Good news: He was sleeping peacefully for most of the day.
Bad news: They inserted a nasal- gastric tube.
His blood pressure and oxygen levels dropped precipitously. The rapid response team was called. He was stabilized. The surgeon said they hope to put drain tubes into his abdomen tomorrow. He was in bad shape at the end of the day. The doctor thought it was a good idea that I spend the night in the hospital.
Boy, it was lovely when I came in. He looked to be sleeping peacefully for the first time in a long time. His face looked relaxed. I was happy to sit by his side and write up Saturday's log.
All went well until about 2:30. He had been coughing a fair amount. It sounded like he was bringing up flehm from his bronchi. The respiratory therapist came in and examined him. He noticed that when the liquid was suctioned from his mouth, it was green. That means that that liquid was bile coming from Mike's stomach. If he inhaled it, he would have pneumonia again.
They decided to place a nasal gastric tube into him. Oh, yay. This means forcing a tube through his nose down into his stomach. Mike had a procedure like that done when he had his swallow response tested. He said it was the worst experience. Of course, he hadn't had his pancreatitis attack yet. His definition of pain has been permanently altered. Knowing what was involved, I had to leave the room. I knew it would be terrible. They assured me that once he adjusted, it wouldn't bother him that much. At first, he was moaning and complaining. His face, which had been calm in repose earlier, was now furrowed.
Three people who were involved with the deacon retreat this weekend, Clarence, Vi, and the monsignor who taught at the retreat, came to visit him around 3 pm. He had just stuffed that tube stuffed down his throat. He was in serious discomfort and moaning. They prayed over him and blessed him. Vi suggested that I ask for the pain nurse to be involved. Who knew there was such a thing as a pain nurse? There are so many things I don't know. I didn't understand why he wasn't given some pain medication right after or during the tube insertion. I think I do now. Pain medication, other than Tylenol, can lower his blood pressure. That is what happened the other day when they gave him Ativan and had to follow it with Narcan.
The group of Baptists who come around to sing to the patients every Sunday was here again. Again, they came into Mike's room at his request.
It was shortly after that I told abruptly to leave the room because the rapid response team was called in. It was a combination of low blood pressure and a low O2 count. They were laughing as they worked on him. Two security guards were standing outside his room. They said when the team laughs like that, it's a good sign. I was prepared to hear it was black humor. I could cope with that. How else do you deal with such difficult situations daily?
I asked the two security guards why they were there. Were they there to manage hysterical family members? They said, "No," they were there to clear the way before the stretcher as it moved quickly to go to the ICU. I made a circling motion in the air and said they were the sirens. They agreed.
After the rapid response team cleared out, a surgeon who works with Izawa came down to talk to me. She told me that they would ask the imaging department to place a drain tube in his abdomen tomorrow. This is a tricky move, at best. There is a threat of bacterial infection. She made it sound quite problematic. She said Mike had taken a turn for the worse. The had him on antibiotics. I was told that he had mild pneumonia again due to aspirating the bile from his stomach. The respiratory therapist asked me again if I wanted them to do everything they could to keep him alive. I said, yes. I think everyone in the family is of that opinion. If there is any chance, he can fully recover and continue to have a full life, definitely.
Damon and I have running debates as to whether we should be optimistic or pessimistic. Damon is a do-something kind of guy. When I tell him to talk to his dad, he says something like, "I don't have any news yet because I haven't spoken to Izawa. "I say, "Say, I love you, Dad."
The same goes for when I call. He wants to do something to fix his dad's situation and mine. All I want from him is to listen and tell me he loves me. It doesn't come easily to him. He's a man of action.
The surgeon who spoke to me was giving a grim picture of Mike's immediate prognosis. When I asked her if I should stay the night, she said yes. I tried to get through to Damon that this might be it. We were arguing back and forth until he finally said, "I'm good if I'm not there when Dad dies." His wife, Cylin, finally figured out why I was pushing Damon to come to HI from LA immediately. Damon has a busy life. He's perfectly right; he can't just jump on a plane every time there is a possible emergency. Hearing that from him eased my apprehension. I was concerned that he was in denial and would feel regret if he was wrong.
I'm sitting by his side now. His blood pressure is 106/57 and his O2 level is 98, but on the bi-pap, and that says nothing about his CO2 level. The bi-pap is supposed to get rid of the CO2. He is calm again. I am watching the bile from his stomach being pumped into a container. It certainly seems to have slowed down from earlier today. He is apparently accumulating bile in his stomach because he digestive processes have been slowed down. I asked the doctor if she heard any noise from his stomach. She said no. Not a good sign. It means that his digestive tract is not processing the bile from his stomach. It just sits there and accumulates. Then he brings it up and aspirates it into his lungs. This is why they had to call the rapid response team; his lungs weren't functioning properly.
Mike has been calling out several things tonight. "I give up," is the most frequent. From his tone of voice, it sounds like his response to his captors when playing Hide and Seek or Cowboys and Indians. It doesn't sound like a surrender to death.
One of the things he started saying is, "Hidey, Hidey, Ho!" Anyone remember Cab Callaway? I asked him if he wanted me to find him on YouTube. I played Minnie the Moocher, and then a bunch of Calloway songs, which he seems to enjoy. They were at least distracting. I had no idea that Mike even knew who Cab Calloway was no less had an interest in his music.
