Hello all, Well Bill is starting to do pretty well with his therapy. Yesterday he was able to walk a few steps with a walker in the hallway which is huge. It only takes one person to help him get out of bed now and he is almost to the point where he can sit himself upright with out 2 people helping him. SO he is slowly getting there physically, he gets winded pretty fast too but that will all come around as he gets stronger.

On the intestinal side things just still really suck, he is having so many problems trying to get food into his stomach. The food their really does suck, SO today I took him in a peanut butter and jelly sandwich, told him to try a few bites as he needs to get protein in him bad, The doctor told him yesterday that he needs to drink at least 4 protein drinks per day to get closer to getting out of there as he needs it to help build his body up during PT. All the liquid drinks they have given him taste like #^&#^&#^&#^&, in his words. So we are trying some like ensure which he had today, he drank the whole can which is a lot for him and half of his cereal, but then threw it all up a half hour later.

His ileostomy is still putting out mega fluid so they continue to draw his blood every four hours and check the levels and adjust his IV TPN and IV fluid.

I still want to doctors to be keeping an eye on his belly as he keeps complaining of massive gas cramps and pain after he eats anything at all. SO he has been refusing to eat anything except his cereal for breakfast. I told the doctors that they need to be paying attention to what he is saying as every time we get Bill to the point where he can put stuff down to his stomach it feels like to him it is all hanging right under his throat. SO hopefully if this keeps up over the next few days they will scan him to make sure, if not I will make sure he gets SCANNED, no more pissing around if you get my drift.

We also want to again thank everybody for all their thoughts, prayers and donations, you guys and gals are the best group of friends a person could have. THANK YOU

THis is an amazing story, continued success on the recovery.

Great news Jules

He is lucky to have you Jules.

Continued strides is great news Jules!:uhuh:

hope his stomach calms down and he is a little more comfortable. keep up the good fight!

excellent! Tell him Salty says if his stomach don't get better we'll start calling him Ralph. That will make him chuckle :)

those protein shakes will cause gas
so make some mint tea
with a teaspoon of honey at home
(honey is for energy)
and let it cool off ...it'll still work as a cold beverage
and let him sip it later on

the mint tea will help him dispel any gas
it's a carminative... (ie dispels gas)
it has no caffiene in it..

glad he's up and walking
step by step....
get better BILL

Nice to hear of some progress.

Prayers continuing for you both.

That's awesome!

glad to hear of the great progress Jules! :uhuh:

Thats great news!! If he needs to increase his protien and is eating cereal, i think Special K makes a ceral fortified with protien. Getting a protien supplement and sprinkling it on the cereal he's eating too might help. Good luck. Our thoughts are certainly with you both!
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That's great news!!

As far as protein shakes go, try isopure. It's got 50 grams of protein per shake and dissolves in water.

The chocolate is great.

Glad to hear he's doing better.
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I'd be concerned that the ongoing GI fluid loss (i.e, the high ileostomy output) is the root of the problem. It indicates some level of small bowel dysfunction causing malabsorbtion and until that is fixed (or resolved) oral feeding won't be very effective (since the food won't be absorbed well). Presumably they are blaming it on poor serum protein levels causing bowel edema and hope that by feeding him his protein levels will improve. Likely that is a factor, but the duration and degree you report seems unusual. You might want to question the GI consultant (not the intern or resident) as to why this has continued. Ask if they have checked for "mesenteric venous thrombosis". Ask whether he thinks checking for other small bowel injury or pathology by endoscopy and biopsy might he helpful (it might or might not). Perhaps all this has been considered or done, perhaps not.

Sometimes family questions serve to refocus a consultant's attentions on a difficult case like this, and that always is helpful. At very least you want a clear explanation from the attending gastroenterologist about what he thinks is going on, why he thinks that, what else has been considered and ruled out, what he expects to see for progress, and when (or if) the lack of progress would cause him to reconsider his diagnosis.

Another thing to realize is that full dose IV feeding (TPN) usually kills people's appetite and severe illness itself often temporarily destroys taste buds which can then take a month or more to recover....once the patient is fully better.

It is good to hear his strength is improving, but until they can get the lines (and their attendant risk of blood infection) out of him, and his GI tract working things are still in the balance.

Good Luck.

DAMN GEORGE!

Is that bassmasters directions to his honey hole?LOL
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Thanks for the update Jules ... glad to hear Bill is improving, and will continue the prayers for his internal stuff to get on the right track.

Great to hear of improvement.Even in baby steps.Keep up the fight.George;It's great to have a doctor in the house:uhuh:.

Numbskull, I totally hear you on that one. I just ask the doctors again the other day. His bowels took a big hit when he suffered the heart attack and his bowels were almost pale when they did the second surgery. They are very inflamed at this point and are not working hence the heavy output which still is not slowing down. They told us the other day that it could take months for the bowels to come around.

They finally got him a few different protein drinks that he likes so he has been drinking them the past 2 days. But he keeps complaining of fullness all the time after he eats. Not right away but even as long as an hour later and then throws up. I realize that his stomach is smaller but he has been putting some food in it, even only little amounts over the past 2 1/2 weeks, so my concern is why is he still throwing up every other day some days 2 times a day. He is very crampy "Gas" when eating and also has nausea constantly so they have him on meds for the nausea. Zofran 4 times a day!!!

Maybe this is just the way things are going to go on till his bowels start working, they told him the other day that as long as his output is so bad he will have to have blood work every 4 hours to balance his fluids and will not be able to leave.

I understand a lot of what he is going thru medically but I have also seen him go thru a lot of agoney because people are not paying attention and that is not acceptable at all!!! I have put a call into a doctor from SICU that had worked with Bill the hole time he was in there and is still following his case. I want him to get down to rehab and check things out and let me know if he thinks Bill should be scoped or do another CT scan as again I am going by my gut feelings and also what I have seen Bill go thru.

The doctor in rehab the other day said well we can not scan him every time he throws up. NO #^&#^&#^&#^& SHERLOCK but he has not been scanned since he was sent to Rehab so lets just check and make sure everything is working and if it is, then Time is going to be the factor in his recovery. But lets not f'n wait till something is very wrong again and we have a huge problem. I feel they need to check things out especially Scoping him because all of the test before where by CT scan looking for leaks so they have no idea if something is wrong on the inside.
Thanks for all of your info on the TPN as well as he does say everything tastes like #^&#^&#^&#^& and now I can tell him why, LOL

Keep those prayers going, thanks again everybody!!!

God Speed.Will keep on praying.

Sounds like they are blaming things on either "short bowel syndrome" or extensive mucosal (the bowel lining) destruction from lack of blood flow. Any acute "inflammation" should be long gone (although this gets into semantics and they may be using the word "inflammation" as a softer term for "damage"). Probably they are hoping for the remaining healthy bowel lining to expand and take up the slack. That takes time.

Whether it explains his vomiting or not, you can't be sure. Lots of other things are concerns and can be missed. If one is not already involved, it would likely be helpful to have a gastroenterologist see him.

Also, did his kidneys recover fully? Kidney dysfunction (particularly high levels of protein waste called "BUN") can kill your appetite and cause nausea. Often this level gets high as a necessary evil when trying to build patients back up on TPN if their kidney function is marginal. You can ask the nurse what this value is. If it is near 100 (nl is 10-20) that can cause issues (but, again, ones you may have to accept in order to build him back up).

if he has any crimp
in his intestine he won't fart
and the gas will just build up
expand that area
cause pressure and subsequent pain

so ask him, whens the last time he farted
this is in all seriousness Jules and S-B
i'd wager he'll say , i haven't


tell that to the other doctor

Great News...really good to hear.


Blend up those protein drinks w/ a scoop or 2 of his favorite Ice Cream....they'll probably get down easier :kewl:

numbskull and Raven, he did suffer damage to his bowel from lack of blood flow from his heart attack, as well as the lining of his bowel due to all the antibiotics they had him on from being septic as well as when his white count went up to well over 58,000 and they could not figure out what was causing it to go that high.

In the past, about 3weeks ago they did a CT scan to see if he was leaking anywhere or if they could see anything wrong. Their answer was that his bowels are very inflamed and that was due to the lack of blood flow to the bowel after his heart attack as well as his numerous surgeries to his abdomen and his long stint of antibiotic that it would take time for the lumin to recover as well as they pretty much killed the good bacteria that breaks down food as well as what ever was causing the white count to go so high.

They told us that it could take months for his bowels to start working again and some of it could be controlled by what he eats to start absorbing the fluids. Well if you can not eat how the hell is that going to happen. I do have to say that the past 2 days he has been drinking his protein shakes and he did not throw up yesterday so that was good.

He is passing plenty of gas threw his ileostomy bag as i can hear it just fine when I am in there. I will let you know what happens when I get back today.