Johnny’s Journal

Mom and Wes “had a real good meeting” with Dad tonight. David, the ICU nurse on duty this shift, had just given him a bath and told them that Dad had been very responsive and aware, helping by moving himself around to get cleaned up.

When they went in, Dad wasn’t responsive and Wes told Mom that he was probably tired out from the bath and all. But then David came in and dialed the Diprivan infusion rate down to zero, and after about five minutes Dad cracked his eyes and started to respond. They both held his hands, and he squeezed Mom’s hand. Wes said Dad must be mad at him because he’d driven the Lexus, and Dad smiled and then squeezed his hand, too.

They talked to Dad for a long time, as they stood by the bed holding his hands. Wes asked if he was in any pain, and he shook his head. They told him about everyone who had come by to visit, and everyone who had called, and he smiled and nodded. He told Dad about this website, and about how so many family and friends are keeping up and sending best wishes, and his mouth turned down and he teared up. Mom said he was really touched.

Wes told Dad how well he was doing and how optimistic everyone was about his recovery. He told him about the re-evaluation on Monday when they plan to remove the oxygen tube, and generally caught Dad up on his progress. Dad followed everything that was said and seemed to understand everything.

The whole time they were with him, Dad never became agitated at all; he was always in control of his senses, and never tried to move around or pull at his tubes. He just held their hands and looked at each of them, responding with light nods and shakes of the head and frequent smiles.

Dad tried to cough a couple of times, but couldn’t because of the intubation. In response, David came in to clear his airway and then dial the medication back up. Mom and Wes said good night and went out, then drove home for some much-needed sleep before they return in the morning.

They were both very happy about the visit, as I’m sure you all are. Thanks so much for continuing to keep up, and for continuing to pray for Dad and for our family.

Dad was “deep in sleep” when Mom and Wes visited at 5:00; they stayed for 15 minutes or so and he never stirred. The head ICU nurse on duty said “I am really pleased with his condition.” Mom said when that nurse is pleased, she is pleased.

Dr. Barnett will be out of town at a conference this weekend, and Dr. John Campbell (no relation) is filling in for him. Dr. Campbell said that they were really happy with Dad’s progress, and that they were planning to “keep the status quo” through the weekend.

The intubation, which was started on Tuesday at 12 breaths per minute, is now down to four breaths per minute at 30% oxygen (that’s almost normal atmosphere), at 700 milliliters volume. They can further reduce it to 500 ml volume and/or reduce the rate to two breaths per minute, but as it is he is almost fully weaned from the additional oxygen. If all goes well, they’ll probably remove the intubation on Monday.

On a side note, the coma-inducing medication he’s being given is Diprivan (propofol) at 1% solution. The infusion rate has varied from 20 to 25 (µg/kg body weight/minute, I think), and today was increased to 30. At 30 he doesn’t move around as much and he is slower to respond, sometimes completely sleeping through a visit as he did this evening, but he rests better.

That’s all the news for now. Thanks for all your prayers and support, folks.

Mom has told Dad’s nurses that from now on, she wants them to “fuss at him” for fifteen or twenty minutes before each visitation. She said it takes him that long to start responding, and she doesn’t want to waste the first part of every visit watching him sleep. (She was kidding of course!)

Dad lay quietly for most of the 1:00 p.m. visit. They’ve started to wean him off the oxygen, which is now providing only four breaths per minute (his respiration is stable at about 14 breaths per minute). We’re looking forward to that tube coming out, but they’ll do it when they know that Dad’s ready and not a minute sooner, and we wouldn’t have it any other way.

Toward the end of the visit, Wes told Dad that he was going to go fill Mom’s gas tank this afternoon, and that Dad had better get up and say something if he didn’t want Wes driving his Lexus. Sure enough, Dad grinned really big. Wes told him to squeeze his hand if he was smiling, and he squeezed. Wes told Mom to take his other hand, and he squeezed her hand and smiled even bigger.

All signs point toward a good recovery, and we’re so grateful for everything the doctors and staff have done, for all the strength that God has given us, and for all the prayers and support that you all have offered and continue to offer.

Mom and Wes got to see Dad about an hour ago. Wes said that they had reduced the drip that’s keeping him in the induced coma, down to 20 from 25 yesterday. Dad wasn’t alert, but he was pulling at his tubes and moving his legs around as if he were trying to get out of bed. When the nurse saw what he was doing she dialed the medication drip up to 30. Apparently, keeping it continuously at the appropriate level is a rather arduous process—I guess that’s why they call it intensive care.

As he began to relax and he stopped concentrating on whatever he’d been trying to do, he noticed Mom and Wes were there and he smiled a lot. They visited with him for a couple of minutes as he drifted off, and when they left he was resting easy. Thanks again for your continuing prayers.

Dr. Misulis came by and talked to Mom and Wes this morning. He said that the clot behind Dad’s left eye is being reabsorbed very well, and that he is progressing nicely. He and Dr. Barnett still believe that Dad didn’t have a myasthenia crisis on Tuesday; they think that Dad’s body had just gotten tired from the “extended period of agitation” and just didn’t have the energy to keep his oxygen intake up. He said that Dad is past that situation now, and that it will not reoccur.

Dr. Misulis told Mom that Dad has gone through a lot, but that he sees no reason that Dad wouldn’t “recover very well” from everything that’s occurred. He said that Dad’s recovery will be more drawn out due to his age, and though he should be walking and talking in not too long, we shouldn’t expect him to be out working in the garden very soon.

As I think I’ve mentioned before, we appreciate all your prayers.

The procedure went well, and the central line is working as advertised. Dad is still in a medically-induced coma, and the nurse on duty during the 9:00 p.m. visitation said that he hadn’t been active at all since the surgery. The nurse stopped the drip, and Dad became somewhat responsive. Wes told him a joke that Wilbur Campbell had asked him to pass along, and Dad smiled through the whole thing. After the visit, the nurse reinstated the drip, and Dad drifted off again.

We’ve come a long way, and a lot of prayers have been answered already. Please continue to pray for Dad and for all of us who love him.

Dad was taken down this afternoon for insertion of a central line, which will make it a lot easier to give him fluids, draw blood, and monitor his blood pressure. He’s back in ICU now, and Mom will get to see him again in an hour. Please continue in prayer for Dad and for us—it’s working wonders.

Dr. Barnett talked to Mom this morning and said Dad is looking much better. He’d told Dad to raise two fingers and he did; he told him to stick out his tongue and he did. He’s moving both arms and both legs equally. Dr. Barnett also said that his ultrasound is still looking better and better, and he’s pretty certain that there will be no long-term impact on Dad’s speech.

On a side note, Dr. Vegors had said last night that they were almost certain that yesterday morning’s incident was a myasthenia crisis, but Dr. Barnett said that he and Dr. Misulis were not sure of that. He didn’t say what they thought it might be, only that they were not convinced that it was myasthenia-related.

A nurse in the ICU told them that Dad was extremely aggressive on Monday and Tuesday, and on Wednesday morning had pulled out two IV’s. He said that it had gone on for so many hours that he believed Dad’s body had gotten extremely tired, and might not have had the strength to breathe deeply enough to keep his oxygen level up. He described it as something like an extended panic attack.

Mom and Wes got to see Dad at 9:10 a.m. Wes thinks that they’ve lowered the dosage of the medication that is keeping him in an induced coma, because he was moving around trying to get up on his side and get comfortable, and he was pretty responsive. Wes said Dad opened his right eye and saw them, and “smiled real big.” They talked to him for quite a while, and he responded to a lot of it. Wes told him to squeeze his hand that if his mouth was dry to squeeze his hand, and “he squeezed really hard.” Wes told him he’d try to get a nurse to come in with some ice or something and relieve that.

They named all the people who had called or come in to visit, and he responded to quite a few. (A note to the Campbell Clan in California: I told Wes about all your messages and prayers, and he said that when they next see him at 1:00 p.m., he would specifically mention all your names to Dad.) He began to tire toward the end and started to drift off to sleep again, so they left him to rest.

They’re going to keep him in the coma for another 24 hours or so, then they’ll take the tube out of his throat and make sure that he’s breathing well. Everyone is very encouraged and optimistic about how well he’s doing. Thanks to everyone for all your prayers, love and support.

Dr. Vegors came to the ICU waiting room about 8:30 tonight and said that they believe that Dad has “turned a corner for the good.” The team is reasonably certain that what Dad experienced this morning was a myasthenia crisis, in which his epiglottis had completely relaxed and collapsed, blocking the windpipe. They intubated him so quickly after it occurred that there was no danger of adverse effects from oxygen deprivation. Also, Dr. Vegors said that the myasthenia medication is doing its job, and the crisis is passed.

They’re planning to keep Dad in a medically-induced coma for the next 24 to 48 hours; this will give his brain time to recover fully, and for the doctors to monitor and adjust his medication. Also, beginning with today’s 5 p.m. visitation, they’ve let Mom talk to Dad—although they don’t know if he’s aware of her, he isn’t in the same danger of agitation now.

Also, Dr. Vegors said that the blood clot behind Dad’s left eye is being reabsorbed and is progressing nicely.

If you ever doubt the power of prayer, call me—I don’t. Thanks so much for your prayers and support, everyone, and please keep it up.

The ICU nurse came down to the waiting room with some news. Dad’s blood oxygen level had dropped, so they intubated him. He is still breathing on his own, she said, but the tube is getting him more oxygen. She said his throat may be swollen from last night’s agitation, and that would have interfered with normal breathing. She wanted us to stay optimistic, though, and said that she’s seen many patients go through this and recover fine.

The doctor asked, though, that Mom bring in a copy of Dad’s living will, “just in case.” Maybe you can imagine the impact that this request had; I couldn’t have until I heard it. Mom is convinced that everything that can be done for Dad is being done; that and her faith have allowed her to cope with what’s going on.

We need your prayers now more than ever. Thank you all for your love and support.