Memoir...

Lately I’ve been thinking of turning my blog about Christopher’s accident and Brain Injury into a Memoir and joined a Teleseminar via NAMW (National Association of Memoir Writers) this morning. My head was spinning by the end of the seminar and I found myself at my blog (leackerman.blogspot.com), reading the words I had written almost 3 years ago. As I read the entry titled, Christopher’s Rehab/Recovery 5, May 7, 2010”, I couldn’t help but laugh through my tears. Chris was only a week out of his coma and was still very confused and frustrated about all that had and was continuing to transpire. Here’s the verbal exchange that ensued that day…

Chris: "You don't love me. If you loved me you'd take me home. I HATE this hospital. I'm not hungry. I WAS going to eat at home but’ NO’… I'm not GOING home. I'm hot. This hospital is STUPID. I HATE it here. Why can't I just go home? Why doesn't this STUPID hospital just let me go home?"

Laura: "I'm tired of you calling this hospital 'stupid' because THIS hospital is the reason you're still ALIVE".

Chris: "FINE... Why doesn't THIS hospital just let me go home?"

Some of the topics that were discussed during the seminar were “Who is your audience?” and “What message do you intend to convey?” As I read the verbal exchange between Christopher and I that day (and on many other blog posts that I had written), I found myself wondering what category MY memoir would fit into. Would it be a tragedy? A success-story? A heart-breaker? An inspiration? Perhaps a mix of all; but I also think it would somehow fit into the category of comedy! Oh, how very thankful I am that we are on the other side of that mountain. Now about that Memoir…

Audrey Assad- Blessed Are The Ones (Live)

"So further up and further in we got nowhere else to go; but You give us seeds of toil and tears, it's beauty we will sow. Yeah blessed are the ones, oh blessed are the ones, blessed are the thirsty ones." Audrey Assad

This Girl

This Girl

Her life seemed so simple; she had not a care;

the world passing by, with her head in the air. 

She smiled and she laughed never shedding a tear,

no need to cry, she knew not what to fear.

Then darkness crept in voices lurking about, 

they whispered and screamed, filled her heart up with doubt. 

She'd opened herself up to evil, unknowing,

how fast it took over, the emptiness growing.

This girl had erected a wall deep and wide, 

between her and God, a created divide. 

She then turned away from the life that she knew,

as she questioned the reason for all she’d been through. 

As time carried on and her struggles increased, 

she encountered misfortune, an unwelcome beast.

She wanted to pray and to cry out to God,

but she just couldn't do it; thought she'd then be a fraud.

So she counted on family and friends far and wide, 

while the pain and the anger destroyed her inside. 

But onward she trudged with regret and great sorrow, 

and found herself dreading another tomorrow. 

Her days were like torture, her nights filled with fear,

she buried herself deep within for a year.

Withdrawing from all of the people she knew,

she kept it a secret, telling only a few. 

A voice from her past came from out of the blue

with a message of love and great hopefulness too.

Though she tried to believe all the things that he said,

the pain, fear and doubt still consumed this girl’s head.

But nothing was going to turn him away,

because God had decided that he was to stay.

At times her rejection was too much to bear,

yet he never gave up, on his knees, deep in prayer,

His faith in this God, who had died for us all,

was so powerfully strong that he could not withdraw.

The Spirit inside him continued to prod;

 believing one day she’d respond to his God.

Her struggle with God was an arduous road,

she kicked and she screamed, just increasing her load.

Refusing to listen to well-meaning friends, 

this girl was determined to not make amends.

What she didn't know was she had it all wrong, 

her quest to be free meant she had to belong. 

Not to an organized group made of man,

no, freedom for her could be found in His plan. 

God's love is so deep that it's hard to imagine, 

being fully forgiven we cannot truly fathom.

He asks us to trust in what is unseen, 

that only through Him can we find ourselves clean. 

So the day that this girl found herself at His door, 

she still had no clue of the blessings in store.

 Deciding to enter, and look toward His face,

she suddenly found herself covered by Grace.

Oh, what a glorious day when she prayed,

that He would accept her, all tattered and frayed.

She laughed and she cried for the Lord had won out,

this girl now God’s child, beyond any doubt.

God works in mysterious ways but we know,

that a deep transformation our hearts undergo.

Sometimes it takes longer for us to embrace,

the ways of our Lord, but He gives us that space.

For He knows where our hearts lie, His patience is great,

from the love of this God, nothing can separate.

Though evil continues to prowl all about,

our God is much greater, He always wins out.

This girl’s story’s not over, she’s just been forgiven,

her new life ahead, destination is heaven.

Good thing don’t come easy; just keep up the fight,

‘cause deep down she knows that things WILL be all right.

                            Written February, 2011 by LEA

Signs of Forgiveness

This is such a powerful video and reminder of how we ought to live our lives on a daily basis...

"And whenever you stand praying, forgive, if you have anything against anyone, so that your Father also who is in heaven may forgive you your trespasses.” (Mark 11:25)

http://youtu.be/FxoMbPWuk0I

A few changes...

Dad, Laura & Mom in Santa Barbara, June 2010

This morning Dad had an appointment with his Internist, Dr. Riddle, and he gave us some great information on Pulmonary Emboli, blood thinners and the circulatory system in general. He is very knowledgeable and was willing to answer our questions.

He taught me some things that I didn't know. One is that Heparin is an organic acid that is found mostly in lung and liver tissues and occurs naturally in the body to prevents blood clots. (Heparin is also made synthetically and can be given as a treatment when required.) Another interesting thing he taught me is that only veins have clots in them and arteries never do. Also, the lung acts as a sieve... it screens the blood and doesn't pass clots out into the arteries (and here I thought I knew everything! Haha!)

Dr. Riddle has changed Dad's course of treatment and I (we) feel very comfortable with it and that Dad is in capable hands. He told us that it takes several days for a person's blood to respond to Warfarin (the generic of Coumadin), so the daily blood draw was really unnecessary. Dad is supposed to take 2.5 mg of Warfarin every other day (because he is highly sensitive to blood thinners) and then have his blood tested (for his PT/INR) on Monday morning. After getting those results, Dr. Riddle will take it from there to determine his Warfarin dose and next blood draw.

As far as the Lovenox injections, we are to continue giving them to him through Sunday night. It makes me feel good to know that he will be receiving that blood thinner.

Once Dad has become therapeutic on his Warfarin, Dr. Riddle is planning to switch him to an anti-coagulant called Pradaxa. This medication has been used for about 4 years, so it is fairly new and I'm yet to be convinced that it's the best form of treatment for him, given his age and the fact that he was in Atrial Fibrillation when he entered the ER on Sunday night. I've got to put my stethoscope on and do some research on this!

The only other possible change is that Mom and Dad might need to delay their move to Minnesota a few more weeks until Dad is completely stable and settled in with his course of treatment. There are far worse things that could happen and fortunately, everyone involved in the move, including the Moving company, the Estate Sales company, their Realtor, my brother, Ken and I have a lot of flexibility and are able to change our plans
accordingly.

Thank you once again for your prayers and words of concern and encouragement. We have much to be thankful for!

Love, Laura

He's Home!

Mom and Dad in Vail, CO celebrating 60 years of marriage in July, 2013

When my dad went to the Emergency Room on the evening of February 3rd, he was experiencing pain on the right side of his chest and under his right arm. When he arrived, they did an EKG which showed that he wasn't having a heart attack but they found that he was in Atrial Fibrillation with Rapid Ventricular Response. He was given Cardizem to bring his heart back into normal rhythm and it worked. His heart has since been in Sinus (normal) rhythm. Blood was drawn and they did a Blood Panel, also known as a CBC (complete blood count), or FBC (full blood count). This test gave an overview of his overall health status.

As part of that blood draw, they looked for Cardiac Enzymes that could have leaked into his blood. This was done 3 times over a period of 18 hours (every 6 hours) and if the enzymes were present, that would indicate that he had had a heart attack and that there was possible injury to his heart. Fortunately, those tests came back negative so it was definitive that he did not have a heart attack.

After the EKG and blood draw, he was taken to have a chest x-ray and a contrast CT scan which showed multiple small blood clots in both lungs. There are clots in his lower and middle right lung and in his lower left lung. He was diagnosed with Bi-lateral Pulmonary Embolism and was immediately given an injection of Lovenox. This is a fast-acting blood thinner and they have continued to give him 70mg of Lovenox twice daily. At the same time, he was given 5mg of Coumadin which is also a blood thinner but it will take several days to build up in his system.

Using a Pulse Oximeter (a device clipped onto his finger), his Oxygen Saturation Level (called Sats or Lung Profusion) was tested and it was at 95%, which was great! Normal Sats are between 95-100% at sea level and on Tuesday morning, his Sats were at 96% on room air. This is a good indication that the clots in his lungs are not keeping his blood from being oxygenated as it travels from his heart, through his pulmonary artery, into his lungs and then back through his circulatory system. 

Because he was stable, Dad was transferred to a high-level care room within the hospital rather than having to be placed in ICU. He was continually monitored there and given narcotics to lessen the pain he was experiencing as a result of the blood clots in this right lung. This medication made him very drowsy but it relieved him of his pain and allowed him to rest peacefully.

An Echocardiogram (an ultrasound of the heart) was performed on Monday morning. His doctor was exploring the atrial fibrillation that had been discovered in the ER. Also, it is not uncommon for the heart to be damaged after a PE because the heart is often stressed as it pumps harder (because of the blood clots) to get blood into and back out of the lungs. What was found is that he had a mildly dilated right atrium, but his valves looked good and his heart continued to be in Sinus (normal) rhythm. His heart rate has consistently been in the 60's over the past couple of days which is very good.

The PE that Dad experienced as a result of clots in his lungs most likely originated from a blood clot (or clots) in his leg(s). He has traveled extensively by plane over the past 12 months and has spent a lot of time in his office sitting at his desk getting everything in order in preparation for their upcoming move to Minnesota. These factors definitely contribute to the development of blood clots, but between the Coumadin and the fact that he's going to get into the routine of getting up and moving around more frequently, we shouldn't have to worry about more clots developing.

The clots that he currently has in his lungs and likely in his legs will gradually dissolve and be reabsorbed into his bloodstream. This will take several months. His doctor wants him to have an ultrasound of his legs in three months to determine if the clots have dissolved and if they have, he will probably be taken off Coumadin. My friend, Patti Heaps who is a Palliative Care Nurse told me that tests are being done on the risk-benefit ratio of elderly patients being on Coumadin. It's not uncommon for them to stumble and fall, usually hitting their heads and being on Coumadin frequently leads to head bleeds. So more and more, patients are taken off Coumadin and put on a low-dose aspirin regimen.

Dad was released from the hospital on Monday, February 5th around 5:00 pm. His discharge diagnosis was 1) Bilateral Pulmonary Embolism and 2) Atrial Fibrillation with Rapid Ventricular Response. He was sent home with an order to have his blood drawn to test his PT/INR (Prothrombin Time/International Normalized Ratio) level every day for seven days. Prothrombin Time (PT) is a blood test that measures how long it takes blood to clot. It is also used to check whether medicine to prevent blood clots is working. The PT laboratory test includes mixing a commercially available reagent with the patients blood plasma and measuring the clotting time. However, PT time shows great variations, depending on the type of reagent used and the way it is measured. To standardize these PT results, the World Health Organization introduced International Normalized Ratio (INR), which allows a doctor anywhere in the world to treat a patient with blood clotting issues.

For most people, their INR should be around 1, and their PT (clotting time) should be around 10-12 seconds. A person on Coumadin typically needs to be in an INR range of 2-3 (which is my dad's goal range) and their PT (blood clotting time) should range from 22-30 seconds. The challenge is to make sure their blood is thin enough to prevent clots from forming yet not so thin that it causes excessive bleeding. He will gradually reduce the frequency of his blood draws from daily to weekly to bi-weekly(every two weeks) to monthly.

Mom and I are also giving Dad twice-daily Lovenox injections until his INR is (and remains) in his goal range. He doesn't seem to mind them but he has some very attractive bruises on his stomach! The pain medication that was prescribed for him is a pretty strong narcotic that makes him drowsy and a bit confused, so he's been taking Tylenol for his chest pain and that seems to be working well.

We will meet with his Primary Care Doctor on Friday for a follow-up visit. I have a few questions for him that I wasn't able to get answered in the hospital and also some questions regarding his follow-up care. I feel bad for the poor nurse and doctor in the hospital who were subject to my copious list of questions yesterday, but they were both great about answering them and giving us so much information and clarity!

The "curse" of my Massive Pulmonary Emboli in December of 2010 has proven to be a blessing these past couple of days. Because of what I went through, I understand all of the medical terminology and have been able to communicate effectively with the Doctors, Nurses and Lab Technicians with confidence and understanding that I would not have possessed otherwise. I knew which questions were important to ask, was familiar with the information they gave us and feel confident that my dad is receiving the care that he needs.

I want to thank everyone for your prayers and well-wishes, notes of compassion and concern, e-mails, texts and phone calls. Our family has been through so many serious medical emergencies in the past 2 1/2 years but God has been gracious and has had His healing hand on all of us. Please pray for my dad's continued speedy recovery and for clarity and peace of mind for both of my parents as they navigate through this new medical terminology, medication and change of lifestyle.

Also, please pray for God's guiding hand on them as they prepare to move from Oklahoma to Minnesota around the first week of April. They have a lot on their plate right now and it can feel daunting at times, but I know they will be fine and will settle into their new home quickly. My brother, Ken lives in Minnesota and it's great that he will be so close to them. I am very thankful for all he has done to help them find a Retirement Community in which to live, and the bonus is that it is fairly close to his home and work. I will be here in Oklahoma through next Monday and then will travel to Minnesota in April to help them unpack and settle in. Hopefully, my next blog post will be an update on how they are thriving in their new home in Eden Prairie, Minnesota!

Again?

My day began with a 5:30am phone call from my mother. Of course, before she could say anything, I asked if everything was alright, to which she replied, "No. Your dad is in the hospital and he has a Pulmonary Embolism." Unbelievable, yet not entirely surprising. My maternal grandmother and mother have a history of blood clots; two of my three brothers, Ken and Scott have had Pulmonary Emboli; of course there was mine in December of 2010 and my oldest son, Nicholas' last July while in Guatemala. That's FIVE of us now! Wow!

I guess the surprise is that we all assumed this genetic tendency (or whatever you want on call it) came from my mother's side of the family. Now we know the truth... it comes from both parents, which probably explains the high rate of Pulmonary Emboli in my immediate family. This gives me more reason to pursue genetic testing in the very near future to determine what is causing the blood clots, whether it be a genetic mutation or a specific gene, and to take the necessary steps to prevent it in the rest of our family members (and their future children). 

Back to my dad, I don't have a lot of information at this point. He had pain under his right arm last night (Sunday evening) that continued to worsen to the point that my parents made the decision to take him to the Emergency Room. I'm so thankful they made that choice. Perhaps they were thinking it was a heart attack, but once at the hospital, an EKG revealed that he was not having a heart attack. They then proceeded to do a CT scan which revealed blood clots in (I believe) both lungs. They immediately began giving him injections of Lovenox and started him on Coumadin, which is a blood thinner. The Lovenox is fast acting whereas the Coumadin will need to build up in his system until he is at a therapeutic level. 

I believe they performed an echocardiogram on his heart this morning. Frequently, when one has a Pulmonary Embolism, the heart is stressed which causes enlargement. I don't know the results of that test yet but will let you know as soon as I do. He was also given Morphine to lessen the pain, so he is very drowsy. He is not in ICU, which I believe is a good thing. My brother, Scott spent 2 days in ICU, Nick was there for 3 days and my stint was 5 days! He's in a regular room and is able to get up and move around a bit, so I take all of that as a good sign that (I hope) he is not suffering from a life-threatening PE. 

I am on the plane as I type this, headed to Oklahoma to be with my parents. I won't arrive in OKC until later this evening so I likely won't see my dad until tomorrow (Tuesday). My mom and I will be at the hospital early in the morning so we can speak with his doctor when he does his rounds. I'll write again tomorrow after I have more information. Please pray for healing for my dad and peace for both my mom and dad. They have a big move coming up next March when they relocate from Oklahoma to Minnesota, so I'm sure their minds are filled with worry and concern about how they will accomplish all that lies ahead of them. 

Thank you in advance for your prayers. 

Love, Laura