Michael22
Michael is still in the hospital: October 24, 2005 --- ???
He is only 22 and this is what he has been through so far...
(Well now he has turned 23 in May and he is still in the hospital)
Surgery date: 10/24/05
Hemorrhaged/lost 2-3 units of blood during BPD/DS duodenal switch bariatric surgery (a typically "bloodless" surgery) resulting in needing life-saving carotid stimulation by the anesthesiologist to manually supply blood to the brain and heart by cutting off blood flow to the less vital organs and body limbs.
Went directly to Intensive Care (ICU) immediately following surgery after 4 hours in the recovery room.
Heart doctor called in following surgery because blood pressure dangerously low (60 over 20 -- where it should be 120/80)and pulse too high, but as we found out over the next few days, medicines were not going to fix the low bp and high hr because there is a hole (leak).
Kidney doctor consulted to find a way to reverse the kidney failure, but as we found out over the next few days medicines were not re-starting the kidney functions because there is a hole (leak).
10/27/05
Went into complete kidney failure due to the massive internal bleeding / blood loss caused by the hole (aka leak) where organs that were to be connected during surgery obviously didn't connect properly.
Note: Gained 66 pounds of fluid from IV nutrition and blood transfusions that simply filled his body in the wrong places because of the hole in the body - despite having not drank or eaten in 3-4 weeks or more -- and no urine output to get rid of the fluid because the kidneys were not functioning.
Began hallucinating this evening during the kidney failure period so we knew things were worsening and contaced surgeon at home. Nurses thought it was just due to pain medicine, but we knew he had been on pain medicine for several days and had not hallucinated any before. The doc rushed in and performed emergency surgery at midnight- 4 days after first surgery to look for and repair leak since kidneys had shut down and body was beginning to shut down.
In the wee hours of the morning following the emergency surgery, he was again sent to ICU on a ventilator machine that breathes for people since he was in critical condition.
10/28/05
Massive, uncontrollable liquid diarrhea developed shortly following the emergency surgery.
Ileus (area of intestines not working) shortly developed as a result of the leak and the 2nd surgery.
Fever as high as 107 degree temperature. Note: At this temperature, brain damage is known to occur.
Abdomen had been swollen ever since first surgery but became excruciatingly painful for Michael to the point he was screaming in pain. A few hours after onset of extreme abdominal pain in acute area, one of the abdominal incision sites split open and a large amount of bloody fluid gushed out all over the bed and floor. It continued to drain a huge amount of dark bloody fluid over the next 24hrs.(equal to five 2-liter soda bottles).
Required numerous blood transfusions.
Extensive infection throughout abdomen. Infectious disease doc prescribed multiple antibiotics to help stop massive infection in abdomen area.
Another wound busted open pouring out pus.
A third wound shortly thereafter opened pouring out pus in large amounts as well.
Holes the size of lemons (abscesses) opened up on buttocks and poured out pus as well as a result of not being turned during all of these days in critical condition in the hospital. A few days later the ulcer wound on his buttocks split and revealed a 9 inch crater all the way to the spine of dead, infected skin and muscle tissue. He is receiving on-going wound care to help heal this horrible extensive bed sore.
All openings draining pus require daily care from team of medical staff specializing in treatment of wounds due to severity.
2 weeks from original surgery date have elapsed and the leak still appears to be present as all symptoms and radiology x-rays and CT scans indicate such. Emergency surgery did not repair it sufficient. Infection still present. Wounds still draining a liter of infected bodily fluid every day. Fever still persists. Still not allowed food or drink. Still on IVs for nutrition, anti-biotics, and pain medicine.
Still in hospital. Not yet stable condition, but hope to transfer to rehab to receive hands-on intensive daily care and rehabilitation if/when gastric bypass surgery complications resolve.
11/14/05 - It has been decided to do a percutaneous tap in interventional radiology to see if the radiologist can get a tube directly at the site of the leak's drainage. It's our hope that getting to the source of the drainage will reduce the drainage out of his 3 wounds that busted open on their own. Ofcourse, this won't fix the leak itself, but maybe the leak is small enough that it can heal on its own if the infection near the hole can get out of his body.
11/15/05 - Infection has been draining out of this tube inserted at the site of the hole's drainage. Maybe this tube is helping drain enough infection from around the leak that it will heal on its own.
11/16/05 - Lab work is showing that the infection in his body is decreasing probably due to this specially placed draianage tube, but it still has a long way to go. Back to interventional radiology for another procedure. This time to re-position the tube a little lower to maybe get out more of the infection near the hole. Also want to put in a larger diameter tube since the infection is so thick. Running a fever.
11/17/05 - The larger tube re-positioned is helping to get more infection out. Lab work still shows a lot of infection in the body. We are hoping this procedure will be the thing to get him over the hill. Running a fever, but maybe that's due to all this poking and prodding.
11/22/05 - Doc transferred him to the rehab hospital today because his fever is finally down below 101.5 -- the magic # you have to be below before discharged from the hospital, I think. He still has a long way to go before he can come home, but we hope the rehab hospital can get him some strength and provide the medical attention he needs (IV nutrition, 4 IV anti-biotics, wound care for his large wound on his bottom, wound care for the 3 incisions that opened and are draining, and care for the site that has the radiologist's drain). We are hoping the hole heals on its own soon b/c otherwise the surgeon will have to do another surgery which is apparently risky with the condition Michael is in.
11/23/05 - Michael's suction drain was not turned on for 8 hours on the day he was admitted to the rehab hospital despite numerous requests. As a result, adomen swelled up with fluid and infection causing Michael tremendous pain. Rehab hospital would not adminster pain medicine despite Michael's pleading. As a result, we called doc and told him this was unacceptable and Michael needed to be sent somewhere else or we were going to figure out how to get him in our car and take him to another hospital.
Ambulance immediately came and picked him up and returned him to hopsital and administered IV nutrition, anti-biotics, and pain medicine quickly upon arrival.
As a result of failure at rehab, surgeon decided to perform another emergency surgery that very evening to try and find that hole and repair it. He had been wanting/preferred that Michael's body rest for a few weeks and try to get infection down, before having to perform such a major operation of opening someone up this soon post-op with all the problems that have been going on.
We were a nervous wreck for all 5 hours that Michael was back on the operating table. He has been through so much. How much more can he take? How much more can his body take? We received updates every hour from the surgical team. In the 3rd hour, they had finally found the big hole. Our worst fear (other than him dying on the table) was that they wouldn't find it and would have to close up with no success. They called to let us know they tested it numerous times before closing up to make sure they didn't see any dye leak out during their tests. Thankfully, he didn't die on the operating table, they found the leak, and the dye tests showed no sign of any more leakage from the hole.
We finally got to see him after several hours in the recover room. We were just so glad to see him and touch him. His vitals were acceptable to where we thought we could breathe a sigh of relief and emotionally prepare to deal with anything that may pop up right after this very major 3rd surgery.
11/24/05 Thanksgiving Day - We are very thankful that Michael is still with us. We are grateful for each moment he is still with us. We just wish he wasn't having to suffer like this. We keep praying for him to make it through this so that he can come back home.
His lab work following surgery shows his hemoglobin dropping so he is going to receive more blood. He always has an allergic reaction to blood transfusions and gets a high fever. This time it went up to 104.6 which feels miserable but a fever is the least of his problems. He atleast got a cooling pad placed under him this time. That was nice. It helped.
11/25/05 Despite all the blood transfusions (red blood cells and plasma) he has received, his hemoglobin is still low. Some other lab work is worrying us as well. His White Blood Cell count is still high - indicating infection. A few diarehhas worry us b/c those might be due to a residual leak still being there. We fear the leak is still there or his body simply can't fight anymore. He is a strong strong guy and he is not going to give in, but there is only so much a body can do.
11/26/05 Today was a relatively good day for Michael as far as stats go. His blood pressure was as normal as it has been in his entire month's stay. His heart-rate was only slightly above normal. We can only hope and pray for 2 good days in a row. He has a CT scan scheduled for tomorrow to make sure the leak is gone for good before the doctor lets him even have ice chips or water.
11/27/05 His numbers, again, looked good all morning. Now, it's time for the CT scan. We all expected good news since afterall he has been opened up and had the repair thoroughly tested before closing him up. He hasn't been allowed to drink or eat so as to not irritate any potential leak, but now he needs to drink about 8-12 oz of dye-fluid so that the CT scan can find a leak if there is one. We fully expected good news that there was no sign that the leak was still there.
To all our shock and disbelief, the radiologist said it was still leaking. The doctor rushed to the hospital and scheduled a stat surgery to go back in AGAIN, just 4 days later.
During the operation, the doc found the tiny leak in the same spot as the one he just repaired 4 days ago. We are all wondering if it was the stupid dye-fluid he had to drink for the CT scan that actually created a leak that wasn't there since Michael's tissue is so inflamed from all the surgeries and complications that to quote the doctor, it is "as fragile as tissue paper".
Nonetheless, the doctor repaired the leak with the standard protocol of stitches/staples, but then added some special gauze-like material and natural sticky glue like substance to hopefully reinforce this leak so that it doesn't open up again.
He is back in ICU on a ventilator as he almost went into respiratory arrest when they optimistically removed it after he got to the recovery room. I'm sure his lungs are so weak b/c of all he has been through, plus, he has acquired pneumonia at some point in this long hospital stay, and he is wearing a binder tightly wrapped around him to hold his incision and muscles tightly together.
His blood pressure is extremely high reaching 180/100 and his heart rate is really fast. He is not looking as well as he did when he came out of the 3rd surgery a few days ago. We are really worried about his recovery from this 4th surgery.
May 2006 UPDATE: Michael's birthday was this month. He was so sick he couldn't even taste the icing on his birthday cake. That really depressed us. His WBC (white count - which indicates the body is having to fight infection) has climbed very high so he is on some heavy antibiotics right now by I.V. The infectious disease doctor is running out of medicines and fears Michael's body can become septic and resistant to anti-biotics.
July 2006 UPDATE: Every year, Michael loves to light fireworks with his family, friends, and neighbors. He really was hoping to get out of the hospital so he could enjoy atleast watching everyone set this year's fireworks off. Unfortunately, he is still too sick to leave the hospital. He was sad that he was going to miss his sister, Heather's birthday and felt he disappointed me. Frankly, I'm just glad he is alive. Each day is a roller-coaster because his body is undergoing so many things.
8/8/06 UPDATE: We have not had a chance to update his profile or even post much on-line, but we have been taking notes in a notebook about various things that have happened. Such as: Septic shock from anti-biotic resistance, chest tube inserted to drain infection that was crushing lungs, passing large pure bloody stools (with no stool since he hasn't eaten in months and months), falling off side of bed when trying to do physical therapy but the bed wasn't locked, finding out that this 2nd fall (after being dropped during one of 9 repair surgeries) has caused more herniated discs, fighting with doctors to get him pain medicine for excruciating back pain,
BUT FINALLY GOOD NEWS...He has had 9 surgeries to repair the leaks that keep coming back, but the doc finally found what was causing him to get leak holes over and over and over even after he would go back in and operate to repair them. When they do the duodenum switch, they cut the duodenum and make it a useless stump or something. But, it didn't get stitched up good so it leaked bile. Bile is that very toxic waste that the liver creates. Now that we have fixed the bile leak, which was the true cause of his repeated stomach leaks, his infection has cleared up and he isn't getting any more stomach leaks! Thanks for your prayers.
9/18/06 UPDATE: We are still at the hospital 24/7 with him on the critical care unit. We have special permission to stay at his bedside instead of being limited to visiting hours.
We think the infection he has been fighting might finally be gone. In his last surgery -- surgery #9 or 10 (I can't remember how many he has had at this point) -- they found the true source of all his leaks. The duodenum was leaking bile ( a toxic substance ) and that was eating his stomach tissue and fresh staple joins apart. Now that he has a drain that drains the bile out of his body, his body has had a chance to get rid of the infection.
He also had a bleeding vessel near his small bowel that caused him to lose 2/3 of his body's blood in less than 36 hours. He almost died 2 weeks ago, but a specialist repaired the vessel and he has now started talking with us and being alert. He has been virtually silent for almost a year b/c he feels so bad, so weak, and so sick.
9/30/2006 UPDATE: Today, after a couple of weeks of stability, with no bad news, we get tons of bad news. Less than a month ago, he lost 2/3 of his body's blood supply. He has come back from that and has been talking to us and carrying on great conversations for the first time in a long time. But, when it rains it pours. Only for Michael, it's been raining non-stop. It's just a matter of the flood waters die down for a little bit, but more rain causes them to rise again. In the middle of the night, at about 2:00 am, Michael wakes his mom up saying he felt really wet on his hospital gown and his bed. Since I.V.'s can leak sometimes, she methodically tried to determine which I.V. tube was leaking with a dim light far away so as not to fully wake Michael. One by one, she ruled out the numerous tubes poking into Michael's body. So, they changed his gown and cleaned off his bed, hoping that maybe whatever tube was leaking has stopped on its own now. Less than 30 minutes later, Michael called mom to the side of his bed saying his gown felt soaked again. She checked all the wires again. None seemed to be leaking. Then she decided to check around and under his binder, knowing that if she found the source of the problem to be under the binder, something was bad wrong.
Mom and the nurse, to their shock and disbelief, turned the overhead light on and find Michael's binder saturated. They unvelcroed the snug binder and found the source of the wetness. Michael has a half-inch gaping hole at the top of his huge incision. His lemonade that he gingerly sips on was leaking out of it. He has been taken for tons of tests in radiology today and more tubes have been put in him. Now he is scared to have his Mom leave his side even though just this week he had said it was okay for her to leave him at night b/c he felt safe. She happened to stay last night b/c she has been missing him this week at night.
About the photo you see: This photo is very special to us (Michael's family) because it is one of the only times in the almost year he has been in the hospital - that he has smiled. It was Christmas time and he received a signed photo from NFL superstar Steve Smith of the Carolina Panthers and also a signed team ball. He loves the Panthers. Now if only we can get him well enough to go to a game.
10/1/2006 UPDATE: Michael went down to radiology this morning to undergo several tests to determine what & where bodily fluids were leaking from to come exiting out of the top of his surgery incision. Upper GI shows no signs of a leak. What a relief! He has had enough life-threatening leaks and major surgeries to repair them -- 10 surgeries. Next test was a fistula-gram to determine if there is a fistuala and if so, where the fistula tract is. Fistula-gram shows a fistula originating from his duodenum and coming out of the top of his surgery incision. Michael's surgeon then ordered Dr. Hollenburg (Interventional Radiologist) to immediately place a drainage tube in the fistula hole and down the tract to the duodenum to get to the source of the fistula drainage to keep the drainage from seeping around in Michael and causing an infection which can lead to a world of problems (sepsis, antibiotic resistance, high blood pressure, nauseau, etc.) Dr. Hollenburg is the one that gave Michael barium to drink a few months ago when doing an Upper GI. Anyone with a medical liscense should know not to give someone barium to swallow when they have a risk of a leak in the gastric system. The barium caused Michael to get very sick after drinking it.
Other than this newly arising fistula, Michael has been doing so good since Dr. Toothman stopped the bleeding vessel near his small bowel that had caused him to lose 2/3 of his blood via passing bloody stool bowel movements just 2 weeks ago.
10/10/2006 UPDATE: Michael is concentrating on physical therapy to improve his range of motion and get his leg muscles strengthened after being dropped while under anesthesia when being transferred from the operating table to a stretcher for a CT scan. His fistula drain is continuously offloading all that drainage from the duodenum leak into a bag on the outside of his body. We have been told that the duodenum leak near the billiary tree will take a year to heal after being severed in one of the operations causing all that bile to leak and make Michael so sick for the latter part of his year-long struggle. The fistula tract that his body has made is like a road to the outside of his body to allow the drainage to exit his body. Pretty cool that his body has that defense mechanism. It makes the doctor's job easier to insert the drainage tube directly to the source!
10/15/2006 UPDATE: Our sweet, precious angel of Schnauzer doggie, Danny Boy, died tonight after having a seizure at only 8 years old. He has been battling pituatary-dependent Cushings disease which means there is a pituatary tumor in the brain that causes the pituatary gland to send non-stop unregulated messages to the adrenal gland to make cortisol. Danny Boy was on medicine to treat Cushings, but we think the pituatary tumor put pressure on the brain to cause neurological problems such as seizures and stopped his breathing. Me (Michael's sister) and Mom were home when the seizure started and were with Danny Boy when he died.
Michael being in the hospital could not come home to see his doggie, so we carried Danny Boy in our arms up to Michael so he could spend time with him and get some degree of closure. Michael became unconsolable and required some strong medicine to calm him down. He loved Danny Boy so much and had missed a whole year of Danny's life while he has been stuck in the hospital. We found Danny Boy on a family trip to Boone, NC one afternoon. He was lost and confused walking across a 4 lane highway with a black lab. The black lab had just got hit and we didn't want him to get hit so we rescued him, looked for his owner to no avail, so we took him home with us and have been blessed to have him in our lives.
This is our second doggie to die while Michael has been in the hospital. Shadow, his black cocker spaniel died near Christmas of 2005 from cancer at just 8 years old. It is truly difficult to deal with death of our loved little ones and it is even more tragic that Michael has not even been able to spend time with them like he would if he was able to.
10/16/2006 UPDATE: Michael's fistula drain tube has started to pull out a little bit on its own. Maybe it's healing from the inside out and needs to be manipulated a little bit to enable healing down inside. He will go down to Interventional Radiology in the morning to have the fistula drain tube manipulated and pulled out a little bit more.
10/17/2006 UPDATE: With the aide of diagnostic radiology tools, Dr. Burns pulled the fistula drain tube out a little bit. He found out something rather shocking in the process. Michael's fistula drain tubing had been threaded through Michael's stomach. He has no explanation for this seeing as the fistula tract per the fistula-gram never passed through the stomach. Having pulled the fistula drain tubing out a little bit, it is evident Michael has a leak in his stomach. As feared, puncturing Michael's stomach has caused another leak. Immediately after pulling the tubing out and seeing that it had went through the stomach, Michael started getting extremely nauseous--an early indicator of a leak.
10/20/2006 UPDATE: Michael is extremely nauseous and now his blood pressure has started to rise to dangerous levels reaching as high as 195/125 where normal is 120/80. A cardiologist consult was called in and was of no help whatsoever. He barely looked at Michael's chart, didn't speak to Michael or stick a stethoscope on him or anything. Thank god the intensivist on duty, Dr. Dalto, cared enough to figure out what to do to get his B.P. down and started him on a cardiem drip. He was ordered to be transfered from Intermediate ICU to ICU itself because a cardiem drip requires intense one-on-one care to manage the levels every 15 minutes. But ICU was full so they broke protocol and started this medicine on his Intermediate ICU unit. His poor nurses were running around like crazy trying to manage Michael's special care and handle their other 2 critical patients. Me (Michael's sister) and Mom vowed not to leave Michael's site during this dangerously critical time period until Michael's B.P. was back under control and he was off the high-intensity medicine management.
At about 10 pm, Michael started complaining that he wanted to die because he felt miserable and his heart was pounding out of his chest and he just couldn't take it anymore. Michael is a very strong guy who never says stuff like this unless something is bad wrong. Sure enough, less than 5 minutes later Michael went into seizures. I ran down to the nurses station to get help because it is faster to run than to wait on them to answer the call bell. Every nurse on the floor came into the room immediately. Dr. Clark, the intensivist came running in shortly thereafter issuing orders. Michael went down for an immediate CT scan of his brain and his abdomen with 2 nurses, a tech, portable computer readings of his vitals, and a manual breathing device in case he needed to be resuscitated. The CT scan of his brain came back fine so we didn't have any answers as to what caused the seizures. Michael has never had seizures before. His dog just died during a seizure.
10/21/2006 UPDATE: Michael hasn't had any more seizures. His blood pressure is slowly coming back down after being on the cardiem drip all night. He is still on it though to get it lower. He is still extremely nauseous. Dr. Dalto wonders if the B.P. and nausea are drug-induced, but whatever the cause, we are treating the B.P. either way to get it back down. He was only supposed to be on the cardiem drip for an hour or so, thinking that his B.P. would come back down quickly but it has turned into an over night and all day the next day affair. This is taxing on the nurses in this unit because they are expected to attend to Michael every 15 minutes because of this medicine and also their other 2 patients. Since his nausea is still unrelenting even though his B.P. has come back down considerably, the surgeon is going to have radiology try to reinsert the fistula tube further down again tomorrow to obstruct/block the leak that Dr. Hollenburg caused when he punctured the stomach.
10/22/2006 UPDATE: Dr. Oke pushed the tubing back further down so that it blocks the puncture in the stomach. Michael's nauseau immediately started getting better once he did this. The only bad thing about sticking the tube back down through the stomach is that it is obviously keeping the puncture hole from healing. What are we supposed to do, Michael's nauseau is out of control if the puncture is unblocked and if we block it the new puncture hole wont heal.
