Jason's Untimely Thoughts

Sarah remains in ICU, on the ventillator, under sedation.  That’s been the case since Monday at around 10:00.  She was moved back to ICU on Sunday.  They’ve told us she has a staph infection (MRSA), which they’ve been treating with antibiotics for a couple of days now.  They actually told me of that infection yesterday, but it took me a solid 24-hours to figure out what they were saying.

Today is the first 24-hour period in a while, perhaps since surgery, where everything they track remained stable throughout the day.  That in itself is progress at the moment.  The doctor describes the situation as playing a chess game, which seems an apt description.  They make slight adjustments to her treatment, which then hopefully make slight improvements for Sarah, and the game goes on.  And no matter how hard we try, we can’t seem to find anything to suggest to the docs to make it better faster.

She has a fever off-and-on, which is natural with the infection.  As her fever rises, so does her heart rate, which is also natural.  For the vast majority of today she rested comfortably, breathed easily (with the ventillator), and was very stable.  She has picked up a bit of a fever late in the day, but all has remained relatively stable since, with the temperature leveling off.

Progress at the moment is measured in baby steps.  I’d prefer it be giant leaps, naturally, or with a wheel chair rolling out the door, but am happy to be measuring progress.

Here’s to more progress tomorrow, Happy 4th of July to you and yours — or Poke a Beaker with a Sparkler Day, as we like to call it.

Technology sucks, but Sarah doesn’t. I hear that some haven’t received the update below, and the blog appears to be having issues as well (although it shows up fine on my iPhone).

Since Update #3, we showed up in the ICU this morning to find further improvement. While there were some rather large bumps along the way today, I go to bed tonight with the measurables all being better than they were this time last night. Her basic treatment is unchanged since last night, but the numbers are all either normal or coming that direction.

She has some infection in her lungs, which is unfortunately common and understandable given everything below. That’s seemingly the biggest obstacle at the moment. With that though, she clearly has amazing strength and will power, so we’ll be past it soon enough.

Thanks to all for the continued thoughts and prayers. And on a side note, screw ku.

*** Update on July 2, 11:53 p.m.
Sarah had a pretty stable day today, with no real changes overall.  There was a repeat of one of the “rather large bumps” from yesterday, but it was a bit smaller and handled more smoothly by all (including me).

Quite a bit has happened since this update, I’ll do my best to fill you in.  This will be mostly repeat information for any that I’ve spoken with personally.

Post-surgery, Sarah was in quite a bit of pain.  It took 24-hours or so before they had that really under control, and I now wonder if it was even under control then.  Initially, it was very difficult for her to breathe deeply because of the pain.  I thought it was going to improve with actions taken before they chased me out of the ICU, but it did not. Later, she was sedated heavily enough that it wasn’t her instinct to breathe deeply (and she couldn’t remind herself to do it because of the sedation).  Otherwise, her recovery was on schedule.

On Saturday, they moved her out of ICU into a regular room.  She continued to struggle with pain when inhaling, and with hindsight I believe she had started to lose some lung capacity at this point.  The situation worsened through the night, with the primary suspect being pain, not lung capacity.  Mid-Sunday morning, it became clear she was not receiving enough oxygen.

They put her on a machine called a BiPAP, which could be described as an oxygen mask on steroids.  Or a cool jet engine strapped to your face.  This happened around 11:00 on Sunday, and she was moved back to ICU shortly after that.  The goal of this machine was to improve her oxygen levels, which it did, while also reinflating her lungs, which it did not.  The experience was also miserable, so called for sedation and general unhappiness for all, but none more than Sarah, who did her best to take the stupid thing off whenever possible.

The BiPAP remained on until this morning around 10:00, when  they intubated her.  The respirator will hopefully reinflate her lungs (appearing to work so far) and provide her with steady supply of oxygen, which it is.  She is ‘out’ with sedation and appears to finally be resting.  They’ve also found signs of infection in her lungs (unknown at my last info what type of infection) and have started her on antibiotics.  She had a pretty good fever, but that has started to drop.  Her pulse rate remains much higher than I would think is reasonable, but they indicate it is normal and OK under the circumstances.  With all that, we’ve asked for and are receiving input from Pulmonology, Infectious Diseases, and Cardiology physicians, in addition to the surgical team.

It’s our hope that the fever dropping is the first sign of this stuff combining to work, with pulse etc to follow.  Time will tell on that.  All the stuff behind the purpose for the surgery continues to do well, by all indications.  Even further, all other vital signs and bodily functions appear to be doing very well.  Blood pressure and other routine readings have all looked good, even while they try to hunt down the cause for the other problems.

The ICU nurses are generally very good, so we trust she’s in good care there, which is critical since we’re not able to be in there much.  Visiting hours are for 30 minutes at 8, Noon, 4, and 8, so I’m in there for an hour or so then and briefly sporadically at other times (my rule breaking is just a minor part of why I’m not very popular here at Ochsner.)  Anyone is welcome to call/e-mail when you’re wanting an update, just be patient in awaiting a response.  While she’s in ICU I have way too much time to respond, so will certainly try to.

Got a stack of cards today, appreciate everyone’s efforts there.  Also got a nice Mizzou Bedpan in the mail, which happened to be blue with some fictional shoe-wearing bird on the outside.  It was appreciated the most.

Continued thoughts and prayers are implied, and appreciated.

Sarah’s surgery was completed about an hour ago.  Although we haven’t seen her yet, reports from the doctors are fabulous.

They removed all carcinoid they were able to find.  And they tried very hard to find it all.  And they didn’t find any carcinoid anywhere we didn’t already know it existed.  Exclamation points!! Exclamation points!!!!  Exclamation points!!!!!

All updates throughout the day and afterwards indicated Sarah handled the 5-hour procedure very well.  “Her vital signs are beautifully stable” was one of the reports.  I asked the surgeons how her liver looked and Dr. Wang responded that it was “one of the healthiest livers we’ve seen in a long time” with a big smile.  They believe it’s possible/likely that some microscopic disease remains in her liver, but “we’ll deal with that in 20 years or so,” said Dr. Boudreaux, and there “was much less (liver disease) than we expected”.

More technically, they surgically resected three one-centimeter or so sized tumors in her liver.  They then used radio frequency ablation to ‘melt’ another nine or so “BB-sized” tumors in her liver.  They also removed three lymph nodes that had carcinoid, and another “few” that were enlarged but didn’t show signs of carcinoid (but will test those too).  Finally, they removed her gall bladder as part of the plan (because the shots she takes can cause gall stones).  They used the geiger counter and couldn’t find any more disease anywhere, including in her stomach (or anywhere else).

Everything that happened was expected, and they didn’t do nor find anything unexpected.  They removed what we were pretty sure already existed, and were unable to find anything else to worry about.  I’m restating, trying to figure out if there’s a better way to say that this is essentially the best possible news that could have come from today.  A long, great day, broken up by a big storm and brief power outage in the hospital (waiting room, not the operating room).

Sarah will be in ICU starting here in a bit, for a day or two, then in a regular room for another few days.  Enormous thanks to all for all, on behalf of all of us in New Orleans.

even ku gets a pass today, stupid shoe-wearing mythical birds.

Sarah, Adelaide, Jack, and I arrived in New Orleans late Monday afternoon. My mom & Bill arrived at basically the same time, with Sarah’s parents arriving this afternoon. Sarah had appointments yesterday and today for lab work, an Octreoscan, an MRI, and other pre-operative admissions junk.

A few things of interest to many, it seems, that I’ve neglected to mention. Or some of it I did mention but got lost amongst my wit and anti-beaker spirit.

• Surgery is scheduled to begin at 7:30 in the morning. We’ve been asked to show up at 5:30, hooray. This surgery “typically” lasts between 6 and 12 hours. The nurse today indicated she’s seen it be as “short” as 4 hours, as long as 16. I’d certainly expect it to be within the typical timeframe. We’ll receive updates from the operating room every couple of hours, and I’ll try to forward on an e-mail after Sarah is in recovery. I’ll definitely e-mail this list again, but it may not happen until sometime Friday.
• After surgery, Sarah will be in ICU for a couple of days in all likelihood. Then in a regular room for a few more days. We’re hopeful this puts us back in Columbia on July 3, but that’s on the short end of their estimates.
• The hospital’s address is: Ochsner Medical Center; 180 W Esplanade, Kenner, LA 70065. Cards of encouragement are certainly appreciated, and while flowers, etc., are nice, won’t be very practical when considering the ICU and our travel schedule from there. The hospital said as long as the envelopes have the patient’s name included in the address, they’ll find the correct room.

Of note so far on the trip — turns out “Ochsner” is Creole for Hollywood. The carcinoid docs have set aside rooms where immediate family can stay in the hospital while the patient is in ICU. Normally on the second floor, but they are on the third floor temporarily. Because last week Harry Connick Jr. and others were using those rooms filming the upcoming made for TV movie Living Proof. After kicking them out, now allegedly Jim Carrey and Ewan McGregor will be on location this weekend filming I Love You Phillip Morris. I’m not making any of that up and am ignoring countless opportunities for jokes.

In my last update I included “snoop around like crazy” as part of the surgical plan. Evidently there’s some more technical aspect to that, as one of the docs was just awarded a patent for part of that process. I assume that means it’s less expensive now.

Finally, thanks to the Columbia Smith family for hooking us up with Tuesday lunch at Cafe Adelaide. We were all treated like royalty, but none more than Sarah and Adelaide, who was convinced the place was named after her. I ate at arm’s length from New Orleans Mayor Nagin who spoke of making numerous improvements to the New Orleans airport as a priority and guessed that “if you’re talking about $10 billion, I’d say no more than $0.5 billion or so” was unaccounted for. Um, I mean, where I ignored him completely and went about enjoying lunch with my family.

Appreciate your prayers and positive thoughts over the past few and next few days, the notes of encouragement and phone calls we’ve received, and the general you-the-manness of all in this crowd. I’ll update again Thursday or Friday (or both) as the situation allows. And on a side note, screw ku.

Given the occasional drawl that both Adelaide and Jack possess, I’ve been hopeful they’d pass as southern types.  Those hopes have been dashed.

Last night, the kids and I were going to the park after I finished dishes.  I asked Adelaide to “bring me y’alls plates first.”

“Um, y’all?” she said digustingly.  You’re supposed to say ‘your’ or ‘you guys’.  Or ‘Bring me yours and Jack’s plates, please.'”

I then informed her emphatically that “y’all” is a completely proper word.  And made her go find me some sweet tea, cornbread, and buttermilk.  (Not really on the buttermilk, it’s gross)

Congrats to Ben Askren, 2008 Olympian in Freestyle Wrestling.

Congrats to the beakers, for embarrassing themselves, junk-rubbers, and elevators.

And congrats to Jungle, new web director (effective soon) at the Missouri Department of Conservation.  In celebration, I went mudding in my truck through the state park and then drove through a bunch of local streams to clean my truck and empty out all my old chemicals that I keep laying around.

p.s.  I’ve discovered that sometimes I need to type junk down (or write it out, but I don’t write hardly anything these days) in order to get it out of my head.  The post below is example of that.

p.p.s.  I wanted the Celtics to win, but I’d much preferred they won with class.  Who does a Gatorade dump on the court while the game is in progress?  A beaker, that’s who.

p.p.p.s.  I have no idea what the proper format is for multiple post-scripts.

p.p.p.p.s.  Screw ku.

The setting is Father’s Day evening, at Mike and Sarah’s house with the Messer family, dinner, four cousins five years old and younger running around, typical loudness.    Until Tiger Woods lined up his putt for birdie on the 18th green.  It wouldn’t have been any quieter in there if everyone was asleep.  Of course the TV was silent, golf tradition and all, but I couldn’t believe how quiet everyone in the house was.  Then he made the putt, the kids start chanting “Let’s Go Tigers!”, and the action was back on.

Speaking of Tiger – absolutely amazing.  Although I did laugh when he backed off of a putt because a bird flew over.  Announcer guy:  “Was that a bird that flew over?”  Announcer guy #2:  “Yes, a sea gull!”  Both announcer guys go on in general amazement at the concentration required to perform with distractions like birds flying over.   All that said though, one of the most amazing sporting events I can remember.  Not that they need it, but kudos to all three of the top finishers from me – thought they all held up to the spotlight extremely well.  The drama that comes from those sporting events is why I have no use for reality TV.

Back to silence (and then selfishness and hypocrisy).  Two years ago Sarah was thrust into surgery, having no idea neither that it was coming nor the diagnosis that would happen after the fact.  We were blown away by the outpouring of calls, e-mails, etc., in the weeks and months after that.  She’s now readying for a fairly more substantial surgery, in all likelihood, but with the ‘benefit’ of preparing for a month.  It’s not so much of a benefit.  Dread, worry, and what ifs have entirely too much time to come to mind.  Yuck.  The silence of not knowing surgery was coming is a little helpful.

Coupled with all that, in general most of those we come in contact with are of the ‘uh, this is no big deal, right?’ opinion.   While that’s because of understandable factors – the old line about minor surgery only happening to someone else, my killing everyone with updates that everything was OK, the fact that she did undergo similar surgery successfully two years ago, the fact that she recovered from that remarkably well, and the point that we’ve been basically hoping for this surgery since then – it’s still weird to us, mostly because we have no idea how to respond.

Except for stupid blog posts, and probably even stupid enough for me to point out the stupidity of this blog post twice, you simply let them believe what they already do.  Sure, yeah, no problem.  Maybe we will get together for dinner after we get back.  Like sometime in September or October maybe.  Doesn’t feel right to tell them what you really think — that we expect the outcome to be good but the process to suck.  Maybe they’re saying it trying to be super positive, or maybe I don’t want to contradict trying to be super positive, or maybe it’s just silly.  And they’re trying to be nice and have problems of their own.

And I type this while simultaneously ignoring a request to provide our e-mail update list to a few people who are trying to organize a something, no doubt.  Because I don’t want a fuss made or people bothered.  The selfishness was the previous two paragraphs, the hypocrisy is now.

Or the Green Wave.  I recently signed up for Mizzou’s “Official Sports Report” out of curiosity.  Mostly generally stuff I already know, but sometimes offers greater detail and then an occasional new item to me.

Credit to them for the following:

The Tiger Who Owned Babe Ruth
Commentary Exclusive to Mizzou OSR
by Todd Donoho
Columbia, MO –  And now the story of Hubert Shelby Pruett.  His friends called him Hub.  His nickname was Shucks.

Hub was from Malden, Mo.  He attended the University of Missouri and lettered on the baseball team in 1921.  He was a left-handed pitcher who perfected a screwball.  Sounds kind of like Fernando Venezuela.

Hub left Mizzou and went to the major leagues where he pitched for the St. Louis Browns in the American League in 1922, 1923 and 1924.  If you were an American League pitcher during those years, that meant you had to pitch against the Yankees’ Babe Ruth during his prime — a daunting task.

Well, nobody pitched to Babe better than Hub.  Babe had fits with Hub’s left-handed screwball.  In his first 13 at bats against Hub, Babe struck out 10 times!  I’ll bet Babe said more than “shucks” when he struck out so often against Hub.

In all, Babe faced Hub 30 times.  He struck out 15 times in those 30 plate appearances against Hub.  He walked eight times, grounded out twice, sacrificed once, and got four hits.  Of those four hits, one was a home run.

Hub died in 1982.  Here is how his obituary read in the New York Times on January 30, 1982:

***********************
“Hubert S. (Hub) Pruett, a left-handed pitcher who was once a nemesis of Babe Ruth, died Thursday at his home in suburban Ladue. He was 81 years old.

Pruett started a seven-year major league career in 1922 with the St. Louis Browns. He had an uncanny fade-away delivery, with which, as a rookie, he struck out Ruth 10 of the first 13 times that Ruth faced him. During his career, Pruett struck out Ruth 15 of the 30 times he pitched to him.

Pruett retired from baseball after a seven-year career in which he pitched for the Browns, the Philadelphia Phillies, the New York Giants and the Boston Braves. His career record was 29 victories and 48 losses.

While still playing baseball, he had enrolled in the St. Louis University School of Medicine, and, having earned his degree after eight years, he became a practicing physician.”
***********************

That’s right, Hub Pruett went on to become a doctor.  He was a physician in St. Louis for 40 years.

A baseball player who became a doctor after his playing days were over?  Where have I heard this before?  Sounds like Hub Pruett was “Moonlight” Graham from the movie “Field of Dreams.”

I only have one thing to say after that.  Shucks!

Adelaide’s last ever day of pre-school was today. Allegedly they had some sort of graduation. “Yeah, you know, we wore, um, plate hats.” Sarah nor I never heard anything about this graduation beforehand.  She and Jack and I were outside, talking about how she was now officially a kindergartener. She was jumping up and down excited, I say “why don’t you yell out ‘Woo Hoo!'”, the kids’ traditional yelp of joy. “Um, whatever,” she replied, leaning casually against the pillar. Way too cool for that.

Jack’s birthday party is Sunday, he turns three on June 9. He wants a “Cowboy Party.” When asked what he wants for his birthday, “A black motorcycle and a swimming pool.” Everytime, those are his answers. Like in all the old cowboy films, I guess.