Wednesday, February 28, 2007

Rehabilitation

It's been two long weeks since we arrived in Adelaide - Rick by air ambulance, Jessie and I by car and Kerran here playing Country Carnival cricket for the week.

Rehabilitation has begun. Had you seen Rick a week ago, you would never have believed the transformation or even that it would be possible to do so much in such a short time frame. The specialist told us that public patients are discharged 4 day after bypass operations.

We are so pleased we have continued our private health cover for so many years. It has certainly paid off now. Visiting Auntie Eileen in the public hospital next door at the same time just re-confirmed that for us. Unfortunately she will probably still be there until the weekend.

This morning Rick walked with me to the shops, sat and rested while I did a bit of shopping, then we successfully walked home again, despite the slight incline.

The recommendation is to walk 10 minutes at a time, three to four times daily and to gradually build up. He is also not allowed to be left on his own for a week, so we carry the phone with us all the time. I don't know what people in this situation did before mobiles. The doctors assure us nothing will happen, but still to be aware that the first 2 weeks are crucial.

Sleeping with the responsibility of "watching" Rick is a bit stressful - there were a few moments last night when I was sure his breathing was "suss", but obviously we made it safely through the night - I'm sure each day will get easier.

Afternoons are designated for resting - for both of us - we have a lot of sleep to catch up on. Hospitals are not places to rest in, no matter how caring and compassionate the nursing and ancillary staff.

We are gradually resuming some sense of normality, after the long days of hospital visiting, although we feel like a mobile pharmacy with all the drugs floating about.

Tuesday, February 27, 2007

Discharged from hospital

After seeing everyone possible - the pharmacist, the doctor, the physio, the nursing staff - and a lot of paperwork, we finally left the hospital at 12.30pm today with a rehabilitation programme, appointments, contact phone numbers and plenty to be pleased about and thankful for.

Rick was anxious to get some fresh air and a cornish pasty! We'd previously heard good reports of the St Peters Bakery, so we ventured there - it's a popular place and well deserved in its praise. (I'm sure we will need to venture down there one day on our daily walk for a coffee). The doctor agreed Rick deserved a treat. So cornish pasties were the order of the day. Yum!

It's a lovely day - around 30 degrees celsius, but a sleep was in order for the afternoon - I had developed a migraine and Rick was worn out from the trip home. At least at home we don't have the interruptions found in hospitals and we can please ourselves what we do and when we do it.

Monday, February 26, 2007

You can't keep a good man down!

Great news. Rick is being discharged from hospital tomorrow.
Today he has climbed stairs and been walking almost as quickly as he normally does! Just not as far.
His oxygen saturation levels are still a little low, but he is rapidly realising his limits - his body reminds him constantly. And I am on his case 24/7. He will get very tired for a while to come.
The surgeon says that he should never have been in that hospital because he is so fit, not overweight, doesn't smoke, doesn't drink and is so young. And that he is"cured". That, of course, comes with the rider that we have to continue to watch our diet, exercise regime, cholesterol and blood pressure, so that there is no other plaque buildup anywhere else.
We've had an excellent "discharge talk" with the nursing staff and the physio has provided a rehabilitation programme for the next few months.
And we learnt tonight that the wire holding the sternum together won't rust (good news living on the coast), so we're set. We're constantly amazed at those who have invented this incredible technology. And ever grateful.

Next on the agenda: the cancer treatment. These past couple of days we have been able to focus more on that than we have been.
The plan is as follows: Hormone therapy is expected to shrink the prostate, so that it is no longer pressing on other organs, there will be an implant in 2 weeks time, followed by another CT scan in 4 weeks, then radiotherapy will start in 6 weeks. Originally the plan was to remove the prostae but the cancer has spread, so that is no longer an option.
One of the main side effects of the radiotherapy is tiredness, so his energy levels are going to be sorely tested in the coming months.

Sunday, February 25, 2007

Focussing on one thing at a time

Whilst our focus this week has been on Rick's heart, we are mindful of the fact that we now have to concentrate on the next phase of his wellbeing - his fitness and his prostate treatment.

Today has seen an ECG (all fine), routine chest X-Rays, increased and speedier walking, a wheelchair trip out into the atrium to get some fresh air and a bit of sun, a visit from Auntie Eileen (in the hospital next door), removal of all remaining stitches and an increase in Rick's energy levels. He's spent most of the day out of bed, but his oxygen saturation levels are still a bit low at times. We had hoped they'd stay up with the extra exercise.

The Dr says we may be discharged from hospital on Tuesday, but the cardiologist and surgeon will make that decision when they return tomorrow.

We are hoping to be able to attend at least a few sessions in the hospital's cardiac rehabilitation programme, which they run on a weekly basis, covering diet, exercise, and lifestyle changes. However, we are investigating the possibility of attending only when we are back in Adelaide for radiotherapy treatment or in getting some help from the Heart Foundation.

Whilst I'm pleased Rick will be able to come home shortly I am still a little apprehensive - we are not out of the woods yet, but by staying in Adelaide at least we'll be close to medical help if need be.

Our bathroom, toilet and laundry renovations are booked to start in the unit next week. My idea was to postpone it for a while (to allow Rick time to recuperate first) but he is determined that it should go ahead as planned.

So....all is progressing well at this point in time, and I'm sure it will continue in that vein.

Apologies to those who have been unable to reach us by phone, but I am usually gone by 9.30am and only arrive home around 10pm.

Life and living

The human body is an amazing thing. Last week Rick shared a room for a day or so before surgery with an elderly medical doctor, who was not a good patient (we felt for the nursing staff, and even his young surgeon was cautious with his words), but he did say one useful thing that we noted and that was that you cannot kill the human body medically. It has been reinforced to us these last few weeks that the body certainly does have an incredible fighting spirit to live.
Rick is in a lovely private room of his own now, overlooking the coast - it gives us time to reflect and to contemplate what is and what might have been.
Jessie is back in Adelaide and we have lovely supportive friends, so we will get through this and the next hurdle.
Rick is strong and positive and we are all in this together.
Uni resumes tomorrow after the long summer break, so there will be a little bit of pressure on us all living together in a 2 bedroom unit, but we are all OK, so that's the main thing. We can go back home in 10 days or so - it feels like an eternity since we came to Adelaide.
We thank God that Rick is going so well. I'm sure He will be with us on the rest of our journey.

Saturday, February 24, 2007

Good news

Another day closer to getting out of hospital.
Apart from a few little lung alveoli collapsing, Rick is making amazing progress. He's walked down the corridor and back several times, continued to eat well, and now has no tubes inundating his body. He slept through the night without too much discomfort.
He's been having ventolin and saline masks during the day to try to help his lungs, but now that he's moving around a bit, we are hoping that will all clear up of its own accord. Getting in and out of bed is getting easier, but the coughing exercises are still painful to watch. He calls me the "slave driver" as I remind him to do just that little bit more with his coughing and breathing each hour. The physio added a few more stretching exercises today and I've been kept busy massaging and getting drinks, rugs etc etc.
He is still very tired, which is to be expected and gets hot and cold intermittently after any exertion, including eating, getting up and down and taking painkillers.
We've had a few visitors today, which has been good. In between, Rick has had several very deep sleeps and I've even managed to catch up on some rest too.
Tomorrow there will be more routine X-Rays and an ECG to see how everything is progressing.
All being well he should be able to come home on Tuesday.

Friday, February 23, 2007

More progress

It is completely amazing how quickly anyone can ambulate and mobilise so quickly after such major surgery.
I arrived at the hospital at 10am to find Rick showered and sitting out in his chair - he sat out for 3 hours until lunch, after which he rested in bed before getting out again for tea.
The nurses and physio have taught him ways to get in and out of bed and the chair with the least pain - with breathing exercises he is gradually gaining strength and confidence in his own ability. He's eating well - everything is stable and functioning almost normally.
At the same time he is realising his limitations, but we are glad of his prior fitness, which is now paying off. By 9pm he was totally exhausted, but still keen to watch the football on TV!
By the end of the day all drains, bandages, oxygen and tubes had been removed, apart from the heart monitor, which is connected to the computer at the nurses' station. There are plenty of scars, a few stitches and lots of bruising to show for his efforts, though. A few muscular aches have surfaced - they say they'll continue for a couple of weeks, so we've got a way to go. I say we, because it's a joint venture. He's going to be reliant on someone for some time to come.
All the staff are extremely impressed with Rick's good progress and the Dr thinks he'll be out of hospital early next week! Just in time for the hot weather.
Thanks to everyone for your phone calls, prayers, support, visits and messages. Greatly appreciated.

Organ donors

Kerran has just registered to be an organ donor. Very recently there has been some publicity that adding it to your drivers licence is not sufficient.
If you're interested you can download a registration form at
http://www.medicareaustralia.gov.au/yourhealth/our_services/aaodr.htm

Thursday, February 22, 2007

Excellent progress

What a contrast in less than 24 hours. Today has been nothing short of amazing, with major positive progress since yesterday.

When I arrived in ICU at 9.30am, Rick was still attached to all sorts of drains, drips and painkillers, barely able to move, though he had had a reasonable night's sleep.

The ICU Dr arrived around 11am and by 12 noon he was detached from the chest drains (ouch!) and we were on the way back to the ward! Moving from one bed to the other was another painful exercise. The drains had been nearly 30cm inside his body so it was a huge relief to have them removed. Only a few stitches remain to remind us of the wonders of modern medicine.

Hunger was the next good indication of progress - he had soup and a sandwich for lunch. The physio visited mid afternoon to advise how to cough and breathe deeply in order to keep the airways clear (to avoid chest infections) and to do a few bed exercises to avoid clots, the two major risks. By 5pm the nurse convinced Rick to venture out of bed to sit out for tea! Although it was a painful exercise he then sat out for 4 hours, feeling more comfortable than he had in bed, before a painful re-entry to bed at 9pm.

It helps to have a lovely view out over the sea. The helicopter landed twice during the day on the adjacent rooftop helipad and ambulances come and go next door all day long. At one stage there were eight lined up ferrying people both in and out.

Our surgeon is very pleased with his handiwork. And so are we just quietly. The chest scar extends vertically about 20cm, with no visible stitching (apart from where the drains had been), the sternum being held together by wire, which stays put forever. The leg wound is usually the one which causes more pain than the chest but to date Rick hasn't had too much trouble with it. It might be a different story when he gets mobile.

Both Rick's blood pressure and heart rate (double what it was last week) are now stable and virtually back to normal. He just experiences some temperature variations after exercise but that's fairly normal from what we can gather.

The surgeon concurs with the oncologist that Rick can start hormone therapy (to shrink the prostate) next Wednesday - it won't affect anything that's happening at the moment, thankfully. Radiotherapy will then begin 6 weeks later, so there's only been a 2 week delay in that treatment; hopefully the cancer has not progressed any further in that time. His heart may not have coped with all this had it not been repaired first, so from that point of view it was good timing.

I've just arrived home in time to watch RPA on television - open heart surgery and an angiogram! Very timely. It is truly amazing how the human body copes.

By tomorrow the oxygen, the catheter and all tubes will be removed and Rick will be able to shower (in a chair I think) and move around the room, albeit cautiously and slowly.

The nursing staff are terrific - he's in good hands. We can all breathe much more easily now.

Wednesday, February 21, 2007

ICU

11pm Just arrived home after a long and worrying day. But all is well.
Rick's surgery started around 12 noon and was finished by 2.30pm.
By 8pm he was waking up and breathing on his own, his heart rate (finally in the 70s) and blood pressure good and all the drainage tubes working well.
Although he's pretty uncomfortable, he's not in too much pain. There's plenty of pain relief on offer.
Two veins (leg and mammary) were used for the double bypass and we are hoping he'll be out of ICU soon after lunch tomorrow.
Open heart surgery is just amazing, cutting through the sternum and keeping the patient alive with a heart-lung machine, whilst cooling the body right down to 15 degrees - it took until 7.30pm to get his body temperature back to 37 degrees celsius.
It's routine surgery these days, but nevertheless daunting when it's happening to you.
As yet I haven't spoken to the surgeon, but we hope to see him tomorrow.
I'm not sure anyone could possibly sleep in ICU - it's a busy place and from a layman's point of view very scary, but the staff are fantastic and very professional.
It has been the longest day of my life I think, but one which should give Rick a new lease on life and the chance to start the prostate treatment, a chance he may otherwise not have had. Science is a wonderful thing and we're very fortunate to live in this highly technological age.

Waiting

It's hard to describe the feeling of helplessness.
Rick went to surgery around 11.45am in better spirits than me.
I decided to come home for a few hours, rather than try to shop or visit anyone in my dazed, nervous state. Until I get a phone call from the hospital I won't feel comfortable.
A good friend is about to call around to sit with me for a while.

Tuesday, February 20, 2007

Preparations

Arrived at the hospital at 12 noon as requested.
Schedule included:
*Shaving legs, arms, chest
*Having (massive) bruise checked from clamping to bed on Friday
*ECG, heart rate (up to low 50s, after days of low 30s to mid 40s)
*Blood taken (for cross matching, cholesterol etc)
*Chest X-Rays
*Nurse's meeting on the procedure, concerns, outcomes
*Visit from cardiologist
*Weight, height etc etc taken
*Numerous, endless forms to complete (mostly my job)
*Visit to ICU where Rick will spend most of tomorrow and part of Thursday
*Sponge shower (another tonight and yet another tomorrow)
*Sharing a room with a doctor who is not the best patient
*Tea
*A few brief walks
Left at 9.30pm, still no sign of the surgeon, whose first patient is scheduled for 7am.
Rick is the third of three, so should be going "on the table" early afternoon, if all goes according to plan. He will be in hospital for a week and then in Adelaide for another week.

Auntie Eileen had surgery in the adjacent public hospital yesterday - she's actually on the same floor so that will make visiting easier tomorrow while Rick is in surgery.

An early start tomorrow and a long day ahead.

Bypass Surgery

Rick is going back to hospital today to have a double and possibly a triple heart bypass tomorrow, depending on the state of his left artery.
We decided to purchase a lotto ticket - not our usual habit - because we were feeling lucky today!
Whilst there are small risks involved with the surgery, the average person recovers very quickly and satisfactorily to live a more comfortable lifestyle by all accounts.
Nevertheless, it is still all very daunting.
The oncologist hopes that the delay in hormone treatment won't meant that the cancer spreads any further, but the heart is the first priority at the moment, so that treatment can be started a week after surgery. Rick will be taking 3 months sick leave initially - it can easily be extended if need be. Not a good way to start the year, but that's life.
I'll try to keep you all updated as often as possible.

Monday, February 19, 2007

Waiting game

Jessie's birthday on Saturday was a VERY low key affair due to Rick's fortunes. Since it was so hot we "celebrated" with an icecream cake.
Just as we were about to go to bed Rick noticed some worrying bleeding from the groin where the angiogram had "gone in", so back to the hospital at 10.30pm to have it checked. That was a minor hiccup after having the vein burst open in the hospital not long after the angiogram, resulting in his leg being clamped to the bed for 3 hours.
We have spent today largely waiting around. Thanks to everyone who has rung to check on Rick's health.
This morning we took a chance that Rick might be able to have his hernia checked, since he'll be incapacitated on Wednesday when his checkup was due. The surgeon from that operation was very happy with the progress, so that's one tick this week!
Then we had an unexpected call from the surgery of one of the doctors we've seen of late, telling us we were due to get a $200 refund! Two ticks. We were ecstatic.
We are due at the hospital at 12 noon tomorrow. Not sure yet of an exact time for the surgery on Wednesday.
It's been another 35-degree-plus day today so the air conditioner is getting a good workout.

Turn of events

What a difference a week makes!
This time last week we were preparing to see the oncologist to plan Rick's course of hormone and radio therapy for localised advanced prostate cancer (the cancer has moved outside the prostate into a neighbouring organ).
Having arrived home from Adelaide on Moday night we were planning how we would tackle the next few months of treatment.
Rick has been recovering well from his hernia operation 5 weeks ago but has been looking unwell (though very fit from a rigorous fitness regime) - in my opinion - ever since, despite the fact that he insisted he felt well. He has exercised and been eating healthily for a long time now so it was a shock when I had to take him to the local hospital on Wedesday morning at 8.30am suffering the symptoms of a heart attack. His heart rate did not go above 40 beats per minute for 2 days so there was obviously something very wrong.
By 3.30 pm he was aboard the RFDS plane bound for Adelaide and admitted to hospital just 90 minutes later for observaion, assessment and finally an angiogram on Friday. Jessie and I packed our bags and drove to Adelaide dazed.
Then the real shock came - he needs a double, and possibly a triple bypass this Wednesday.
The Dr says that had he not lived a healthy lifestyle he would've been back (after his heart attack and operation to implant a stent 2 years ago) a lot sooner.
Now he has two 90%, two 60% and one 50% blockages in the left artery. His right artery (where the stent is) is quite good, so he obviously has a predispostion to heart disease. We almost have 000 on speed dial as he is only allowed gentle walking so that his heart is not put under any stress whatsoever.
Now we can only pray that God will look after all of us as we face this next hurdle.
Rick should still be able to start hormone therapy to shrink the prostate once surgery is over, and then undergo radiotherapy in 6 weeks time providing all goes according to plan this week.
He will be having at least 3 months off work and I won't be teaching indefinitely.
We are so glad to have the unit as a base, even though the hospital is a 30 minute drive away, but we are grateful to have private health insurance and very good cardiologist, oncologist, urologist and surgeon - and we're learning a lot about human anatomy!

Sunday, February 11, 2007

My week....

No, the bathroom wasn't finished yesterday as promised, but it "will be tomorrow" are the famous last words.
I was determined not to go to Adelaide today until I'd scrubbed the tiles etc etc but I have had to concede defeat on that front.
There is only some silicone sealant needed around the bath and walls - at least we can use the shower, after 7 weeks!
To top it all off our landlord has been flown to Adelaide with the RFDS after a heart attack. Amazingly, I was crossing the road on Monday morning when he drove down the road, appearing to be asleep at the wheel, but at 9am that scenario was unlikely. He did not see me (nor did he respond to my wave) in the bike lane and when he nudged the kerbing he veered into the middle of the road and over the white line, narrowly missing another car. Apparently when he arrived at work he collapsed - that was after negotiating a roundabout and another 500 metres of the main street. He's very lucky not to have hit anyone.
Then....on Friday afternoon as I was pulling out of the kerb I witnessed a car accident about 200 metres from home - a local didn't stop or give way to an elderly couple visiting town. I called the police and stayed with the couple, both with heart conditions, until police and SES etc arrived. Fortunately noone was hurt but the local, who is known for his bad driving, said he'd "lost concentration".

Friday, February 09, 2007

The saga continues

Arrrrrrrrrrrrrggggggggggghhhhhhhhhh! The bathroom was meant to be finished today. But, you guessed it - tomorrow. Fingers crossed.
Then I can actually clean Kerran's room, the bathroom walls, inside the cupboards and wash the floor and it'll be free of ......... grot.

Tuesday, February 06, 2007

Not our choice

If this were our house, we would definitely NOT choose to have two different floor tiles in the same room! And I'm sure if the landlord lived in this house, he would also not choose to have two different floor tiles in the same room.
The ones in the forefront of the photo are the original tiles, which cover the rest of the bathroom floor, and the grey ones are the new shower tiles. Ugly.
Maybe when the shower screen is put back in it may - just may - look less obvious. They don't match at all.
The latest estimate for the work to be finished is Friday.
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Monday, February 05, 2007

To clean or not to clean?

That is the question.....
The tiler actually returned today - only 2 days later than promised - but at least he came.
So, the tiling and grouting are finished, but the shower screen, painting and walls are not. Maybe Friday!
Shock, horror - the plastering (applied on Friday) on the passage wall had started showing signs of moisture again this morning, but the builder thinks sealing it will force any residue water UP the walls into the heavens. Let's hope so for his sake. The landlord will not be impressed if he has to repair it for a third time in less than 12 months.
After 6 weeks of showering in the bathtub, I think I can be forgiven for being a little frustrated.
So, the question remains - do I clean the bathroom again so that it is habitable, or do we put up with the grit and grime till the end of the week?
With two totally different floor tiles in the room I have lost interest now, so maybe the latter option will win out this time round.

Friday, February 02, 2007

Passage wall

It seems as though the whole house is under siege! The passage wall was the worst affected wall from the bathroom moisture but it is finally dry and being repaired. Kerran's room is through the door and is also being repaired. Repainting is next. Another mess no doubt.
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Bathroom tiles

At least the new wall tiles match the original ones but the landlord has chosen not to replace all the floor tiles - only those in the shower alcove, so the ones on the floor won't match the rest in colour or size!
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Bathroom

Once again we have workmen in the bathroom, but at last we can see some progress. I think it's been 5 weeks!

The tiler finally rocked up after 11am today, had 2 hours off for lunch and has an awful lot to do before he's finished.

The hose attached to the bath tap has been our shower for the last few weeks - it's apt to disconnect and spurt water everywhere around the bathroom.

Another mess to clean up tonight. Grouting will hopefully happen tomorrow and painting some time next week.

The joys of living in a rental property is that someone else makes all the decisions and they are not always the ones you would make yourself. Having lived here for 24 years the house feels like ours (and we've looked after it as though it is ours) but we don't have much say in what happens.
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