Monthly Archives: November 2013

Day 20

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Check out the new story in Memory Lane – Stories from Jeff Cohen.

Cindy struggled a little with her breathing yesterday.  It was scary for those of us visiting (Rita, Mary and Debbie) but the medical team got her back into shape.  With a little sedation and pain killer, Cindy was sleeping like a baby.  She was stable all night. Her tracheotomy is happening at 9:30 AM (Pacific) today.

Image from Mayo Clinic

Cindy got back to her room around11:30 AM Pacific today.  It is now noon and Rita and I are with her.  The procedure went very well.  The ventilator tube is out of her mousth.  There is a small tube in her neck that is MUCH smaller than the ventilator tube.  Cindy is sleeping comfortably.  The trachea is connected to the monitor.  She is on Assist Control.

The best part of the trachea is that weaning her from being dependant from the mahine that helps her breath will be much easier.  Since nothing is in her mouth, she will be able to at least mouth words.  Her face even looks more relaxed.


Check out the Memory Lane – Pictures and Memory Lane – Stories pages on the right side of the blog.   There is also a new page called Talkies.  You can create a You Tube video and send me the link at debra.lobel@gmail.com.


And don’t forget to send stories and pictures to debra.lobel@gmail.com.

You can also leave a comment at the end of the post.

If you want to be notified when the daily post is ready, please subscribe by entering your email address in the box under where it says: 

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If you need help navigating around the blog, please find someone under the age of 25 (the new 30 for all you Baby Boomers) to help you.

Day 19

Cindy Lobel, Health, Physical Therapist, Physical Therapy, Pulmonary, Status
I’m going to start posting in the morning (Pacific time) and update the daily post if needed.

Cindy had a good night.  Dr. Cheung (pulmonary specialist and Cindy’s primary doctor right now)  came in to see her today and was impressed with her weight loss and the progress she made with the ventilator over the weekend.  She believes that Cindy will need another week before she can breath on her own, so she is calling Dr. Chen to see if he can do the tracheotomy.  Dr. Chen has worked with Cindy when she was in the hospital last year, so he knows her situation.  Remember that the ventilator tube that Cindy is using now is not a good idea to use for more than two weeks which was this past Saturday.  The tracheotomy is not permanent.  Cindy might be able to talk and eat by mouth.  The tracheotomy is scheduled for tomorrow at 9:40 am.
 

More good news.  Dr. Cheung is also ordering Physical Therapy (also called PT).  That will help Cindy regain her mobility.  She is able to move her arms, legs and shoulders but doesn’t have much strength.  She can’t squeeze your hand or push down with her feet.  The Physical Therapist will help her get back into shape.
 

Image from Wikipedia

Check out the Memory Lane – Pictures and Memory Lane – Stories pages on the right side of the blog.   There is also a new page called Talkies.  You can create a You Tube video and send me the link at debra.lobel@gmail.com.


And don’t forget to send stories and pictures to debra.lobel@gmail.com.

You can also leave a comment at the end of the post.

If you want to be notified when the daily post is ready, please subscribe by entering your email address in the box under where it says: 

     Please subscribe to get the latest posts

If you need help navigating around the blog, please find someone under the age of 25 (the new 30 for all you Baby Boomers) to help you.

 

Day 18

Cindy Lobel, Health
Cindy continues to attempt to breathe on her own as best she can.  The process is slow but steady.

Tests were done to make sure that her digestive system is good.  All is A-OK.

Cindy’s childhood friend, Nike was here for the weekend and left today to go back to Los Angeles.  But first, she left Cindy a piece of art work on her Daily Board in her room:

The following is a text message from my cousin Amy.  It is dedicated to Cindy’s patience:

“Hi Debbie. I loved yesterday’s blog because it was beautiful, poignant, sad, and funny! Not only does it tell how Cindy keeps doing better and is working so hard with her recovery (Yaaah!!!) but also made me sad thinking of your mom as well as sad again how right now Cindy isn’t able to “deal with” my mom. It made me laugh and was funny to me because of what you said about my mom not getting any of what you were explaining about seeing the blog, etc. and your losing patience. I’m going to use your trick to help me – I’ll pretend I’m Cindy when I talk with my mom! “

My partner, Pauline, asks me how Cindy is every day.  I tell her she can check the blog like everyone else.  She says she can just ask me.  I get insulted.  She says:

“Ok.  I’ll call Aunt Sandy and ask her how to access the blog.  How about that?”

Rita carries around Cindy’s phone.  It rings constantly all day long.  The caller at the other end of the conversation usually needs Cindy’s help,  When they find out that she is incapacitated, they tell Rita they hope she feels better and often tell her that they are lost without her.   Then they proceed to ask Rita to help.  She begs ignorance and gets off the phone and screams:

“Cindy!  How do you take care of all these people!!!”



Check out the Memory Lane – Pictures and Memory Lane – Stories pages on the right side of the blog.   There is also a new page called Talkies.  You can create a You Tube video and send me the link at debra.lobel@gmail.com.


And don’t forget to send stories and pictures to debra.lobel@gmail.com.

You can also leave a comment at the end of the post.

Day 17

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Cindy had a good night.  She was working very hard to be weaned off the ventilator.  It was on Spontaneous mode.  Late this morning, her heart rate and blood pressure went up.  She started to get agiated and the ventilator was adjusted to Assist mode so she could get a break.  This was just a minor set back.  Cindy slept most of the day.  Late this evening, the ventilator was reset to Spontaneous.

The doctors were talking today to try to decide if she should remain on the ventilator or do a tracheotomy.  We will be meeing with the team of doctors either Monday or Tuesday.

The nasaal feeding tube is working well.  The TPN feeding was stopped yesterday.  Her digestive system is working well.  The picture below is what Cindy has for breakfast, lunch and dinner.  Sometimes she has a midnight snack from this container, too.  The picture is not upside down.  This is the way it hangs.  It is attached to the nasal tube.

Check out the Memory Lane pages on the right side of the blog.  And don’t forget to send stories and pictures to debra.lobel@gmail.com or you can leave a comment at the end of the post.

Day 16

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Nothing but good news today.  Cindy was doing her best to get herself weaned off the ventilator by initiating the breathes of the ventilator.  This is done by setting the ventilator to Spontaneous mode.  Several times during the day, she struggled with her breathing and getting enough oxygen.  They had to give her breaks throughout the day and put the ventilator on Assist mode so the ventilator did all the work.  The green ‘A’ in the machine below shows the ventilator in Assist mode.  It can be set to ‘S’ mode which puts it in Spontaneous mode.

This is actually the machine that Cindy is using.

The doctors are trying to get her totally weaned off the ventilator by the end of the weekend.  They do not want to have to do a tracheotomty.  The ventilator should be used no more than 2 weeks (which is tomorrow).  Cindy is literally trying really hard and wee’re rooting for her.

Since Debbie is the administrator of this blog, she is going to tell this story:

Last night, Debbie called her Aunt Sandy to make sure she could see where her picture was posted on this site (Memory Lane – Pictures).   She was getting the link via text messaging, but didn’t know that it linked to this blog.  Long story short, it took 45 minutes to get her to get to the site and see this blog for the first time.  Needless to say, Debbie’s blood pressure skyrocketed.  Sandy apologized and said “doesn’t this remind you of your mother”?  Debbie didn’t have patience with her mother and was running out of patience with her aunt.  Dealing with her mother was left to Cindy.  Debbie was about to tell her aunt to call Cindy and realized that wasn’t possible.

Aunt Sandy sent the following email:

THANK YOU FOR YOUR TIME, PATIENCE, LOVE, UNDERSTANDING – AND
FOR BEING YOU.   XXXXXXXXXXXXXXXXOOOOOOOOOOOOOOOOOO

Debbie responded:

That’s not really me.  I had to make believe I was Cindy.  She has all the patience.  

Debbie told this story to Cindy this morning.  It gave her a huge smile.

Day 15

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This is the 2 week anniversary of Cindy’s medical crisis.  Mary (see picture below) brought her to the ER two weeks ago today.  It was Halloween and things in the ER were pretty frightening.   Thankfully, things have changed.

Cindy has been able to “communicate” by nodding, shaking of the head, smiling, raising her eyebrows,  and other interesting facial expressions.  The doctor is thrilled as we all are.  The doctor is so thrilled she decided to try to have the nasal feeding tube inserted into her stomach again.  This procedure had failed a few times in the past few weeks.  The medical team thought it would be better for Cindy so her digestive system would not stop working.  The tube was inserted at bedside using an endoscope (see picture below).

Image from Wikipedia


This time the doctor was able to insert the tube in 15 minutes.

 
Mary and Rita in waiting room waiting for Endoscopy to be finished.

Cindy’s childhood friend Nike came to visit from L.A..  They played 20 questions.  It was lopsided, with Nike asking all the questions.  Hopefully, Cindy will get a turn soon.

Check out the Memory Lane pages on the right side of the blog.  And don’t forget to send stories and pictures to debra.lobel@gmail.com.

Day 14

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When Rita arrived at the hospital today, the primary doctor came running after her to tell her that Cindy is responsive.  The doctor was thrilled.  Her exact words were “This is a good day.”   Coming from a cautious doctor, this was excellent news.   Cindy was able to look at the doctor when the doctor called her name and was able to nod her head when the doctor asked her a question.

Dr. Debbie is going to take a little credit here.  She suggested that they remove the Fentanyl drip so she can wake up.  They did that and Voila!  She is doing better (but still not out of the woods).

Cindy is not on any medication.  That includes no pain killer and no sedation.  She is able to keep her Blood pressure up without medication.  She is Breathing partially on her own.  She can initiate the ventilator to breathe.  The ventilator is also expanding her lungs after each breath so her oxygen saturation improves.

Cindy responded to Debbie, Rita and Mary when spoken to but seemed confused at times.  Tonight she was able to sit in a chair for about an hour.  That is GREAT progress.

This is Tammy’s card to her Aunt Cindy.  That’s a picture of Cindy as Superman because she has super powers.


Tammy’s rendition of Cindy as Superman

Debbie’s conversation with Cindy:

“Are you in pain”?  Shakes her head no,

“Headache”?  Shakes her head no,

“Dizzy”?  Shakes her head no.

“Am I being a pain the in the neck”?  Nods her head yes.

Text conversation with Phedra after she finds out that Cindy is responsive:

Phedra:  “You need to remind her that I want my Leslie Gore records back.”

Debbue:  “I gave Cindy your message.  She nodded her head yes.”

Phedra:  “Sure!  Like she means it!  I’m gonna have to get out there and beat her up.  In the meantime, plant a little kiss on her, will you”?

Don’t forget to look at the Memory Lane Pages and send me your pictures and stories at debra.lobel@gmail.com.

Day 13

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Cindy is not sedated anymore.  However, she is also not very responsive.  The doctors decided to make sure there was no brain damage, so they did a CAT scan.  Thankfully, everything is OK.  The hospital doctor said he might want to an MRI on her head just to make sure.

Cindy remains in critical condition in ICU.
Rita, Mary and I met with a team of doctors including her primary doctor, 2 palliative doctors, the hospital doctor, 2 social workers and her nurse from today.  They went over the plan they have for her recovery.  
The biggest problem is the hiatal hernia.  They cannot do anything about it while she is in her current condition.
She is not responsive right now.  We suggested that they stop giving her Fentanyl which is a narcotic for pain.  Cindy takes a long time to “wake up” from medications like that.
The right side of her heart is not strong and isn’t working at 100%
She is getting nutrition through and IV.  They would like to get her nutrition into her stomach.  They might place a feeding tube into her stomach next week.

There were a few sources of infections.

     Urinary tract from the Foley catheter.  It was finally changed after 10 days.
     Found bacteria in sputum
     Bacteria found in Triple Lumen line from dialysis
     
The ventilator is still helping her breathe.  If she is still on a ventilator on Monday, they might do a tracheotomy.  This would be a surgical procedure where an incision is made in the next to open an airway directly to the trachea.  It is not a permanent tube.
Her kidneys are working fine.
There is no prognosis for Cindy.  They are taking things one day at a time.
Don’t forget to check out the Memory Lane pages and send in you pictures and stories for her.

Day 12

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Here’s a brief wrap-up for today:

Cindy remains in ICU in critical condition and on life support.  The ventilator is still breathing for her and she continues to be fed via an IV.  She is being kept sedated and is not aware of what is going on.   

Progress continues to be slow.  It is mixed with some obstacles.  Things get confusing.
Her kidneys are working again and she is not on dialysis anymore.  
 
The infections disease doctor thinks she might have an infection in her blood.  Thankfully, she is already on antibiotics.  Her white blood cell count continues to go down.
On Tuesday, Rita and Debbie are having a meeting with the doctors to find out what their plan is.

Day 11

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We woke to some good news today.  Cindy had a good night and is improving.

Don’t forget how Cindy likes to be the social butterfly.  Please send your favorite story and/or pictures for this blog.  Make sure you check out the pictures and stories on the Memory Lane pages.  You can get to them by the links on the right.

  • Her lungs sound better.
  • Her oxygen setting level on the ventilator was lowered to 50% which means the ventilator is only giving her 50% of her oxygen.  The other 50% is on her own.  Big improvement.

    Ventilator in action – Image from hnibi.nih.gov

    • She is less sedated.
    • She is now being fed (TPN via PICC)
    • Her Blood Pressure medication has been reduced.
    • She is urinating – kidneys working.  She won’t be having dialysis today and no diuretics to she how her kidneys function.
    • White blood cell count went from 24000 to 17000

    Cindy has been getting lots of prayers.

    A Rabbi came in to do a m’sheberach.  Her blood pressure dropped.
    Cousin Cliff is putting her on his shul’s m’sheberach list.
    Rita prays the Rosary morning and night.
    Lucy, Rita’s mom, and her friends pray the Rosary when they are at the hospital.
    Everyone is ‘virtually’ praying for her.
    Nike says that Mercury is going direct!  Three day wobble but she is out of the astrological woods!
    I think Cindy is in good shape, spiritually.

    Homemade card from Edgar
    On the wall in her room

    Taped to her bed

    Debbie in gown and gloves