Hello family, friends, and fellow bloggers...
I am extremely happy to report Sr is being discharged from the hospital this afternoon.
Pam, Joel Jr, Sarah, and I met with his heart doctor this morning and received alot of helpful information.
Sr will remain on Coumadin (this anticoagulant should help prevent blood clots which can lead to another stroke) and he is back on 2 of the 4 medications (a beta blocker and al-bactil) and will slowly be weaned on to the other medications over the course of the next few weeks during weekly visits to the doctor.
In addition to congestive heart failure, Sr also has dilated, cardiomyopathy (a large, weakened heart causing difficulty to pump blood efficiently) with an ejection fraction of 15-30%. The progression of his congestive heart failure is associated with regression of his left ventricular. While this process is usually associated with a continuous decline in ejection fraction, please note that his heart condition has remained relatively unchanged over the past 2 years. So, his recent stroke did not cause much additional damage...positive news. The doctors described this condition as idiopathic - meaning that the cause is unknown.
Sr's pacemaker will help continue to help with his intraventricular conduction delay and his defibrillator will help with his heart's arrhythmia. Very fortunate!
The stroke cause a mild visual field deficit on the left side which doctors believe will come back over time. Daily home health visits from physical therapists will help Sr build up and regain strength on his left side. He is scheduled to met with his neurologist next week. Although a bit shakey, Sr was up, fully dressed, and walking this morning when we arrived.
Pam met with the dietitian and will be learning how to cook low sodium foods (salty foods cause excessive fluid build up and because of the congestive heart failure Sr's heart has a hard time getting rid of the fluids). Diet modifications should significantly help improve Sr's heart condition. So, that is great! When needed, Sr will be given diuretics to help increase the excretion of water and fluids around his heart.
We are ready to have him home and want to thank all of you for your love, prayers, and support.
Posts will be made as we have more news.
With Love, Michelle
Thursday, May 22, 2008
Wednesday, May 21, 2008
Wednesday Morning, May 21st
Joel Jr and I just returned from our morning visit with Senior. He was finishing up his breakfast as we arrived and was excited to start his physical therapy at 10:30 today. We waited around for awhile with hopes of seeing the doctors but they didn't show up while we were there. The nurse will give us the reports from the doctors' assessments later today.
He is back on two of his heart medications along with the blood thinner. He is taking those orally. His heart is doing really good -- the nurse Charlie (so nice) said that his heart and vitals were excellent throughout the night.
I told the nurse to leave ANOTHER note for the doctor to see if SR could get a bath or shower...geez louise..they have to sign for EVERYTHING. He is starting to stink ;).
My parents brought up their portable DVD player to help pass the time as Sr is getting really, really bored. I got it all hooked up for him and he plans to watch Three's Company episodes (my favorite), National Lampoon's Christmas Vacation and Fatal Attraction throughout the day.
We left him with a cup of coffee reading today's paper. He was jovial and looking forward to Pam and Sarah coming up.
I will post his physical therapy report later this evening.
Much Love, Michelle
He is back on two of his heart medications along with the blood thinner. He is taking those orally. His heart is doing really good -- the nurse Charlie (so nice) said that his heart and vitals were excellent throughout the night.
I told the nurse to leave ANOTHER note for the doctor to see if SR could get a bath or shower...geez louise..they have to sign for EVERYTHING. He is starting to stink ;).
My parents brought up their portable DVD player to help pass the time as Sr is getting really, really bored. I got it all hooked up for him and he plans to watch Three's Company episodes (my favorite), National Lampoon's Christmas Vacation and Fatal Attraction throughout the day.
We left him with a cup of coffee reading today's paper. He was jovial and looking forward to Pam and Sarah coming up.
I will post his physical therapy report later this evening.
Much Love, Michelle
Tuesday, May 20, 2008
Tuesday Evening, May 20th 8:15 pm
Joel spent the majority of the day with Sr and this evening the girls and I went back to visit him. He was moved from ICU to a cardiac room and is doing incredible. He had no IV's and was sporting a portable heart monitor...allowing him to move around the room freely. He went for a small walk during our visit and was in great spirits.
As we were leaving for dinner, Pam arrived with a suitcase full of things for Sr to do because he was "bored". They were getting ready to play cards and then they were going to eat dinner together. Pam is hanging in there and is so relieved because of Sr's amazing improvements over the past 24 hours. He really had us very concerned.
Sr will have more assessments done by the doctors tomorrow and will continue with OT (occupational therapy) and PT (physical therapy). If no major set backs occur, I would imagine Sr will get to home within the next few days. He will have quite a few follow up doctor appointments after he goes home...but, hey, we will take them all! Whatever it takes to get him better.
Sr has golf league on Thursday night and wanted to know if he was gonna be able to play...holy cow...we need to go back to the "common sense" approach the docs talked about! ;)
His recovery really is a miracle and we are so thankful for all the prayers sent our way...they have definitely been answered.
I will post more tomorrow after my morning visit at the hospital with Sr.
Love, Michelle
As we were leaving for dinner, Pam arrived with a suitcase full of things for Sr to do because he was "bored". They were getting ready to play cards and then they were going to eat dinner together. Pam is hanging in there and is so relieved because of Sr's amazing improvements over the past 24 hours. He really had us very concerned.
Sr will have more assessments done by the doctors tomorrow and will continue with OT (occupational therapy) and PT (physical therapy). If no major set backs occur, I would imagine Sr will get to home within the next few days. He will have quite a few follow up doctor appointments after he goes home...but, hey, we will take them all! Whatever it takes to get him better.
Sr has golf league on Thursday night and wanted to know if he was gonna be able to play...holy cow...we need to go back to the "common sense" approach the docs talked about! ;)
His recovery really is a miracle and we are so thankful for all the prayers sent our way...they have definitely been answered.
I will post more tomorrow after my morning visit at the hospital with Sr.
Love, Michelle
Summary of the past 4 days
Hello. I will start with giving a summary of Joel Sr's past few days so that everyone can gain a full understanding of the events that have occurred with Sr's health. We apologize for not getting this information out sooner; however, as you might imagine, we've had alot to deal with and until today, we did not know alot.
On Saturday, May17th, at 2:30 Joe Petty (Sarah's husband) walked into Joel Sr's office and found him curled up in his chair. Apparently Sr had just gone to the bathroom and noted some difficulty in getting his belt buckled because his left arm was weak and numb. As he was finishing up, he heard the phone ringing so headed to his office to answer the phone...because his left side had gone numb...he fumbled with the phone and it got knocked off the hook...we believe it was at this time he had a stroke. When Joe found him, Sr was having difficulty speaking and his left side was non-functional. Luckily, Joe found him within a few short minutes of Sr having his stroke and 911 was called.
Upon being admitted to St. John's ER, Sr underwent a battery test including a 64-slice CAT scan, blood work, and neurology exams. The initial CAT scan came back showing no signs of damage and no brain bleeds which was great news; however, we found out that the CAT scan was taken so quickly after the stroke occurred that the results were not completely accurate. To get the most accurate reading, a CAT scan needs to be performed at least 12 hours after the stroke occurs. They gave the initial scan to ensure he was not having a hemorrhagic or intracerebal hemorrhaging of the brain.
Further neurological assessments that evening showed extreme weakness on Sr's left side, muscle coordination problems, and vision and fine motor skill problems. After being seen by a team of stroke specialists, it was first thought SR had a mini-stroke on the right side of his brain (the right side of the brain is what controls the movements and feelings on the left side of the body) known as a TIA...transient ischemic attack..which produces temporary stroke like symptoms that typically resolve within 24 hours. We now believe it was a full-blown stroke called an ischemic stroke.
If a stroke is caught within 3 hours after the onset and if the patient is a candidate, doctors like to start an IV treatment of t-PA - which is a clot busting drug that can greatly reduce brain damage and prevent subsequent strokes from occurring. Strokes occur one of 2 ways: 1. blood clots or 2. plaque build up in the carotid arteries.
Unfortunately, the stroke was not Sr's only problem...his heart was showing weakness and the EKG showed his heart to be unstable because of his congestive heart failure. Therefore, the t-PA, clot busting treatment, could not be administered because he didn't meet the medical criteria to be deemed a good candidate for the treatment. So doctor's decided to put Sr on a blood thinner with hopes of dissolving any more blood clots he might have.
Saturday evening, SR was moved to ICU where he continued to undergo more testing to determine the cause of the stroke and was seen by a team of doctors (heart specialist, neurologists, and a stroke team).
On Sunday, Sr was given a carotid artery dye test which came back perfect - no signs of any blockage or build up in the veins of his neck. Great news!
So, that confirmed that the stroke was caused from a blood clot somewhere in his body. He underwent an esophageal EKG test yesterday to assess his heart. Doctors believe that the stroke was caused from his congestive heart failure. To explain, SR's has a very weak heart and it does not pump blood or fluids the way it should. They believe Sr had fluid build up around his heart which caused an excessive amount of blood to pool around his heart...this blood, most likely clotted, and then traveled to his brain causing the ischemic stroke.
Sr will remain on a blood thinner with hopes that no more clotting will occur. Sr's heart rate was very low yesterday due to all the medicines that were given for the various procedures he underwent. For the time being, they have removed him from all of his heart medications and will slowly wean him back on over the course of the next several days. He is currently being given dopamine to increase his heart rate and is responding to the medicine wonderfully.
While Sr's congestive heart failure is very serious, his heart specialist and neurologist are confident that with proper medical care, appropriate medicines, and a "common sense" approach Sr will be okay.
As of this morning (Tuesday, May 20th) Sr has regained movement on his left side. His vision is great and he his fine motor skills are quickly improving. The dopamine continues to keep his heart rate up and he has no diet restrictions. He is still experiencing numbness on his left side but overtime doctors believe feeling to the area will come back. He was even able to get out of bed and walk a little this morning...first time he has been out of bed since Saturday. He was in great spirits this morning, ate a full breakfast, and read the paper and carried on many conversations with me.
He will be moved a cardiac floor sometime today and they will work to get his stamina built up and will continue to re-introduce the heart medications as his body allows. He will also be going through some physical therapy to help his left side. The recovery he has made since Sunday is absolutely miraculous!!
He'll have to do a little lifestyle adjustment (ie- no mowing the grass when it is 102 degrees outside)! But, at this time, doctors have not given him too many restrictions other than saying to use a common sense approach when doing things. And, we all know that this is something that Sr's lacks once and awhile which has nothing to do with his stroke, mental state, or his medical condition but rather his sheer stubbornness!
I am working closely with the doctors and specialists to ensure nothing is being overlooked and that Sr is getting everything he needs. I will continue to post information as I get it...so please check back often! Over the weekend, Pam asked me to bring my broom along to deal with the doctors (you know how specialists can be) ;).
Much love, Michelle
On Saturday, May17th, at 2:30 Joe Petty (Sarah's husband) walked into Joel Sr's office and found him curled up in his chair. Apparently Sr had just gone to the bathroom and noted some difficulty in getting his belt buckled because his left arm was weak and numb. As he was finishing up, he heard the phone ringing so headed to his office to answer the phone...because his left side had gone numb...he fumbled with the phone and it got knocked off the hook...we believe it was at this time he had a stroke. When Joe found him, Sr was having difficulty speaking and his left side was non-functional. Luckily, Joe found him within a few short minutes of Sr having his stroke and 911 was called.
Upon being admitted to St. John's ER, Sr underwent a battery test including a 64-slice CAT scan, blood work, and neurology exams. The initial CAT scan came back showing no signs of damage and no brain bleeds which was great news; however, we found out that the CAT scan was taken so quickly after the stroke occurred that the results were not completely accurate. To get the most accurate reading, a CAT scan needs to be performed at least 12 hours after the stroke occurs. They gave the initial scan to ensure he was not having a hemorrhagic or intracerebal hemorrhaging of the brain.
Further neurological assessments that evening showed extreme weakness on Sr's left side, muscle coordination problems, and vision and fine motor skill problems. After being seen by a team of stroke specialists, it was first thought SR had a mini-stroke on the right side of his brain (the right side of the brain is what controls the movements and feelings on the left side of the body) known as a TIA...transient ischemic attack..which produces temporary stroke like symptoms that typically resolve within 24 hours. We now believe it was a full-blown stroke called an ischemic stroke.
If a stroke is caught within 3 hours after the onset and if the patient is a candidate, doctors like to start an IV treatment of t-PA - which is a clot busting drug that can greatly reduce brain damage and prevent subsequent strokes from occurring. Strokes occur one of 2 ways: 1. blood clots or 2. plaque build up in the carotid arteries.
Unfortunately, the stroke was not Sr's only problem...his heart was showing weakness and the EKG showed his heart to be unstable because of his congestive heart failure. Therefore, the t-PA, clot busting treatment, could not be administered because he didn't meet the medical criteria to be deemed a good candidate for the treatment. So doctor's decided to put Sr on a blood thinner with hopes of dissolving any more blood clots he might have.
Saturday evening, SR was moved to ICU where he continued to undergo more testing to determine the cause of the stroke and was seen by a team of doctors (heart specialist, neurologists, and a stroke team).
On Sunday, Sr was given a carotid artery dye test which came back perfect - no signs of any blockage or build up in the veins of his neck. Great news!
So, that confirmed that the stroke was caused from a blood clot somewhere in his body. He underwent an esophageal EKG test yesterday to assess his heart. Doctors believe that the stroke was caused from his congestive heart failure. To explain, SR's has a very weak heart and it does not pump blood or fluids the way it should. They believe Sr had fluid build up around his heart which caused an excessive amount of blood to pool around his heart...this blood, most likely clotted, and then traveled to his brain causing the ischemic stroke.
Sr will remain on a blood thinner with hopes that no more clotting will occur. Sr's heart rate was very low yesterday due to all the medicines that were given for the various procedures he underwent. For the time being, they have removed him from all of his heart medications and will slowly wean him back on over the course of the next several days. He is currently being given dopamine to increase his heart rate and is responding to the medicine wonderfully.
While Sr's congestive heart failure is very serious, his heart specialist and neurologist are confident that with proper medical care, appropriate medicines, and a "common sense" approach Sr will be okay.
As of this morning (Tuesday, May 20th) Sr has regained movement on his left side. His vision is great and he his fine motor skills are quickly improving. The dopamine continues to keep his heart rate up and he has no diet restrictions. He is still experiencing numbness on his left side but overtime doctors believe feeling to the area will come back. He was even able to get out of bed and walk a little this morning...first time he has been out of bed since Saturday. He was in great spirits this morning, ate a full breakfast, and read the paper and carried on many conversations with me.
He will be moved a cardiac floor sometime today and they will work to get his stamina built up and will continue to re-introduce the heart medications as his body allows. He will also be going through some physical therapy to help his left side. The recovery he has made since Sunday is absolutely miraculous!!
He'll have to do a little lifestyle adjustment (ie- no mowing the grass when it is 102 degrees outside)! But, at this time, doctors have not given him too many restrictions other than saying to use a common sense approach when doing things. And, we all know that this is something that Sr's lacks once and awhile which has nothing to do with his stroke, mental state, or his medical condition but rather his sheer stubbornness!
I am working closely with the doctors and specialists to ensure nothing is being overlooked and that Sr is getting everything he needs. I will continue to post information as I get it...so please check back often! Over the weekend, Pam asked me to bring my broom along to deal with the doctors (you know how specialists can be) ;).
Much love, Michelle
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