Irv Update - February 2011 #4

Dear F&F;

The referral process has started! It looks like sometime in early April Irv will be seeing Dr. Michael Gluck at the downtown Seattle Campus of VM.

The process is this:

All medical records faxed to Dr. Gluck
He checks them out and decides what testing, etc he wants done when Irv arrives
His assistant calls with the appointment schedule
We go to Seattle and get it done!

Right now Irv is feeling really well. He is almost back to being himself. Let us hope this euphoria isn't dashed with a reality check of some sort.

We've finally had new snow, but only about 5-6" and it is really heavy and wet. Just like cement.

Mt. Bachelor has given us a voucher for 2 season passes for next year. We bought season passes in Sept. but didn't get the chance to use them before Irv got so sick. Thankfully, Mt. Bachelor was good enough to allow us to use them next year instead. That is $1100 saved. Kuddos to them.

I am grateful to be finally on the road to another opinion for Irv. Even if Dr. Gluck just corroborates what we have already been told will be welcome. At least we know that Irv is receiving the correct treatments for his aliments.

Thanks to all of your for your tremendous support. Let's all hope for an uneventful period until Irv is seen in Seattle.

Penny

Irv Update - February 2011 #3

Dear F&F;

Irv was discharged late this afternoon. As per usual, NOT ONE doctor had a clue why Irv just had this dramatic episode of sickness. Dr. Kowalski said that Irv needs to be seen by the NW expert GI docs at Virginia Mason in Seattle ASAP. Plus, now, the cardiac docs, too. We will get in touch with the Bend GI doc Dr. Koteen to start the ball rolling. He has already been in touch with the VM docs so we hope this will happen quickly. Before yesterday we were going to wait until after Feb. 23, when Irv has his regular appt. with Dr. Koteen. That time frame would have allowed most of the healing to take place after the surgery. BUT, with this latest nonsense it is felt the entire power of The Mason Clinic and its many, many tertiary care doctors need to figure out what is wrong with Irv. Since we do not know how long it will take to get the referral appts. made it is a good idea to start NOW. We agree.

A CT scan was not done, just an X-ray series of the abdomen. An "air bubble" was found in the stomach, but no other abnormalities. Today, Irv was able to eat clear liquids, then some mac and cheese and a smoothie without trouble so he got to come home. A hypertension drug called Atenolol was added to his medicines to help with the a-fib. The initial dose of the drug has lowered his already low blood pressure to about 90/60, so the dose was halved. Irv has to be very careful when he stands up to be sure he doesn't get too lightheaded. He also is to take an enteric coated 325 mg aspirin every day. Irv's white count went down to 18,000, which is still high, but lower than before. Since Irv didn't show any signs of infection it was decided it was okay to send him home.

At least now if Irv has another a-fib attack, and he knows about it, he can call Dr. Noble, his new cardiologist to see what we should do. Irv does see him on Feb. 25 unless we are in Seattle.

That's the news.

Penny

Irv Update - February 2011 #2

Dear F&F;

Irv and I went to the cardiologists this morning for Irv's 9:30 am appt. Irv was still in a-fib. It was decided that Irv would come back tomorrow and have a cardio-version done under some sort of anesthesia. While we were waiting for all that to be scheduled, Irv developed impressive chest pain and vomiting. The doctor was in the room for all this so he saw first hand just what was happening. After about 7 tries an IV was started and fluids given plus an anti-nausea drug. (Irv had tried to take a heart drug but vomited it back up in about 30 seconds.) Dr. Noble, the cardiologist, had the lab people come and draw a bunch of blood and, of course, an EKG was done. EKG showed the a-fib, the heart lab tests were normal, BUT he had quite an elevated white count of 20,000 and his liver tests were up as well.

Dr. Noble got Dr. Koteen (gastroenterologist) and Dr. Kowalski (surgeon) on board. Between them they decided to direct admit Irv into the hospital to see if he has developed a severe infection from his surgery, has another abdominal problem, or what? The a-fib is now secondary. A CT scan of the abdomen is scheduled for this afternoon, but there was a mix-up about which hospital based doctor was going to see Irv so it hadn't been officially scheduled by the time I left at 3:30 pm. ^%$#*)

By the time I left Irv was being monitored via telemetry (the cardiac unit was full so he is on a general medical floor) and waiting for the CT. He was feeling pretty good. We had brought the dogs into town with us as we were going to go to our favorite breakfast place and split a breakfast. (Irv still isn't eating very much food.) Then we were going to take the pups to one of several dog off-leash parks in Bend and come on home. Obviously, that didn't happen. I took the dogs out twice during all this chaos but leaving them in the car much longer wasn't an option so I had to come home with them.

I was getting a little calmer until the hospitalist finally came. She asked questions, got a history, did a physical exam and then proceeded to ask about advance directive stuff such as if Irv did go into cardiac arrest how aggressive did he want the medical staff to be. (We both feel strongly that when your body is ready to die, let it! Both of us have seen way too many people rotting away in the hospital on every imaginable device to keep the body working, but that person is not necessarily alive.) Anyway, then I could only imagine that they were thinking he was on death's doorstep. Not a very nice place, let me tell you.

I'm waiting for Irv or the doctor to call with the CT results. I'll relay them when I have them. I will be back very early in the morning to catch all the doctors on their morning rounds and will hopefully see what the plan is for that day. It is conceivable that Irv could still have the cardio-version and come home tomorrow. Not likely, but possible!

Penny

Irv Update - February 2011 #1

Dear F&F;

Today Irv and I spent most of the day in the ER after he noticed a heaviness and discomfort in his chest. I was able to easily feel that his heart rate was very irregular so off we went to the ER.

He was found to be in atrial fibrillation and they gave him the same drug, Cardizem, he had had previously. Unfortunately, it would only help his heart for a short period of time. The ER doc consulted with the hospitalist who treated Irv while he was in the hospital for his surgery, and also a cardiologist. Finally, a different class of drug, a beta-blocker, was tried. It also didn't completely solve the irregularity but did slow down the heart rate to an acceptable rate. After about 4 hours of monitoring it was decided that Irv could come home but he has to see a cardiologist tomorrow morning at 9:30.

So, we assume he now has a cardiac problem! Crap!

I'm not happy that he is home and will probably not sleep all night worrying that he is going to die on me. Will this nightmare ever end?

Let's hope the cardiologist will be able to easily solve this problem tomorrow and get Irv on a drug that will help his heart. As to why it is happening, let's hope that will come to light as well.

Meanwhile, we had a gorgeous day in Central Oregon.

Penny