Temperature of 102.6…not good.

Brad had an x-ray this morning that must have shown fluid on his lungs. Dr. Wade showed up and said that the fluid had to be removed. She got right in his face and told him it was really going to hurt. A radiologist determined with an ultrasound exactly where the fluid was. Then they deadened his back and drew it out. They drew out a liter of fluid, which is a huge amount. Rhonda said that he took the pain well. Since then, he’s mostly been sleeping. The respiratory therapist came in while I was here and he blew 500 to 700 pretty consistently. His breathing while sleeping seems deep to me and I was surprised that he wasn’t back up to 1000.

Dr. Voyles came by and said that things are looking up and that Brad looks a lot better. He said Brad looked exhausted yesterday and that Rhonda looked worse.

Rhonda and I have a theory that Brad’s other problems (kyphosis, or curved spine) are causing his pain to be more intense than others who have had this surgery. Saturday, we went back up to the pool for more exercise. He walked around a little in chest deep water, moving his arms for exercise, but couldn’t swim or raise his arms enough to get on a float and kick. Oh, yeah…the fever. His fever had been hovering over 100, but not up to 101 until Friday evening. Saturday, it was down below 100 every time it was taken. However, he still feels really bad all the time. Since the surgery, he hasn’t been able to really deeply cough and get that stuff out of his lungs. He can only raise the breathing contraption they gave him to a 500 level. In the hospital, he blew 1000 regularly. Friday, he blew a 750 consistently, then could only do 500 Saturday.

Naturally, we were concerned that he was regressing. Also, he was out of pain pills. Rhonda called Dr. Voyles, who was on call for Dr. Koury, to get more pills called in. Dr. Voyles was concerned that he had taken so many pills since he left the hospital. He did call in some more, but wanted us to back off the pain medicine. I called him back to discuss how to back off the pain medicine, yet continue breathing exercises. Also, I expressed my concern with the intense pain Brad is still experiencing. Dr. Voyles used the phrase “moderate discomfort after this type of surgery” and I went off on him. Lying in bed covered with sweat in the 3rd hour of the pain medicine cycle is not “moderate discomfort”. He said if we’re concerned something has gone wrong, bring him in and he’ll look at a chest x-ray. However, he asked that we bring him in immediately as that was convenient for him.

We went in to the emergency room. Brad mainly was complaining about his back, not this ribs. His back has gotten much worse since the surgery. Dr. Voyles came in after the x-ray was done and said that the lungs looked worse than when he was in the hospital. He said they should look much better. He said he was putting him back in the hospital and calling in a pulmonary doctor (Dr. Wade). That would also enable us to go back to the pump where Brad controls the pain medicine and would allow physical and respiratory therapy regularly. Also, he would switch to Demoral rather than the Lorcet pills. We agreed without question as we sensed Brad was going backwards.

About the time that Rhonda went home to get an overnight bag, the pulmonary doctor came in. She made the following points:

• The x-ray that was taken was pretty crummy and she really couldn’t see whether there was a problem or not. She couldn’t hear a problem, though, by listening to his lungs.
• She stressed the seriousness of jumping on this thing so that fluid wouldn’t collect outside the lungs and really cause a problem with breathing.
• She said she would arrange for a radiologist to do an ultrasound to determine whether fluid has collected. if so, they would get it out. I asked her how and she said with a needle.
• She said she wanted an anesthesiologist in here to block the pain so Brad could do better on the breathing exercises. I pointed out that he’s not really trying to do the exercises and that he had Demoral available for more than an hour without hitting the pump even once. She asked why in the world he was worried about pain medicine and I told him about Dr. Voyles’s lecture on overusing the pain medicine. She said use it and breathe, because avoiding penumonia is crucial. She did agree that it’s too early for an anesthesiologist until he’s tried really hard.
• She mentioned that Dr. Voyles had already prescribed that the respiratory therapist measure Brad’s breathing capacity. If it’s not progressing, the therapist is to hook Brad up to a machine that will hyper-expand his lungs, forcing a deep breath. She told him it would hurt like hell and that she was choosing her words very carefully. The alternative is for him to do it on his own. By the way, Dr. Voyles never mentioned this procedure.
• She said that Dr. Voyles had ordered another x-ray for Sunday morning and that she would be evaluating that.

After she left, Brad was worried sick about being hooked up to the breathing machine. The respiratory therapist came in and reinforced that he really doesn’t want that. While I was there, he was able to keep the machine at bay by blowing 500 or above fairly consistently. He was worn out from the day, though.

I left around 8:30 or so and packed a bag in case I needed to head back up there. The respiratory therapist was coming one more time that night and I assumed I could get back up there before she hooked him up, if that turned out to be necessary. Rhonda called at about 10:30 and said that he didn’t do well during the second visit from the respiratory therapist and that they were just about to do the forced breathing procedure. I knew I didn’t have time to get there beforehand, so she just called me back afterwards. She said that he did fine and it wasn’t as painful as advertised. I’ve always thought Brad had a high tolerance to pain – that’s why this post-surgery problem has been so frustrating.

Brad’s back in the hospital. More details later…

Last night was really rotten as Brad just hurt and hurt. He has not been doing the exercises and walking like he should. This morning, he just wanted to lay in bed.

Finally, in the afternoon, he got up and got going. I don’t really know why he changed. I was cleaning out the garage when he came walking out and around the yard. We actually went up to the pool for the first time in a long time. I know that walking around in chest-deep water had to be good for him. He didn’t swim, but he did get some exercise. He earned a nap, so he took one when we got home.

The plan for now is to keep him on two Lorcets so he’ll exercise and do his breathing. That should help control his pain in the long run while we wean him off the Lorcet.

It’s discouraging that he seems to be hurting more today than yesterday. Yesterday evening, he walked down the street about 4 or 5 houses, then pooped out. I brought him back in the car. We sat outside for a little bit by the pond and visited with Laura. But today, he has no interest in going outside and just kicked back for a nap. He didn’t nap at all yesterday and was hurting less.

His kyphosis seems a lot worse (because he’s holding his chest?), but the real surprise is his spine seems crooked now (scoliosis). He had a little bit before, but it seems really noticeable now.

Brad’s doing pretty well today. Yesterday, he seemed to be in extreme pain and was during the night. He went 8 hours without a Lorcet last night. Today, we gave Lorcet along with Advil and things seem a lot better. He can walk to the mailbox or around the den, kitchen, and dining room about 4 times before he crashes.

He’s going to make it.

Liz stayed last night to help take care of him. His cousin Laura is visiting tonight and Rita (Jamie’s mom) is visiting now.