June 30

Thank you everyone for your supportive wishes. Your good will is helping Steve heal. All of your e-mails, cards, blog comments, phone calls, letters, etc have meant a lot to him. Steve still is very weak, but growing stronger every day (the physical therapist had to slow him down today). Steve still is very anemic. The sutures for his draining tube unfortunately came out today, so we had to drive down to Stanford to have them replaced. His surgeon also did a thorough (and painful) cleaning of his incision to improve the healing.
The girls and I figured out the feeding tube protocol last night (unfortunately, there is a huge gap in training between the provider and the nursing staff). Overall things are moving forward.

June 28

Steve is home! He climbed the stairs from our garage and enjoyed sitting on the couch watching TV and talking with family (Steve's brother, sister-in-law, father and stepmother were also here). He enjoyed takeout from Betelnut. We're all very happy to have him home.

June 28

Steve will be coming home this afternoon!

June 27

Steve gets out of bed a lot and is walking without assistance. Steve's family (father , stepmother, brother and sister in law) visited again. Their presence raises everyones' spirits.

June 25

Steve took a trip to interventional radiology today to fix "the leak" that keeps draining into the remaining external drainage bag. It turns out that they will schedule a second endoscopic procedure tomorrow to insert a larger stent to deal with the drainage. In preparation for Steve's homecoming, I learned how to dress his incision and got preliminary training in setting up tube feedings. Steve spends a lot more time out of bed and takes longer and farther walks every day. He was hungry for lunch today, but at the very last minute (I really mean that - he had just put the salad dressing on his salad) - he was ordered not to eat because they would be taking him to interventional radiology - so he had to skip the lunch he was looking forward to.

June 24

Steve practiced doing stairs today in preparation for coming home Monday. A few things still need to get resolved over the weekend, particularly the fluid that continues to accumulate in the remaining external drain.

June 23

Steve continues to make slow progress forward. He's now on a normal diet. He's spending more time out of bed. The next goal is to get him home.

June 22

Steve's stent was inserted today. The procedure required conscious sedation. Steve was worn out after the procedure, but still was able to take a short walk around the floor.

June 21

Steve did a lap around his floor today! He is very motivated to get out of the hospital. He will undergo a procedure tomorrow to install a stent to drain his bile internally, rather than externally.

June 20

Happy Father's Day to all the fathers out there! The whole family came out to visit Steve today. We brought a "card", actually a poster, of pictures of his family, pets,plants and special places. The doctors gave an order to the nurses that Steve was allowed to go outside in a wheelchair with just his family, today. This meant a lot to Steve. I drove the wheelchair and bumped him around a few times. He wasn't too happy about that. He directed us to a shady courtyard. We spent about 30 minutes just talking outside. It was relaxing and a lot of fun for the whole family. After about 30 minutes, Steve got a little overheated, because it was so nice and hot outside. We decided to take him back in at that time.

June 19

Well since it is the weekend, the staff is reduced, so Steve conducted his own physical rehabilitation program. When Kendall and I showed up, he had already moved himself into a chair. Steve is doing well on all his therapies. His nurse, Myra, has been so very responsive.

June 18

Steve is benefitting from all the positive energy. He was able to sit in a wheelchair and go outside for some sun and fresh air for the first time today. He also enjoyed drinking milk and coffee. And he savored manicotti for lunch (so what if it's hospital fare - at least it has texture and flavor). Steve is working hard on all his physical rehabilitation and making slow, but steady progress.

June 17

Big Day today!! Steve was transferred out of the ICU at midnight last night. He is in a private room overlooking a lush courtyard. His swallowing is good, so he can eat pureed foods. He's still very weak, so sitting and standing are a real effort, but he's working on them. He got to see Kendall today for the first time in 3 1/2 weeks. Justine was able to visit him on Tuesday. It will be a while before Steve is strong enough to visit with his friends, but he appreciates all the supportive messages that have been sent to him.

June 16

Well, Steve didn't escape from the ICU today. He spiked a fever last night, so he's back on antibiotics. However, he's talking more clearly and he was able to stand twice.

June 15

Continued progress forward. Steve stood briefly and sat in a chair. He passed his sipping tests and now can drink ice-cold Hetch-Hetchy water whenever he pleases. His voice is getting stronger. He's still in the ICU, but should be moving out soon.

June 14

Steve made more progress today. He got to sit up and hang his legs over the side of the bed. A physical therapist helped him do stretching exercises. Steve tires easily and his voice is weak. Most of his pumps have been removed and his team is talking about moving him out of the ICU.

June 13

Steve continues to make progress. His breathing is great. He was able to enjoy a few sips of water today and suck on some ice chips. After having a tube down his throat for 2.5 weeks, he has to get used to swallowing again. His fever was a little higher today.

June 12

We crossed a big milestone today! Steve's breathing tube was removed and he has continued to breath steadily and deeply all day today - so it looks like the ventilator is gone for good. His fever is down, too. They have been unable to culture anything out of the latest drain, so have stopped the antibiotics. It will be awhile before Steve can have a conversation, because his voice is pretty weak. but he was able to ask about his daughters.

June 11

They had to sedate Steve today for a CT-guided drainage placement procedure, so he was pretty out-of-it today. They are draining a lot of fluid and sent a sample off for culture. He's on two anti-bacterial antibiotics and one anti-fungal medication. Steve still has a fever and elevated white blood cell count, but those counts haven't really changed since yesterday.

June 10

Today was spent adjusting Steve's sedative levels in order to have him more awake (but not uncomfortable or agitated) in preparation for removing his breathing tube. They want him to be alert enough to follow some basic commands. They've also angled his bed so gravity can pull his abdomen downward slightly to give him more room to expand his lungs. They're planning to insert an additional drain tomorrow. Overall he's still making slow progress forward. Steve still has a fever and elevated white blood cell count, but neither are as high as previous days.

June 9

I got a call this morning to authorize the insertion of a PICC (peripherally inserted central catheter) line. That will allow his team to remove the other central lines and IVs that could be potential sources of Steve's ongoing fevers. Last night and this morning Steve's fever was up, his white blood cell count was up and his blood pressure had dropped, requiring blood pressure medication. This turn of events led to the decision to do another CT to check on the status of Steve's abdomen. Tonight, Steve's surgeon relayed the good news that his colon looks good (the concern about the pneumatosis is gone), his white blood cell count has decreased to 21 from its earlier high of 27, his blood pressure is stabilized and his kidney function is looking better. All this is small forward movement.

June 8

Thanks for your supportive comments, everyone. They mean a lot to me and will mean a lot to Steve when he can read them. I talked with Steve's surgeon today and he said that Steve is "inching forward". They're getting more abdominal fluid out and Steve's abdominal pressure hovers around high normal. Steve is able to breath more on his own, since his diaphragm now has more room to expand. The biggest concern now is that Steve is still running a fever, his white blood cell count remains elevated and his platelet count is about twice normal. Steve remains on antibiotics and they've also added an anti-fungal medication. They haven't been able to culture any bacteria out of his blood or fluids.

June 6

Steve's fever spiked and his white blood cell count went up last night. He'll get another CT scan on Monday. His doctors are still worried about whether his colon is infected. His abdominal pressure remains elevated. We received the disappointing news that his portal vein remains clotted off, but his collateral veins can continue functioning as they had before the surgery.

June 4

Today was a recovery day. Steve remained heavily sedated. He is stable. His blood pressure is good, bladder pressure is good and his fever is a bit lower. His white blood cell count has increased a bit since the morning.

June 3

Steve returned to the operating room this morning. His surgeon made the decision for several reasons: 1) Steve's white blood cell count was going up, 2) Steve's abdominal pressure was still elevated and 3) the CT scan had suggested pneumatosis (which is a pocket of air) in the right colon, which could indicate that the colon might be injured and might need to be taken out. If the right colon were taken out, the additional surgery could put back Steve's recovery for several reasons. Fortunately, I don't have to describe those reasons, because Steve's colon looks fine. On the positive side, going back into the abdomen reduced the abdominal fluid pressure (at least temporarily) and allowed them to insert more drains. They also inserted a feeding tube into his intestines. His portal vein remains obstructed by clots, which they hope to dissolve when they start giving him heparin again. However, even if the portal vein remains obstructed, Steve has developed collateral blood vessels which are functioning to maintain blood supply.
As of this evening, Steve's white blood cell count is going down, his blood pressure is stable and his abdominal fluid pressure is low.

June 2

Not much has changed. Steve was transfused with one unit of blood. They haven't cultured anything out of his fluids, but he still has a fever and remains on antibiotics. His abdominal pressure is still elevated. And he still remains on the ventilator. His blood pressure remains stable.

June 1

Because Steve's blood pressure has stabilized, the team was able to use diuretics to increase fluid removal and removed about a liter and 1/2 of fluid. Steve's fever spiked last night, so they have sent more fluid samples off for culture and started new antibiotics. Today his team did a CT scan of his abdomen. So they had to stop the diuretic drug and increase his sedation. The report from his nurse tonight is that we're awaiting the final readout of his CT scan, but that his fever has dropped. The team is still concerned about his abdominal pressure and the health of his intestines.