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.