Tyler's Heart

Pictures - Pictures from Houston.
LVAD Video - A YouTube video about living with an LVAD.
HeartMate II Video Clip - Short video clip about the pump Tyler has.

Another good blog to read is from our friend Bill. Cozumel Part 1 - This Might Be Habit Forming.

Monday, November 30, 2009

ALMOST 6 WEEKS

Yes, this is really me. I'm finally able to concentrate enough to write this blog, and I want to thank everyone for their thoughts and prayers. It is very difficult when you go on a trip to Mexico and the next thing you know, 6 weeks later, you're in Houston recovering from a heart attack.

I have been awake for a little over 2 weeks now, and today was the most difficult day I've had thus far. It was emotional because I'm so far away from home. I miss my animals, friends, and family. Robert and I are researching the possibility of a transplant in Denver because I'm so homesick.

Thank God for Robert. If it wasn't for him, I don't know how I could see myself through any of this. Not only does he show support for me personally, but as you all know, his support is helpful to all of my friends and family.

Keep us in your thoughts and prayers.

Love,
Tyler

Sunday, November 29, 2009

What next?

Tyler is still pretty stable for his condition. He is still trying to get surgery scheduled for the cyst in his leg. He was wheeled outside to get some "fresh" air, but his blood pressure dropped and had to go back to the hospital room. He is still weak and trying to eat more. Once he gets his leg problem dealt with, he will start doing more physical therapy.

We have begun talking more about finances and the future. We can only get so far before it becomes overwhelming. There are just so many variables that are unknown still, including ....when can he leave the hospital, when can we get back to Denver, can we stay in Denver or is it just a visit? What bills can/should be paid?
Now that Tyler is conscious, we have signed a bunch of power of attorney's. We have been cutting expenses as fast as we can. We are trying to grapple with what our new reality will look like and it gets frustrating as we don't know from day to day what will happen. After a point, we back down and decide we will see what "tomorrow" will bring. I still just want to be able to help him physically and emotionally.

Tyler has learned more about his LVAD. How it sits in his body, what the components are, and has started switching from direct power to batteries. I was able to change his dressing at the cord exit site while being instructed about how to keep things sterile. I was happy that he dozed off while I was doing it. Made me feel less nervous and that I wasn't hurting him. All these new things will become routine one day. At some point Tyler might be able to change the dressing himself while sitting in front of a mirror.


Tyler is getting closer to posting something on the blog...stay tuned.

Robert

Tuesday, November 24, 2009

Adjusting

My apologies for missing a blog entry yesterday. I hope it didn't worry anyone unnecessarily. I got wrapped up in financial stuff and just wanted to spend time with Tyler.

Happy Thanksgiving.
It is obvious what I'm thankful for this year....that this year is is almost over! ;-) The year started off with ELE (his cat of I think 11 - 13 years) being killed. Then I had my cancer surgery and chemo. Then Tyler's heart attack. I know it goes without saying, but I am so thankful I can talk to Tyler again even if it is about the long road ahead. I'm thankful that Tyler and I continue to survive life's biggest challenges that can be thrown at us. Talk about a reality show!

Tyler continues to make progress and I continue to tell the story of what happened. Or try to. Tyler is visited by so many nurses and doctors it truly is like a revolving door and it is frustrating to both Tyler and me. We get to a heavy part of the story and another person walks in. Also, each different doctor (who has a different specialty) is telling us different things and we keep trying to adjust to new information. Tyler is very determined to get up and out of bed, but something is going on with his right lower leg. It is a large cyst in his calf muscle that is putting pressure on his nerves and his is going to have surgery once the cardiologist determines when he can have it.

Tyler's mini-laptop came in and I'll be taking that to him today. He'll be able to be more connected and the next post you see on this blog could be from him. He is still working at getting his strength back and eating more. He was able to sign his name on some documents so that I can continue to hold things together. His meds keep being adjusted and he also is having problems sleeping. Our next goal is to be able to get him in a wheel chair so we can at least go outside for a little bit for some fresh Houston air (sarcasm intended).

The biggest thing he is struggling with is what has happened and dealing with this new reality. He commented how unreal this was and how he has a new appreciation for what Kelley went through. He is very homesick and getting tired of being in the hospital bed and he is also becoming overwhelmed by all the information coming in and decisions that have to be made. More importantly, he is becoming overwhelmed by the support and love from his friends and family. He has read through the e-greetings that have been sent so far and will be reading the blog and blog comments soon. I hope he understands that there is a reason he is still alive and continues to improve, that there can be a decent life with the LVAD, and that someone with this many friends needs to be around to see just how much he is loved. We continue to talk to the transplant social worker as Tyler tries to digest all that a transplant will entail. We keep getting mixed dates about when he may be able to get out of the hospital and when we could take a trip to visit Denver and when we would have to come back to Houston. All depends on how quickly Tyler recovers. We both have to go to a LVAD class that is mandatory, go on 3 or 4 short "outings" from the hospital, and he has to be able to walk around the 12th floor six full laps before he can be discharged. Once he is discharged I'll have to stay with Tyler until someone else learns about the LVAD. One funny side note is that I was being shown how to switch the controller's cords from the Power Base Unit (beside unit) to batteries as Tyler was being transported to have an ultra-sound and CT Scan. The nurse made a point of how important it was to always have the backup controller and batteries. After they took Tyler away, I was leaving his room and noticed the transport nurses had left the backup controller and batteries. I saw his nurse in the hallway and told her about it. She couldn't believe the transport nurses forgot to take it and I said, ".....okay, that is one demerit. Better not be another."

We are both now struggling with what the future will bring, both start thinking about the long term future, and then try to remember that the only future we can really deal with is the next day. As we struggle to try and get back some normalcy, we are also trying to still make sense of what has happened and where we are headed next. The biggest struggle is making sure I can still work, that we can keep the house, and where we will be living in 2010....Houston or Denver. These decisions will work themselves out but both Tyler and I are very anxious. I'm starting to get angry at different things that aren't really the true sources of my anger. Just going through the anger stage every now and then. Tyler will hit these stages also, but has already commented.. "how could I be mad at anyone for making this decision for me." He understands the situation we were put in and while he struggles with this major adjustment, he knows the decisions made were out of love. I've also told him about the struggles we went through in making this decision for him. We wanted Tyler to be able to have a good life again and made the best choice based on the info we received.

It sounds like the fund-raising event on December 6th is coming along. Many, many thanks to everyone that is donating items for the raffle and that are planning on attending. I've told Tyler about this and it makes him and I cry to know how much support we are receiving. I truly hope that this is good karma coming back to us.

I hope everyone has a good Thanksgiving and that this blog has not been to overwhelming for people to read. I'm truly looking forward to Tyler writing on this blog and things finally calming down enough to spend actual quality time with Tyler.

Robert

Moving Up and the Five Stages

11/23/2009
First, thanks to everyone who has left comments on the blog. I do get to see them but can't reply to them. And it will be great for Tyler to see them soon.

Another powerful day for Tyler. I walked in to see him working with Physical Therapy. Moving his arms around and lifting his legs while in his chair. I mentioned to them that he always wanted to have Jillian (from The Biggest Looser) train him. The physical therapist knows the show and said she would know how to treat Tyler now. (Ha, ha, my revenge!) Tyler smiled his sly smile. They had him stand up while they blocked his feet. He did well but 30 seconds was extremely tough for him to do. He was also having some difficulty ascertaining left from right. But other than that he was doing well. A speech therapist also came by to work with Tyler and test his speech.

I was told an order had been put in to move him up to the "12th floor". I was shocked. He is progressing very well. The 8th floor nurses said they were happy for him but really enjoyed working with him over the past 3 or 4 days. The social worker, Stephanie, came in to see Tyler and told him how good it is to be moving to the 12th floor as it was next step to leaving the hospital. Tyler also mentioned his heart surgery and referred to it as his by-pass surgery. Stephanie told him he didn't have a bypass but had a device implanted to help his heart pump his blood.

I was alone with Tyler before they moved him and he asked how he was supposed to get to the 12th floor. I didn't understand the question and asked what he meant. "I can't even stand for 30 seconds and I'm on the 8th floor. How am I supposed to get all the way to the 12th floor?" I admit I laughed a little. I told him that while he was changing rooms, he was keeping the same bed and that he would get to take another "bed ride" through the hospital. He also asked what Stephanie meant about the 12th floor begin close to the exit. Stephanie talks pretty fast and while it looks like Tyler is understanding it all, he still needs time to process. I explained that the 12th floor was the last floor he would be on before he could leave the hospital. "Oh, great." I then had to explain that leaving the hospital did not equal going back to Denver, and that we would have to see what the next few weeks would bring. "Oh."

When I visited him on the 12th floor he was in decent spirits. Completely exhausted, but in good spirits. My mother was with me and Tyler said to the cardiac rehab nurse, "that is my wife". (Again with that wise-ass smile). The nurse looked at my Mom a bit bewildered, and I responded, "I'll be damned, I'm lugging all your stuff from the 8th floor to the 12th floor, handling paper work, trying to have my business meeting, and taking care of you. Who's the wife!" Tyler and I laughed.
Stephanie visited again with Tyler and I and the surgery discussion came up again. I could tell Tyler and Stephanie were confusing each other so I finally said to Tyler, "you did have a triple bypass, but you also had a pump implanted to help circulate your blood." Stephanie hadn't realized he had also had bypass surgery and Tyler was starting to realize he had more than just bypass surgery. Stephanie went off to get Tyler a print out about his HeartMate II LVAD device.

I had a business meeting (phone call) with my business partners so I told him I would be back and he could take a nap.

When I saw him again in the afternoon we talked some more and went over his food choices for breakfast, lunch, and dinner. By the way, the feeding tube is gone! This helps his voice sound more normal. He then began to look at the cards he was sent and the e-greetings. He got choked up and I asked what was wrong. He said he was noticing the dates of the e-greetings and it was overwhelming to him how long it has been. He then asked, "what happened?" I looked at him, took a deep breath, and asked "..are you sure you want to hear this?" "Yes."

I began by asking him some questions to try and figure out what he remembered. He somewhat remembered Bill, Heidi, and DJ coming over to the house to go to the airport. He also remembered the flamingos and iguanas at the resort and that we liked the resort. I began telling him the story of Sunday and that we were having a great time sitting by the pool and beach, drinking virgin fruity drinks, and that Heidi and him went snorkeling. He also remembered that we went to the lobby to play cards before dinner. As I began to tell him what happened that evening I began to cry a bit uncontrollably. He reached out and grabbed my hand and was crying also. We got as far as being at the clinic preparing for the air ambulance flight. At this point his food was arriving or something, and I said that was all we could do for tonight and to let that absorb. He knows how upset I am and said "..I love you so much." We held on for a minute and then started to move on. Retelling the story was so much more difficult than I had imagined and made me understand the movie cliche of "i had to re-live the event." I really had to re-live the event with Tyler. My mom was trying to take notes at the request of Tyler, but was asking for clarifications as I was telling the story. I finally said that it was in the blog and Tyler could read it soon. I couldn't re-live the story and re-live writing it at the same time.

My mother and I finally left to get back to the apartment. There was a Houston Texans vs Tennessee Titans game that night and the light rail was packed. We finally squeezed into one of the trains and got back to the apartment. I talked to his mom and sister and let them know they could call him. The nurses want him to still go slow with phone calls. Tyler then called the apartment. Weird! I talked to him and asked how his phone call with his sister went. He said it was hard and that he didn't know he had died. I told him that he did technically die, but he was back now. He then switched into Tyler mode again talking about how he didn't know how to work the TV remote and it was "just ridiculous..." This is typical Tyler and made me laugh. I told him to hit the nurse button and they would explain it to him. Ugh! I'm still technical support! He then said, "...well, the reason I really called is I wanted to make sure you knew about the meeting on Tuesday about 'my pump'". Of course he doesn't know that the "meeting" is a mandatory class I have to go to about "his pump", which is a class for the caretakers of the patients that have this LVAD. I said I did know about the class and was going to the "meeting" tomorrow. He also told me that a volunteer had come in and prayed with him, which he said was really good. I also told him to look at his left wrist and the wrist band with my name on it. I let him know that Bill and Heidi had gotten a couple of wrist bands made while still in Mexico and that ours had his name and a heart on them. I said, "....Heidi said that if Lance Armstrong can have a wrist band then so can Tyler". Tyler said that was so sweet. I of course said "...what the hell? I didn't get wristbands made for me during cancer!" He laughed with me. He then said that he was going to finish his cereal, get his pain meds, and go to bed.

As I was thinking about today I realized that I had always thought that the 5 stages of coping was something you did about an event and then it was over. What I've come to realize is that we are going to be going through the 5 stages on a daily basis. Each day brings all the 5 stages but also hope, fear, laughter, sadness, and acceptance.

His family is sending some money so that I can get Tyler a mini-laptop he can use to read/write the blog and start emailing again. Before that I'll continue to fill him in on the past month and while excruciating for both of us, I'm very impressed that Tyler wants to know and is handling it as best as one could expect.

Tyler also seems to be at peace with the fact that the house and animals are being taken care of and that we have some big decisions to make. He still is having problems writing and standing, but he continues to improve every day. It is amazing to watch him struggle with these seemingly minor steps and yet know how huge each step is for him. He is strong and determined and I'm looking forward (although nervously) to him leaving the hospital in the next 3 to 4 weeks.

Nicole is coming out this Friday, the same day my mother goes back. This is going to be really good for Tyler as he has already said, "...well I hope people visit!" I said that he needs to remember that he is in Houston. My mom could tell I was getting tired trying to help Tyler with his menu choices. She stepped up to the plate and "nagged" Tyler the way only a mother can to finish making his choices. I'm able to bring in some clothes and stuff for him on Tuesday and he is very happy about that.

Robert

Sunday, November 22, 2009

Hello Tyler

11/22/2009
Tyler has made very good progress the past few days. No catheter, less IV's, and is starting to pull things together. Some things are still confusing but he knows he is in Houston and has had some type of heart surgery. He is concerned about bills, work, the animals, on and on. Reminds me of me during the first week of this crisis. I tried to reassure him that we would make it through but only day by day.

He is starting to bounce off the walls wanting his phone and saying he is bored. His phone is on the way and I got him a hand held poker game and his iPod. It will still be a while before the nurses are going to allow him to make calls.

This afternoon they didn't have to lift him from his chair back to the bed. He, with support, was able to stand and then be lowered to the bed. Physical therapy will be back on Monday to keep working with him. He is asking a lot of questions and trying to soak it all in. He got sad twice while we were talking but for the majority of the visit he was doing fine. He is not eating much and he may be given medicine to help his appetite.

I said to him, "Do you remember the blog I did about my cancer?".
Tyler: "Yeah. I have one now?".
Robert: "Yep!"
Tyler: "good."

He has shown interest in starting to take over the blog at some point. Of course this would mean that he will be reading the events he has forgotten. He was surprised that we were in Cozumel only for one day. I told him we had a good day up until the attack. He seemed to remember that his phone would be coming from Verizon and would need to be signed for. I had to tell him that Bill and Heidi had already retrieved his phone from the plane he left it on. But what he was remembering is that he had made a call to Verizon about his lost phone and at the time Verizon was going to have to ship him a new one. I don't know if he will remember/realize more fragments from the trip or not.

I also wanted to thank Nicole Bauman for wanting to host a fundraiser. This is one of the first things she talked about when she heard the news. She has it scheduled for December 6th at Rock Bottom Brewery (Tyler's old restaurant). She is going to have a raffle and if you know of any donations, please let her know.

My favorite part of the evening was just sitting next to Tyler watching the Sunday night football game for a little bit. My first goal has been achieved.....

Robert

STEMI - ST Elevation Myocardial Infarction

11/21/2009
Tyler is starting to retain more of the current situation. Memory still foggy. Understanding what month it is, that he is on a transplant list, and that DJ is at the house taking care of the animals. Showed him Karen's (our neighbor) card that she sent from "the kids" (Toby, Bowser, Max, and Marlow). Made him cry a bit. Understands that the kids are fine. Desperately wants to go back to work, call clients, and keeps thinking he can work from home "tomorrow".

He made a comment about the LVAD controller next to him (didn't know what it was) and thought that he didn't need the LVAD power unit at the end of the bed anymore. I told him that he did need the machine and controller and that it was providing power to the pump in his heart. He seemed to accept this, but it doesn't appear that he knows he will be hooked up to these two machines for a very long time.

He was put into a chair for most of yesterday so he can get used to sitting. Is having the catheter removed and some more IV's removed. On a liquid diet and is swallowing pills instead of having them crushed up and put down his feeding tube. He still is very, very thin and a bit bony. I'm hoping he is able to start eating more and gaining back some weight. He weighs around 150 lbs., when normally he weighs around 175 lbs.

Went to the symposium at the hospital. Larry Brown (RN, BSN, STEMI Coordinator) presented information on how to recognize an ST Elevation Myocardial Infarction and proper reading of an EKG. At the end he presented some case studies for the audience (about 150 nurses) to figure out how to read the EKG he was presenting and to see angiograms of the heart begin studied. Tyler's case was presented last. "44 year old male on vacation in Cozumel. Complained of chest pain....flown to Houston...." He then showed the EKG and the audience responded by reading the EKG. He then showed the moving angiogram of Tyler's left side of his heart, before and after being in the cath lab. The audience actually gasped. He then explained that the patient was on the 8th floor recovering from LVAD surgery and doing very well for his condition. It was another surreal experience watching Tyler's left heart just sitting there, not moving.

When I went back for the 5pm visitation, I heard a bunch of nurses in Tyler's room talking to Tyler. They were negotiating with Tyler about putting him back in the bed. I heard one nurse say, "..see, there is your friend right now. And you said he wasn't coming back." Tyler responded that he figured if I wasn't back by 5pm, I wasn't going to make it. He wanted to wait so I could see him sitting in the chair.
He told me that the nurses were telling him what had been going on the past month. After he asked, I started filling him in on the events of Mexico. He was surprised that we only got one day in Cozumel and didn't know that we had gone with Bill and Heidi. I got as far as telling him about getting him to Houston, but stopped because it looked like it was becoming to much information. I did explain that we haven't been home for a month so far. He didn't like that but seemed to take it in stride.
He is worried about things "falling through the cracks". I let him know that things were being handled as best they could be, but that this was going to be a huge change to our lives and that we both could only take things day by day. Also, that his primary job was to eat and get healthy.

After he was moved back to the bed, I noticed that his wires were tangled and that his monitor was showing wild movements of his heart. When the nurse came back in I was looking at his right side. She asked what I was doing and I responded that I was making sure his drive line wasn't bent. She seemed to change her attitude towards me (from being a little to much Nurse Ratchet!). I also asked about the monitor and she explained a lead had come loose and not to worry. Hmmm, not to worry.....I wish!

At this point I'm hoping that he continues to fill in the blanks as best as he can and maybe sometime next week really "wakes" up. I also know that when this happens it is going to be extremely hard for him. He will continue physical therapy and once he can take enough steps on his own, should be moved to the 12th floor. I'm looking forward to this as the visiting times are less restrictive and I can spend more time with him.

Robert

Friday, November 20, 2009

And then the next day

11/20/2009
As I was hoping the next day was better. Tyler does better in the morning after he has had some rest (and probably me to). He is still foggy but not as bad as yesterday. The nurses started to comment how Tyler is being satirical and funny with them. The social worker told Tyler that he was on Seroquel because he might be experiencing anxiety. Tyler's response: "You think!".

In the morning he thought we were at Mary Alice's house. This was the name of the nurse on duty. Also thought it was Wednesday, but when I told him to look at the board he saw that I had written that it was Friday, the 20th of November. Seemed like it amazed him it was Friday and not Wednesday, but didn't faze him that it was November.

In the afternoon, the physical therapy nurses came by and got him to be able to sit up on the edge of the bed. This had worn him out completely. It is amazing how much of his muscles have atrophied.

A nurse from the cath lab that had been there when Tyler was first brought in came by to see Tyler. He wanted to see the progress Tyler had made and to let Tyler know that Tyler's case was being presented on Saturday to a large group of doctors. The nurse told Tyler that after an accident, he was in the hospital and in recovery for over a year and that if Tyler wants to rebuild your life, he can. Tyler seemed to stay very focused on what he was saying.

I bought him a ball to work on his hand strength. He is now being given a liquid diet (thick apple juice, soup, thick tomato juice), but is still being primarily fed through the feeding tube. Tyler is very thin.

He also talked about Toby again and wondered if Toby was okay. He wanted to see Toby on Saturday, but I explained that Toby was in Denver with DJ and was being taken care of. He then came back to reality and said that he understood, but missed Toby.

The physical therapy really wore him out and he went to sleep pretty quick. I stayed with him awhile and then finally had to leave. Tyler seemed to only "check out" a couple of times while I was talking to him. He continues to want to get back to work, walk the dogs, and more. The nurses and doctors are bringing him up to speed on the medical side and I will have to start bringing him up to date on the personal side. To be honest, I'm not quite sure how slow to go as there are some very large decisions looming. But for now, still 'kid gloves'.

Robert

Still Foggy

11/19/2009
This morning Tyler had the remaining chest drainage tubes removed. He was glad the tubes were out since they were very uncomfortable. A nurse showed me where the ice chips, crackers, soda, etc. were and when he is able I can just go get these for him. I'm trying to adjust to this new hospital floor. The nurses don't talk a whole lot and aren't around much. Nice and bad at the same time. I get to spend more time just talking with Tyler, but don't exactly know what he can and can't do or his status on things. I just have to adjust. Talked to one nurse who said I can bug them whenever I need to.

They will do a test to see how well he can chew and swallow so that they can start moving him off the feeding tube.

He is retaining more, but still very confused. He seemed to remember that we are in Houston, but then commented how weird the weather was for this time of year (lapsed back to thinking we were in Denver). Was upset that we missed Thanksgiving dinner at Kelley's. He wants his phone desperately and wants to go home. He sneakily asked me if we could go have a cigarette. I told him that we don't smoke anymore. He responded: "oh, good". He knows he had a surgery and knows he is going to need another. I told him that was far into the future and not to worry about it. He is coming up with a plan on how he is going to work when he gets out of the hospital. "20 hours a week at first just like Warren (contractor/friend) did after his heart surgery." He misses the house and family. Wants to be in his own bed. Then he was worried about his car. He also told me that he had talked with his mother and his uncle. He even thought one of the doctors was Wilfredo (a friend from Puerto Rico). I also had to get on to him about winking at the nurse, Edith!

The afternoon was harder. I think I tricked myself into thinking that he would be clearer and clearer, but he seemed more confused. When he had lucid moments they were sad. He said the hardest thing was the lack of intimacy, since I couldn't stay with him for very long on my visits. He mentioned he is in pain, but he is also moving his legs more. His cardiologist, Dr. Sherron, happened to be there so I asked if this was normal at this time. He said yes, but then became a doctor and said they just won't know how much he will retain of the old Tyler. Didn't need to hear that! I'm very scared for Tyler (and me). I need Tyler to be clear headed, out of the bed, back to work, back at the house, back to his old voice......normal. I also know that once he is clear headed, he may become very depressed about the situation. One day at a time.

The doctor commented to Tyler that he had been in a hospital bed for a month, then looked at me and said I would know better. I responded immediately, "3 weeks and 4 days". He also told Tyler that he would probably be in the hospital for another month. I found a lot of e-greetings that have been sent to us and felt bad that I couldn't read them to him just yet. He is still to confused. I just can't get his bewildered look out of my head. Maybe mornings are just better since he gets rest over night. As I left he asked for the lights to be turned off since he was resigned to just going to sleep.

I left the hospital feeling very depressed, confused, and sad. Finally I called Janet (from Arkansas who's husband went through this) and checked to see if this was normal from her point of view. She said to be patient and the fogginess would eventually lift. It may be a few more days or a week.

I've started writing the current date on a dry-erase board that he can see from his bed. I'm also going to see if I can start helping him with moving his arms, legs, and fingers. He has lost a lot of weight and muscle tone. Still looks good, it is just those eyes.

I am looking forward to when Tyler realizes just how many people are out there supporting him. Again, I can't thank everyone enough. When I got back to the apartment I cried with my mother and finally said, "what did we do to deserve this year!". A moment of anger that I got out of my system. On to the next day!

Robert

Thursday, November 19, 2009

Talking, but confused

11/18/2009
I saw Tyler at the morning visitation. He has been moved to the 8th floor ICU (one notch below the CV ICU, but still ICU). His new address is: 8 Cooley A, Bed 2. He recognized me but is confused. His voice was a little better and I could understand him more.
Robert: "Do you know where you are?".
Tyler: "Ft. Wayne, Indiana". (I think this is based on hearing his family's voices)
Robert: "No. You are in a hospital in Houston".
Tyler: "Oh".
Robert: "Do you know what happened?"
Tyler: "No."
Robert: "You had a heart attack."
Tyler: "Oh. Is everyone else okay?" (he thinks there was a plane crash).
Robert: "What do you remember last?"
Tyler: "I was meeting with Anne Mounsey." (I believe that was the day before we left for Cozumel)
He was able to tell me he was cold, so I got a nurse to bring a blanket. The nurse said he had told her he was warm. I explained that Tyler bounces back and forth between hot and cold. Must be menopause! He also was fixating on bills, and I told him things were being handled. I looked at his heart beats per minute and they were getting high. Good ole Type A personality. I told him to relax, just relax. That is all he needs to do. He had yawned a bit, so slowly he started to fall back to sleep and I watched his beats per minute drop and his monitor stopped alarming.
The neurologist had seen Tyler before I got there and is still happy with his progress. I told Tyler I would be back in the afternoon.

The afternoon visit became hilarious and let me know that Tyler was becoming Tyler again. His voice was even better, but still weak and he is very confused. When I got in to the room I asked him how he was doing. "Well, I've been laying here doing nothing and you weren't here forever. I mean what am I supposed to do if you are gone all the time." Okay, Tyler is coming back. Then he went loopy. He told me that the doctor had told him that the doctor rushed surgery and that the doctor should have waited. Because the doctor rushed surgery, he was going to have to have another surgery. I think Tyler picked up that he had surgery and knows that he will eventually have to have another (when a heart becomes available). He also thought he was now in Kelley's house (his friend and business partner). He rattled off some figures because he wanted to prepare for taxes. Something about a party he needed to get ready for tomorrow. He just kept talking and talking and talking and talking.

I told him his family had been to visit and that his Mother and sister were planning on coming back. Tyler: "For Easter?". I'm not sure when he is going to realize the current date.

He asked how long it took to get home. I said 15 minutes to the place I'm staying at right now.
Robert: "Did you mean Denver?"
Tyler: "Well, yeah."
Robert: "About 20 hours."
Tyler: "That's ridiculous!" (in that typical Tyler inflection).

Of course the other lucid moment Tyler had was when I talked about the house.
Tyler: "Do you think Toby misses me?"
Robert (in my head): "Are you kidding me! Of course you would ask about Toby"
Robert (out loud): "Yes, he misses you and we'll see him soon."

The nurses have been able to start giving him ice chips finally. Still being fed through a tube.
Tyler: "You just don't know how good water tastes until you haven't had it for awhile."

My mother is in Houston now and will help a lot. I had to admit to Tyler's mom that I had lied to her about when she was coming in. His mom is worried about me and was somehow under the impression that my mom was coming in the same day they were leaving. I lied because I wanted his parents to feel okay about leaving.

So, a better day. Voice is coming back and they are already starting him on physical therapy. It is great that I can talk to him again and when I said I needed to leave, he moved his head toward me and pursed his lips for a kiss. After 3 1/2 weeks....finally!

Today was a great day!

Robert

Tuesday, November 17, 2009

No tube, No tracheotomy.

11/17/2009
Today was another good step forward. Tyler is more alert and drifts away less. He also had the breathing tube removed because he can breath on his own. Because of this they didn't have to due a tracheotomy. He is looking around more and had a lot of visits from the nursing staff. He is trying to talk but his vocal chords aren't ready quite yet and he barely produces a whisper. He is in a lot of pain but is hanging in there. He also keeps trying to grab his feeding tube to try and remove it. It has got to be irritating having a tube running through his nose. Until his vocal chords repair themselves he can't even have ice chips because the water may trickle into his wind pipe.

A cardiologist explained to Tyler what happened medically over the past three weeks, but he may not remember what he was told. Hopefully he will make more progress today and in the next few days be able to talk a little more. At the last visitation I read a couple of notes/cards to him, including a note from his mother. I also let him know the huge number of people thinking of him. A lot of his nurses stopped by to say hi to him and I thought .."typical Tyler, even in a coma he makes friends"! But I also think he is overwhelmed by the situation. He will probably be moved to another floor today (still an ICU) and they will begin physical therapy.

I was also shown how to change the dressing around his drive line and was given a kind-of pop quiz about the LVAD. The staff asked if I was going to LVAD class and my response was I still was trying to handle things and that I've been bugging the nurses about the LVAD already. I know they do understand but it felt like I had to remind them that I still had fires to put out, other fires to prevent, and needed to work so there could be some income coming in. While it is great that he is breathing on his own and didn't have to have a tracheotomy, I'm still concerned about his state of mind. To wake up three weeks later, be in a hospital (in Houston), having an implant, and a cord running out of him has got to be a living hell. It appears he doesn't remember going to Cozumel and it will be good to know what was the last thing he remembers so I can start to bring him up to date.

For me, I'm realizing that as he gets better our lives continue to get harder. My short term goal is to be able to watch TV with him, but with the H1N1 flu going around the visitation times are pretty restrictive. Only four times a day and only 30 minutes at a time. I'm trying to remain as strong as possible and am worried about Tyler being upset and depressed. I keep reminding myself that Tyler has quite the strong personality and will overcome this. I'm also working hard to be "normal" with Tyler. The nurses wanted me to bring in balloons, jump up and down, and be celebratory but I needed to just be with Tyler quietly. To watch him look around at all the tubes, IV's, and equipment as he tries to take it all in is disconcerting for me. I'm working on trying to be upbeat but I think since he is medically okay, my adrenaline is dropping and I'm starting to have some moments to really understand what has happened over the last three weeks and what is about to come.

Okay, I'm going to get my attitude in order and tomorrow's post better be upbeat! My mother is here today and will be able to help me with a lot of things and beat me into shape!

Robert

Monday, November 16, 2009

Awake, almost

11/16/2009
Today was a good but odd day. I arrived at the hospital early and called in for a status. The nurse said Tyler was responding to commands and they asked him "Do you want to see Robert". He nodded his head up and down. They let me go in ahead of the normal visitation schedule. It was great to see him more alert. I gave his mom a call and told her she was about to have a long shuttle ride. I told her he was awake and alert and she was over-joyed. I think she may have considered running to the hospital instead of waiting for the shuttle.

He still fades in and out due to the drugs still in his system. They have stopped giving him any sedatives, unless he gets to agitated. He was given a clean bill of mental health by a neurologist and also had a complete CT scan. Everything looks good and he was able to complete all the tests given him by the neurologist. It is very encouraging and all his doctors were pleased. He will remain in the CardioVascular ICU for a least one more day and I'm hoping tomorrow he can get the tube out of his throat. He'll then be moved to another ICU on a different floor. Unfortunately the visiting hours are the same so I basically only get to see him for 30 minutes at a time. The nurses usually let me stay longer, but I want to be able to spend more time with him.

We saw Tyler again at 5:00 pm. His eyes were wide open. He kinda looked angry to his Mom and me, but I think he was more confused/scared. His Mom and Dad talked to him mostly. I just kind-of stared for a while. At the end, after his Mom and Dad stepped out of the little room, I looked directly at Tyler and told him he was going to have to work at this, but he will be fine. I asked if he understood and after about 20 seconds he nodded his head. I think at this point he is just coming to realize he is in a hospital and doesn't understand what is going on. His eyes seemed to keep looking around at all the equipment. He still can't move or talk and I'm sure that must be a nightmare for him. I don't know if he knows it has been three weeks.

For me, while being great that he is more alert, it was a busy day like all the others.
I wanted to stay next to Tyler all day, but what is hard is that there are so many things to stay on top of and I need to do some work for my business. I'm starting to understand the thing that makes this so hard. I'm trying to set up a life for Tyler and me in Houston for now and I want to just be with Tyler by his bed side. But the reality is that I need to work while trying to get things going in Houston. I'm basically just putting out fires all day and trying to prevent new ones.

His parents leave tomorrow with heavy hearts. It is going to be a very, very hard day for them. They wanted me to express to everyone how much they appreciated the thoughts and prayers. I've been able to share the blog and your comments with them. They have been wonderful to me and we have had some interesting days! They explored yesterday and found a tunnel running between St. Luke and Methodist hospital. We took the tunnel to go to the Methodist hospital cafeteria which is much better than St. Luke's. Going through the tunnels with them was hilarious. We weren't sure at times where we were or how to get there. We eventually found the cafeteria and even found our way back to St. Luke. They also had a lot of fun playing in the tunnels. I'll miss them, but his mother and sister are planning on coming back to Houston in a few weeks or so.
They also wanted me to post their address and email.
donswoverland@verizon.net.
8725 Crosier
Ft. Wayne, IN 46825

I also ran into Mitzy again (the lady from the first night at the hospital). Her husband is not doing well which was sad. She asked about Tyler and it was a little odd to say he was doing pretty good so far and waking up. It is interesting that I'm developing a group of "disaster" friends here in Houston. I already had a disaster buddy in Colorado for this year. What the .....?! Is 2009 over yet!?

Thanks for all the comments on the blog. I'm looking forward to sharing these with Tyler!

Robert

And then a better day

11/15/2009
Today was a better day. Even though today marks 3 weeks from the initial heart attack.
This Hallmark movie continues on.

We met Nurse Carlton. He was very informative and let us know that they were once again trying to get Tyler off the sedatives (fentanyl, adavan, etc.). They were now using Seroquel to keep Tyler relaxed, but it isn't a sedative. In order for them to remove the tube running down his throat, Tyler has to regain consciousness, so that he can clear his throat and breath on his own. The longer the tube is in his throat, the greater chance of vocal chord paralysis. Again, didn't want to hear that but have to be prepared.

We were introduced to Janet and David who went through a very similar experience. They were dropped into Houston (they lived in Arkansas) and David had an LVAD placed also. He was unconscious for almost two months. They showed up Friday and I was shocked. There he was walking around with a little bag holding his controller and batteries. He can talk, but very quietly and has trouble forming some words. He had a lot more complications than Tyler, so if he can recover I know Tyler can.

Tyler has begun to have more facial movements (he looks pissed!), and moved his leg and arm a little bit. We continue to talk to him and I swear he can see and hear us. He is running a temperature but is also continuing to work his bladder. A great sign. He also has a pulse that you can feel. Not insignificant. We were told he wouldn't have a pulse because the LVAD is a "continuous flow" device, so in order to check his blood pressure the hospital would have to use a Doppler method. Having a pulse means the left side of his heart is still hanging in there. What we are hoping for now is that the implant will continue to support the healing of his heart and maybe the end-game will be that Tyler will be able to have the LVAD removed and not need a transplant. We have been told that this is a slim chance but I've decided I can hope and pray for this.

He also produced two tears (one from each eye), while his mother and I were talking to him. I also have to believe this is him communicating with us. I know he must be scared and still wondering what is going on. I'm hoping today will show even more signs of "waking" up.

I have posted two more entries ('Back to Houston' and 'More on the First Week') to finally get the past few weeks up to date. I know I'm forgetting certain things and more importantly the moments of humor. Such as standing across the street watching his parents. We got split up and I was going to meet them. I looked across the street and saw his father wandering around at one end and his mother at the other end looking for him and me. I finally noticed her seeing his father, shaking her head, and running to catch up. When they got across the street to my side, still not knowing I was there, I was laughing. We make each other laugh.

His mother also got onto me about drifting off. Many, many times I would just be staring off into space. She asked what I was thinking of when I did that. There truly is nothing particular I'm thinking of, I just see Tyler's name in my head as I'm still trying to comprehend this situation. His father said he was taking offense at this since I tended to drift off when he is talking. I just said, "hmmmm, isn't that interesting", while laughing.

Nicole is closer to setting the date for the Denver Rock Bottom fund raiser. She has her plan together and I won't be able to thank her enough for this.

I continue to try and keep Tyler's affairs in order as best I can and to manage my Colorado and Houston lives. But today I need to start working again. Wish me luck.

Keep your fingers crossed and the thoughts and prayers going for today!

Robert

More on the first week

I'm trying my best to write the events in the order they happened but am missing some things. Most important, his family arriving.

His family arrived on Wednesday, October 28th. I was able to get them up to see Tyler even though it was outside of visiting hours. His family and I quickly had to learn each other on a different level than we had known before. We all have Tyler's best interest at heart and were trying to work through all of the information we were being given. We finally had "the talk" to decide together what we thought the best decisions would be. We even signed and made copies of the decisions we had made so that as things happened further down the road we could refer back to when we were the most logical we could be during this. I went to confirm our understanding with one of the nurses and one of the doctors. The doctor said we were being extremely reasonable, even though there were never right or wrong decisions necessarily. (I like this particular doctor a lot. He has always kept me in the loop of things and been patient when asked the same question over and over. But, I haven't seen this level of CYA (cover your ass) ever before and I worked in a banking institution for 4 years.) The nurse explained that the family was "literally" on the same page and I showed him what we had signed together. His jaw truly dropped and he kept saying, "no one ever does this, no one ever does this!". He thought under the circumstances we were doing very well. We would be reminded of this 'signing of the paper' story a couple of times by the St. Luke's staff.

At one point during the first week I was there, I noticed his mother patting his arm. I mentioned that only a month or so ago, Tyler had hugged me and was patting my back. I asked Tyler what that was all about and he said "...that is how my mother did it". Of course I meant this in the best way and his mother started to cry. I looked up at the nurse at the foot of the bed and she was tearing up also. I asked Barbara, the nurse, if she was okay and if there was anything I could do for her in her time of need. This broke the sadness a bit.

During this time we were also trying to figure out how to legally deal with things since his family would need to get back home and I would be in Houston. Without a power of attorney from Tyler the only option was to petition the courts in Houston for guardianship. A very expensive and long process. I finally harassed enough people at St. Luke's to find out that any legal consents needed could be done by phone with his parents. His parents decided they would stay until I got back from Denver. They ended up staying for almost two weeks after I got back.

We started to meet a lot of the St. Luke's staff that would help guide us through this situation. Did I mention how surreal this still is? Besides the nurses and doctors, we met Stephanie (transplant social worker), and Mary (hospital chaplain).

Trenton and Temple found the Blood Bank at the hospital and gave blood before leaving. They also began discussions with Kelley about fundraisers. Bless them, because my head was beyond thinking about that stuff. The night after the meeting with Stephanie (in which she discussed all that we were facing), I looked at Kelley (she gracefully got a room at the Marriott for both of us) and began crying and saying I just wouldn't be able to handle all of this. She kept saying I would be able to handle it and I agreed, but I just need to release some of the fear. I was beginning to realize how long and hard the road was going to be for Tyler and I. I also started to understand that I wasn't going to make it back to the resort with Tyler after all.

Tyler's parents had met Mary, the hospital Chaplain. She prayed with them and she also introduced herself to me. Told me if I needed anything to let her know. I just kept saying that I would get in touch with her someday if I needed anything, blah, blah, blah. I didn't think I was going to need to talk to a Chaplain. My spirituality was intact. I'm logical. Thanks, but no thanks. That changed one morning during a melt down. I was standing next to Tyler's bed and just began to cry those heavy tears again. Tyler's mom came in and saw this. I noticed the look on her face and I kept saying ... "he's fine, he's fine, it is just me". His mom hugged me and cried a bit with me. At this point I grabbed Mary and took her to go talk. I talked to her for about an hour and it was a good counseling session. God/the Universe was sending me what I needed, when I needed it.

Sunday, November 15, 2009

Hard Day for the Family

Yesterday we discussed with the doctor about Tyler's waking up progress. He explained that it may take a week before he actually wakes up and there was a possibility that he may never wake up. Needless to say I was pretty upset. Then I understood that Tyler is still on sedatives and they are trying to ween him off. The problem is that when they stop the sedatives, he starts to hyper-ventilate. So it appears it is going to be a slow process.

His parents and I were in a funk, but by yesterday evening re-assured ourselves that Tyler is strong and will come through this. Amazing, but we are all looking forward to Tyler yelling and complaining.

Looks like by this afternoon he will probably have to have a tracheotomy so they can remove the tube down his throat. While I don't want this, it will be better for him and maybe the hyper-ventilating is due to him not liking the tube.

Some of his chest drainage tubes were remove along with some PIC lines. He "moved his bowels" or as the nurse said "he made a poopy". This is another good sign that he is coming back.

The nurse handed us a paper that showed how much blood product Tyler has used so far and encouraged us to donate. Of course the three of us can't donate blood (me for at least 5 years due to the cancer and chemo), but Temple and Trenton (brother and sister of Tyler) donated while they were in Houston. The information was for the local blood bank in Houston. At this point if you would like to donate blood, go to your local blood bank and you may be able to donate it in Tyler's name. This wouldn't mean it would go directly to Tyler or to Houston, but thank god people donated in Houston so Tyler could have theirs. They don't want to give Tyler to much blood because it makes it harder down the road to match to a donor heart.

Robert

Saturday, November 14, 2009

Back to Houston - 11/3

Dane, DJ, and I got the car packed up and we left at 3:30 am on Wednesday morning. I originally thought we would leave Tuesday, but I just couldn't get everything done I needed. While still in Colorado on Highway 287, I got pulled over by a cop. Thankfully the cop didn't write a ticket and was very nice. I pulled away from being stopped and within 1/4 mile was already speeding again. Hmmmm, wonder why. I looked at the speedometer and immediately pulled back over. I told Dane she would have to drive. I finally got some sleep in the car and started feeling better. The drive was pretty uneventful and took us about 19 hours.

We got back to Houston and as we were driving down I-45 I started to see familiar landmarks. Unfortunately these were the landmarks I saw riding in the ambulance a week earlier. Dane noticed I was getting tense and anxious. We spent the first night with Tyler's parents, but I went to the hospital first to see Tyler. When I got back from the hospital I just couldn't go up to the hotel room. I probably spent an hour talking to Melissa expressing all the fears I had.

It is still amazing to me that Sunday 10/25/2009 has never stopped. I'm always confused as to what day it is and just feel like this has been one continuous day.

Tyler continued to remain pretty stable over the next few days and I continued trying to get on top of the situation. His brother and sister had gone back to their homes, with his Mom and Dad staying at the hotel. His parents were planning on leaving Friday (Nov. 6), but we started to hear from the doctors that unless a heart came he was going to have the LVAD surgery. They decided to stay longer. By this time his parents and I were getting closer and closer to each other. What a wonderful bonding experience for us! The following day after I arrived, his parents, Dane, and I visited Tyler at night. The nurse, Barbara, mentioned that I was being very quiet (unlike me she said). I just said I was exhausted from the drive back. I was at a point that I didn't care about the medial details, I just wanted to know he was still doing good for his condition. His parents left and I mentioned that I needed to do something. The nurse pulled the curtain and I began reading two cards to Tyler that our neighbors (Karen and Dave) had given me. I started describing and reading the cards and was having a hard time getting through them. I looked up and Dane and the nurses were tearing up and crying. I asked if there was anything I could do for them! Dane felt bad about crying, since she was there to support me and felt she should hold back and be strong. But she said the emotion was just to much for her not to cry.

Dane helped me buy groceries and get set up in Houston. It was good to have someone to talk to those first few days back in Houston. She flew back on Saturday (11/07/2009). I spent the next week with his parents riding the roller-coaster that this experience is. The first Sunday I was back, his Dad invited me to their hotel room to hang-out and watch football. I wouldn't have TV until the end of the following week.
His parents and I got closer and closer over the next week. We spent our time visiting Tyler, meeting with doctors and nurses, meeting with social workers, trying to stay on top of finances, meeting with social workers, meeting other patients. Finally on Tuesday (11//17/2009) the doctor's decided to proceed with the LVAD implant. We understood but felt if we could get a heart that would be better. In fact it appears that due to the Ft. Hood incident (I never knew what happened at Ft. Hood), the hospital had received to "offers" of hearts for Tyler. They weren't the right size so both had to be refused. The LVAD surgery might be a "blessing in disguise" (copyright permission goes to my mother).

We were then introduced to Peggy, the LVAD coordinator/social worker. She showed us the LVAD pump and explained how it worked. Yet another freaky, surreal moment. I'm holding what will be going into Tyler. She of course gave us overwhelming information and she noticed that I was just staring at a piece of paper. She asked if I was okay and I just said, "...this is so much information that I can only take in so much at one time, and know I will be told again." She commented that I just got a 'gold star'. Like it was some pop-quiz. At the end she made us sign some papers. Basically these papers are a pseudo contract that states I, Tyler, and his parents will do certain things so that Tyler can stay on the transplant list. Peggy said, "Since I know how much you like to sign things, I have some papers for you to sign". My response was, "..so you know about that?". She then said we have received multiple gold stars for the paper we all signed about decisions, and that the entire 2nd floor ICU knew about it. That was good for a little laugh.

Then I got this blog together and started making daily updates on Tyler's progress. Many thanks to Dane for styling the blog since that is not my specialty. I was still a bit foggy and his parents and I continue to take turns crying and consoling each other. His parents have been here in a hotel room for almost three weeks straight.

I will continue to say the following many, many times. The support and love from all of our friends and family is so much appreciated. I've not been shy at all asking for support since I'm in full protection mode for Tyler. I'm comforted in knowing how many people are taking care of things like the house, our "children", help with the blog, fund raising, and thoughts and prayers. When a need arises or a decision has to be made, I'm always presented in my mind with the right person. I know a lot of people would like to visit or do whatever they can to help. Please accept my sincere thanks and keep hanging in there with us. I'm still slowly accepting the fact that Tyler and I will be in Houston for quite a while and that our lives have radically changed. If I can just bring our loved ones and maybe the house into this new reality then we will be fine. If I can hold onto some of Tyler and I's previous life, we will be fine.

Status - 11/14/2009

I saw Tyler this morning at about 5:30 am. He was sleeping but slowly tried to wake up. He is still under the influence and his muscles in every part of his body are weak. He opened his eye lids and move his eyes a bit. He also had some deep yawns, but then gagged a bit on the tube running down his throat. He then started slightly moving his arms and legs. Maybe by the 10:00 visitation he will be moving more (fingers crossed). I was also told that his breathing had improved (he is still on a ventilator). Right before I left, I said I was leaving but would be back, and a single tear came out of his eye. I don't know how much he is really comprehending right now, but can hardly wait for him to at least get past the next day or two.

Things change day to day, but it looks like he will be in ICU for a couple of more days. Then he will be moved to the 8th floor, where rehab will start. We are still looking at about 4 - 6 weeks before he would be discharged from the hospital.

R

Friday, November 13, 2009

Status Update - 11/13/2009

Yesterday Tyler was taken back to the OR to sew up his incision after drainage. He had his eyes open after surgery and was able to move them just a little. He moved his head, leg, and arm about once. This morning he was more alert and moving a bit more. He actually could look directly at me and would move both arms slightly every now and then.
He is still unable to communicate but I'm hoping that will improve over the next week. It is harder to leave visitation now, but he is in good hands.

Thursday, November 12, 2009

Unstable to somewhat stable - 10/27 - 10/31

Tyler remained in the Cardiovascular ICU into Tuesday (and is still there). Dr. Scott Sherron and two nurses got Kelly and I and took us to a room. We both knew this can't be good. The doctor explained that Tyler was still very unstable and his heart was racing back and forth. At this time I told the doctor that he needed to call his parents directly since they would need to sign consent forms.
After the doctor talked to Tyler's father, he looked at Kelly and me and said, "You need to get out of the hospital". I knew what he meant but couldn't resist saying, "Wow, you are kicking us out already?!". The doctor at first was shocked but then realized I was joking and laughed. They left us in the room waiting for an admitting nurse and that was when we both broke down. It was a hard but good cry. We picked ourselves up and kept dealing with the issues we needed to.

We finally were able to see Tyler and his nurses. His bed was in what I call a cubicle room. While standing there I started to cry again and the nurse asked if I would be all right. My comment was .. "I did my part, now it is up to you". The staff at St. Luke's is beyond wonderful and I immediately felt that they would be the best to help Tyler.

Over the next few days, we continued to visit his bedside and got updates on his condition. Besides his heart all other organs were doing very well. The main comments from the nurses was about how strong a fighter Tyler was. He kept trying to wake up from the sedatives and sit up. By this time he had a tandem heart in place which meant he could only move about one inch before dislodging the tube running through his heart. One nurse even made a comment that she was to old and small to try and keep Tyler pinned down. They had to put him on more sedatives and paralytics so he wouldn't move.

At some point a doctor came in and made a comment that a decision might have to be made in the next 24 hours to implant the LVAD. His parents were preparing to come to Houston at the time. Kelly and I quickly asked pointed questions to understand what this would mean for Tyler and his quality of life. We finally came to the point that I had gone through cancer surgery, she had no use of her legs, and Tyler would just have to deal with an implant. The last thing we wanted was for Tyler to be stuck in a hospital bed for the rest of his life. Fortunately we ended up having two more weeks before that decision had to be made.

The rest of the week we kept checking on Tyler, meeting new nurses, and trying to update as many people as we could. One nurse finally commented that we needed to realize that we were still in shock and would be for many days to come. At this point I started relying heavily on DJ to take care of the house and coordinate things in Denver.

I was told by the nurses that if I need to go back home to take care of things I should plan to go very soon. Tyler was going to be sedated for quite a while and if I waited I would never get back. It was with the heaviest heart I've ever felt that I went back to Denver that Saturday. I was at the hospital at 3:30am for one last visit and never felt such heavy tears fall from my eyes. I finally said good bye and slowly made it back to the hotel. I called a friend, Michael, on the east coast (and woke him up) just to talk. Kelly and I made it to the airport somehow and basically drifted through as we had been doing all week. We looked like hell.

Denver had a major snow storm while I was gone, but DJ shoveled out the house before I got back. Another friend, Jim, had also stopped by with a shovel to help, but DJ had already finished.

I got back to Denver and DJ picked me up from the airport. We were headed home but I decided that I needed something to eat. We went to Sloan's Grill in Edgewater. As we passed 29th Avenue (down the street from the house), I asked DJ if he knew what I was doing. He knew I was avoiding the house for a little bit. DJ and I had lunch and finally went to the house. It was so good to see Toby (beagle), Bowser (lab), and Max and Marlow (the cats). I was still in a mode of getting things done since I only had 3 days to get ready to go back to Houston. I avoided really looking around the house because I knew I would feel an emptiness. Neighbors came over to check on me and Dane and Diane Doyle showed up to figure out how to help me out. Bernie and Jim helped the next day repair the fence that Bowser destroyed and tighten up the kitchen sink faucet.

Over the next three days I just kept busy trying to get everything together I could and pack what I would need. One problem was that I didn't know how long I would be gone and didn't know if I would need to pack everything possible. Finally (with direction from DJ) I started to pack. Being at the house wasn't to bad since I was always exhausted by the time I went to bed. One day, around 9pm, I finally decided that I couldn't do anymore that day and would watch a little TV. It was at this point that an odd guilty feeling came over me. There was just so much to do and I was going to watch TV? Tyler was in Houston fighting for his life and I was going to catch The Daily Show? I talked this over with Dane. I felt like I wasn't thinking of Tyler enough. Dane graciously explained that everything I was doing every moment of the day was for Tyler.

Towards the end of the first week in Houston and back in Denver I had decided on a 100% honesty policy. So many people were asking what they could do and I was being honest with them about what I needed. I never held back any requests and also felt I was leaning on DJ and Dane very hard. My business partners were working very hard to keep control of the business and met me Monday so I could transfer things to them. Everyone who stopped by or called got a request from me. Nobody refused. All of Tyler and my friends and family continued to be extremely supportive. Those that are able will eventually be able to come to Houston. Those that can't can help me with things in Denver. And everyone can continue to think, pray, and mediate about Tyler for his well being.

I was able to walk Toby and Bowser a couple of times while I was at home. I kept thinking I didn't have the time, but it was very good for me. By the second night all the critters were sleeping in our bedroom again. Toby of course kept looking for Tyler. How I can't wait to reunite those two! Bowser was sick for some reason I still don't know. He threw up and then had bad diarrhea for about a day. Of course he had diarrhea in the middle of the night also, so I had to get up to let him out. Or did I? One time standing outside I heard the flaps of Toby's dog door. Out comes this large black lab through a door meant for a beagle! While odd it reassured me that the kids would be okay.

While in Denver I talked to Nicole about the fundraiser she wanted to have and about a website for status updates. I could tell I was loosing the battle in trying to keep everyone updated. Tyler just has so many great friends. Once back in Houston I finally had some time to set up this blog.

11/11/2009 - Surgery Update

Tyler went into surgery today around 8:00 am. This surgery was to implant an LVAD (Left Ventricle Assist Device) so that the left side of his heart could begin pumping blood through his body. They also had to do three by-passes on certain arteries of the heart.

This afternoon his was moved from surgery back to the Cardiovascular Intensive Care Unit, but to a new bed. The surgery went very well, but this is just the beginning of a very long road for Tyler. They are letting him slowly come out of sedation just long enough to ascertain his neurological state. Then they will sedate him again. His sternum has been wired back together, but the incision is still open for now. If all goes well over night then they will close the incision tomorrow.

I will be posting more information as I have time to explain what happened in Cozumel and start doing more updates since this blog is up and running. I do want to stress that Tyler is still far from being out of the woods and it appears we will be in Houston for many more months to come. This is actually the beginning of the long road for Tyler's recovery and he will need a lot of rest and care along the way.

He can receive cards to the hospital but no plants or flowers of any kind.
The hospital's website is: http://www.sleh.com/sleh/index.cfm.

Robert

St. Luke's Hospital - 10/26/2009

At this time it was just about midnight. We had gotten Tyler to the Hospital around 9:30pm. I met the lady who had shouted "is that my husband". Her name is Mitzi and it was great to talk to someone and console each other. I still didn't my phone so I stared making credit card calls trying to get in touch with Kelly. I still didn't know she had been notified. Also at this time Dr. Karr and Dr. Sherron came out to tell me what was happening and that Tyler not only had a massive heart attack, but that due to the delay his heart was very damaged. Comments like, "if he survives tonight" were being made.

Kelly arrived at the hospital and was able to notify me. I met her out front and she told me she had already talked to DJ (our friend who rents Tyler's apartment). I used Kelly's phone and called DJ. This was when I really started crying. The overwhelming feeling of the situation took over and I was scared. This is also the moment when DJ was put to the test by me and has passed with flying colors. He got in touch with our house sitter, explained the situation, and now has even moved in to the house to take care of the "children" (Toby, Bowser, Max, and Marlow). I also called an updated him Mom and Dad about what was going on. It was becoming apparent that they were going to need to make plans to come to Houston.

During this time Tyler had to be shocked a couple of times to get his heart going again after flat lining. They cleared a clog but were unable to clear another one. This is also when I lost Tyler. He wasn't on the 6th floor, he wasn't back in ER, I couldn't find him. The St. Luke's staff tracked him down and told me I should get some rest. Kelly secured a room at the Marriott and we finally got to lay down for a little bit. We got to the hotel around 3 am on 10/27/2009. During this first week I always felt like it was still Sunday, just one long day that never stopped.

Let's Ride - 10/26/2009

Again, thanks to Kelly for dealing with the air flight. Without her this story would be quite different and short.

While Bill, Heidi, and I were waiting for the airplane, we continued to make calls and I continued to harass the clinic staff. The staff took this in stride and helped me where ever possible. Bill took some photographs and when Tyler is awake again and approves it, we may post those pictures. Tyler was conscious but in a lot of pain. When with Tyler I would stare in dis-belief and talked to him as much as possible. His vomiting, due to the meds, was done for the most part. He still felt nauseous, was in pain, and basically quietly laid in the bed. Heidi continued to massage his back and Bill helped me deal with the payments the clinic needed...even going with me to a local ATM to get peso's for part of the bill. The bill came out to roughly 40,000 pesos. This was about $3,000 - $4,000. I had made contact with Tyler's insurance company and the travel insurance company. We had started to notify people about what was going on and started asking for help in keeping things as stable as possible.

About 5pm an local ambulance finally loaded Tyler and I for the ride to the Cozumel airport. I had gone back to the resort to grab all of our stuff and to inquire about finding Tyler's phone. The resort had called me earlier at the clinic to let me know that they would handle our checkout and I was just to grab my stuff and leave.

At the airport I was taken through a special security post, quickly, and walked out onto the tarmac to meet up with the plane and ambulance. As I rounded the front of the plane a pilot met me and introduced himself. I experienced such a relief as I realized that I was now talking to someone in English and he was from the U.S. Another odd moment that was something out of a movie. "Americans! Oh thank God!".

As we loaded Tyler into the plane a swarm of mosquitoes descended on us. The mosquitoes also swarmed into the plane. And these were good Mexican sized mosquitoes! The two pilots, Tyler and I, and two paramedics got on the plane quickly and shut the door. As the plane took off....fast...I was killing as many mosquitoes as possible while the paramedics continued to hook Tyler up to equipment. As I was smacking mosquitoes between my hands and up against the plane, I noticed the pilots were in the cockpit doing the same.....as they were taking off. This is when I realized I had just entered into some kind of Lifetime movie meets action flick. One of the paramedics commented that I was duly deputized (for continuing to kill mosquitoes). I replied that while nice of him, it was more self-preservation for Tyler and me. Once in the air and with the air conditioning going, the swarm was mostly dead. The paramedics had Tyler hooked up and were monitoring what was going on. Space on the plane was very tight and I just did my best to stay out of the way and pray for Tyler.

As the plane headed for Texas the paramedics started asking me questions about Tyler and his medical history. At one point they asked if Tyler had a history in his family with heart problems. I didn't think so but didn't really know. Tyler then lifted his air mask off and told them about his family's history with by-passes and heart attacks.
Mid flight the paramedics, due to fuel and weather and Tyler's condition, told me we were diverting from San Antonio and instead we headed for Houston. Kelly was trying to get a flight from Denver to San Antonio at the time and I started wondering how I was going to contact her since I still didn't have a phone. Thankfully the coordinator of the flight got in touch with Kelly just as she was boarding her San Antonio flight.

We landed in Houston at either a private airport or Houston Hobby. One of the paramedics asked if I had ever ridden in an ambulance with the lights going, etc. I said no and he said it will be quite the experience. Of course my comment was it was an experience I could have lived without. We had to fill out customs declarations and I asked if the mosquitoes should be considered livestock since there had been so many. As we were waiting for the customs agent to make sure we weren't smuggling drugs, bombs, etc., Tyler told the paramedic that he wanted to sit up since his back was hurting. The paramedic explained that his blood pressure was low and he couldn't sit up. Tyler said, "My back hurts and this has nothing to do with my heart! I want to sit up now!". I looked at the paramedic and said Tyler would be fine if he was acting this way.

We loaded into the ambulance with barely enough room for all of us. I did get to ride in front and the experience, well, sucked. The ambulance didn't go fast enough for my taste and I got the sense that the driver wasn't quite sure how to get to the hospital. More praying! The driver did comment that her husband had just had a heart attack last week and that I was going to have a lot of 'power' over Tyler for him putting me through this. My response was that Tyler had to go through my cancer this summer so he was just getting me back. In spades!

We finally made it to St. Luke's and they took him to ER and then right to the Cath Lab. The scene was truly out of ER or Grey's Anatomy, with 10 people rolling him onto an elevator and up to the OR. Once they rolled him through the orderly stopped me directed me to the waiting room. This was when a lady in the hall way yelled out, "is that my husband!". A moment passed with a look between me and the orderly and we then just said "No". This was also the first time in about 30 hours that I wasn't running around trying to manage the situation and things started to sink in.

Tuesday, November 10, 2009

The Resort & Clinic - 10/25/2009

"It's exactly what we wanted"! This is how we felt when Tyler, I, Bill, and Heidi finally arrived at the resort in Cozumel. We arrived Saturday evening on October 24, 2009. Preparing for this week long vacation was rough on Tyler while trying to get business and personal affairs in order for the trip. This was also going to be our 6 year anniversary trip and a trip to celebrate my being free of cancer that I went through in in the summer of 2009 (http://robertdenvertc.blogspot.com/). We had a nice night hanging out by the pool and looking around the resort.

Sunday started out a bit rough. Tyler discovered he had left his phone on the plane and was trying to figure out how to get it back. He met me in the lobby and told me about this. What Bill, Heidi, and I noted was how calm he was about this. A bit uncharacteristic of Tyler. He blocked the phone number, we ate breakfast, and went on about our day. All four of us hung out at the pool for hours joking and laughing and really enjoying the resort. Tyler and Heidi went snorkeling for a little bit also. About early afternoon Tyler decided to take a nap and our little group broke up. I ended up sitting at a table working on my laptop and enjoying working in a tropical setting. Eventually all of us met up at my table. Tyler mentioned that his throat and chest were hurting a little bit, but it didn't seem to serious at the time. This pain passed and Tyler and I were able to enjoy some alone time before meeting up with Bill and Heidi to play cards in the resort lobby. We played for a few hours and then decided to eat dinner at the buffet.

As we finished dinner (around 9pm) Tyler made the comment again that his throat and chest hurt. But he would turn to me and smile. He did this twice at the table and I decided that dinner was over and we should go. Once we got into the lobby he made the comments again and smiled again. At this point I turned to Tyler and said this wasn't funny anymore and he needed to tell me if he was truly in pain or not. Unfortunately he looked me in the eye and was only able to get out "I hurt". Because of his look I immediately started to go up to the resort personnel to inquire about medical help. At the moment I left, Tyler froze up and Bill caught him and eased him into a chair. I was told by Bill and Heidi that he became stiff as a board and was making horrible gurgling noises. I looked over from across the lobby and started demanding from the resort manager that we need medical help immediately and pointed to where Tyler was. This was the heart-attack moment.

All that the resort had available was a life guard and being able to call a local doctor at the San Miquel Clinic. As I was scrambling around to get help, Tyler did come back but was in massive pain and limp. The life guard took his blood pressure and we moved him to a couch with his legs up. Tyler then commented that he needed to go to the bathroom. While Tyler's was in the bathroom, I continued to talk the doctor on the phone. The doctor asked the standard tourist questions - drinking?, diving? - and I relayed that he didn't drink and doesn't dive. I was also trying to relay all that had happened and the symptoms. The doctor basically said to take Tyler back to our room and put his feet up. During this Bill, Heidi, and I still had no clue what was going on. It was our first moment into shock that would last quite a while.

The resort's quest services person finally commented to me that I shouldn't wait for anything else to occur or wait for the doctor to come to the resort. I should take Tyler to the clinic right away. Bless her for this. I would be writing a much different blog if she had not been so upfront. By this time the resort staff and Bill and Heidi were bringing Tyler back into the lobby in a wheelchair. He had been vomiting in the bathroom. Unfortunately the staff that was pushing Tyler was moving him at a speed that looked like they were taking him on a tour of the resort. This was the first moment that I started truly going into management mode. I started demanding that it didn't take 6 staff members to push Tyler and that someone needed to get the van ready. As we were putting Tyler into the van, Bill and Heidi ran back to our room to get our passports and money. Our room was to far away so I just told the driver to go. Of course only having a plastic wrist-band on my arm. Nothing else.

The van ride to the clinic was about a 30 minute ride (felt like an hour). Tyler continued to hang in there but with a lot of vomiting. At one point we had to stop to let him hang out the door to vomit. As he was vomiting, I looked up and noticed we had stopped right in front of a restaurant with windows. What a nice view for the restaurant patrons. The clinic took Tyler in and started giving him fluids and hooked him up to an EKG. As I was trying to deal with the doctors (and language barrier), a front desk staff member came in to collect a $500.00 deposit. I still didn't have our wallets and explained that I needed to call the resort. The resort staff let me know that Bill and Heidi were already on their way. The clinic staff said that was okay and continued to work on Tyler. Tyler and I spent the night at the clinic with Tyler still in pain and occasionally vomiting. I stayed awake listening to Tyler groaning throughout most of the night. In the morning the clinic did an ultrasound to see if there was a problem with his gall bladder. Finally, in the morning, an internist came in that talked to Tyler and looked at the EKG. Then our world changed radically. We were informed that Tyler experienced a heart attack and that we must get him back to the U.S. right away. Since I couldn't remember where I parked my Lear jet or speed boat, I just looked at the clinic staff in disbelief. They told me they would contact Air Ambulance to see if they could get him back. Unfortunately Tyler's health insurance would only cover $5000.00 for the expense. Not quite enough to cover the flight is an understatement. Fortunately his business partner, Kelly, was able to secure the flight for us. The plane would be coming from San Antonio, TX. It would take at least 4 hours just for them to file flight plans and prepare for customs.

While waiting for the air ambulance, Bill, Heidi, Kelly, and I started scrambling to keep things moving along. I had not brought my phone and Tyler left his on the plane. Heidi was the only one with a phone. The medical clinic also let me use their U.S. connected phone as much as I needed. I had finally saved enough energy to make what would be the hardest phone call I had to make. I called his mother and tried to start telling her what was going on. At the time she was driving to a local hospital in Indiana to pick up Tyler's father from a scheduled treatment. The last thing I needed to hear was squealing tires and I told her Tyler was basically stable and we were making arrangements to get him back to the U.S.

During this time Tyler was laying in the clinic's ICU room with his heart beat being monitored, but that was about it. His beats per minute fluctuated rapidly between about 74 bpm to 113 bpm. He was in a lot of pain but still basically responsive. He requested that Heidi massage his upper back which helped him a lot. Also during all this activity and trying to stay on top of insurance and arrangements, we kept commenting how surreal the situation was. A 44 year old healthy Tyler had just had a heart attack and was being flown to the U.S. It wasn't until Houston that I was told that I had been in shock since the attack and would be in shock for a while. Another understatement!

A quick note about the clinic staff. While they missed seeing the heart attack and starting this process much earlier, they did what they could do. My comment has been that you don't get a cut-rate third world vacation with first-rate medical. The clinic staff was very friendly to me and did all they knew how to do.