Monday, April 30, 2012

Red jello with bananas & whipped cream

I am not a big fan of jello.  If I have to have jello, I would definitely not choose red jello with bananas.  And putting whipped cream on it is just a waste, if you ask me.  I would go with the strawberries, pretzels and cream cheese recipe.  It has so much stuff in it that you forget it is jello.  Perfect!

Many of you know why I am writing about red jello with bananas and whipped cream (the rest of you think that I have finally lost it!).  While it may be true that I have "lost it", there is a point to this blog entry.  Dad liked red jello with bananas and whipped cream and considered it a part of the mandatory menu for "funeral food".  (I may be bringing a sack lunch because I don't like much on his list.)

Yesterday, we were discussing and planning the service that we want to have for Dad.  Our hearts are to honor Dad and his decisions.  We want this to be about him and his life and his preferences.  There have been other decisions that Dad has made that I didn't agree with (most of them having to do with my behavior as a teenager!), but this is not about me.  Unfortunately! ; )

I was thinking about all of this while I was trying to sleep last night.  I realized that there have also been many decisions that I have made that Dad didn't agree with (I know, hard to believe).  About 10 years ago, Don and I started building our house.  We told Dad that we were going to build a concrete house.  His response, "I like wood, it is more forgiving."  If you know Dad at all, you know that there is really no convincing him when he is sure of something.  So we just started building.  My dad honored our decision, even though he disagreed, and came alongside of us.  He spent many, many weeks with us, drove 2 hours each way and did whatever we asked him to do.  When it was finished, he was the first to tell people that it was a concrete house!

Dad was just that way especially when it came to the people that he loved.  His greatest pleasure came when all of us were gathered together.  He didn't really care about Christmas presents as long as we were all at his house for Christmas (that brings to mind another decision we made that he didn't agree with - the first year we spent Christmas in Guatemala - oy vey!)

It wasn't just the 12 of us that he enjoyed having around him.  Every couple of years, the Kooiman side of the family organizes a reunion.  It was very important that we always attended this gathering.  He wanted all of us to spend time with his brothers and sisters and their families.  Vacations, when I was little, were spent with his extended family.  He valued all of these relationships and made them a priority.

If we widen the circle a little bit more, we get to his friends.  Wow, we had no idea how many lives he had touched until the cards starting pouring into the hospital.  His Bible study guys, his coffee drinking buddies, the people he delivered mail to, the neighbors - past and present, etc. etc. etc.

Well, friends and family of Dad, we would like to gather one more time.  Please join us as we honor and remember Dad on Wednesday, May 9th at 10 am.  We will be gathering at the Elk Point United Parish church in Elk Point, SD.  There will be a lunch following and yes, . . . we will be serving red jello with bananas and whipped cream!

"Let us hold unswervingly to the hope we profess, for he who promised is faithful.  And let us consider how we may spur one another on toward love and good deeds, not giving up meeting together, as some are in the habit of doing, but encouraging one another - and all the more as you see the Day approaching."  Hebrews 10:23-25.


Sunday, April 29, 2012

In Heaven

Dad struggled all day yesterday with his breathing and anxiety.  His oxygen requirements kept going up and he knew that he was going to need to be intubated again in order to keep breathing.  Before the surgery, Dad had been insistent that he and Mom finish their living wills.  During one of the many doctor appointments before his surgery, Mom handed us his living will.  He wanted it very clear that he did not want to live on machines.

Yesterday, he decided that he did not want to go back on the vent.  He made all the decisions up to the end.  I told the nurse (Nick) what Dad had decided so Nick got right into Dad's face.  He wanted to make sure that Dad understood and could hear him.  Nick asked him specifically if he wanted to be on the breathing machine and Dad emphatically shook his head no.  Then Nick asked him if he wanted medicine or assistance if his heart should stop and, again, Dad emphatically shook his head no.

Nick looked at Dad and said that he knew this was a hard decision to make and it was a little scary.  Dad again shook his head no.  Dad thought he was going to die twice during these last 5 weeks and he told us that he was not afraid.  He had peace because he loved Jesus and he knew without a doubt that he was going to heaven.  He was so brave and we needed to respect his decisions.

We gathered around him and read scripture over him and held his hands.  We promised we would take care of Mom and thanked him for being such a great dad and "bumpa".  We watched him peacefully take his last breaths.  He was such a blessing and a gift to us.  We know that he is with the Lord, breathing with two healthy lungs and chatting with someone!

We will miss him so much and the ache is deep but we know that this is how he wanted it to be.  Thank you for all of your prayers and support and encouragement.  This has been a long road and it didn't end the way we wanted it to but you all held us up in so many ways.

We don't know the plans yet for a funeral.  Dad also decided that he wanted to be cremated so we have some time to plan and pull things together.  We are taking one day at a time and today . . . Mom wants to go to church.

Saturday, April 28, 2012

A Bad Turn

Dad has had a rough 12 to 15 hours.  The reprieve from the diarrhea lasted less than 24 hours.  Yesterday afternoon he had two bouts and then 3 last night.  He had another small one this morning.  His white count has gone up to 18.9 today.  He is on the biPap and 80% oxygen.  He tried to go back to the other masks but cannot hold his sat numbers.

We all gathered this morning in his room so that we could talk to the doctors.  They have lots of options but no real answers.  They decided to change his antibiotics to see if they can fight the infection, but they don't know where it is.  The cultures from his diarrhea and his sputum are both negative.  They have talked about bronchoscopies and other procedures but they wouldn't do any of it unless they intubate him again.  If he maintains this oxygen level, they may decide to do an ecmo where they take blood out, oxygenate it and then put it back in.  (They brought this up earlier but then he was intubated and we thought he wouldn't need it).  The ecmo would allow his lung to rest while they figure out the other stuff.

Dad wanted us to write down all of the options and then Don explained them to him.  He wrote back that he does not want to live on machines.  We all acknowledged that and agree.  Please pray for wisdom - for the doctors, for us etc.  He is extremely weak and tired.  He hates this biPap machine but knows that he needs it.  He can't swallow any of his meds so they are filling up his I.V. pole again so he can get what he needs through his PIC line.

I don't need to tell you that we are all tired.  Mom is struggling and really wants to know what he is thinking. She wants to talk to him.  Please pray for her - she told us that her heart is breaking.

Friday, April 27, 2012

Finest Oil

Remember my post about "strong as a wild ox"?  Here is the verse again:

"But you have made me as strong as a wild ox.
You have anointed me with the finest oil."  Psalm 92:10


We are still praying for strength for Dad.  He had lots of rest yesterday and did pretty well eating.  He had a "super shake" in the afternoon.  It is ice cream, carnation instant breakfast, protein powder and some other things that make it count 700 calories.  It really filled him up.

Dad was also anointed with the "finest oil" yesterday.  I had forgotten about the second part of that verse until a pastor from our church came to pray.  He read some Psalms over Dad and then reached in his pocket for his oil.  He said that there is nothing "magic" about the oil but it is from Israel so that makes it "really cool".  I was thinking it makes it "really fine maybe even the finest"!  In the Bible, James chapter 5 talks about the elders praying over the sick and anointing them with oil.  We believe that the Lord heals and we are trusting that the Lord hears our prayers.

And He did.  Dad had one more bout of diarrhea (just realized that I have been spelling that wrong in ALL of my posts!) yesterday afternoon.  He has not had diarrhea for almost 24 hours!  Yee-haw!  Dad's white blood cell count went back down to 14 today!  Double Yee-haw!

I read this "celebration" Psalm over Dad this morning:

Sing a new song to the Lord,
    for he has done wonderful deeds.
His right hand has won a mighty victory;
    his holy arm has shown his saving power!

The 
Lord has announced his victory

    and has revealed his righteousness to every nation!
 He has remembered his promise to love and be faithful to Israel.
    The ends of the earth have seen the victory of our God.
 Shout to the Lord, all the earth;
    break out in praise and sing for joy!
 Sing your praise to the Lord with the harp,
    with the harp and melodious song,
 with trumpets and the sound of the ram’s horn.
    Make a joyful symphony before the Lord, the King!
 Let the sea and everything in it shout his praise!
    Let the earth and all living things join in.
 Let the rivers clap their hands in glee!
    Let the hills sing out their songs of joy
 before the Lord.
    For the Lord is coming to judge the earth.
He will judge the world with justice,
    and the nations with fairness.  Psalm 98:1-9

Thursday, April 26, 2012

Quick Update

As I am sitting "guard" over Dad today, I thought I would give you a quick update!  Dad's white count has gone up to 17.  They have taken another stool culture as well as a sputum culture to see if they can figure out what he is fighting.  Some infection along with the diahrea certainly explains the weakness and exhaustion.

Dad's nurse and I have set some goals for today - eat, sleep, breathe and try not to poop!  We know we don't have much control over the last one!  I am working on the eating - they would like to put the feeding tube back into Dad's nose but we are trying really hard to get him enough calories with real food.  He ate very well yesterday for his first day.  This morning he ate a bowl of cream of wheat and drank his whole container of milk.  He was so tired after he ate so I now have the door closed so we can work on goal #2 - sleep!  He needs to rest to fight the infection and recover from the diahrea.

As far as breathing, he is doing well so far.  His sat numbers are wonderful as long as he rests and is relaxed.  Once he moves they drop a little bit.

Mom is home doing laundry.  She plans on lunch with friends and then she will come here.  Hopefully, she will feel a little more rested today!  Thanks for praying!

A Couple Steps Back

When I left yesterday morning, Dad was struggling.  He is incredibly weak.  He is having a hard time holding his oxygen again and his diahrea continues.  We are on day 7 with diahrea.  I cannot even fathom how hard that is on him.  Don and I were talking about when we have a bug that gives us diahrea for 24 to 48 hours and the affects on our body - and we start from a healthy place!

Yesterday morning, Dad was trying to eat some breakfast and it took everything he had to just get a banana down.  Mom said he tried some other food later and they were supplementing with some Ensure.  His white count went up to 14.3 yesterday but they can't find an infection.  The nurse sent another culture of his diahrea this morning.  He is hoping that it comes back "positive" for infection so at least they would know what to treat.  The last 3 cultures have been negative.  He has no fevers.  Please pray for some answers.  They started him back on two antibiotics after I left yesterday.  They don't know what they are fighting but don't want an infection to get started again.  I have not heard the white count for today yet.    

When I arrived at 4 am, Dad was very anxious.  His sat numbers were low and he was breathing very fast.  I talked to him a little bit and prayed.  The nurse came in and we decided that a percocet might help with the anxiety.  It took just a little bit of time, but he calmed down.  He is now sleeping pretty hard and his sat numbers are good.

Last Friday, Dad felt so good.  He had told me that he felt like he could get out of bed and walk out of here.   Yesterday, he was so weak that he couldn't eat a banana.  It gives me anxiety to be on this rollercoaster; it is not surprising that he is feeling anxious as well.

I was reading about Gideon today in Judges 6.  The Israelites are in this really tough time with the Midianites ruling over them with cruelty.  Gideon feels like the Lord has abandoned them.  Then an angel appears to him and tells him not to be afraid because the Lord is with him.  Gideon offers a sacrifice and then realizes that the angel was from the Lord.  He gets fearful until the Lord reassures him.  Gideon builds an altar and names it "Yahweh-Shalom" (or Jehovah Shalom) which means "The Lord is peace".

In the midst of this hard struggle, Gideon remembers that "The Lord is peace".  Anxiety does not come from Him.  Fear and discouragement do not come from Him.  The Lord is peace.  This reminded me of other names for God.  "Jehovah Rapha" - the Lord that heals.  "Jehovah Jireh" - the Lord that provides.

He is "more than sufficient" to meet all of Dad's needs.  He is more than able to turn things back around again.  He is peace and hope and healing and provision.  He is our strong tower.  Please continue to pray for stamina and perseverance.  Please pray for the diahrea to stop.  Please pray for forward steps.

Wednesday, April 25, 2012

Wednesday

When doubts filled my mind,
    your comfort gave me renewed hope and cheer.  Psalm 94:19


Jen called me as I was driving to the hospital this morning.  We have been splitting the nights so we each have a little bit of time in our own beds!  It works great but it means that we haven't been seeing each other much for the past week or so.  "Ships passing in the night!"

Anyway, Jen wanted me to know that her and Dad had a little bit of excitement at about 1 am.  She wasn't sure if Dad was dreaming or had an itch or whatever, but she woke up to him pulling off his biPap mask.  In the process of pulling the mask off, he also pulled out his feeding tube.  The nurse came in right away because the machine was alarming so everything was fine.  Dad had been able to eat a little bit more yesterday so maybe we can get him enough nutrition without having to put the feeding tube back in.  In some ways, it is a blessing that it is out.  We think the liquid diet was contributing to his diahrea so maybe this will help slow things down a bit.

Dad had a good day yesterday.  He got up out of bed and sat in the chair.  He ate a ham sandwich and some chocolate pudding.  He did well on his oxygen with some switches to the biPap when he needed to rest.  He has nothing hanging from IV pole.  They took him off all of the IV antibiotics and his insulin drip.  All of this things are little steps forward and we are very grateful.

We all desire to be encouraging, supportive and positive, but sometimes, we have some tough days.  In the midst of these little steps of progress, we want to see "bigger" improvements.  Mom is getting weary so we are trying to adjust our schedules a little bit so she can have some bigger breaks.  Please pray for her to get some rest.  She wants to be with Dad yet she also needs to make sure she is rested so she has something to give.

Please pray for Dad's lung.  He just really needs it to be healthy and built back up.  He does great as long as he is lying still.  Once he starts moving, his oxygen levels drop.  Please pray for his health and healing over his lung.

But the Lord is my fortress;
    my God is the mighty rock where I hide.  Psalm 94:22

Tuesday, April 24, 2012

Tuesday

When I arrived at Dad's room this morning, all the lights were on and the nurse was in with him. I had this initial feeling of "ugh - what has happened." Turns out the nurse likes to turn the lights on when he does his 4 am assessment. Later Dad told me that he had to be cleaned up as well which justifies the lights a little bit more. I realized that I am excited about the progress but a little anxious about another setback.

 I did my Bible reading (by flashlight so the lights could go back off!) and just sat and prayed for a little while. These past almost 5 weeks have been such a rollercoaster ride that I am finding myself waiting for the next setback. I do not want to be in this place. Our Bible reading for today was Psalm 92. There are often verses that I read and have no insight as to how they apply to me. Here is one that caught my eye:

But you have made me as strong as a wild ox. 
You have anointed me with the finest oil. Psalm 92:10

Hmmm. . . really Lord? Then I started praying it over Dad - "May You make him as strong as a wild ox and anoint him with the finest oil." I am not really sure how strong a wild ox is but it seems like it should be strong enough to get him out of bed, strong enough to breathe on his own, strong enough to start eating solid foods, strong enough to do whatever it takes to get him better.

Dad is working on a clear liquid tray right now. He had a red popsicle, a few bites of jello and some hot tea. They have stopped the cipro. They plan to stop the zosyn today. Hopefully this will help with the diahrea. His white cell count is still hovering around 13. They will keep him on the bactrim for a couple more days. There is talk of moving him - one resident says "yes"; the other one says "I am not in a hurry" - we shall see. Dad needs to get up and get moving today. He needs to keep trying to eat some solids. Please keep praying that the diahrea stops. . . and that the Lord makes him "as strong as a wild ox!" ; )

Monday, April 23, 2012

Monday

The Lord says, “I will rescue those who love me.
I will protect those who trust in my name.
When they call on me, I will answer;
I will be with them in trouble.
I will rescue and honor them.
I will reward them with a long life
and give them my salvation. Psalm 91:14-16


We meant to post yesterday after church and a quick trip to the hospital, but the day got away from us. Sorry about that. Dad had a pretty good day yesterday. He is on and off the biPap machine. In between he has a mask with oxygen. The difference between the two is the pressure. The biPap machine pushes oxygen into his lung. It helps it stay open and nicely inflated. When he is on the oxygen mask, he has to breathe and work his lung.

Dad asked for the biPap machine last night at about 8 pm and just came off of it this morning at about 7 am. His first feeling when he makes the switch is panic. He feels short of breath right away. He is really "learning" how to breathe on his own. He has had a machine breathing for him for over 2 weeks now. Please pray for peace over him. Please pray that the transitions will get easier and he won't panic.

Dad is still struggling with diahrea. He and I decided this morning that they will keep giving him things to help and then, the next thing will be that he is constipated! It seems to flip from one extreme to another around here.

Dad would also like to eat something, even a clear liquid tray sounds good right now. The issue will be making sure he gets enough oxygen while he eats. They have lots of options so I am hoping that they find something that works well. I think he would feel better if he could eat some actual food.

Dad's white cell count was back at 13 today. We seem to be jumping back and forth between 12 and 13. We would like to see that go back down. He is still on 3 antibiotics. It would be nice to taper that down if they can.

The resident also asked about the insulin drip and how he handles his diabetes at home. Dad does not use any insulin at home, but we don't have any control over his "food" right now. It is all still coming through his nasal feeding tube. The resident would like to get him off of the drip but I think that would mean insulin shots. We were doing that before the vent so going back there would mean another step forward.

We are on the journey back. It is slow going but at least the path is leading the right direction. The Lord is so faithful and is holding Dad in the palm of His hand. We are so thankful for the progress that we are seeing.

Saturday, April 21, 2012

Quick Note

Just a quick note before trying to get some sleep. Jim & I (Don) are watching NCIS. He is resting, BIPAP mask in place. The critical care doctor wanted to be conservative and leave it on overnight. We were all hoping to switch sooner but tomorrow will have to do.

Extubated!

Dad passed the trials so they pulled the tube! He is now on the bipap machine. We have not talked to the doctor so we aren't sure of the plan from here. He is doing great on it though so we are hoping that it is very temporary. Dad said it felt "amazing" to get the tube out. Thanks for praying!

Quick Update

Dad is doing really well with his breathing today. They have put him on a "trial" for an hour to see how he handles the low settings while doing most of the work himself. His trial is up at about noon. If he does well (so far, so good) then they will extubate him this afternoon. Once he is off the ventilator, they will make sure he is good with the bipap machine. Not his favorite but it is just a step forward. Please pray that he continues to go in the right direction. I will let you know how it goes. Thanks for praying!

Saturday Morning

Dad had a great day yesterday, at least in the area of breathing. He was on the cPap for 9 hours which was great exercise for his lung. They are trying to get him down to a level where they can extubate which would mean no more ventilator! Please keep praying for his lung to continue to heal and for his diaphragm to get stronger so they can get him off of this machine.

Dad is having some issues with diahrea. They think it is the combination of the bactrim (very high dose) and the anti-nausea medicine. He did not get up and walk or even stand yesterday because of how bad the diahrea was. We are praying that it is not a bug. We don't want anything to slow down his progress.

It is a little active in here this morning. He just told me that he has been awake since 2 am and it is now 5 am. He has lots of secretions, he had to use the bedpan, his pic line isn't working so lab had to come to draw blood etc. etc. Please pray for peace in this room so he can rest. His nights have a huge impact on the productivity of the next day. Soon the doctors will be arriving so I am praying for a very restful, peaceful time before the next interruption.

Dad's white count remained about the same yesterday - at about 12.5 or so. His xray showed that his lung is continuing to get clearer. His doctors were very optimistic. I will post another entry once we have updated information for today. Thanks for your prayers.

Friday, April 20, 2012

Friday Morning

Good morning! Dad is resting comfortably this morning - well, as comfortably as you can rest in a room filled with machines and beeping and nurses etc. I have not talked to Jen to see how the first part of his night went but this last part seems to be pretty peaceful.

Dad had a great day yesterday. When I came back in the evening (to pick up my "date"), he was on 35% oxygen and a PEEP of 7. They were stretching his time on the cPap mode from 2 to 4 hours and he was doing well. He actually said that he thinks the cPap mode is easier. This is the mode where he does most of the work himself. I think this means that he is getting close to doing all the work himself without the vent.

Dad was also able to move around, stand and even walk a little yesterday. He gets tired so quickly from all of his time in bed but he is really trying hard. His disposition changed yesterday when the decision was made to cancel the procedure. He was greatly encouraged and ready to work hard. I am praying that he continues to be encouraged today. I have not heard any new numbers yet this morning but will update once I hear something. I am trusting that his white count continues to go down and his xray continues to improve!

Thank you for standing with us. We feel your prayers holding up our arms. Your encouraging words bless us. The visits that many of you have made to the hospital have really meant a lot to Dad. We feel like we have finally stopped circling the mountain and are headed north! Blessings!

Thursday, April 19, 2012

Change of Plan

The surgical resident came in this morning and asked what we thought about waiting on the trach. I hesitated so he showed me Dad's chest xrays over the past 2 days. There is incredible improvement. Two days again the top lobe was "hazy" and the bottom lobe was a solid white. Today, the top lobe is clear and the bottom is just "hazy". Much better. Also, his white count is down to 12.3 (top range of normal is 11). The resident is very optimistic. He would rather see Dad improve on his own then put him through another surgical procedure.

We left the decision up to Dad and he decided he wanted to wait. He said that he slept well last night and that he feels good this morning. The resident said that we will re-evaluate in two days and if he hasn't continued this trend, we will reconsider doing the trach.

This is such wonderful, positive news. Dad seems encouraged. He is sitting up and doing leg exercises as I type! Praise the Lord! There IS light at the end of this tunnel! ; )

The Party


When I arrived at the hospital yesterday morning, one of the first things that Dad asked me was, "Do you feel better today than you did 15 years ago?". Caleb's birthday was obviously on his mind. We wanted Dad to be a part of the celebration so we started in his hospital room.






Dad made it through the opening of a few presents, but he was very tired out from his little walk earlier. We all gave hugs and kisses and then left him alone to rest.









We took our party to "Don and Millie's". We ate, had cake and then Caleb opened a few more presents.

















Dad will have his tracheostomy today at 9 am. They plan to take him to pre-op at about 8 am. I will update as we have news. We all have peace that this is the right thing to do. Thank you for your prayers!

Wednesday, April 18, 2012

Trying to Escape



Dad took his first steps in 2 weeks! He was a little bit anxious about trying but once they stood him up, he started to "run". He doesn't really have a slow mode. He made it about 5 steps and then was tuckered out. It was awesome for his first time since the intubation.

His white count is still 14.4 (or so) - basically unchanged from the past few days. They have asked the infectious disease doctors to consult. They can't seem to get the white count down any further. They added bactrim a couple days ago but it doesn't seem to be helping the count go down. It may just take a while but they want to make sure that they are using the right antibiotics.

Tracheostomy is stilled scheduled for tomorrow morning. There was some question as to if we should wait until Friday because he has been improving so well. It is hard to know if he is improving enough to get off the vent in the next couple days. We are asking the Lord for clarity and direction.

We are planning to have a little "birthday party" for Caleb here later. We want to include Dad in the festivities (dependent on how tired he feels) so we will have some present opening in his room. Then most of us will leave for lunch. I may have pictures to post later! : )

Tuesday, April 17, 2012

Tuesday Morning

Dad had a pretty quiet night last night - better than the night before. He is having throat pain from the vent tube and it seems a little worse in the night - maybe because he is distracted during the day??

He has been on cPap mode since about 6 this morning and is doing very well. The resident would like to extend his time on it today and see how he does. It is good exercise but they don't want him too tired. It is a balance, like everything else.

He feels really good. He told me that he feels like he could get up and walk until he actually stands up. Then he feels light-headed and weak. It is just going to take some time to get his strength back but even feeling that good while he is laying down is improvement.

He and I are doubtful that he will be weaned off of the vent before Thursday morning. He knows he needs to keep trying and exercising but we are thinking the trach is the best option for him. Many doctors/nurses etc. have told us that the improvement speeds up tremendously once patients have the trach. He will be more mobile b/c the trach is a more secure air source than the vent tube down his throat. He will also be able to talk which will be a relief to those of us not so good at charades! He is writing more now so that is helping with the communication some.

I have not heard any white count numbers or have anything new "number-wise" to report. He just feels so much better that I am thinking the pneumonia must be about gone. He is having some issues with nausea but they have medicine for that as well!

When I was sitting in his room in the dark this morning, I was thinking how grateful I am for all of these machines. With their loud beeps and alarms and blinking lights, they are annoying at times but I am so thankful that they are here to help Dad.

This was in my Bible reading this morning:

"But you, O Lord,
are a God of compassion and mercy,
slow to get angry
and filled with unfailing love and faithfulness." Psalm 86:15


This morning I am so thankful for His compassion, mercy, love and faithfulness. This has been a much longer journey than we anticipated but we know that we are not walking it alone! Blessings on your day!

Monday, April 16, 2012

Monday

Dad is doing well. He has had a busy day today. He did great with his physical therapy but it tired him out. His sat numbers have been great all day. He is doing 2 hours of the forced pressure mode and then 2 hours of cPap mode where he does most of the work himself.

His white count is at about 15 today. Yesterday they told us 11 but apparently they looked at it wrong b/c the nurse today said that it was about the same yesterday. They did identify the bacteria that he is still fighting and were able to take him off of one of the antibiotics. He is only on the cipro now.

He does very well during the day but seems to have some anxiety at night. We are thinking that we may need to be here more during the night so he feels "safe". He says that he has these thoughts of "I can't walk, I can't talk, and I can't breathe" then he panics. Please pray for peace for him especially during the night.

The surgeon has scheduled his tracheostomy on Thursday at 9 am if he is not able to wean off of the vent before then. There are definite benefits to having the trach so we have alot of peace about it. We want to do whatever he needs to do to get better.

Sunday, April 15, 2012

Sunday Morning

After storms yesterday, sun is shining in the window as I write this entry. The morning is calm outside and inside as well. Jim is resting comfortably, pain controlled, numbers all look good. His white count is down to 11. They are alternating the vent from higher support and less support (cpap) every two hours during the day and will leave him on more support overnight. Peep is at 8 and Oxygen is at 55%. Jim is using an alphabet board to spell out words and doing things like adjusting his bed himself.

There continue to be rumors of a trach at the end of this week if he still requires the vent. The more people we talk to, the less it feels like a step backwards. If it is needed, it will be more comforatble and 'efficient' allowing for quicker healing of his lung.

We are thankful for forward progress even if it is not as quick as we would like. And again, we are so thankful for the great caregivers working with Jim and for all of your prayers. Have a happy Sabbath - a day of rest.

Saturday, April 14, 2012

We Moved . . . Again

Yesterday at about 5 pm, the nurse came in and told us that they had to move Dad. The ICU that he was in is a "trauma" ICU and they didn't have any empty beds. If they were to receive a trauma patient they would have no place to put him or her. They wanted Dad to make a "lateral" transfer to the cardiac ICU. This makes our 7th move in the last 3 weeks. Dad's new mailing address is

James Kooiman
Patient Mail
Hospital Room 8859
PO Box 6159
Omaha, NE 68106-0159

The move was a little hard on both Mom and Dad - more emotionally than physically. They are both weary. We have sent Mom away from the hospital today. Jen took her, and I am on "duty". We are hoping that a little time away will refresh her and encourage her. It always helps to have a new perspective.

Dad has been on the cPap for about 2 hours this morning at 40% with a peep of 8. He is getting a little bit tired so they are now switching him back to the "normal" mode to rest. This is part of the weaning process and helps him to exercise his diaphragm muscle but we don't want him to overdo it.

His white blood cell count went up a little bit today to 17. He has been going up and down the last few days. They have put him back on 2 antibiotics to help any potential infection from growing. He is also feeling a little bit more congested today. We are praying for his lung to clear up COMPLETELY. He needs a healthy lung so we can get him stronger and breathing on his own.

If Dad cannot come off of the vent by Thursday or Friday, they are talking about a temporary tracheostomy tube. They would create an opening in his neck to get to his windpipe. They would then give him oxygen through this opening. The benefits to this procedure would be that he won't feel like he is breathing through a straw any longer plus he would be able to talk. The surgeon does not want us to consider this a step backwards. They do not want him on the ventilator for more than two weeks and this is a step to get him off. We are praying that he will be weaned off of the vent by next Thursday (or sooner) and not have to go to the trach.

Thanks for you prayers.

Friday, April 13, 2012

Getting Along Well

When I arrived at the hospital this afternoon, I was greeted with great news! Dad is much more alert today. He was on the cPap at 40% oxygen and a PEEP of 8. This is incredible! We don't want him to overdo it again so they will watch him and if he gets tired put him back to the PRVC mode (pressure regulated volume control).

He did well with his physical therapist - more standing and some marching.

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Dad's brother, wife and their daughter (Bill, Clazina and Brenda) came for a visit today. Visitors are a good distraction for both Mom and Dad. He also got a package from his sister, Jenny. It is fun to see things put a smile on his face!

Mom had this verse in her devotion this morning. She thought it was applicable and wanted to share it.

Dear friend, I pray that you may enjoy good health and that all may go well with you, even as your soul is getting along well." 3 John 1:2

Thursday, April 12, 2012

The Dance

Dad is spending most of the day today asleep. We are all thinking that he maybe overdid it yesterday. He was on the cPap for about 18 hours yesterday. This was very good but it was alot. He as not been on cPap at all today. His oxygen is still at 55% and his PEEP is at 8. We also found out that his white blood cell count was up to 19 today. Ugh. We felt like we were making progress yesterday and just stepped backwards today.

Everyone is telling us that this is part of the process - part of "the dance". So Mom and I are again looking for things to be thankful for.

Mom is thankful that he is doing much better today than he was last Thursday (when they intubated him).

We are thankful for how close this is bringing our family.

We are thankful for place that he is. He is receiving great care from the nurses, doctors, respiratory therapists, physical therapists. etc. etc.

We are also thankful that he is in Omaha so that Jen and I can help Mom more with his care as well as be with her during all of this.

We are thankful the rest of us are staying healthy.

We are so thankful for the love that is outpouring from family, friends, church family, co-workers, etc. These encouraging words via cards, emails, comments, texts etc. are awesome for Dad but they are spurring us on as well.

We are thankful that the Lord is so faithful. We are thankful for His joy in the midst of really hard situations. We are thankful that "His power is made perfect in our weakness". 2 Corinth 12:9

"May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit." Romans 15:13

Perspective

We did some of Dad's exercises while breathing through a straw last night. We also tried some more "strenuous" ones since we all have two lungs and are healthy!
Hannah, Bethany and Don resting!

Samuel jumping.

Caleb posing!

We all gained a new understanding of how hard it is for Bumpa to breathe.

It sounds like Dad had a little bit of a rough night. When they intubated him, they had to use restraints for his hands. Over the past several days, they have taken his restraints off but are watching him so tubes don't get pulled out. Apparently, last night, he was reaching for a tube and the restraints had to go back on. He also needed his oxygen to go up to 60% and the pressure to 8 (from 5 yesterday). This is all from Don's report when he arrived at 7 am. I will try to post later once I talk to Mom and get to the hospital. Please pray that we would regain the ground we made yesterday and continue to move forward. Thanks!

Wednesday, April 11, 2012

A Straw

This morning the physical therapist came in just as I was ready to leave. She is so good at what she does so I decided to see what she was going to make Dad do. She had him do some exercises in bed yet gave him the grace to rest as he needed. She did get him to stand and march in place. It was hard for him but he did a great job. She told us to breathe through a coffee straw if we wanted to get an understanding of how he is feeling. I am thinking I am going to get the straws out with the kids tonight as we talk and pray about Dad. It will be a good perspective for all of us!

Dad has had a good day. He has been on cPap all day which is great exercise for his lung. His oxygen percentage has been 55 or 60 all day. This too high to wean him off of the ventilator. Please pray for his lung to continue to heal so that this percentage can go down. It needs to be down to 40 before they will try to wean him. The doctors are all very positive and are talking about a couple more days. We are very excited about this possibility - it will be a week tomorrow since they had to intubate him.

Please pray for sleep for him tonight as well. He did not sleep well last night so we are trying to keep him a little bit more awake during the day today. Mom is going to stay later into the evening so maybe that will help as well. Jen came and took her to Walmart so she could have a little bit of a break. A change of scenery does wonders! Thanks for praying!

Pretty Good Night?

When we arrived this morning, the nurse was very excited about what a great night Dad had. He needed some pain medicine but all of his numbers looked great throughout the night. When we asked Dad, he said he didn't have a good night. We are wondering if he is not wanting to be alone again now that he is more aware of his surroundings. Mom has been staying throughout the days with Jen and I coming in for a few hours at a time, but we are all going home at night. We may just try to extend our time into the evenings more which seems to be the worst time for him. Please pray for contentment and peace in his room especially when he is alone.

We talked to the resident this morning. He is very positive about all of Dad's improvements. They have taken him off all of the antibiotics but one (cipro). His white count was about the same as yesterday. He is on cPap mode (since 4 am) and is doing well. They want him to build up his endurance and strength but they don't want him to get too tired. We are praying for another good day today with more baby steps in the right direction!

Tuesday, April 10, 2012

A Couple More Steps!

Dad had a pretty quiet night. The nurse said he had trouble with pain a couple times but otherwise did great. His PEEP was changed to 6 yesterday just as I was leaving and this morning we are down to a 5. The oxygen percent is 55%. They have switched his ventilator to "cpap" mode which means he is doing some of the work now too. His white blood cell count is down to 14.5. Everything is still moving in the right direction!

Mom said that physical therapy was in this morning and Dad was actually sitting and even stood up for a little bit. They are saying that he is very strong which is awesome considering how much time he has been spending in bed.

I was talking to a couple people yesterday and realized that I had not explained very well what happened when Dad had to be put on the ventilator. Last Thursday was a very rough day for Dad. He was on the biPap and they had to keep increasing his oxygen. This was due to the pain plus pneumonia plus he was getting tired as it got harder to breathe. They transferred him to ICU and decided to put him on the ventilator. The ventilator or "vent" is a tube that goes down his windpipe and forces air directly into his lung. To put this tube in they have to sedate the patient. They then keep the patient sedated so that he is relaxed and lets the machine help him breathe. They periodically take his sedation away just to see how he reacts. They want to keep him at this fine line of not fighting the machine but not too sedated.

On Friday and most of Saturday, Dad was very sedated and didn't respond much when we talked to them. By Sunday they were taking the sedation completely off and he was opening his eyes and turning his head to our voices. He is still on the vent and on a pain medicine drip but they have completely taken off the sedation. He is aware when we are here and nods or shakes his head to our questions. We are now making these little steps forward so that he can eventually get off of the vent. We are praying that he will get to the point soon where he can just breathe on his own with some oxygen going into the nasal cannula (a tube that blows oxygen directly into his nostrils). We are many steps from this but are trusting that we are heading in the right direction. Thanks for praying!

Monday, April 9, 2012

Slow Steps

Dad is doing well. The white blood cell count is down to 15. We are very happy about the continued decrease. Dad is responding and has his eyes open occasionally. He is nodding or shaking his head when we ask him about pain or if he is hot. It is nice to be able to communicate with him a little bit more.

He is having a little bit of trouble taking deep breaths so they have put his oxygen percent back up to 55% but the PEEP number (pressure of the air going in) is lower. Any damage to the lung would be caused by the high pressure so they would like to keep the PEEP number low. (It has been as high as 20 but is now down to an 8).

Dad won't like me talking about his bowel movements for the world to hear, but he can't argue right now so here we go! Pooping is a big deal at the hospital so we are excited to report that Dad has had some success today. He has been a little uncomfortable so we are hoping that this will help. (Dad - when you are better and read this just know that Mom wanted me to add this part!)

Dr. Lackner said that we have to take slow steps and that Dad could be on the vent as long as two weeks. We are praying against this timeline. We know we need to be patient but we also know that the Lord is bigger than all of this. We know that He has His own timeline and His own plan.

"For my thoughts are not your thoughts, neither are your ways my ways,” declares the LORD." Isaiah 55:8

Sunday, April 8, 2012

Happy Easter

Our family went to church this morning and is now enjoying our Easter dinner of Taco Bell and McDonalds in the ICU waiting room. I don't we have ever had an Easter quite like this one!

Dad is doing well this morning. His white blood cell count is down to 17.6. He is down to 50% oxygen on his vent. He had his eyes open and was responding to commands for the nurse this morning. We are very grateful for the positive direction we seem to be going these past two days.

Be joyful in hope, patient in affliction, faithful in prayer. Romans 12:12

Saturday, April 7, 2012

Bad Guys Identified

The doctor reported this morning that Dad's culture is now growing something. More specifically, streptococcus pneumoniae and haemophilus influenzae. His white blood cell count is down to 21 this morning which means the antibiotics are finally working. Yee-haw! He is still on 60% oxygen with the ventilator. They tried to go down to 55% but he couldn't hold his numbers. They need to get that number down before he can get off of the machine. Please pray that the antibiotics will continue working to clear up his lung. He also has some extra fluid so they are continuing with the lasix. We need all of these things to work so that he can breathe better and get off of the vent.

Finally, some positive news! Please continue to pray for Dad and Mom. This has really been hard on Mom especially since we have started leaving him at night. She said that she doesn't want to let him down. We are trying to convince her that the best way to help him is to take care of herself. When he gets off of this vent, he will need us there again around the clock so she needs to get some rest now while she can. Please pray for good sleep for her. Thank you!

Friday, April 6, 2012

Little Bit of News

The doctors just finished the bronchoscopy. They were able to extract quite a bit of mucus which will be sent for cultures. His white blood cell count was up to 30 this morning but they just told us it was back down to 28. His oxygen levels are down to 60%. He is right now sleeping comfortably.

Well, he was sleeping comfortably until they came to put a feeding tube down his nose. He struggled a little bit and tried to move his head. They are done now and he is much more relaxed now.

We are still waiting for some answers. We are trying not to be anxious.

"Rejoice in the Lord always. I will say it again: Rejoice! Let your gentleness be evident to all. The Lord is near. Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things." Phil 4:4-8

Friday Morning

The last two weeks are just running together. We can't remember what day it is today or what day things happened in the past. Last night was the first night that we left Dad alone in the hospital. He was sedated because of the ventilator and wouldn't have known if we were there. We all needed to sleep in a bed.

Don checked on Dad early this morning before he had to start working. When he arrived at Dad's room, the resident for the surgeon was there. It is hard to know when the doctors will be doing rounds so it was such a blessing that Don was able to talk to him. The surgeon does not want Dad to be on the ventilator very long because it can make the lung stiff, but while he is on it, they are going to try to figure out some answers. Dad is currently on about 90% oxygen but his sat numbers are at about 100. They wanted him to be stable last night so they increased the percentage. They plan to take that down today. His lung is full of "snot" so thick that Dad can't cough it out. They have taken a couple samples but can't get bacteria to grow. They started him on antibiotics because there was a significant chance that it was pneumonia but they aren't so sure.

They plan to do a bronchoscopy which is a scope down into his chest. They did this during the biosopy of the mass way at the beginning of this journey. They also did it when they fixed his vocal chords. They want to take another look and see if they can figure out what is going on in his lung. This procedure may happen this afternoon. Please pray for answers so that they can begin implementing the solutions.

They are also considering echmo where they would take blood out of his body through a vein, oxygenate it and then return it to the body. This would take some of the pressure off of the lung but help him maintain his oxygen level. This is a pretty big, deal and probably won't happen today.

Don is working today and will check in on Dad periodically. Mom and Jen just arrived and will try to be there in case the doctors come in with any news or changes. Please keep praying with us. We have had many people send us verses on "waiting" on the Lord. It is really hard but we trust Him who holds live in His hand. We are praying for answers and healing for Dad; for rest for all of us and for peace in the midst of this very hard situation. Thank you for standing with us. Blessings.

Thursday, April 5, 2012

Time to sleep

Jim had a rough day. Tonight, he was tiring out and uncomfortable. The doctors just thought it was too much. The decision was made to place him on the breathing machine. The tube placement was uneventful and he is now resting - drugs on board! This was a hard night but the right decision.

Please be praying for rest, for a good sleep, for full restoration, for a short number of days on the vent.

Back to ICU

Dad has been struggling all day. His oxygen needs increased steadily throughout the day. His pain seems to get the best of him at times if we aren't watching his pain meds. They decided to move him back to the ICU where they can watch him more carefully. He is on 70% oxygen with the BiPap (20/5 pressure) and is maintaining his sats in the mid-90's.

They can't seem to get his lung clear. He is still on 3 antibiotics but we don't have any news from the culture of the sputum. He is getting weary of the BiPap and the pain. They have a couple options for helping him get his oxygen more easily while we wait for the antibiotics to work but they won't make any changes until necessary.

We are still "circling" this mountain. Please pray for improvement and positive news. This has been a rough day for all of us, especially Dad. Thanks!

Morning

Let the morning bring me word of your unfailing love,
for I have put my trust in you.
Show me the way I should go,
for to you I lift up my soul. Psalm 143:8


Dad is little bit short of breath this morning. They think it is because of all of the fluid. They are going to give him some more lasix to try to get it off. His white blood cell count went up to 27. They have not yet been able to identify the infection. Hopefully we will have news today. He received two units of blood last night. He seems a little more agitated and uncomfortable this morning.

Scott, my brother-in-law, sent Mom a text with a verse for Dad this morning. It came from Psalm 71

"Though you have made me
see troubles, many and bitter,
you will restore my life again;
from the depths of the earth
you will again bring me up.
You will increase my honor
and comfort me once again." Psalm 71:20-21


Please continue to pray for Dad. Thanks.

Wednesday, April 4, 2012

Persevere

We have been really seeking the Lord this morning. He promises that His "burden is light" and His "yoke is easy". This burden has been feeling heavy for all of us and we just want to continue seeking the Lord. We have been asking Him if there is something else that He has for us - a different way to do this? Are we relying on our own strength instead of His? What do we need to do?

I did my daily Bible reading after asking Him all of these questions and the verse in bold print in my Bible was

"And so I tell you, keep on asking, and you will receive what you ask for. Keep on seeking, and you will find. Keep on knocking, and the door will be opened to you." Luke 11:9

So we are going to persevere. We are going to continue to ask for healing and for the Lord to move this mountain.

Dad had a pretty quiet night. He was stable this morning. His white cell count had been slowly inching up and had reached 25 (normal is closer to 10). It did not move today so we are hoping it has peaked and will start to go down. They took a culture of his sputum yesterday. It is growing something already but they have not identified it. They are hoping to find that out today or tomorrow so they can tailor the antibiotics to whatever infection he has. They are doing a "shotgun" approach right now with 3 or 4 different ones. They put his catheter back in while he is on the bipap (which is 24 hours a day currently). They have been giving him more lasix to get the fluid off of his lung. He may also get some blood because his hemoglobin dropped to an 8. They also put him back on the insulin drip.

We were so excited a few days ago that all of these things had been taken away and here we are again. We are trying to find things to be thankful for in the midst of all of this.

We are thankful that he can talk again. He was getting so frustrated at not having a voice.

We are thankful that his incision is healing very well.

We are thankful that he is strong. He moves himself around in bed. He just finished with leg and arm exercises.

We are thankful for his sense of humor. He is joking with the nurses and therapists.

We are thankful for all of the cards and encouraging words as he has been receiving. They are keeping his spirits up and reminding him how much he is loved.

We are thankful for the care he is receiving. The majority of the nurses and techs have been wonderful. Many of them are outstanding!

Thanks for standing with us during this time. Thanks for persevering with us!

Tuesday, April 3, 2012

Let Us Not Become Weary

"Let us not become weary in doing good, for at the proper time we will reap a harvest if we do not give up." Galatians 6:9

I (Jennifer) am feeling a bit weary, so I am holding onto this verse and thanking God for His strength. As Lori posted earlier, we have been earnestly praying for breakthrough for Dad today for his breathing and to be able to cough up the mucus in his lungs/throat. He is receiving antibiotics and the surgeon said there is a "little bit" of pneumonia. Mom just called me from the hospital to say that Dad is being moved from his regular room back to an intermediate care room (8831) so that they can use the b-pap machine again that forces oxygen into his lung. However, she did also say that Dad is pretty upbeat and is joking with his caregivers.

I am feeling a bit like the man who tries to roll the rock up the hill and it keeps rolling back down. Please pray with us that God will reach out His mighty hand and push that rock all the way over the mountain so we can see His harvest on the other side! I know that God is our strength and our protector and that He has my dad (and all of us) in the palm of His hand. Thank you for standing with us in prayer!

Mom and I (Lori) are sitting at the hospital in Dad's new room. We are also weary and pretty much basketcases! The tears are really close and have been occasionally spilling despite using all we have to hold them back. Dad is in a better mood than we are!

Jen's picture of rolling a humongous rock up a hill (so I may have added the "
humongous" part!) is a really great picture of how we are all feeling. Mom and I were just saying that it feels like we are starting over. It makes me think of the Israelites who kept "circling" the same mountain. God finally said to them,

"You've stayed long enough at this mountain. On your way now. Get moving." Deut. 1:6 (Message Bible)

We hope that we are only in this room temporarily. We are getting tired of "circling" this mountain. We are waiting for the time when the Lord says "on your way now"!

We need a breakthrough

Jen and I are praying for a breakthrough today. Dad took a turn yesterday afternoon after his procedure. He was short of breath and needed more oxygen. The "gunk" in his chest is so thick and he can't cough it out. He gets lightheaded very easily. The resident put him back on lasix this morning to try to get some fluid off of his lung so he can breathe better. They are supposed to be putting him on IV antibiotics. We feel like we are going in the wrong direction.

He is sleeping now. As he breathes, I can hear the "gunk" rattling in his chest. I am praying and seeking the Lord for His healing hand to touch Dad. I asking the Lord to show us what we need to do to get through this. I am praying for wisdom for the nurses and doctors. We need the Lord's encouragement and hope today.

We wait in hope for the LORD;
he is our help and our shield. Psalm 33:20

Monday, April 2, 2012

He Speaks!

Dad had his procedure a couple hours ago. He came out of the anesthesia talking! He is very happy to have his voice back. He is also coughing much better. We are very excited that the procedure went so well.

Dad has lots of "gunk" in his chest. They said it is very thick and white. They are giving him an "anti-fungal" to help get rid of it. His white blood cell count has also gone up a little bit. They are taking samples of the "gunk", urine, etc. to check for infection. He has not had a fever so we are hoping that getting him up and walking plus his coughing will help. They are watching him closely for pneumonia. We are praying that he doesn't get it.

Dad received another big stack of cards today! Thank you so much for your encouragement and kind words!

Mom is sleeping here tonight. Please pray for a quiet night and some sleep for both of them. Blessings!

Sunday, April 1, 2012

April 1st


A friend of Mom and Dad's emailed me this picture.  She rode her bike to church past their house and noticed that their lilacs were in bloom.  I thought it was a cool picture and wanted to share it.

Sorry it has taken us all day to write a blog entry.  Don and I covered last night from about 7 pm until 10 am this morning.  Don took the majority of it and then I relieved him at about 4 am so he could get a couple houses of sleep before church.  We went to church, had lunch and both of us took a nap!!

The night went well. Dad was having some pain control issues.  He is really trying to get up more and walk around etc. and the pain medicine was not cutting the pain very well.  When the medicine starts to wear off, his blood pressure and heart rate go up.  At midnight, the nurse was very concerned and called the resident.  Once the pain medicine starts working, it all goes back down again (which it did) but all of the excitement had everyone up and awake.  It quieted down after that. 

My shift was pretty quiet with just a few interruptions to take vitals and weigh him etc. until about 7:30 am.  His medicine was due at 8:30 and again, his blood pressure was up.   Dad ate a great breakfast and had a breathing treatment and then my family arrived at about 10 am.  Don brought all of the kids and Mom up to see Dad.  Then Mom took over and we went to church.

Mom talked to the surgeon about Dad's pain and he added another medicine.  She also found out that Dad's procedure for his vocal chord will be tomorrow at about noon.  The surgeon is talking about discharing him on either Tuesday or Wednesday.  Dad is doing great.  He is trying to get up more and build up his strength and endurance.  They are trying to wean him off of the oxygen or to get it as low as possible.  We are very thankful for his progress.  We see improvements everyday!  Thanks for praying.