Update 9/20/2011

So, things were fairly quiet the last few days. Dad is still in the hospital, fighting an infection in the incision made to replace the pump. The put a wound vac on it after doing a surgical clean-out and debridement and we thought he was over the hump. Turns out he's now got another injection just above the first one. He's going back to the OR today for another clean-out and debridement.

Not sure when he'll be coming home. The main doctor seems to want to get him home ASAP, even though his family, therapy and most of the nursing staff think he needs to stay until he's at least over all these infections. Especially the last couple of days where he's been very tired and no energy from his body fighting the infection. Whenever he's tired, his mental confusion goes up, which makes him potentially be home by himself a bad idea.

We are waiting to find out today what the doctors find in the OR. Not sure we'll get any resolution to the apparent stalemate, but at least we should have more information to debate.

Update 9/14

So, Dad had to have minor surgery last night to clean up an infection. The infection was in the incision made during his pump replacement. They had tried lots of antibiotics, but it wasn't going away so they had to open him up and clean it out. Now he has a "wound vac" on it and hopefully it will heal properly.

Not sure when he's going home yet. He thinks Friday at the earliest, the family is hoping for a few days more than that so that he regains as much strength as possible. That's about it for now.

Update 9/10

Dad is doing good today. He woke up with minimal confusion and is definitely more awake. The pain in his abdomen is better, so hopefully the blood clot in his spleen is clearing. They haven't done another CT and they won't unless his symptoms change or the pain comes back.

They are continuing the antibiotics for the infection. His incision is oozing quite a bit, so hopefully the meds will start working soon.

That's about it for today. Good news for the most part so hopefully we are further along the road to full recovery.

Update 9/9

Just talked to the nurse. Dad is doing ok. Dr. Joyce was just in and said everything is looking good. He's up in a chair right now. Still has the chest tube for now. The nurse thought the confusion was a little less today. He got a little agitated and restless last night,but they think that was from pain. They got that under control and now he seems calmer.
Update 11:30am: Dad is pretty out of it. He hasn't really eaten anything and is in a considerable amount of pain. Infectious disease has found bacteria in his blood. His WBC count is normal and he does not have a fever. It does not appear to be sepis at this point, but there are blood results pending for that. They have also cultured his urine.
Because of pain in his abdomen and the infection, he will be going down soon for a chest and stomach CT. More as we find out.

Update 8:30pm: So, Dad does have a blood infection. He's not septic yet thankfully, and they have started him on super powerful anti-biotics. The other thing we learned is that he has a spleen infarction. Basically, there's a blood clot cutting off the oxygen to his spleen. It's very painful. At this point they are keeping a close eye on it and hoping the clot dissolves on its own. They really don't want to have to do another surgery.

They've also removed the chest tube, so the PICC line is the only thing he's "hooked up to". They can use that for giving meds, drawing blood, etc.

He's still pretty confused and sleepy. Tonight he couldn't remember how to feed himself. Hopefully this will all pass very soon as it's very hard to watch (or even hear about).

Update 9/8

Guess I forgot to update last night. They got the PICC line in with no problems and removed the central line.
He had a bit of a rough evening at first because he can't verbalize asking for pain meds. Once the nurses figured that out, he did better as they were able to keep meds on board. He didn't sleep much last night as he's easily stimulated with activity in the room. They are considering moving him to the step-down unit where it's a little quieter.
Right now they're taking him for a CT of his head to check for signs of a new stroke. It's precautionary only at this point. He's still not able to communicate very well and not really able to follow commands. That is not surprising as we knew the anesthesia would aggravate the stroke symptoms. We won't know results until this afternoon.
I'll try to post more frequently, but I'm at work so it's not as easy.

UPDATE 1:40PM: CT came back clear. No new stroke or bleed!

Update 9/7/2011

Dad is doing well. They removed the vent about 1pm and put him on a CPAP as he was getting pretty agitated from the breathing tube. He's much calmer now.

His vitals continue to look good, and his kidneys appear to have recovered at this point.

Right now they are putting in a PICC line and possibly removing the central line they put in yesterday.

Final Surgery Update

First and most important, the surgery is done and they are working on closing him up. Dr. J. said that the surgery was challenging, but obviously successful. They did not go through the sternum like last time, they did something called a "subcostal" incision, which means they went in under the ribs. There was a fair amount of scar tissue already built up in the ribcage, so they had to put the pump in at an angle and the first time they did it they broke an o-ring on the pump. That is why he had to go back on bypass - so they could fix it. They found a large clot around the cuff that attaches to the heart. They suspect pieces of it were breaking off and getting into the pump, causing the problems he's had for the last few days. They can't see inside the pump right now, but they suspect the company will find a piece of the clot inside it and stuck. During the surgery he started producing urine and it was clearing up. That's not to say that his kidneys are completely ok at this point, but it's encouraging. He may still need dialysis, but they won't know for sure until things have settled down more from the surgery. Dr J. said he was confident that whatever his kidneys might need right now is only temporary. This whole thing could happen again, although it's not common for this model of pump. Dr J. felt that the clot started to form when they had to back down his anti-coagulation meds to account for the GI bleed he had a month or so ago. This time around they will be more aggressive with the anti-coagulates and not as sensitive to the GI bleed. "It's all a balancing act" was the quote. He's on a vent until probably tomorrow. They'll also hopefully get a mental evaluation tomorrow, or whenever they get him off the vent. Dr J. did tell us to expect him to act like he did the first time, if not a little worse. Apparently the affected parts of the brain from a stroke hold onto the anesthesia longer than the rest of the brain. It should clear up in a few days though. Recovery in the hospital will likely be longer than last time, but it's way too early to know for sure. Dad got back to his room about midnight and looked pretty good all things considered.