Hartford Letters

INTRODUCTION

“Nine-one-one, what is your emergency?” asked the operator. “We have a white male, age 58, experiencing chest pains, was the hurried reply. “He has a history of cardiomyopathy. We have given him nitroglycerin, and need to meet an ambulance somewhere. We are traveling south on Interstate 91 approaching exit 18. “

We were two couples, husband and wife, traveling through Connecticut on our way home from vacationing together in Maine. We were nearing the end of our first day of leisurely travel back to central Indiana. Reservations had previously been made for that night at a motel in Waterbury, just a short drive south of their present location near Hartford. The next day’s travel plans would take us to the Gettysburg National Battlefield Park in Pennsylvania, with a layover at Chambersburg, and then another full day’s drive to get us back home the following day.

My wife, Lea, and I lived within two blocks of the other couple, Pat and Joe, in a small town northeast of Indianapolis. We had served together in the Lions Club in our community, giving many hours of charitable service and cash donations to benefit our community each year. Joe and Pat, were the club’s current First Vice President and Secretary, respectively. Lea was the current president, and I, Larry, had served as President, and then went on to serve in district-wide offices working with numerous clubs. I had just been awarded Lions International’s highest award at the club level, the Melvin Jones Fellowship.

Joe had been at the wheel all day when he began to experience discomfort in his chest. He suddenly pulled his four-door pickup to the side of the interstate, got out, and went around the rear to stand between the guardrail and the truck. I quickly stepped out of the passenger’s seat to approach Joe and find out what the problem was, and saw a look of panic on Joe’s face. He was clutching his hands to his chest.

“What’s wrong, Joe?” I blurted. “My chest hurts. I’ve been having some pain for a while, and it is getting worse,” Joe replied, as he leaned away from the truck resting his weight on his hands on the guardrail. He was very pale, and he was clammy to the touch. The symptoms of heart attack were quite evident, so I told Joe to move toward the front of the truck, away from the exhaust fumes, to see if he could get his breath in the fresh air. He couldn’t.

Time was of the essence at that point. Helping Joe get into the front passenger’s seat, I gave him a nitroglycerin tablet and told him to let it dissolve under his tongue, and told Pat and Lea, “Someone make note of the time. If he isn’t feeling better in five minutes, I need to give him another nitro tablet. Meanwhile, I’m driving to the next mile marker to see where we are. Lea, call 911 and find out how we can get some help.”

I was a cardiac rehabilitation patient myself, having had a coronary stent implanted almost a year earlier, and carried nitroglycerin in case of a heart attack. I had offered a nitroglycerine tablet to Joe earlier in the week, when he was experiencing a lot of chest discomfort after carrying several suitcases from the truck into the house we had rented for vacation. Joe, however, refused it, saying that he had cardiomyopathy, and commonly had to take extended rest breaks to recover after physical activity.

Back in Connecticut, after three tense minutes of getting back into traffic and watching for a roadside mile marker to identify where we were, I asked Joe if the nitroglycerin had helped his discomfort any. Joe replied that it had not dissolved yet. I replied, “Move it around and make sure it is getting wet,” and added, jokingly, “Don’t make me spit in your mouth!”  The thought of having to do that struck everyone as funny and helped relieve a little of the tension for a moment.

It was Lea’s voice on the phone with the 911 Operator. “Is there an exit nearby where we can find a hospital or meet an ambulance?” Lea inquired. Lea turned on her cell phone’s speaker, so we could all hear the instructions. We were directed to an exit a couple of miles ahead, on I-691, where we found a Car Pool parking lot just off the exit ramp. The ambulance arrived only moments after we did. They gave Joe an additional dose of nitroglycerin and an aspirin, and within minutes had transported him to a nearby medical center.

He was taken straight to the emergency room in Meriden, evaluated, and taken to intensive care to get him stabilized. His heart was in arrhythmia, and it was discovered that he had likely experienced a pulmonary embolism, which could have caused him to go into aortic fibrillation. He was quickly placed on a respirator and a combination of blood pressure medications was flowing intravenously in order to get his cardiac system to settle down.

After a couple of hours Joe’s blood pressure was brought under control, but his heart stayed in arrhythmia. Plans were made to schedule him for a heart catheterization the next day and no plans were made to get his heart back into sinus rhythm because of the risk that a shock could cause the blood clot in the lung to move, which might be fatal. Pat stayed with him overnight, while Lea and I took their truck and went on to the hotel.

Joe, an automotive industry engineer, had already planned this leg of the trip well before the vacation began. Everything was scheduled, including possible side trips if time allowed. Just seven hours south of Prospect Harbor, Maine, Waterbury, Connecticut offered nice accommodations with needed amenities right on the interstate highway, so we would be able to relax before resuming our drive the following morning.

After Joe was admitted to the hospital, it seemed to us that he was likely to be there for several days, so, Lea and I decided to rent a car the next day, Saturday, so we could resume the drive home, leaving their truck there for Pat’s transportation. The following morning, we arose early, and decided to skip breakfast so we could find the car rental, and still be able to get to the hospital early enough to pick up Pat and return her to the hotel where she could freshen up before check out time.

Lea wasn’t feeling very well when we finally located the car rental agency, and she chose to stay in the truck while the rental paperwork was completed. She said that her stomach was hurting her, indicating her lower right side. We both presumed it might be another gall bladder flare-up.

She had experienced bouts of abdominal discomfort frequently, and tests indicated she had a malfunctioning gall bladder. Our family doctor told her that it would flare up occasionally, and eventually she would have an attack bad enough that she would decide to have it removed. To date the flare ups seemed to pass in just a few hours.

When the paperwork was nearly completed for the car rental, Lea was required to sign as a co-driver, so I went out to the truck to have her come into the office. She was feeling pretty sick, and I asked her if there was anything we could do to make her feel better. She said, “No, I’ll get over it.” She mustered her strength, and walked inside the rental office to sign the papers, and then she returned to the truck.

A few more paperwork details were completed, and the rented vehicle was pulled up to the front door for me, and the rental agent handed over the keys and documentation. I got into the vehicle and swung it around the end of the parking lot, and pulled in next to Joe’s truck, to lead Lea back to the hospital, but I didn’t see her in the cab.

I stepped out of the car and peered through the front passenger’s window into the cab of the truck, Lea was no where to be seen. I opened the passenger door, and still didn’t see her. Just as I was about to step up onto the running board to climb inside, I heard a groan, “Oh-h-h-h,” come from the back seat.

Lea’s pain had gotten much worse. When she returned to the truck after signing the paperwork she decided to lie down in the back seat. I saw her doubled up in pain on the back seat. Her abdomen was hurting much more than before, and she said that she didn’t think she would be able to drive the truck back to the hospital. This might be the gall bladder attack their doctor had predicted for some time. What terrible timing! But, we thought, given time, this attack would surely pass just as all the others had.

This also meant that our return home might be delayed. The timing of the vacation had been carefully selected to work around her work schedule. Lea, an officer of a national mortgage company in the Indianapolis area, was scheduled to lead a massive computer software conversion for her department over the next several months, beginning the following Monday morning.

I quickly drove the car back around the end of the row of parked cars, stopping back where the car had been delivered to me just moments before. I explained that Lea was too ill to drive, and that we would have to delay our return by a day or two, and that I wanted to cancel the rental. The agency would not cancel, and charged me nearly one hundred dollars for the five-minute rental! Needless to say, they lost a long time Club member that day!

Back in the truck during the drive to the hospital to pick up Pat, I tried to get an idea of how Lea was doing, while she continued to curl up in the back seat. She kept saying that she thought she might be feeling a little better, and just needed to rest. There wasn’t a lot of conversation during that uneasy drive, but Lea thought maybe she was feeling a little better as we arrived in the parking lot outside the emergency entrance of the medical center.

We decided that I would go inside to locate Pat, and that Lea would stay in the truck with the motor running and air conditioner on, to try to lie still and get her gall bladder under control. I quickly located Pat, and got an update on Joe, who, heavily sedated and ventilated, had been moved to the Intensive Care Unit. She was ready to get cleaned up, after having been in the truck all day traveling, and then at Joe’s bedside all night.

A few minutes later, after our cell phone information had been given to the ICU medical team, we left through the emergency exit doors to return to the truck. As we walked across the lot, I told Pat that Lea was not feeling well, and began describing our morning activity. As we opened the doors to the truck, we found Lea on her knees on the floor of the back seat, resting her upper body on the seat. She was moaning loudly.

It was obvious that she had gotten sicker. I asked her if she needed to go to the emergency room, and she said, “I think so! I hurt SO bad!” Still thinking it was her gall bladder, I helped her from the truck. She was in too much pain to stand up straight, so, Pat took Lea’s right arm, while I held her left, and we held her up and walked her to the emergency room lobby. I went to the desk to tell the admissions clerk that Lea needed help right away.

The clerk asked a transporter to take a wheelchair over for Lea, and then asked Lea to come sit at the desk to fill out admission forms. Lea was in way too much pain, and couldn’t be of much help at all. Pat was carrying Lea’s purse, and she began searching for the needed insurance information. Moments later, a nurse arrived and wheeled Lea into the emergency room, Pat following closely behind, while I remained to complete the required paperwork.

Meanwhile, Lea began answering questions from doctors and nurses to try to help them understand what her medical problem was, so they could begin a proper course of treatment. She indicated that her lower right abdomen was hurting, and that the pain had started that morning and grown progressively worse. When asked to rate her pain on a scale of one to ten, she replied, “Four.” Blood was drawn to begin doing some laboratory research for any indications of what might be causing her pain.

She was given a intravenous drip of saline solution, just as a precautionary move to keep her fluid level up where it needed to be. She also received an injection of a pain medication to reduce her discomfort. A few minutes after the injection she was asked again to rate her level of pain, and she replied, “Four.” During the ten hours she spent in the emergency room while tests were being run to isolate her problem, she kept replying that her pain level was a four, when it was obvious to me that it was much higher, and she was just trying to be brave.

Finally, in frustration, I told her, “Lea, think of the worst pain you can stand without passing out as being ten on a scale of one to ten. What is the pain level you’re feeling now? She replied, “Eight, or nine.” That helped everyone understand that she had a high level of pain tolerance, and that she was dealing with a lot more pain than they had understood. They knew, though, that they weren’t able to give her enough pain medication to keep up with her worsening condition.

Eventually, as her pain continued to increase and her general condition worsened, she was given a morphine injection pump that allowed her to get doses of pain just by pressing a button with her thumb. The pump had a regulator that allowed her to get only the amount of medication allowed, at controlled time intervals that ensured she wouldn’t get an overdose. The amount, and the frequency, was periodically adjusted upwards, to meet her need for pain relief.

She was quickly sedating herself into unconsciousness, as her pain continued to increase and her tolerance waned significantly. We both knew that she was struggling with something very, very serious, and that she soon wouldn’t be able to communicate, because she was getting very drowsy already, and was pressing the button on the pump to request more medication with increasing frequency, well before another dose would be released.

An ultrasound of the gall bladder was performed there at her bedside, and as I watched, the technician moved the transducer over her abdomen in an effort to see the gall bladder from as many angles as possible. The image of the gall bladder formed, faded, and reformed on the screen as the transducer was moved around on her abdomen. No abnormalities were evident. The technician went over the area a second and third time, looking for signs of a problem, all to no avail.

Then, almost as an afterthought, he slowly moved the transducer over toward the left side of the abdomen, looking at the images of the organs formed on the screen. He stopped the transducer at the left side of the stomach, where the liver can be seen projecting from behind, and said, softly, “Uh oh.” There was a great deal of fluid in the back of the abdomen that shouldn’t be there.

The technician continued to move the transducer slowly from spot to spot, pressing the keyboard to capture still images each time he stopped. The printer on his machine was printing constantly now. After a few minutes, he completed his examination, and exited the room with the machine and a whole string of printed images. The problem had been identified, and now, treatment would soon begin.

Meanwhile, Lea kept pressing the button to get another dose of medication long before the pump would release another dose. She was now pressing the button frantically over and over, saying, “I don’t feel good.”

Realizing that this illness was going to be very serious, and that Lea would probably soon put herself into a drug-induced coma, I used my cell phone to have Lea talk to both of our sons for a few moments. I had a feeling it was important to have her say a few words to each of them, just in case there wasn’t another chance in the future. Her conversations were short, but the boys were, at least, able to talk to their mother for a few minutes.

She and I talked about how much we love each other, and that we would look for each other in heaven, so we could be together for eternity. We talked about many magnificent memories we have shared during our lives together; our wonderful family; the enjoyment we got from running our bed & breakfast in a beautiful Victorian era house; the many friends back home that would want to know that she was in the hospital. And, then she dozed off.

She slept a lot during those first couple of days, but was brought up out of her sleep occasionally so further assessments could be done, and, sometimes the only way to find out what is going on is to have the patient tell you. Soon, it became increasingly difficult to awaken her, as she got sicker.

On the third day, Monday, the doctors told me to call our sons, Link and Lance, and have them come to Meriden because she had started deteriorating so quickly the doctors said she wasn’t expected to live another 72 hours. Link lived in Hawaii, and Lance in Texas. They might not be able to get there in time to see their mother alive.

Dialysis to remove fat from her blood was started, and a remarkable amount of fat was collected. In fact, the technician said he had never seen that much fat, and that her blood had to be thick as molasses. But, the procedure, called plasma phoresis, seemed to help. By Monday she seemed to stabilize a little, and Tuesday she was transferred to Hartford Hospital, a Tier One Trauma Center, where she could receive the intensive treatment she would need if she were going to survive.

Lance arrived just as his mother was being loaded into a Life Star helicopter for transport. She was unconscious, had pneumonia, necrotizing pancreatitis, her kidneys have failed, and she was on a respirator. Larry and Lance drove to Hartford Hospital, arriving as Lea was being placed in the Cardiac Critical Care area because the pancreatitis ward was already full.

Link was able to get emergency flights and landed in Hartford the following day. Four of Lea’s five brothers and her sister, two nieces and a nephew, from Ohio, Indiana and Missouri also arrived. Lea was being given massive amounts of intravenous fluids in an attempt to defuse foreign bodies in the bloodstream. She has been unconscious almost a week. She was on dialysis, and now had a catheter in place. Things continued to worsen.

By day seven the fluid in her body had increased to the point it was pooling on the exterior of her skin in her joints. Dr Orlando Kirton and Dr John Mah performed a 3-hour surgery on Lea’s abdomen, creating an eleven inch long crescent shaped incision from one hip to the other. They reported she had so much fluid in her abdomen it squirted across the operating room when they made the first incision. They removed part of her pancreas in that first surgery, and reported that she had only a 15% chance of survival.

Thus began a harrowing medical journey for her, and an extremely difficult spiritual journey for me. The following chapters not only give you insight into what happens in a long term medical crisis, but the personalities that wove their way through the fabric of her eventual recovery, and the many lives touched by this ordeal.

The story of her days in Hartford Hospital, and the day to day reports of her medical trials, can be found in a collection of daily email updates sent to friends and family. The collection is called, The Hartford Letters, and a link is provided at the top of the page, or you can click on the dates listed below to open the full daily report to follow this amazing medical journey.

7/15/2005 – While returning home from vacation in Maine, our friend, Joe, who was driving to our planned overnight destination in Connecticut, suffered chest pains and was admitted to Mid-State Medical Center, Meriden CT.

7/16/2005, Day 1 – Lea enters the Emergency Room of Mid-State Medical Center in Meriden, CT with severe abdominal pains. Ten hours of tests in the Emergency Room before being admitted to the floor with Pancreatitis. She is given a morphine pump to control her pain. She talks to both sons by cell phone from her hospital bed.

7/17/2005, Day 2 – Pain is still severe. The doctor believes the pancreatitis was brought on by an extremely high cholesterol level. Moved to ICU. She continues to push the morphine pump button, gets a dose of pain killer, and then fades back to sleep.

7/18/2005, Day 3 – She is diagnosed with pneumonia in addition to pancreatitis. Unable to breathe sufficiently on her own, they have placed her on a respirator. She is unconscious. Plasma Phoresis was started to remove fat from the blood. Doctors recommend calling the sons. She is expected to survive no more than 72 hours.

7/19/2005, Day 4 –Her kidneys fail. Son, Lance, arrives from Texas moments before LifeStar helicopter crew airlifted her to Hartford Hospital. Lance and Larry drive to Hartford from Meriden in Lance’s rental car.

7/20/2005, Day 5 – Son, Link, arrives in Hartford from Hawaii. Four of Lea’s five brothers and her sister arrive, along with two nieces and a nephew, from Ohio, Indiana and Missouri. She is being given massive amounts of intravenous fluids in an attempt to defuse any foreign bodies in the bloodstream.

7/21/2005, Day 6 – She has been unconscious since 7/17. She continues to receive large amounts of fluids. She is on dialysis, and now has a catheter in place.

7/22/2005, Day 7 Moved to 9th floor ICU. The fluid in her body was increasing to the point it was pooling on the exterior of her skin at her joints. Dr Orlando Kirton and Dr John Mah perform 3-hour surgery on Lea’s abdomen, removing part of the pancreas. She has 15% chance of survival.

7/23/2005, Day 8 – No change today. Condition remained stable. She is in a drug induced coma. Her abdomen remains open, packed with wet dressings.

7/24/2005, Day 9 – Has a dedicated nurse 24 hours a day. Receiving 18 fluids by IV, is on dialysis and breathing assistance. In coma. Larry writes his first Lea Update for friends and family.

7/25/2005, Day 10 – Dr. John Mah, Lea’s surgeon, said that he and the staff remain optimistic for her eventual, complete recovery, but that it is going to take many months to get there.

7/26/2005, Day 11 – Two more medication drips were added today. Steroids to stabilize her, and Sudafed to stop her runny nose . . . 20 medications in all!

7/27/2005, Day 12 –Urine and other blood poisons are being removed via dialysis. Temperature spikes at 102 degrees. Prognosis for survival is still at 15%.

7/28/2005, Day 13 – Pressure cuffs added to inflate/deflate on shins, to keep blood circulating in the lower legs. Small blisters appear all over her body.

7/29/2005, Day 14 – Sedation is reduced to allow the nurse to validate that Lea could respond to commands by blinking her eyes. Develops nose bleed.

7/30/2005, Day 15 – She has been running a temperature ever since the last surgery. It was about 101-102 initially, but dropped to about 99 degrees by this morning. Her next (5th) surgery is scheduled for Sunday.

7/31/2005, Day 16 – Today’s surgery has been cancelled, to allow her more restorative time. The next surgery will probably be tomorrow.

8/01/2005, Day 17 – The surgery today was conducted in her ICU room, rather than in the Operating Room. Dr. Ivy said that he believes he sees some improvement, although there is still swelling present in the wound.

8/02/2005, Day 18 –She is being weaned back off ventilator support , to help her lungs take over more of the work. Kidneys start working again!

8/03/2005, Day 19 – Lea underwent her eighth surgery, in which surgeons removed dead tissue from her pancreas again today, and found some “sludge” (blood leakage) in her abdominal cavity. They will be taking her to the operating room Friday so they can get a better look at things.

8/04/2005, Day 20 – Fluctuating blood pressure following yesterday’s surgery; kidneys reduced their output by 50% from the previous day’s volume.

8/05/2005, Day 21 – More dead pancreas tissue found during today’s surgery at a time when Dr Mah expected her to be healing. Disappointing development. Her respirator was replaced with a tracheotomy today.

8/06/2005, Day 22 – Lea went from critical to very critical, and almost terminal, hours after her surgery today. Dr Mah says odds are against her survival.

8/07/2005, Day 23 – Dr. Kirton and Dr. Mah are “cautiously optimistic that she has better than a fifty per cent chance of survival” after today’s surgery.

8/08/2005, Day 24 – Hope for recovery continues to improve as her systems appear to be holding steady today after Sunday’s surgery.

8/09/2005, Day 25 – According to Dr. Orlando Kirton, Chief Surgeon, Lea is much farther along than most people are at this time, simply because of her inner strength and desire to heal.

8/10/2005, Day 26 – Respiratory therapist came in and put Lea on reduced ventilator support for 4 hours to let her practice doing some breathing on her own.

8/11/2005, Day 27 – Fluid build up continues in her tissues; diuretic scheduled for tomorrow. She had surgery #12 this afternoon.

8/12/2005, Day 28 – Could not breathe on her own at all today. It was decided that her lung muscles were probably sore from the exercise last night, and that she would have to wait a couple of days to do some more exercising.

8/13/2005, Day 29 – Lea spent five hours on ventilator assist this morning, in which she initiates a breath and the ventilator helps her finish it. Her lungs continue to improve.

8/14/2005, Day 30 – Critical condition; stomach pump, ventilator, circulation pumps on her legs, medications hanging all around feeding into her veins.

8/15/2005, Day 31 – Lea’s cardiac system suddenly shut down. Code blue! Nick, her nurse, administered epinephrine. Entire medical team quickly assembles to stabilize her. I observed the entire procedure from behind Dr Bill Marshall, who was at her bedside with the team.

8/16/2005, Day 32 – Lea seemed to just give up, and her heart rate dropped to nil again today, just about 23 hours after she did it the first time. In this case, however, the nurse was in the room watching her when the event took place, and stabilization was much quicker.

8/17/2005, Day 33 – Lea suffered acute decompression of the lungs early this morning. She is sicker, suffering system sepsis. She is heavily sedated to eliminate the possibility that she is feeling any pain. Placed on Roto-Bed to clear fluid from the lungs. This bed is called “the bed of death” by the nursing staff. It is often the last resort, and doesn’t always work.

8/18/2005, Day 34 – Doctor Mah told me that they were pulling out the big guns in a last ditch effort to turn Lea around. Ultrasounds. Bronchial suction. P.I.C.C. line. SWAN. Blood clot filter. Wonder drug, Xigris. Odds of survival are 30%. Continuation of treatment on the Roto-Bed.

8/19/2005, Day 35 – Still on Roto-Bed. Paralyzing chemicals reduced and sedatives increased to relieve pain.

8/20/2005, Day 36 – The only change planned for tonight is the introduction of some plain water into her stomach to see if her intestines are able to absorb it. It’s now over 30 days since she last used her stomach and digestive system. Still on Roto-Bed bed, unconcious.

8/21/2005, Day 37 – Lea’s four-week long low-grade fever finally broke. Chances of survival slightly improved.

8/22/2005, Day 38 – Recovery looks likely! The staff feels she has all of her mental capacity, and will be able to return to a normal life after completing physical rehabilitation.

8/23/2005, Day 39 – Still on rotating bed. SWAN removed. Dr. Kirton says, “She is doing a spectacular job” of overcoming her medical problems.

8/24/2005, Day 40 – Breathing is improved. Lungs are clearing. She may be able to move back to a regular bed if the improvement continues.

8/25/2005, Day 41 – Removed from Roto-Bed and returned to regular hospital bed with a massaging air mattress.

8/26/2005, Day 42 – Fluid reduction is making her features recognizable again. Padded stockings used to protect skin breakdown on legs.

8/27/2005, Day 43 – Sedatives reduced slightly. She now opens her eyes and grimaces as soon as you touch her. Makes horrible, painful expressions when being moved, but no noise.

8/28/2005, Day 44 – Intravenous ports in her arm replaced today, a unit of blood, and albumen infused periodically to keep her blood pressure up.

8/29/2005, Day 45 – Her lungs are continuing to produce small quantities of thick fluid, and she seems to be able to tolerate the every-other-day dressing changes better, reacting with shorter term temperature spikes.

8/30/2005, Day 46 – Lea continues to struggle tonight, as she is being required to take on more of the chore of breathing for herself.

8/31/2005, Day 47 – CATSCAN scheduled to see why she is having such a difficult time breathing.

9/1/2005, Day 48 – Nearly 2 liters of fluid drained from chest cavity behind the left lung. Breathing greatly improved.

9/2/2005, Day 49 – Lea continued to struggle today, trying to breathe a little more on her own, and had to stop to rest occasionally, by being put back on full ventilator support for a resting period.

9/3/2005, Day 50 – She is slowly being brought up off her pain meds and sedatives a little each day. She mouthed some words in her sleep today.

9/4/2005, Day 51 – Blood pressure spikes alarmingly high twice in ten hour period. High temperature.

9/5/2005, Day 52 – SHE’S IN THERE!! She opened her eyes several times today, mouthed silent words, even turned her eyes to the side when requested, and smiled when son, Link, mentioned our granddaughters’ names!

9/6/2005, Day 53 – Dr. Mah has determined the wound should not be closed up, but, rather, allowed to heal itself from the inside out. He wasn’t comfortable doing the planned closing once he examined her abdominal area durng the surgery today.

9/7/2005, Day 54 – Dr. Mah states that he thinks that Lea is almost ready to turn the corner toward recovery.

9/8/2005, Day 55 – She is working to regain control of her lungs, breaking a sweat each time the ventilator support is reduced.

9/9/2005, Day 56 – Pulmonary relapse requiring increased sedation. She has not responded to commands for the last two or three days,

9/10/2005, Day 57 – Lea is gotten out of bed and into a cardiac chair for the first time. She is completely unconscious, and doesn’t know she’s being moved.

9/11/2005, Day 58 – She worked five hours breathing on her own, and then placed back on the ventilator for rest.

9/12/2005, Day 59 – Dressing changed at mid-day (25th surgical procedure). Fourteen hours of breathing on her own, with ventilator backup support.

9/13/2005, Day 60 – Twelve hours of breathing on her own today. She started running a low-grade temperature mid-afternoon, and given rest.

9/14/2005, Day 61 – Opened her eyes wide when Amy told her that she was going to be rolled over, and she quickly started mouthing words of protest.

9/15/2005, Day 62 – Able to breathe 18 hours without ventilator support before tiring too much to go on.

9/16/2005, Day 63 – She was transported downstairs during the afternoon for a chest & abdomen CATSCAN to determine the source of breathing problems.

9/17/2005, Day 64 – CATSCAN indicated small pockets of fluid around the pancreas, called pseudocysts. May clear up on their own in time.

9/18/2005, Day 65 – The amount of support she gets while in rest mode on the ventilator was reduced today. She continues to slowly progress.

9/19/2005, Day 66 – Ultrasound showed negligible fluid around the lungs; bronchoscopy showed very little fluid inside the lungs; CATSCAN was clear.

9/20/2005, Day 67 – High temperature peaks at 102.3 degrees. Unknown infection or cause.

9/21/2005, Day 68 – High temperature. Delirium and panic.

9/22/2005, Day 69 – Fever of over 101 degrees. CATSCAN negative. Psychocysts seem to have reduced in size.

9/23/2005, Day 70 – Lea kept alternating from high blood pressure to low blood pressure, delusion, Detoxification Tremors, and adjustments to medications.

9/24/2005, Day 71 – Lea was awake for about six hours this morning, talking to persons unknown in a constant stream of delirious conversations. Brain scan scheduled for today. She stares at the ceiling as though focusing on something there.

9/25/2005, Day 72 – Staff psychiatrist reports no stroke or seizures involved with detoxification tremors Lea is exhibiting.

9/26/2005, Day 73 – Nearly 1000 CCs fluid removed from left chest cavity to relieve pressure on the lung. Fever, delirium and body tremors continue.

9/27/2005, Day 74 – She is still delusional, still shuttering with withdrawal symptoms, still on the ventilator.

9/28/2005, Day 75 – Returned to working on the ventilator today, made eye contact with several of us, actually focused on us, and smiled at several people as they came in to say, “Hello.” (Praise God!) She puckered up when I arrived!

9/29/2005, Day 76 – Third attempt at getting weaned off ventilator support begins.

9/30/2005, Day 77 – Lea consciously emerged from the coma, and began communicating.

10/01/2005, Day 78 – Lea attempts to communicate by mouthing words. Looks at us, but arms and hands still paralyzed.

10/02/2005, Day 79 – Frustration with trying to communicate sets in. She gets visibly upset, needs tranquilizer. Starting to move hands.

10/03/2005, Day80 – Tremors decreasing in intensity; frustration with inability to communicate increases. Requests crackers. (Request denied).

10/04/2005, Day 81 – Scribbles illegible notes on clipboard held in front of her in attempt to coomunicate to us what she wants.

10/05/2005, Day 82 – First physical therapy session today. She seemed to tolerate it well.

10/06/2005, Day 83 – She is able to get her hands onto her abdomen. Depression sets in as she realizes size of stomach wound.

10/07/2005, Day 84 – Psychological paralysis sets in. No longer able to move limbs on her own.

10/08/2005, Day 85 – Short term memory returns. She remembered the bathrobe I have been giving her every day.

10/09/2005, Day 86 – Lea completed her third consecutive 16-hour day of breathing on her own, with eight hours of overnight rest.

10/10/2005, Day 87 – Maria helps Lea sit up on side of her bed for first time. She has to be supported the entire time.

10/11/2005, Day 88 – Eyes badly inflamed, bloodshot and photosensitive. Unknown cause, but suspect something sprayed in air while her eyes were open..

10/12/2005, Day 89 – Endoscopy. Ulcer in stomach lining caulterized.

10/13/2005, Day 90 – Passy-Muir valve installed in the tracheostomy tube. First speech. First swallow test. Ice chips. Sleep schedule posted.

10/14/2005, Day 91 – Lea makes her first phone calls with Passy-Muir valve in place.

10/15/2005, Day 92 – Pureed meals allowed. Low fat diet. Thickened liquids, only, due to danger of liquid slipping into the lungs.

10/16/2005, Day 93 – Nurse, Chris Watkins, takes Lea on her first wheelchair trip out of doors! Sunlight, wind and sun! Grey squirrels!

10/17/2005, Day 94 –Trouble breathing again; experienced a panic attack that sent her blood pressure sky high.

10/18/2005, Day 95 – Second field trip outside the hospital. She requests a pedicure, a manicure, a haircut and a massage!

10/19/2005, Day 96 – Tilt table used to begin reversal of drop foot syndrome. Lea attends family conference call in wheelchair. Speaks a few words.

10/20/2005, Day 97 – Skin graft over her wound completed. Last day of ventilator support.

10/21/2005, Day 98 – Completed 24 hours off ventilator.

10/22/2005, Day 99 – Completed 48 hours off the ventilator. Ventilator removed from room.

10/23/2005, Day 100 – Lea does her own voice mail update on the ICU system.

10/24/2005, Day 101 – Moved to the ICU Step Down Unit on 9th floor.

10/25/2005, Day 102 – Anxiety levels high. Blood pressure high. Didn’t eat again today.

10/26/2005, Day 103 – 100th day in Hartford Hospital. Smaller tracheostomy installed. First trip out of the Step Down unit for dinner in the family lounge.

10/27/2005, Day 104 – Staples removed from abdominal skin graft.

10/28/2005, Day 105 – Physical Therapists help Lea stand up for first time since July. Tube in nose to pump stomach removed.

10/29/2005, Day 106 – Dr Chuckwumah reports skin graft on the incision site is advancing better than expected.

10/30/2005, Day 107 – Medications being administered as tablets, rather than intravenous fluids.

10/31/2005, Day 108 – Lea took a big step forward when she was able to eat a meal without assistance.

11/1/2005, Day 109 – Large amount of pancreatic fluid voluntarily drains from the abdominal wound area. Planned departure for Indiana on Thursday postponed.

11/2/2005, Day 110 – Endoscopic ultrasound performed to determine whether source of yesterday’s fluid leakage could be located. Unsuccessful.

11/3/2005, Day 111 – Drain inserted into her right side, near the back, to drain fluid from the pancreatic cavity, which connects to the volunteer drain hole in her abdomen. Endoscopic procedure performed to possibly place stent in pancreas to small intestine. Unsuccessful.

11/4/2005, Day 112 – Preliminary plans made for return to Indiana later this week.

11/5/2005, Day 113 – (#4 size) smaller metal tracheostomy installed to replace the temporary plastic model installed for the endoscopic procedures.

11/6/2005, Day 114 – Fever, nausea, P.I.C.C. line change.

11/7/2005, Day 115 – A change in the nausea medication she is receiving seemed to make her feel better. Fever persists.

11/8/2005, Day 116 – Continued nausea. Temperature now under control. Transfer to Indiana delayed again until next week.

11/9/2005, Day 117 – Larry took Lea on wheelchair trip to the family lounge, pulling along the required IV tower.

11/10/2005, Day 118 – Wheelchair trip to the front lobby. Made a small purchase of a few items at a vendor’s display.

11/11/2005, Day 119 – Wheelchair trip to the gift shop. Didn’t see anything she had to have.

11/12/2005, Day 120 – Lea given a Prayer Shawl from a church in nearby Hebron, Connecticut.

11/13/2005, Day 121 – Wheelchair trip to the hospital’s chapel. Later, watched a bit of a rented movie, then was ready to get some rest.

11/14/2005, Day 122 – Wheelchair trip to 11th floor ICU which was empty during renovations. She liked the quiet.

11/15/2005, Day 123 – Wheelchair trip to cafeteria; chocolate hazelnut frozen yogurt and diet Stewart’s root beer. Dr Mah removed tracheostomy. Transfer to Riverview Hospital, back home, canceled due to lack of adequate surgical services there. Dr Miller, our family physician back home, has not located an Indianapolis surgeon at who would take Lea as a patient, due to her severe medical issues.

11/16/2005, Day 124 – Dr Mah scheduled CT Scan to determine why Lea is not able to eat, and she continues to vomit her intake of liquid. Notifies us that we should plan to be here in Hartford through end of the year. Lea is moved from Step Down unit 3 to private room 928 on the same floor.

11/17/2005, Day 125 – “Trapeze” exercise frame ordered to be placed on her bed so she can start trying some strengthening exercises.

11/18/2005, Day 126 – Lea is back on nothing to eat or drink for at least one more week. EKG leads removed.

11/19/2005, Day 127 – Developed a light cough that continued to increase in frequency during the day. By noon she was coughing up thick phlegm, and by evening was coughing frequently, and deeply, bringing up thick yellow matter from her lungs.

11/20/2005, Day 128 – She has a deep chest cold. Her temperature by nine o’clock this morning climbed to 102.5 degrees. Slept biggest part of the afternoon.

11/21/2005, Day 129 – Currently on a water-only diet, to attempt to stop drainage of pancreatic fluid through the abdomen.

11/22/2005, Day 130 – She discovered that she is able to roll over on her side enough to reach the controls that raise and lower the head of her bed. It keeps her busy. She also discovered that she has a clock on the wall at the foot of her bed, and is tracking her medication times. She rings for the nurse as soon as her dose is due.

11/23/2005, Day 131 – Lea gets haircut and styling in her room. Son, Link, and granddaughters arrive from Hawaii.

11/24/2005, Day 132 – Thanksgiving Day. Lea’s brother, Jim, Ruth and their grandson, Josh, arrived mid-afternoon for a surprise visit.

11/25/2005, Day 133 – Link and the granddaughters continued to entertain Lea and son, Lance, and his finance’, Kristin, arrived from Texas this evening to complete the holiday gathering. It didn’t seem to be such a difficult chore for her to get out of bed into the wheelchair to go do family events today.  🙂

11/26/2005, Day 134 – Another spectacular day with our children and grandchildren! We had nice “outings” for Lea, which involved getting out of bed and moving around. We went to the cafeteria for lunch, and then went to the family lounge after dark for a nice quiet dinner with Lance and Kristin.

11/27/2005, Day 135 – Lea felt pretty well all day, ate a couple of times without getting nauseous, and was able to visit quite extensively.

11/28/2005, Day 136 – Endoscopic study of her stomach and duodenum, to see if the cause of her vomiting could be located. Stricture in duodenum identified.

11/29/2005, Day 137 – Physical therapist takes Lea on first trip to the shower in wheelchair. Instructs Larry on procedures and techniques to help Lea in the shower; her skin graft areas and fistula must be kept dry.

11/30/2005, Day 138 – First trip via wheelchair to PT gym to look it over. We may get transferred to the wing where the gym is located so she can access it regularly.

12/04/2005 – Updates reduced to weekly. No vomiting since early this week, and her nausea has been greatly reduced. Drain in side removed.

12/11/2005 – Queasiness continues. Pancreatic fluid continues to drain from abdomen. Heart monitor eliminated. Saline drip eliminated.

12/18/2005 – Fistula may be closing up, indicating that the body may be ready to deal with the pancreatic fluids. She walked in a walker!! She walked into the ICU and received a round of applause from the nurses!! Lea spent well over an hour arranging fresh flowers into two large vases. Then slept.

12/25/2005 – Wonderful Christmas Day in the hospital. CT scan ordered to see what is going on in her abdomen that is causing her to feel full all the time. Dr Mah tells her she needs to be out of bed more than she is in it. Lab reports came back with nearly normal results. Walked to family lounge from her room, using only the wall mounted hand rail for support.

01/01/2006 – Lea stood up, unassisted, by the side of her bed, held out her hand to shake hands, and greeted Chief Surgeon, “Dr Kirton, It sure is nice to see you again!” He was overwhelmed! Her medical issues seem to continue to improve.

01/11/2006 – Discharged from Hartford Hospital, we flew commercial airline back to Indianapolis to begin recovery.

To read further updates on Lea’s recovery, click on the “Lea’s Timeline” page. The above collection of Lea Updates has become known as The Hartford Letters, and all content is property of Vaughn Consulting Group, LLC. All rights reserved.