Moving Forward...... 2014 is here!

I hope everyone reading this first post of 2014 enjoyed all that the spirit of Christmas has to offer....faith, family, food, fun and more family (and food)! The Rueckert house was bustling with siblings, inlaws, outlaws, and cousins from Christmas Eve through the 30th. It was nice b/c there was one overlap day when ALL of us were together at Mom and Dad's house.

Now that our house is empty again, Sam wants to know who's coming for a sleepover next. Lego building and Hot Wheels racing preferred resume activities. Any takers????

On the 23rd, Dad went back to UMMC for Intervention Radiology to take a look at the drain and determine if the abscesses had been adequately drained of the infections. Thankfully, when Mom and I met Dad back in recovery, all the drainage apparatus had been removed! This was a fairly good birthday present; Dad is a Christmas Eve baby, and turned 72 this year. Getting that "thing" removed was a nice boost to our spirits, and it felt like forward progress was in the works. ALL of us needed that!

The last couple of weeks have been "eh." Not terribly horrific, but not tremendously great either. Just, "eh." We're all just taking it one day at a time, and celebrating each success, no matter how small. For a period of time after the hospitalization, Dad's mobility consisted of a 10 inch round trip commute between the recliner and the couch. He needed assistance to travel any further, and going upstairs was not happening. At one point, my mom's walker (from her hip replacement days) was introduced. Dad was extraordinarily weak and fatigued very quickly. This was one tough infection and bouncing back has been like a golf ball in a sand trap....not so bouncy. It's taken a whole lot of "wedges" to chip this ball out! Steadily, and I mean s-t-e-a-d-i-l-y, progress is being made. Dad is finally able to make it upstairs and sleep in his own bed, enjoying the soft (or not so soft) hum of my mother's snoring. He's eating more, and able to taste Mom's cooking again (muy importante!). My inbox was added to this morning for the first time in a long time, and Dad was talking about working on his taxes. Sooo.....small steps to normalcy are attempted each day, but Dad just doesn't have the "juice" to maintain his efforts. Frustrating.

Dad has been taking Cipro and Flagyl for almost a month now in attempts to completely get this infection under control. Hopefully, once he's off these drugs, gets his full appetite back, and can eat more, he'll regain his strength and get some energy back.

What next?

January 7th is a CT scan to take a look at the liver and make sure all the abscesses are totally gone. Before any decisions related to the cancer can be made, the infections have to be eliminated completely. Please pray that the course of antibiotics erases all traces of unwanted bacteria. Forward progress, please!

January 9th is a follow up visit with the "I love pus" docs.....infectious disease. They will review the CT scan with us, and we'll find out if all is clear. Forward progress, please!

January 14th is a visit with Dr. Jiang, the oncologist. I'm not exactly sure the purpose of this visit, other than blood work and discussing a time frame for future treatments. Again, though, no cancer treatments until every bit of infection is gone.

As always, please pray for continued healing, and to rid Dad of these infections and the cancer. Pray that both my parents get back to enjoying a good quality of life. Pray for forward progress!

Thanks everyone, and much love to ALL!
Jen

One tough infection

Tomorrow will be a week since dad was released from the hospital for this infection.  It's not been an easy week...for anyone. Dad still has the drain in his side to continue to clean out the abscess. He's on 2 antibiotics to kill the nasty bugs too. Problem is, dad has no appetite.  He's still very weak and has very little energy. Is this an effect of the drugs? The infection?  Or dare i it say....the cancer. I'm not sure.

Mom is the best caregiver.....ever. Anything he has a taste for, she makes. She flushes the drain, changes the dressing,  and stays on top of his meds.  She's there.

Prayer warriors,  please keep both my parents close to your hearts in prayer. Much love to all.......Jen

Would you like a dab of dijon mustard with that?

Um, no thank you....

Mom and I are sitting here at UMMC Baltimore, watching Dad sleep more peacefully than he was able to last night. It seems the pain is managed much better now. Thanks so much for all your prayers. 

So now to explain how we got to where we are right now....

After the ERCP last Monday, Dad's health was not improving. He lost his appetite. He was extraordinarily weak and tired. He pretty much stopped eating or drinking anything. He was beginnning to need my mother to help him get around, which....yeah, well....not a good time in the Snead house. On Monday, I made contact with Dr. Darwin and Dr. Jiang. They both responded and contacted Dad at home. The plan was put into motion to get Dad to UMMC asap. The issue, though, was that the hospital was full. There was no room at the inn, and there was another winter storm on the way. It was pretty paramount that we get into Baltimore Monday night, or he wasn't going to get there. I was fairly sure that even though Dad is a Christmas Eve baby, we weren't going to be able to secure ourselves a manger on the way either. His Drs were in close communication with us and worked whatever magic they did to get dad a bed, bypass the ER, and have him admitted directly Monday evening. 

A CT scan done 2am Tuesday showed that his liver is still infected with a monster, 5cm by 3cm abscess. A pyogenic liver abscess. Sounds lovely, doesn't it? No wonder he wasn't feeling better. The antibiotics that he'd been taking hadn't been able to take care of that part of his infection. 

Yesterday his team of docs eventually determined the plan of action to physically drain the abscess. Because of it's location, though, this consensus was not a decision at which all could easily arrive.  There was a lot of back and forth discussion as to whether or not this procedure could be done. It was a real possibility that the lung could have been punctured in the process, which, well...we won't go there. Yup, to stick a needle in his side to drain the pus out had to be timed precisely with his breathing. Dad's surgeon, Dr. Alexander, was confident it could be done. Others, however, were skeptical. (It appears, surgeons are a bit more aggressive in nature.) Sounds even lovelier, doesn't it? Evidently, these abscesses do not go away on antibiotics alone. So, if this abscess could not be drained, the septic infections would continue. 

Thankfully, the abscess was able to be reached without lung involvement, and boy did it drain! The infectious disease doc we met last night so proudly announced how much he loves pus, and based upon the volume of dijon mustard looking stuff coming out of Dad's side, there might be a prize involved. I mean, seriously. N-A-S-T-Y. No WONDER he felt so icky!  

So right now, Dad is resting fairly comfortably, and has slept most of the day. Percocet is doing her job beautifully, keeping his pain level reasonable. He's been able to eat a few meals and has his appetite back. Infectious disease docs are growing a garden with the pus to determine the bugs and the precise antibiotics to take care of the infection. The drain will stay in for quite a few days to make sure all of the infection is drained. Not sure of a discharge date and couldn't even begin to venture a guess. 

Again, I greatly appreciate all of your thoughts and prayers. God is good. We have made it this far in this cancer b/c of the loving support of our friends and family. Thanks everyone and much love to all.....Jen

Morphine....check....oxycodone...check....

...and those are just appetizers that haven't even come close to satiating the pain that Dad is in right now.

I promise when not on my phone that I will fill in the details.  For now, need my prayer warriors to pray for comfort and sleep for Dad. He is in excruciating pain after a procedure today. 

Much love to all who are doing those little (and big things) to help my parents and me while we are here.

Just Pray.....Please.

The Reader's Digest version of the last couple of weeks, which is also available in LARGE PRINT, if needed. 

Dad was released from Meritus 3 days before Thanksgiving. The infections were under control. However, the suspected root of said infections was the biliary tree, which still needed to be addressed to make sure no more infections occurred. Dad was given a 7 day script of Levaquin to make sure it completely knocked out the bacterial infections. 

We had a nice family gathering on Thanksgiving Day with Dad's side of the family and all of my siblings and nephews and niece. We ate a lot, watched a lot of football, and ate some more. 

Last Monday, I took Dad down to Baltimore to have his 4th ERCP done to take a look at the entire biliary tree. Dr. Darwin was able to put a stent inside the existing biliary stent. This is the 4th time Dad has had this procedure done, but for some reason, he had a tough time in recovery, and it took longer than usual to get the nausea under control and get him to a state where he could travel home. 

Well, he's not improved. Since then, his appetite has decreased significantly. Food tastes weird. He's very tired and very weak. I'm at a loss as to WHY. 

So please, just pray. 

"Mary, Mary, quite contrary.....

...how does your gut flora grow?

No silver bells or cockle shells, but Dad's got quite the bacterial garden growing. The cultures the infectious disease folks are growing showed a second type of bacterial infection -- enterococcus. The specific type hasn't been confirmed yet. It's still flourishing in the petri dish. Until that is confirmed, we don't know the exact antibiotic that will kill it.

We need your prayers. Dad's immune system hasn't even hit its lowest since finishing up 3 rounds of chemo, and he's trying to fight not only one, but TWO blood infections. It's like "double sepsis." Not sure if that's a real term, but it's the best way I can describe the current situation.  He's fighting it, though. The fever comes and goes. He sleeps a LOT (or tries to....hospitals aren't known for good night's rest). He's eating ok. His vitals are stable now. All of those are positive, and we're going with that. Thanks, prayer warriors! Keep them coming and going. For those of you praying to clear Dad of the klebsiella sepsis, pray doubly dose to rid him of the enterococcus too. Pray that the species of enterococcus IS of the variety that can be annihilated with an antibiotic. There is a slight chance of the alternative. Think positive, be positive, and pray!

Love to all......Jen

I sit here in Meritus Medical Center with my parents. Dad was brought to the ER last night for major fatigue, pretty intense chills, fever, and just plain, old overall ickyness. This started Wednesday night, but Dad is such a "good" patient, not wanting to bother the doctors, that he waited to see if his symptoms would just go away the next day.....because fevers, chills, and fatigue just do that???? Not to mention that he was told that if he experienced even ONE of these symptoms that he was to go directly to the hospital.

Let me catch you up a bit.....

Dad's been receiving chemo every Tuesday over the last 3 weeks. Just this past Tuesday was his last treatment of this first cycle. He starts up again Dec. 3rd. (His CA 19-9 marker had increased through October, so regardless of what that CT scan had shown after Cipro last month, the blood work showed that the cancer was on the move again.)

Dad's done very well tolerating this most recent cycle, as he has all the other ones too.  He's amazingly tough. Typically, patients receiving this regiment cannot do three weeks in a row b/c their white blood cell count drops to dangerously low levels. He was able to get all three treatments in! He was warned that after the 3rd treatment, though, he would definitely have depleted white blood cells. It was extremely important that he take every precaution necessary to avoid getting sick. He was told his body would have no way to fight off anything. Mom's been the best care-taker, making sure he has his daily 3 square meals, and nightly cocktails of prune juice, Smooth Move tea, and Ensure milkshake. Quite the bartender she's become.

Haven't my parents have become the most entertaining old people? Hard to believe there was a day when they placed in a dance contest at Studebaker's! At that time, the bartender was not preparing prune juice:)

Turns out, the fever, chills, and overall YUCK are another bacterial infection. (Last October his gall bladder kicked up and caused sepsis.) Dad is septic....again. The labs showed klebsiella pneumoniae in his blood. The timing of the symptoms and the type of bacteria that it is led infectious disease to believe that his medi-port was infected during Tuesday's chemo infusion. Um....yeeeaaahh. True to Scarlett O'Hara, "I can't think about that right now. If I do, I'll go crazy. I'll think about that tomorrow." Love me some GWTW...
The nurses working with him on Tuesday were not regular faces. One was "filling in" and the other was shadowing, and I let my guard down not stalking their every move.

Fluids and IV antibiotics have been the regiment today, and it is helping, and doing so quickly. As of this moment, Dad reports feeling much better than he did when he came in last night, while still not admitting that he really needed to come to the hospital. It seems his temp is staying normal without the help of Tylenol or Motrin. He's been able to eat and sleep. All "output" is normal and functioning.  Your prayers are working; he's doing pretty well considering. Not sure of a discharge day yet. Stay tuned.

Thanks, prayer warriors! Much love to all......Jen