Thursday, January 19, 2006

Galium scan, J-tube tomorrow

First, some plagiarism from my aunt's email, telling about her conversation with the hospitalst:
"The GI doctor discussed the benefits vs the risks of J tube. Her
white blood cell count is normal and she has had no temp since the
weekend. Having the feedings for nutrition present far less risks
than long term TPN. So, tomorrow a procedure will be done in
radiology to insert a tube into the stomach and then advance it to
the jejunum for feedings. It will not have the G (gastric tube) only
the J ( jejunal) tube. Feeding through the tube will begin 12 to 24
hours after the insertion. The feedings will be started very slowly
and advanced to a rate to meet her caloric need. As the feedings
increase the TPN ( IV nutrition) will be slowly tapered off. Crushed
pills cannot be put down the tube because it is a small diameter and
they would clog it. The doctor and pharmacist will confer and try to
put whatever is available in liquid form down the tube and only what
isn't for Denise to have to swallow. Her transfer to the SNF (skilled
nursing facility) will probably not happen till Monday or Tuesday
depending on how she tolerates the feedings. They will watch for
distention, diarrhea, and abdominal cramping. The hospitalist works
closely with the doctor who will follow her in the SNF and will
appraise him of Denise's condition before she is transferred. The
galium scan (test to look for infection) was completed today but the
doctor did not have results back yet to report to us. We hope to find
that out tomorrow."

And now my two cents worth:
So several things went well today. The suggestion late last night to get a feeding tube into Denise went over very well. It was presented this morning to the GI doctor, who got on the horn to the hospitalist. Both saw the value in having it in place, and we were pleased to have the suggestion acted upon so quickly. Denise is encouraged by the thought of fewer infection risks with the feeding tube, and the fact that she had about two months of successful feeding with the previous tube. The hospitalist also talked about what usually happens with feeding tube start-ups, but that Denise is unique. That was good to hear... indicates some extra TLC, we hope. It turns out that the hospitalist is familiar with and is in frequent contact with the doctor that would be on call for Denise at the SNF. My aunt also called the SNF and spoke to a nurse to give a little history about Denise, just to get people warmed up for Denise and her special circumstances. For a while at least, she'll be staying at the hospital, hopefully on the current surgical floor with the very attentive nurses. While Gracie & I visited this morning, we all took a stroll around the short corridor. One of the chaplains came by for some prayer with us, too. I told him it was good to see him again, but really wish I didn't have any need to see him again. Also got a visit from one of the gentlemen from church that's been dropping by since the Arcadia Methodist days. And I forgot to mention these things the other day, but I got a call on my cell phone from someone in Texas that said their whole church is praying for my wife. I assume that they're Texas-sized prayers. And thank you to the mystery person that left delicious fresh strawberries on our doorstep.
A couple things went not so well, too. She vomited up after gagging on a pill this morning. That always scares Gracie. Denise vomited some more during the galium scan. She didn't eat much today at all. She was sleepy most of the time I was visiting (that or I just bore her). Still trying to regain full control of bowel & urinary function, and that's very frustrating to her.
The vitals: pulse 92, 118/70, temp 98.4, complaint of back ache but no headache.

Update on my dad's cancer: During his last checkup it was discovered that his tumors grew, indicating that the chemotherapy he was on is no longer working. Today he started a new chemotherapy protocol that is a clinical trial. He's apparently been coughing up increasing amounts of blood and isn't feeling well, and the chemo has some pretty harsh side-effects. So save some pull, even tug, for my folks.


Anonymous Anonymous said...

Mr. Williams, You are a great husband, son and father! You are doing a remarkable job during this very difficult time. We lift you up to the Lord!


January 20, 2006 7:26 AM  
Anonymous Anonymous said...

Continuing to pray for Denise's healing, a successful go with the feeding tubes, and a smooth and easy transfer to Glendora. Additional prayers for your Dad, may God heal him and give your Mom strength to handle the difficulty of cancer in a loved one.

You are an amazing person, Phil, and Denise, the kids, and your family and friends are lucky to have you!

January 20, 2006 8:33 AM  

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