I went to see Glen last night since I took a little hiatus over the weekend. I went after work so that I could spend more than 30 minutes with him on my lunch hour. He was laying on his side for a change (not on his back), but not because he really wanted to - he has a little pressure sore on his back end from laying in the bed for so long.
He looked really good, though. He said he was cold, but his face was warm and so were his hands. The bed has an air pillow, so I think it must be a little cooler than just being on a mattress. You know how a water bed without a heater is, right? No matter how many blankets you put between the mattress and your skin, you eventually freeze to death without that heater! Been there - done that.
Yesterday Glen was up out of the bed two times walking. They are even getting him up in the nifty huge wheelchair he has in his room. He was telling me they have been giving him steroids for his vocal chords and that the left side is frozen up. As we were talking, Dr. Misselback came in and visited with us at length.
He gave Glen a kind of plan of action. He said that they still do not know why his vocal chords are not working correctly. He suspects that the prolonged use of the breathing tube (over 2 weeks) may have had something to do with it. He is waiting on the speech therapist and throat specialist to consult with him, but the main block to quicker recovery for Glen is that he still cannot swallow. He has to be able to swallow, not to eat necessarily for the moment, but to be able to clear his own airway. He said that we all constantly are clearing out mucous from our lungs during the day whether we realize it or not. And right now, Glen is unable to cough up or even swallow the secretions if he were to be able to get them up. Until he can do that, Glen will have to stay in the hospital. If he can't swallow properly, then what will happen is that he will possibly be pulling the mucous into his lungs, which will cause infection, that would lead to pneumonia and then he'd be really sick again.
Dr. Misselback said that even the small feeding tube Glen has in his nose could be irritating his vocal chords right now. And Glen is MORE than ready to have that thing out. He told me yesterday that he wanted a Dr. Pepper and some FOOD. The doctor told Glen that he believes that the most prudent thing to do in the next couple of days is to put a feeding tube into his stomach and remove the one from his nose. That will give Glen more freedom to move around and psychologically give him a lift. After all - who wants to go around with a tube dangling from your nose?
He started Glen on Steroids over the weekend to help with the swelling of the vocal chords above the trach. And he also stopped the coumadin (I probably spelled this wrong) - the stuff that things Glen's blood - to keep him from having blood clots since he has a mechanical valve. He has stopped the coumadin so that they can put the stomach tube in. It will be a little local procedure (Dr. Misselback said like a Dental procedure). He won't be completely out, but he won't remember either. So - in the next several days after the coumadin gets out of his system, we can expect to see the feeding tube in a different place.
IF - and only IF Glen can manage to swallow on his own and clear his own secretions in the next couple of days, then they will probably not do that procedure. If he can swallow, clear his chest and eat on his own, then there is no reason to do it. Glen's OK with it I think though cause he really wants the nose thing out. The feeding tube though the stomach will make it easier for him to move around and to be fed. He can get boluses every so many hours instead of a continual drip. One of the main reasons for doing this procedure is that IF Glen can qualify to get into TIRR for rehabilitation, they will not take a patient who is on a nose drip. But they will take someone who has the gastric feeding tube. So now that I've talked you all into the feeding tube - he's what else Dr. Misselback said:
He expects for Glen to be in ICU for probably at least 7 - 10 more days until they can get the vocal chord/swallowing issue somewhat resolved. Once that is resolved, then he is ready for full rehab - and could go to TIRR. Or, if he can't go there, then they will be able to move him to a larger, more rehab friendly room where he can work hard on his own with the help of the Ben Taub therapists. Dr. Misselback said he could expect to spend probably another month in the hospital or rehab.
Glen asked why they had done the heart catherization before he had his surgery and was wondering if that could have caused some of the complications. Dr. Misselback said that in people over 45, they always did one to see if there were any blocked or clogged arteries so that those could be repaired at the same time the valve was replaced. In Glen's case, his arteries were clean as a whistle. He could eat every day at McDonald's and not worry. He said that Glen's aortic valve was a congenital deformity. Instead of having 3 little flaps on the valve, he was born with only 2. And what happened was that the 2 little flaps had developed calcium deposits on them causing the valve to not work properly. He said that people with normal valves usually never develop calcium build up until their 70's, 80's or 90's.
And as to why Glen had all these complications - Dr. Misselback said they just do not know. The surgery was textbook. Everything about what happened to Glen is a mystery. He may not have suggested that Glen have the surgery if he had known then what he knows now, but one thing is for certain. His heart is fine now and once he gets over this hurdle, he'll be like new. I don't think any of us will be able to keep up with him.
I have to say I'm pretty proud of him so far. He has been able to keep his spirits up and (knock on wood) has been getting stronger every day.
If I haven't covered some of the stuff the doctor talked to us about, it's not on purpose, guys. If I think of anything else, I'll blog about it a little later.
If left after about and hour and a half when a friend of his from school dropped by to visit. Dr. Misselback said Glen has more different friends visit him than he's ever see a person have. He knows many of you by name!. Isn't that amazing?
Sincerely,
Darla
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