These entries were posted by either Karen's husband Donnie or her mother Dora during the times Karen was in the hospital and unable to type.  They include the period following her transplant surgery in Pittsburgh in 2007 and then when she was admitted to Emory Hospital in August 2008. She died in Emory on November 21, 2008.

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EMORY 2008 UPDATES

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11-24-08 - Today Rev. Pat Williams gave Karen a beautiful memorial ceremony filled with tears and laughter and her 2 favorite Josh Groban songs; You Raise Me Up and To Where You Are. She was laid to rest in Melrose Memorial Park on Highway 61 in Paulding County on a cold rainy day. Karen will forever be in our hearts. We will always love her and never forget how she fought so hard. One day we will be reunited in the Kingdom of Heaven.

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November 21, 2008  - It pains me deeply to say that tonight I lost my dear, beloved wife. She passed this afternoon due to all of the complications that we have discussed lately.  Thank you for the prayers, messages, and kind words that have been given on behalf of Karen over these months and years.

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11-20-08 - Today a spark of hope glimmers.  On top of all the other obstacles Karen is facing right now one of them is a compromised airway; and this one is one of the biggest. Because the trach has been in for so long now her airway has become "floppy". This condition is called tracheomalacia.  If they remove the trach, her airway will collapse upon itself when she tried to breath.  Right now, the trach in place is a long one and holding her airway open.  After spending hours on the internet last night I discovered that it is possible to stent an airway. I discussed this with her doctor this morning.  The current head of the ICU team just happens to be the Atlanta specialist in airway problems.  He said that in her current condition with her still being on the vent, the present infections, and her dimished lung function, he could not do the required 9 hour surgery to do this; however, if she improves to the point to where she can be free of the vent, get the infections cleared, and gain better lung function he would be willing to explore the possibility of placing this stent.  In the meantime, like I said earlier the trach itself is acting like a stent.  The doctor said that it can stay in place and hold her airway open as long as it needs to. Today they are continuing the process of weaning her off blood pressure support medicine and right now she is down to none with her blood pressure holding good. They are going to start trying again to do trach mask trials to see where she is at as far as breathing on her own. The highest, fastest roller coaster they can build cannot hold a candle to the one we have been riding.  Please keep praying for Karen. She is asking to see the boys again and maybe starting to come around again.

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11-19-08 - Sorry for not putting anything up yesterday but it was a stressful day. We had another meeting with the doctors and recieved information we did not want to hear.  In a nutshell they put forward the possibility that Karen may not be able to recover from this condition.  As we already know she has many complications and we went through them all in the meeting.  However, none of us (Karen's family and friends) are giving up hope. Infectious disease docs have been by today and told us of their continuing effort to treat the infection in her lungs that is causing this cavity that the lung doctors are so concerned about.  The lung docs feel like her lungs are getting to a point where they cannot recover. They are also concerned about the amount of lung function she has remaining after these infections over the past 3 months.  We have gotten copies of her lung CT scans put on a disk and have overnighted it to her pulmonologist in Pittsburgh to get an opinion from her.  Nobody knows Karen's new lungs like Dr. Crespo in Pittsburgh. Hopefully we will hear from her in the next day or so. The doctors here are also concerned about her airway and the trach.  We were told that they may not be able to remove the trach ever because her airway has become damaged.  This of course is a major concern for us. We intend to get more information about this soon.  We are still taking one day at a time and not looking too far ahead right now. We know that no matter what the doctors have to say it is ultimately up to a higher power. Hunter and Carter came up to see Mommy yesterday and sat and held her hand for a little while.  She smiled at them during the times she was awake. They miss each other alot. Thank you for your prayers, messages, and cards that Karen has gotten lately.

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11-17-08 - Karen was still a little sleepy today.  She has been awake from time to time and mouthed words to us.  Donnie read her birthday cards to her this morning.  She is still not up to opening her presents, but we hope she will be soon.  Thanks to everyone for the birthday cards and birthday wishes sent to her website.  She had a bronchoscopy this morning to pull fluid from her lungs to try to see what kind of infection is there.  We hope to have the results in a couple of days.  In the meantime, she has been started on an antibiotic that she has not had before.  It's in the penicillin family.  We were told when she was 2 yrs. old that she was allergic to penicillin.  The doctors said she could have outgrown the allergy.  So far she has done just fine on this antibiotic.  We hope it will help clear up the infection.  They also started her back on Vancomycin, another antibiotic that covers a wide range of infections.  Karen had dialysis today for 3 1/2 hours.  They did not remove any fluid since her blood pressure is so low.  She has been back in ICU for 2 weeks now and in the hospital a little over 3 months. Please continue to pray that these infections will clear up quickly and not come back.  Thanks again for all of your support and prayers.

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11-16-08 - Karen had an up and down birthday.  She was a lot more alert today and responded to us more than she has recently.  We told her several times it was her birthday and she nodded her head in response.  She held our hand and squeezed when she could. Every day they take a chest x-ray.  Late this afternoon they took Karen for a CT of her chest.  They rarely do this so we knew something was up.  There was a change from yesterday's to today's x-ray. The doctor told us that she has a spot on her left lung.  Right now the best they can tell us is that a small portion of her left lung may be deteriorating.  It could  be from infection or it could be an air pocket with infection surrounding it.  They started her on another antibiotic that she is not currently on to see if they can stop whatever is going on.  When the doctor went back to look at a CT done in October she believes she can see the beginning of this on the October CT.  It was not noticed back then because there was so many other things going on with her lungs at that time. Hopefully the antibiotic will work and there will be no permanent damage. Thank you Danny and Rachel, and John and Dora's former and current co-workers for visiting Karen on her special day. 

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November 16, 2008 -  HAPPY BIRTHDAY KAREN!!!  She had a good night last night.  Check back later for an update of how her birthday went.

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11-15-08 - Today has been fairly quiet except for late this afternoon.  Her nurse was working on getting her blood pressure support medicine down and her blood pressure dropped too low.  When she raised her blood pressure support medicine it caused her heart rate to escalate.  Karen walks a thin line balancining act of blood pressure support right now. Things seemed to have settled down somewhat even though her heart rate is still a little above where it usually is.  Please pray for a good day tomorrow for Karen's birthday.

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11-14-08 - Karen had a rough night last night.  Her dad peaked in on her at 1:30 am and saw that she was very agitated, her heart rate was about 140 and her blood pressure was way up.  He summoned the nurse and long story short the resident doctor ended up coming down and worked with her for a couple hours to get her stabilized again.  This morning after discussions with doctors, respiratory supervisors, and nursing supervisors hopefully some things have been straightened out about some care issues.  This morning the ventilator continued alarming so her ICU doctor did a quick bronchoscopy to take a "look see" in her lungs.  She said she had some small blood clots that were not of much concern and got them out. They changed all the tubing on the vent and recalibrated it and now everything seems to be better.  This afternoon the ICU doctor did a more thorough bronch and said all seems to be well as far as she could see. Karen is sedated again for now to help with her breathing pattern.  She is having a very difficult time being comfortable when the sedation is removed. Please pray that she can find comfort in the next few days, as her birthday approaches on Sunday, as sedation is once again slowly weaned down. 

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11-13-08 - Karen is still waking up little by little.  Today, she was very agitated all day.  We have seen this every time that she has come out from under sedation.  It usually takes a week or so for her to get all of the medicine out of her system. We are hoping that she will be more awake and more comfortable by Sunday, her birthday.  The doctors still say she is slowly improving.  A couple of the antibiotics have been stopped now.  She is still on a small amount of medicine to support her blood pressure.  Tomorrow is a dialysis day, so she will probably need to stay on the blood pressure medicine since dialysis drops her blood pressure.  This has been a long road and she still has a long way to go.  Please keep praying for her--we thank you.

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11-12-08 - Today Karen seemed a little more awake. The Infectious Disease doctor said that her infection seems to be coming under control again. They have backed down on some of the antibiotics. They did have to change out her trach again today because the one they changed yesterday was still leaking and not allowing them to ventilate her exactly like they wanted. This one seems to be doing a lot better.  Before her day shift nurse went home this evening she said she thinks Karen is a lot better today.  Hopefully this will continue.  

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11-11-08 - Karen is doing about the same. She is still being treated with numerous antibiotics and remains sedated.  The doctors put in a new trach today, a different kind than she had before.  She has had a leak in her trach since she first got it in August.  Let's hope this one works better.  She is still on medicine to support her blood pressure.  She is receiving nutrition by IV again.  She will have dialysis again tomorrow.  Please continue to remember Karen in your prayers...thank you.

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11-10-08 - Karen remained sedated again today.  It is better for her right now as it keeps her calm and more able to fight the infection.  The course of treatment will remain the same for now.  She is on a number of antibiotics, including some inhaled antibiotics that she receives through the ventilator.  The doctors decided that she would have regular dialysis today instead of the continuous.  She is still on medicine to help her blood pressure and has not been able to be weaned off of it yet.  We hope that as the infection improves that her blood pressure will be more stable.  We hope to see more progress in the coming days--it is very slow right now.  She needs your prayers, so keep them coming.  We appreciate all of your support. 

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11-09-08 -  Karen has been sedated all day today and will be sedated through the night. An x-ray last night showed an increased amount of infiltration in her lungs.  They suctioned her lungs and pulled some fluids out.  The doctors were concerned that the infection was getting worse and becoming resistant to the antibiotics.  It appears now that she had aspirated some of the tube feedings into her lungs, and this morning the tube feedings were backing up and coming out of her nose.  The tube feedings have been stopped.  An x-ray of her lungs this morning was much improved.  They plan on restarting the IV nutrition sometime tomorrow.  This evening, they started with continuous dialysis, which is much slower dialysis and is easier on the heart.  However, they had to stop it because of clotting in the filter.  It will be restarted tomorrow.  She is still on a small amount of medicine to keep her blood pressure up.  Please keep praying for Karen....thank you. 

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11-08-08 - Today Karen has been much more restless. She is unable to get comfortable and even seems to be fighting against the ventilator somewhat. Hunter and Carter came up for a visit today but did not stay long because she was so anxious. Even though she's on the vent it almost seems like she can't get her breath. Her trach was replaced today because of a leak, but it still sounds like there is a leak even after changing it. She has received some sedation to help her relax and breathe better with the vent. I hope tonight she can rest easy.

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11-07-08 - Karen has had a pretty good day today. She has been a little more awake all day and seems to even be a little bit stronger in her arm and leg movement. She had dialysis and 2 litres of fluid was removed. Molly from PT has poked her head in a couple times and may try to do some therapy with Karen later if she's up to it after the dialysis. The lab has also detected a better antibiotic to treat Karen's infection so they will be switching her antibiotic treatment. It still amazes me how many departments, doctors, nurses, technicians and so on have helped Karen recover while being here. Her blood pressure medicine was stopped this morning at 9:30 and it has held fine today even through dialysis, which usually causes it to drop.  Tomorrow the boys have their last soccer games of the season (Karen did not get to see one game this year) and they will be coming up for a visit afterward. She has been asking about them. Let's hope she has a good day tomorrow so she can enjoy seeing her boys.

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11-6-08 - Karen napped most of this morning, because she had some pain medicine for her back overnight and it just takes a while to get out of her system. She was wide awake in the afternoon and smiling at the staff that came in and out of her room.  Infectious disease doctors said they have identified a bacteria in her lungs which caused the infection.  She is doing better, so they will continue with the antibiotics she has been getting since they seem to be working.  She is still on a small amount of medicine for her blood pressure, but they are working on weaning her off of it.  Her nutrition was started back today through a feeding tube in her nose.  Hopefully she can tolerate this--it is better than the TPN she was getting through her IV, which can cause infection.  She had an ultrasound of the TIPS to see if it is still working properly.  She also had an ultrasound of her right leg and groin area to check for blood clots. We should have the results sometime tomorrow.  Her nurse today did some range of motion exercises with her arms and legs.  Hopefully, PT will be in tomorrow to work with her.  She is also scheduled for dialysis tomorrow.  Please continue to pray for Karen...we really appreciate all of your prayers and support.

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11-05-08 - Hopefully today is the beginning of another recovery. Today Karen has been awake a good bit with periods of napping. Her backside is sore understandably and she has a couple bed wounds that they are taking care of, but they hurt. She has received a little pain medicine to help with that and of course the pain med puts her out. Infectious Disease doctors came by and gave us encouraging news as well as the liver docs. Infectious Disease believe the infections appear to be under control with no detectable CMV in her system and the fungal infection is now undectable as well. Blood cultures are still growing in the lab to see if they show anything new. Both ID and Liver docs said she should be able to recover and the liver team will continue to assess her for relist for transplant. She is getting dialysis now and the goal is to remove 2-3 litres of fluid. The blood pressure medicine was started again during dialysis to keep her blood pressure up. It always drops some during dialysis. Hopefully she will be able to rest tonight and have a good day tomorrow.

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11-05-08 - Quick morning update. Karen's mom stayed with her last night and when I got here this morning after taking the kids to school Karen was awake and gave me a big smile when I walked in her room. They stopped her blood pressure medicine for now and it is holding on the low end of acceptable. If it drops any more they may need to start it again but hopefully she is on her way to being free of that again. I will try to do another update later after we get more information throughout the day. She is due for dialysis today also.

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11-04-08 - This afternoon we had a meeting with the team of doctors that are taking care of Karen in the ICU. The meeting was to make sure we know exactly what Karen is facing and also to make some decisions. We really did not learn anything new during this meeting.  She is basically facing another infection. She has sepsis, which is a very dangerous condition. She has beat sepsis twice while being in the hospital since August; when she first arrived and then after the first TIPS procedure attempt. The concern this time is that she does not have as much in reserve as she did the first and second time. We were also asked to make a decision about her continuing care, specifically if her heart stops again. Without giving too many details of personal conversations between Karen and I, I told them to take reasonable steps to revive her in the event her heart stops again. In the event this does happen we will make the decisions that need to made then, not now without all the information we need to make an informed decision. After the meeting, Sandra from the Echo Lab arrived and started an echo of Karen's heart. Dr. Book (Karen's all-time favorite doctor and cardiologist) arrived just as Sandra was finishing. We were very concerned about the leaking valve and the possibility of infection being on the leaking valve. Long story short, there is no infection on the valve and in Dr. Book's words, "she can live for 50 years or more with a leaking heart valve." She also told us that her heart function is still very strong and there is no sign of damage after yesterday's events. She was able to tell us that if her heart does stop again for some reason there is no reason to believe that she could not be revived using reasonable measures. This was obviously a relief. Our eye is still on the big picture while taking one day at a time. She is very, very, sick and needs your prayers like so many times before.

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11-04-08 - A real quick update. Karen did good through the night and is resting comfortably this morning. Her blood pressure is more stable with a little help from a small amount of support medicine. We are waiting on the ICU team to round to get the game plan. Thank you for the prayers and messages.

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11-03-08 - What we thought was going to be a simple ambulance ride from Wesley Woods to ICU turned out to be anything but. Please bear with me because this is not easy to write about. On the way to ICU Karen went into full cardiac arrest. She seems to be stable now but has had a battle this evening. From what we were told in the ER is that when she was being shifted around and put on the stretcher and loaded into the ambulance, the secretions in her lungs also shifted around. They became lodged in her airways and caused her oxygen level to plummett and caused her heart to stop. The ambulance driver had to run code to get her here quickly while the medic was working on her in the back. When they arrived they were doing full CPR on her and then administered a medicine to restart her heart. When they began pulling the secretions out of her lungs with a suction catheter her oxygen level came back up to 100% and her heart seems to functioning fine right now. She is stable but has had to recieve blood pressure medicine because it has been low since they revived her. We had no idea all this was going on at the time. Her parents and I were sitting in the ICU waiting room awaiting her arrival to the ICU room when a nurse came out and asked me to go down to the ER. I figured somebody had gotten mixed up or they needed paperwork signed or something. When I arrived and told them who I was the first thing the nurse said was, "she's ok now, we brought her back"; I could not believe what I had just heard because I knew what it meant. If they brought her back, there was only one thing that could have happened. When I walked into the ER room they were still working on her but they were basically finished doing what they needed to do. Shortly after, they moved her up to ICU where we are now. She seems to be resting now. Our hope is that she recovers from this and tomorrow we can move forward again. Thank you to everyone who posted messages earlier today. 

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11-03-08 - Today Karen is going back to ICU at Emory. Bottom line as explained by her doctors here is that she is just too sick to be properly cared for here at Wesley Woods. We have also learned today that Karen has a leaking heart valve. The doc here was not able to give us much information other than it was possibly caused by an infection.  The leaking valve showed up on her last echo. This could explain the large amount of fluid that she keeps in her system. He was also not able to tell us what could be done about the heart valve since he is not a cardiologist. We will have to discuss this with the ICU team at Emory. She is pretty confused today and not really coherent. I think this is from ammonia build up due to no dialysis on the weekend and her continuing liver issues. One option in ICU is continuous dialysis and this is not possible at Wesley Woods. As was explained to us Karen has many obstacles and challenges ahead of her. Before she will be eligible to come back here she will have to be much better than she was this time. Please, please, keep her in your prayers.

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11-2-08 - Yesterday, Hunter and Carter surprised Karen in their Halloween costumes--Hunter was Darth Vader and Carter was Indiana Jones.  She had a huge smile on her face when they walked in.  Today was pretty quiet.  Karen still has a bloated stomach which is making it difficult to breathe.  She continues to stay on the vent. She did a short trach mask trial today.  It is really frustrating that she cannot get weaned from the vent because of this problem.  Today, she was very confused, which is probably because her ammonia level is high. It's hard to believe it is November now--seems like such a long time ago that she was admitted to the hospital (August 14th).  Please keep Karen in your prayers as they are needed. 

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10-31-08 - Karen had dialysis today for 4 hours and 4 litres of fluid was removed.  Today was a very trying day.  Late morning, Karen started saying that she couldn't breathe.  The machine that displays her oxygen sats was not working. Her dad was with her at the time and called for help. The nurse checked her sats with a finger monitor, and her sats had dropped down into the 70's. After a few scary moments, she was put on the vent and recovered.  Evidently, there were major electrical problems in her room and this caused her equipment to malfunction.  None of the call buttons or warning bells were working.  I shudder to think what could have happened had her dad not been with her.  This is the reason that we never leave her alone.  We have since been moved to another room so the equipment can be fixed.  Karen had some PT and OT in the afternoon while on the vent.  Later in the afternoon, she began to have nausea, vomiting and lots of gas in her stomach.  This causes her to be short of breath because of all the pressure in the stomach.  We think it may be from the anti-fungal medication she is getting, which is really strong.  She was pretty miserable the rest of the day.  She has been on full vent support, so she is unable to eat right now.  Hopefully, she can get back off the vent again soon.  Please remember her in your prayers.

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10-30-08 - Today Karen was able to participate in music therapy. They bring the patients out into the lobby area and sing songs and do exercises. They also give the patients instruments like tamborines and hand drums to play along. She enjoyed getting out of the room and doing something different. This is something they do once a week; she's always been doing something else like dialysis or tests when the music therapist came up. We spoke with the doctor today to see if we could get any idea of her discharge plan and timeline. She has to free of the ventilator, the trach tube removed, clear of any infections, and able to provide for herself on a basic level. The doctor is thinking right now as little as 3-4 weeks or as many as 8-12 weeks. As the doctor said she is still very sick and still has a long road ahead of her. At this point she will definitley be here for her birthday Nov. 16 and probably Thanksgiving. If she could be home for Christmas we would consider it a real blessing.

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10-29-08 -  Karen was feeling much better today.  She has had no more nausea and vomiting.  She had dialysis early this morning.  After dialysis, she sat up in the chair for about an hour.  After lunch, OT/PT came and worked with her on arm and leg exercises. She did real well with these.  Tomorrow, they will try again to see if the can stand up.  Let's hope she can.  Please continue to pray for Karen. She has been a little discouraged lately and we've been trying to keep her spirits up.  It has been a long road.   

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10-28-08 - Today Karen went to radiology and had a parencentises (abdomen drain). About 4 litres of fluid was removed from her abdomen. She has been extremely uncomfortable the past few days because of her swellling abdomen. A CT two days ago also showed a large amount of gas in her stomach. She is now getting medicine to help with that. Hopefully tomorrow she will be more comfortable and able to do some rehab again.

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10-27-08 - Yesterday, PT worked with Karen and got her up in the chair.  The boys came to visit again.  Later in the afternoon, she did not feel well.  She was very nauseous and threw up a couple of times.  Her stomach was very full and she couldn't eat.  Being so full made her short of breath, and she was put back on the vent.  Today brought more  nausea and throwing up.  She had dialysis and 6 litres of fluid was removed. She went down for a CT of her abdomen following dialysis. It showed a lot of fluid in her belly, and it will be drained tomorrow.  Hopefully, this will make her feel a lot better and be able to eat again.  

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10-25-08 - Karen had an anxiety filled day today after a night of virtually no sleep. She is getting more and more sick of being in the hospital. She feels like she is missing a large part of Hunter and Carter's childhood. Today we took them to Disney On Ice and she really wished she could have been there. She was able to get out a little today in the converter chair. After Disney the boys came up for a brief visit and will be back tomorrow. Right now she seems to be resting more comfortably after going back on the vent. Let's hope for a restful night.

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10-24-08 - Karen started off the day with OT/PT.  They did an evaluation and worked with her on a few exercises and sitting on the side of the bed.  Then, she had dialysis for 4 hours, removing 5.5 litres of fluid.  She is on a very strict fluid restriction, which makes it hard at times. She ate really good today, and that was good to see.  Let's hope she gets a good night's rest tonight.

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10-23-08 - Karen went to radiology early this morning to get her dialysis line placed.  Then she had dialysis for about 3 hours, and 4 litres of fluid was removed.  She will have dialysis again tomorrow.  This will put her back on the Mon-Wed-Fri schedule.  She is receiving 2 units of blood tonight.  OT/PT will come tomorrow to do an evaluation. Other than that, her first full day back at Wesley Woods was pretty uneventful.  Please continue to pray for Karen.  

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10-22-08 - Today Karen made it back to Wesley Woods. They feel the infection is under control as well as the other issues that sent her back over to ICU. Not too much happened today other than the move. She is glad to be out of ICU again and on her way to recovery again.

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10-21-08 - Karen felt pretty good today.  Molly was here early for some PT.  Karen almost stood completely up--she tried twice. She did sit up in the converter chair for about an hour.  Her feet and legs are really swollen since dialysis did not remove a lot of fluid yesterday.  Hopefully, dialysis tomorrow will get rid of a lot more fluid.  Today brought another day of nothing to eat or drink all day, since we were told the new lines would be placed today.  About 5:00 this afternoon, radiology said they weren't going to be able to do it after all.  Needless to say, Karen was very upset and became very anxious. Her dad talked to the nurse to try to see if there was any way they could do it today.  The nurse was able to persuade radiology to go ahead today.  Karen went down to radiology about 7:00 tonight.  It will take one hour for each line to be placed.  She will receive a little sedation and hopefully that will help her sleep all night tonight.  If all goes well, she may be returning to Wesley Woods sometime tomorrow. We'll see. 

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10-20-08 - Yesterday, the boys came to visit Karen. That, of course, was the highlight of her day.  Not much else happened.  Last night, she did not sleep very well.  She's been awake all day today, so hopefully she will sleep tonight.  Molly from PT worked with Karen on some arm and leg exercises.  Karen was supposed to get her permanent dialysis line and PICC line placed today, but that never happened.  She was not allowed to have anything to eat or drink all day but that was all for nothing.  Finally, she was able to eat and drink about 6:30 tonight when they said she wasn't going to have the lines placed after all.  She was starving.  She did have dialysis for 3 1/2 hours today and they removed 1.5 litres of fluid.  They didn't want to remove anymore than that because her blood pressure was so low.  Hopefully, tomorrow they will take her to radiology to have the lines placed.  The infection in her leg is much better and the redness and pain is gone.  The last blood culture was clean, so there is no more evidence of the fungal infection in her blood.  However, they will continue the medication for another 2 weeks just to be sure.  Hopefully, we are back on track again and close to getting back to rehab in a few days.  Please keep those prayers coming--they are needed so much. Thanks.

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10-18-08 - Today was somewhat uneventful. This morning they placed the line in her neck to do dialysis. Because she received a little sedation Karen slept on and off most of the day and has barely eaten anything. Dialysis was started about 4:00 this afternoon and is ending up at 8:00. They pulled around 2 litres of fluid off and because her blood pressure was dropping they did not pull anymore. Let's hope that she can get some sleep tonight since she has been asleep a good part of the day. Her digestive tract seems to be doing better because she is now producing what we all do after we eat (no need to be graphic here). She is also breathing quite good on her own; most of the time completely on her own with the trach mask since she has been back in ICU. As always thank you for your prayers and messages of encouragememt.

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10-17-08 - Karen got a good night's sleep last night.  Today, she was very alert, felt good and ate good.  Her favorite Physical Therapist, Molly, worked with her today and Karen did really well.  Thanks, Molly!  Her cardiologist, Dr. Book, came by and was so pleased at how well Karen looked.  Infectious disease doctors said they have identified the type of fungal infection in her blood, and it is a milder form of the infection.  They said they will change her anti-fungal medicine to one that is not as strong as she has been getting. They are doing another blood culture today and if it comes back clean, they can re-insert her PICC line.  They will continue to treat the infection for an additional 2 weeks after a clean blood culture.  They are continuing to treat the CMV aggressively with IV medication.  Tomorrow, a temporary dialysis line will be inserted and she will receive dialysis.  Today would have been a dialysis day, but they wanted to delay it as much as possible because of the fungal infection in her blood.  Eventually, a permanent dialysis line will be placed again. She started taking Reglan today, the medicine to help her stomach work better.  It appears to be working so far. They have also started her back on the TPN (IV nutrition)...this is good because prior to today, she had not eaten in a couple of days.  She is still using the ventilator at night to rest and then off all day.  An extensive ultrasound of the TIPS was done today and we should have the report tomorrow. 

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10-16-08 - Last night Karen got a good night's sleep for her first night back in ICU and she slept late this morning. We were told they would come in after lunch to check the TIPS. A little later we were told they were going to do a scope of her stomach. Around 3:00 or so a lady arrived to do an echocardiogram of her heart to make sure the infection has not gotten into her heart. As she was doing the procedure the tech told Karen her heart looked good and there were no signs of infection in her heart. We'll wait for official word from the doctor. As soon as she got finished with the echo, the team arrived to do the scope of her stomach. When they got inside they found undigested food that had been sitting in her stomach. The last time she ate was about 2 or 3 days ago. This means her stomach and intestines are not working the way they should. Her stomach lining is very irritated. She has a small ulcer which they took a biopsy of to test. There was some evidence of her stomach lining bleeding. It is not bleeding bad though and this is what we saw when she threw up the coffee ground liquid substance a few nights ago. There was no evidence of any veins bleeding like before. Her hemoglobin level is actually staying pretty stable. She also has a tremendous amount of acid. Lately she has complained of acid reflux and this explains why. She is already on the max dose of acid blockers she can have. They are going to put her on IV nexium to see if it will help. Tomorrow they are going to start giving her a medicine called reglin to help kickstart her digestive system again and try small amounts of liquid and food. There are two reasons why this may have happened. When she was sedated for the two long periods she received large amounts of narcotics. As the doctor explained, narcotics can slow the digestive system as has happened. She also just has not been putting much into her stomach to keep it active and replacing food with the TPN nutrition through IV. Hopefully the reglin will work. The good news is after they did the scope they did the ultrasound of the TIPS and all looks good with that. They also pulled her line for dialysis and inserted a central line in her neck for meds. She is still getting antibiotic and antifungal meds; the infectious disease doctors believe the infection is under control. It's hard to believe that 2 months ago has gone by since I brought her to the ER. She has made progress but obviously she is still facing significant challenges. We know prayers are being said for her and we appreciate them all. 

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10-15-08 - Right now Karen is doing dialysis in her room at Wesley Woods. This morning she had a CT of her right leg. It has been red, swollen, and painful to the touch. Their pretty sure it's an infection of some sort that they have been treating with an antibiotic. After dialysis they are going to hang another medicine because they have detected more infection in her bloodstream. Her CMV has come back detectable now also. They believe she has gotten an infection from her port lines and the TPN nutrition that runs through those lines. It appears that yeast has built up on the inside of the PIC line and maybe caused infection. This is something that we were told a while back could happen. They have now pulled the PIC line and later will be pulling the dialysis port. Each of these will have to be replaced; which brings me to this. After dialysis she is going back over to the main hospital and admitted to ICU to get more issues taken care of. She will be in the same unit that she was in prior to coming to Wesley Woods. They are somewhat concerned about bleeding again. Her hemoglobin levels haven't dropped significantly but have dropped some. Prior to her throwing up last night her hemoglobin number was 9.2. After throwing up it dropped to 8.6. This morning it was down to 8.4. They are going to scope her stomach and see if they can pinpoint where the bleeding is coming from. They also want to do an ultrasound of her TIPS shunt to see if it is still open completely. Her abdomin seems to be filling with fluid again and they may look at doing a parencentises.  At some point in the next couple days she will also go back to radiology to have the PIC line and dialysis port replaced. She has really not felt good the past couple days and now we may be seeing why; infection. Hopefully she will not be back in the ICU too long and can get these issues resolved in short time. 

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10-14-08 - Karen is having more episodes of nausea tonight. She went back on the vent about 7:00 pm and will be on until in the morning. She threw up once and they gave her some Phenergan to help her upset stomach. It was dark red and brown; possibly some blood. They took her blood pressure and it was pretty low even for her standards. They started some IV fluid and her blood pressure came back up some. They have drawn a blood level to see if her hemoglobin level has dropped. We're still waiting on the results of that. She has thrown up again more of the same dark red/brown liquid. Right now she seems to be resting comfortably. Tomorrow the plan is to take her to CT to do an exam on her right leg that is still bright red and painful to touch. She is also scheduled for dialysis. On Thursday they plan to take her back up to the main hospital at Emory and look at doing a paracentesis (abdomen fluid drain) and do an ultrasound of her liver to see if the TIPS is still functioning as it should. Progress seems to be exruciatingly slow right now. She is so homesick she can't stand it. Congratulations to our friends Danny and Rachel who just welcomed their new baby girl into the world; Anna Lee Fortney.

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10-13-08 - Last night Karen had a rough night. During the day yesterday she was having episodes of halucinating and hearing things again. We think this is from the liver disease and a rise in her ammonia level. Last night was going to be her third night off the vent when she had a small setback. She got real nauseous about 2:30 and started throwing up pretty bad. They were a little concerned about maybe infection but so far it does not look like any infection. They did put her back on the vent to allow her to rest. Today they started dialysis about 11:30 and ended about 3:30. Once the dialysis was done they took her back off the vent and the process of vent wean will start again; hopefully not as long this time around. She seems to be a little better since she had dialisys. PT and OT have kind of taken a back seat the past few days so hopefully tomorrow she can start some exercises again. She is really getting homesick but she knows she still has a road ahead as she continues to try to gain enough strength to stand on her own. Please pray for Karen to begin gaining some strength in the coming days.

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10-12-08 - Yesterday, Karen had a pretty good day.  She wasn't able to stand up but did sit in the chair for about an hour.  The boys came to see her late yesterday after their soccer games.  Today, Karen did not feel very well.  Besides not feeling well, she was very confused. We're hoping that dialysis tomorrow will help clear her mind.  She was pretty restless all day.  The boys came to visit again.  Please pray that very soon Karen can stand up and begin walking.  She gets so down in the dumps because she cannot go home.  Going home seems so far away, especially since she cannot get up and walk yet.  Hopefully, she will have a much better day tomorrow.  Thanks for your prayers and support.

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10-10-08 - Dialysis started at 6:30 this morning and lasted 3 1/2 hours.  During dialysis, Karen received 2 units of blood--her hemoglobin had dropped making it necessary to get blood.  She was pretty wiped out after dialysis and her blood pressure was pretty low, so they did not get her out of bed today.  Donnie brought a DVD player and some movies so she could watch movies for a change.  It gets pretty boring sitting in a hospital bed day after day.  It has been 8 weeks today since she was admitted to Emory.  Thanks to everyone for all the messages and words of encouragement sent to her website.  We especially appreciate all the prayers--keep them coming.

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10-9-08 - Karen did not have the test to check the TIPS, because if they did find that it was not working properly, they could not fix it at the LTACH--she will need to be taken over to Emory to have this test.  It will be scheduled soon.  Other than PT, Karen's day was pretty quiet.  PT came this afternoon and worked with her on standing up. She managed to stand up 4 times.  This took a lot of energy.  Then they worked with her on leg and arm exercises.  She was pretty tired after all of this.  PT gave her a list of exercises that she should do while in the bed during the day.  She is really frustrated that she is not up walking yet.  It's just going to take time.   

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10-8-08 - Karen is doing pretty well.  Yesterday, she was able to go outside for a little while.  After coming back inside, PT did some arm and leg exercises with her while she was in the bed.  Early this morning, she had dialysis for about 3 1/2 hours.  PT came by and worked with her on standing but she was unable to--the dialysis had wiped her out.  She did sit up in the chair for about an hour.  Her C02 levels are still just a bit on the high side.  They will be checked again tomorrow.  Plans are to put her on the vent for 1 hour tonight, then off for good, provided her C02 levels come down.  She has been working on breathing exercises to help her breathe deeper--right now she is breathing with the muscles in her upper chest instead of using her diaphragm.  She is having to relearn how to breathe, just like she did after her transplant.  She is still pretty weak and it is going to take time for her to regain her strength.  Tomorrow morning, she is scheduled to go to radiology so they can check the shunt in her liver to see if it is still functioning properly.  There's no reason to believe it isn't--they just want to check it periodically.  Karen is still so ready to go home.  She knows it will be a while before she can go and she gets discouraged at times.  We are trying to keep her spirits up and let her know just how far she has come.  Please continue to pray for her...thank you.

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10-6-08 - Yesterday, Hunter and Carter came to visit with Karen.  It was a very nice visit.  They brought her Halloween balloons and a lighted pumpkin--she had a good day!  Today, dialysis started at 6:30 am and went for 4 hours, removing 3 litres of fluid.  PT got Karen out of bed and into the wheelchair today.  She wasn't able to stand, but when she went back to bed, she actually stood and took two steps over to the bed.  OT then worked with her on arm exercises.  She has felt pretty good today.  Someone gave Karen wrong information a couple of days ago when they told her she would be off the vent by today.  Actually, she will cut down the time on the vent by an hour each day until she is completely off.  So, she will go on the vent tonight from 12 midnight until 3 am.  This afternoon, Karen's brother, John, and his wife, Natalie, gave birth to a little boy, Chaz Landon Poulk, weighing 6 lbs. 10 oz.  This is their second little boy.  Jayden will be 3 yrs. old in January.  Congratulations John and Natalie!

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10-4-08 - Not a lot happens on the weekends when you're in the hospital.  Today was pretty quiet. Karen did not sleep well last night again.  Seems like no matter what she does, she doesn't sleep.  I guess it's just being in the hospital.  She is really, really ready to go home and really misses the boys and being home with them.  Today, she sat up in the chair for about an hour.  Other than that, nothing else happened.  She is feeling pretty good.  The boys will be coming to see her tomorrow and she is really looking forward to their visit. 

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10-3-08 - Dialysis began at 6:30 this morning--pretty early!  It lasted for 4 hours and removed 5 litres of fluid.  Karen's legs and feet are almost back to normal.  She can actually lift them now.  The doctor said she is doing fine--test results were fine.  They hope to take her completely off the vent by Monday.  She is down to 4 hours at night now.  PT/OT came after lunch.  With assistance, Karen stood up and sat in the wheelchair. She was rolled outside to enjoy the beautiful weather.  It was so nice outside and she really enjoyed it--the first time in 7 weeks that she has been outside.  She is back in bed resting now.  I think she's done for the day!  Please keep the prayers going. 

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10-2-08 - Karen had a very busy morning.  First, she went down to get a CT of her lungs.  Then, she went to radiology where they drained a little over 5 litres of fluid from her belly (the dialysis does not remove the fluid from her belly).  Hopefully, she will not need to be drained again and if so, not very often.  After the visit to radiology, she had an echo of her heart.  We will probably have the test results in about 24 hours.  They are taking good care of her here at Wesley Woods Hospital.  She was pretty tired after all of this, so she has been resting this afternoon and is taking a nap right now.  She hasn't slept well the past couple of nights, so I know she needs to catch up.  She didn't have PT today because of everything she had going on.  I hope they will be able to get her out of bed and work with her tomorrow on standing and maybe walking.  The fluid in her legs and feet is much better so this will help a lot.  Hopefully dialysis tomorrow will not interfere with PT.  She is really ready to go home. 

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10-01-08 - Karen had a busy first day in her new room. This morning they took her off the vent around 5:30.  PT and OT came in and evaluated her to formulate a plan for therapy in the coming days. They put her through a range of exercises in the bed and she was able to sit up on the edge of the bed but they did not try to have her stand up just yet. Dialysis then came in and she had about a 4 hour session. During the course of dialysis they were able to pull off a little over 5 litres of fluid. She still has alot of fluid remaining though. During her dialysis session Karen's aunts Helen and Janice came for an afternoon visit. Tomorrow radiology is coming to her room to see if she needs any fluid drained out of her abdomin; if she does, hopefully this will be the last time. She has now met her doctors and therapists here and she really seems to like everyone that will be working with her. She is relieved to be out of ICU and is excited about moving forward.

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9-30-08 - After 6 1/2 weeks, Karen is finally out of ICU!!  She was taken by ambulance to the LTACH around 4 pm today.  The LTACH is down the road from Emory (and parking is free and close to the front door!!).  Upon arrival, she was seen by both a medical doctor and a pulmonologist.  The hospital is very nice and all of the people are, too!  She will go back on the vent tonight and they will be working to wean her off.  She is back on the TPN, and it will run mostly at night.  She is eating a little and seems to have a good appetite--she can't eat a lot at one time, just small portions several times during the day.  Tomorrow, she will have dialysis again and be evaluated by PT/OT.  We are so glad she has moved on to this part of her recovery.  Hopefully in 2-4 weeks, she will be able to go home.  Please keep praying... thank you.

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9-29-08 - Hopefully today will be Karen's last day in ICU. Since her PICC line fell out yesterday they had to replace it today. They tried her left arm this morning with no success. Dialysis came and did a four hour session pulling off around 3 litres of fluid. They then came back in and placed the PICC line back into her right arm with success. Shortly after that Molly with Physical Therapy arrived for a work out. Karen was able to stand twice today with assistance. This is the first time she has been able to stand since being back in ICU; it was not easy though with a ton of fluid remaining in her legs and feet. After all this it was getting too late to transfer her to the LTACH, so the plan is to go tomorrow morning. It looks like as of now she will get dialysis three times a week; Monday, Wednesday, and Friday. Karen wants to give a big thank you to Jill, Lilly, Carolyn, Ann, Mimi and all the rest of the staff of 6G ICU. Your care has been above wonderful.

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9-28-08 - Karen had another good day today.  She ate a good breakfast, and had apple pie and F.O. from the Varsity for lunch.  The TPN (IV nutrition) is turned off for now because her PICC line came out.  She will go to radiology tomorrow morning to get another one placed in her arm.  She will also have dialysis in the morning.  The plan is to move her to LTACH tomorrow. They will work to get her completely off the vent and regain her strength so she can go home.  She is so ready for that!  Hunter and Carter came to visit today and Karen really enjoyed their visit. 

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9-27-08 - Today has been all the difference in the world. She is fully alert today and seems to be Karen again. Dialysis came again this morning and did another 3 hour session. Today they pulled a little over a litre out of her system.They said she will probably be dialyzed again on Monday.  She is still puffy though with the majority of fluid collecting in her legs and feet. When she's in bed they raise the foot up so the fluid can move around a little and drain from her legs and feet. She spent a little time in the chair today before getting back in bed and getting her feet raised again. Because of the fluid, her feet get really sore when they dangle from the chair. She was able to eat some Varsity fries, an apple pie and yes her favorite, drink an F.O. She has really been asking about Hunter and Carter so we plan a visit tomorrow; they had soccer games today.

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9-26-08 - Karen was taken down to radiology early this morning to get her dialysis port placed in her chest--this was done under general anesthesia and went fine.  It looks just like her PICC line, just slightly bigger.  Her dialysis began around 4 pm this afternoon and ended at 7:30 pm.  She tolerated the dialysis really well.  Her heart rate and blood pressure remained steady the entire time.  Her blood was was filtered through the dialysis machine 8 times.  A little over 2 liters of fluid was removed.  Karen will be monitored closely and will receive more dialysis when necessary.  We are hoping this will not be permanent.   Karen's mental state was much better today--she had very little confusion at all.  Compared to yesterday, this is a big improvement.  Please continue to pray for Karen.  Thank you.

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9-25-08 - Well tomorrow begins dialysis from what we are being told today. Her kidney numbers rose a little today; her creatnin level is now up to 3. Also she is producing half the urine today than she has daily the past few days. She is also much more confused today and unable to hold any kind of continuation of thought. Her mind is wandering, asking when it's time to get dressed and so on. Her nurse says that because her kidney function is down and toxins are building in her system this could be the reason why she is so much more confused. She is also not getting rid of any of the excess fluid that has built over the past week or so. The plan is to take her to radiology sometime tomorrow and place a port in her neck or chest area. She will then come back and probably have her first session tomorrow afternoon. The goal for dialysis will be two-fold: clean her blood of toxins and get rid of excess fluid. Hopefully this will allow her to begin better rehab sessions with less fluid. It should also help her mental status. Obviously with this new development, moving out of ICU and into the LTACH is not going to happen this weekend. They want to get a good routine of dialysis going this week and weekend and then look at moving her to LTACH maybe later next week. We did not want her to have to deal with dialysis but we see why it is necessary at this point.

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9-24-08 - Karen was very sleepy this morning.  She had been off the vent for 2 days.  A blood gas showed that her C02 levels were too high, so she had to go back on the vent this morning.  They took her back off around lunch time for a little while so she could eat.  She downed some chocolate pudding, OJ, coffee and ice chips.  She is only allowed thickened liquids at this time.  She sat up in the chair for about 2 hours.  While in the chair, physical therapy worked with her on exercising her arms and legs and her nurse washed her hair. After getting back in bed, she went back on the vent and is now resting.  She will be getting drained at some point today or tomorrow.  She has been accepted at LTACH for rehab and may be moving there as soon as they get a bed.  

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9-23-08 - Karen has had somewhat of a busy day today. This morning she went for a barium swallow test and did ok. She didn't ace it but she passed it. She can now have thickened liquids to drink. A Varsity F.O. qualifies. She can't drink thin liquids yet because she still runs the risk of aspirating thin liquids into her lungs. They can thicken the thin liquids with a gel type substance but it looks kind of disgusting. Imagine a gelatin Sprite. She's not crazy about it but it's better than nothing at this point. She can also have things like chocolate pudding and anything with that type of consistency. Last night when they tried to put her back on the vent she did not like it and did not do well on the vent. So, they took her back off and she did alot better when she was breathing on her own. She has been off the vent since. She seems to be more awake today and more coherent. She still says some off the wall things from time to time but she can now focus on what she's looking at and maintain somewhat of a conversation. She also sat up in the converter chair today for about three hours. The swelling in her legs is still substantial; the goal is to get her more active and hopefully it will work itself off. They have put in for physical therapy consults so maybe soon she will start moving more significantly again.

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9-22-08 - Karen was a little more awake today.  Her H&H numbers remain the same, so there is no bleeding.  Her kidney numbers are the same also.  Blood was drawn today to check for high ammonia levels, which can occur after a TIPS procedure.  This can cause confusion and can be treated with medication.  Karen sat up in the chair today for 2 hours.  She really wanted to exercise her legs, but her legs and feet are so full of fluid that she couldn't move them.  This made her very frustrated.  She has been off the vent since 8 am this morning, a total of 12 hours now.  However, they will be putting her back on the vent overnight to give her a rest. Now it's just a matter of moving around more and more and working towards being able to walk again and do physicial therapy.  The progress is slow, but it's progress that we are so happy to see.  Please continue to pray for her.

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9-21-08 - Karen was really sleepy today and slept a lot of the day.  The doctors are going to adjust her medications so that she will not be so sleepy during the day.  Karen's numbers remain about the same, except for her H&H, which has dropped just slightly.  The doctors will keep a close check on this to make sure that there is no bleeding.  Sometimes it's just a matter of being in ICU so long and the amount of blood that is drawn each day for lab work can also contribute to the lower numbers.  Karen is constantly begging for something to drink but can only have ice chips at this time. The speech therapist came today to check Karen's swallowing and speech.  When Karen wore the speaking valve, her sats dropped, so she is not quite ready for that yet, and besides, she was just too sleepy to work at it today.  The speech therapist will come back tomorrow to try again.  Karen stayed off he vent for about 11 hours today and went back on about 9 pm tonight.  Hunter and Carter came to see her today--she was really glad to see them, even though she was really sleepy while they were here.  We hope that tomorrow she will be more awake and can possibly get into a chair and start working on getting her strength back. 

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9-20-08 - Today Karen continues to "wake up". She did 5 hours this morning on the trach mask. The rest of the day has been pretty uneventful. She seems even more alert than she did yesterday and now can have little bits of ice chips at a time. Sometime tomorrow or Monday speach therapy is supposed to come by and evaluate her swallow ability again. How many times has she been evaluated for swallow? I have lost count. Hopefully tomorrow she will be more "awake" yet and can last even longer on the trach mask.

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9-19-08 - An ultrasound of Karen's liver showed that the stent is working fine...this is great news!  The ultrasound of her kidneys showed nothing significant, even though her numbers are still a little elevated.  Hopefully, the kidneys will get better like the have in the past.  An echo of her heart showed that her heart is doing fine.  This is all great news.  She may still need to be tapped to remove fluid from her belly, but the doctor said this will improve in time and she may get to the point that she doesn't need to be drained at all.  Depending on how her kidneys are doing, they may drain her on Monday.  Karen was on the trach mask today, breathing on her own, for about 1 1/2 hours.  She is a little more herself today, although not totally back to normal.  She is still coming out from under the sedation medications. Hopefully tomorrow she will be feeling even better and will be able to breathe on her own for a longer period of time.  She is anxious to get off the vent, sit up in a chair again, and get out of ICU.  It has been five weeks today that she was admitted to the ICU.  No wonder she is so ready to get out.  Please continue to pray for Karen--we appreciate all of the prayers and support you have given. 

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9-18-08 - This morning Karen was able to breath on her own using the trach mask for 2 hours and 20 minutes. She began showing signs of fatigue late in the trial in that she was breathing extremely slow and her sats were dropping into the lower 90's and upper 80's. They put her back on the vent and since that time it has been pretty much a mirror image of yesterday. She seems miserable at times almost like having withdrawal symptoms. The nurse said this is a possibility because the sedation and pain medicine she has been on is actually a narcotic. They are trying to let her wake up but also minimize discomfort. Her vital signs still look real good. Tomorrow will be day three of weaning off the sedation and vent. We have noticed that she has been taking three to four days to fully wake up from long periods of sedation. With a comprimised liver and kidney we are not surprised. Let's hope and pray for a little more success tomorrow.

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9-17-08 - As is so often the case Karen has had a tough day transitioning off the sedation medicine. She is very uncomfortable and has been all day long. She has not been able to do any spontaneous breathing trials. She is still trying to fight off the effects of the past several days worth of sedation. She sleeps for a period of literally 30-45 seconds then wakes up trying to move her legs and arms around. Her legs must feel like led bricks because they are full of fluid. She just can't get comfortable no matter what she does. All her numbers still look good though. Hopefully tomorrow will bring more comfort and more success in getting her off the vent once again.

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9-16-08 - Karen had a successful procedure today to place the shunt in her liver. They took her down finally about 1:30 this afternoon and by 4:45 she was back in her room. Dr. Martin said the procedure went so much smoother than the last time and he believes that it was a success. He said her vascular system has decompressed as the shunt is supposed to do. This should alleviate any more gastric bleeds. Her heart function is good and her blood pressure is good as well. Her lungs are also working as they should. As you will remember all of these were major issues after the last attempt. Over the next 24 hours they will still measure her blood levels just to make sure there is no bleeding as a result of the procedure. They did have to puncture her skin and go through her liver to do this. Tomorrow they will do an ultrasound to make sure the shunt remains open. The first 24 hours are usually the most risky for the shunt to collapse. If this happens they will have to reopen it with a balloon. Tomorrow they will probably stop her sedation and let her wake up; then we can give her the good news of the successful procedure today. They also plan to start letting her breath on her own again tomorrow. Hopefully today is the start of her recovery once again. As always thank you so much for your prayers.

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9-15-08 - Good news--the bleeding did stop on its own.  We are thankful for that.  The doctor that was to do the TIPS procedure this afternoon got called away to an emergency, so the procedure has been postponed until tomorrow morning.  All of Karen's numbers are still looking good.  She is off all blood pressure medications now, which is great news.  She is still sedated, although the sedation has been cut down a little and she has opened her eyes a time or two and squeezed the doctors hands when asked to.  Her color is much better.  She is real puffy from all the fluids she has been getting, but that will go away in time.  We understand that they may drain some more fluid from her belly tomorrow morning when she is down in radiology for the TIPS procedure.  Please pray that this procedure is successful tomorrow morning.  Thanks again to everyone for your prayers and support. 

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9-14-08 - 11 am - We are hopeful that the bleeding has slowed down and possibly stopped.  Her H&H numbers have been steady overnight and she has not received any blood since last night.  Another level will be repeated at noon today--let's pray it is stable.  She continues to be sedated and on the vent.  Her numbers look very good--hear rate is down, blood pressure holding.  They had taken her off her last blood pressure medicine, but the pressure dropped a little, so they have put her back on it.  Plans are the same--to talk tomorrow about doing the TIPS procedure again.  We pray that it works this time--this is the only thing that will stop the continued bleeds.  Please pray for Karen that this procedure will be successful.  Once she can get the TIPS procedure and recovers from infection and gets weaned off the vent again, she can get back on her way to rehab and working towards getting healthy enough for the liver transplant.  Of course, this will be a slow process, but we will get there with God's help.  Please keep praying.  Thank you.

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9-13-08 - 11:15 am - Karen began bleeding again overnight.  She has just had 2 units of blood and they are checking her H&H levels now to see if it has slowed down or stopped.  Her doctor wants to wait and see if it will stop on its own like it did last time, and for now just replace the blood she is losing.  He does not want to attempt another TIPS procedure right now.  When they are ready to consider TIPS again, their is another way they can try it by going in directly through her side.  The really good news is that her lungs are getting better--the oxygen has been turned down to 40% now, she is on 1 remaining blood pressure medicine, down from 3 yesterday.  Her blood pressure is good, heart rate has dropped, oxygen levels are good.  The fever has also gone away.  We are so thankful that her lungs are getting better.  Just pray that this bleeding will stop and allow her enough time to fully recover from the lung infection.  As always, we appreciate your support and prayers.

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9-12-08 4:30 pm - Karen is holding her own this afternoon. They are slowly reducing the amount of support they are giving her. This morning she was on 3 seperate blood pressure support meds to keep her blood pressure up and now she is down to 2. This morning she was on 2 breathing machines; the vent and a nitrous oxide machine. The nitrous machine is now gone and she is still on the vent. This morning she was on about as much support as possible on the vent and this afternoon they are able to start weaning the support down on the vent. Her urine output is a little better from last night as is her blood gas levels.  She is running a bit of a fever but right now it is not a major concern as it is seen as her body fighting infection. Her ICU doctor did a bronch this afternoon and said her lungs look good. The same ICU doctor just came in as I was typing and said she is making steady improvement throughout the day. Please continue to pray for Karen during the next few days as she very much needs them still.

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9-12-08 - Unfortunately the TIPS procedure did not work last night. The surgeon spoke with us late and said her portal vein was too small to see on x-ray and they would have been flying blind to try and insert the needle as they needed. But that's not the worst. While in the procedure we believe she aspirated some stomach bile into her lungs and now she is facing all new challenges. I spoke with the ICU doctor this morning. As it happens it is the same doctor that was on duty the very first Friday she came in with pneumonia. Basically she is now in the same condition as when she arrived in the ICU the first day; completely sedated, on the ventilator, blood pressure support, fluid in her lungs, etc. They are once again giving her antibiotics to counter the fluid in her lungs that her body has produced in reaction to the aspiration. The doctor believes he can once again pull her through this but it is another large challenge that she is facing. Please continue to pray for Karen.

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9-11-08 8:15pm - Karen is right now in a procedure in radiology to correct the reoccuring bleeding that she is having in her stomach. She went down about 4:00 this afternoon and I just got an update from the surgeon. They were looking at two possible scenarios to fix the problem. The first suggested fix (which they did not think would be the answer) is not the cure. They are now starting on a T.I.P.S. procedure. This is a procedure that was discussed with Karen back when she first learned of her liver problems at the end of last year. It has been put off because there are risks involved and the transplant was going to be the better option for her. It is believed that the bleeds are from gourged veins in her stomach caused by the liver disease. They will place a stent in a vessell near her liver and basically reroute blood flow around her liver as it gets sent back to her heart. The problem up to this point is that blood flow has been severly constricted going through the liver and is backing up and causing the problems she is having. Obviously blood is supposed to flow through the liver so it can be cleansed and not around it. They will deal with this issue with medication. Once they reroute the blood flow it should fix the problem of the fluid building up in her abdomin and the bleeds. There are other issues to contend with though but just realize that at this point the doctors feel as this is the best course of action. This procedure could last anywhere from 2-4 hours (began at 8:00 pm) so I don't know if I will be able to post again tonight. I will definetly have something up tomorrow to let you know how the procedure went and how she is doing. Please remember her in your prayers tonight.

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9-11-08 - Some dissapointing news this morning. Last night Karen starting bleeding again from inside her stomach. This was first noticed with bloody bowell movements yesterday evening. She was quickly moved from acute rehab back over to the ER at the hospital. When she got to the ER they ran some blood numbers and confirmed the bleed when her hemoglobin level dropped from 11 yesterday morning to 7 last night. Thats' a pretty big drop in one day. They gave her one unit of blood in the ER and did another scope into her stomach. Luckily the same doctor that did her last scope was on call and was able to do this one as well so he knew exactly what to look for. When he got in he saw a gorged blood vessell that looked like it had been bleeding but was not bleeding at the moment. He decided to do nothing at that time for fear of creating a worse problem. Long story short they are running some diagnostic tests last night and this morning to see what the next step needs to be. The issue once again is very complicated because of Karen's weakend condition. She is back in ICU a few rooms down from where she just left. I will try to post another update this evening if we know more and have information on what the course of action was during the day or will be in the days ahead. We know prayer works and I have faith it will once again.

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9-10-08 -Karen had a pretty good day for her first day in rehab. She had a full day of sessions; occupational therapy, speach therapy, physical therapy, and rehab therapy. For the most part it was a lot of assessment today. When the physical therapist came she rolled Karen up to the gym area where most of her rehab will be until she leaves. She walked more today than she has in a while and then she used a stationary bike while she sat in her wheelchair. Last night she did not sleep at all (even after two doses of sleeping pill) so today she was pretty tired. We hope that since she has had a full day today she will be tired tonight and will sleep. She also had extreme neck pain today so tonight they said they are going to give here a muscle relaxer. Let's hope for a restful night tonight.

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9-9-08 - Karen had a big day today. She is out of ICU and in the acute rehab facility across the street from the main hospital. This morning when I arrived her mom was packing up her room and getting ready for the move. At 1:30 this afternoon the ambulance arrived and moved her over to the rehab center. It is now about 6:30 pm and basically other than getting into her room all that has happened is she has been evaluated by the doctor here. Tomorrow they will evaluate her physical strength and start working with her. She will do at least three hours every day of physical therapy; broken into segments and not all at once. She will also have occupational therapy. These are the every day part of life things that we take for granted; for example, dressing herself, bathing, combing her hair etc. She is not helpless by any means but she does need some help with some of these things. We keep hearing that maybe within 7-10 days and definitely within two weeks she should be on her way home. It is now coming up on 4 weeks since I brought her to the ER in worse shape than we thought at the time; she has made a lot of progress since then with some ups and downs along the way. She continues to fight and says thank you for your prayers.

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9-8-08 - Karen had another eventful (good) day. She sat in the chair some this morning and was able to eat a decent breakfast; cereal, banana and OJ. She is still breathing on her own and once again the vent has been removed from her room. A representative from the acute rehab center came to visit and assess her today for transfer. He said that there is a possibility she could be moved over as soon as tomorrow if her critical care docs approve. While he was here, physical therapy arrived and got her up and walking. She walked around the nurses station and then back to her room. The guy from rehab said she will have three hours every day concentrating on physical rehab. This will happen over the course of the day with breaks in between. Karen is very excited about getting out of ICU and moving again.

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9-7-08 - Today Karen has been breathing on her own all day again. Her CO2 numbers are better. This morning she was able to get in the converter chair and sit up for a while before getting back in bed. They also drained a little over 4 litres of fluid from her abdomin this afternoon. We are still waiting on the result of a stomach x-ray to see when she can resume eating again. She can drink liquids but she is ready again for something more solid. A somewhat unventful day today so far; let's hope she can start working again tomorrow with physical therapy and maybe start walking.

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9-6-08 - Today was pretty uneventful, which is a good thing, especially after yesterday.  Karen did come back off the ventilator for a short time overnight, but she is now back on it because her CO2 levels were a little high.  She is not taking deep enough breaths.  She will probably stay on the ventilator at least through the night and they will do another blood gas to see what her levels are before they take her off again.  She absolutely does not want to be on it, but it is best for her right now. Her hemoglobin levels remain steady, which is a good indication that there is no more bleeding.  The doctors want to keep her in ICU for a few more days just to keep an eye on her.  The boys came to see her again today, so of course, that made her day!  Her good friend, Evalina, came to see her this morning.  Lisa and Mike Smith, Mallory's parents, also came to visit.  Mallory is our friend who has had 2 liver transplants. Please keep Mallory in your prayers (teammal.org).  Please continue to pray that Karen will be able to stay off the vent and will be able to regain her strength soon.  We appreciate all of the prayers. 

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9-5-08 - Karen gave us another bleeding scare today. We had hoped that today she would possibly be moved over to the Wesley Woods LTACH hospital. This morning when they took a hemoglobin level it showed that her number had dropped and of course this raised concern. Later in the morning the concern was raised when she had blood showing up in her bowel movement. Over the course of the morning she received 4 units of blood running back to back. That brought her blood numbers up but they had to get to the bottom of why she was bleeding again. They did a scope and once again could not see her stomach lining because her stomach was filled with blood. They pulled out and started trying to clear her stomach. Over the course of two hours they suctioned blood out and again retried the scope. Dr. Spivey (her liver doctor) was on-hand to do this one. He discovered a spot in her stomach that he believes is the same spot as last time and again repaired it. He said he is not 100% percent certain this is the spot but it looked "very suspicious". It was not actively bleeding but it was the only spot that looked like it was causing problems. He also stated that the rest of her stomach lining looked very good and did not see any other areas of concern. Right now she is sedated and back on the vent. They had to put her back on the vent to do the procedure. Dr. Spivey said this was a "rough" procedure for her to endure and therefore she received a pretty good amount of sedation medicine. Hopefully she will sleep through the night and bounce back tomorrow. Please, please, please pray that this is the last bleed that she gets. They are scary because the options are extremely limited if they cannot stop the bleeding using the scope through her mouth. Her weakened condition right now pretty much leaves surgery off the table except for the most extreme emergency.

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9-4-08 - Karen had a pretty good day today, although she seemed really tired.  She did manage to walk out into the nurses station for a short way but was not up to physical therapy.  She didn't sleep real well last night and I'm sure that contributed to her being so tired. For the first time since she was admitted to the ICU, she actually ate some real food today--cereal and a banana!  The highlight of her day, though, was the visit from Hunter and Carter.  She was so excited to see them as were they.  They told her about what they had been doing in school and told her they missed her and wished she could come home. They stayed for about 4 hours. Another big thing today was that the vent was removed from her room!  We were all glad to see it go.  Around 9 pm tonight, the doctors removed about 4.7 liters off her belly.  This should make her feel better.  Doctors are now talking about moving her to the LTACH once again, mainly because this is a rehab/medical facility. The acute rehab unit they had talked about earlier this week would not be able to treat her for any type of medical condition so that is why they want her to go to LTACH.  That way, if she did need any type of medical treatment, they could do it there and not have to send her back to Emory.  We are hoping that she can move in the next day or two. The rehab will get her back on her feet and able to go home.  The amount of time she will need to spend there will depend on how well she does. Once doctors are certain she is free of all infection and has regained her strength, then she can be put back on liver/kidney transplant list.  At that time, an exception letter will be written in an effort to move her up to the top of the transplant list. Please pray that this will be soon.  Karen has improved so much over the last few days, and we know that the prayers are the reason why.  Please continue to pray for her. 

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9-3-08 - Another day of progress. When I got here this morning Karen was asleep and on the vent. She had been off all night until 6:30 this morning. Her numbers were still great but she was getting fatigued. They put her on the vent for a few hours so she could rest. She went back on the trach mask at 10:00 and is still breathing on her own comfortably at 2:00 pm. She had her swallowing test this morning and passed. For today they want her to start out with liquids only and then tomorrow transition slowly back to solids and liquids. Her mom was able to go to the Varsity and get what she had been craving; an F.O.  Physical therapy will come in later this afternoon and let her walk again. Hopefully in the next night or two she will stay off the vent totally and be completely free once again. Thanks again for the prayers and support.

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9-2-08 - Karen is having a great day today. She started breathing on her own using a trach mask at 8:00 this morning. Some of you may remember that the trach mask is where they put a mask contraption over her trach opening and blow oxygen over the trach opening. She breathes 100% on her own and the vent is not connected in any fashion. She is still doing great and feels great. They did a couple tests today to measure her lung function and from what we have been told her lungs appear to be functioning like they should. Physical therapy came in and worked with her. She got out of bed with assistance and then stood on her own for about 5 minutes before she sat in a chair and began her excercises. She then stood up and walked around her room with the assistance of a walker. The goal for her tomorrow is to go out into the nurses area and walk around more. The doctor came in this afternoon and said if she can stay off the ventilator tonight he believes she is clinically well enough now that she could be released from ICU within a couple days. Keep in mind that 2 days ago she was bleeding in her stomach faster than they could replace it. They are talking now about a facility across the street called acute rehab. Here the emphasis will not be on trach wean (since she is hopefully almost clear of the vent) but instead on intense physical therapy to rebuild her strength. Hopefully now the goal is to get her in shape to be relisted for the liver transplant. Tomorrow is another big day. They will give her a swallow test to see if she can eat and drink. She is starving and wants a Varsity Frosted Orange (F.O. for native Atlantans). As is evident two things are clear, Karen is a fighter and prayer works. As always thank you for the prayers and Karen will keep fighting. Her spirits are pretty high considering what she has been through the past 2 1/2 weeks.

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9-1-08 - Karen got a good night's rest last night after a very difficult day yesterday.  Today, her hemoglobin held steady, which is a good indication that the bleeding is indeed stopped.  Karen was actually hungry today.  She is scheduled to have a swallow test tomorrow which will tell us whether or not she can go ahead and start eating and drinking a little.  She is really hoping that this goes good, because she is so looking forward to eating and drinking again.  She has not had a swallow or a bite of anything in over 2 weeks. Today was pretty uneventful, except that Karen was really missing Hunter and Carter.  She had a long crying spell and eventually settled down.  They talked to her over the phone, even though she could barely make a whisper back to them.  They were supposed to come see her today, but Hunter was too sick.  Donnie ended up having to take him to the ER, and he has strep throat--they were there for about 6 hours. Tomorrow, Karen will be undergoing a test to see how well she will be able to wean from the vent. The Pneumonia she had was very bad and there could possibly be some damage to the lungs.  Please pray that the test will go well and that there is no damage to the lungs.  Karen really needs your continued prayers...she has been very, very sick and still has a long way to go.  Please pray for all of us, as well.  We have been staying at the Emory ICU for almost 2 1/2 weeks now.  Thanks once again for all of your prayers. 

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08-31-08 - Karen gave us another scare today. This morning she was complaining of her stomach hurting. She then started throwing up blood and the staff got pretty anxious. Her blood pressure was a little unsteady, her hemoglobin numbers were low and they ended up giving her 4 units of blood. The doctors decided to do a scope again of her throat and stomach to see if they could identify the problem. When they got the scope in they discovered a large amount of blood in her stomach. At first they were unable to get a clear picture of what was bleeding but after sucking all the blood out they discovered a spot in her stomach that was bleeding. They were able to cauterize it and inject the site with medicine that is supposed to stop the bleed. Because her liver is damaged it is harder for her to produce clotting agents to stop bleeds such as this. They are giving her some medicine to hopefully counter this. She is awake this afternoon and feeling much better. No physical therapy or vent wean today because of the emergency activity. Please pray that this is the end of the bleeding episodes and we can get back on the road to recovery.

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8-30-08 - Karen slept more last night than she has in the past several nights.  She had been unable to sleep at all.  Thank goodness she finally got a few hours of sleep.  She did not have PT or do any breathing trials today. She has been slowly losing blood and has had to receive blood over the last couple of days.  She received two units this morning.  Around 11 am today, the doctors decided to once again look into her stomach to try and locate the source of the bleeding.  When they went down into her stomach, they discovered a fair amount of blood.  They were unable to get a clear picture of where the blood was coming from. They have removed the feeding tube, will give her antibiotics over the next couple of days and repeat the scope on Tuesday to try to see exactly where the blood is coming from.  She is receiving nutrition through an IV, but the doctors do not want to keep her on it for too long because of the risk of infection.  The doctors also drained another 4 litres of fluid from her stomach today.  That was a big relief and made her stomach feel much better. She has felt pretty good, though, and was able to stand on her own for about 30 seconds today when she was being moved from the bed to the chair.  Please keep those prayers coming.  We appreciate the support and prayers.

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08-29-08 - Karen is still doing better. Today she lasted 2 1/2 hours off the vent. She also had an excellent session with physical therapy. She moved from the bed and into a regular chair that stays in her ICU room. She then participated with the therapist and was able to do what was asked of her. She was able to stand up with the assistance of the therapist and was able to assist in getting herself back into bed. This may not seem like much, but right now it really is. As I said before she is significantly weaker than when she came in two weeks ago. I had a chance this afternoon to take a tour of the Wesley Woods LTACH Facility that they are suggesting she transition to after she is released from ICU. It looks like a place that can get her back on her feet again and moving forward. Thanks for keeping up with her progress.

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08-29-08 - In order to maintain this section as "Karen's" blog, updates going forward will be posted on the post-surgery section. This will keep this section as her's to post when she is able. We will make every effort to keep up to date posts on her condition.

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08-28-08 - Karen is having a much better day today. She is much more alert and communicative. Speach therapy was just in and adjusted her trach (briefly) to allow her to talk and we could her voice for the first time in two weeks. The talk is now possibly moving from ICU and into a facility known as an LTACH. This is a facility that is a step down from ICU but for a patient that is not ready for a regular hospital room on the general floor. They will work on getting her weaned off the vent over the period of a couple weeks with a large emphasis on physical therapy to help her regain strength. She is open to this possibility and looks forward to getting stronger and back to life outside the hospital. Yesterday during the tap of her abdomin they withdrew a little more than 4 litres of fluid which has helped her feel better today. For now the plan is the same in ICU; continue to recover from what landed her here, vent wean, and some rehab. They have not tried to allow her to walk yet and I would be surprised if she could right now. She has really lost alot of strength; but this morning she really worked hard with physical therapy. She seems to be in pretty good spirits today with some discomfort here and there. We are hoping to speak with her liver doc this afternoon and get some more answers in going forward with transplant in the future.

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08-27-08 - Today has been almost a mirror image of yesterday. She lasted an hour this morning breathing on her own. A little progress. She participated in the same excercises as yesterday. They put in a "pick" line to administer her meds and plan to remove the central line in her neck. The pick line is less prone to infection and provides more options than a regular IV line in her arm. This afternoon a doctor is going to drain the fluid that is building up in her abdomin. She looks pretty full; we'll see how many litres they get. She's a little less communicative today; she's probably pretty tired now because she hasn't slept well the past couple nights. Let's hope that tonight she can get some rest.

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08-26-08 - Today Karen has been more active. This morning she was up in a chair doing a spontaneous breathing trial and lasted 45 minutes on her own. Speach therapy had her swallow some ice chips with green dye to see how her swallowing reflex is. They will keep an eye on her trach and see if they see any green dye show up. If there is no dye she is swallowing into her stomach. If they see green dye she aspirated into her lungs. Time will tell. She is more alert and communicative. Physical therapy came in this morning, did some excercises with her and showed us some excercises to do with her to help her gain some strength again. They were able to assist her in sitting up on the edge of the bed and support herself. She is making progress now but is extremely weak and sore. They also removed an arterial line in her leg that gave a constant blood pressure reading. Slowly but surely they are removing lines that can create further infection. All good signes but still a long way to go for full recovery. Thanks again for the support and prayers.

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8-25-08 - Karen received her third tracheostomy this morning. Right now she is still sedated but should begin waking up this afternoon. There is no longer anything in her mouth which she will be glad of when she does wake up. The plan is for her to wake up today, interact some and then tomorrow get down to business. Orders are being put in for occupational therapy and physical therapy to begin working on rebuilding her strength. Speach therapy will also come and evaluate her ability to swallow which may have been compromised with the tube in her throat for a week. If she can swallow ok they will give her pills orally again. If she is unable to swallow they will put a small feeding tube in her nose to avoid anything in her mouth. The task for her now will be to once again build the strength to breath on her own. She has done this two times before when she was still in UPMC after her transplant. Please now pray for strength to breath on her own and her ability to wean off the ventilator. It could still be a tough time for her in the coming weeks.

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8-24-08 - Karen continues to be about the same.  She has not done well on the breathing trials.  Plans are to do a tracheostomy tomorrow.  This will make her much more comfortable and will make it easier for her to wean from the vent.  All of the sedation has been removed and she was awake today.  She was very uncomfortable and was having a hard time not biting the ventilator tube.  The feeding tube was inserted again..her medications are given through this tube. Late this evening, Karen was sedated again to allow her to get some rest during the night.  Thank you for all of your prayers and support.  Please continue to pray for her--we know the prayers are working. 

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08-23-08 - Karen is more stable today. She was ok through the night and this morning the pulmonary doctor said she is the same as she was 24 hours ago even with the challenge of last night. She is now on a medicine to keep her heart rate stable and in a normal rate and rythm. With time they will probably stop this drug; we'll see. He is still optomistic that she is heading in the right direction. The plan is still to allow her to have breathing trials later today and tomorrow and put the trach in on Monday if necessary. She had a small amount of blood coming from her stomach yesterday so this morning a G.I. doctor looked at her esophagus and stomach with a scope. She said there were no problems such as ulcers but believed the bleeding was coming from the stomach tube that may have been rubbing against the inside of the stomach wall creating some irritation. The stomach tube was removed to allow her stomach wall to heal. She has been sedated all morning with the scope and will probably sleep the remainder of the day. Thank you for the posts on her message board. She will definitely read them once she recovers.

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08-22-08 - Karen is struggling again today. This morning they tried another breathing trial and she did not do well. The lung doctor said he will give her through this weekend and if she is not off the vent he will have to put a tracheostomy in to assist her. This will make it easier and more comfortable for her as well as cut down on other complications that come with having a tube down her throat. Throughout the morning she seemed to be a bit more relaxed and trying to breath more than the machine was giving her. Late this afternoon she had a bad episode though. As they were moving her around (as they have to often to prevent bedsores and such) her heart rate shot through the roof and topped out at about 190 bpm. Her mom and dad was in with her and they had to leave when the medical team came in to start working on her. Her heart rate was up and down along with her blood pressure. They worked on her for the better part of an hour trying to get her heart rate down with various medicines. They brought the crash cart in but thank God they did not have to use it.  The underlying issues are complicated and numerous right now but just know that she is fighting. Once again we ask for prayers to help her through this difficult time in her continued recovery.

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08-21-08 - Today Karen has been completely restless and agitated with her current surroundings. She tried a breathing trial this morning and did not have much luck. She was not able to breath in enough volume, her respiratory rate increased and her heart rate and blood pressure increased. These are all signs that she was distressed and not ready to be free from the vent. The remainder of the day she has been miserable. We knew this would be the hardest part of this ordeal. They gave her a sedative again to help her relax this afternoon and right now she seems to be sleeping. Please pray for her to gain strength again and for her find comfort while she deals with this difficult time. They are doing two breathing trials a day now so let's hope that each one shows some improvement.

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08-20-08 - Today has been somewhat uneventful. This morning they removed the last sedative at 6:00 am as was planned and later tried a breathing trial. She did ok but soon gave out because so much of the sedative remains in her system. The doctor said this morning that because her Liver and Kidney function are decreased it will take longer than normal for her body to metabolize the sedatives and rid them from her system. She has slept most of this afternoon and stirs a little from time to time. She is becoming more and more irritated with the tube, but that's ok because it's motivation for her to get it out. The plan is to try another beathing trial later this afternoon or evening and see if she can get the tube out. Her doctor's are still pleased with her progress and have now outlined her next goal: off the vent. Once she is off the vent she will have to have a swallowing test to make sure she does aspirate anything into her lungs. She continuously asks for something to drink. She has not had any liquid since last Friday. I'm sure she is thirsty.

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8-19-08 - Karen continues to make progress. She is now down to 40% oxygen support on the ventilator and the settings on the vent have been reduced to minimal support as well. Up until this morning she was on 2 sedatives. They removed one this morning and she is more responsive this afternoon. She is still pretty sleepy though. She does respond when we call her name. The docs came in this morning and made some changes to her antibiotics.  Still no word on what exactly the infection was and I believe it will probably remain a mystery at this point. Her creatnine level (kidney numbers) are elevated at 2.2. They should be below 1. She is making urine though so they say this is not an immediate concern. The goal for tomorrow is to remove the remaining sedative at 6:00 am and get her awake enough to start doing some breathing trials. The pulmonologist said that if she does good she could be off the ventilator tomorrow. The doctors and nurses are extremely impressed with her progress since Friday: a testament to the wisdom of her caregivers and the prayers that have been said on her behalf. Thank you to you all.

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8-18-08 - Quick afternoon update. Karen has been in and out of sedation today with brief periods of being awake. She opens her eyes, acknowledges us and squeezes our hands and wiggles her toes. Her sat levels are holding fine along with her BP. As always when we spend time at the hospital we meet other families with loved ones in rooms around Karen. Two nights ago Life Flight brought a gentleman in and he was put in ICU in the room next to Karen. He was in bad shape. He died today from complications. We had met the family and shared stories. The family decided today to donate any organs that could be because they saw first hand in Karen how organ donation can save lives. We will tell Karen this story when she fully wakes up and can communicate without the ventilator. Please keep the prayers coming. She is progressing slowly every day.

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8-18-08 - Today again brings some encouraging news. Her ventilator has now been bumped down to 50% oxygen support and she is holding her sat level. The goal for today is to continue the antibiotics and maybe this afternoon have a better picture on the infection. The doctor said this morning however that they may never know what caused the infection but as long as she is improving it's not a big deal. They are also slowly reducing the amount of paralytic they are giving her. Up to this point the ventilator has been breathing for her 100% of the time. The reason for this was to allow her body to completly rest while it fights the infection. They now want to see how much she will be able to breath on her own with the assistance of the ventilator. She will still remain sedated for now though. She had a new doctor this morning and he said even though she is still very sick there is definite improvement. The boys started school today and I was able to walk them in. They were excited and I took a picture of each of them at their desk to show mommy when she wakes up. They know she is here but do not know the full extent of her new challenge. Please continue to remember Karen in your prayers.

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8-17-08- Again today has shown some improvement. The pulmonlogist that has been with Karen this weekend came in this morning and said, "she may have turned a corner." She is now down to 60% percent O2 through the ventilator and she is still holding her sats. Her heart rate also continues to come down. The respiratory therapist said the goal is to get her down to 50% or less on the vent but as all other things they take one small step at a time; but she is heading in the right direction. There is still no word from the lab. They are monitoring the cultures closely and when something grows they'll get some better direction. Bottom line she is still very sick with small improvements over the past two days. Today the plan is the same; continue broad spectrum antibiotics and decrease her O2 support slowly. Thank you for the prayers; there is no doubt they are being heard and I believe they are being answered in her recovery. We don't know if Karen can hear us but we are telling her we are here, we love her and encouraging her to keep fighting. Karen's mom and I are trying to get access to her email to post any messages that are being sent but are not having any luck. I am taking the boys to their first day of school tomorrow and am going to go to the house and see if I can find Karen's password list. Please keep praying; I know it's working.

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8-16-08 - Today has shown some improvement. She did fine last night and has been ok through today. Her sat level is doing better holding at 94-96 %. Last night she was on 100% oxygen through the ventilator and they have now cut the oxygen level back to 80%. Her doctor was in this morning and said she seemed to have made improvement from yesterday. He is encouraged that maybe one of the antibiotics they are giving her may be having some positive effect. She is still completly sedated while her body fights the infection. One of the infectious disease doctors told us this morning that she is producing a large amount of white blood cells. These are the cells that fight infection; so we know she is fighting. Her blood pressure and heart rate are also somewhat better. As of yet there is no information from the lab as to which bug they may be fighting. She still has a long road to go; please keep up the prayers. They are working.

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8-15-08- Donnie again about 11:30 pm. Aside from Transplant Day,

today has been the most difficult day of our lives. Karen is very sick and in critical condition.  After her bronch she continued to struggle with her sat level and blood pressure even though she was sedated and on the ventilator. They took her for a CT of her lungs and discovered widespread pneumonia in both her lungs apparently caused by the infection. As I said in the earlier post they are unsure at this time what bug they are dealing with and they are hitting her hard and often with a wide range of broad spectrum antibiotics. She is a little more stable now with the help of supporting medicines for her blood pressure. They have her heavily sedated and even administered a paralytic to ensure she absolutly rests while her body fights this infection.  Her dad and I are holding vigil outside her room tonight. Her mom was beyond wiped out from working the day before, coming to the ER last night, staying up all night and then the events of today. We forced her to go home and get at least a shower and a couple hours of sleep. If you believe in the power of prayer please pray for Karen tonight and in the days ahead. When we came into the ER last night we did not know what was going on but we never thought Karen would be fighting for her life tonight and in the days ahead. I will try to keep this blog updated as often as possible.

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8-15-08 - Once again we ask for your prayers. As I (Donnie, or as Karen is now calling me in her blog; DJ) type this Karen is in ICU at Emory. She is being intubated and having a bronch done. We came to the ER last night around 10ish with still an excelerated heart rate (154 on admission to ER) and she was having much more difficulty breathing. She had oxygen on the way here and from the time she got out of the car and into the ER triage her O2 sat level had dropped to 73 (it should be 92 or higher). She was maybe 3 minutes without oxygen. After being stabilized in the ER she was admitted directly to ICU. This morning she continued to struggle to hold her sat levels so they put her on a Bi-Pap machine. Some of you may remember she was on and off this machine while she recovered from her transplant in Pittsburgh. She still struggled somewhat and her heart rate remained elevated so they decided to intubate her and do the bronch. The purpose of the bronch is two-fold. They believe she has an infection which is causing all this and they need to determine exactly what the infection is. They have started her on broad-base antibiotics but they need to target the bug directly so they pulled fluid samples from her lungs. They also went ahead and did biopsies to check for any sign of rejection. No reason to suspect but they want to cover all bases. As I was typing the doc came out and gave us an update. The bronch went well. Her lungs look good with some mucus present. They are putting a central line in her neck to administer any necessary meds quickly should she need it. She will be sedated throughout the weekend while she remains intubated. They will sart growing cultures in the lab of the fluid they pulled from her lungs and see what bug they are fighting. This usually takes a few days for the cultures to grow. The plan is to find the specific infection and treat it directly. Obviously when she first heard the word intubation she was not happy but as she continued to struggle to breathe and realize it was inevitable she finally said, "ok let's go." The boys are staying with my mom and dad right now. Their first day of school is Monday and Karen is sad that she will miss their first day especially with Carter starting big boy school this year. She has fought off these type bugs before and she will again. As I said at the top please say a prayer for her, she needs it.

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