Day two on proton inhibitor drip

David is on day 2 (out of 72 hours) on the Protinix drip.  His hemoglobin seems to be somewhat stable, but remains low at around 9 grams of hemoglobin per deciliter of blood.  It will take a few weeks to build back up.  If the hemoglobin drops that it means he is bleeding again and that they will need to go back in with the scope and cauterize the bleed.  They say that the risk of re-bleeding is highest in the first 72 hours.  I don't know when he can get out of here and have a list of questions for the doctor since I will be teaching tomorrow and Jeff is heading back home to OK.  David has his Kindle Fire, his mini-iPad and his iPhone and all the Chargers associated with those in addition to a hospital phone and the TV control cords.  His beds get tangled up with cords but nothing runs out of power;}. It is nice to post an uneventful day and I am hopeful that he will be home soon, then back on his feet and feeling good.  The only pain he's experienced has been from the frequent blood draws and IV lines.  His arms are a black and blue mess.

Three more days in the hospital

David had an endoscopy just now.  The doctor found a large ulcer in the small intestine with active bleeding and clots.  They cauterized it but are worried about the position and the possibility of re-bleeding and so will give him two units of blood, watch him carefully, give him IV proteomics for 72 hours and blood work periodically to see if the hemoglobin goes up.  So he could go home Thursday or Friday.  He is very lucky that we got him here.  The blood thinners made the ulcer much worse that it would have been but we don't know what caused it.  The gastroenterologist, Dr. Lee, is deferring to the cardiologist, Dr. Clemo, to decide about continuing the blood thinners.  Blood thinners prevent clots due to atrial fibrillation, which David has had for sometime.  So the risks to weigh are clots (stroke, pulmonary embolism, heart attack) vs. GI bleeds.  So a cardio consult is probably going to happen today too.

As always more when I know more.

Endoscopy?

David's hemoglobin dropped 2.5% in a day so it looks like there is definitely a GI bleed.  He is on a clear diet and gets broth and apple juice through his feeding tube.  He is off the blood thinner for now and on a reduced LaSIX regemin.  His urine output is being measured and recorded.  It is still high so the fluid retention should be abating.  Tomorrow morning it looks like the endoscopy will be evaluated.  His mouth opening is much less wide that most due to his surgeries and radiation.  His lungs appear to be clear with a chronic (residual) area that today's Doctor did not call pneumonia.  I got here about 11 and Rabbi Weisblatt was here.  Than and Katya came by en route to a beer and cook-out on Lake Anne in Reston and Jeff is on his way from BWI en route back home to OK.  David tried to watch the Global Public Square that we can play on my iPad Pro but he fell assleep and I turned it off.  He is napping peacefully and has his hearing aids off.  It is really quiet here and I hope he gets some good rest.
In other news the upstairs dryer is not producing heat.  Luckily there is a downstairs dryer that is producing heat.

Overnight just turned into two days

Since it is not possible to do an endoscopy until a patient has been without the blood thinner for two days, Dr. Lee cannot scope David until Monday unless there is an emergency.  If David's hematocrit drops too low that will be an emergency and they will go in, find the bleed and close it.  Since his stool was black not bloody red, it seems to come from further up the digestive tract allowing the undigested food to mix with it in creating the feces.  His feces tested positive for blood.  The ER doc did an exam and showed us.  Sometimes David appears to understand but really didn't hear it and I repeat it.  Up here in the room the nurses are amazing.   They read off the meds that were ordered and the hospitalist ordered a drug that caused an interaction with another one, plus it cannot go into the feeding tube.  That drug was changed almost immediately when he was admitted the last time.  I keep a list of everything and brought all the current meds in their original bottles.  The nurse called the hospitalist and it has been corrected.  Poor David.
On the other hand the room is big and well appointed.  He has a nice view and it is off the main circle of the wing next to a conference room, so it is very quiet and restful.  I have the iPad Pro set up to connect with our DVR at home so that David will be able to watch CNN, Fareed Zakaria tomorrow, as well as all of the other talking head shows he so loves.  Jeff called and is coming down from Boston tomorrow to see his dad and Nathaniel comes every day to be with us and does whatever he can to help.

Back in the hospital for observation

This morning we were happy to see the LaSIX working as he was two pounds lighter.  That mood changed rapidly when he used the bathroom and there was blood in his stools.  Since he is on a blood thinner the home nurse sent us to the ER because he is high risk for GI bleeding.  So off we go.  They took lots of blood and his levels have not varied since he was here last Tuesday so they will just watch him overnight and then he can come home....I think.  He looks good and is impatient to get up to his room where he can control the temperature of the room.  It is freezing in the ER.  The nurses brought me a warm blanket and hot tea.  David has four hot blankets, (three pillows, a urinal and a bedside commode).  I brought his food and meds and so far gave him lunch and 2:00 LaSIX.  I'm experienced with the overworked staff here.  They are all on overdrive so that the hospital investors can see a profit.  Georgetown was better staffed.  Of course he was in critical care there not observation so it could be the standard of care for patients in for observation.

Crazy day ups and downs. - literally

Started off good.  Although David still cannot sleep very much, I managed to get into deep sleep after each bout of into or out of the family room to bed.  At 5:30 I told him I had to sleep and was getting him situated until I woke up.  Then I got 2 more hours of slumber.  We did our routines,  meds, breakfast, surgical knee highs, dressed, got to the doctor's office by 1:10 and waited to be seen.  Dr. Clemo answered all the questions, changed a problematic medication, discussed sleep.  She declined a sleeping pill for David and offered me something.  I declined.  I have no trouble sleeping except when he needs me and then I WANT to be awake.  Next stop was the home health place for a new egg carton cushion for David to sit on and a call to the physical therapist who could get to the those shortly after we did.  Good so far, right?

At home David got out of the car, used his walker to approach the one step to the house, pulled himself onto the step using the grab bar on his mega-tool chest that Than and I located adjacent to the door and then.  Well and then he tried to step up into the house but the grab bar was too low so he reached for the door frame and the rolling walker.  I watched with grave concern as his hand slid down the door frame and he came onto his knees.  To make a long story short, he ended up prone on the hall floor, declined my help or ideas to get up, so I got him a pillow and we waited for the physical therapist.

Amy, the physical therapist is the incarnation of Mary Poppins.  On, she said, what a great opportunity to show you how to get up by yourself from a fall.  She talked him through what to do and he was up on the first try.  No one saw the stain on the knee of his jeans.  He sat on the chair and chatted away.  Finally I asked her advice on grad bar installation and commode holds.  We walked through the house and decided on one additional bar in the master shower (We had two.), two bars on either side of the garage door entrance and a modification of the commode so that he can raise and lower himself onto it.  Next she "walked" us through how to get him into the shower, shower and out.

A neighbor brough dinner (for eight) and volunteered to do anything we need.  The temple's former president called to see if she could come tomorrow to light Shabbat candles, drink wine and eat challah ( YES).  The rabbi showed up, a week after I spoke with him and told him that David was hospitalized.  Neumiro came by, got the supplies at Lowe's and installed the grab bars and toilet handles.  Nancy and Bill asked to bring grilling stuff on Monday and cook for us.  Than was here to help us by keeping David company so that I could do a quick grocery run and agreed to be here so that I can present two sessions at a conference in DC next weekend.  David spoke with Adam, Jeff and Lorrie.

I was feeling a lot better about recovery, support from friends and family, full of chicken and salad from our neighbor Mary and some iced white wine.  Then we tried the shower.  As David was undressing he mentioned that it looked like there was blood on the knee of his jeans.  Well, yes it was blood from two large scrapes from the fall.  The shower hurt but he persisted.  I installed a huge gauze patch over antibiotic ointment.  He is now in bed dozing with a book.  Tomorrow he has another doctor's appointment at 11 and then we plan to go to Costco and Wegmans.  He may end up sitting in the car with the AC running while I pick up some things like his new prescriptions and some melatonin to try to get him more sleep.  Well, the washer is done with this evening's load of towels & underwear.  We go through a lot of both and he has very few large sizes left.  He was wearing small before he started this massive water retention.  Luckily some larges were hidden on the bottom of drawers and he can wear them now and be a lot more comfortable.  He's gained about 20 pounds of water weight around his midsection and legs, hence the surgical/compression knee highs.  I really hope that the LaSIX is going to be effective, reduce the swelling in his legs and allow him to walk easily again.

It is not all bad but that does seem to be the things that knaw on me.  Hoping for sweet, peaceful dreams for David tonight.

Home safe and sound

We arrived home about 6:50 with a big bag of prescription medications from Costco and a walker from a medical supply place.  A four-legged cane and an additional pair of compression stockings are coming from Amazon tomorrow.  A nurse, a physical therapist and an occupational therapist are coming tomorrow and/or Thursday.  David has appointments with Dr. Lynne Clemo on Thursday and Dr. Henry Clemo on Friday to discuss progress/ medications and future tests.
Than was a huge help getting David into the house and then working with him to make a safe, workable place on the couch with his electronics, papers and such.  We did a dry run to be sure David and I could manage alone.  We can.  He had dinner and evening meds and then used the bathroom and went to bed.  Using the bathroom is a puzzle and I hope to get grab bars into both upstairs bathrooms by the toilets.  We have then in our walk-in shower.  No shower until I get home tomorrow.  His good friend, Fred, is coming to visit with him while I work tomorrow...just to be safe. David already seems stronger here at home.  He is in bed with the electric blanket on full blast and will undoubtedly have a wonderful night's sleep without anyone interested in taking his vitals, his blood or for tests.
Mary Washington Hospital's staff did a great job of puzzling through all the issues affecting his health and addressing them.  The hospitalist a were superb and the nurses are overworked.  I think that the facility is understaffed for the patient load they experienced during David's seven day stay.  Good night everyone.

David is coming home

Dr Akbarzadeh is discharging David later today.  More when he gets home.  Borray.

Monday morning the sun is out

So David does have congestive heart failure.  His lungs are full of fluid from that.  Additionally there is a pneumonia indicator on the X-rays for which he is getting antibiotics.  He got Lasix, IV, about 4 and will get more tomorrow morning.  It is causing him to urinate a lot and he is less bloated and is not wheezing at all when he goes into the bathroom.  Yesterday he wheezed a lot.  After the Lasix tomorrow, he will walk again and they will try it without oxygen.  If he does OK on the walk, with our without oxygen, he will be able to come home.  We will get home health care with a nurse, a physical therapist and an occupational therapist.  They will advise us (and authorize through Medicare) a grab bar for the bathroom, a walker, and one of those chairs that stands you up.  Although Medicare will pay only for the mechanical parts of the chair and we will be responsible for the rest of it.  I hope that we have selections that are not hideous.
In addition to improved breathing, he seems to be stronger overall and have better fine motor skills today.  Yesterday he could not open the feeding tube cap, today he can.  He is also grabbing and using the urinal without shaking a lot.  He is extremely tired but cannot nap for long due to the busy hospital.
Jeff, Mimi and Adam called him today and he enjoyed that a lot.  Than and Katya came for a visit, as well as the across-the-street neighbor who brought a vase of flowers.  I left my phone on during my class and answered it when he called - 4 times.  I think that he was bored.  Whatever, it worked out and I am confident that we will work it out when he comes home.  I am just so relieved that he is improving and coming home.  Not quite ready to party, just relaxed and happyl

David does FaceTime

Just Facetimed with David on his cell phone.  He already had a new chest X-ray this morning (He was the first one of the day) to see what is going on there.  Don't know who ordered it. He also had a nebulizer treatment last night. The night nurse taped the oxygen line to his face so that it does not fall out.  He looked and sounded good.  He did not appear to be short of breath or wheezing but he was laying down.  He also had a successful trip to the bathroom this morning "like he has at home" so that is working again.

Nothing happens in the hospital on Sunday

Nothing new.  David waited all day for an enema, got some prune juice after hours of waiting for that and once the enema was ordered, was able to use the bathroom successfully.  That made him feel much better.  Otherwise it's been a dull day medically.  He had a walk this morning and was asked to stop when his oxygen (with oxygen being administered) dropped below 93.  It happened a lot.  They put him back to bed and did not walk him again today.  His nurse just ordered another nebulizer treatment for the wheezing.  It is very bad.  Albuterol did seem to help last night but the therapist said it could be that he was just recovered from exertion of being up trying to use the bathroom.  Whatever, I just want them to help him.  Than was here most of the afternoon and this evening our friend Nancy was here for a few hours.  He got to talk politics with them and that made him wheeze too.
A side note:  Than & Katya went to Mass at St. Mary's.  I went to Mass at St. Jude's.  Both priests gave the same homily, complete with the same joke.  I guess there is a dioscean sermon generator just like college Profs can get canned PowerPoints with lecture notes!!  It was still a good homily about the importance of relationships and that relationships are the only things that really matter.

Tomorrow I teach until 1:45.  I will ask David to FaceTime me when doctors come and I will interrupt the class for his calls.  It's the best I can do under the circumstances.

We want a diagnosis and  a prognosis.  I hope that it possible.

Saturday evening at Mary Washington Hospital

David has had his dinner and is reading the local paper.  He had a good walk around the floor about 200 steps.  He did need oxygen to do it and will have to come home with oxygen.  It looks like he has fluid around his lungs and Lasix was prescribed to reduce fluid retention.  Otherwise he's had several breathing treatments with Albuterol but that does not seem to give the dramatic, immediate results that would indicate bronchial constriction.  By process of elimination it is looking like fluid retention, maybe heart failure, that can be treated so that he can come home tomorrow.  I have to teach on Monday between 8:30 and 2:30 so he will be on his own then but with a cell phone, a walker or cane and lots of urinal bottles strategically placed.  I almost prefer that he wait until late Monday to come home so that we could have all day Tuesday to get a routine established.  I only teach Monday and Wednesday in the summer, so I will be around a lot.

Saturday morning May 21

The pulmonologist ordered tests to rule out a blood clot in the lungs:  blood work and a special X-ray.  Imaging our surprise when the guy from across the street that we've known since he was a little child in elementary school came to take him down.  Yesterday the radiologist was Dr. Neil Green from the temple and the urologist is also a member of the temple.  This makes David feel very confident in the institution and in the overall results.  He will not be able to walk again until these tests are evaluated.  His care board indicates that discharge planning is on the agenda for today.  His arms are covered with bruises for all the blood work stabs.

I brought the MacBook and connected to HBO on the go so that we can watch shows he's missed.  He was really disappointed to miss Real Time last night.  We are binging on VEEP right now  I also brought five DVDs so the hospital TV won't be his only source of entertainment.

Discharge delayed

The plan was to discharge David today after 3.  Prior to discharging David they took him on a walk up the hall.  He was short of breath, fell into the bed and his oxygen level was very low.  They immediately put him on oxygen and the levels returned to normal.  His doctor wants him to stay and be evaluated by a pulmonologist and perhaps go home with oxygen.  The ultrasound of his kidneys and bladder that showed no damage that would cause blood in the urine.  There is currently no blood in the urine, that was Monday.  His bladder is emptying fine.  His lungs show a little bit of "effusion?" But not much.  The pulmonologist will look at all of the labs, etc. tomorrow.  His heart beat has normalized after the medication prescribed two weeks ago.  His swallow test indicates that he is swallowing fine, with no aspiration.  The only reason that makes sense for the dizziness and fainting is the medication interaction and that has been changed.
The reason he went to see Dr. Clemo was he is so tired/exhausted and thought it was due to sleep interruption from getting up to urinate so many times at night.  Since then he has become progressively more tired, then not feeling right, then dizzy.  About a month ago he had trouble walking a block without stopping to rest.  Last Sunday in the park, he walked about 15 steps and then had to stop and rest.  He would wheeze when he stopped.  This is what happened today walking up the hall at the hospital and the nurses reacted quickly with oxygen.  Right now he is sitting up in a reclines with oxygen and dozing off.
David really, really wanted to come home today.  I wanted to take him home but Dr. Yusufi ( a good friend of David's good friend Zee) told me that it was risky and may result in me bringing him back here, so we decided to extend his stay until he is evaluated to be safe to return home.  I will bring my MacBook with some DVD movies tomorrow because Saturday TV is terrible.  We may be able to watch some of the ABC shows on the iPad today.
I feel much better today after a good night's sleep.  Now I need to write email messages to the students whose class starts on Monday at 9 so that they have the right book and Internet access...or maybe just wait and have them do it in class on Monday. Either will work.
Than is coming over later as well as Zee.

Updates:
 David will be at the hospital overnight and have a swallowing test in the morning. All his meds with the exception of the Pradaxa can be administered through his feeding tube and not taken with water. Dr. Hoffman, a urologist (and the Moyle at the temple) visited and to combat the drug interaction he is replacing the Flowmax with another drug,  He also ordered ultrasound of kidneys and bladder and while David was down for that he had a chest X-ray.
David is getting IV fluids and a stool softener.
 Dr. Davidson , the surgeon from Georgetown, called. The differential diagnosis is that the head CT changes are radiological in nature, from all the radiation he had his bones reacted. The advice is to wait 3 months and repeat the CT to track any changes before doing further tests. It doesn't look like a cancer to anyone there. Whew! I want to celebrate - by getting 8 hours of sleep tonight. Too bad David won't because of the nursing staff taking his vitals and waking him up.  I'm hoping that he will be able to come home tomorrow after his swallowing test.  He is struggling to breath and wheezing but his oxygen levels remain high so...?

Thanks for all the prayers.

David met with Dr. Henry Clemo, his cardiologist, who discontinued the Carvidiol and believes that it interacted with another drug to cause the symptoms. He and his wife, Dr. Lynne Clemo, are going to discuss another medication to replace the Carvidiol. David also had another echocardiogram and Dr. Henry will compare that one to the one David had last week. He has the room set at 75 degrees and wants the door closed to keep the heat in the room. They gave him a walker and he uses that to get to the bathroom. He did get his medications this morning but not breakfast. I gave him the Jevity about 11. I also brought more Jevity for additional meals today in are he has to stay here. More when I know more.

By the way, David has his cell phone with him and it gets excellent reception in his room.  The times on this blog are Pacific Daylight Savings time, not Eastern Daylight Savings time.  I may have to tweet the settings when I have the time and mental capacity to do so.

Day 2 MWH morning

The hospitalist came about 2:15 a.m.  David got to the ER at 5 p.m. And so this was a nine hour wait.  We were both sleeping when he came.  He asked the same questions that all the other staff asked and wrote things down on some sheets of paper.  Why can't they use computers to centralize all of this information stuff?  I came home and finally turned out my light at 3:45 a.m.  I woke up to the phone.  Then I called David and he was in a echocardiogram.  I'm getting ready to head over there because he has not yet had his breakfast and the urinal bottle is out of reach and he is not supposed to get out of bed.  I'm having some yogurt and coffee and then going over there.  I'm clean but not well groomed.  I got all of the stuff he wants:  fresh hearing aid batteries, socks, clothes, more Jevity, syringes, bottles but not the living will.  I can't take time to dig it up.  They probably have one there but we'll need a notary.  More updates as information emerges.

From room # 2043 on 2 South

Yea!  David has a room.  It is quiet, dimly lit with a very nice nursing staff.  We are still waiting for the hospitalist to visit.  David is doing a lot better and got to the bathroom with only one person helping...and a lot of grab bars.  They may get him a walker to help.  One of the nursing staff wanted to get him oxygen because he is having trouble breathing and wheezing but his oxygen cons is nearly 100% so that is more oxygen is not going to be useful.  We brought his iPhone, iPad and Fire.  Both the iPhone and Fire are charging so he is using the iPad.  My iPad is down to 17% and I have no additional charger here.  I have a recliner that is a lot more comfy than the chairs in the ER but not as good as the one at home.  He is not clammoring to come home and is in a very good mood.  Go figure.  By the time anyone reads this it will be daylight and I will be home in bed.

Mary Washington Hospital ER

About 2 this afternoon I was happily eating lunch and planning the next couple of semesters of water sampling, David was dizzy, fell, hit his head and couldn't get up.  He was sitting on the floor when I came home looking confused and wanted me to help him get up.  After a lot of maneuvering with the ottoman and coffee table, we got him to the couch.  I took his b.p. Then I called Dr. Clemo.  She came to the phone right away, listened to me and said to call an ambulance to take him to the hospital.  We're in the ER waiting for results from a heat CT and a lot of blood work.  This doctor identified two issues:  damage from the fall and the dizziness that preceded the fall.

The nurse got me stuff to crush his meds and give him his Jevity for this evening.  He has one more pill to take for sure and possibly another one, pending the doctor's decision after the test results are in.  David is in a good mood, clear headed and happily using his Kindle Fire on the hospital's WiFi to read his blogs, podcasts, check the weather and email.  The TV doesn't have MSNBC and that doesn't make him happy.  He's going to miss Rachael and Chris but I've got them being recorded at home.

His head CT showed no change and the blood work showed a little kidney damage that is also unchanged over the last few visits here.  He will be monitored overnight and probably released tomorrow afternoon.  They are admitting him into a room upstairs and once he is comfortable, I will go home.  I will update when there is news.

Bladder infection
David and I met with Dr. Lynne Clelmo today.  She is our internist.  David had blood in his urine this morning and so called her.  Since the prostate is enlarged but does not appear to be inflamed, she believes it is a bladder infection and will culture his urine.  She prescribed a sulfa drug to treat it rather an an antibiotic to prevent any interaction with the Flecainade for the arrhythmia.   Then she mentioned the CT scans and I told her that David is seeing the pulmonologist and that Dr. Davidson is taking his case with the head and neck growths to the differential diagnosis committee.  She was relieved that we know about the results and are already dealing with it.  She really hopes that the urine culture comes back with an infection.  A UTI can explain his having no energy and needing more sleep.  He is gone to a political meeting tonight so his mood has certainly improved. He has another one on Wednesday and then one to choose delegates to the national Democratic convention.  He is a delegate to the Virginia convention.  He does love politics.

Today I got up at 6 and by 6:35 was driving David to Prince William Forest for his "weekly walk" and breakfast with Fred.  Fred started his walk before we arrived.  David and I walked for 19 minutes with stops as necessary.  Fred got to our car just after we did and David was in the passenger's seat getting the dog treats out.  Ali jumped into the driver's seat to get her treats.  She was extremely excited to see David and strained to get to him (and the treat).  We went to the Dumfries' Diner for breakfast.  Fred and I ate.  David had his meal before we left home.  One of the frequent patrons came over to the table and commented that there were no raised voices.  Fred, David and I calmly disagreed about the presidential race.  Fred mentioned Fox News' reports of "The Energizer" who supposedly is having an affair with Bill Clinton as well as owning an energy company and getting $$ from Clinton's foundation and the government.  David was a bit quiet and not arguing.  Fred did not get upset either.  We talked about water quality, pandemics and Ron's going away party.  I had some good coffee, french toast and bacon.  We got back home about 9:30.  I got all the newspapers for recycling into David's trunk and he headed off to the temple to recycle the and go inside for more conversations.  He had his walking stick throughout the walk, stopped and started and was wheezing but not short of breath once he stopped.  He seemed to move more easily to day compared to yesterday when we were in Alexandria; however, when I asked him if he felt stronger/better he said no, it is about the same.  Nonetheless, he had the energy to go out to the temple after we got home so I do see an improvement in his overall physical and mental state.

New info about CT

We just spoke with Dr. Davidson from Georgetown.  He thinks that the mass in David's head looks like a mucoid growth, not a recurrence of the ameloblastoma.  He plans to take this to his differential diagnosis group next Thursday for their input about the diagnosis and follow up tests.  He said that an MRI will be difficult with the kind of pacemaker David has so he is thinking that a PET scan will be the next step. That will be able to detect cancer.  The two enlarged lymph nodes could be due to an infection but will be clarified with the PET.  This sounds a LOT better than the radiological report.  Dr. Davidson is a rock star and an expert on ameloblastoma, so I believe him that it isn't that.  He is going to call us at the end of next week with his recommendation.
David continues to be easily fatigued.  He took the recycling can to the street and that wore him out.  At the library he could not walk from the car to the door without stopping to rest.  I think that the lung problem may be the culprit.  He sees Dr. Goyal on the 25th.  I think I will call his office early in the week and ask to get fit in if there is a cancellation.
Otherwise, keep up the prayers.

CT of chest, neck and head

David had a CT of the chest, neck and head yesterday.  Today he went to the Imaging place and got a copy of the radiologist's findings.  

The head CT showed soft tissue growth suggestive of a recurrent tumor in the left side of the head, as well as enlarged supraclavicular (around the collarbone) right and left lymph nodes.  The radiologist suggested a follow-up MRI.  David called Georgetown to discuss their MRI that he can have with the pacemaker and is waiting for a call back.

The chest CT indicates atelectasis in the right lower lung with small left and small to moderate right pleural effusions.  Pneumonitis is not excluded.  I looked up atelectasis and can mean a partially collapsed lung.  He has a call in to the pulmonologist about this one and is waiting for a call back.

He is really tired and wheezing with not enough energy to go to the Silver Sneakers classes, walk in the mall or, today, even stop by GoodWill to make a donation.  He has been taking his new medications religiously, hoping to regulate the heartbeat and reduce the number of times he wakes up each night to use the bathroom.

We are scheduled to meet Lorrie, Richard and David for lunch on Saturday and we are both looking forward to that get together.

I write more once appointments are set and when we learn more about what all of this means.  Prayers are really appreciated.

Cardiologist on board

David saw Dr. Henry Clemo (his wife Dr. Lynne Clemo is his internist.) the cardiologist today on the advice of his internist because he is tired and short of breath. His heart if "throwing" extra beats causing the pacemaker to be ineffective.  He prescribed a medication to try to regularize the beat and did an echocardiogram.  David will see him again in two weeks to see how the meds work and discuss the results of the echocardiogram.  Side effects can be numb extremeties, vivid dreams, dizziness, fainting.  If he can't tolerate them he can halve the pills.  He is not happy about it but wants to regularize his heart so he'll do it.  Next Tuesday is his lung and neck CT to see what's going on with his lungs, as well as a routine follow-up from the cancer surgeries.  Stay tuned.