A little tube to help

Early this morning doctors placed a breathing tube in Adele's throat to help with the respiratory distress she has been having.  A tube was also inserted into her nose which can be used to deliver nutrients.

A slew of tests have been performed and so far the doctors are pleased with the results.  They have not found any infections and are hoping with time the breathing tube will be able to come out.     



What is an intubation?
Intubation is a general term referring to the placement of a tube into a patient's body. The most common use of this term in the ICU refers to placing a breathing tube into a patient's airway (endotracheal intubation).

Why is endotracheal intubation needed?
Endotracheal intubation is necessary when patients can no longer cough and clear secretions or breathe on their own.

How is endotracheal intubation done?
Patients needing endotracheal intubation usually have a serious condition preventing them from breathing on their own. An endotracheal tube (breathing tube) can be inserted through the mouth or through the nose then advanced into the airway. Some patients do not require much sedation when the endotracheal tube is inserted through the nose. The breathing tube is slowly advanced into the nose passage and then slips into the patient's airway. Patients always require sedation when the endotracheal tube is inserted through the mouth. The person placing the breathing tube uses a small device called a laryngoscope to move the patient's tongue out of the way to see the airway. The endotracheal tube is then inserted while looking directly at the airway.

Does endotracheal intubation hurt?
If the breathing tube is placed through the nose, the patient will feel some discomfort. The patient will receive sedation and pain medications for this. If the breathing tube is placed through the mouth, the patient will receive anesthesia. After the tube is in place most patients have temporary difficulties with gagging that slowly lessens with time. Patients can not speak or eat while the breathing tube is in place.

Diagram of an endotracheal tube that has been inserted into the trachea:
A - endotracheal tube (blue)
B - cuff inflation tube with pilot balloon
C - trachea
D - esophagus

 

A nasogastric tube is a clear plastic tube that is inserted through the nose, down the back of the throat, through the esophagus and into the stomach. This tube can be used initially to remove air and digestive juices from the stomach. It is also used as a feeding tube for the comatose patient. This tube is uncomfortable, but not painful.

Nasogastric Tube





Physical strength is measured by what we can carry; spiritual by what we can bear.  ~Author Unknown

ICU

The ICU will be carefully watching over Adele until her respiratory difficulties clear up.  She was moved to the ICU this afternoon after being placed on a higher flow of oxygen.  She was very tired and a little confused but in true Adele fashion said she felt okay and didn't know what all the fuss was about.

We wish there was more to post.  More words from her doctors, more funny stories, more comfort to share...just more of anything.  But the truth is, for now there is no more.  There is only time, rest and most importantly the love & support of amazing friends and family.   

Visiting Guidelines and Hours
Intensive Care/ Coronary Care
Limited to immediate family, 3 visitors (over 14 years of age) maximum :
11:00 a.m. - 2:00 p.m. and 5:00 p.m. - 8:00 p.m.

All visitors experiencing flu-like symptoms (body aches, fever, runny nose, coughing and sneezing) are asked to refrain from visiting the hospital at this time. 


"We all take different paths in life, but no matter where we go, we take a little of each other everywhere." --Tim McGraw

Chemo

Adele is doing about the same with some additional swelling in her arms.  She is still very tired, we just can't say that enough.  So please keep this in mind if you are planning a visit or trying to give her a call. 

Chemotherapy is due to begin today.  There are many side effects some of which include nausea, vomiting, hair loss, anemia, fatigue and risk of infection.  Due to the high risk of infection if you have a cold, runny nose or ANYTHING that could spread please do NOT visit.  You must be healthy for at least 72 hours after any illness.

This Chemotherapy in not a cure, it is a treatment to help with the quality of life.  We are not sure how her body is going to respond to the Chemo.  But we are hoping to reduce the size of the tumor to decrease some of her symptoms as well as prolong her life. 


Who will tell whether one happy moment of love or the joy of breathing or walking on a bright morning and smelling the fresh air, is not worth all the suffering and effort which life implies.  ~Erich Fromm

Same

Adele's estimated time of departure from room 302 has been delayed.  Not much has changed over the weekend. There is some swelling which the doctors are keeping an eye on and right now the best place to do so is the hospital. 

Otherwise she is doing well and getting some much needed rest.


It doesn't hurt to be optimistic.  You can always cry later. 
~Lucimar Santos de Lima

Home is with you





Payphone at the hospital - B had never seen one

B wanted to be Grandma's roommate

Bryce and his Uncle Mike

Say Cheese Grandma

Friday Movie Night

Wonder Pet's save the Sea Turtle
(Bryce said "Grandma likes turtles, she will like this movie.")

   
  A man is not where he lives, but where he loves.~Latin Proverb

Fluid be Gone

Adele has been busy getting lots of rest in-between her visits with family and friends.  Everyone has been doing a wonderful job staying just long enough to say hello, wish her well and then be on their way.  Trust us, she remembers when you guys stay too long and boy do we hear about it, just kidding...kind of!

The doctor is very happy with the amount of fluid that has been drained from Adele's chest.  This afternoon she was given medicine to hopefully prevent the fluid from accumulating again.  Then, depending on her body's response, Adele should be home early next week.

Here is some additional information.  Hopefully this will help to answer any lingering questions you may have regarding Adele's latest hospitalization. 

Malignant pleural effusion — A pleural effusion is a collection of fluid in the chest that is located in the pleural space, a pocket between the lung and the tissues of the chest wall. This space is normally empty, although it can accumulate fluid in people with advanced lung cancer. The fluid pushes against the lung, compressing it and preventing the lung from fully expanding when breathing. Thus, the most common symptom of a pleural effusion is shortness of breath.

In most people with lung cancer, the pleural effusion is caused by the cancer. This is called a malignant pleural effusion.
Treatment of the pleural effusion is usually recommended for people who develop shortness of breath. Shortness of breath often worsens as more fluid accumulates.

Fluid drainage — The simplest way to treat a pleural effusion is to insert a small tube (a catheter) into the space around the lung and allow the fluid to drain out. Afterward, the catheter is removed. This is called a thoracentesis. Thoracentesis can usually be done in the office or hospital room using local anesthesia.

If the fluid reaccumulates quickly, meaning that you need another thoracentesis in less than one month, a more aggressive treatment might be recommended. This includes a catheter that is left in place (a tunneled catheter) or using a substance to block the build-up of fluid (called pleurodesis).

• Tunneled catheter — Some people are treated with a catheter that is left in the pleural space and connected to a container. This is called a tunneled catheter. The patient (or a family member) uses a hand pump to drain the fluid once a day or as needed. The catheter is usually inserted during a day surgery procedure. It is left in place for several weeks or months, as long as the fluid continues to drain. The advantage of a catheter over other treatments is that it allows the patient and their doctors to manage the fluid collection out of the hospital.
• Pleurodesis — Another option for treating a malignant effusion is called chemical pleurodesis. This involves draining the fluid and then applying a substance (usually talcum powder) to fill the pleural space, preventing the fluid from collecting again. This treatment is usually done in the hospital and requires a three- to five-day stay.

A truly happy person is one who can enjoy the scenery while on a detour.  ~Author Unknown

Much better

Adele is doing much better, she will be in the hospital for a few days. 

Will post more details later, running late for Tyson's open house at school :)

Room 302

Adele will be spending the next few days at Community General Hospital.  She has developed fluid in her lung, which needs to be drained slowly.  As I'm sure you can imagine she is very tired and at times she seems dazed.  Almost appearing to be in a dream like state where her words are not fitting with the present.

Maria and Yvonne both stopped by to see Adele in the ER.  Doug and Big Doug had already gone home but they were able to chat with Mike and Adele for awhile.  Maria was able to stay for most of the afternoon and help out. 

Adele is able to have visitors, she is currently in room 302.  But please keep in mind that she is very tired and really needs time to regain her strength.

There may be questions or concerns which we have not addressed in this post but I'm not sure we have the answers.  Peachytlb@hotmail.com  and this blog would be the best way to ask questions or voice concerns.  It's not that we mind phone calls but with all the daily running around it's difficult to find time to talk or even just to return a call.  There are also many days, such as today when Doug has to work nights so he sleeps during the day.

And if we could ask one last very important favor...if Tyson and Bryce are around please watch what you say.  They are well aware that Adele has cancer and is very sick.  But they are also children who have spent the last month watching their beloved Grandma become ill.  They do not need to hear every last detail of her care.  They are blessed to have such an amazing women as their Grandma.  Share a funny Adele story with them, just be sure to keep it PG rated ;)


 
A good laugh and a long sleep are the best cures in the doctor's book.  ~Irish Proverb

Hospital

Adele has been admitted to the hospital (Community).  She was having heavy breathing and extreme fatigue so we thought it best to take her to the ER this morning.  The doctors have run some tests and have decided it would be in her best interest to stay at the hospital for now.  We will let you know more as soon as we know more. 

Thank you once again for all of your thoughts and prayers, they do not go unnoticed or appreciated.

PORT

Tuesday was a very long day that for Doug and I has now become Wednesday.  So this will be short and sweet...Adele's port is in and looking great.  However she is VERY tired.  So until further notice visiting hours are closed.  We are thinking by Friday she'll be feeling better and up for some friendly faces.


 Count the garden by the flowers, never by the leaves that fall.  Count your life with smiles and not the tears that roll.  ~Author Unknown

For everyone to see

The blog has been set to public instead of private.  Some people were having trouble viewing the postings which really defeats the purpose of the blog.    

Reasons to smile :)

Flowers from the ladies

Yummy Fruit from the Daley Family

Beautiful flowers from Mary

Flowers loving the sun

And more flowers :)

Big Doug wanted to be sure Adele got a
chance to see the New sign before he put it up

Angie's amazing banana chocolate chip bread

Grandma and the kids (Bryce is laying on the floor)

Monday...no FUNday

Mondays only remind me how much I dislike Mondays.  And today was no exception.
 
Adele, Big Doug and I headed over to the doctors office around 10:30am for some lab work followed by a "TEACH" session.  This basically involves the doctor explaining the course of Chemotherapy Adele would be receiving. 

For almost an hour we sat and listened to the good, the bad and everything in between.  Mrs. Woodford, a very dear family friend who also happens to be an RN kindly offered to join us for this discussion.  She was a wealth of knowledge as well as a great emotional comfort through out the morning.

There is no start date for the Chemo as of yet.  The port still needs to be put into place and a few more tests need to be done before we get the green light on Chemo. 

Towards the end of the visit the doctor noticed that Adele was a bit dehydrated. And with the second port attempt coming up tomorrow afternoon the doctor thought it best to rehydrate her with some intravenous fluids before going home.

Adele was extremely tired form the days events but otherwise just fine.  Tomorrow is going to be another long day so it's off to bed for us.  We love you all so very much and a great BIG thank you to all of Adele's visitors this weekend. 

I have sometimes been wildly, despairingly, acutely miserable, but through it all I still know quite certainly that just to be alive is a grand thing. 
~Agatha Christie

No Port

It has been a very long day so this will be short and sweet...NO PORT TODAY! 

Okay I'll add a few details, but just a few.  We arrived at the hospital bright and early (7:30am) checked in, listened to a very cheerful nurse explain the entire procedure then went off to get a port.  But Adele's blood pressure was a little too high ( I'm blaming the way too cheerful nurse ;) and she also had a fever.  So we rescheduled for next week and went home with some antibiotics to help the fever, which they believe is due to a small infection.


Every day may not be good, but there's something good in every day.  ~Author Unknown

Stay at home days

Radiation complete!  Adele's last treatment was on Wednesday and everything went well.  Although the radiation machine did break an hour or so before her appointment; they were able to fix it and just had us come in a few hours later. 
Now the fun begins...Stay at home days!!!!  When it's the weekend or the kids have a day off from school we like to refer to them as "stay at home days."  ( very original, I know ) But Adele has gladly adopted the saying as her own and is looking forward to a few days off from treatments and doctors.  She does not have to report back to the hospital until Monday morning.  Bright and early she will have a procedure for her port placement.  What is a port you ask?    

Choosing the Chemo Port

A chemo port is used when a person requires regular infusions with chemotherapy drugs and related blood draws for testing. The port makes it easier to perform these functions without countless needle sticks. The port includes a catheter that connects to a vein. Different designs, materials and diameters and lengths of catheters are available to fit the medical need.

Outpatient Surgery

The port is inserted under the skin by a surgeon or interventional radiologist in a minor surgery that takes about an hour. During the procedure, the patient will most likely be given local anaesthesia and what is called conscious sedation; the patient's vital signs will be monitored. The procedure is not particularly painful and, although the patient could feel some discomfort after the surgery, this is usually handled with simple pain killers.

Read more: How Is a Chemo Port Inserted? | eHow.com http://www.ehow.com/how-does_5633327_chemo-port-inserted_.html#ixzz1GMLC5og1

 

 

Then on Tuesday 3/15 we have a day of testing.  Which will look something like this....fasting, yummy drink followed by x-ray pictures.  And that should sum up next week.

 

Wishing you all some relaxing "stay at home days"!

Family, friends, flowers and food

The weekend was full of family, friends, beautiful flowers and of course food!!!  Thank you SO much to everyone who stopped by to say hello and visit with Adele.  It really lifts her spirits to see some familiar smiling faces.  And a great BIG thank you for all of the flowers, cards, food and gifts.  Adele is so blessed to have you all in her life.

Ty reading to Grandma

An AMAZING dinner from the Cusimano Family

Comfy clothes from Aunt Pat

Someone has a sweet tooth :)

Soup from Patsy

Bryce loves Grandma's "green jet packs"

+

Just another Monday...

As far as Monday’s go today was a pretty good day.  We are gearing up for a week full of radiation which will continue into next week.  The doctor wanted to add a few extra days so next Wednesday will be her last radiation for this round.  Today’s treatment went well, except when I accidently hit Adele in the face!!!  Big Doug had parked the wheelchair right behind my heel so when I went to turn around I tripped and fell right into Adele’s lap and then her face.  I’m not sure who is taking her to radiation tomorrow but I don’t think it’ll be me or Big Doug ;)  The radiation has been making Adele really tired but other than that she is doing well.