Friday, August 31, 2007

Update Aug 31

The bleeding turned out to be minor. There was evidently not a lot of blood in Jimm's abdomen after all.. but the reason for the bleeding is not known. No whole blood was needed, but there was word of some plasma. Because he has been very weak, and to assist in blood clotting, Jimm was given vitamin K and others today, and dialysis was done. During dialysis about 2 liters of fluid was removed, helping to reduce tissue swelling. Part of that swelling was due to earlier fluid drips during his time of low BP and high fever.
His temp was down to about 99 today.. a marked improvement.. and he is back on a pain med drip.
He was feeling better today and was awake and responsive from time to time.

aw

Thursday, August 30, 2007

Update Aug 30th

Last night Jimm had dialysis and later in the evening it was discovered that there was blood coming from his abdomen. It was packed to stop the flow. They have scanned him and it looks like there is some more blood in his abdominal cavity. At this point the cause of the bleeding is not known.. will check in soon to see if we can get more info on what's going on.
Today Jimm is pretty much out on sedatives due to the pain involved with last night's ordeal.

aw -d 94

Tuesday, August 28, 2007

Update Aug 28th

Jimm aspirated some stomach discharge last night and spiked a 102.7 temp.
His kidneys have been putting out pretty well during the past week but can't keep up totally, so dialysis will be happening soon.
He is weak today and will need rest.

aw

Sunday, August 26, 2007

Update August 26th

Friday night another temperature spike occurred, and for the first time it is thought that this may be the same bug just hitting Jimm again. The infectious disease guys don't really seem to know the origin of these in many cases and so they get him cleaned up, change dressings and replace tubes and drains, etc... trying to minimize chances of the infection sticking around and weakening him further. Jimm encountered another tough night Saturday, but during each day he has gained a bit of strength and is talking well and getting pain meds only on an 'as needed' basis. That means he is pretty awake much of the time, and could use a friendly face even if it's for just a few minutes. He is often on the vent at night so he can rest, and off of it during the daytime so he can communicate by talking using his trach speaking valve.

I know it's scary thinking about seeing him so sick, but we are hoping a few of his closer pals will take a shot at it. Once you do it you will learn the ropes and be more able to visit with confidence as he continues to improve.. which he will.
Thanks so much for being there.. all of you.

aw -d 89



Thursday, August 23, 2007

Update Aug 23rd

He had another MRI yesterday and his lungs looked OK. Jimm has a strong enough cough to cause trouble with his mouth feeding tube so they have put him back on IV feeding for the time being. He is being weaned off the vent.. again, and has not had dialysis for a while because his blood pressure hasn't been up to it.
He is stable though, and doing pretty well.

aw

Tuesday, August 21, 2007

Update August 21st

Late Sunday evening Jimm's heart rate and BP dropped and he began having trouble breathing.. you should be able to nail the diagnosis by now.
Infection #6.
MRI showed enough pleural fluid to restrict breathing. The rest by rote: pressors to raise BP, more antibiotics, fluid removed, drains replaced, infectious disease(ID)doc on the scene, increased pain meds
, back on vent. Yesterday, new belly bandage, two bags of frozen plasma.

Surprisingly, Jimm was fairly responsive yesterday. Either it wasn't as much of a hit as he has had in the past, or his body is getting more used to dealing with this.

Longtime friend Lee Ziemsky visited yesterday, and Jimm was glad to see him.

aw

Sunday, August 19, 2007

Update August 19th

Jimm is awake and talking today(using his tube).. and the nurse on duty says he needs visitors to take his mind off things. Wow, that is so good to hear.
He is off the 24 hour dialysis machine and should be able to come off the vent very soon.
See the following note on visiting for specifics about times, etc. When you can, go see Jimm while he's feeling better!

Saturday, August 18, 2007

Financial Update Aug 18th

Contributions are starting to roll in.. and that's great. They will be put into the JR Fund when it's official this coming week. We have received generous checks from Tony Guiffre and Ann Klimas, and the new funding blog is ready to go at any moment. For now, keep up on activities by looking at the *Contributions* blog available in archive list on right.

aw

Friday, August 17, 2007

Update August 17th

This morning Jimm had surgery to clean out an abscess on his side. 400cc's of fluid was removed and the area cleaned out. A nearby drain has been readjusted to make it work more efficiently. He is tired right now, but doing pretty well and his numbers are good.

aw

Wednesday, August 15, 2007

Update August 15th

Better news today- Jimm is now on milder pain meds and is off the morphine. He is also off the ventilator and is using his speaking valve more(we think Jenna may have read him the riot act). He is on the 24 hour dialysis machine that is more gentle and does a good job of removing fluid buildup. An abscess on his left flank will be addressed tomorrow by Johnson and his team.
Deborah got no less than three calls from the hospital today offering info. The "squeaky wheel" syndrome at work.

aw -day78

Tuesday, August 14, 2007

Update August 14th

Deborah, Laura, Jenna, and Mandi met with doctors and other key staff members yesterday. Steven Johnson, head of the surgical team, was especially interested in what the family had to say. They spoke of not being notified in a timely manner when a significant change occurs in Jimm's condition; not having that change explained in detail afterwards; inaction, rudeness, sloppiness and possible carelessness on the part of some nursing personnel; lack of responsiveness on the part of certain medical teams; and lack of efficient communication between the various medical teams*. Deborah displayed pictures she had taken to drive certain points home. It is hoped that this will cause Jimm's treatment to improve.

Since taking a turn for the worse Tuesday night, Jimm has suffered a severe backslide in his status. He picked up an infection(no one has really been counting, but it seems to be perhaps the fifth hospital-acquired bacterial infection), spiked a temp and began to become septic. He is now on an antibiotic cocktail of four or so drugs. He had a respiratory issue that was finally explained as very shallow breathing that resulted in insufficient oxygen intake.. he was put on a respirator again. His BP declined so that he once again needed meds, often called simply pressors, and fluids. His kidney performance worsened, therefore more dialysis would be needed. He was in need of no-nonsense pain meds and was given morphine. He developed a facial twitch which doctors don't seem worried about and which has decreased with the lowering of the morphine dosage(connection?).

During these days, in which he was set back further than he has been for a long while, there were other occurrences such as drain jostling during a flip, and clogging of at least one drain resulting in a buildup of internal fluid.
As a result of the morphine dosage he has been unconscious and unresponsive.. to look at it optimistically, he is resting, and should be able to gather strength and start to heal again.
The next moves will be to continue lowering of morphine.. continue fighting the infection(the ID team has done cultures and knows what it is- we don't).. weaning off the respirator and BP meds.. pressing on with dialyzing(now more fluids are again present that beg removal too).. and hoping he is as responsive as he has been able to be in the past.

Kudos to the family for standing up for Jimm. Now it's time for everybody, including the Jimmer, to give it their best.


*numerous teams are involved in Jimm's complex care such as: surgical, pulmonary, plastics, nursing, infectious disease(ID), and numerous others.. and as you can imagine coordination of treatments among all these parties, some of which don't see particular patients that often, is not always easy- but critically important.

aw -day77

Sunday, August 12, 2007

Update August 12th

Friday night Jimm had a 102 degree fever and an uncomfortable night. He is still on heavy pain medication, has undergone some swelling again and his BP has been too low to do dialysis for three days. They hope to do that tomorrow. The infection is not yet under control and they found a clogged drain that may have caused pooling of infected fluid in his abdomen. The drain has been replaced.
As of late Saturday evening he was resting more comfortably.

The family hopes to have that meeting with doctors and nurses Monday or Tuesday. Not only is the communication
poor between medical teams and the family members, but Jimm doesn't seem to be tended to in a manner he is in need of, and the room is not being kept as clean as it should be. All that will be discussed at the meeting.

aw -day75

Friday, August 10, 2007

Update August 10th

Due to an new infection and a "respiratory issue", Jimm was moved back down to SICU on Tuesday night. It is now Friday, and the family still has not been able to find out what that "issue" was. They are not happy with the poor communication between the medical teams and them, and between the medical teams and the nursing staff.
The family has asked for a meeting with the docs to find out what is going on(that probably won't happen until next week at this rate).
They are also in close communication with a patient advocate and social worker.. and, someone who
has been helpful in the past.. a friend at the hospital who is in charge of guest and volunteer services.

As for Jimm.. and this seems unbelievable.. he has contracted yet another new infection on top of the one mentioned above. He is on rather heavy pain meds and has developed a disturbing facial twitch that was not there before. The fun never stops.
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Financial note- we have obtained papers to be signed from the CFCC that do not jibe with what the Foundation's lawyer has told Lee Ziemski(one of our group's main contact people). Lee will get clarification asap so things can move ahead.
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Jimm has been moved around a lot. See new room assignment record in archive section.


aw -day73

Wednesday, August 8, 2007

Update 2 August 8th

The reason for the return to SICU.. it seems Jimm has picked up yet another infection and suffered another setback. Drains and lines, including the CVC, have been changed out and he is back on the respirator.

aw

Update August 8th

Jimm was moved back down to Surgical Intensive Care(SICU) during the night.
Respiratory issues is all we know at this time.
He is on 4th floor room 402.

Tuesday, August 7, 2007

Update August 7th

Dialysis was done yesterday which lead to Jimm being pretty exhausted and out of it last night. The closing looks good so far. All is quiet, and not much else to report.

aw

Sunday, August 5, 2007

Update August 5th

The procedure was completed Friday evening and grafts taken from the abdomen. Jimm spent most of Saturday in recovery and was given 7 units of blood in all. They almost sent him back down to SICU, but that did not happen.. his BP finally came back up and he stabilized enough to go back to his 7th floor room. The closed and grafted upper section is about 6 inches long, and we all hope for good news concerning the grafts 'taking'. Healing will take place for at least a week before anything further is done.

This afternoon he was on pretty heavy pain meds following a dressing change, but still closed his eyes and shook his head in amazement when I told him about his pal Tony working for him to donate his paycheck for the day(see August 5th section of Contributions-Fundraising.. and see also the notification of Longaberger activities from Dinah Seisman
).

aw

Friday, August 3, 2007

Update August 3rd

The top half closure was finally done today in the late afternoon. If it goes well this is a positive step that may help Jimm get out of the funk he has fallen back into.

Regarding the fistula, the external opening is in fact up high near the stomach. See this page for an illustration that shows how close the transverse colon is to the pancreas- the original source of trouble. It's on a kid's site that gives some good straightforward info on the human digestive system.
No further mention has been made of the "other" fistula(as reported on July 27), so we're hoping it doesn't exist. That would be great.

aw

Wednesday, August 1, 2007

Update August 1st

Deborah has been in touch with Dr. Johnson and he says the plan is to close the upper portion of the main incision today or tomorrow, complete with grafts.. then after it heals for two weeks, do the rest. With this two-pronged approach they hope to minimize the problems with finding a way to drain off the pesky fistula (which sounds like it may be up high in the colon.. maybe in the transverse portion.. if I find out more I'll let you know). After all closing is done they can start more serious feeding routines.

Even though the trach speaking valve works pretty well, Jimm doesn't like using it because of the breath it takes. Despite this, he is communicating better by moving his lips and sort of whispering. His strength is gradually returning so that now he can probably push the nurse call-button, so maybe he'll be able to write more soon.

He is still getting antibiotics, and now also iron. His color is good and his feet and legs are getting skinny.. they were quite swollen before. He sits up in a chair at least an hour each day(which actually helps keep his chest clear), and is in a more positive mood than a few days ago.

aw

Contributions and Fundraising - Please Go To JRFund

This post has been left as a record, but is now inactive. An active copy of it is on the funding blog. Thanks.
We know now that Jimm's recovery will be lengthy and expensive. This is the place where
questions, ideas and news about various efforts to raise funds can come together.

So far we have a racquetball tournament in the works, two Longaberger events planned, and a suggestion for an eBay auction. A freelancer friend of Jimm's, Eric Weinstein, is going to be in touch with a Penn State alumni group to see what they might be able to do. Work friends of Deborah's have held a bake sale to lend a welcome hand, and a bunch of Jenna's pals have given her a thoughtful gift card for gas money and snacks on the road.

Also, as you will see mentioned in other notes to follow.. a bunch of Deborah's Walmart associates raffled off one of the newly published Harry Potter books and earned her some spending money;
Jenna and some friends in the Upper Darby area of Philadelphia are planning a charity Beef and Beer event; our friend Tony Guiffre has contributed a generous $250.00 which will be applied to the JR Fund when it gets rolling; Jeff Wachter has offered to give $150.00 from his next mortgage transaction; Ann Klimas from MPT has kindly offered a donation of $200.00; and I will be contributing $150.00 as soon as we get Jimm Revelle Fund approval.
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New note- July 2nd:
The racquetball tourney date looks like it will be Saturday, November 3rd. Kathy Cornell is looking into a special bank account for contributions.. and arranging non-profit status so a tax write off would apply.
In the meantime, since the tournament is some time away, we are looking into a simple direct donation account too. This would enable anyone to simply send in money- what a novel idea!! So, save your mad money and hang on while we plan for this.. and watch this space for constantly updated info.
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Also July 2nd: A good friend has suggested a motorcycle charity ride for Jimm and Deborah.. a great idea that would be tons of fun, and earn a sidecar full of bucks too. I'm not affiliated with a club, but would happily join such a ride. If you are a biker, please find out if there might be some person or MC club willing to do this.
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July 4th: Jenna and some friends in the Upper Darby area of Philadelphia are planning a charity Beef and Beer event(we might call it a Bull Roast around here). It will most likely take place some time this fall. Updates on this when we get them.
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July 15th: Efforts continue to find a safe place for contributions. Right now some folks from the racquetball group are working on aligning Jimm's cause with a foundation in Carroll County. More on this soon.
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July 17th: Please see new note below in the 'comments' section from Kathy and Joe regarding the benefit tournament for Jimm.
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Aug 3rd: Deborah's pals at Walmart came through again and raffled off one of the first copies of the latest Harry Potter book. The proceeds will go toward gas and EZ Passes for our gal.
___________________________________________________________________
Aug 4th: Those in our racquetball group who are coordinating the non-profit effort are waiting for word from the lawyer at the Community Foundation of Carroll County to see if they will assist with Jimm and Deborah's finances. More on this important topic soon I hope.
___________________________________________________________________
Aug 5th: A good friend of Jimm's, Tony Guiffre, is working at MPT on Sunday for Jimm(meaning Tony's paycheck will go to Jimm). This gesture will be deeply appreciated by Deborah, Jimm and the entire family. Tony, thank you for your generosity.
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August 5th:
This is big enough news to move up from Comments below... if interested in more info on the Revelle Team Basket.. and participating in the Basket Lotto please call Dinah at 410-409-4117.
Just an idea.. would someone at MPT want to get a bunch of tickets from Dinah for friends there? (I'll buy a couple:)
------------ ------------- ------------- -------------

Dinah Seisman said...

...Deborah's Longaberger friends will be hosting 2 fundraisers:

1) AUGUST: We've designed "The Revelle Team Basket" with Ravens color trim strips, Rball tacks and a commemorative brass splint. Other colors and sport tacks are also available for those who might want this for a graduate gift or to support their local sports team.

2) BASKET LOTTERY. Tickets will be $10 and include 40 chances (Nov & Dec) to win a Longaberger basket. Winning numbers will be determined by the MD State Lotto.

We can circulate the word through our Longaberger family. Can you post ticket info on the Blog?

Proceeds from all Revelle Team Baskets and 100% of the profits from the Lottery will be donated to Jimm and Deborah.

For more info, please call Dinah at 410-409-4117

August 4, 2007 11:17 AM

___________________________________________________________________
August 7th:
We are close to an agreement with the Community Foundation Of Carroll County that will give us the non-profit status we have been seeking. This will mean that all contributions made through the Jimm Revelle Fund, as it will be called, will be tax deductible for the donor and better tax-wise for the recipients as well.
All checks will be addressed(or later routed) to the Fund in care of the Foundation(charges and cash contibutions will also be possible).. and in turn the Foundation will pay medical, and home expenses such as mortgage, utilities and others to be determined.

As friends of Deborah and Jimm, we have all been frustrated by not being able to do anything. If this works out as well as we hope, it will be a major step toward being able to help in a rather dramatic way. This, in turn, can only have a positive influence on Jimm's future recuperation.. which will undoubtedly take quite a while.

Soon we will open a new blogsite to concentrate on funding and contributions only. Watch for that in the near future.
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August 8th:
Jeff Wachter, MPT master control supervisor.. who also does mortgage financing, has offered to contribute $150.00 from his next mortgage transaction. So if you want to buy a house, go to Jeff for financing, and in turn you will be contributing to Jimm's fund.
Thanks Jeff.
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Aug 16th:
It's disappointing that the Jimm Revelle Fund has not been officially launched yet.. there have been more nuts and bolts to iron out than was first expected. Those who are involved estimate that next week it may happen. At that time I am planning on shooting in a $150.00 check.
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Aug 18th:
MPT's Ann Klimas has kindly contributed $200.00.. excellent, that will help so much. Thanks Ann.

aw