Monday May, 1 – Wednesday May 8, 2017

Monday – 5/1 –Rick drove to the Bradenton Yacht Club basin to help a few of the members who are replacing some wooden finger docks.  We met Bill and Ruth for our “Mexican Monday” supper.

Tuesday, 5/2 – Rick went to the yacht club to work on a dock restoration project while I stayed home and cleaned the house.  We made a reservation to attend his upcoming reunion.

Wednesday, 5/3 – I dropped Rick off at the yacht club to continue working on our “finger dock” while I went to have bloodwork done and then get my hair cut.  We stopped by JP’s to pick up our mail and discuss an e-mail we received from the builder yesterday.  We will go out to the model to discuss the changes they suggested on Saturday afternoon.

Thursday, 5/4 – We drove out to the lot this morning to see if any more activity had taken place.  For a very short time, right after we were married, Rick worked for a soil boring company, so it was easy for him to spot the borings that had been done.  The property is bordered by a conservation area, but we haven’t been sure where it started because of a lot of vegetation that has grown up on our lot next to the area.  The property is also located next to a lift station.  This is very unobtrusive and just means there is more vacant land between us and the house next door.  So, this morning, I walked to the back of the lift station property and noticed a tall marker in the woods behind it.  After peeking through the bushes to see what it said, we were happy to discover that it was a marker for the conservation property about 12 feet back from the cleared area. 

Friday, 5/5 – Rick went to the boat early this morning to meet JP who is going to help him work on the dingy lift wench on the top of the boat.  Ocala Health and Rehab center called this morning to tell me that Dad’s feeding tube has stopped working.  The doctor was called in to see if there was anything they could do to fix it, but he has recommended that Dad be transported to the emergency room to have it replaced.  The nurse said there was no need for me to come up there and she would call me later today to give me a report on him.  True to her word, nurse Lauren called me back about 3:30 saying that Dad had returned to the facility.  She said that the hospital did not have to replace the tube; they were able to fix it.  I asked her to tell him that I would be there to see him on Tuesday.  Rick and I spent the weekend on the boat.

Saturday, 5/6 – I left the boat to go to a “Painting with a Purpose” fundraiser for the North River Care Pregnancy Center which was held in the fellowship hall of our church. 

In the afternoon, JP, Kellie, Rick and I met with the builder’s rep at the model.  The discussion went well and we left about an hour later.  Rick and I attended the annual membership meeting of the Bradenton Yacht Club in the evening which was followed by a scrumptious buffet dinner.

Sunday, 5/7 – We went to church from the boat and returned to spend the rest of the day relaxing on the boat.

Monday, 5/8 – We picked JP and Kellie up in the early afternoon.  While her parents, Judy and Roy watched Emma, we went to the Bruce Williams Homes design center in downtown Bradenton where we spent more than two hours with Judy (design specialist) discussing our options for kitchens, baths, flooring and more.  Today’s meeting was to give her our initial feelings on whether we wanted the standard materials or upgraded materials.  This will help them to give us an estimate of cost for our new home.  Rick also talked to Britt Williams, the builder, who told him that a new survey had been completed with elevations.  He gave both couples a print out of the survey.  When we returned to JP’s house, Kellie took her mom out to dinner to celebrate Mothers’ Day early since Judy works on Sunday while Rick and I stayed and had supper with JP and Emma before returning home.

HOSPITALS – May 9 – May 20, 2017

Tuesday, 5/9 – We drove to Moffitt to have a second session of “stretching” of Rick’s esophagus. Rick felt fine after the procedure, so we drove to the cabin where I was going to let him stay and rest while I went in to see Dad.  But as the day went on, he felt worse and worse.  We called Moffitt about 3:45 and they said his symptoms could indicate a perforation of the esophagus.  I should get Rick to the nearest Emergency Room ASAP.

“An esophageal perforation is a hole in the esophagus.  Perforation of the esophagus is uncommon, but it’s a serious medical condition.  An esophageal perforation is usually repaired surgically. The condition can be life-threatening if it’s left untreated.”

Rick was transported by ambulance from Dad’s cabin in the forest to the Munroe Regional Medical Center in Ocala.  Once he was interviewed by the emergency room doctor, it did not take them long to confirm Moffitt’s predicted diagnosis.  Later the doctor came back and told us that treatment of this condition required specialized doctors and they did not have one on staff.  They wanted to transport Rick either to Moffitt (because he was already a patient) or to Shands Medical Center on the University of Florida campus in Gainesville (about 35 miles away).  After more than four hours, the physician in charge in told us that Moffitt couldn’t take him, so we were going to Shands.

Wednesday, 5/10 – Rick was transported, again with lights and sirens, from Ocala to Gainesville, Florida arriving at their emergency room around 1:30 a.m.  We saw a thoracic surgeon around 5 a.m. in the ER.  He told us that Rick’s condition could become very serious and, yes, life-threatening.  They could see from the CT done in Ocala that some fluids had leaked through the perforation into the area between his lungs – where his heart is.  The danger lies in a major infection forming.  So, they would be treating it aggressively with massive injections of antibiotics and monitoring his condition for approximately 72 hours.  While the perforation could typically be corrected with surgery, that would be the absolute last thing they would want to do with Rick because opening his chest would just spread the cancer.  The alternative was to put a stent into his esophagus.  They also saw fluid in his right lung and would be putting a tube into it to drain the fluid off.  This is the same thing that they did to his left lung when it collapsed in 2015.  He was admitted around 6 a.m. to the ICU and those procedures were accomplished successfully today.  They will keep him here for 3 to 5 days or longer.  JP, Kellie, Vanessa and Emma came up to stay with me, in a local hotel, until we are more confident that all is going well.  The doctor that performed the endoscopy and stretching at Moffitt called this evening profusely apologizing for his role in our current predicament saying that all of Rick’s doctors wished he was in Tampa instead of Gainesville.

Thursday, 5/11 – Rick was in a lot of pain when the critical care team came in for their early morning rounds, so the doctor ordered a different set of pain meds for him which helped pretty quickly.  The pain is from the incisions made for the drainage tubes in his right lung as well as from the stent expanding in his esophagus.  Both of these things are supposed to start feeling better tomorrow according to the doctors.  Now, he sleeps as much as possible.  Thoracic surgeon, Dr. Travino, came in around 1:30 and told Rick that it is very important that he use the breathing machine as often as possible.  This will help to drive the fluid out of the lung area thus avoiding getting pneumonia.  (A complication we really don’t want to have.)  The doctor said that Rick might be released on Monday.  After talking with the doctor, JP and I felt it was OK for him and his family to return home, as it looks like Rick will be OK.

Kellie accounts herself as a University of Florida “Gator” fan.  Imagine how excited she was to see the mascot, Albert Alligator, on the Terrace while we were eating a late lunch.  He was there helping to celebrate “Nurses Week” and was kind enough to let her get a couple of pictures with him.

The following came from Wikipedia.  “Albert E. Gator and Alberta Gator are the official mascots of the University of Florida in Gainesville, Florida. Costumed in plush, Albert and Alberta are anthropomorphic representations of American alligators, which are commonly found throughout the state of Florida.”

Friday, 5/12 – Rick had a CT done to determine if the stent has done what they hoped it would.  The doctor who inserted the stent came to talk with both of us mid-afternoon.  He said that there are no further leaks – yeah!  He showed us the CT and explained that because Rick’s esophagus is so constricted by scar tissue at the top the stent was not able to open completely.  It is working and liquid is flowing from his mouth to his stomach.  He will be able to eat any food as long as I liquefy it in a blender, for at least eight weeks.  He has been given a combination of nausea medicine and different pain meds which seems to be making him a little “loopy”.

Saturday, 5/13 – Rick has graduated to a clear liquid diet.  He ate jello, broth, and an Italian ice.  He also drank a little bit of black coffee in the afternoon.  His brother, Edward, came over for a visit and JP came up to see him and spend the night.  They are still trying to balance his medications so that he stays in the present a little more.

Sunday, 5/14 – Happy Mothers’ Day.  JP and I visited Rick in the morning.  He seemed much more coherent.  We left at the same time, him to go home to Palmetto and me to go to Dad’s place in the Ocala forest and then to visit Dad at the rehab center before returning back to the hospital. 

Monday, 5/15 – The chest tube was removed about 11:30 this morning.  The doctor said that she would contact the nutritionist; physical therapist; and social worker to come in to discuss with us what kind of foods Rick can eat; check his oxygen level while walking to see if he is going to have to be on oxygen at home; and complete all of the paperwork needed for his discharge which could be tomorrow.  The doc also ordered a chest x-ray to be done 4 hours after removal of the chest tube.  Things are looking up.

This will help avert unwanted drug you can try this out order cheap levitra reactions and health issues.
Tuesday, 5/16 – Rick said that the doctors had told him that the x-ray showed he still has fluid in his right lung and that they would have to put in another tube.  Therefore, he was not allowed anything to eat or drink this morning.  Just after I got here, the nurse came in and said that the report submitted on the oxygen test that was done late yesterday was not worded in such a way that Rick would qualify for oxygen at home, so she was doing the test again and wording in a different way.  As she was taking Rick on a walk for the test, the doctor in charge, Dr. Trevino, came in and told us that he thought that another tube would not be needed, but since there was still a question about his oxygen, they would keep him here one more day and take another x-ray in the morning.

Wednesday, 5/17 – Dr. Trevino said, the x-ray showed Rick was getting better but he warned us that he worried that the esophagus could rupture again if he has another dilation.  Rick may need to have another stent, otherwise the stricture will come back.  As far as follow-up goes, he does not need to see Rick again.  He said we should come back to have the stent removed, but everything else could be followed-up with the docs at Moffitt.  They are still trying to make arrangements for us to have oxygen to go home with as well as delivered at home.  As soon as that is taken care of he should be discharged today.  Later, one of Dr. Travino’s Physician Assistants came in to say that there was a now a question as to whether Rick should stay another night.  This morning’s x-ray showed a smaller air portion (good) but more fluid (not good.)  Now, they are getting a CT to get a better picture.  He will not be discharged today.  Mid-afternoon, a tank of oxygen was delivered and the rep. went over how to use it.  When he heard the level of oxygen Rick required, he was a little concerned as to whether we would need a different size or type of regulator to make the trip home.  Later, another person came with a different type of connection for the oxygen bottle which will conserve the oxygen and ensure that he won’t run out on the drive home.  Their Tampa office called to confirm the delivery address and when we expected to get home.  I will just need to call when I have a good idea of the time we will arrive home.

Thursday, 5/18 – When I came in this morning, Rick said that the doctors on early morning rounds told him that the CT showed more fluid on his lung and they were concerned that it might become infected, so they were going to put in another chest tube and drain it and he will be here for a couple more days.  The procedure was scheduled for 2:00 and he was not allowed to eat or drink from that point.  Then, several hours later, Dr. Travino came by and told us that he didn’t think another tube was necessary and Rick could go home this afternoon.  JP met an oxygen delivery man, Mario, at our house in the early evening, so that we would have oxygen when we got there.  We arrived home around 10 p.m.  What a roller coaster we have been on! 

Friday, 5/19 – Rick felt uncomfortable and very much at loose ends.  We called Moffitt to see if he could in to see his doctor.  The nurse set us up to go to their Direct Referral Center (DRC).  (I’d equate it to an emergency room for established Moffitt Patients with a doctor’s referral.)  We were taken right in when we arrived in Tampa.  They already had all of the records from Moffitt, Monroe Regional, and Shands.  They sent him for a chest x-ray and then for a CT Scan.  Then, they sent him for a needle thoracentesis where they removed another liter of fluid from his right lung.  Rick continued to be concerned that he hadn’t established a good pattern for when his medications should be administered (especially pain), so they decided to keep him overnight for observation.  I arrived home again around 10 p.m.

Saturday, 5/20 – When I returned to the Moffitt DRC, this morning, Rick was feeling much better.  The nurse told us that his morning bloodwork showed that he was very low in magnesium, so they were administering some thru an IV.  Later the doctor said that Rick would be released as soon as his magnesium level got back up to normal.  He told us that his bloodwork over the past several months had shown a low level of magnesium, so this was not something new.  After taking a second bag of magnesium in the afternoon, Rick was released and we returned home about 6 p.m.

Sunday, 5/21 – Rick was feeling good so we attended church services this morning.  After lunch of cream of chicken soup, JP, Kellie and Emma came over for a visit.  They showed us a video of the pre-school graduation ceremony that they attended on Friday night where 3-year-old, Emma, sang and danced to several musical pieces along with the other pre-school students.  We were so happy that we were able to enjoy it, through video.

Monday, 5/22 – We ran a couple of errands and did a little grocery shopping and then returned home to spend a quiet afternoon. 

Tuesday, 5/23 – While Rick was eating his breakfast on the back porch this morning, he had a couple of visitors.  You can see one of them in the picture below.

The Southwest Florida Water Management District website includes the following information about Sandhill Cranes.

https://www.swfwmd.state.fl.us/education/interactive/springscoast/sandhillcranes.shtml

 “Florida sandhill cranes are long-legged, long-necked, gray, heron-like birds with a patch of bald, red skin on top of their heads. …Florida’s sandhill cranes are a threatened species that are found in inland shallow freshwater marshes, prairies, pastures and farmlands. Sometimes they can be seen on lawns throughout Florida. … some sandhill cranes live up to 20 years.”

Rick was in a lot of pain again in the afternoon and finding it hard to breathe, so we went back to Moffitt.  They kept him overnight.

Wednesday, 5/24 – Moffitt removed about ½ liter of fluid from his right lung this morning and gave him more magnesium.  The doctors tell us that low magnesium is common when getting chemotherapy.  We met Ken and Jackie at the yacht club in the evening where Rick ate a bowl of French onion soup that had been put through a blender for him (minus the bread and cheese – so maybe just onion soup).  We had a nice “catch up” with them as they prepare to leave in the morning for a 10-day vacation on their boat.

Thursday, 5/25 – Rick is continuing to recuperate at home.  We went to Walgreens in the afternoon.  He is enjoying sitting outside reading.

Friday, 5/26 – We had planned to go to Ocala today to see my Dad, but Rick just didn’t seem to have the energy, so we put it off until next week.  We made a quick trip to get some groceries for tomorrow night’s supper.  JP and his girls are coming over and Rick’s brother, Edward, is coming for the long weekend.  After the store, we went to the boat to sit and enjoy the weather and the view.  Rick went to bed as soon as we got home and a few hours later, I was calling Moffitt again telling them that he had the same symptoms as mid-week.  They told us to come back.

Saturday, 5/27 – In the wee hours of the morning, Rick was admitted to Moffitt.   They have determined that he needs a permanent drain called a PleurX catheter in his left lung.  This will enable us to drain the fluid at home when needed.  Because of the Memorial Day weekend, he will probably not get the procedure done until Tuesday, so they will keep him here for the weekend.  Since I was at the hospital all night, I was too tired to cook, so I went to JP and Kellie’s for supper.

Sunday, 5/28 – Today, the doctors confirmed that Rick would have the catheter placed on Tuesday.  Edward drove over from Ormond Beach to visit his brother and then followed me back to the house to spend the night.  He took the picture of Rick below.

Monday, 5/29 – Rick told us that the doctors have ordered an echocardiogram as well as the catheter placement tomorrow.  Rick was tired so we left about 2:30 with Edward heading back to Ormond and me returning to Palmetto.  I took steaks and more over to JP and Kellie’s for our Memorial Day cook out (broiled in the oven) and Kellie topped off the meal with vanilla ice cream with sliced bananas and chocolate syrup.  It was delicious.

Tuesday, 5/30 – The doctors put the PleurX catheter in Rick’s left lung this morning.  He is doing OK.

Wednesday, 5/31 – Rick is still at Moffitt.  They were going to release him today, but when they used the PleurX catheter to drain fluid from his lung he had excruciating pain.  They decided to keep him another night.