Rudy’s first day of 2009 included family and football!  Rolf, Max, Olivia and Grandpa Dick arrived close to noon.  Wilson wanted a quiet day at home in SB so Grandma Jo was kind enough to stay home with him.  The rest of us enjoyed lunch together before we settled down in Rudy’s room for the Rose Bowl.  Rudy had a good day today with only a small fever in the morning and then the periodic lowering of his oxygen sats.  This morning’s chest xray looked good and he continued to tolerate the ventilator rate at 24bpm all day!  It was a day to sit back and stabilize. 

Grandpa Dick had an opportunity to hold Rudy for a bit before his numbers went a little wacko but it was special nonetheless.  Rudy’s numbers were great when he was relaxed and asleep but as soon as he woke up, it was hard to control his breath rate and oxygen saturation.  He’s getting another blood transfusion tonight and resting comfortably.  Rolf et al left for SB at dinnertime.  I’ll head home tomorrow (Friday) afternoon, Rolf will return to UCLA Saturday and Sunday and then it will be my turn again Monday-Friday of next week.  It will be interesting to see what next week brings if the chest fluid issue is truly behind us!!  Baby steps…baby steps…

Well, here we are on the eve of yet another holiday.  Olivia called earlier to ask me where we keep balloons!  It sounds like quite a New Year’s Eve celebration is being prepped at home in Santa Barbara.  Rudy and I are gearing up for a big bash here in the CTICU.  I walked to the drugstore yesterday to stock up on some yummy snack foods to share as we await the countdown to the new year tonight.  It has been a full day today with a handful of patients in our unit either being discharged or sent to the floor so we’re down to 3 patients again…(the other two are different from the other two  of last week).  The CTICU sure has been in a flurry of activity this past week with what feels like a revolving door of patients in and out…and then there is Rudy who has very quietly sat back and made his slow but somewhat measurable progress. 

Today was much like yesterday…he spiked a fever in the morning and battled a fluctuating blood pressure but by afternoon, his fever broke and his numbers were back where they should be.  Today’s chest x-ray detected a small amount of fluid outside the left lung but still not enough to make a concrete decision about the pleurodesis at this point.  His red blood cell count was down so he needed another blood transfusion and one of his picc lines needed to be replaced.  I enjoyed helping Nurse Jenny give Rudy a bath.  He now has a fresh gown and fresh linens…it’s a good thing, too, because Rudy is going to have a long line of nurses wanting their first kiss of the new year to be with him!  Dr. Mary, though, has already reserved her kiss to be the very first at the stroke of midnight!  

It’s so hard to look much past tomorrow…hard to imagine what 2009 will bring but one thing is for sure – Rudy’s first New Year celebration will be filled with lots of love, an ever-growing fan club, and a never-ceasing hope for a future nestled in the hands of God…a comforting reality in the midst of all the uncertainty.

from our family to yours!!!

It’s been a great Christmas so far here in our unique environs.  Rudy has been stable.  We were glad to find out that what fluid is coming from the left chest tube is only 8% chylous so perhaps not another issue of chylothorax.  He’s breathing much better since the fluid came off, so Dr. Robert might just start to slowly wean the ventilator tonight as his nutrition looks good.  The kids discovered there had been a visitor overnight, so the day started with presents and fun.  Since then, the day has been full: fun with Nurse Kelly, Nurse Aliza, Drs. Abel and Robert; visits from friends, firefighters and (yet another) Santa.  Things are just getting started as Trish is set to go pick up Grandma and Grandpa at LAX and, after they have a chance to visit with Rudy, we’ll all head back home for a couple of days enjoying a lazy Christmas at home.

I’m not sure any more words could do our Christmas celebration justice…so here is a pictorial diary of the past couple of days…

What would a Christmas Eve in the CTICU be without a traditional game of “udderball”.  All you need is a surgical glove, an extension cord and an empty room with a very expensive ICU rig to serve as stantions. 

Hot Chocolate, the Christmas Story and Christmas Carols at Rudy’s bedside – (Christmas Eve 2008)

blessings abound!  As you can tell from Rolf’s frequent updates, the past couple of days have been emotionally draining and the threat of dialysis today was a real discouragement to me so, I admit, I haven’t felt like following up on Rolf’s “teaser” yesterday but I realize that it’s important for you to hear of the blessings as well as the concerns…

It’s funny how extremely focused I am when I’m at the hospital with Rudy and how very UNfocused I get when I come home.  I’ve kind of been walking in circles around the house today unable to focus on any of the “to dos” and was pleasantly surprised by a friend who took the initiative to come over and take me and Olivia to lunch while the boys were at a friend’s house playing video games…this past week with Rudy was so full with so much to process and I didn’t fully realize the impact until I got home and let down a bit…time with a friend was a warmly welcomed distraction – thanks Lisa!

The good news this evening is that Rudy’s kidney function has picked up.  Rolf has been reporting progress to me regularly.  He’s done at least 3ccs every hour (the target set by Dr. Abel) and did twice that during the 7pm hour.  Some of the lab numbers are elevated but nowhere near the danger levels.  So, thanks for praying and please continue.  The chest tubes have been dry and we want them to stay that way, so that’s encouraging progress.  Hopefully the pee tube will continue to see lots of acti0n overnight so we can truly feel like we’re moving forward.

Yesterday was another one of those surreal days that included drama, anquish, tears of concern, tears of joy AND fun all wrapped into one!  It all started when I returned from breakfast to find nurses Sara and Heather and doctor Andy S. in Rudy’s room mixing a strange concoction at Rudy’s bedside.  When I greeted them with a cheerful “hello”, they all looked up with wide eyes and a collective sigh of disappointment.  Dr. Andy quickly excused himself and the gals started to laugh.  “What’s going on?”, I said.  “Oh, you came back too soon!”, they replied.  I took a closer look and realized the strange concoction was plaster!  They were attempting to get Rudy’s hand and footprint for me as a surprise…come to find out later, nurse Gladys was involved in the plan as well!  I mentioned to nurse Sara a few days earlier that I wished I had had the presence of mind to ask for a foot print of Rudy when he was born.  She remembered and found a kit to do just that when she was out shopping.  I was so touched by their thoughfulness, teared up and then quickly offered to join in and help.  Unfortunately, the plaster project ended up being a bust but just as we were aborting the project, social worker Erin stopped to see what was going on.  When we explained how the plaster wasn’t working to get the prints, she told us to wait just a minute and came back with some molding clay her department uses  for just such a purpose!  With the help of nurse Sara holding the clay and with Erin’s help unclenching Rudy’s little hand, we got the prints!  The prints are precious but I think I cherish more the visual of all these sweet gals working so hard together to fulfill a mom’s random request – thanks Sara, Heather and Erin!

‘Just another crazy day in LA – LA Land. 

Well, our little fighter looks like he spent the day in the ring!  Rudy has had a very full day and looks pretty pale and beat up but he’s holding steady.  The challenge today has been to find his balance again…his heart rate and blood pressure have been high and, at times, his sats have been low.  Anytime he has a procedure it takes a while to fine-tune the meds just right so everything works together.  He also has had a fever off and on which Dr. Rick described as a post-op fever…most likely caused by the inflammation in the chest cavity produced during the pleurodesis.  Although the procedure itself is relatively minor, the recovery is actually quite painful.  Rudy will be monitored closely for pain the next 48 hours as he has many sources of pain…his chest cavity, the incision on his side from today’s surgery, the sutures on each foot from Tuesday’s lymphangiogram attempt, and the new picc line they put in his right arm today because the line in his groin fell out after surgery!  I normally have to leave the room when they put picc lines in but today nurse practitioner Anita let me stay if I wore a hair net and mask…I was glad I could stay with Rudy.

As we wait to see whether or not the pleurodesis was effective, we would appreciate your prayers for Rudy’s comfort and the team’s ability to manage his pain the next couple of days.  He deserves a long rest and we pray he does so with as little discomfort as possible.  There hasn’t been any discussion about starting his formula feeds again and I imagine they’ll wait a day or two on that.  Rolf will make his way down tomorrow and stay with Rudy over the weekend…hopefully they’ll both rest comfortably in preparation for a full holiday week next week!  I’ll head home tomorrow to be with the kids and do last minute Christmas prep!  Our whole family will return to L.A. on Tuesday to spend Christmas with Rudy!  How is it that Christmas is only 1 week away?  Blessings to you all…

Rudy is back.  Once again, he was a real trooper and, I think,  is glad to be back in his room safe and sound (I wonder how many guardian angels have been deployed for Rudy over the past 11 weeks?).  Nurses Sara and Cheryl have been getting him settled back in with a fresh diaper (they always bring him back from OR diaperless) and fresh blankets so he is looking cozy warm now.  Dr. Brian said all went as he expected.  He looked for any obvious leakage and couldn’t pinpoint anything specific so he conducted the pleurodesis on the right side.  It appeared that there was some drainage coming from the left side out the right chest tube which means that once the right pleural cavity is closed off, fluid could start to collect on the left side requiring a pleurodesis procedure on the left side as well but we’ll have to wait and see.  “Why not do both sides at once” you ask?  Well, I understand that you wouldn’t ever do both sides simultaneously in case there are complications – you’d need the support of the other lung.  So, we’ll relax and see what transpires the next couple of days.  Rudy is doing well right now…stable and sleeping.  Thank you, dear ones, for your prayers for him today!