Very briefly...last night was pretty rough. Richard thought he was going to die. The day was pretty routine but punctuated by two visits from Professor Hanna both of which left a smile on Richard's face and confidence in his heart. Constant moist oxygen altered with a nebuliser to get the phlegm broken down. I wanted to stay the night at the hospital and luckily they had the same room available. I went up around midnight leaving Richard sounding pretty awful and told him to call me at any moment he felt like he wanted me near. The call came at 3am and Maria, the duty nurse said he wanted me. He was very agitated and said he thought he might be dying. I got Maria and another amazingly sweet nurse to come over and tell him how well he was doing (no lie), all his vital signs looked very good and it was just going to take some time to get rid of the infection. This put him in a better mood and by 3:30 he was asleep holding my hand and we pretty much stayed that way until 5am when he woke and said he felt a lot calmer. They kicked me out at 6am and I went back to sleep upstairs til 8:00. He seemed a bit better and full of purpose when I returned and he shooed me off to take the car back to Earl's Court and get back by 10:20 for a big doctors meeting about him. I did that but when I returned I had to wait til he was finished with physio. By the time I got back he'd already done two walks around the ICU unit and was being taught coughing techniques.
Janine, the day duty nurse, set my mind at ease saying he was doing really well and we shouldn't get worried.
Signs of progress: he had a bowel movement! (momentous occasion), they've reduced the concentration of his oxygen by about half and he is getting excellent saturation levels which shows that the lungs are improving, I think. They turned off his epidural and will remove it tonight if he's still comfortable. The neck iv should be removed this evening and he is scheduled to have his SALT (Speech and Language Test) later today to access how his throat valve is working as it must stop liquids and food from getting into his bronchial tubes before they let him drink and eat.
When I left around 12:45 after the panel of doctors had done their assessment and seemed pleased with the progress, Richard seemed determined to do lots of walking and practice his coughing. He said his life depended upon it. So he's still very nervous about his condition but feeling optimistic at the same time.
It's 2:19, I'm back at the flat and am going to sleep for a couple of hours or else I won't be good for anything.
Monday 31 January 2011
Sunday 30 January 2011
The Fourth Day
I saw Richard in hospital around 1pm where he was again sitting in his chair. They'd already had him up walking and had to insist that he couldn't go up the stairs! (I haven't seen the process of 'walking' myself but I think its a bit of a to do...like a courtly procession, with all the machines being dragged around behind him and people making sure he's not snagging any tubes!) I sat opposite him and rubbed his stockinged legs until the new lady patient next to him said, "When you're through with him you can start on me!" Nice to be appreciated. I was told that they'd started him on antibiotics to head off the little infection in his chest. Two visitors kindly came in very briefly to say hi just before 2pm.
Around 4:30 I returned to find Richard soundly asleep so went into the reception to give him some time. When I returned around 5pm there were several nurses huddled around his bed and I rushed over. He was shivering violently and said he'd just awakened from the worst nightmare he'd ever had. His temperature rose to 38c and they gave him some paracetamol intravenously. In about five minutes he was fairly well settled again. He told me he'd had two more lovely visitors since he'd last seen me.
The evening progressed with another visitor coming in and cheering Richard up wonderfully. We all, with the fantastic nurses, rather comically stood/sat around and practiced our coughing techniques as it's important that Richard eventually can cough up the phlegm in his chest.
Dr Patel came in and looked over Richards charts and heard about his shivering episode and didn't seem too worried. He asked that a new type of moistening oxygen mask be put on. At the 8pm shift change Professor Hanna came in and looked over all Richards charts, spoke to all the nurses and introduced us to one his sweet young daughters who was making the rounds with him. He said that the infection in Richard's lung was being treated and he fully expected it to clear up. The reason that Richard was having trouble coughing was that the nerve which controls the valve around the larynx was bruised and therefore impeding the process. It would take a few more days to recover. He said that Sunday he wanted for Richard to have his leak test, which if he passes, will allow him to take some small quantities of water and slowly build up to soft solid foods. He also said the neck iv port would be removed and replaced by an arm one and a couple of the drains would be removed. A few less wires, tubes and piercings. Yipee!
Richard was shooing me away at 8:30 to have dinner with good friends, David and Ian, in Earls Court but I told him to call me if he wanted me back as I could tell he was a bit on edge after his shivering episode. Sure enough, at around 11pm Freddy, his nurse called to say Richard wanted me back in...the duty doctor was talking about putting him back on a ventilator as his congestion was a bit worse. Ian, himself a renowned surgeon who was on call with his hospital, selflessly drove me back to the hospital and came in to talk with the staff and see Richard. It appears that, whatever Richard understood the duty doctor to have said left him extremely frightened that unless he stayed up all night and cleared his lungs every 20 minutes, he would die!!! So, no wonder Richard was agitated and wanted me there. Because of this Richard had also asked that a physio come in to see him immediately. And, in fact, the lovely Eve appeared in no time and helped Richard in a wonderfully quiet, reassuring way to try and cough up what he needed to and assisted with a vacuum tube down his nose. Ian felt Richard was in good hands and saw all his vital signs were good so went home. I sat around until about 12:30 am when Maria, the duty nurse kindly found a room upstairs for me to sleep in, just in case Richard wanted me during the night. I slept til about 7:45 then went down to be there during the shift change. Richard told me he had slept some and had gotten some phlegm up during the night. All his signs were good. He's still having to have constant oxygen til the lung that was collapsed for the surgery regains it's full capacity. And sadly, his new mask, while providing warm, moist air which is giving him oxygen plus helping to break up the fluids in his lungs, is a bit less comfortable than the other ones. I left him around 9am looking forward to a dressing change, then getting to his chair and hopefully the leak test, though his nurse Manga said she thought those were only done on weekdays. Poor guy, he's been through the wars! It will be such a good step change when he's into a private room where I know he will sleep as I did last night. With luck, that should be Monday or Tuesday. It's 11:28 as I sit here back in the flat and post this update. Onwards and upwards!!
Around 4:30 I returned to find Richard soundly asleep so went into the reception to give him some time. When I returned around 5pm there were several nurses huddled around his bed and I rushed over. He was shivering violently and said he'd just awakened from the worst nightmare he'd ever had. His temperature rose to 38c and they gave him some paracetamol intravenously. In about five minutes he was fairly well settled again. He told me he'd had two more lovely visitors since he'd last seen me.
The evening progressed with another visitor coming in and cheering Richard up wonderfully. We all, with the fantastic nurses, rather comically stood/sat around and practiced our coughing techniques as it's important that Richard eventually can cough up the phlegm in his chest.
Dr Patel came in and looked over Richards charts and heard about his shivering episode and didn't seem too worried. He asked that a new type of moistening oxygen mask be put on. At the 8pm shift change Professor Hanna came in and looked over all Richards charts, spoke to all the nurses and introduced us to one his sweet young daughters who was making the rounds with him. He said that the infection in Richard's lung was being treated and he fully expected it to clear up. The reason that Richard was having trouble coughing was that the nerve which controls the valve around the larynx was bruised and therefore impeding the process. It would take a few more days to recover. He said that Sunday he wanted for Richard to have his leak test, which if he passes, will allow him to take some small quantities of water and slowly build up to soft solid foods. He also said the neck iv port would be removed and replaced by an arm one and a couple of the drains would be removed. A few less wires, tubes and piercings. Yipee!
Richard was shooing me away at 8:30 to have dinner with good friends, David and Ian, in Earls Court but I told him to call me if he wanted me back as I could tell he was a bit on edge after his shivering episode. Sure enough, at around 11pm Freddy, his nurse called to say Richard wanted me back in...the duty doctor was talking about putting him back on a ventilator as his congestion was a bit worse. Ian, himself a renowned surgeon who was on call with his hospital, selflessly drove me back to the hospital and came in to talk with the staff and see Richard. It appears that, whatever Richard understood the duty doctor to have said left him extremely frightened that unless he stayed up all night and cleared his lungs every 20 minutes, he would die!!! So, no wonder Richard was agitated and wanted me there. Because of this Richard had also asked that a physio come in to see him immediately. And, in fact, the lovely Eve appeared in no time and helped Richard in a wonderfully quiet, reassuring way to try and cough up what he needed to and assisted with a vacuum tube down his nose. Ian felt Richard was in good hands and saw all his vital signs were good so went home. I sat around until about 12:30 am when Maria, the duty nurse kindly found a room upstairs for me to sleep in, just in case Richard wanted me during the night. I slept til about 7:45 then went down to be there during the shift change. Richard told me he had slept some and had gotten some phlegm up during the night. All his signs were good. He's still having to have constant oxygen til the lung that was collapsed for the surgery regains it's full capacity. And sadly, his new mask, while providing warm, moist air which is giving him oxygen plus helping to break up the fluids in his lungs, is a bit less comfortable than the other ones. I left him around 9am looking forward to a dressing change, then getting to his chair and hopefully the leak test, though his nurse Manga said she thought those were only done on weekdays. Poor guy, he's been through the wars! It will be such a good step change when he's into a private room where I know he will sleep as I did last night. With luck, that should be Monday or Tuesday. It's 11:28 as I sit here back in the flat and post this update. Onwards and upwards!!
Friday 28 January 2011
The Third Day
He's doing well. That's what all the marvelous nurses were saying today.
Apparently, Prof Hanna came in to see Richard last night at 11pm after he had completed another long surgical procedure. I think he asked that Richard be put in his chair as early as 5am to help clear the fluid in his lungs and I believe Richard stayed there until 11am. He got to go back to bed where I greeted him around noon. He seemed a bit groggy and was desperately trying to cough up his congestion. We're practicing cause he's about 85% there. Angeline, the Sister on duty said, "Don't worry...It will come!"
He was in his chair visiting with a friend when I returned around 5pm and while the friend and I visited Richard dropped off into a deep sleep for about 30 minutes. Nice to see. A bit later another friend arrived and Richard perked up more to reach his cresendo for the day which seems to end at the shift change around 8pm.
If Richard progresses like his neighbor in the ICU who had exactly the same operation by George Hanna last Saturday, he should be graduating to a private room on Monday. That will be wonderful for all concerned, as there he will be reunited with his mobile phone and his texting fingers will get back to their former glory!
Apparently, Prof Hanna came in to see Richard last night at 11pm after he had completed another long surgical procedure. I think he asked that Richard be put in his chair as early as 5am to help clear the fluid in his lungs and I believe Richard stayed there until 11am. He got to go back to bed where I greeted him around noon. He seemed a bit groggy and was desperately trying to cough up his congestion. We're practicing cause he's about 85% there. Angeline, the Sister on duty said, "Don't worry...It will come!"
He was in his chair visiting with a friend when I returned around 5pm and while the friend and I visited Richard dropped off into a deep sleep for about 30 minutes. Nice to see. A bit later another friend arrived and Richard perked up more to reach his cresendo for the day which seems to end at the shift change around 8pm.
If Richard progresses like his neighbor in the ICU who had exactly the same operation by George Hanna last Saturday, he should be graduating to a private room on Monday. That will be wonderful for all concerned, as there he will be reunited with his mobile phone and his texting fingers will get back to their former glory!
Thursday 27 January 2011
The Second Day
Doctors stated they were all happy with Richard's progress at this mornings daily pow wow. Richard told me he was exhausted though as he hadn't slept at all. He had also been in a bit of pain as they had decreased the epidural so they put it back up to what it was. He's pretty swollen again...something very temporary, apparently.
He sat upright in a chair for over an hour today which is considered excellent therapy for the lungs and chest cavity. He's going to try and top that tomorrow!
When I saw him again this evening from 6 til 8 he'd been bathed and his nurse Edgar said he'd actually slept for an hour. We saw in three visitors who were wonderfully sensitive to Richard's fragility right now but who also added the spice that gave his day a good flavour to go to sleep with.
He sat upright in a chair for over an hour today which is considered excellent therapy for the lungs and chest cavity. He's going to try and top that tomorrow!
When I saw him again this evening from 6 til 8 he'd been bathed and his nurse Edgar said he'd actually slept for an hour. We saw in three visitors who were wonderfully sensitive to Richard's fragility right now but who also added the spice that gave his day a good flavour to go to sleep with.
Wednesday 26 January 2011
The Morning After
Richard is doing amazingly well! He was having "physio" when I arrived at 10am this morning so I had to wait for a bit to see him. He's connected to a zillion tubes but gave me a big smile and squeezed my hand. Our friend Charl joined us and he awakened further through the visit talking through his oxygen mask and asking very lucid questions and joking that he was bored and ready to leave.
The nurses are pleased with all his signs and the progress he's making, one sign of which was the removal of the oxygen mask to be replaced by the less cumbersome oxygen tube under his nose.
So far he's had five visitors!
Before I forget it, some pertinent info:
Harley Street Clinic
35 Weymouth Street
London W1G 8BJ
0207-935-7700
ICU2 Visiting Hours: 10am-2pm 4-8pm daily
Direct tel numbers 0207-034-8483 and 8484
no more than two visitors at a time
for the moment very short visits are recommended (5-10 minutes)
as his defenses are down don't visit if you're not feeling 100% Should be obvious but worth mentioning!
This is still a pretty critical period in Richard's recovery and I think the ICU nurses know the right balance regarding the benefits of seeing ones friends and the necessity of rest and avoiding infection so I completely defer to their instructions. That is not to put anyone off who really wants to visit, just to add a note of caution.
Hopefully, in five days when he passes the leak test he'll be moved to a private room and the party can begin!
Thanks for the cascade of notes, prayers, good wishes, helpful thoughts and offers. Truly, truly amazing!!
The nurses are pleased with all his signs and the progress he's making, one sign of which was the removal of the oxygen mask to be replaced by the less cumbersome oxygen tube under his nose.
So far he's had five visitors!
Before I forget it, some pertinent info:
Harley Street Clinic
35 Weymouth Street
London W1G 8BJ
0207-935-7700
ICU2 Visiting Hours: 10am-2pm 4-8pm daily
Direct tel numbers 0207-034-8483 and 8484
no more than two visitors at a time
for the moment very short visits are recommended (5-10 minutes)
as his defenses are down don't visit if you're not feeling 100% Should be obvious but worth mentioning!
This is still a pretty critical period in Richard's recovery and I think the ICU nurses know the right balance regarding the benefits of seeing ones friends and the necessity of rest and avoiding infection so I completely defer to their instructions. That is not to put anyone off who really wants to visit, just to add a note of caution.
Hopefully, in five days when he passes the leak test he'll be moved to a private room and the party can begin!
Thanks for the cascade of notes, prayers, good wishes, helpful thoughts and offers. Truly, truly amazing!!
Tuesday 25 January 2011
11:15, The Night of the Operation
Professor Hanna just called to say that Richard is now in the ICU and that all went well. He removed all of the lymph glands which might have become cancerous and he doesn't think Richard should have any problems with his recovery. Phew!! He advised I should wait til 10am to see him. All is well.
10:00 pm, The Night of the Operation
What we thought was going to take 10 hours is looking more like 14 hours at the moment. I just spoke to an ICU nurse who says they are waiting for Richard to be wheeled in, probably within the hour. Apparently Professor Hanna is so amazingly thorough, precise and detailed, the procedure takes longer than one might expect. I was assured by a senior vascular surgeon this evening that this is why he has such high success rates so it's a wonderful thing it's taking so long.
An ICU nurse is going to call me when Richard arrives and advises that it will probably be best for me not to come in tonight as he will still be deeply sedated and not able to talk. If I arrive at 10am tomorrow, the start of visiting hours, he will most likely have been brought 'round and will be in some state fit to communicate. I don't know if I will hear from Prof Hanna by phone this evening as it is growing so late so can just report that when I went in to the hospital around 7pm I was shown to the entrance to the operating theatres by a lovely ICU nurse and she spoke with several of Prof Hanna's team who said Richard would be in til 11pm but didn't indicate that anything was amiss. So I am assuming that everything is OK.
We'll all just keep embracing Richard in our thoughts and know he will be getting some restorative rest in the ICU which will allow him to face the morning's challenges.
If I hear anything significant during the night I'll give an update as soon as possible.
An ICU nurse is going to call me when Richard arrives and advises that it will probably be best for me not to come in tonight as he will still be deeply sedated and not able to talk. If I arrive at 10am tomorrow, the start of visiting hours, he will most likely have been brought 'round and will be in some state fit to communicate. I don't know if I will hear from Prof Hanna by phone this evening as it is growing so late so can just report that when I went in to the hospital around 7pm I was shown to the entrance to the operating theatres by a lovely ICU nurse and she spoke with several of Prof Hanna's team who said Richard would be in til 11pm but didn't indicate that anything was amiss. So I am assuming that everything is OK.
We'll all just keep embracing Richard in our thoughts and know he will be getting some restorative rest in the ICU which will allow him to face the morning's challenges.
If I hear anything significant during the night I'll give an update as soon as possible.
The Operation
Richard is approaching the halfway point of the estimated 10 hour operation as I write this. It is 1:49 pm GMT now and he walked down to the operating theatre a little past 9 this morning. He was well rested, blood pressure perfect, ECG perfect, has had no weight loss and I assume his blood tests all looked very good. The doctors told me to go home to our flat in London and they would call me if needed as after the operation he will be sedated to sleep through the night and won't wake up until tomorrow morning. He will/does have an epidural to control the pain and will be in the Intensive Care ward for up to five days. They hope to get him up and walking around a bit tomorrow to decrease the possibility of a chest infection. On the fourth or fifth day they will do a "leak" test to make sure all the inner crafting is as it should be and then he will be allowed into a private room where he will be able to take liquids and some soft foods. So I imagine that will be this upcoming Saturday or Sunday and he'll probably be there for a further week until all his bodily functions have returned to a somewhat normal state and he is discharged to go home to Whithurst.
Richard was in good spirits but, as one might expect, scared of what he was about to embark upon. But, I think everybody's (including the doctors and nurses!) good wishes, thoughts, prayers, kind words and immeasurable skills have and will be sustaining and helping him (and me!) through his difficult time of unknowns. So "Thank You!" and keep it coming!
Have yet to find out about visiting hours but suspect that most visits might have to wait until he's in his private room next week.
Professor Hanna, his surgeon, is supposed to call me when the operation is finished so I will update the blog this evening when I know how it all went.
Richard was in good spirits but, as one might expect, scared of what he was about to embark upon. But, I think everybody's (including the doctors and nurses!) good wishes, thoughts, prayers, kind words and immeasurable skills have and will be sustaining and helping him (and me!) through his difficult time of unknowns. So "Thank You!" and keep it coming!
Have yet to find out about visiting hours but suspect that most visits might have to wait until he's in his private room next week.
Professor Hanna, his surgeon, is supposed to call me when the operation is finished so I will update the blog this evening when I know how it all went.
Sunday 9 January 2011
Since the third chemo into the New Year...
It's January 9th and Richard is doing wonderfully!
Since the last post alot has happened. His last chemo session at The Marsden went much as the others and his reactions were much as before, some mild nausea and tiredness, but nothing too dramatic until the morning of December 14th when we had to rush him to hospital with a raging temp of 40c (104 farenheit). We were very fortunate to find a bed available at The Royal Marsden in Sutton (a sister hospital located in a suburban community about 30 minutes southwest of London) and within two hours of leaving Whithurst he was in a lovely private room with an intraveinous drip of antibiotics in his arm to fight the pneumonia that had crept up on him. It was coincidental that he was scheduled to have another endoscopy at the same hospital the next day which, suprisingly, they went ahead with. After three days of loving care, lots of iv's, shots, measuring, monitoring he was released the Friday morning of the 17th and we drove home at a snails pace through a magical winter wonderland of snow and ice feeling so very grateful.
Saturday evening though found us at The Royal Surrey Hospital A&E department in Guilford (about 30 minutes from Whithurst) with a "suspected Deep Vein Thrombosis" in Richards right calf which was 3 to 4 cm larger than his left. A surreal experience but after about four hours we were back home having had blood taken and analyzed and a doctor show me how to inject Richard with a blood thinner until he could have an ultrasound exam on Monday to see what was up in more detail. Long story short, it was not a DVT, just bleeding into his leg (apparently not so bad!) and it corrected itself, slowly shrinking over the next week.
And then it was Christmas with Richard feeling almost completely restored as he had been taken off the chemo pills a week early because of the pneumonia. We had a wonderful time with Richard's lovely family and friends. Twentythree of us around the table for Christmas lunch! Lots of love and affection savoured and shared.
On New Year's Eve day we had an appointment with David Cunningham, Richard's oncologist, in London. We were both trying to self-soothe our fears of a bad report regarding the cancer and its possible spread as we had not heard the final results of the latest endoscopy and MRI scans. We left elated as Mr. Cunningham told us that the tumour had shrunk from 7 to 4 cm and the lymph nodes near the tumour which were also cancerous had cleared dramatically. so everything was GO for the operation and our goal of a cure!
So now we are preparing for Phase 2 of the journey. The big op with George Hanna at the Harley Street Clinic which is scheduled for Tuesday, January 25th. An 8-10 hour operation with a probable two days in ICU, then 10-12 days in hospital until normal eating and body functions resume. Then it will most likely be 4-6 weeks or longer, depending on how Richard does, until Phase 3, the final three cycles of chemo to eradicate any cancer cells that might have gone undetected. I figure the whole process might be finished by early to mid June.
Since the last post, along with the doctors and nurses, we've also experienced so many friends wonderful healing intentions with sessions of reiki, group prayer, sacred music, coherence breathing and more. All of it seems to stem from a profound love for Richard and our common humanity. A HUGE heart-felt Thank You from Richard and me!
Onwards and upwards!
Since the last post alot has happened. His last chemo session at The Marsden went much as the others and his reactions were much as before, some mild nausea and tiredness, but nothing too dramatic until the morning of December 14th when we had to rush him to hospital with a raging temp of 40c (104 farenheit). We were very fortunate to find a bed available at The Royal Marsden in Sutton (a sister hospital located in a suburban community about 30 minutes southwest of London) and within two hours of leaving Whithurst he was in a lovely private room with an intraveinous drip of antibiotics in his arm to fight the pneumonia that had crept up on him. It was coincidental that he was scheduled to have another endoscopy at the same hospital the next day which, suprisingly, they went ahead with. After three days of loving care, lots of iv's, shots, measuring, monitoring he was released the Friday morning of the 17th and we drove home at a snails pace through a magical winter wonderland of snow and ice feeling so very grateful.
Saturday evening though found us at The Royal Surrey Hospital A&E department in Guilford (about 30 minutes from Whithurst) with a "suspected Deep Vein Thrombosis" in Richards right calf which was 3 to 4 cm larger than his left. A surreal experience but after about four hours we were back home having had blood taken and analyzed and a doctor show me how to inject Richard with a blood thinner until he could have an ultrasound exam on Monday to see what was up in more detail. Long story short, it was not a DVT, just bleeding into his leg (apparently not so bad!) and it corrected itself, slowly shrinking over the next week.
And then it was Christmas with Richard feeling almost completely restored as he had been taken off the chemo pills a week early because of the pneumonia. We had a wonderful time with Richard's lovely family and friends. Twentythree of us around the table for Christmas lunch! Lots of love and affection savoured and shared.
On New Year's Eve day we had an appointment with David Cunningham, Richard's oncologist, in London. We were both trying to self-soothe our fears of a bad report regarding the cancer and its possible spread as we had not heard the final results of the latest endoscopy and MRI scans. We left elated as Mr. Cunningham told us that the tumour had shrunk from 7 to 4 cm and the lymph nodes near the tumour which were also cancerous had cleared dramatically. so everything was GO for the operation and our goal of a cure!
So now we are preparing for Phase 2 of the journey. The big op with George Hanna at the Harley Street Clinic which is scheduled for Tuesday, January 25th. An 8-10 hour operation with a probable two days in ICU, then 10-12 days in hospital until normal eating and body functions resume. Then it will most likely be 4-6 weeks or longer, depending on how Richard does, until Phase 3, the final three cycles of chemo to eradicate any cancer cells that might have gone undetected. I figure the whole process might be finished by early to mid June.
Since the last post, along with the doctors and nurses, we've also experienced so many friends wonderful healing intentions with sessions of reiki, group prayer, sacred music, coherence breathing and more. All of it seems to stem from a profound love for Richard and our common humanity. A HUGE heart-felt Thank You from Richard and me!
Onwards and upwards!
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