Saturday, February 12, 2011

Update #133 on Kevin - ICU

Just finished meeting with Kevin's Critical Care Doctor. Both of Kevin's Critical Care Doctors have been great. We have appreciated their patience and teaching as we went through a difficult situation. We have been able to relax due to the entire staff in the CC unit.


His doctor said that Kevin is doing well and definitely making progress. He is not septic anymore, and now we are just basically finishing up the treatment for his pneumonia. Earlier in the week he had told us about Kevin's X-rays which showed a lot of fluid in his left lung. Today's X-rays were great. They are absolutely clear. It shows too, because Kevin has not been coughing near as much the last few days.

Kevin's progress off the CPAP machine is going well too. With the low settings that I told you about in the previous update (8 Pressure and 30% O2), he is now just needing to tolerate this well. What that means for prayer terms is that he is breathing around 30-37 times per minute now, and he needs to slow down to the 20's. His doctor thinks by tomorrow (Sunday) or Monday that Kevin will be able to switch to flowby.

No real concern left on the light amount of blood in his urine, hopefully that continues to resolve itself. The doctor is thinking Kevin will stay in ICU until Monday. Then maybe between Monday and Tuesday, he will be switched to a step down unit that is outside of Critical Care. Please be praying for the doctors that Kevin will have in that department.

We had asked the doctor earlier in the week to take a look at Kevin's peg tube and see what he thought about replacing it. That should be something that can be done Monday or after next week. Also, I mentioned to him that Kevin is overdue on some MRI's that Kevin's neurologist is wanting. The CC Doctor thinks that can be done around Wednesday next week. We started trying to schedule an MRI back in early December so this will be a great help to get it done now too.

Quicklinks to Recent posts -
Update #132 - http://bit.ly/update132
Update #131 - http://bit.ly/update131
Update #130 - http://bit.ly/update130
Update #129 - http://bit.ly/update129
Update #128 - http://bit.ly/update128


Thanks for reading and praying,
Matt, Angie and family
_______________________________
Pray For Kevin
http://www.prayforkevin.com/
follow on twitter: pray4kevin
facebook: Pray for Kevin

Update #132 on Kevin - ICU

Today continues to bring good news for praise. After trying a little last night, to wean the pressure support (I misadvertently said previously they were reducing the PEEP setting, but I meant the pressure support), Kevin has made great strides today. They reduced the pressure support settings on the CPAP machine from 14 to 8.


They've also lowered the oxygen amount to 30%. Once Kevin is tolerating these levels well, they can switch him to flowby getting him closer to regular breathing.

This morning also brought the news that Kevin does not have Cdiff. He is still having a little blood in his urine, but overall that has improved tremendously since they replaced his catheter and started irrigating his bladder.

We talked to his doctor about changing his feeding tube. If you'll remember, we went in to change it back in September and the doctor said it just needed cleaned out. It has deteriorated more since then and we hoped they might be able to change it. His critical care doctor didn't think this would be a problem, once he got stabilized.

Taylor, Kevin's daughter, arrived from Midwest City yesterday afternoon. We spent the evening together as a family and went back to visit Kevin once the visiting hours started again. Today, she went up to the hospital in order to give Angie and I a break. Thanks Tay!

Thanks so much for your prayers on behalf of Kevin and our family! It means so much.

Quicklings to Recent posts -
Update #131 - http://bit.ly/update131
Update #130 - http://bit.ly/update130
Update #129 - http://bit.ly/update129
Update #128 - http://bit.ly/update128

Thanks for reading and praying!!!!
Matt, Angie and family
_______________________________
Pray For Kevin
http://www.prayforkevin.com/
follow on twitter: pray4kevin
facebook: Pray for Kevin

Friday, February 11, 2011

Update #131 on Kevin - ICU

Kevin is continuing to improve. We spoke with his doctor this afternoon and feel really good about Kevin's progress. He has been on CPAP settings on the vent for about 33 hours now with no problems. An hour or so ago, the doctor started lowering the pressure from 14 to 12 (PEEP) on the vent. After a couple hours, if he seems to tolerate it, they'll lower it again. They'll keep doing that and when he is tolerating an 8, they can switch him over to flowby.


For the past couple days, Kevin has been getting food through his feeding tube. It is the same formula that he gets at home, that is jevity 1.2.

For the infection in his body and pneumonia, Kevin has been getting three different antibiotics. Vancomyacin, piperacyllin and another more generic antiobiotic. While these are helping with his infection, there is a side effect too. There is potential for C-Diff in his colon. He had it at Saint Francis and Meadowbrook a year and a half ago, which makes him more likely to get it again. They tested him for it, and we should find out tomorrow.

The doctors' focus had shifted onto the blood in Kevin's urine. Last night they took three steps towards diagnosing it. First they changed his catheter. Next they tried irrigating his bladder. Then they took him for a Ctscan. When they changed the catheter, they found that it had been put in incorrectly when he arrived in the ER. The urologist said just that could have caused the bleeding that we have been seeing since arriving (especially since his blood was too thin). The irrigation has been flushing any blood out of his bladder, and right now the blood is very faint. The ctscan showed nothing of importance and therefore would not need to do a scope based on the ctscan.

We are starting to have more routine with Kevin again. Physical therapy has been coming by each day to work out his muscles and keep him from getting rigid. When they bathed him last night they also shaved him. He was starting to get scratchy barbs on his face so it was definitely time for a change.

For about 36 hours Kevin has been completely off of dopamine. That was the medicine used to raise his blood pressure to regular levels. His blood pressure has stabilized and is doing good. Right now, it is 100/65 with a map of 78. Looking good.

If you've missed the previous updates here are some quick links:
Recent posts -
Update #130 - http://bit.ly/update130
Update #129 - http://bit.ly/update129
Update #128 - http://bit.ly/update128

Thanks for reading and praying!!!!
Matt, Angie and family
_______________________________
Pray For Kevin
http://www.prayforkevin.com/
follow on twitter: pray4kevin
facebook: Pray for Kevin

Wednesday, February 9, 2011

Update #130 on Kevin - ICU

Of course, we didn't know what to expect from the weather and we ended up getting 5.5 inches more snow. It seems to be more driveable than the sleet driven snow last week. Glad we weren't 40 minutes to the Northeast, they got 25 inches!!! So, Kevin and I have been fairly isolated today as far as external visitors go. There have been several staff that have stopped by.


The chaplain, a little elderly nun, came by and introduced herself. She told me that she has seen us the past few days and told us what great condition Kevin is in for Home Health Care. She then proceeded to pray for him silently.

Then the Family Care Specialist came by and introduced herself. She said she only started a couple days ago and was there anything that the family needed. I told her that most everything was great. The biggest hangup we have had is the visiting hours. Visiting hours are closed until 6-9AM; then 6-8 PM and finally 10-midnight. We've had a couple come up and not be able to see him during those hours.

Rene, the nurse manager came in and introduced herself too. While I was out (due to visiting hours being off), she brought by an approved power strip for all my electronics and laptop. Earlier I didn't know who brought it in, the current nurse just told me it was there to use.

Stephanie, Barbara and Norma came in after lunch. They are the physical therapists that will be working on Kevin's range of motion. As he improves, they will try more advanced things, such as he does at therapy twice weekly. Examples might include, sitting up on the side of the bed assisted, more strengh training for neck/legs, etc…

Dopamine/Blood Pressure - As far as getting him off dopamine, we slowed down. Part of the issue is that we got a new nurse today, not a bad one, just new to Kevin. During the night, the night nurse had got Kevin down to 2 mg of dopamine. The day nurse hadn't been on more than an hour or two when she saw his Blood Pressure levels hovering near the low side and she bumped up his dopamine from 2 to 5 mg again. It took me several hours to get her to try to reduce it again. She has now his Blood Pressure is doing well and he is getting 4 mg. Hopefully, we can keep taking ten steps forward and only two steps back.

Not sure where it is at, but Kevin has put on some extra weight. He weighs 205 lbs. Before this trip to the hospital he was around 194. So that means he has picked up ten or eleven pounds, although there is the possibility there is a difference in the bed scale and the therapy scale that we normally use.

Ventilator - Twice now they have switched the ventilator so that Kevin is breathing on his own and the vent is helping him. Twice they have stopped it very close to breathing treatments. This is normal at home and normal for Kevin to have increased breathing rates and coughing after a breathing treatment. The doctor said they will keep working on it and not have the knee jerk precautionary reactions. To do everything he can to at the very least get him on flowby (room air).

Today, Kevin has been awake for several hours. Probably 4 hours so far. I have talked with him and put different shows on TV on for him.

We also found out that they might be some sort of blockage in his urinary tract, but not bad, he is still urinating. The doctor is getting a Urologist on board to come see him tomorrow. His echo came back fairly good for his heart. He just had some pulmonary hypertension on his right side. But its not bad and nothing can really be done about it.

Just finished speaking with one of his critical care doctors. Both of them have been great so far, Dr. Taneja and Dr. Suku. We talked about thirty minutes. At the end he told me that he has done this for a long time and that he has seen many chronically trached patients like Kevin and that he has never seen a family more invested or educated about their family member's situation and what to do to help. Makes ya feel like you are doing things right. The doctor also said that Kevin is winning.

Recent posts -
Update #129 - http://bit.ly/update129
Update #128 - http://bit.ly/update128

Thanks for reading and praying!!!!
Matt, Angie and family
_______________________________
Pray For Kevin
http://www.prayforkevin.com/
follow on twitter: pray4kevin
facebook: Pray for Kevin

Update #129 on Kevin - ICU

Tonight, in preparation for the upcoming winter storm/blizzard, we decided that I would stay the night with Kevin at the hospital. That way, in case everyone is snowed in, someone is with him in ICU. They are all very nice here and are allowing me to stay on a couch/bed that is in Kevin's room.


Kevin's fever is still gone, two days in a row. His heartrate has become much more normal , right now it is 79 and he's awake (yeah it's 2 AM - he's still a night owl). The medical staff have been weaning Kevin off the dopamine, which is to combat low blood pressure. They have lowered the dopamine from 15 mg yesterday (Monday) to 3 mg by this evening (Tuesday). His blood pressure is remaining steady and keeping up with the changes in medicine.

Also, this evening they have started weaning him off the ventilator. All evening he has been initiating all his breathing and the machine only helps if he doesn't take a deep enough breath. Because of the pneumonia, his breathing has been more shallow. Yet, even with the changes in the ventilator, his lungs are keeping up, for 9 hours so far. After his most recent breathing treatment, he needed a break so they switched back his vent settings with a plan to start the weaning again in the morning.

His nurse tonight, told me that every nurse that comes in to help her do something with Kevin cannot believe that he has been at home with home health care. They have all said the family is doing an excellent job caring for him. They can see it in his skin and the lack of any pressure sores whatsoever. And this morning when the physical therapist came and did and evaluation on him, she said that he has excellent range. They are now sending techs to come and do range of motion even while in ICU.

Apparently, at first Kevin's kidneys were not functioning good after we arrived here. Now Kevin's kidneys are functioning well, so they started giving him food through his peg tube. We spoke with the doctor about the possibility of changing his peg tube while we were here at the hospital, since his is approximately one year and five months old. Once things get stabilized they will look into that.

He still has blood in his urine that is unaccounted for, however it is lessening. They would still like to know where it is coming from. There is a plan to do an ultra sound to see if he has any kidney stones sometime soon.

Tomorrow they plan to restart provigil (at home we use nuvigil), which is an alert medication. However, throughout the day today it has been more alert than yesterday. And as normal, wide awake about an hour ago in the night.

If you would like to send cards you can get the address at St John's website. However, you can also do this digitally by clicking the following link http://www.sjmc.org/general.asp?id=322&siteuse=11 and filling out the form. Kevin is in room 809. We have a wall that we can tape any cards up, cheering Kevin up in the process.

More later, but for now, thanks for reading and praying,
Matt, Angie and family
_______________________________
Pray For Kevin
http://www.prayforkevin.com/
follow on twitter: pray4kevin
facebook: Pray for Kevin

Monday, February 7, 2011

Update #128 on Kevin - ICU

     We know it’s been a few months since we've done an update on Kevin.  Life has moved forward.  Angie and I returned to Italy to pack up our house and close out our aspect of the ministry that's still going on there.  We had a great Thanksgiving, Christmas and New Year's at home with Kevin and the rest of the family.

     However, I'm writing you from an ICU room at St John's Hospital in Tulsa, Oklahoma. It's been a whirlwind this last week, so I'll try to update you quick and get to the prayer needs for Kevin. 

     Things started getting tough about a week and a half ago.  First Angie, then Jacob,
finally Kohl all got the flu.  With the blizzard last week and record-setting snowfall in Tulsa, we didn't have nursing.  I found myself caring for a housefull of sickos and Kevin.  Fortunately, Brandon was able to come and help some days, because of being out of school due to the snow.

     We thought we had made it out of the woods but Saturday night things took a turn.  Kevin has spells of coughing, but it will eventually be resolved with one of several methods of care.  He started coughing at 9PM Saturday night and continued coughing, getting more incessant and worse over the next seven hours.  We ran through the checklist of everything we were taught to do in order to relieve his coughing (cough syrup, saline breathing treatment, repositioning, xopenex breathing treatments, etc….).  After calling a couple medical professionals, we followed their advice and called 911.  On a normal day, we could have just taken Kevin in the van, however, there is still so much snow on the ground and driveway that it was not possible. Firemen and EMSA (ambulance service) arrived and got Kevin ready for transport.  Angie rode in the EMSA truck and I met them at the hospital driving in the snow in the early hours between Saturday and Sunday.

     After some time in the ER, we found a rapidly rising temperature (at home it was 99) of 102-103.  His blood was way too thin. His potassium was very high. Kevin’s blood pressure was dangerously low (at the lowest I saw it was 69/39) and his oxygen levels were dropping.  He had blood in his urine and had thrown up some as well.  Kevin’s heart rate and breathing rate were very fast. 

     Yesterday afternoon, they moved Kevin into an Adult ICU room on the 8th floor.  A vitamin K shot was given to combat the thin blood, electrolytes for the high potassium, dopamine for the low blood pressure, O2 for the low O2 levels and Tylenol for the fever.  They found pneumonia and some sort of infection that made him septic.  Septic is an issue where the blood is infected. This made the staff use a Septic protocol of constant testing to insure the various levels of his body’s statistics.

     During the night (last night), Kevin’s nurse called to tell us that from a blood gas test, his O2 levels were too low in his lungs and his Carbon Dioxide (CO2) levels were too high.  They needed to put Kevin on a ventilator in order to keep the infection from winning in his lungs.  Since then his blood gas levels have been good.  Kevin’s fever is now gone.  His heart rate is much more normal now.  With the dopamine his blood pressure is getting back to normal, although to wean him off the dopamine it needs to become stabilized.  This morning, after we got here, Kevin cracked open his eyes and even turned toward me when we came over to his bedside.  He immediately went back to sleep, but that was good since he hadn’t opened his eyes since getting to the hospital.  Several other times today, he has reopened his eyes, twice with visitors and a couple others just with Angie and I in the room. Even though he still has some septic symptoms, he is no longer under the septic protocol. 

     As things progress, we will update you via email, facebook and the prayforkevin.com website.  More up to date info can be gotten by following me on Twitter (username mcrosser or pray4kevin) and my Facebook status.  Thanks so much for your prayers and thoughts.  No flowers or balloons can be sent to his ICU room, but please feel free to send cards to Kevin Crosser, room 809 at St John’s Hospital in Tulsa, Oklahoma. 
Thanks for reading and praying,
Matt, Angie and family
_______________________________

Pray For Kevin
http://www.prayforkevin.com/
follow on twitter: pray4kevin
facebook: Pray for Kevin