endlessly ringing phone that no one answered. So I'm hoping that my non-appearance won't cause problems, and that they'll reschedule my appointment for a later date over the winter.

Defying all the odds...

Well, rather amazingly, my Dad has made it through another day and another night. Doctors keep telling us that he is probably dying; we've already said our goodbyes a few times, and told Dad that it's okay for him to go now and be with the Lord.... but he just seems to keep hanging in there and fighting back against incredible odds.
This "hospital journey" has been somewhat complicated by two or three incidences of possible human error, which have been what one doctor called a "red herring" and caused setbacks that got in the way of our seeing whether Dad could really recover or not. The latest of these was the amiodarone toxicity which caused his heart to stop literally fifty times over the past four days. Yesterday, Dad was still having a few of these "episodes," but his heart was no longer going down to zero and completely stopping; it would drop to around 20 heartbeats per minute, and then go back up to normal again. Recognising that these days of heart problems have been due to "reversible cause," medical staff have been trying to keep Dad comfortable and see whether the amiodarone can work its way out of his system again. (Now I understand why I felt prompted to pray for the strengthening of his heart when the episodes first began last Wednesday.) Tests show that there is nothing wrong with Dad's heart muscle, and he has not suffered a "heart attack" at any point during this process.
This means that we are now back in the place that we should have been in last week: watching and waiting to see if Dad's body can realistically recover from the multi-organ failure caused by the post-surgery complications. He is breathing for himself, with just a little help from the ventilator, but his stomach and kidney functions have not really kicked in again yet. They took him off the dialysis machine yesterday when a blood clot caused it to pack in, and so now it remains to be seen whether his kidneys will improve or deteriorate on their own, without the help of the filter. And he still has infection at the site of his wound, which could possibly cause fever as time goes by.
We really don't know what to expect, but things don't look good. It's hard to see Dad hanging in there and overcoming impossible odds, yet not having any guarantee whether he will ever make it out of the hospital. Everyone has always said that he has a strong heart and he is a "fighter." I'm trusting that God will help Dad to know if the time comes when it's better to stop fighting and go home. But for now, he keeps rallying, and we as a family continue our daily vigils by his bedside. He recognises us and sometimes talks to us when we are there. Sometimes I sing his favourite hymns to him, or we simply chat about funny memories from his lifetime. Please pray with us that Dad will know peace and freedom from pain; that there will be no more "avoidable setbacks" during this difficult time.

Saying goodbye...

Dad was looking brighter and more alert when we went in to see him yesterday afternoon. Physiotherapists reported that he had been more responsive when working with them in the morning, and that he had managed to sit up on the edge of his bed. During our visit, he was very animated: "talking" and responding quite a lot. Sadly, our lip reading skills are pretty hopeless and we were able to understand less than half of what he was saying to us. At one point, a nurse deflated the cuff of his tracheostomy tube so that we could sort of hear what he was trying to say, but the sound was indistinct and we were still only able to discern some of the words in his sentences. However, he was obviously able to hear us and respond, so we spoke with him and played some of his favourite hymns to him.
After sixteen hours without a problem, Dad began to have heart-stopping episodes again in the early evening. While it's not possible to say for certain, the general opinion seems to be that these episodes have been provoked by the amiodarine drug that he'd been getting earlier in the week. The cardiologist's report said that Dad could feel the effects of it for days or even weeks. A consultant came to us and told us, somewhat brutally, that none of the doctors thought that Dad could come out of the ICU alive, and that they expected he would probably die during the night. Of course, this was the second time this week that we were told to expect him to pass on in the night, so we decided not to wait in the hospital this time, but simply to go home and "wait and see."
We hadn't been home for long, when the night nurse phoned to say that Dad had had two more episodes and that their policy now was not to speak to him or do anything that would cause him to "come back" again. As a family, we were in agreement with this, so that my Dad could be able to "slip away" quietly, without struggling to resuscitate for a family member who was there beside him. My brother and I decided to drive up to the hospital one last time and say our goodbyes. Dad was asleep when we arrived, but woke up when he heard our voices. After chatting a bit with the nurse, Graham and I went over to see him again. We told him we loved him, and he nodded and responded to us. Then I told him that we knew he'd been putting up a brave fight and we understood that he was probably tired. (He nodded again.) I told him that we were here for him if he chose to keep fighting.... but that it was totally okay with us if he decided that he didn't want to fight any more and just wanted to go home and be with the Lord. We asked him if he understood, and he nodded again. So we said our goodbyes and goodnights, and headed home for the night. We knew that the nurse might phone us at any time in the night to give us news.
This morning, when I woke up, I looked at my clock, and realised that Dad had made it through another night. I phoned the hospital, as we've been doing every morning for the past three weeks, to find out how the night had been. The nurse told me that Dad had had about twenty more episodes during the night and, despite the fact that no efforts were made to resuscitate him, his heart started up again every time. There's a concern, though, that these episodes (his heart has now stopped and started nearly fifty times) could begin to cause him pain and distress, and so he's receiving morphine at the moment to keep him "comfortable."
It's incredibly hard to realise that a drug seems to be the culprit for these distressing episodes he's been having.... and yet we recognise that Dad is an old man who has been critically ill for three weeks now, and whose organs are still not totally recovered from the septic shock that ravaged his body after the surgeries. It's amazing to us that he has been able to keep rallying and fighting back..... but today seems to be one of those times where we can only watch and wait to see how much longer he can keep it up. Please would you pray for my family today, as we continue to wait and see what the outcome will be. Thank you.

Settled and stable

Well, despite having an insight into the possible cause of what had been causing my Dad's heart to stop last night, he had three more "episodes" today (bringing his total number of heart stoppages to twenty one!) and this was a cause of some concern. Finally, they decided to remove the central IV line from his right shoulder and replace it with a new line into his left shoulder. Then it came to light that the dramatic drop in blood pressure and heartbeat might also be a reaction to one of the drugs that had been given to him for his irregular pulse. A decision was made to change one of the antibiotics he's receiving and to stop the drug that might possibly be the cause of the heart stoppages. By late afternoon he was sedated and sleeping, though he did have a couple more episodes in the evening. Doctors say that he is "stable, but poorly" after his ordeal.  My Dad has been through so much over the past sixteen days. Please join us in praying that there will be no further setbacks. As for us, we're all becoming aware of our sleep deprivation and will be trying to get an early night tonight.

Trauma and turnaround...

When we got back to the hospital at 6 pm yesterday, nurses told us that Dad's heart had stopped another twice and that they'd revived him with CPR. By the time the night nurse came on duty,  Dad’s heart had zeroed out ten times yesterday: the heartbeat just stopped for several excruciating seconds and then always started up again on its own. The doctor in charge spoke to us and said that Dad's heart didn't seem to be coping any more and that they didn’t know how long it could keep it up; that one of the times it stopped, it probably wouldn’t be able to start up again. He told us he thought it was extremely likely that Dad would die during the night, and that they felt it was wisest not to do any more CPR. And so we settled down for a gruelling 13 hour watch by Dad's bedside - a traumatic vigil where we watched his heart stop eight more times.. making a total of eighteen cardiac arrests in a twenty four hour period. 

It seemed like the longest night of our lives. Sometimes we simply watched Dad sleep. Sometimes he woke up in the night and "spoke" to us  (to the extent that you can speak with a ventilator tube in your vocal cords - which meant that he was trying to form sentences and we were trying to lip read.) Sometimes it was easy to discern what he was saying -  like when we said, “We love you very much,” and he very clearly said, “I love you too.” ... or when he mouthed "thank you" after we helped him to drink some water from the little sponge sticks that they use to moisten the patient’s mouth.  At other times, though, our lip reading skills were inadequate and we weren’t able to understand what he was trying to say to us. 

Time after time, in the darkness of the night, we thought that we had lost him and that it was time to say goodbye. The monitor would begin to bleep dramatically, the ECG reading would plummet to zero and flatline. Each time, I would ask him, "Dad, are you wanting to leave us now, or are you still going to come back to us?" And every single time, he rallied, the heart rate went back to normal again and he somehow communicated to us that he wasn't ready to give up the fight yet. Sometimes there were long periods between "episodes" - of two or three hours where he was simply sleeping peacefully. At those times I also felt a deep sense of peace, and I would simply declare over him the scripture I felt God had given me in the afternoon (from Psalm 138): The Lord will preserve your life and make you strong hearted. After the fourteenth arrest, my Mum couldn't handle it any more. Watching your husband "die" eight times over is a slow and painful torture, and we persuaded her to lie down for an hour, even though she knew she wouldn't be able to sleep. The hospital staff were very compassionate, giving her blankets and a private "relatives' room" to lie down in.

Around the fifteenth or sixteenth cardiac arrest, in the quietness of the darkened ICU, my brother noticed that the attacks always came on after something was introduced to Dad's system - like his intravenous antibiotic or the medicine for his stomach. The night nurse had begun to realise this too, so he phoned the doctor early in the morning and a decision was made to withhold Dad's 6 am meds until the doctors could investigate further. When the new doctor in charge came on duty, we explained our observations to him. We pointed out that the central intravenous line goes into his shoulder, very close to his heart and said we wondered perhaps if his heart just isn’t able to take the onslaught any more. My brother and I asked whether it would make a difference to move the IV line to the other side of Dad's body so that the meds don't affect his heart so directly. The doctor did a print out of the monitor readings for our dramatic nighttime vigil - showing in graphic form each episode where Dad's heartbeat had stopped, sometimes for ten to fifteen seconds, and once for as long as twenty five seconds. Then he called in the cardiologist to analyse the printouts and check Dad's heart. 

When the cardiologist asked to speak with us, we didn't know what to expect. She showed us the ECG printouts, and what she said next sent our hearts soaring again. "You must have had a terrible night," she said,"but let me assure you that there is absolutely nothing wrong with his heart." Yes, it stopped beating... but it always started again, and Dad wouldn't have "come back" to us sixteen times without help, if his heart wasn't strong. He has a condition called A.F. (atrial fibrillation - a form of cardiac arrhythmia) which was diagnosed back in 2005, but which is common in elderly people and isn't life threatening. The cardiologist assured us that the traumatic episodes of our nightime vigil had not done any harm to Dad and that the problem was totally "fixable."

They also did a chest x-ray to see how the central IV line was positioned and, sure enough, it was very close to the heart. It's quite possible that it was simply the sensation of cold liquids entering his body that was causing the heart to go into shock momentarily. This morning, a doctor is working to reposition the line and to do some "test runs" with medication to see if everything is back to normal again. But everyone keeps telling us, "his heart is strong" and his heartbeat is mostly quite strong compared to the average. What a joy it was to hear the cardiologist say this, when I had just spent half the night declaring over Dad that, "It is God who preserves your life and who makes you strong hearted!!"

Dad has a slight lung infection at the moment (which physiotherapists are working to clear) and still needs medication for pain, and antibiotics to keep fighting the general infection from the original sepsis. But generally speaking, doctors are satisfied that he is "comfortable" and 'stable' now.  My Mum, brother and I have come home to get washed and get something to eat, and we'll be heading back to the hospital again in the afternoon.

Brushes with death

Dad's heart stopped four or five times today. Two of the times were when we were visiting him this afternoon. Doctors don't know why it's happening, but are concerned that it means his condition isn't stable. Each time, his heartbeat slows and then stops.... and then kicks in again a few seconds later and goes back up to normal again. Mum says that all the uncertainty is killing her: one day there's good news and she allows herself to hope again; and then the next day there's yet another setback and it looks as if we're losing him again.
Because Dad's not stable, they need to increase his sedation and his ventilation from time to time. When he is more conscious, he moves his mouth and tries to speak to us... but we usually can't understand what he's saying. When the nurse moistened his mouth with a wet sponge this afternoon, we could clearly see that he was saying, "thank you," but mostly it's not really possible to discern what he's trying to say.
Today I leaned across his bed and asked him if this was all too much for him; did he want to give up the fight? He just looked at me, and so then I asked him, "Do you want us to keep fighting for you, so that perhaps you can be home again for your birthday?" And he simply nodded, before closing his eyes again. I know that if I was the person in intensive care, and was ready to go and be with the Lord, I wouldn't want everyone else fighting to hold me back and keep me here on earth. And so that's why I felt I had to ask Dad today; I had to get a sense of whether he had the will and the energy to keep on fighting.
This is such a hard and uncertain time. Today I read some verses from Psalm 138 at his bedside. It says: Though I walk in the midst of trouble, You, Lord will preserve my life. I call to You and You answer me; You make me bold and strong hearted. I don't know how long Dad can keep up this fight, but I'm not going to let him go unless I really have a sense that it is the right thing to do.

Blessings and blips...

Well, Dad had his tracheostomy yesterday - which means that the breathing tube from the ventilator now enters through his throat and not through his mouth... hopefully reducing discomfort and the risk of further infection. He was still recovering from the anaesthetic when we saw him in the afternoon, but was more alert again when we saw him in the evening. Of course, being more alert, he is more aware of pain, and we noticed that he was sometimes a little distressed. He was able to nod his head or shake his head appropriately when we asked, "Are you in pain?"or "Are you warm enough?" At one point last night, he began moving his lips, as if trying to speak... but of course he can't yet speak because of the tube in his vocal cords, and it was hard that we couldn't lip read to understand what he was telling us about where he had pain.
Doctors, who were telling us at the weekend that he might not make it, were yesterday telling us that he is "heading in the right direction" and that we just need to hope and pray there are no further complications or setbacks. Unfortunately, the night nurse told us this morning that Dad did have a little "blip" in the night, when his blood pressure dropped and something went wrong with his heart.... but it corrected itself again fairly quickly. I wonder if that was when I woke at 4 am and began to pray for him.... or when one of you in some other part of the world was awake and sending up a prayer for Ernie. Thank you for your ongoing prayers that the way ahead would be smoother, and God bless you.

Tiny steps of progress...

Well, after a critical weekend, Dad has managed to sustain one or two tiny improvements over the past two days. Nurses have been able to reduce some of his medication and also to lessen the help he's receiving from the breathing machine. From time to time, he's alert enough to respond to us with a slight nod of the head - for example, when we ask if he hears us, or if he's in pain. Now that he's a little more awake, he's also a little more aware of the pain and the discomfort from the breathing tube. It's likely that tomorrow they'll try to take the tube out of his mouth and do a tracheostomy so that the tube enters through his throat instead. This will reduce his discomfort and allow him to close his mouth. It's the next step towards getting him breathing on his own.  After that, we'll be praying and hoping to see similar improvements in his kidney and stomach functions. He still has a long way to go, but it's been encouraging to see one or two steps forward this week. Thank you for your continued prayers.

A turbulent day...

Yesterday afternoon, when we went to visit Dad in intensive care, they were giving him a blood transfusion because his blood count had been low... and they told us they were concerned that he hadn't really woken up properly since the surgery. He was still pretty unresponsive, just staring into space. Medical staff didn't really know why, but thought it might be because his kidneys aren't working, that he hasn't really eliminated the anaesthetic and isn't totally conscious yet after Friday's surgery. The doctor said yesterday that the chances of recovery are probably less than 50%, but they haven't given up hope yet. He said they may do a tracheostomy on Monday or Tuesday, so that the ventilator tube enters through his throat and not through his mouth - thus reducing discomfort and the risk of further infection. Dad's almost at the point that he could breathe on his own.... but isn't doing so, because of not being totally awake yet.

We left the hospital in the afternoon, with rather a heavy feeling in our hearts, and could only pray that Dad would begin to wake up properly and start to improve again. Last night, when we went back to the hospital, there had already been quite a change in him since the afternoon: he was starting to wake up, and the nurse was really encouraged that he was beginning to move and respond a bit more again. There was a more obvious sense that he was able to hear us and follow us with his eyes. If he continues to improve like that, there might still be a chance that they'll be able to get him breathing on his own without having to do the tracheostomy. We just need to pray that there are no more complications and setbacks.

Both my Mum and brother have also struggled with a sense of anger that my Dad was actually feeling so well before he went into hospital.. and now he's lying lifeless and unresponsive on a bunch of machines that are keeping him alive. My Mum had had misgivings about his having the surgery, and she'd been wishing that they'd decided not to do it. But yesterday's nurse had shared this with one of the doctors and last night she told us the doctor said that the decision to have surgery was the right one: the lump in Dad's intestine was large and would soon have caused an obstruction, probably within the next two or three months, which means Dad would have ended up having to have emergency surgery anyway. So that has helped resolve the awful feeling of regret they've had about going ahead with the surgery. 

We felt a little more positive as we left the hospital again last night. However, as the doctors say, Dad is critically ill and there is still "a long way to go." I am conscious of being upheld by your prayers. Thank you so much for standing with us in this difficult time.

Back to square one?

Well, Dad had his third surgery this morning, and they cleared a lot of infected stuff out of his body. Now, in a sense, we're back where we were this time last week: watching and waiting to see if this gives him the chance he needs to fight off the infection that's causing multi-organ failure. It's really hard to see him lying there like that, and I'd value your prayers for the rest of my family members too. It's been an emotionally draining week.

Dad due for more surgery

Dad still wasn't doing too well today. The level of infection is so high that the antibiotics aren't really able to cope with it. When we arrived at the hospital this afternoon, the nurse told us that the doctor would probably want to speak with us. You can imagine the sinking feeling in our chests as we waited to hear the news. Were they going to tell us that they couldn't do any more to help Dad fight the infection?
In fact, when the surgeon came to speak with us, he told us that they aren't giving up the fight yet. As long as there is still a chance that Dad could pull through, they're going to do everything possible to help him fight and overcome the infection. Tomorrow morning, they're going to take him back into surgery to clean out all the infected gunk in his abdominal cavity, so that hopefully this will give his organs a better chance to recover and start working again. He's breathing a little (with help from the ventilator) but there's so much infection that his stomach and his kidneys aren't able to work for themselves yet.
Doctors say they wouldn't do this surgery (putting him through his third operation in ten days) if they didn't think it could give him a better chance to recover. But they were honest in telling us that they wouldn't keep putting him through procedures if things came to a stage where they felt that he wasn't able to make it. But it's not at that stage yet, and so they feel that "cleaning out" the infected fluid is the best next step to give him a chance of beginning to improve again - as he was doing at the beginning of this week. He'll go in for the operation at around 9 am tomorrow (Friday) morning. Thanks for your prayers.