Day 228

I see it's been 49 days since the last post. Not too bad!

By means of an update, R had surgery on December 5 to (basically) take everything that was sticking out of his abdomen, put it together and put it back in. We knew it would be a difficult recovery and that there was no timeline for the healing process. We also understand from transplant patients that more often than not, the problems encountered during the healing process do not have as much to do with the transplanted organs as much as it might have to do with the heart, lungs and/or other areas.

In the 47 days following surgery, R would have good days and bad days, but for the most part, he was making slow progress and getting better. This past Thursday evening, he had a very bad night. I called for an update on R around 4:45 pm. All seemed to be well. They were removing a chest tube and planned an x-ray to make sure all was well. I intended to call back before the shift change at 7 pm to find out if all went well. At 6 pm, while we were having dinner, we received a call from the hospital indicating R was not doing well, that they were working on him and we needed to come to the hospital as soon as we could. The nurse did not elaborate. We did not ask questions. It is never good news when they call.

We arrived at the hospital around 6:30 pm to find a number of people working on him. We looked at him and could not believe what he looked like. He was extremely swollen from all of the fluids and a blue/purplish color. He looked terrible. We were told that around 5:30 pm, his blood pressure began to fall and attempts to bring it up were not working. After his blood pressure fell, his heart rate soon began to fall and his oxygen saturation level (sats) also fell. At one point, he had no blood pressure and compressions were needed to revive him. Over the next 2+ hours, they were bagging him to help him breathe. That was not working. They put him on a ventilator. That did not help. They brought in a nitrous oxide machine and that eventually helped keep his pressures and sats up at decent levels. During this time, hospital staff pulled us aside and told us to prepare for the worst - that we would be able to take as much time with him as we needed if he were not to pull through. Over the course of the next few hours, his vital signs climbed to decent levels, but still were unstable. We were told that he was on as much medical support (meds and machinery) to keep him alive as the hospital could possibly give. The rest would be up to R. Truth be told, he was in God's hands all this time.

We left the hospital close to midnight Thursday night as R had settled into a relatively stable pattern (pattern meaning he was exchanging oxygen and carbon dioxide in his lungs at a decent level and his vitals: bp, hr and sats were leveling out). We left understanding the goal for the evening was to keep his heart beating and his lungs working. About 4:55 am Friday morning, the nurse called and gave us an update. She indicated that over the past few hours, R had been trending in the wrong direction. Because of all the fluid that had been used to resuscitate him, it was beginning to compromise his breathing. If the trend continued, he would not last long. We got up and made it to the hospital at 6 am. We saw the transplant surgeon in the hallway on the way in and he was nice to come and talk with us about R's condition. During rounds that morning, the doctors informed us that he needed dialysis to get some fluid off. The challenge was that the dialysis sometimes compromised his blood pressure and, being maxed out on the bp drugs, there was no room for them to help if he went into distress.

The dialysis started around 11 am, with several people in the room watching his status, Jen & I included. Over the course of the next few hours, there were some real positive signs that R was tolerating the dialysis well and his blood pressure was stable, sometimes even increasing. Over the last 24 hours, he has come off of all of the three (maxed out) meds that were keeping his pressure up. The settings on the ventilator are not maxed out as they had been. His color is turning back to pink, indicating decent blood flow and they are pulling some of the fluid off. His breathing is much better. While his condition is improved, he is not yet out of the woods. Staff continue to watch him very closely. We are hoping for continued very slow progress.

I cannot end this message without some mention of the staff at the hospital. Simply amazing. It is a tribute to our Creator to see people that would work so hard to save a life. It has been a blessing to see them in action and get to know them. Our prayer is hat we would be a testimony to them.

Finally, thank you for praying. I have been thinking a good deal this week about a song that says "the Lord gives and takes away". Regardless of whether he gives or takes, "blessed be the name of the Lord".