Update Sept 28th

Today's report is good. Jimm spent about four hours on the trach collar(speaking valve or speaking tube.. whatever you want to call it)today. The rest of the time he is on the vent. A deal has been struck between Deborah and Jimm that the goal is to get off the respirator completely as soon as possible.
He is on pain meds as needed, and luckily that isn't a lot recently. Kidneys are doing pretty well, so dialysis is mainly taking fluids off.
His grafted area is looking very good.

He has been right talkative, but still thinks he is back at Upper Chesapeake(in fact that was in late May-early June). They have had him look out the window at the stadium.. but don't think he really has the whole picture yet.
Still, considering all he's been through, he's doing well.

aw

Update Sept 25th

Things went well during surgery last night, tightening and grafting the bottom part of the surgical wound site. Grafts were taken from the thigh.. from a smaller area than last time when they came from the side of the abdomen. This procedure is seen by the docs as one of the last major hurdles prior to rehab. As said before, if our boy can stay free of debilitating infections, they may begin talking about the possibility of that major move away from the hospital. In rehab he will be much more aggressively removed from the vent and receive increasingly intense PT.

Those direct questions to Dr. Dexter that we spoke of recently included:
-Are his stomach and intestines intact? Yes, and he may eat normally in time.
-What is the status of his pancreas? There is only a residual amount of the pancreas left, so he will be diabetic and need insulin.. his need for digestive enzymes and other aids of that sort will have to be determined after further study.
-As for other procedures such as fistula and hernia repairs, and realignment of displaced organs.. some may be elective, others become necessary. We'll know more later.

Today Jimm was on the vent to let him rest, getting meds for pain as needed, in a pretty good mood, and more awake than he had been over the weekend.

aw
(day 120)

Update Sept 24th

Jimm had a good day today. He had dialysis and was a little more awake. The stomach site grafting was not done during the day, but is planned for between 5 and 9 this evening.
Mandi and Deborah are visiting tonight so we should know tomorrow if and how it went.

aw

Many of our readers are associated with MPT, and it has been noted that another member of the MPT family is involved in a health struggle: Mindy Mintz's husband Monte Mordecai will be undergoing surgery soon for esophageal cancer. Our thoughts are with the entire Mordecai family during this critical time.

Update Sept 22nd - And An Orioles Game Note

On Monday they are planning to do the final grafting on the main surgical site. As long as Jimm can stay away from infections and other backslides, and get rid of a few drains here and there that are seeming to run dryer all the time, this graft will be the last step until more serious rehab can begin. During the rehab Jimm will be much more aggressively weaned off the vent and other medications.
As of now he is off the Fentanyl drip and is being given meds for pain only as needed. Today he had dialysis, and it was said that his kidneys are actually putting out pretty well. He was very tired and conscious only in the 50% range. He has been tired most of the week, but some of the reasons may be: enough dialysis to drain off 5 liters of fluid, non-bacterial pneumonia.. perhaps caused by aspirations, and a lot of coughing that will probably lessen when they are able to raise him up in bed a bit more.

Dr. Dexter, who is a surgeon on Dr. Johnson's team(and who is around much more often than the super-busy Johnson), has been helpful in answering questions that the family has about Jimm's condition and the prognosis for the future. More on that soon.

Interesting note:
Recently, during an Orioles Camden Yard game, one of the commentators mentioned Jimm and the fact that he was ill. They took shots of other camera guys waving and wishing Jimm well. It is so fantastic to hear about this.. and Jenna told Jimm about it today. It was one of the rare times when he had an expression of joy on his face. If any of you freelance folks know when this happened, and if a tape of it could be obtained to show Jimm, that would be so amazing. Please try. Thanks.

aw

Update Sept 20th

Yesterday the vent was unhooked for a while but Jimm was put back on it last night and stayed on much of today. He continues to be very sleepy.
Dialysis is done usually every other day and the effort will be concentrating on fluid removal which has him more puffy than usual.
The fistula is now a real ostomy, with not just drainage, but a tube, bag and suction pump.
Jimm has had some blood in his urine, but they don't seem too concerned.. blood has also recently been found in his trach tube(origin unknown), and the family has just been made aware that he has had pneumonia.
More skin grafts are tentatively planned for Monday.
Also on Monday, Deborah hopes to discuss poor communication and inconsistent care with a patient advocate.

aw

Update Sept 19th

It has been observed that every so often(especially when the head honcho Dr. Johnson isn't around)the level of Jimm's care sort of declines. We seem to be in one of those periods now. He spent most of the weekend sleeping with maybe a tad more Fentanyl than he needed.. and he has been kept on the vent and has become pretty dependent on it. Additionally, not all of his nurses have been totally into keeping him and his area as clean as they might. These kinds of things drive the family members nuts. Complaints have been lodged.

Many folks have been very bravely going to see Jimm. This is good, but as we have discussed before, such visits are not always easy. An old Air Force buddy Bob, and his wife Debi, went to see him this weekend and reportedly he was not awake enough to be able to communicate much. So disappointing. But we all have to hang in there and keep trying. Thanks so much for all you are doing in that area.

Today dialysis was done, pain meds decreased, and he was taken off the vent for a while to fend for himself.. not comfortable for him, but necessary.

aw

Update Sept 17th

Happily not much new to report on Jimm. BP had been down, but now it is better and he is off the pressors used to boost it. He continues to get dialysis as needed and remains on the vent.
Deborah is spending time with him today.

aw

Update Sept 15th

The family stayed late last night, until about 11:00 PM, and things were good. Jimm is steady and his mood has continued to be positive.
Jenna has been with him today.

aw

Update Sept 13th

IV Feeding has been replaced for the time being with liquid introduced into the jejunum, and if there are no adverse indications they may turn up the spigot a bit tonight on that. Jimm remains on antibiotics and Fentanyl for pain. The perverse bleeding issue of last week was caused by abdominal vein blistering, which occurred because of all the trauma in that area. Flow has been stopped as reported earlier, but during the problematic period a good amount of FFP was used, as well as an undetermined amount of blood.
There were plans to do more skin grafts on the belly, but that will probably be put on hold due to clots in both arms that have been found. They will have to be cleared before any other procedure is done.

The fluoroscopy that was done yesterday to examine his GI tract for more fistulas did not yield needed info, so it will have to be redone.

Jimm had physical therapy today, and although still more comfortable with assistance from the vent, has been in a good mood. In fact, according to his nurse, he has been "animated".
A number of folks have been visiting Jimm in recent days, and we have to think that seeing friends has been an attitude booster. Many thanks to everyone who has dropped in on Jimm and who is planning to!

aw

Update Sept 12th

Jimm still has a TPN line for IV feeding, so the result of his jejunoscopy yesterday, to find a place for food introduction that will encourage better absorption, is not known. He is still on the vent and so is usually unable to talk using his trach tube, but his numbers are good. Today he had a sonogram to check his neck veins for clots, and was due to get a fluoroscopy to look for more fistulas and other abnormalities in the intestines.
He was a bit groggy on pain meds, but responsive at times.. enough to appreciate visitors.

aw

Update Sept 11th- Room Move

As last post indicated, Jimm's weekend was very good. He is as aware as he has been and in a positive mood. Today they are inserting a feeding tube endoscopically into the GI tract past the stomach to see if it works better there.

His bleeding problem has been addressed and has been stopped. He is still on a mild vent assist.
He was moved to room 420 yesterday.

aw -d 106

Update Sept 10th

The weekend report was pretty positive. Jimm was in good spirits Saturday and on the vent only for mild assistance, so he used his trach tube to talk until he wore himself out. He has accumulated some tissue fluids, and dialysis on Monday will help to reduce that. Now off the 24 hour dialyzer, he will be hooked up every few days to a machine as needed.

Monday is the day for rounds and conferences to determine the patient's status, and for mapping out the care plan for the week. So with any luck, today or tomorrow we should hear more details about our pal's condition.. including the latest on that bleeding situation that was so worrisome last week.

aw

Golf and Picture Note Sept 5th

John Valente, a good friend of Jimm's and MPT alumnus, is exploring the possibility of a golf tournament to benefit Jimm and his family. Please see info about this on the JimmRevelleFund blog.
Also take a look at some of the new pics on JimmPics. You will enjoy them.

aw

Update Sept 5th

Today(Wednesday) Jimm is scheduled to go to IR, interventional radiology, so they can look for the source of the bleeding. The plan is to inject a contrast agent, go into the femoral artery and find and embolize the damaged area.

Since he can't keep liquid food down, and it's not being properly absorbed for some reason, Jimm is still being IV fed. He is on the vent and on the 24 hour dialysis machine.. has been put on a new antibiotic, and in spite of all this he looks good, and is better than he was yesterday. A visit today would probably not be advised.

Interesting note: Although we did not have info on this before, it seems that the main abdominal operative site has been essentially closed. He still has numerous holes here and there, but that is no longer one of them. However, if you are a faithful reader, you will recall that even though closed up now, that wound will eventually have to be reopened and other work completed before all is said and done. Additionally, the fact that this closing surgery could happen and sort of slip by members of the extremely interested family, indicates a continuing serious shortfall in communication.

Update Sept 4th

The persistent bleeding is now thought to be from a vessel in Jimm's abdomen. An angiogram or MRA will be done soon to locate the source, then it will be repaired using a special stent or an injected clotting agent.

Jimm's consciousness comes and goes. If you are someone who wants to go see him, admittedly you may not have a meeting that is rewarding to you.. but even if Jimm retains a small part of the encounter.. it could be hugely rewarding to him. If we put enough of these together in a consistent way, they could make a big difference in the way Jimm is able to pull himself together emotionally. One of his biggest problems now is depression. When he is awake enough to know what's going on, he doesn't see a very pretty picture. If there is a caring pal in his memory banks somewhere, that can only help.

Please see new info in the *Visiting Jimm post- available in archive list on the right. Thanks.

aw -d 99

Update Sept 3rd

There is still bleeding and they are not sure of the origin, but Jimm has had replacement blood and plasma over the weekend. His temps have been a bit elevated, and dialysis was started yesterday but stopped due to low BP.
On the good side he is back off the vent and talking using his tube.
He is responsive and still needs folks to visit him.

aw -d 98