Good news: He's stable, and there is no sign of infection in the abdominal area.
Bad news: No significant change, and there is some sign of possible infection in his lung area, pleural sack, I believe.
He has had two more interventions: a Foley catheter and a gastric tube into his small intestines through his nose, bypassing his stomach, and avoiding triggering responses from his pancreas. Pretty sneaky.
This was moving day for me. I had to move from the hotel back to the ashram. They had room for me again. I loaded up my luggage and was out of the motel at a reasonable hour. I wanted to go to Costco to get gas. The gas warning light beeped went on while I was trying to get there. It was a new route, and Lady Gaga was confusing me. I don't have any idea where I went. I resolved to follow her to Costco or stop at the first gas station I saw. I've had that car for over two weeks, and it just now needs gas. I found an Aloha gas station; (Yes, we have a gas station named Aloha.), fueled up, and set Lady Gaga to get me to the hospital.
They told me this morning that when they scanned his abdominal area, they indeed found some urine in his bladder. That's both good and bad news. Good news because it means his kidneys are still functioning at some level, but certainly not enough to keep him alive without dialysis. Bad news because now they have put a Foley catheter in him permanently.
The nurse also told me that they put him back on a blood pressure drug that they had taken him off. His blood pressure was dropping again.
Damon, Cylin, and August arrived around 10 am. Mike's room has a door with a glass window. I went in and told Mike that Damon was here to see him. Damon went in first and spent some time with him. Then Damon brought in Cylin and August separately. It's rough for 15-year-old August to deal with seeing his grandpa in this condition. They left to have lunch while I sat with Mike.
An infectious disease doctor came in and gave me the information that the bacterial cultures from his abdomen show no sign of infection. That's incredible. Very hopeful. However, an infection can start at any time. He does, however, have some bacterial something in his lung area. When all these tubes were inserted, they preemptively threw every antibiotic at him. This way, any bacteria that might have tried to grow was suppressed. It is still possible that they will rise up in protest and win the day, leaving all of us who love and value Mike the losers. The doctor determined that there was one antibiotic that she was giving him that clearly had no function and took him off it.
Damon plus two drove with me to the ashram. When we got there, Damon kept saying, 'This is incredible. This is perfect for you, Betty." I am in a cabin with three beds, one is bunk bed. It's not the elegance of the Prince Waikiki, but it is perfectly functional – and it has a bathroom. Damon promptly broke it in. I could see he was relieved that I was staying somewhere comfortable.
As we were walking across the grounds, I spotted my friends Jamie and Hari. I met them over dinner at the ashram. They are not Krishna's; they only frequently eat there. Jamie is the one who brought me flowers. Lovely. I sat down and with them while Damon, Cylin, and August carried my belongings into the cabin. I finally also got myself something to eat. It was so good to be sitting in the sunshine in beautiful surroundings. I was reenergized.
I stayed a while longer at the ashram, enjoying the surroundings while D, C, and A caught an Uber and back to the hotel. Damon's mom, Jean, and my sister, Dorothy, were arriving today from New Jersey.
Mike's road is very rocky. We never know when some bump will be his last. Everyone wants to say hello, and if necessary, good-bye. Dorothy texted me, remembering how Mike helped her straighten out her checkbook close to 40 years ago. Mike has touched all our lives.
The medical team is looking out for infections in a big way now. This is the next big hurdle Mike must pass through. They would not do another bacterial culture. They would be looking for other signs of infection: drop in blood pressure, high white blood cell count, and a high fever. There may have been a fourth criterion, but I'm too tired to remember it. The infectious disease doctor pointed out that since Mike does not have a compromised immune system, his body will respond to an infection appropriately by turning up the heat.
I think everyone would be in despair now if it wasn't for the information Tom Wnuk gave us about his trials with this disease: 5 months in and out of hospitals. He detailed all the procedures he went through. They sound a lot like Mike's. Tom is out there to say, "There is life after pancreatitis." We're all holding on to that glimmer of hope. The doctors have told us it would be an up and down journey, but hearing that from someone who went through it and survived feels very different. It alters our perspective.
Here are the other interesting developments of the day. Mike has been put on a feeding tube that bypasses his stomach, thus avoiding exciting the pancreas into action. Irritating the pancreas is still a concern. This means he will be off the TPN, which is the intravenous nourishment he has been receiving. Things are so bad, I almost referred to the TPN as food. I doubt you will ever find it on any restaurant menu. Just as well. They gave him Propofol to keep him calm and put him back on Fentanyl to deal with the pain of the Foley and for the pain of the procedure. I hope he's up somewhat tomorrow. More family is coming on Saturday; Mike's sister is coming in.
Since they didn't do dialysis on Thursday as they planned, they did it today. He was asleep for much of it , or at least not anxious. Of course, he is on Propofol, the drug that killed Michael Jackson. It's an antianxiety drug that doesn't make you sleepy. The dialysis nurse was not one of my favorites. She stares at her computer the whole time and pays no attention to the comfort of the patient. As she was about to leave, I said he needs to pee. She is standing between me and the door and said, "They just cleaned him up." I said, "Get out of my way!" She giggled and did. I went to get the nurse and get help for Mike.
Cylin, my daughter-in-law, had Propofol when she had some eye-surgery. She said it makes you lose your inhibitions. She thinks she was singing during the procedure. I realize now this drug may explain some of Michael's behavior the other day when he returned from having the first tube put in. His celebration of the reduced pain was joyful, but his complaints about some other pain were not so welcome. If I had been told that his unusual behavior wasn't just a result of his relief, I wouldn't have reacted as I did when his complaints started. I told him to can it. He was yelling about a discomfort just as loudly as he had yelled about the initial stage of the pancreatitis attack in the emergency room in Kona.
The respiratory therapist came in while I was here too. She said they are going to reduce his respiratory support. She put him on a spontaneous breathing trial, which means he will be breathing on his own. If he does this successfully, they can move toward extubating him. This is a step in the right direction. I asked if extubation means he can get out of the ICU. She said it was only one step in the process. There were still other criteria. There is no question that at this point, Mike is being kept alive by medical intervention. Two more tubes have been added today: the Foley catheter and the feeding tube.
I left the hospital a little earlier this evening. Damon called from the Prince and said dinner was poolside, the only eating place with any openings left. I had to be there by 6:30. While I left promptly at 5:45, the traffic was running at 5 to 9 mph. When I told Damon that had been my speed, he said, "Oh, you were being careful." No. Driving 9mph when everyone else is driving 45 is just weird. No, that was the speed of the traffic during rush hour in Honolulu. It is one of the joys of living here.
The poolside menu wasn't great, very limited, but the view of the sunset was spectacular. Mike and I get something like it every night in Kona from our lanai.
I find I appreciate them more over time. And then, and then, once it was dark, there was this spectacular firecracker show; apparently, there's one every Friday night. I left for the ashram and my first night in the cabin.
