No HBO yet

Nice to have K home. We're back to having me pick her up from dialysis after 8pm. Even though the docs were working hard to get her out of the hospital, and into the hyper baric oxygen chamber, she apparently has to be re-approved, before they can accept her. So she hasn't gone yesterday or today. Sounds to me, like yet another dropped ball. Sigh.

She's Home!

Kristan is home! She's trying to get back to some semblance of her regular schedule. She is terminating her evening post-dialysis caregiver, in favor of having me pick her up after dialysis, and get her home and to bed. It will be interesting, to see if/how the DaVita people will accommodate the requirement from the Infectious Diseases doc, to administer two separate antibiotics intravenously. The ID doc seemed to think that one of them could be given during dialysis, and the other would have to be run in, after dialysis. I am nervously anticipating the possibility that we won't be getting home on those evenings, until after 10pm.

It's never simple

So the caregiver, who was supposed to bring K her favorite baguette, help her pack up, get her to her Wound Care appointment, and then home, let me know at 7am that she is getting sick. Our kind neighbor Ken stepped in to help, and was there on time, ready to transport her. Then K realized she didn't need outside help getting to the Wound Clinic, because it's in the Swedish Medical Complex, and the hospital staff were willing to drop her over there. I didn't know she also had a HyperBaric Oxygen treatment today from 12-2 (update: 1-3), so now she just needs a ride home after HBO. Ken also volunteered for that. Thank goodness for our wonderful life saver friends.

Little rant

I had to laugh, and choke back a wail, when the case manager blamed the insurance primary/secondary billing confusion on the Affordable Care Act. We knew this was coming... yet another handy excuse for avoiding responsibility. I really hope they get this figured out, before I get yet another call from a bill collector, demanding I pay the huge upcoming hospital bill that should've been covered.

On schedule

They are still talking about letting her go in the morning Tuesday, so that she can get to a 10:30 wound care appointment. Her morning caregiver will arrive at 8:30 to help her pack up and get going.

Freezing fog

It's a chilly 20°F morning, pretty view of low lying clouds (fog) to the West. The local airports are reporting FZFG (Freezing Fog). Kristan didn't get a PICC line on Sunday either, no surprise. So it still doesn't seem likely she'll get out on Monday.

Billing confusion

Still no PICC line, maybe tomorrow. And they have the primary and secondary insurance confused, which is very concerning. Doesn't seem likely she'll get out tomorrow. The good news is, I was able to sneak Mandy in to see her tonight! It was snowing heavily, as we walked out to the car, and drove home. — at Swedish Medical Center.

Could be weeks?!

Just met with the case manager, who gets off for the weekend now. Love their hours. Kristan's still not home. The antibiotic logistics are very problematic. Three docs need to get together and agree on a solution. Worst case, she stays in hospital 3-4 more weeks. They may still figure it out. — at Swedish Medical Center.

The revised plan

And now I'm learning that her hospitalist won't discharge her, at least until Saturday, because of his concern about high blood glucose levels. I finally got to talk to her Case Manager, and it sounds like several things are not going to happen the way we expected. No nocturnal dialysis. No IV antibiotics at her regular dialysis center. Looking for a way to get a nurse to the house, to administer antibiotics after dialysis for the next month...

The Plan

Ugh. Kristan says she woke up a little while ago, to find two people at her bedside: her regular Podiatrist, and a new Ortho doc, who will do the left leg amputation, "if it goes that way". Then her hospitalist doc showed up, and finally told her THE PLAN: Discharge tomorrow, after an early dialysis, although he might keep her longer, because he has concerns about her unstable blood glucose. 

She wants to switch to nocturnal dialysis, which was finally approved, a short time ago. The nocturnal program has great potential, but will completely upset her caregiver (really, everyone's) schedule, since it would start at 8pm on Tue/Thu/Sun and finish at 4am on Mon/Wed/Fri.

Waffling on discharge...

She says the docs are hemming and hawing, but generally still talking about discharging her tomorrow (Thursday). Her nurse is unconvinced, and thinks it's unlikely. But she's new, so what does she know? Not much warning to get the support system going again. — at Swedish Medical Center.

A few minutes later: Sleeting, then raining buckets, then thunder snow, now just really heavy snow, all in the 20 minutes it took to drive home.

Less jerking

She was in good spirits when I visited this evening. The uncontrolled jerking of arms and legs is much reduced. They caught several jerking events during the EEG, but didn't see anything, which is good. They did find she had extremely low thyroid levels (not sure what that means), which could be the cause, and are increasing her Synthroid medication to deal with that. I still think her extreme lack of sleep may have been a factor. She said the Infectious Diseases doctor said her leg looks a little better, but it will be a long haul, will need the entire run of IV antibiotics before they will know what to do next. They're talking about a Thursday or Friday discharge to home. Still planning six weeks of (now two) IV antibiotics, administered after each dialysis. — at Swedish Medical Center.

Jerking

Kristan seems in good spirits. She has had a certain amount of uncontrolled jerking of her arms and other muscles in the last few years, but today it was very pronounced, and very concerning. If she was holding a drink, it would be all over her and the floor. Haven't heard from the hospitalist. I'm wondering if it could be the result of sleep deprivation, or maybe a medication interaction. She says the hospitalist called in a neurology consult, and they took an EEG, which should be analyzed by tomorrow.

Staying longer

Kristan's nurse says she probably won't be sent home Monday or Tuesday. Don't know after that.

Finally -- we saw some "chopper" activity at the helipad across the way! Might be a bad indicator for someone. But at least it's fun to watch, when stuck in a hospital room.

 — at Swedish Medical Center.

Starting Ceftazidime

I brought Katie with me to visit K this afternoon. The Infectious Diseases doc has started her on a second IV antibiotic, which makes us all feel better. Late last night, an X-Ray showed osteomyelitis where her toes used to be. Don't know exactly what that means. She says they told her she'll be here awhile longer.

Happy Valentine's Day

Not a very special day for us. I brought her a package of Valentine-themed dark-and-light chocolate-dipped strawberries, with little edible red hearts stuck over them, earlier this week. Here's our tired girl, halfway through dialysis. She seems ok. Her leg is cooler than yesterday. She just finished lunch, says Hillary the tech. I'm in and out, after a half hour of watching her sleep. She's talking in her sleep, occasionally waking herself up and grinning sheepishly at me. — at Swedish Medical Center.

Not good enough

Kristan's Infectious Diseases (ID) doc told her it wasn't likely that she'll get out Friday after dialysis. I suppose I'm relieved they agree the leg doesn't look good enough yet. We've been telling anyone who will listen, that we don't think the single antibiotic Vancomycin is working as well this week, as the dual Vanco / Zocin treatment did, the first week she was there.

Successful Fistulagram

Kristan's nurse says they had a hard time getting her into the Interventional Radiology (IR) department today, because of several emergencies they were working, but finally the IR folks saw her, and accomplished a successful Fistulagram. Apparently, she's just getting back from IR now. She couldn't eat before the procedure, and her glucose level was going low, which made it all the more exciting. Now that her Fistula works, they will keep her tonight and dialyze her in the morning. I didn't hear any talk of discharge, but I'm allowing myself some hope that it will happen later tomorrow.

Failed dialysis

She had a failed dialysis today, will get another Fistulogram tomorrow. The infectious disease doc indicated that she probably won't get out tomorrow either.

Discharge deferred

Tried to reach Kristan's nurse at Swedish, about today's dialysis and discharge plans. Got shunted around from the main nursing station to various (wrong) nurses' phones. Finally, the charge nurse looked into it for me. She reports that K went to dialysis at 10am, and they DON'T plan to discharge her today. No other details available, and lucky to learn that, she said. I sure wish I was privy to hospitalist planning BEYOND the next 10 seconds! K just checked in -- they sent her back to her room early, after a failed dialysis. I hate to ask what's next.

Awake and alert

She was chipper and cheery this afternoon. Mixed feelings about the possibility of being discharged tomorrow. Still a lot of redness, swelling, and heat in the ankle area, on both sides. Concerned about reducing the IV antibiotic dose from every day to three times a week. But we're looking forward to having her home.

Maybe home Wednesday

I just talked to Kristan's nurse. He said maybe discharge tomorrow after dialysis. High BGs today, not comfortable going home like that.

Still there

We are still hoping they will discharge Kristan tomorrow, but I got no indication of that from the nurse this evening when I was there.

Talking discharge

Stopped by the hospital with Ken, on our way home from "walking" (which didn't last long), bearing gifts: Vege Sushi, and chocolate-dipped Valentine strawberries. Dr Patel was here, and said they will try to get her discharged, once they make arrangements with her DaVita dialysis center, to administer IV Vancomycin after each dialysis, for the next six weeks. Probably won't accomplish that until tomorrow. — at Swedish Medical Center.

Freezing fog

Brr. It looked a little gloomy out the bedroom window this morning, so I checked weather with ForeFlight, the aviation flight planning app on my phone. It says it's 21° F, with freezing fog and light snow, at Denver airport this morning... Oh yeah, and the visibility is only 0.2 miles. Not too many planes flying right now, I'll bet. But it's got to be beautiful weather (haha!), for driving up to Racines for a nice hot breakfast, and attempting a walk around the lake at City Park.

Still no growth

The infectious disease doc says the culture still hasn't grown anything yet, so they don't know what pathogen to target. Probably there was still some antibiotic in her blood, even after discontinuing the IV for a week. That happens with renal failure patients. On a good note, it seems like the Vancomycin is working again, since her leg is showing fewer signs of infection. — at Swedish Medical Center.

Staying the weekend

It looks like Kristan must stay in hospital at least over the weekend, since nothing has grown yet, in the blood culture they took earlier. — at Swedish Medical Center.

Aspiration done

K is less than pleased with her new room. The MTU floor is much busier and noisier. And she's got a roommate, in a room designed for one bed. All crammed in. Hardly any place for me to sit nearby, while we both eat our dinners. Oh well. They finally accomplished the aspiration procedure today. Hopefully they'll identify the pathogen in her ankle, and have a treatment plan soon. — at Swedish Hospital.

Sochi hackers

Is anybody else as disappointed as I am, to learn how quickly (seconds!) people's smartphones, computers, and other network-connected gadgets are being hacked, as they arrive in Sochi? Here are some links to pertinent articles:

ABC News article
NBC News article
Gizmodo article
Huffington Post article
CNET article
Engadget article

K moved to MTU

They've moved Kristan to the 6th floor Multiple Trauma Unit, I think because they're better suited to handle more complicated cases like hers. They have still not done the aspiration procedure. They were waiting for her to be dialyzed, and then I think they ran out of time, and the radiology dept went home. — at Swedish Hospital.

Still in hospital

Kristan is still in Swedish hospital. It looks like she will be there until at least the end of the week. Talking about embedding antibiotic time release beads into her ankle. Still don't know what's in there, or what antibiotic will work best. At least she likes her nurses this time. Someone asked about it this morning, so I'll say that she has in the past asked me to discourage people from sending flowers.

Problem with Java 7u51

Watch out for problems using websites that have Java applets, after updating Java on your computer to version 7 Update 51. They added a security check that prevents self-signed applets from running, in favor of applets signed by a "trusted authority". It turns out, lots of websites have self-signed applets. There's a workaround, assuming you trust the author of that website: In the Java control panel, they added a new "Exception Site" list, to which you can add the address of the website you're trying to use, which will disable the security check for that site. Be careful to match the URL exactly! Good luck out there!

Some of the things that are broken by this security update include:
www.time.gov
www.dslreports.com
Web-based Citrix server
Web-based RealVNC server
Web-based Juniper VPN server
Various self-signed java applets embedded in hardware/firmware

Something's in there

Her leg is getting warm and red again, so they were likely correct. They are planning to pull some fluid from the ankle joint today, to try to identify the bacteria that must be in there, so they can target a more effective antibiotic to that particular villain.

Airport trip

It's a beautiful day for a trip to the airport. Wishing my walking buddy a safe trip! We stopped at Racines and split the Farmer's Breakfast, then I dropped him off at the Denver airport, so he can go visit his wife in CA, and drive back with her later this week.

No walk

Cold snowy morning. Breakfast? Sure! Walk? Maybe not. Too cold for Mandy's dainty little feet.