Happy Halloween 2013!

We had quite the crowd tonight! Mandy even got involved, sneaking out behind everyone, while I was snapping a picture, to go greet a friendly old Pug that one of our visitors' parents had brought with them. I posted the pics on Facebook. See if you can spot her!

Portable Concentrator?

K is seriously considering transitioning from using portable liquid oxygen bottles to a portable oxygen concentrator offered by Inogen. In theory, it would give her a little more freedom. The concentrator battery lasts 3-4 hours, a little shorter than a bottle would, but it comes with two batteries, so in theory she could go 6-8 hours, if she's willing and able to switch the batteries while she's out. Plus, if she plugs it in, when she's in a car, or waiting at the doctor's office, it will run and charge at the same time, in which case, it can theoretically last longer than a bottle would.

The downside I'm struggling with, is what to do when we get four feet of snow, so there's no access in or out of our neighborhood, and the power goes out for a few days (it's happened). Right now, she can tap into the big liquid oxygen storage bottle in the garage, which will probably last for days, at a low flow rate.

The Inogen representative says, "just buy a couple of oxygen bottles to keep around the house for emergencies." But he's dreaming. Each bottle like he's talking about lasts just 3 hours at her flow rate, so we'd need 8 fully-loaded oxygen bottles to last an entire day, or 24 bottles to last three days, and we don't have room for all that stuff. Much less, the time and energy to keep it all. Ugh. I know she is being drawn in by the idea of having more freedom, but Medicare will only pay for the bottles or the concentrator, not both, so we'd have to cover the additional cost ourselves.

Considering we've only been stuck for an extended period without power twice in the past 18 years, once for almost three days, and once for about a day, I guess maybe I'm overly concerned. If she thinks it will give her more freedom, I'm inclined to let her go for it, and figure out how to handle the contingencies as best we can. The concentrator company says to call for a backup oxygen bottle, if the weather forecast seems to call for it, but that is such an iffy proposition, I have to laugh. The reality is, she can survive without supplemental oxygen for awhile, if there's no other option.

Oh, and some friends have suggested a generator, which is a possibility, but I think it just brings more logistical complications, to the point of diminishing returns. We'd have to keep enough gasoline on hand to run the generator for a few days, which is dangerous, and gas gets old, so if we don't use it, we'd have to change it out, or hope an additive like Sta-Bil will keep it usable for a few years. Then we'd have to deal with the intake/exhaust venting issue, if we wanted to run it in the garage, or we'd have to move it out onto the well-ventilated back patio. But then we'd be bothering our neighbors with the noise all day and night, and we'd have a long run for the cord through the basement, up the stairs, to the laundry room where the concentrator is.

And of course, I might have the option of blasting through the snow in my CR-V, before it gets too deep, and either taking her and the portable concentrator somewhere (hotel? hospital? friend's house?) that has power. The first time we lost power, it didn't happen until the roads were impassable, so I'm not sure how viable an option this is. On the other hand, that time, we had neighbors on a separate power circuit, that never lost power, and after a day without power ourselves, we just went and stayed with them, after they invited us over. Did I mention, she wasn't on oxygen back then? And she had both of her legs? And she wasn't going to dialysis three times a week? So losing power wasn't anywhere near as much of a concern, more of an inconvenience.

Castle Rock Plane Crash

It seems (from the Flightaware track info) like that Glasair GS-2 (N535SP) that crashed on approach to Centennial airport in freezing fog last night, was consistently operating pretty far below the minimum descent altitudes for the approach. Flightaware thinks she was descending below 7000 feet, when the MDA for that segment of the approach is 8000. Either the rime ice she reported was dragging her down, or maybe she had the airport lights in sight, and was descending to land. The news said she told rescuers she couldn't see the power lines in the fog, so maybe she thought she had things under control, right up until she hit them... fingers crossed for her quick recovery.

Nice memorial

I found it really, really, worthwhile, being at David Segal's memorial this afternoon. Brad and everyone did a super job, putting it together and executing it. The Denver Press Club was a really nice choice, quiet, close, and understated. I learned a bunch of new things about David, and heard a lot of what I suspected were his wild stories verified as truth. He pulled together quite a crowd of wonderful people. I finally got to meet two of the really delightful caregivers he was raving about. It looks like I'll be driving home in freezing mist tonight...

A Gothic Folktale

We really enjoyed "A Gothic Folktale" at Parker Arts, Culture & Events (PACE) center, a birthday gift for K, courtesy of our awesome friend Karen. We especially enjoyed being there, as her kids got to meet some of the cast. Very fun.

Bad day at the Vet

I just broke Mandy out of vet jail, and got her home. Too much trauma for such a sweet little dog as her. She had an annual exam, dental exam, shots, nails, heartworm test, and more. We missed her on our morning walk. It's going to be a long haul recovery. She's had tooth and gum problems since we rescued her, and she lost eight more teeth today. The Vet put her on two pain meds for the next week. Poor little pooch. — at Southwest Veterinary Hospital, P.C.

Another procedure

K checked in for another surgical procedure at Swedish Medical Center, to remove some pre-cancerous tissue this morning, less than 1mm deep. She had a low BG before surgery, and we caught it before she felt it. The surgery went well. They got what they wanted to get. It took several hours before she was ready to leave. Somewhere in there, her BG went low again, even worse than before. By that time, she was awake, and doing OK, so they were able to feed her a bunch of snacks to bring it back up. She was supposed to go in for the afternoon hyperbaric oxygen treatment, but unfortunately, those people never updated their calendar, after she called them last week to reschedule, so they didn't have any openings. Administrative fail. Again. This is perhaps the 4th time they've really messed things up for her. I got her home safe by mid afternoon. She was still awake, but very sleepy. Wasn't able to get her to Dialysis i time, but at least I got her there.

RIP David Segal

Sad to say, I just learned last night from his son Bradley, that our friend David Segal passed away Sunday night, at peace in Denver. I had been meeting him for occasional lunches since way back, when we both lived in San Diego. I regret that I let life get in the way, and I haven't seen him since last year. I met him through my dad, who dated his sister for awhile. I liked that he usually said what he was thinking, the stereotypical gruff old bear with a heart of gold. He repeatedly told Dad, "after you break up with my sister, don't be a stranger." I remember he took us for the occasional but very enjoyable boat ride, and one time invited my brother in law Bob to steer his yacht around San Diego Bay. He seemed excited to see how the details of an actual IFR approach played out, when we flew him to Palm Springs for brunch one time, and I had to shoot the ILS approach back into Montgomery field. More recently, I would occasionally pick him up at his apartment, and drive him to lunch, always at Racines. Rest in Peace, David.

Early day

I dropped K at makeup dialysis this morning at 6am. Ugh. We really struggled to get going sooner, but just couldn't pull it off. She had a quiet Birthday yesterday, with a visitor at the house, and part of that included skipping her oxygen chamber treatment, and her dialysis. Mandy's with me at work again, snug in her warm bed, on this chilly 38 degree morning. I'm treating myself to a pumpkin spiced latte, since we were up and moving so early.

Chilly day

It's a beautiful clear sub-freezing morning. And a whole new week. K has another, hopefully minor, surgery on Wednesday. Jen's husband Bob is home from hospital, and recovering from a critical head injury, so she'll be out all week. I'll have Mandy with me, out in the car, since K is planning to be out most of the day. I'm so glad the dog loves going anywhere with me in the car, and doesn't seem to mind sleeping most of the day out there.

Home at last!

FINALLY got K home from the hospital tonight! What a long, arduous process. She and I started talking in the morning, about when to pick her up. By the time they had done a nurse shift change, measured her glucose, fed her, administered meds, and processed the paperwork, the 3pm estimated discharge time had turned into 6pm. Then by the time we got to Walgreens to pick up her prescription, their pharmacy was closed, so we went a few miles down the road, to the 24 hour pharmacy. By the time we got out of that Walgreens, with the usual and various complications, it was 9pm. SO tired...

All hail the great hospital doctor. Their sliding scale for insulin was going to kill her, if they didn't discharge her soon. Would be nice if they paid attention to mine. They were giving her much more insulin than I felt was appropriate for her measured glucose levels. I told them to subtract 150 from Blood Glucose, and divide the result by 150. So instead they gave her 9 units for a BG of 350. No wonder she kept crashing in the mornings.

Procedure complete

The arteriogram (angiogram) procedure on K's left leg is all done. Dr Morin's goal was to find something he could fix, to improve the circulation, and help her ankle wound to heal. He had me wait in the employee's lounge by the Catheterization Lab during the procedure. He called me in after 20 minutes, to show me the pics on the computer. He said he didn't find much, and showed me that most of the arteries looked healthy and clear. He pointed out one very short narrowed section of artery, really just a "kink", and suggested putting in a stent there. It seemed like the thing to do, so I agreed, and he went back in, and installed a short stent. He showed me the "after" pics as well, and the artery looked much better with the stent in it. Hard to tell how big the stent is, from the picture on the screen, but it looked about an inch or two long He wanted to send her home today, but by the time they got her into dialysis, to clear out the dye from the arteriogram, it was 4pm, and she came out after 8pm, so he decided to keep her overnight, with the plan to discharge her tomorrow.

Happy dog

Mandy's a happy dog. She got to drive to work with me today. She gets to sleep under the warm blankets in her bed in the back seat of my car, in the nice cool shady covered garage at work. Then she got to go for a chilly 43° walk at lunch time.

Low morning BG

Stopped by Swedish to give K some strawberries, and found her complaining of low blood glucose symptoms. I remembered that I was concerned about that last night, as they gave her more insulin than I would have, but then I forgot. Got the nurse to measure ("we will soon, after shift change") NOW, and found it to be 45, godawful low, especially for being in hospital. Fed her the strawberries, while they looked for apple juice. Fifteen minutes later it was 40, but that's a normal delayed reading. We took bets on what the reading would be after 30 minutes, and K won, as it was 80, heading back up faster than I predicted.

Today is supposed to be the "safe measures" day... I interpret that as "can you just try to keep her alive, until she can start the procedure tomorrow with a normal blood glucose" day. Fail.

Keeping her until Friday

Katherine at the Cath Lab just called to let me know, they will be keeping K in the hospital until Friday. The dialysis isn't done yet, and there's no time left to do the procedure today. There are no open slots tomorrow, so they will keep her inpatient at Swedish, and apply "safe measures" to ensure that she is ready for the procedure on Friday. It will probably be around 11am, but no guarantee of the time. Heavy sigh...

Procedure deferred

They deferred the arteriogram procedure scheduled for this morning, until after they can dialyze her later today, to get her creatinine level down. It's hard to imagine them getting the dialysis, and then the procedure done, before it's too late to discharge her, so I'm guessing that means they'll be keeping her overnight tonight. So now I'm calling around to cancel her regular dialysis appointment. Probably should cancel the morning caregiver, but they haven't committed to keeping her yet, so the schedule is in limbo yet again.

K at Swedish Hospital

K is at Swedish Hospital tonight, in preparation for an arteriogram tomorrow morning. We took her to the Cath Lab for this procedure on Friday, but the doc didn't like her blood glucose, and deferred it. The doc decided he wanted to admit her to the hospital overnight, so they could get her BG under control, for a morning procedure.

Ear maybe better

She saw her ENT Friday. He prescribed antibiotic ear drops. She's taking them in both ears every day for a week or two. I think the infection in her right ear is improving, but not positive about that.

Home from ER

I brought K came home early (2am) this morning -- an unusually short turnaround for a hospital visit, for us. The ER doc assumed her ear is infected, and said there's no sign bone infection in the CT scan. She needs to get an appointment with an ENT and be cleared by them, before going back to her daily hyberbaric treatments.

K to Littleton ER

Took K to the ER with intense ear pain and bloody drainage, dizziness and nausea. She's in an ER bed. No big discovery yet. Gave her an anti-vertigo med. Going to get a CT scan to check mastoid bone for infection. — at Littleton Hospital ER.

Right into it!

Oh yeah. This is the time of year, when the sun and the traffic signal are in the same place in my windscreen. Ow.