9/30/2005

GOOD FRIDAY!




Today was amazing! Rob was great. Kate, the physical therapist came in today and got him all set to walk in the hallway. He was able to walk down the hallway and back to his room. We're thinking he went about 60 feet all together. He did so well. All the nurses were in the hallway cheering him on. One nurse actually called Cheryl (one of his nurses) and told her the good news. Cheryl called back and talked to me about how proud she is of Rob! We all had tears in our eyes to see the progess that Rob has done. Denise was so overwhelmed with emotion, she got all the nurses to cry. It was a great moment. The nurses were great and stood at his room to see what Kate was going to do with him next. He got up and sat in the chair. He was tired from all that exercise. He ran marathon today!

Rob also got half of his staples out. Dr Colen came in and took them out. Rob said his incision was numb, so it didn't really hurt. They pinched the staple in the middle and it came right out. He got his pic line in his leg out. It didn't bleed at all, so that was really nice.

I took Rob to Disney World today. We got a game down here called Magic Kingdom. It is set up so you play in the park and go to different attractions. It was so fun. He won, of course!

We are grateful to have a good friday. For awhile every friday seemed to be scary. We thank you for all your prayers. They worked, keep them coming =)

Going forward


So far so good today. Rob has already been up in his chair. Everyday he is looking stronger. One of the residents, Dr Wall,came in today and said good bye to Rob. She is off to a new area in the hospital. Rob was sad because he really liked her. She told us that his chest xray looked "surprisingly good!" She looked happy with the results.

Rob had his foley catheter taken out today. It's nice to see progess. One less thing to walk with.

He is having a lot of pain in his left lung today. We're thinking it is from his procedure yesterday. We told him he looked really good and he said he was in a lot of pain. So then I said, "Well Pain equals beauty" and he responded.. "Well I must be gorgeous!" And of course he is.

9/29/2005

Another big day!

Rob just amazes me. He is great. A Physical therapist came in today. Her name was Kate Walker. He was able to stand up and walk with a walker. He walked in a circle since he still has a chest tube in and the machine doesn't have a long cord. But he did so well. He was able to do 10 small squats, 10 ankle raisers and 10 knee lifts. When he was exercising Kate needed to watch his oxygen levels and his finger thing wasn't registering. So I pulled out the gift Mike and Denise got Rob. A Nonin Onyx sensor. It measures the oxygen level fast and your heartbeat. Kate was laughing because she said she never saw a patient own one of those. She said she'll be back tomorrow to have him exercise a little more. He also was able to sit in the chair for an hour and a half.

They took out his arterial line. One time when Mike and Denise were in the room they took one out and it wouldn't stop bleeding. The nurse told Mike to find someone to help with Rob's bleed. The person who came in asked what was his platelet level and his nurse didn't know. So today, Denise made sure Rob's blood was doing well and it would be ok to pull it. Everything went well.

Rob is still has the feeding tube in. That is nice since he is getting a lot of calories still. Rob is able to eat with it in, but it's a little harder to swallow. They were talking about cutting down on the feeding tube amount, maybe only running it at night, so he would be hungry during the day so he would eat more real food.

It's been nice to spend time with Rob. He is acting more like himself. He always makes me laugh. It was fun today for me since I was able to spend a lot of time alone with Rob. I was with him with the physical therapist, when they gave him a bath, and when they put him in the chair. I'm getting used to being a little nurse. Maybe I need an outfit, any ideas?

Talc powder

They decided to do the talc powder in Rob's left lung. What they did was mix talc powder with liquid, then insert it in his chest tube. They are trying to successfully remove the chest tube without anymore problems. Doing this procedure will help that. It helps scar tissue to form making the lung adhere to the chest wall so it will stay open. Once they inserted the talc, every 15 minutes Rob had to move into a different position for two hours. At one point he was angled so that his head was lower than his feet. Surprisingly that looked the most comfortable since he fell asleep.

Rob is having another good day. He hasn't sat in the chair, but moved around quite a bit from the procedure. He was able to have bacon, eggs, hash browns and an english muffin this morning. He didn't eat all of it, but he was so excited to be able to pick and choose what he wanted to eat.

9/28/2005

Liquids!


Here's Rob decided which drink to drink next. He had quite the selection. Today was a very good day. Lots of progress. They removed one of his chest tubes. They xrayed his chest afterwards and said everything looked good. We are very excited about that. We'll see what tomorrow brings! Keep scrolling down to see more pictures!

Blue gatorade


Here's Rob drinking gatorade!

Getting Food!



Here is Letty and Rob. This was when he got a whole plate of real food. He says it wasn't the best, but it was something to eat! Letty was his pca today.

Cheryl


This is Cheryl. She is great. We just got her address, email address and phone number to keep in touch when we go home. She got Rob a balloon that says Congrats! She was so proud of what Rob has done these past three days.

All clean


Here we are washing Rob's hair. He has had his hair washed with a cap and some soap in it before, but that didn't work very well. So today we decided to figure out to wash it with shampoo. They did have baby shampoo there, so we decided it was worth trying. Rob kept pointing at me to wash the hair. So here is a picture of me and his pca Lettie washing it. Cheryl was laughing because of how flexible Rob was. And yes... that is a bed pan and a urinal we are using. =) They were both clean.

Walking!

Rob is doing well. Cheryl got him to walk to the window and look outside. He liked having the sun on him. Right now he is sitting in the chair. He is looking up psp stuff on the internet. It is nice to see him sitting up and playing on the computer. A physical therapist stopped by today and will be back this afternoon to work with him. He is also eating lunch. He is still on an all liquid diet, but the nutrionist stopped in and said maybe some solid foods for dinner. Rob gave the thumbs up for that. So far another great day.

9/27/2005

Dinner!

Denise here--

We just got back from the hospital (Marla, Diane and I) and we were impressed with and grateful for another good day for Rob. He was very tired last night after being up a few times during the day and at the evening visit Mike and I just enjoyed watching him sleep so soundly--it was a terriffic anniversary gift!!!

He got up twice today for an hour in the chair. This evening they brought him a "dinner" tray of liquids, jello and sherbet--the sherbet he liked the best. I came in to see him sitting there eating with Marla by his side and it was so fun. He had a little twinkle in his eyes. He had been resting during the afternoon and I didn't think he had the energy to get up again and--wow--he looked good sitting in the chair.

Rob knew to the hour that the pain patch on his back from 3 days ago needed to be changed. He keeps the staff on their toes because he knows what's going on around him.

Happy Birthday Poppa!! And happy belated birthday Delores (things have been so stressful sorry we weren't on the right day.) We love you both so much!!

How are Steph and Dan's girls?

Doing well



Rob is having another good day. Mike left this morning for Minnesota. My mom and I went to the hospital early. Rob was sleeping soundly from 8:30-10. It was nice to see him a good tired, not a drug induced tired. Rob has Cheryl again. She is soo good. Rob was able to stand and move to the chair. He sat there for an hour. My mom left us alone and Rob and I were able to sit and talk to each other. It's weird to hear him talk now. He was showing me all the cars he liked in the car magazine. I helped him walked backwards to his little bathroom in his room. The nurses were able to give him a bath and change his bedsheets. He also drank blue gatorade and apple juice. He is on the trache collar. He went four hours without pain medication. He was tired when we left. Denise is in the room now. Hopefully Rob will be able to sleep this afternoon so he will be able to stand and sit in the chair again.

9/26/2005

Swallow test!

Rob is doing well today! We walked into his room this morning and he was sitting on the edge of the bed. Then he was able to stand and walk over to the bathroom. He got a bath and his bedsheets were changed. Cheryl is his nurse today. She is just so good with Rob. She was or is in the military and she set up a list for Rob of things she wants him to be able to do this week. One thing on the list was Rob being able to go more than 2 hours with morphine. He had been on a constant schedule of getting morphine every 2 hours. So far today he's been able to go 3 hours.

He was also able to speak to us today! It's not his normal voice, but it was great to hear something. They put a little cap on his trache and it allows him to use his vocal cords. Michael, a speech therapist came into see Rob today. He bought in grape juice, apple sauce and Boost chocolate pudding. Rob was able to swallow them and Mike was great. He talked to Rob well and was able to calm Rob down when he got a little anxious. Now we're waiting for the doctors orders. Rob asked to keep the feeding tube in for a couple days because he didn't think he could eat enough. The feeding tube is giving him a lot of calories, so we don't want it out yet either. It takes a lot of energy to eat enough food to fuel your body. Rob was getting tired, so hopefully he is able to nap. Denise is over there right now. Thanks for all your comments and prayers!

9/25/2005

Sunday update by Mike

Today Rob was moved back to 7th floor. He is happier there and we are used to the area. We went to church this morning and had so many people offer help and support. The bishop there is also a neurosurgeon at the same hospital that Rob is at. He has visited Rob twice already and we appreciate the extra attention. He has reassured us that Rob’s doctor is the best in the world for what Rob needs. Rob has put about 3 to 4 days of reasonable sleep and rest together. We sense he has a little energy now and that if he could get unhooked from some of the wires and tubes, he could stand and walk a little. Laying in bed and no real food for 5 weeks is taking its toll. He made a list last night of apple juice, blue Gatorade, cold apple sauce, and chocolate pudding as his desire to try if they allow him to drink or eat anything. With the hurricane, we think a lot of tests, etc. are delayed. This week should bring more normal operations at the hospital.

The hurricane really was not an issue in this immediate area. There are no gas stations with gas and there are many street lights not working. Stores and restaurants are closed, with very little exceptions. The hospital seems back to normal today, but struggling for staff. Only leaves and small branches down around this area. People are told not to return until Monday or Tuesday for opening stores and most schools are closed until Wednesday. Landon’s rotation is delayed until October 3rd. Jen is still waiting for a call to start her work. This will give them a week or so to shop and get their apartments set up. I am trying to fly out this Tuesday to work for a week or so and then return.

Marla and Diane are at the hospital now and we are waiting to hear how Rob is doing. The phone just rang and we have a little update from Diane. It is 1PM and Rob is tired from the move upstairs. The nurse does not feel he will be able to drink or eat today. Maybe tomorrow. (?) Landon and Jen just went over to be with Rob. Maybe he can get a better sleep up in intensive care. It is still loud there but at least there is not a loud speaker over head that is used all the time. We are grateful for each day that he can remain stable. We pray for each day of healing and more ability to breath on his own. We appreciate all your thoughts and prayers. We hope to have a more upbeat report tomorrow.

9/24/2005

Isn't he cute?



Rob has been having a good day. He has been able to sleep a little bit. He looks rested and told us he is ready to fly out of here. He will be moved back upstairs tomorrow so we will be able to see him more. It is also quieter upstairs. The poor nurses look tired. A lot of them have been here for a few days. His nurse Cheryl told Rob she will be back monday. We had never had her until this week and just loved her. She said that we hadn't had her yet because once the nurses have Rob, they want to keep taking care of him! We showed some nurses today pictures of Robs' and my honeymoon pictures. They said it was nice to see Rob out of a hospital bed. He's so cute.

Landon moving

MOV00488.MPG

We just went to see Rob. He is doing well. He was able to sleep ok last night. We weren't able to see him very long. We will be seeing him around12:30. We haven't heard anything about Rob doing the swallow test. He is on the trache today, but not on the collar. Rob is being very patient about that. He did say he was thirsty and hungry, so hopefully soon!

Some pics






I know bri.. some are blurry. I'm trying to be a better photographer. Here is where we stayed last night!

We're alive

But extremely tired... The floor is hard, people are not smart, they would stand in our room and talk.. the nerve... There are vending machines in our room. As fas as we know, we barely got hit. There are leaves and branches on the ground. Mike got up this morning and drove around. He saw no cars and dark and windy. A little drizzly.

We haven't heard anymore about Rob. We all said that last night was probably the first night that Rob got better sleep than any of us.

We are packing up and going back to the hotel. Thank you for all your prayers. They worked.

9/23/2005

Eating strong

Hello everyone! No... Rob hasn't eaten yet. But we have. A lot. Cafeteria was open for dinner, so we ate there. We tried getting back in, but it was closed.

Rob is doing well. He has been sleeping pretty well. It's nice to see him sleep. He was watching tv for a little while. Earlier today, Cheryl helped us cover the speaker on the ceiling because it was so loud. You should have seen it.. She was on a chair taping up washcloths and paper. It helped a tiny bit. He has a new nurse for tonight and she is nice. Alison with one L.

So far just raining. We are waiting for the flying cows and whales. We think all the cows are inside and the whales... who knows. So we're sorry Bri. As for mom (Diane) hanging from the street sign, we're locked in and can't get outside. We feel safe where we are. We look forward to sleeping with bright lights over our heads, a hard floor, vending machines and three phones that ring all the time.

We will try to keep updating... We have now found a secret phone line that rings a lot... so it's now quiet in the room while we're on the computer... =)

In the hospital

Hello everyone! Rob is doing well. He is back on the trache, so he can get some rest. Rob's nurse Cheryl is awesome. She got Rob into his own room. He has a tv and a fan. Rob is happy about that. We hugged Cheryl and said Thank you!

So far no sign of the storm. Mike, Jen and landon were able to volunteer some. Mike was answering phones, Jen was filling up bathtubs and Landon is still gone doing something. Mike is going to go up soon to keep helping. Diane, Denise and I are claiming our spot and not letting anyone take our chairs. Look out we're pretty mean. =) So far there aren't too many people in this waiting room, but you never know.

We are eating our food supply right now so we will have to see how long we last. We just got visited by Bishop Thomas Mims from the ward here. He was very nice. He had a nice prayer with us. He also told us he would feed us at one point so we can't wait.

We will try to keep you posted. Hopefully we won't lose electricity.

Getting ready...

Rob is down on floor two. He was brought down yesterday around 7. He is now with four other patients in the room. There are curtains between them all, but it's loud. He was able to sleep ok last night. He is away from all windows. The windows that are down there are boarded up with plywood. He is pretty bored too. There isn't a tv, so we're bringing him the laptop.

Rob is on the trache collar today. That is one step closer to eating! The nurses in his room are two that we like, so today should go well.

As for us.. We'll be in the hospital. Mike asked to help around the hospital and they said that will be nice. So we will see what kind of help any of us could be. It is already more windy than normal.

We will try to update later. We are unsure if we'll be able to update this weekend. Thank you for all your thoughts and prayers.

9/22/2005

We're grateful for...

1. Rob had a really good day
2. Rob's heart has stayed strong through out high blood pressures and fast heart rates at times
3. That his heart rythmn was able to stay corrected after the changes in blood pressure and craziness.
4. He doesn't remember the first two weeks
5. His wonderful personality
6. Rob's bleeding problems/surgery was last weekend before Rita and not now
7. For Tessie saving his life a couple times
8. Mike saving Rob's life a couple times
9. Marla medicine
10. Hurricane katrina hit so Jen and Landon have been here
11. Rob being moved down to the second floor away from windows in prepartion for Rita
12. A roof over our heads (for now)
13. A dvd player
14. The skills and knowledge the doctors have
15. The nurses and pca's that have taken care of Rob
16. This website
17. The hospital chaplain for his meeting with us and having a nice prayer after code blue
18. 10 pillows for Rob
19. Apple releasing the Nano at the perfect time for Rob
20. Rob's sense of humor
21. Rob having legible handwriting
22. Rob's patience with us trying to understand him
23. M&M's
24. Target
25. A hotel with a fridge in it, so we had food to eat today
26. Skyway system so we don't have to walk in the heat
27. Disneyworld (for Rob to dream about and plan vacations for)
28. The Galleria
29. Medications that can relieve Rob's pain
30. The jewish/mexican family that always ask about Robbie
31. How the staff loves Rob
32. The people that have been putting Rob on all the temple prayer roles
33. Handheld fans
34. Rob having good family and friends
35. Psp
36. Computers
37. Cell phones
38. Bennihanna
39. Nutrition that Rob is able to get
40. Rob being able to have a trache
41. Cars
42. Air conditioning
43. People's videos for Rob
44. Hospital beds that turn into a chair
45. How the beds are air cushioned to relieve pressure
46. Robbie being cute
47. Rob being able to be suctioned since he can't cough to make it easier to breath
48. Everyone down here being healthy and able to be with Rob
49. Insurance!
50. For everyones prayers, thoughts and comments. Thank you

Mike had time to use his lap top.

Another Long Post by Mike.
September 22nd, 2005.
I will try to highlight each paragraph so you can decide if you want to read it all.

Rob’s condition. Denise and I arrived at 7:50 this morning in an attempt to catch the doctors. We had missed them. They do their rounds between 6 and 8 AM to avoid family encounters, I think. Rob had asked them how much longer he would be in here. They said he needed to get his breathing down and then they would consider removal of chest tubes and allow him to proceed with therapy. He seemed a little frustrated this morning. I like to see that because it means he is focusing on being home and not all the pain of surgery and the struggle for every breath. His statistics look better each day - if only by a little. His heart rate is now at the low 90’s, blood pressure is 125/64, oxygen levels at 95%. He is back on the respirator at present but I hope the respiratory therapist will put him back on cpap to breathe more on his own. The O2 level on the machine is still at 60%. While breathing on his own through the machine the 02 needs to be at 40% to imitate normal breathing. He is basically breathing through a long straw. Normal O2 in the air is about 21%. His chest tubes seem to be releasing very small amounts of fluid - which is normal. They have begun thinning his blood so we are nervous about any more internal bleeding. He is being given morphine on a less frequent basis now and he is not real happy about that since his pain level is still about a 6-7 out of 10. That is a good improvement in the last 3 days. He is sitting up now but still leaning back which is great-- compared to being hunched over all the time like before. He does not want his feet, back, or neck massaged right now. His window shades were open when we came in and he did not want them pulled. This is also a great move to allow him to get his night and day time orientation. With the coming of hurricane Rita I am not as happy to have large windows in his 7th floor room. We will check to see what precautions they are taking for flying debris and high winds. He is still getting drugs to control the heart rate and blood pressure and they are working better as his body heals from the most recent surgery. He is moving his left arm a little more and that is encouraging. His color looks a little pale and I sometimes wonder if they have equalized blood input with all the blood loss he has had. They draw blood from his leg IV and I will check on the indications with the nurse. It is pretty quiet around here this morning and the city is beginning to look like a ghost town. I hope enough staff stays on through the storm to care for the patients here. I just asked Rob if he remembers the deal his brother Brian made with him about growing his beard. Bri can’t remember if it was until Rob got off the respirator or until he got out of the hospital. Rob smiled, but could not recall either. It is just heart warming to see him relax in his bed and look bored and frustrated with the whole thing. Yesterday as his PCA, (personal care assistant) Sharon, gave him a bed bath, she could sense he was becoming frustrated and a little down. In her great happy voice and big smile, (with her heart shaped gold tooth) said “The good Lord is in control! You know dat? You know he won’t gei you mo dan you can hanel - you knows he won’t!” I just love her. She is such a happy worker and makes many bright moments in Rob’s days.

What do we do all day? Our normal day is that I come over at 8 in the morning and sometimes Denise joins me. The mornings are great times --when Rob has had a reasonable sleep. Marla and Diane come over at about 10 and stay until about 12-30 or 1. Then Denise, or Jen or I give them a break for lunch. Marla and Diane come back about 3-30 to 4 and stay until 6. We sometimes change things around to allow for laundry, shopping, and other small chores to be done. In the evening Diane and Marla usually come over with some assistance by Denise, Jen, Landon and me. Our days are pretty full between visiting Rob, shopping for stuff, doing laundry, checking email and returning calls. Denise is trying to read her college course work and I am trying to stay up with work by email and phone. Diane has gotten the girls interested in reading Mary Higgins Clark books so they have a little diversion. I bought this laptop so I can keep up with work stuff and write long posts to bore all of you. When Rob is resting we can get some reading and writing done. We have 2 rooms in the local Best Western which is about a 7-10 minute walk to Rob’s room. It is an ok place but the elevators seem to be out of order as much as they are working. We are on the 4th floor so we get a little extra exercise. They have a tiny little kitchen and Diane and Denise purchased a toaster and skillet so we have toast, grilled cheese, and some stir fry meals to avoid eating out so much. Our hotel rooms have two separate rooms, each with a nice TV with about 12 channels. Yesterday Marla got a package from her sister Nichole with a DVD player so maybe we could watch some movies now.

Jen and Landon, our refugees. Since hurricane Katrina, it has been a pleasure to have Jen and Landon here. Landon went home for awhile and just returned yesterday - just in time for hurricane Rita. Jen and Landon feel like they may be jinxed. They found a couple apartments in a complex about 10 minutes away and were supposed to be able to move in yesterday -- however, the offices already closed down due to the hurricane. We were trying to get household items to help them get set up but we need to wait now. I enjoy having them at the hotel with us for a few more days. We may consider moving in with Jen for awhile starting in a week or so. Jen had orientation and is supposed to start back at her job on Monday but now with the hurricane she may need to wait some more. Landon is scheduled to start medical schooling again on Monday. We found a lot of cool stuff at IKEA for cheap furnishings for their apartments. Jen negotiated a great deal at the mattress store near their apartments so they each have a mattress. (no frame or box spring. - It is great to be young and able to get by on so little.) They both have such great abilities and wonderful dispositions.

Future plans. I was scheduled to fly home for a week this Sunday. With the hurricane, I have changed those to Tuesday. My clients have been patient but the IRS is not. I am hoping that I can pay the bills, get caught up at work and return the following Tuesday. I have been constantly scheduling out Rob’s recovery on a daily schedule I keep. It has been changed many times but it is important to have small goals to work towards. At present I am projecting another 3-6 days in intensive care and then a transition to another facility where Rob can be up and around and gain back his strength. I would expect a week or two in there and then be able to come home. Melissa may come out during the time I am gone to be with Denise. It is so helpful to have someone close during many of these times. My prayer is that Rob will now have a normal, steady recovery.

Thoughts on adversity. I do not feel like I have had much adversity in my life. Even now, it is not me that is in pain or hurting. I can understand the need to go through difficult times in order to become stronger, wiser, and more empathetic. Many times we have wished that we could take Rob’s pain so he could rest. As a parent there is a deep hurt when you have a sick child - you feel somehow responsible for the suffering. You do not feel like you deserve to be happy or comfortable when your child is hurting. You feel so helpless to comfort the one you love. I try to understand a little of what Rob is going through based on my heart surgery in May. I have been told by the staff here that “that was like having a band-aid put on compared to what he is going through!” Even with the little I went through it allows me to understand how totally exhausted you can be. I remember crying at the breakfast table one morning, 2-3 weeks after the surgery. I didn’t know if I would ever feel strong again. I do feel strong again! Time -- that is the answer to so many of our challenges. We can’t get around them, we cannot avoid many of them, we need to take the TIME to go through them. It is the process of time that teaches us the lessons that will help us in the eternities. Before Rob’s surgery it was clear that he had already been through enough with his other two surgeries to be at peace with the procedures he would be facing. It is so clear that his wisdom came from suffering through his other two operations. He is young in years but very mature in his understanding of life. I love the promise in Corinthians from Paul which says we do not see clearly now - but we will. I know that the process of understanding all these things comes with time, and I know that we will learn to accept and even embrace all these experiences - in time.

Thank you all! It has been a real help to read all you comments and hear from so many of you. Denise and I have commented many times that it is so comforting to know that Rob is remembered in so many prayers, notes, thoughts, videos, pictures, etc. I have not worried about home with Melissa watching over things. It was so great to get a call from Uncle Gordon last night and his reassurance that our basement would not flood even though the power was out and our sump was ready to overflow. After he talked to me, while in the basement, he did not disconnect his cell phone. I heard him talking to Tom and telling him, “We gotta get a power cord over here somehow.” Tom said, “Run a cord from our house? Are you crazy?” I then hung up with the comfort that it would be figured out. Thanks, Gordon, for always making me feel like there is nothing you would not do for us!!! And for the call back that you got it all taken care of. I appreciate all the offers of help from all of you and I know if I needed anything I could call on any of you. Thanks, Brian, for the great web site and the work to keep it all going. Thanks, Kevin, for being such a hard working missionary. Keep up the great service. It is so nice to have Jen here and a willing partner in visiting and supporting Rob. Most of all, like always, I cannot describe my gratitude for Marla. She is a mature, loving, faithful, beautiful wife. Rob is so blessed to have such a wonderful, best friend. Thank you Diane for being such a great support and comfort to Marla. Thanks, Kent for letting your lovely wife be away so long. To my wife of 30 years (Our anniversary is in 4 more days!) and my best friend, I love you and thank you for caring for all of us so tenderly. Thank you all, so much.

9/21/2005

Our first date =)

Today Rob and I were able to be alone and just talk for 45 minutes. Well he wrote, I talked, but that's the best. He can't write as fast as I talk. We made plans for future dates like a trip to Disney. He just looks more like Rob now. He is still in a lot of pain though. They did put him back on a pain killer that should last longer for him. He has it in a patch form, so hopefully it will last for a few days. Rob's drainage seems less each day. He was on the cpap most of the day which is just one more step to recovery! Rob wrote to me that he wants to take things very slow. He doesn't want to keep taking one step forward and then two back. He's such a smart boy. Cute too =)

Landon and Jen went over tonight. He was watching tv pretty much the whole time. He is moving around more, sitting up and laying back.

As for us and RIta... One of the nurses quietly told us to come to the hospital and stay there. They are not advertising that they are a shelter, but they can't kick us out. The hospital is the newest of the buildings and has it's own generator. It was built after hurricane Allison in 2001. We were told it is hurricane proof. So we'll just have to see.

Back on the c-pap machine

Mike just phoned me (Denise) and said when he was there this am a group of doctors came in and told Rob they were putting him back on the c-pap machine (instead of being assisted full time by the ventilator) and wanted him to soon be on the trache collar so he could eat and drink. And then one said, "We want you out of here!"

Mike said Rob slept "so-so" last night and when I phoned at 4am the nurse said he had slept off and on--that's so good to hear. He was lying back a bit inclined through the night also which is better than a week or so ago when the only comfortable position was slumped forward on his bed tray with pillows. He says his left arm feels a little better--Mike saw the incision on his side and said it's no wonder he hurts, it's quite good sized with staples holding it together. Rob must feel like a major pincushion by now.

His blood pressure and heart rate are good this am but they both go up so high when they suction his lungs. They do that plus the nebulizer treatment to loosen secretions that he is unable to cough up with a trache. They started the coumadin yesterday and hopefully they are giving him smaller amounts so there is no internal bleeding like last time.

We are so grateful for each and every improvement that Rob makes. We know that the Lord is watching over him and are so grateful to all of you for your sustaining prayers.

We also pray that hurricane Rita can somehow evaporate and not shut down the Houston area--we've been told the hospitals here have huge generators to keep things going. Hopefully there won't be any problems. Jen and Mike are out getting supplies for hers and Landon's apartments that Jen found. Since they couldn't get back to N.O. this week with another storm coming, they don't have the basics they thought they'd have from their past apartments and have to start from scratch. Their past places had beds and a few other pieces of furniture--these have nothing.

9/20/2005

"HGTV is my favorite channel"

Well we all know that the hospital doesn't have many channels when Rob wrote to me, "HGTV is my favorite." Tonight we were trying to get him connected to the internet, but the cord was a little to short to reach. So Rob decided he wanted his bed at an angle. We joked with him that he is redecorating the room. He pointed out that now he can see the tv better and outside a little bit better.
Rob is doing a little better. He is still on blood pressure medication. Right now his stats look good, so we're hoping they stay that way. He still has drainage coming out. But his color looks good. He was able to watch a few movies from the website and they got him to smile.
Thank you for all your prayers and comments! We're hoping that the pain will ease and he'll be able to regain his strength and move forward.

A short one

In case you are still reading Mike's post, I'll just write a quick one. =) Rob is doing well. Rob has been complaining about his left arm hurting him all day. We all got worried since he does have an aneurism around there. A doctor came up and said that during his surgery on sunday, they twisted his arm weird, so they are thinking that it is what is causing the pain. They will keep monitoring his arm. Rob is still in a lot of pain. He watches the clock and waits for pain medication. Hopefully he will start healing and be in less pain. He actaully looks more comfortable. He has been laying back more, so it is nice to see him more relaxed.

Long update, Rob is resting

I will just post a typical report I try to give Marla and Diane when they come in at about 9:30-10. I also like to write all this stuff out so I can tell Denise and Jen all the latest. Between all of us we try to keep a watch on so many different readings. We do not understand as much as we would all like to, but we can read Rob pretty well and are sensitive to any little improvements, and other changes.
8 AM Sept. 20th. His nurse today is Larissa, with the “i” sounding like an e! I think this is the first time we have had her. His PCA is Lettie and she is a short little gal who has been very nice to have. Dr. Coselli and his team had stopped in earlier. Rob had asked them to come back when I arrived at 8. He had taken some morphine at 7:50 so he knew he would be out of it. He complained to me of pain in his left arm. He said it hurt so much that he needed his right arm to move his left arm. I told him I thought it was due to the surgery and the probing up and around his chest area. He showed me the pain in his arm pit area extending up to his collar bone area in both front and back from the way he was motioning. I reminded him of the recent surgery and that it will take another day or two for his body to adjust to the probing up and around his chest cavity. That is also an area of another aneurism, so I hope it is just surgical pain. He said his pain level is about a 7 when not on the morphine, and about a 2 when he has some. He says he can lay back now. When I asked him if he could lay back and still breathe, he gave me the thumbs up. He says his breathing is very labored, and that it is hard to take a deep breath. When I asked him to take a few deep breaths so I could check his volumes, he did a couple breaths over .500 CL. He was tired so I told him to rest, because that is his number one job right now. He still likes to rest in an almost sitting up straight position.
His heart rate is about 105 and BP is 145/80 and O2 readings staying around 94. His temperature is 100.2. He seems to be resting comfortably after taking the morphine. He has his feeding tube in his nose now, which he is grateful for. He is on the vent with 60% o2 and 500 as a setting for amounts to breathe as an average with 4 minimum beats per minute by machine. He is at about 16 now and was at 25 when more awake. He said he slept some during the night. He was sure glad to see me this morning. His container for collecting his chest fluids has 2 chambers, since he has two large tubes coming out of his left chest. It is measuring about 375 on #1 and about 540 on the other one. # 2 is pretty red and looks like similar blood as before surgery. It may be a little clearer. #1 is more yellow in the tube and looks less active compared to the other one. Dr. Coselli said it could take a day or two for that to work itself out. He has an IV line in his right leg for blood pressure monitoring and for infusions. They are running out of any veins they can get to stay open on his arms and I think they want to stay away from the neck areas they have used in the past. He has his special leggings that inflate and deflate to avoid blood clots. They will have to begin thinning his blood again to a good balance that will not allow clotting too much but will allow his lungs and chest area to heal without continual bleeding.
He has a drip of Propofol going, a feeding bottle, sodium Chloride, potassium Chloride, and another sodium chloride injection on some sort of pressure infusion bag. He also has a system that slowly releases local pain relief inside where the tubes are and the area of the recent surgery. I do not know how well that is working because his pain level still seems pretty high. I do not know the other injections they give him or what else they put through his feeding tube. I will try to get a review from the doctors or his nurse in the next hour or so.
His chart is so thick that they started a second one and it already has a bunch of paperwork in it. I do not know how each new nurse, specialist, doctor, etc. can get up to speed on this guy with so much to look at. We have to have faith that they can laser in on the pertinent information. It is scary, the questions that get asked of Rob sometimes. I am amazed at his recall. He knows how many milligrams of various medications he has taken and when. I do not know if the nurses tell him more when we are not there because most will come in and give him something without any explanations. We have never found Rob to be wrong in his recall of times and amounts over this period of time. It is so comforting to know that his sharp mind is all there and he is able to communicate effectively when given the opportunity.
It is now 9:10 and the doctors have not returned. They may not, since they do rounds early and then go to surgery. I would assume that the schedule for the day is to keep his blood pressure low, try to get him to breathe more on his own, and rest. If he has a good day and night, I would hope he will be put more on the trache collar. He will then be asked to do more activity, like standing up at his bedside. If the chest tubes stop draining, they will try to remove them over the next few days. If his breathing improves, and he can tolerate the trache collar, he will be allowed to eat and drink on his own. If his strength can return he will start to get some therapy and hopefully be able to walk around a bit. Once we get there - it is working to build up stamina and other therapy so Rob can go home. It has been so hard to see him struggle so much. After the first two heart surgeries, he just recovered so well and had such great and immediate progress. Hopefully we are getting back to that pattern now.
I talked to the nurse and asked what else he was getting for meds. She said he was on a couple drugs to help lower his blood pressure. As far as she knew, the morphine was the only pain killer he was on. The Propofol is like a tranquilizer to help him rest. It must be working ok with the morphine because he has been pretty sleepy since I got here. It is just great to see him sleep. I do not know how he does it in such a loud and busy setting.
9:30 - The heart rhythm doctors just came by and talked to Rob. He reached out to shake their hands and when asked how he was doing he gave them a wave of “so so”. We have never seen a thumbs down from Rob. It is always thumbs up or “so so” even when he is in pain and weak. The social administrator stopped by to check on him. She is in charge of transfers. She told Rob, “when you get better you can get out of this place.” He smiled and gave the thumbs up. Rob asked if the doctors team had been back. I said no and asked if he wanted me to ask them anything for him. He wanted to know if it was normal for his left arm to hurt so much. The nurse came in and gave him a shot of Lovanox for blood pressure control. I asked the nurse to inform the doctors of the pain in his left arm, if they are not aware of it yet, and if it is normal pain, due to the surgery. I also told her to ask if the CT scan showed any further dilation of the artery with the aneurism near his left arm.
He just had another IV bag added to give him meds that slow stomach acids since he is on the feeding tube. He is wanting to know how many surgeries he has had since being here in Texas. I explained that he has had three. He nodded like he agreed. He wanted know when he could get more pain medicine. I checked with the nurse and she said not until 10. I massaged his left arm and his feet and it was good to see his respiration and blood pressure drop. I think it was more due to the Lovanox than the massage.

9/19/2005

Quiet Evening

Hello everyone. Rob was still doing well tonight. His drainage has decreased quite a bit, so that's good. It is so nice and quiet upstairs. We're glad he is back there. He wanted us to sit there and hold his hands. He is in pain, but just had morphine at 9. He also got some sleeping medicine. We want to make sure he sleeps well tonight.
They removed his right chest tube today. He has had that one clamped for awhile and we were told there was no problem removing it, so we're excited about that. Now we just have to wait for the left lung to heal. Today was a nice day, we're just hoping that the pain will ease soon. The poor guy has gone through so much.
Thank you for all your prayers and comments. We love them all. Also, how are the twins doing?

Back to 7th floor ICU

Denise's Post
This morning at the recovery ICU visit we just had 1/2 an hour with Rob that we had to do in shifts. He was very sleepy and sedated but opened his eyes a lot and wrote us questions on his clipboard. He wanted his handheld fan which we already thought of bringing because when he was in there before he got so warm. He said his side really hurt--the side that was operated on. He was grateful that we told them not to put any tubes down his throat--we told them to do a nose tube if needed which they did but only temporarily. Since he's on a trache he doesn't have the big vent tube in either. They will feed him intraveneously until he's ready to take drinks, etc. by mouth. He was pretty good at mouthing words to us too--we don't always get it right but we're pretty good. He hasn't spoken outloud since last Friday when the swallow test was done and the man explained to him how to cover the trache to speak. Right now that is too much work so he writes of mouths the words. He mentioned another one of his nurses, Sharon, from upstairs had visited him this a.m.--that was so nice of her.

When we went to the 5pm visit they had just moved him to the ICU on 7th floor again, back in his same room. He was really exhausted so only Mike stayed and waited for him to get settled and find out how things are going. There were 5 people helping get him situated so the rest of us returned to the hotel. I don't know yet how things are for this afternoon since we weren't able to be there. So sometime tonight we'll update with the latest.

9/18/2005

Doing better

Denise and I went in tonight. He was still pretty sedated, but he did open his eyes a few times. He squeezed my hand when I said Hello, so he's doing well. =) Rob is now back down to the recovery room he was in after his heart surgery. The nurse told us that three of the nurses from where he was, came down to check on him and see how everything was going. We thought that was so nice of them. Rob's color looked good and his drainage was less. Over all he looked comfortable. So that's good! We will have to see what tomorrow will bring us.

Out of Surgery and on the mend.

Rob came out of surgery well. The surgeon gave us the report that. It is his hope that Rob will stabalize over the next couple days. It is great to have him under 24 hour watch in the recovery room. He has gotten some of the drugs that he liked soooo much last time. We hope that his withdrawal will be less eventfull! They inserted two large drainage tubes in his left chest area. They also have lines to allow for direct insertion of local anesthetics for pain control. He came to in the recovery room and responded to the medical staff. They remember him and call him "the kid". They said he certainly looks much better now than after his heart surgery.

The recovery room visiting schedule is much more restrictive. That will give us the chance to recooperate somewhat ourselves. It is so comforting to have him under the watchful care of constant supervision. It is our hope that the lining of the lung will adhere to his chest wall. They did not use the talc which was originally planned. The surgeon said that he was opened enough and enough of the chest wall was irirtated by the surgery that it should do the same thing without the talc. They are trying to get enough plasma, platelets, and red blood into him, to get his strength back. It was great just to see him laying back and apparently sleeping. The other good thing is that since he had the trache in he did not have to have a respirator tube in his mouth like the last time. Hopefully he will come back strong from this surgery and will be on a nice pattern of success.

We get to go back in a couple hours for a little visit. Please keep him in your prayers, and thanks for all your support.

Posted by Mike

Back in Surgery

Again last night was a late night so nothing was posted. Mike had been there rubbing Rob's back and helping him drink some liquids. His heart rate has still been high and his blood pressure low. They were still giving him blood and plasma. At about 8:00 pm Mike looked at the chest tube and saw that it was kinked. When he straightened it a lot of blood drained into the reservoir. He called to the nurse who was so worried. She contacted the dr. and was told to keep giving Rob the blood products and the teams would get together to consult in the am--which they had lready planned to do. Mike literally saved Rob's life twice Saturday.

Mike figured that the 7 units of blood they had given him that day had totally come back out. The dr. earlier in the day after doing the ct scan said the first time there was drainage (Sat. am) it probably was old blood and with taking him off the heparin and cumadin (blood thinners that he needs for the mechanical valve) and giving him plasma and platelets he'd stop bleeding. Well--no one thought to check that the tube was straight and he was still bleeding internally all afternoon. No wonder he was in such pain since it was collecting and not able to drain out. Marla had questioned the nurse because she said Rob's stomach was puffing out and that was not normal. The nurse felt it and said it was probably because he had started to drink liquids by mouth and had had a few bites of mashed potatoes.

Today the pulmonolgist came by and told Mike they were going to get Rob ready for surgery.

(Mike here, back at hotel to drop off Rob's belongings from ICU, since he will be back in a recovery unit for awhile.) They are going to make a large incision on the left rib cage, in the back, like Mike Duncombe had. (I told Rob, He will be like Maddogg the Machine with a matching scar.) Then they will, after drainage comes out during surgery, put in a saline and talc mixture through the tubes which irritate the lining of the lung to create scar tissue and thus help it adhere to the wall of the chest cavity. I would assume they will place some additional drainage tubes. It is kind of like using 2-sided tape to help it adhere. They've done this for 20+ years and it works well in cases like this where the lungs have collapsed or there are tears in the lining.

Rob was consulted about the surgery and wants it to happen--he is so exhausted and in pain that he hopes for relief. He reached out and shook Dr. Coselli's hand and gave him the thumbs up for surgery. He continues to amaze me. After so many days with very little rest, very little food or liquids, coming in and out of consciousness, struggling to breathe, massive loss of blood (Over 12 units in just the past 24 hours, that we know of. More is happening inside!) not being able to lay back, stuck in bed for almost a month while being poked, beeped awake every few minutes, and constantly annoyed by all the noise in his room and ICU area--he still has a smile for all those who help him and a positive attitude towards his treatments. After passing out yesterday, during a difficult time he awoke to see Marla in fornt of him, very tearful. He held her had and said "Everything is going to be alright!"

9/17/2005

Mike talks, They listen

This morning, Mike noticed Rob's drainage chest tube was draining a lot more than it was before. He has had this tube since the 15th and it really hasn't drained much at all until this morning. He saw large amounts of what looked like old dark blood. The doctors came in and Mike told them about it and they didn't really listen. Then Mike told the nurse and showed her. She listened, called the doctors back and by then his blood pressure started to go down. We came in around 10 (my mom and I) and he wasn't looking like cute Robbie. He looked exhausted and wouldn't even open his eyes. His blood pressure was low. They started giving him blood and plasma. Probably half an hour later, Rob had his eyes open and looked better. I was in the room alone looking at Rob and started to cry. He looked at me and mouthed, "Everything will be ok, I'm fine." I just looked at him and started to laugh. It amazed me that he was saying this, when I was supposed to say that to him. His chest tube was still draining quite a bit. There were 4 doctors standing around discussing what was going on. They sent him for a CAT scan. This time with a respirator nurse, his nurse, and a doctor in the room. We felt confident we weren't going to hear a code blue code again. He did well, even adjusting the levels on his portable respirator as he was being wheeled down. He knows what he likes I guess. The scan did not show one specific area that was bleeding, He is now having more blood. They are trying to thicken his blood to stop the bleeding, but also trying to not make it too thick to affect the new valve he has.
Mike and Denise will update more when we switch places around 4 or 5. Thanks for your prayers and comments. We need them, he's giving us all grey hair. =)

Rough Night

It was so late when Jen and I (Denise) returned from the hospital last night we didn't post anything. Rob was still in a lot of pain from the chest tube, trache and his back from the time of the collapsed lung (referred pain.) He's had morphine and toradol but it doesn't seem to help much. The poor guy didn't sleep at all through the night they told me when I called this am.

They did remove the feeding tube last night so nothing is in his throat. He was so thrilled--he said it was like being choked constantly. He had had a swallow test earlier yesterday and passed it with flying colors but it took a while for them to finally remove the tube--Denise had to really bug the dr. about it.

He has been given a sodium chloride drip through an IV and another 2 units of blood. His hemoglobin had come back low again and the nurse was afraid he was getting dehydrated. She said it is not uncommon to become anemic when a person is off regular food for so long. They give him different nutrients through the IV but it's not the same as getting the nurtients when eating normally.

Hopefully they will find out why he is in so much pain and be able to help him--he so needs to sleep. The pain is causing his heart rate to be fast and the morphine causes his blood pressure to be slow. It is so hard to see him going through all this. Please keep your prayers going for Rob--it is such a help and comfort to him and us.

BEST WISHES TO JON AND MICHELLE ON YOUR WEDDING DAY!!!!
WE ARE THERE WITH YOU IN SPIRIT-WE HOPE YOU ARE VIDEO TAPING A LOT OF IT SO IN THE NEAR FUTURE WE CAN BE A PART OF THE HAPPY EVENT.

9/16/2005

Two Blood Transfusions

Hello everyone. Sorry for the late update. Rob is doing a little better today. His hemoglobin was really low this morning, so they gave him two blood transfusions. Thanks to Brian and Melissa for donating blood. It went towards the transfusions. My mom and I were there for the first one and by the end of it, he was way more like himself. He was really sleepy before. He is still getting used to his new chest tube, so he's in some pain.
Rob has a pca nurse that is great with him. She has a gold tooth with a heart on it, (we call her goldie) but her name is Sharon. Sharon felt bad that Rob wasn't himself, so she shook her booty for Rob twice. She was also singing. He was crackin up (as well as someone with a tube in his mouth could do.) So we like her too. She's pretty funny. Rob's nurse is Tina and is full of energy. We saw her in the hall yesterday and asked her to be Rob's nurse today.
When we were leaving (Mike is there now) they were talking about him doing a swallow test with the speech therapist. We haven't heard anything, so we're not sure if Rob can drink yet.

9/15/2005

A bump in the road

Unfortunately, poor Rob developed another pneumothorax today. They removed the larger tube that had been in since the surgery and when they x-rayed him a few hours later they found his whole lung had collapsed. The doctor was so amazed and puzzled since they had clamped off both tubes (the smaller one from last week on the other side which they had planned to remove tomorrow) 24 hours before. Dr. Casar was also surprised since he didn't have any symptoms such as difficulty breathing--though Rob was a bit tired from all the breathing on his own.

Rob's back on the ventilator with just a bit of breathing assistance to let him rest up. They seem to think with a much smaller tube, when they remove them that if a bubble forms again it would be smaller and then get reabsorbed into his system without a problem. The larger tube could have been the problem both times.

Rob is such a trooper. We are constantly amazed at him--sure he's been down at times--he's got to be so sick and tired of being in a hospital bed, tubing connecting his to machines and having so much noise all around--but he's dealing so well it seems.

They think there could be a slight tear in the lining of his lung and the air is escaping through it to the cavity around the lung. They are considering putting a kind of powder into the torn area to help it create scar tissue which then plugs it. We aren't sure how they do that exactly but at least there is something they've done in past cases that sounds helpful.

The pulmonologist said, "Rob, you are driving me crazy!" Rob shook his head, put his hands on his head and then shook his hands while raising them above his head--which looked like, "I don't know either, this is driving me crazy too!" Rob was so happy to have Marla walk in at the end of the procedure when they put in the new tinier tube. They are just so sweet and loving to watch. It makes me (Denise) choke up just thinking of those two lovebirds. They are both so special it makes us happy to see them together.

We are happy for the progress of Dan and Steph's babies. To have one already on the c-pap machine is a wonderful step forward. We are praying that they both continue to progress.

Progess!

Rob is doing well today. Mike was there in the morning, then my mom and I went at 10. Doctor B (can't pronounce his name) came in and told us he was going to pull out one of Rob's chest tubes. Rob was happy since he knew he would be getting moriphine before that would happen. So now Rob only has one chest tube in! He said he was more comfortable without that tube in. They also pulled out his catheter (we left the room for that.) It was an eventful morning.
Now Rob has a trache collar on. It is an oxygen mask that goes over the trache. It's kind of cute. If Rob does ok all day, then tomorrow they'll try the swallow test. Then some food! It was nice to see some progress today.
Rob was enjoying the psp this morning. Once again teaching the nurses and doctors all about technology. He's a funny guy.

9/14/2005

Two Vicodines Later...

Rob slept from noon until 6:30 pm today.. They are trying to get him off moriphine, so now it's on to vicodine. Rob kept asking for morphine.. he likes how fast it takes effect. He laughs when we tell him no more morphine. My mom and I went and saw him at 8 and then left around 10. We were able to play old maid which he won... He was alseep when we left. He is finally catching up on sleep. Rob was still breathing on his own when we left, so that is great news! His trache fell out tonight. It was ok since he can breath, but it kind of shocked him and it really shocked me... So the nurse put the tube back in and attached the other part...

We still are not sure when he will be moved. The chest tubes have not come out yet. It is nice to see that they are moving slowly and being careful.

Handsome Rob was able to watch the video clips that were on the website. He loved them. It was nice to see him laughing and smiling. So thank you to everyone for making them. We all loved them too.

Rob's new job

Here is tessy his nurse. She is the nurse that saved his life during his code blue incident and the nurse for the first incident with his breathing as well. So we thanked her today. She thinks that she is bad luck for Rob, but we assured her that she saved Rob's life. The other nurse, in the green is the trache guy, Rob likes him too... I don't remember his name. He's great though. Rob is teaching both of them about the nano and the computer. It was funny.

Getting Better

Post by Mike

It is September 14th, 2005 and Rob is resting now in the ICU and has been breathing through the trache, on his own for over an hour now and the numbers are looking good. In this resting mode he breathes at 14 breaths per minute and draws in about a half of a cubic liter with each breath. To see him rest in this mode is a great thing because it could mean that he is able to recover while breathing on his own.

Yesterday afternoon while Marla and Diane were with Rob one of the doctors came in and told Rob that he would have the feeding tube in for another week. That really bummed him out since he was so looking forward to being able to eat and drink. He also really wants the feeding tube out so he does not have to put up with the gag reflex with the tube going in his mouth and down his throat. With the exception of a few hours when he drank a little and had soup and ice cream when the respirator was removed last time, it will be a month without eating. Like all the other changes, he adjusts and looks forward with even more excitement to when he can eat.

Denise and I are in his room now and it is nice to see him adjusting to all the hoses and wires. He has become quite proficient at moving all the tubes, wires, pillows, sheets, towels, etc. to gain a reasonable position. I hope today they will consider removing chest tubes and catheter. That would go a long way to adding some mobility. I also keep praying that they can do some swallow studies and see that he is able to drink sooner. At least he can rest some now . That also allows us all to rest. Yesterday was the first time I could actually sit in his room and rest a little. When he wants his feet or hands or back rubbed, we all love to do it because he has so little comfort, it is nice to be able to do something he enjoys. He really enjoys company ; he asked Denise and Jen to stay late last night . Jen said she has never given anyone such a long foot massage. Yesterday there was a beautiful sight --- His mother-in-law massaging his back as his wife read a book. Marla deserves a big rest and Diane is a former nurse with all the right skills. She also has to be the world’s greatest mother-in-law. That Rob knows how to work it!

I am proud of myself because I am typing this in Rob’s room on my new laptop computer. I even installed the printer and went on line “wireless” all without having help from Brian or Rob. They are probably excited that I did not bother them--like I usually do. I was able to go to my email and check my messages. (over 200) I never even checked my phone or email the first three weeks. I just could not deal with any other issues. I am grateful to have the time to devote to Rob. It is more relaxing now seeing him in a pattern of improvement with so many accomplishments.

We have heard from so many of you and it has been such a support. I think Rob’s name is on about 50 temple prayer rolls. I have had clients include him in their prayer groups, light candles for him, nurses have been quite emotional saying they are praying for him and ministers have offer ed prayers on his behalf. Denise’s college professors have said they do not know if God exists but that they are offering requests for health to “what ever powers that may exist.“ It is great to know that God does live and that he answers our prayers. The world is filled with such wonderful people who are willing to do what they can for the comfort of others.

We have been praying for Dan and Steph’s little girls. When Denise and Jen told Rob about those little 2 pound wonders he was so surprised, excited, and concerned. We are so happy for Dan and Steph and we know those little girls are going to have such wonderful lives. What loving parents they will be. It is such a blessing that our nature to care for others, grows, as we go through trials. It is so comforting to know that the Lord is mindful of these two little angels and he will inspire the doctors, nurses, and family to bring them to health.

Marla and Diane just arrived so Denise and I will go back to the hotel and I will try to get this posted.

9/13/2005

NANO MAN!

Mike, Denise and Jen went out this morning looking for a nano. I think they went to 5 stores before getting one. Rob was so excited to get it. He played with it for about an hour and half. He put pictures on it and songs. The nano is so small. It's perfect for Rob. It was nice to see him a little happier, since today has been a lot of different news. We had one doctor come in and say maybe a week with the feeding tube in and no food... We'll see. He's still my cute Robbie.

Also, here is an explaination about the picture. The tape on his nose is holding the feeding tube in place. The trache has now been in for 24 hours. It was hard for us to see something in his throat, but it's nice to see him smile. We saw them trying to put the feeding tube down his nose... and I was glad to see they gave up and put it in his mouth. His E.T finger is his oxygen level being checked. He looks pretty good for all he's been through. If you look closely, his nails are nicely manicured from Denise. =)

Moving forward

Robbie is doing ok today. He is a little frustrated about not being able to eat still. They need to test him and see how he swallows. Rob was able to sleep from 10-3, 5-8, last night. He wrote and told us that. That it's nice that he been sleeping better.
Today my mom and I were in the room when a social worker called us out. She gave us the news that they want to move Rob to another hospital to keep moving forward in his progress. He no longer needs an acute care facility. The new hospital will be focusing on rehab. They will wean him off the trache there as well. We all went to visit the place (except for Rob) and we were impressed. They all were private rooms, private bath with shower, a door that is not glass and it's quiet. We think he will like it better. Someone from that hospital has to come over and evaluate him. We noticed an empty room while we were there and requested it. There are other places Rob can go to in Texas, but this one is our first choice. His current lung doctor works there and Rob really likes him. We all talked to Rob about this and he is ready for a change. It will be nice to have him out of the icu.

9/12/2005

Long day

Hello everyone! Rob's surgery went well. He is all trached. He did not go in until 4 o'clock and got out at 4:45. He watched the clock all day waiting for them to come and get him. He didn't have a feeding tube, so he was really hungry. Rob was able to be on the computer and the internet today, but we were unable to write an update. Rob is now to the point that when a machine starts beeping.. he knows how to turn it off.
When we were going down to the operating room, Rob was being his own nurse. There was a special person to manually bag him into his breathing tube since the machine is electric, but Rob took it and started doing it himself. A doctor came out after surgery and said,"I have never seen a patient bag himself." And then before they gave him medicine to go asleep, Rob made sure to wave to every single person in the operating room before falling asleep. She was laughing pretty hard about that. She was impressed with his positive attitude and his cute personality. We all just said, "that's rob for you"
Rob is back in his room now in a little bit of pain, but don't worry.. they gave him some moriphine. He is hopefully sleeping right now. His feeding tube went back in, we're not sure when he will be able to eat. It depends on whether or not he can swallow. They should be looking into that tomorrow or the next day.
Thank you for all your comments. We love them all.

Trache Me Away!

It is 10:30 on Monday morning. Mom and I went to the hospital to see Rob at 8. He was happy to see us and put us to work massaging his back and feet. It is good that he can get some peace and enjoyment. He also asked if Marla was sleeping. We said she was probably up getting ready to come over but that we got first shift since she and her mom were there so late last night. She and Diane arrived a little after 9 and when Rob saw marla he just smiled and waved and motioned for her to come in his room. She is really great medicine for him. Denise and I left the room so they could have some alone time!!!!

He is so excited to get the trache in. I hope they can take him to surgery a little after noon. His surgeon has a seperate surgery this AM. He will still not be able to talk or eat right away. If he adapts well he will then be able to try to eat and drink. He will have to have the feeding tube reinserted after surgery and use that for awhile. He is soooooo hungry and thirsty. He is just dreaming of all sorts of things to eat and drink. He was laying on his side looking out into the nursing area and he saw the food cart. He just reached out and motioned like he wanted it rolled in. Denise got up and closed the curtain and said "Pay no attention to what is behind the curtain." He just smiled. He sure takes things in stride.

He was proud of himself this morning because he wrote that he had slept a little laying back with only 4 pillows. He says his lungs seem to be clearing and that he thinks he is gaining strength back. He is wondering when they will remove the chest tubes. I think they will see how he does the next day or two after his surgery. If he does not have any problems they should remove them. It will be great to have some mobility as the tubes, feeding line, and other IVs are removed. He can get a long flexible hose attached to the trache and he will be able to walk around his room if the other chest tubes, etc. can be dealt with.

A nurse that had been watching him during some of his altered state of mind, as a tough guy being held against his will, came in to see him. He had said some things to her that she was laughing about and Rob even remembered some and they had a good laugh together. She said he was welcome at any of her parties and that he is a funny guy.

I read an email from Kev and it is so great to hear from him. We feel the strength of his prayers on Rob's behalf. He is doing great in England and is enjoying serving the Lord. He is a great man and a real blessing to us all.

I am thankful that Brian is putting together a video for Rob and Marla. He is so gifted at that stuff. I really enjoy all his productions. I know that Rob and Marla are looking forward to seeing it.

I hope that Rob may add to the site today. He and Marla may even be doing something as I prepare this update. I need to run and get some keys copied and take care of some other little things. I will be back at the hospital around noon and hope to see Rob go into surgery and come out in a nice recovery mode. I think he will adapt to the trache pretty well.

Please keep up all the prayers for Rob, Stephanie and the babies, and Jon and Michelle as they get ready for their wedding day. We love you all and thanks again.

Mike

9/11/2005

Pampered Shrubby

Mike's Post:

Today was a good day. Rob was very clear minded and was able to have a nice sponge bath, followed by a 1 1/2 –2 hour massage (by mom, dad and Jen) in a seated massage chair that allowed him to be in a different position after almost three weeks of laying down. He then had a nice hair shampoo and a style by his mom and dad--so he looks very cool! He then stood and sat back in nice clean bedding, positioned his eating tray and pillows so he could rest. Hopefully he will rest now for an hour or two. Marla and Diane are now on “Shrubbie-watch.” I hope Rob can keep his blood pressure down with Marla in the room.

Rob has been looking at this website with great interest and sends a thank you to everybody for all of their prayers, comments, and concerns. He may be able to make some of his own comments now but he gets tired pretty easily.

Tomorrow in the AM he is scheduled for his trache. They are doing this as a safeguard in case he incurs any more breathing problems. Great news so far is the cultures came back from the last tests regarding infection and all were negative. He is still on antibiotics as continued precaution. The doctors informed me today he had suffered a collapsed lung and still has congestion in that same lung and it is also affected by what they call a bleb which is a bulged out part of the lung that takes space but is not effective at oxygenation. Their hope is that over the next few days at least two of these three problems can be fixed. Rob mentioned today that he felt his lungs were more clear. This is great news and we pray that it continues. Rob has a great attitude towards all the stuff that is happening and it is so reassuring to all of us to have him so alert so that he can be an effective part of the healing process.

Who is that handsome guy?



Hello everyone. We asked Rob for permission to put this picture on and he typed that would be fine. He is doing well today. His stats are consistant and looking good. My mom and I went in around 10, Mike was already there so we switched spots. He was sleepy on and off until around 12. He then asked for the computer. I had to set up it for internet, so I went through my aol name. I explained that to Rob and his first question was, "Who is paying for aol?" I told him not to worry... my parents are =). We got connected to the internet and the first thing he went to was Brihogan.com. He started from the beginning and was reading everything. He loves the comments and is happy to see the website. It really makes him happy. Happy enough to let us post a picture of him. It was very funny to see Rob with a respirator in, typing and online.

9/10/2005

A Cruel Deception

Mike's Post:

This morning at 8 we talked to Rob. He was very clear headed and told us the pulmonologist had just left. He said they will do a trache on Monday. We communicated some more - us writing and he writing. I asked him how he was feeling. He wrote, "A little sad. I was dreaming that we both came down here to get our hearts fixed and that they had discovered a cure for Marfan's." During his altered state due to the drugs, he was feeling so fired up and physically powerful, that he looked at his arms and body and said, "The next generation Shrubba!" Another time he looked at his arms and said, "They don't need to be any bigger than this!" This morning I reminded him that his real world was fantastic and he agreed. He then wrote, "Where is Marla?"

He is resting a little now- as best as he can- since he can not lay back. I went and got a seated massage chair and my hope is we can get him into it. He wants to, but the staff will have to cooperate in moving him. He has so many tubes, hoses, wires, and the respirator that it will take a few of us. I think the position will really be good for him.

Marla and her mom brought his lap top computer and he has enjoyed typing. He would still like some of the medications that played games with his mind- who wouldn't? He is so patient and so hungry. He writes that he can not wait for Monday since he may be able to drink a little if he can tolerate it. We are hoping that as his lungs strengthen and heal, he will gain back the ability to breathe if he lays back. He is now hunched over the movable food tray on some pillows. I hope he can now get some rest as we find ways to get him comfortable and the stimulation of the drugs have passed.

Landon is flying home tonight and I am happy for his family - but I am sad for Jen and the rest of us. He has been so much support. His hopes are to do a month long rotation at Mayo, and then return to Houston where Tulane should have their program up and running. I think Jen will stay here for now. She is such a sweetheart and always so willing to help.

It has been such a blessing to have Marla's mom here. I don't know how Marla could have handled last Friday without her. I am 52 years old and had to just hold Denise as we both cried. Marla's mom is so upbeat and positive that she lifts us all up. It has been very helpful to cry and laugh together.

Thank you all for your comments. Rob will hopefully have internet hooked up tomorrow and he can read all your comments and maybe even make some if they can keep him on reasonable medications. They told me in the ICU that they will get someone to set it up. Thank you all for your prayers. You are all in ours.

Being Calm and Patient

Rob is doing better today. His mind is clearer and he's been writing notes. "Where's Marla?" was his first question. Later he asked questions about what was going on and asked for his PSP and computer - sounds like Rob's back to his old self. Dad told him some funny things he had said when he was going through his withdrawals. He smiled really big and nodded his head as if he could remember some of the things he had said.

Rob still hasn't slept much. He said he slept about 1 1/2 hours last night. Dad is out renting a seated massage chair so Rob can sit in different positions

Dr. Casar had seen Rob today and is still planning on doing a tracheostomy on Monday. Rob seems to be ok with it since he knows it will be temporary and he can drink. He's been asking for something to drink ever since he got the respirator put back in (you can't drink when it's in).

Right now Marla is with Rob. His bed is bent into a chair position. He's been calm and hasn't yanked on any cords. He's being very patient.

Landon's flying home to Utah tonight. His school will start again in two weeks. He'll go to Mayo Clinic for a month and then will return to Houston for the remainder of the time.

Thank you for your prayers and comments. We hope Steph and Dan are doing ok and that Jon and Michelle's wedding plans are going well.

9/09/2005

Maybe they will listen now.

Mike's Post:

It is now 8PM and it has been a long day. Rob is on the respirator and is resting as best he can. We talked to a doctor tonight and it sounds like they are not sure what has caused his breathing problem. They suspect that the surgery may have altered his anatomy to where something (possibly the dacron grafted aorta) is impinging his airway when he lays back. I keep hoping that the swelling from surgery may recede and that may open it up better. They also said that he had a large air bubble in his chest (pneumothorax) that caused his lung to collapse. That, along with his lung infection made it very difficult to breathe. I don't think this explains why he cannot lay back. They will consult more and they said they will trache him on Monday. I keep feeling like all will work out and that each day his heart is still healing, and his chest is healing while these other challengs are being sorted out.

We made clear to the medical staff that they should listen to the family since we are with him all the time. We explained that the first major lung problem when he was revived, we told them something was wrong and they told us to leave and not agitate him. The nurse then found him blue. The next time we told them to restrain and watch him closely at night due to the drug reaction he had. They did not, and found him standing and with tubes and his main vein line pulled out. We told the doctor that removed the chest tube that he was reacting to drugs and was breathing too fast and not able to lay back. He needed to hold his breath for the tube to be removed and I don't believe he was able to. I told her to have him practice holding his breath so she could observe him. She did not. When he went to CT scan I told them he could not lay back. NOW THEY ARE LISTENING!

It is great to be here where there are so many specialists - but Rob's chart is getting so voluminous that I am afraid that each specialist is not able to see the whole picture. It seems like a great group that is caring for him but we have also hit the worst bumps on a Friday. His last big incident was just before the Labor Day weekend and now we feel like we are on hold until Monday for more information and to know what is to be done. I am sorry if I feel like I am not grateful. I am very grateful for all the great men and women that are caring for Rob and he would not be alive today without all the great medical expertise.

Please pray that Rob can sleep. The nurse said he had enough drugs today to put an elephant to sleep. Even with that he was still writing in my hand and even wrote on the Magnadoodle that he wanted apple juice. I told him he couldn't because the breathing tube was back in. He wrote, "maybe later" and then added "and rootbeer, cream soda, pizza and Benehanas!"

Please pray that his antibiotics can kill the infection in his lungs. He is on 3 antibiotics.

Thank you all for your prayers and support.

Video Project

**** ANOTHER UPDATE: Due to people wanting to make short funny videos, I think I'm gonna scrap my original idea to make a "music video" with everyone. If you have any funny short clips send them my way and I'll get them posted. I've had about 3 really good ideas from people. I think Rob & Marla will like the videos - look for them by the end of the week.

Thanks,
Brian

Rob is back on respirator

Posted by Mike and Denise:

Today at about 9 am Rob was taken to get a CT scan because of the problem created when one chest tube was removed yesterday. He had begun to think more clearly last night. Landon spent time with him until early this morning and he was becoming more clear. They also assigned a 12 hour watch on him, which was nice because he was a handful due to the drug reactions. Denise and I were there at 8 and he was doing great but laboring to breath. His heart rate was down to about 110 instead of the 130 plus he had been running on under the drug reaction as his system cleared from all the drugs during his time on the respirator. I knew he would crash from lack of sleep but I had hoped it would be by sleeping. He has been wired and had no sleep since the respirator was removed. I think that was 48 hours but my time frame is pretty out of whack right now. They ordered a CT scan and we went down to CT with him. I asked the scan team if he could be scanned sitting up since he cannot lay down. They said no. He has not been able to lay back for more than 20-30 seconds since the removal of his tube. He would try and sometimes, in a look of complete exhaustion, he would lay back at a small recline and then pop up in just 20-30 seconds. As Denise and I sat outside the CT room I saw the "In Use" light flash on and then off in about 5 seconds, it did that twice and then as I waited for the third time we heard them all yell and we saw through the glass of the next room everyone running and moving. The door flew open and they pushed his cart out to make room for all the people. We were then ushered out to a waiting room. We were told later his breathing had just stopped while lying down. I think the poor little guy was so tired that he could not take any more. Prior to Rob stopping breathing, Denise had called Marla and her mom to let them know where we were. They had gone to Rob's room and seen that he was gone. They then went to the waiting room on Rob's floor to wait and then they heard "Code Blue, CT Room." They came and got them and told them he was stabilized and brought to the CT waiting area with us.

Rob probably has some problems with his lungs due to infection and the possible collapse of his lungs or parts. When Rob was talking to me yesterday in one of his altered states he told me defiantly, "I know more than the doctors. I need to have a tracheotomy and bed rest." He will now get what he thought he needed. His statement has actually given me a lot of peace to tolerate this period of time. It is so difficult to deal with the different challenges we are asked to face. I think that he was so tired that this could be the best thing now since he will continue to heal and will have some rest. We hope that as he is taken off again and that the problems are diagnosed and treated, he will have a more reasonable transition of the drugs. We just got a call from Marla and her mom that he is back in his room and resting again. As I was sitting in the CT room, my mind reflected on Rob's conversation just before going down to the CT room. He asked about Marla and I told him she was on her way over. I asked him if he remembered some of his conversations. He said he remembered some. I told him at one point when Marla came in he had forgotten they were married. When she told him they were married, he was so excited and all he wanted to do was kiss her over and over. Marla has been so wonderful dealing with all the ups and downs. She is so loving and supportive. As I sat in the CT room before he crashed, I just felt so grateful for Marla. I love her so much and thank her for the best gift Rob has ever had.

We are going to go back to the hospital now just to look at him sleeping. I needed to walk and move so Denise and I came back to the hotel to post this update. Thank you all for your prayers.

9/08/2005

Married once again

Today has been interesting. Rob is having to withdraw from all the drugs they used from the respirator. Mike stayed up all night with Rob. He needed to be restrained. We got there around 9:30 and he decided that he wanted to leave. He was also very parnoid. He's had enough. It took three of us to restrain him. He looks skinny, but once you try to restrain him, he's a strong little thing. He told me that he had alchohol in his viens and needed his ivs out so they wouldn't get infected. Poor little Robbie... Mike deserves a father of the year award staying with him all night. He still hasn't slept. We didn't know how bad it was until we got there.
But later this afternoon, My mom and I went back and Rob was just so happy. He told us that the united states of america is just so cool. He then asked us why we were in texas. We responded that we came to see you! and he was just so happy. Then I said, you remember when we got married? His face was so funny.. he was just the happiest boy in the world and said NO, we're married? And then he grabbed me and started kissing me and his stats went crazy. So then luckily jen and landon walked in because it was time for me to go. I apparenlty get him too exicited.
The doctors are saying this is normal for him with this type of surgery and with having a respirator in so long. We're all hoping it ends soon. He does have an infection in his left lung. His chest tubes are still in. We're not sure when they will be taken out.
We're sorry we haven't updated. It has just been too hard to leave the hospital.

9/07/2005

PSP

My mom and I went to see Rob tonight. Earlier Rob was asking for the psp (play station portable) so I brought it for him. I was a bad wife bringing it to him with a low battery... but He was able to play it for a half hour. I thought that all you psp owners would love to hear that. He played the new Mercury game we got him.

Rob is doing very well. He is breathing with oxygen in his nose, not a mask. He is looking more like my Robbie. Today he said, "can I have a blanket," "I want to check my email," "yes," "thank you," and among other things. He is hard to hear since he doesn't have a voice. It's nice to see him respond to things. He was sweet saying thank you to every nurse. Rob just seems so happy to have the tube out.

Also, We found out later today, that Rob not only pulled out stuff, he acually climbed out of bed and was standing last night. We are not sure how he did that, but 4 nurses told us about it... so we just had to laugh. He does have a pretty big bruise on the back of his arm that wasn't there before... Rob doesn't have any memory of doing any of that. He does however remember me telling him I lost his stylus for his phone. I'm not sure why he chose to remember the one memory where I lost something of his... but I let him know I had to order new ones from london....

Still breathing strong

Things are looking good! His doctor talked about taking the chest tubes out tomorrow morning. That will be nice since they are huge tubes stuck inbetween his ribs. The nurse said he would be more comfortable breathing without them. Rob should be getting his first meal tomorrow morning. He isn't getting any nutrition since he played doctor and pulled the feeding tube out himself. He is breathing well. Rob just realized the three scabs on his forehead from the brain eeg during surgery and he keeps picking at them. No matter what I say... he won't stop. He's cute though! Also, his temp has been normal all day, so more good news!

Thank you for all your comments! We love reading them!

Yay! Now, Get Well Soon!


Here's a picture of Rob in the hospital. You can see how rugged his face has gotten from lack of shaving.

Just kidding, this isn't Rob. Rob's tail is much smaller.

Everyone's happy the tube's out! Now, focus on getting well, Rob.

Shrub, make sure you're fingers are well rested, we have a lot of video game playing to catch up on!

It's OUT!

Rob can smile now! The doctor came in around 11 and said "HOGAN, are you ready?" Rob woke up from his sleep and looked pleased. So about a half an hour later, the nurses came in and took the breathing tube out! His dad was in the room, but all of us ladies were in the waiting room. It was very exciting to go back to Rob and see how happy he was. He was sitting indian style, all relaxed. He whispered "where am I?" So his dad brought him up to date. He does have an oxygen mask on. We are all very happy.

Smile of Success

Dad left this message on my phone this morning:
-Jen

Sept 9 –
We arrived at 8 o’clock and Rob had a big smile on his face. He had pulled out the feeding tube and the main line into his neck artery during the night. The nurse said it was lucky there were nurses just outside his door - he could have lost a lot of blood. Since he had lost a lot of blood during surgery, he can’t afford any additional loss. I think his smile was one of success. He had relieved himself of two intrusions into his body. They hadn’t put the main line back in yet. When asked if he wanted the feeding tube back in, he shook his head no with authority. He needed to be suctioned again. He hates it but seems to understand why he needs to do it. He motioned again that he wants his respirator tube out. He had the nurse contact the doctor. We were told they may consider removing the respirator in another five hours which makes it about 1:30 or 2 PM. We think he is ready. The added strain will be helped by the reduction in annoyance of the tube down his throat.

The doctor was concerned about Rob’s temperature last night. His fever has gone down this morning but they’re going to culture some fluids to see if they’re infected.

Currently Rob is trying to sleep. He’s trying to be on good behavior so he can have his tube removed.

Doctor Rob...?

Mom called the hospital last night and they had to restrain Rob since he was attempting to be his own doctor and remove the tube. We are off to see him this AM and hope today will bring continued progress and mental clarity for Rob.

Jen and Landon are still up in the air waiting to hear what Tulane officials decide. I think they will try to keep a strong grip on their students since it will be a huge financial loss if they let them go to other med schools and have to fear exodus from their program. They are still with us and both are great to have here. Lando is studying every day and checking into every potential opportunity. Things will work out well for him because he will do the work required in any situation.

Our prayers are filled with support for Dan and Stephany. What precious little gifts await them - and what great parents those little girls will have!

9/06/2005

Chococat


O_o (a little mental vacation)
Originally uploaded by SpatialK.
Marla and Rob both really like this cat named "Chococat". I saw this picture and thought it would raise their spirits 110% - cause it's so cute! Look at that little hat. And the orange scarf!

Marla bought one of these for Rob to hug while recovering. Rob's version is "naked", though.

(Now back to your regularly scheduled Robbie updates)

Getting stronger, Breathing longer

9:00 pm-Rob breathed on his own for 12 hours and 10 minutes---wow--twice as much as yesterday! Mike told him it's just like he ran 3 marathons how tired he is--Rob nodded," yes." We kept our visit short to let him rest up for tomorrow. We told him how proud we are of him and he smiled a big smile through the tape.

The doctor said today he wants him to breathe 24 hours on his own before they take the tube out--so it still may be a day or two. Rob was so alert this afternoon and upset with the darn tube still in. He motioned several times to get it out--we would have loved to have given him his wish. It is probably so puzzling to still have it in because the other two surgeries he only had it in part of a day or so. We tried explaining why this time was different but we'll see what he remembers when he can talk. We have been told when the tube comes out the person can't really speak for a few days because of some swelling in the throat that needs to heal.

He also stood with help three times today. That's quite an accomplishment--the first time out of bed. He's getting stronger.

He's got a good beard and mustache going--we really like it--lots of red like Mike and Pops. The nurse asked if he wanted it shaved a few days ago when it was bugging him but he decided not to bother with it.

Funny Robbie

Rob is breathing on his own again. He has been breathing on his own since 7 this morning. He is more awake and he is not doing the breathing test that was ordered yesterday. His regular doctor is back in town and said he didn't need it. He said he was very happy with Rob. We are still unsure when the tube will be taken out, but we're thinking soon. Today has been the first day that he had motioned he wants it out. The doctor also told them to lower some medication, so he will be less tired. Rob is getting a little more impatient. He has been picking at his bandages... taking them off.. looking at his tubes. He's being quite funny. He was quite surprised to see his mother in law today. His eyes got huge and we're thinking he just realized she is in houston. He has acknowledged her before, but we're not sure what he was thinking. It was really funny.

9/05/2005

So Sleepy

Back at the hotel at 6;30 PM. After breathing on his own for 6 hours our little man is very tired. He is exhausted and a little disoriented. He said he needed to use the bathroom - which is great because it will be the first time since surgery. He signaled to me that he wanted to get out of bed and go to the toilet in his room. I told him he cannot get out of bed because he is all hooked up to so many things. He just motioned again to get him out of bed. He tapped the side rail and motioned to put it down. He started to move his legs as if he was getting out the side. We told him again he cannot and he seemed pretty upset with us. I asked him if he would go in the bedpan and he made it clear he was not going to. He finally laid back and rested. Maybe after a rest he will understand better. He also tried to write a message but was too tired and it was not legible. It is tough to see him so confused. After working so hard to breath for 6 hours, we were told, it is not unusual to be so exhausted and kind of disoriented. We hope he gets a good rest and can have enough energy to try again tomorrow.