This morning started off with a real bang – literally. There was a 4.0 earthquake at 6:49 that rocked the household awake. After checking to make sure everyone was okay I went to get ready for work. It took me a few minutes to remember I didn’t have a job. So I decided to look at my email and found some very sweet and supportive emails from friends and family.

The day continued to go well. My friend Marika called and we got together for coffee. It was a treat to sit outside and talk to a friend for a while. Rita texted me to tell me that Cindy was in the hospital. Cindy was retaining weight again and need to go the hospital to have the fluid diuresed (giving a patient diuretics through an IV). I returned home after that to make appointments with dentists and doctors since my insurance is going to run out at the end of the month. I even got an invitation to lunch by Rabbi Kelman. Edgar and I went to get new glasses since we qualified for new glasses. Then we went to the store, bought dinner and went home. I got home just in time to take my wonderful sister-in-law Lucy to the airport. I was certainly going to miss all her help with taking care of Pauline and making meals.

As Lucy was saying her goodbyes, I got a call from Rita saying that Cindy had a temperature and her blood pressure was very low. I took Lucy to the airport and then headed over to the hospital to see Cindy.

When I got there, she looked pretty bad. She was very flushed and looked like she didn’t feel very good. Her temperature was 104.1 degrees and her blood pressure was 68/45. The doctors weren’t sure what was wrong. They did labs and took x-rays. Finally they determined that she probably had pneumonia in her right lung. This explained why fluid was building up again (see Pulmonary Hypertension )

Cindy’s doctor had a central line inserted so it would be easier to give her medications, fluids, etc. An hour later, her temperature was at 102.9 and her blood pressure was at 80/45. By 9 PM, her temperature was a cool 98 degrees and her blood pressure had gone up to an acceptable 111/73.

Thankfully, the day ended well.

Pauline spent the night in the ER.  After doing an EKG and taking some blood work, it was determined she was anemic.  Anemia is what happens when your hemoglobin (red blood cells) is low.  It means that the blood can’t carry oxygen to the rest of the body.  For Pauline, that meant fatigue dizziness, low blood pressure, palpations and a very pale complexion.  It is often caused by internal bleeding.  They did an ultrasound and didn’t find anything.  Then they decided to do a CT scan.  Pauline is allergic to the iodine contrast so they had to pump her full of prednisone for a couple of hours.  The CT scan showed nothing.

The remedy to losing blood is to replenish it.  She was given 2 units of blood.  For some reason, Pauline had an allergic reaction to the first bag of blood and had to be given a double dose of Benadryl.  The second bag was fine.  By 9:30 the next day, she was ready to come home.

A few hours later, Pauline had her first Physical Therapist visit.  She did great.  It was mostly an assessment meeting.  He gave us some good tips for walking, icing, standing, sitting, and a few other important steps to Pauline’s recovery.

And Cindy?  She lost power in her home yesterday.  That meant no air conditioners or fans and it was very hot (for Northern California).  Thankfully, all her oxygen tanks were full.

That’s it for now!

Things were hectic today.  Cindy has been complaining of having headaches and not being able to see well ever since her surgery.  She couldn’t watch TV, work on the computer or read.   I got a call from her asking if I would be able to drive her to the Eye Doctor sometime this week.  I was happy to tell her that I could because I had a lot of free time.  Later on that day she called me back, asking if I could take her to an eyeglass place to get her eyeglasses adjusted.  She had been lying down today and her glasses slipped up.  She was able to see fine.  It seems that the last time she was in the hospital, someone had messed up the alignment of her glasses.  I took her to get them adjusted.   She is now able to see just fine.

But not all is well with Cindy still.  She is retaining water.  Her doctor wants her to go to the hospital to get the fluids removed from her system.  She refuses to go, saying she doesn’t want to go back to the hospital yet.  Cindy has an appointment with the doctor on Tuesday.  She promised she would go directly from the doctor’s office to the hospital.

So that leaves Pauline to be in the hospital.  I had gone out for my nightly constitutional.  When I got home, Lucy, Pauline’s sister, was on the phone with the advice nurse.  Pauline was complaining of severe stomach pain, nausea and light headed-ness every time she tried to stand up.  The advice nurse told her to go to the ER.  That is where we are now.  We have no news yet.

For the past few nights, Cindy has not been feeling well.  She has been having fevers at night and feeling sick to her stomach.  On Thurssday, she went for labs and Friday she went to see the surgeon.  Everything looked good,   The surgeon thought one of the medications he had prescribed for her was not agreeing with her and he took her off of it.  He also put her on antibiotics just in case …  Cindy is susceptible ot pneumonia and wants be precautious.  When I spoke to her this afternoon, she was feeling much better.

Also on Thursday, I was working from home.  Pauline was in the hospital and my kids were home so I didn’t go into the office.  Around 10 that morning, I received an email from my boss, saying he was coming into the office and wanted to meet with me.  He lives in Texas and had been in Chicago, so I knew this was serious.  I emaied him back telling him my situation.  He called me a half-hour later to let me know that my job had been eliminated.  This is the way a company in California says “You’re Fired” while  protect themselves from a lawsuit.  My heart was pounding since I am the breadwinner.  I told him I had to wait for Sarah, my daughter-in-law, to pick up Lucy and Emma, my sister-in-law and granddaugter, from the airport and would be in by 1 to clean out my stuff.

As most of you know, I have a hectic life.  Pauline has many health issues.  I have 2 special needs teenagers, and Cindy has a long way to go to recover.  Working full time and being a caregiver can be a challenge and stressful.  I wasn’t sure what to do with the news that I had just received.  Then I realized that one of the stresses in my life had just been eliminated for me.  I shutdown my computer and just sat there.  Then I realized I was beginning to relax.

When I went into the office I was bombarded by co-workers hugs and good wishes.  They all told me that I would have no problem finding another job with my experience.  I packed up my stuff, met with HR to get my severence package and drove home.    I thought about getting another job – updating my resume, making calls, using LinkedIn, etc.

I also thought about my family life and how I now have more time to dedicate to caring for them without the pressure of work.  I was likeing my new situation more and more.  I’ve been working on a memoir for a few years, but hadn’t been able to dedicate much time to it.  Now was my big opportunity.

So readers, you can expect more blogging from me about Cindy and Pauline.  I’ll also be sharing my writing progress and possibly some exerpts from the book.

Pauline’s knee replacement surgery went very well.  The picture above shows how much of her knee had to be cut.  The surgeon found that the problem was bone rubbinb against bone.  No wonder she was in so much pain.

The picture below shows a ball of medication that has a line going from her leg into her knee.  The rectangular object pumps the medication  in

to her knee to numb.   It has certainly reduced the pain she would probably feel without it.

Lucy, Pauline’s sister from Palm Desert, is visiting for a few days to help Pauline with whatever she needs.  This includes trips to the bathroom, a sponge bth and, of course, bringing her the other pain medications

I’ve had the experience recently – twice – of being in a space in two different hospitals, waiting for a loved one to come out of surgery.   The first was last Monday when my sister Cindy had her hiatal hernia repaired.  The second was today.  My wife, Pauline, had knee replacement surgery.

The first one took place at John Muir Medical Center in Concord, CA.  The waiting area was in the main lobby of the hospital, conveniently close to the Gift Shop, Cafeteria and bathrooms.  Smaller sections  for groups were created by they way the chairs and tables were placed.    A monitor was on the wall at one end of the waiting area, advising waiting friends and family as to the status of the surgery – basically Pre Op, In OR, Recovery and Out of Recovery in different colors.    There was a table by the monitor that was manned by someone who could “find out” more detail from the OR.  We were given a patient number that was used to track the patient on the monitor.  We were also handed a paging device just like you get in a restaurant.    It went off when the surgery was over and we were taken to a room where the surgeon met us and explained the surgery, how Cindy was and what to expect.  Cindy went to the ICU immediately.

Today’s experience was much different.    The surgery was at Kaiser and the waiting area was on the second floor and consisted of chairs and tables haphazardly placed in the waiting area.  There was a table manned by a woman who told you what the patient’s assigned number was and wrote it on the back of a card like the one seen above.  She couldn’t explain what anything meant and often let me know that she couldn’t help me with any information.  She hoped that the doctor would call me before Pauline got out of surgery.  If not, there was nothing she could do.  There was also a monitor on the wall that was color coordinated with the information above.  Luckily I got a call a half hour after Pauline got out of surgery.  I was given minimal information about the surgery and about Pauline’s condition.  Pauline’s surgery lasted for about four hours and was in recovery for five hours before they moved her to a room.  I was allowed to visit Pauline in the Recovery room for ten minutes.

In conclusion, the experiences were the same but different.  Each hospital tried their best to make waiting more informative by using technology.  But one had staff that cared and the other had staff that told you – without being asked – that they knew nothing.

Bottom line?  Communication was much better at John Muir than at Kaiser.  Cindy’s support team was able to tell her about her surgery, how it went and what to expect.  When Pauline asked me what the doctor said about her surgery, I couldn’t tell her anything other than how long it took.

Question – should hospitals put a lot of effort into the business of customer service to friends and families of patients?  What does it mean for patient recovery?

If you would like to review Cindy’s journey to now, you can read ALL the posts on this blog.   The previous blog, Cindy’s Status, has been combined with the posts on this site.

Things seem to be quiet on the western front.  Cindy was busy making appointments with her doctors and for labs:

• Labwork this Thursday.
• A trip to the surgeon for a checkup on Friday.
• Next Wednesday is a trip to see the Pulmonologist.

That’s it for now.

If you would like to review Cindy’s journey to now, you can read the last few posts on this blog and find the posts from previous years at Cindy’s Status.

Today, being my birthday, I thought I’d treat Cindy with my presence.  I let her know I was coming over.  She met me outside her house just at the top of her driveway.  She grabbed my arm and we took a small walk.  You can see the path we took in the picture below (just follow the blue line)

Cindy was able to walk without an oxygen tank.  We took it slow.  She made it to the target destination and back into the house.  She tested her oxygen saturation level when she sat down.  It should be at least 90 but it was at 76.  She rested an it slowly came up to 89 and eventually hit 96.  It has been a long time since she was able to do that.  Just before she went in for her surgery, she walked to the bathroom (about 20 steps) without oxygen and her saturation level was 75.  She wasn’t able to get her saturation level to come up without oxygen.

Before the surgery, Cindy couldn’t talk for more than 2 minutes without running out of breath.   I sat and talked with her for about an hour today.  She didn’t need any oxygen and was able to talk clearly without sounding winded.

It was a very nice birthday present.

If you would like to review Cindy’s journey to now, you can read the last few posts on this blog and find the posts from previous years at Cindy’s Status.

Crazy Eyes, Cindy’s favorite Frizzie Minion, decided to help crush her medicine.  He took the pill crusher, put Cindy’s pills in he container and crushed them.    But before he could hand the powder to Cindy, he sneezed and the powder went all over the place.  Cindy went to grab him but he got away.

(Okay, this didn’t really happen but I thought it was a good story since there isn’t much going on today).

Today’s menu started with light liquids (broth, Jello and ice cream cup) and ended with heavier liquids and soft food (shake and mashed potatoes).

If anyone has any suggestions for liquids and soft foods, please let us know.  My friend, Tobie Lurie, suggested a juicer.  She uses it and loves it.  That’s a great idea.