Good news: As far as I know, Mike is still alive. He is down in imaging, getting CT scan and another tube inserted into his abdomen.
Bad news: He is now in the ICU. The doctors are not optimistic about his chances of surviving.
I slept in his room again last night. When I woke up, he was asleep. I thought, “This is great. He is finally comfortable and resting. Wow, this is going to be boring. I’m not going to have anything to write about.”
Then his blood pressure dropped. It was a low as 85/50. His oxygen level was dropping too. The nurse, following the doctor’s orders, did all she could to raise his blood pressure. Finally, he was unresponsive. The hospitalist had already checked room availability in the ICU. The decision was made to move him.
Once in the ICU, they intubated him. They were preparing to take him down to get a Cat Scan. I heard two different reports: it was just going to be a Cat Scan, and they were not planning any procedures; and, they were planning to stick a tube directly into the pancreatic sack.
Dr. Izawa came into the waiting room to talk to me. I called Damon so we could have a three-way conversation. I know that Mike wants Damon involved in the process. After I tried to do some healing techniques with Mike, I think he started fearing that I would use those and not approve standard medical approaches. That was never a thought.
Izawa told us that they had extracted 5 liters of liquid from his abdomen already since yesterday. However, they never found a particular substance, something like amyloids, in the fluid that would mean they were pulling out the liquid from the pancreatic sack. His blood was also showing a high white count, meaning he has an infection somewhere in his body.
As they rolled him out to take him down to the imaging room, I heard a nurse say, “Do a head scan.” I saw her try to provoke Mike into responding, “Open your eyes, Michael.” His face flinched in pain as I accidentally moved his breathing tube, but that was it. I thought the worst. The doctor told me he wasn’t too concerned about brain damage, but since he was getting scanned anyway, he thought he would throw it in for good measure.
All our stuff was brought up from room 319, plus two packages which had just been delivered. The three beautiful plants which had been sent, and they were the nicest ones I had ever seen could not stay in the ICU. I had to take them somewhere. We had accumulated a fair amount of stuff in three-plus weeks. The clerk on the 3rd floor ordered a rolling cart, it was loaded with 4 shopping bags, my briefcase, Honolulu Elsa (a small white stuffed dog that Judy sent that looks just like her), the two packages which had just arrived and the plants and wheeled up to the ICU. Robert, the clerk in the ICU, took it downstairs to help me load it in my car. While he took the cart down to the lobby, I had to follow Mike because I had to sign a release form, giving them permission to stick more tubes into him. I was going to drive the plants over to the ashram while Mike was being processed. I was told the procedure would take only an hour. I was concerned since they had started the procedure before the doctor arrived with the release form that I had to sign that I wouldn’t be back when he got out. They had told me this would be a quick procedure, so I stayed.
I had given permission for them to try to get a tube into the pancreatic sack. Mike wasn’t back up from the procedure yet, but I ran into the doctor in the hallway, and he updated me. Everyone’s pancreas is located toward the center of the body. Mike’s is located in a position that they cannot get at it directly with the drain tube without doing damage to tissues and then spleen. They felt they couldn’t go in that way. They are choosing instead to go in through another part of the abdomen, which is hopefully contiguous with the pancreatic sack and will drain it.
The other option is an operation. Mike would be unlikely to survive an operation now. That will only be tried if it looks like he is going to die anyway.
The CT scan showed that he had fluid in his pleural sack, the sack around his lungs. The liquid would have accumulated as a reaction to the aspiration pneumonia when he breathed the bile coming up from his stomach into his lungs. In response to that, they placed a tube on each side of his body to drain that liquid.
Then they tried to get another tube directly into the pancreatic sack. Whoever the tech was felt he couldn’t do it without damaging other body parts, I believe his spleen. Instead, they placed a tube into another section of the abdomen, higher up than the first one which was placed in the morning, and hoped it would be contiguous with the fluid in the pancreatic sack. I was told that he had eliminated 5 liters of fluid from his stomach just through the first tube.
Tube count:
-A breathing tube, intubation.
-GN tube: goes down to his stomach and drain the bile from it
-2 tubes into his abdomen draining peritoneal fluids. Hopefully,
one of them will drain his pancreatic fluid.
-2 tubes on either side of the body, each one going into one of the pleural sacks.
- A portal for his dialysis, (not a tube, but a port for tubes.)
-A tube for the TPN, which is thicker than the normal intravenous tube and delivers liquid nutrition and some medication.
- One regular intravenous tube for saline and some other medications.
Total -9
It was 3 ½ hours before he was back, and I went checked once myself. I sat in the ICU visitors’ lounge writing this. I went into the ICU a second time, and there he was. Ah, I was quietly thinking something had gone terribly wrong. No. The nurse was apologetic and told me he had only been back for 10 minutes.
I’m exhausted from this day. I drove over to the ashram to have some dinner and deliver the flowers. If I left them here at the hospital, they would probably have been thrown away. Then I stopped at Long’s on the way to the hotel to get a larger back brace.
When I arrived at the hotel where I stayed the previous two nights, which is built more like an inn, I checked in. It’s not elegant. Damon was upset that I wouldn’t spend more money to get a better class of hotel. This one was just 2 ½ stars on Yelp. I pointed out to him that I had spent one night sleeping on three chairs, pushed together in a small bathroom with my head next to the toilet. My standards for acceptability aren’t very high.
However, I did make a videotape of what would have been my walk from the Bnb room to the bathroom at the ashram. I texted them to family. The responses have been hilarious.
