This past weekend we were fortunate enough to get hooked up for a Packer Game weekend package. Back when I got sick, this nonprofit group called CORE (Chilren Of Restaurant Employees) contacted us about doing something beneficial for our family. Wow! We had talked about a few optons and it came down to either doing a trip to Disney Land, or a Packer game trip to Lambeau Field. We, of course choose the Lambeau Field option which included 2 hotel rooms for two nights, 4 pregame football passes, and 4 tickets to the game. We got to go on a behind the doors trip to see everything from the locker room, weight room, football practice facility with the 3 biggest 'movies screens' on the practie field i've ever seen, as well as meeting the equipment manager. We also saw all of the Lombardi Super Bowl trophy's in their glass cases as well as the tour bringing us out to the field through the tunnel where the players come through and got to walk across the championship labeled flooring and touch the same quotation plaque as all the players do. CORE had hooked our baby Scarlett up with Packer clothes and awesome Packer gear. Ryan had gotten a Rodgers jersey as well as some other great Packer attire for him as well. The highlight of the tour was Ryan getting to not only meet John Kuhn but he got to shake his hand, get his autograph and get several pictures with him. Amazing! Ryan absolutely loved it when during the game, the crowd cheered 'Kuuuuuuhn'
With all of this going on, it was the first time that most of us had been to Lambeau. I personally had been there many times for several games, mainly in the late 90's to early '00's which were a blast every time. So many of those stories should be a different post hahaha. Anyway, I remember being there some 30 years ago obviously as a youngster with my folks when the Packers were terrible but they still had a relatively good following. I recall back then, again with some help from my parents pictures, that a few of the players rode me and my brothers' bikes around. How great was that as a child growing up as a huge Packer fan!
This reminded me of how awesome it was to see not only my 7 year old son see a game for the first time, but for my wife for the first time in years as well, and especially my dad to be able to see a game in person for the first time ever at Lambeau. I believe my dad enjoyed all of the experiences the most. The game itself for on one of course, but he also got to see the half-time 'show' including the acknowledgment of many of his idols who were there as a part of the "all-time" packers club. He said that he broke a tear. Made my weekend. This was defiantly a once in a lifetime weekend.. Awesome!
P.S. We hooked up with some friends we knew after the game. Some friends have turned into great friends, some acquaintances have become really good friends and some strangers have become good friends as well. What a tremendous weekend!
-Cheek
Wednesday, September 17, 2014
Tuesday, September 16, 2014
Hospital (ongoing)
Hey folks, I titled this 'ongoing' because I think I'll plan on using this topic to post multiple stories from my time staying in my hospitals. I've got at least a dozen stories, whether I write about them all here or not I have yet to decide. I hope not to offend any people or gross any one out with these stories, but this is how I remember things while at my time recovering at Bethezda. Some stories I laugh about, some make me angry, some make me want to cry. Some are too disturbing I'm not sure if I'm ready to re-live them. I keep repeating here that these are stories, because most of them never happened. Whether I dreamed about them while asleep, awake, or in the middle I'm not sure, but I remember them nonetheless. Because of all my time being sedated and all the drugs I was on and still am on, I struggled with and still have struggled with some post traumatic stress disorder (PTSD). The doctors were, and still are aware that this should happen and ask if I want medication and or counseling. Well I feel like I have a grasp on reality and know whats real or not real so no shrinks for this guy. Once again, this is as much for myself as it is for my family and friends. Hope you enjoy..
In no particular order..
1. This one is true.
So it's early May. I wake up in the middle of the night. It's late and dark outside and it's storming out, nothing bad, just a storm and I felt kind of relaxed by it. Then it hits me.. where in the fuck am I !??!
Shit, shit shit, where am I? I'm thinking how drunk did I get last night? I don't even remember drinking.. Holy Christ, I'm dead, Sarah is going to kill me, after she cuts my nuts off. OK, think.. where is my phone, I can't find it. Who the hell's bed am I in? OMG I'm a married man, what am I doing here, where? Ok, don't move, think, think..Where is my phone, any phone, my keys, my clothes... Then I hear some talking in the next room. Oh fuck, I'm screwed, 'she' is coming back to bed. Ok, play dead, or at least asleep, maybe I'll figure out a way out of this. (Now I should probably back up here a little and say, back 'in the day' this wouldn't be so far fetched from something I may have gotten myself into.) I'm frozen, not sure if I could move if I had to (weird) so I'm going to stay here quiet and still as long as I can. Maybe this chick will leave and I can sneak out and figure the rest out later. I don't know where I am let alone where my car is or even what I drove, I just gotta get out of here and hope to find my phone and deal with the consequences then. I hear more talking now in the hallway, I'm terrified. Then a light comes on where she is and I can barely see her appearing to get dressed. Ok, she's getting dressed, maybe she's leaving soon and I can get out of here. Then I see a little more of her and notice she's a nurse. I'm like, where the hell did I meet a nurse? God I drank way too much.. Well, shortly after that she comes into the room, oh shit, I'm so screwed and busted, and then she walks to the bed and.... checks my vital signs.. God damn it was a freaking dream and this 'chick' is my nurse! I'm sleeping in my hospital bed like I'm supposed to! Nice! God I'm an idiot! Then I peed myself and had to call 'the chick' back in to change me.. awkward !
-Cheek
2,
In no particular order..
1. This one is true.
So it's early May. I wake up in the middle of the night. It's late and dark outside and it's storming out, nothing bad, just a storm and I felt kind of relaxed by it. Then it hits me.. where in the fuck am I !??!
Shit, shit shit, where am I? I'm thinking how drunk did I get last night? I don't even remember drinking.. Holy Christ, I'm dead, Sarah is going to kill me, after she cuts my nuts off. OK, think.. where is my phone, I can't find it. Who the hell's bed am I in? OMG I'm a married man, what am I doing here, where? Ok, don't move, think, think..Where is my phone, any phone, my keys, my clothes... Then I hear some talking in the next room. Oh fuck, I'm screwed, 'she' is coming back to bed. Ok, play dead, or at least asleep, maybe I'll figure out a way out of this. (Now I should probably back up here a little and say, back 'in the day' this wouldn't be so far fetched from something I may have gotten myself into.) I'm frozen, not sure if I could move if I had to (weird) so I'm going to stay here quiet and still as long as I can. Maybe this chick will leave and I can sneak out and figure the rest out later. I don't know where I am let alone where my car is or even what I drove, I just gotta get out of here and hope to find my phone and deal with the consequences then. I hear more talking now in the hallway, I'm terrified. Then a light comes on where she is and I can barely see her appearing to get dressed. Ok, she's getting dressed, maybe she's leaving soon and I can get out of here. Then I see a little more of her and notice she's a nurse. I'm like, where the hell did I meet a nurse? God I drank way too much.. Well, shortly after that she comes into the room, oh shit, I'm so screwed and busted, and then she walks to the bed and.... checks my vital signs.. God damn it was a freaking dream and this 'chick' is my nurse! I'm sleeping in my hospital bed like I'm supposed to! Nice! God I'm an idiot! Then I peed myself and had to call 'the chick' back in to change me.. awkward !
-Cheek
2,
Monday, September 15, 2014
ME
Hello everyone, Welcome to my blog. Here is a little something about me and what I am doing here. As I'm sure most of you know, I nearly lost the battle to a very bad illness I contracted by breathing in a spore earlier this year. We believe it was during my time on vacation up in the North Shore area back in October. Doctors feel that my strong immune system actually 'helped' lead to me getting this Blastomycosis with ARDS so very badly. Since coming home, we have decided to close our business and put it up for sale. With that, there are some legal matters to deal with, but in the time being, and maybe a long time being, I am going to be a stay at home daddy since I can't work. It's been going pretty well, I'm enjoying my time with the kids and not working full time(plus) for once. I do get some free time, however, and have been trying to figure out what I can do to fill this time, as well as help me through some of my troubles accrued from this illness. This blog is hopefully going to cure both desires. Thank you for your time.
Little background about me. As most of you know, my name is Mike "Cheek" Moore. I met my long time buddy Jason McRoberts in kindergarten and we became good friends later in middle school and still to this day. I think it was about 6th grade he randomly came up with a nickname for me which of course was, Cheek. Sorry folks, some of you had it wrong for whatever reason, which is fine, but to set the record straight, it is Cheek. Heard many variations of it throughout my years but now you know! Jason tried to be the only one to call me Cheek for awhile but he soon allowed friends to use this nickname and then some others, then not before long it was used by nearly everyone, to this day.
I am 39 years old, am married to my wonderful wife Sarah, we have a 5 month old beautiful baby girl named Scarlett and an amazing and sweet boy named Ryan from a previous marriage. Sarah and I have been together since Ryan was about 1 year old and the two are amazing together, I couldn't ask for a better relationship.
I have one sibling, a brother that is one year older than me who lives with his family in Woodbury, MN. The two of us are close and we have a unique relationship that seems to fit us just right. My parents are both retired school teachers, although my dad is now on the NR School Board, who have always been there for me. This includes now, as we have been living with them for about a month now due to several outside factors.
I grew up in the country just outside of Emerald but have been in the New Richmond school system since Kindergarten and then graduated in 1994. I spent time at UW-Stout and UW-River Falls before I decided to go full time into bar tending. I started out at The Old Saloon in 1995 for about 1 and 1/2 years and then moved on to Champ's Bar & Grill for about 4 years. In June of 2000 I decided to go out on my own and purchased Mike's Place "On Skid Row" and remained there for 3 years before I moved my business across the street for a larger location in which I stayed there for 3 more years before I decided to sell.
I then moved on to Ready Randy's and soon became their Front of the House and bar manager. I was there from the opening of the restaurant and stayed working there for 6 years when Sarah and I decided to open our own business in 2012. During this time I also decided to go back to college at WITC for my marketing associates degree.
I have had the pleasure of meeting many great people in this town, from being a student here, working here, and doing business with people in this community. Friends have changed as expected through the years because of families or whatever reasons but I will always remember the good times and look forward to seeing them again. Some friends have stayed the same while some are newer and have formed great relationships with and I am happy to call so many people, whether I see them as much or not: friends.
This is my blog. I wasn't really sure I wanted to do a blog because I didn't really understand what is was; it sounded snooty or something to me that wasn't 'my style.' Of course I really don't know what my style is! I wanted to use my time (not working anymore) to write things that happened to me when I got sick. Then that moved to more of a diary of things I enjoy. They both kind of formed into this. I hope you all will enjoy what I have to say. Please respond to whatever you may want or ask questions you may have.
Little background about me. As most of you know, my name is Mike "Cheek" Moore. I met my long time buddy Jason McRoberts in kindergarten and we became good friends later in middle school and still to this day. I think it was about 6th grade he randomly came up with a nickname for me which of course was, Cheek. Sorry folks, some of you had it wrong for whatever reason, which is fine, but to set the record straight, it is Cheek. Heard many variations of it throughout my years but now you know! Jason tried to be the only one to call me Cheek for awhile but he soon allowed friends to use this nickname and then some others, then not before long it was used by nearly everyone, to this day.
I am 39 years old, am married to my wonderful wife Sarah, we have a 5 month old beautiful baby girl named Scarlett and an amazing and sweet boy named Ryan from a previous marriage. Sarah and I have been together since Ryan was about 1 year old and the two are amazing together, I couldn't ask for a better relationship.
I have one sibling, a brother that is one year older than me who lives with his family in Woodbury, MN. The two of us are close and we have a unique relationship that seems to fit us just right. My parents are both retired school teachers, although my dad is now on the NR School Board, who have always been there for me. This includes now, as we have been living with them for about a month now due to several outside factors.
I grew up in the country just outside of Emerald but have been in the New Richmond school system since Kindergarten and then graduated in 1994. I spent time at UW-Stout and UW-River Falls before I decided to go full time into bar tending. I started out at The Old Saloon in 1995 for about 1 and 1/2 years and then moved on to Champ's Bar & Grill for about 4 years. In June of 2000 I decided to go out on my own and purchased Mike's Place "On Skid Row" and remained there for 3 years before I moved my business across the street for a larger location in which I stayed there for 3 more years before I decided to sell.
I then moved on to Ready Randy's and soon became their Front of the House and bar manager. I was there from the opening of the restaurant and stayed working there for 6 years when Sarah and I decided to open our own business in 2012. During this time I also decided to go back to college at WITC for my marketing associates degree.
I have had the pleasure of meeting many great people in this town, from being a student here, working here, and doing business with people in this community. Friends have changed as expected through the years because of families or whatever reasons but I will always remember the good times and look forward to seeing them again. Some friends have stayed the same while some are newer and have formed great relationships with and I am happy to call so many people, whether I see them as much or not: friends.
This is my blog. I wasn't really sure I wanted to do a blog because I didn't really understand what is was; it sounded snooty or something to me that wasn't 'my style.' Of course I really don't know what my style is! I wanted to use my time (not working anymore) to write things that happened to me when I got sick. Then that moved to more of a diary of things I enjoy. They both kind of formed into this. I hope you all will enjoy what I have to say. Please respond to whatever you may want or ask questions you may have.
Discharge from U of M
This is kind of long and winded with a lot of weird ass medical words and terms. I tried to add a few more simple words or meanings to help out (because I needed to know as well) with some of the difficult ones. Hope you 'enjoy' this, I plan to add my summary papers from Westfields, Regions, and Bethezda as well.. Thanks.
This is my Fairview (U of M) Hosptial Discharge Summary. Dates: 3/21/14 - 4/19/14
I had been at Regions since March 13 until I came [here] to U of M.
Discharge Diagnosis:
Blastomycosis Pneumonia
Acute Respiratory Distress Syndrome (ARDS)
Subarachnoid Hemorrhage
Procedures:
Extracorporeal Membrane Oxygenation (ECMO) - March 21-April 3
Intubation (Breathing tube down my throat) March 18 - April 8
Tracheostomy (Breathing tube now cut into my throat) April 8 - May...? Exercises to help breathe
Percutaneous endoscopic gastrostomy (PEG) Tube Placement -Feeding tube into my belly. April 18 - until mid-June.
CT Scan - Head (Brain) March 25:
Small amount of subarachnoid hemorrhage involving the right high parietal sulci. There is associated scalp hematoma (bleed) just anterior to the vertex.
Critical Result: Subarachnoid hemorrhage involving the right high parietal lobe.
*On a more recent side note to this my latest MRI revealed up to 30 brain bleeds revealed in my brain. I go back Sept 16 and 23 for further testing and consulting.
MRI/MRA April 15:
1. Resolving small amount of high right parietal subarachnoid hemorrhage.
2. No intracranial aneurysm is identified.
Discharge Medications:
Amphotericin B lipid 500 mg
Inject 500 mg into the vein every 24 hours
-This the anti-fungal: Extremely toxic, 2nd to chemo
Cetirizine 5 mg tablet
1 tablet by PEG tube route daily
-For allergy, I was allergic to the Amphotericin
Cholecalciferol 50,000 units capsule
Take 1 capsule by mouth three time a week
-Vitamins (Vitamin D) For help with medicine absorptions
Docusate 50 mg liquid, 50 mg by Feeding Tube
Take two times daily
-Bowel regularity (diarrhea)
Guaifenesin-Codeine 100-10 mg/5ml
Take 5 mls by mouth every four hours
-For pain
Hydroxyzine 25 mg tablet
1 tablet by mouth every 6 hours
-For pain and itching
Ipratropium (Albuterol) 0.5 mg
Take 1 vial by nebulization four times daily
-For help with breathing
Intraconazole 10 mg solution
Take 200 mg by PEG Tube two times daily
-Anti-fungal
Labetalol 100 mg tablet
Take 0.5 tablets by mouth every 12 hours
-For blood pressure
Multivitamins with minerals, liquid
Take 15 mls by oral or Feeding Tube daily
Ondansetron (Zofran) 4 mg tablet
1 tablet by mouth every 8 hours
-For nausea
Polyethylene Glycol packet
Take 17 g by Feeding Tube daily
-Bowel regularity (constipation)
Prochlorperazine 5 mg tablet
Take 1-2 tablets by mouth every 6 hours
-For nausea or vomiting
Quetiapine (Seroquel) 500 mg tablet
1 tablet by oral or Feeding Tube 3 times daily
-Sleep aid, anti-psychotic
Ranitidine 150 mg/10 ml syrup
Take by Feeding Tube 2 times daily
-Reduces stomach acid
Sennosides 8.8 mg/5 ml syrup
Take by Feeding Tube 2 times daily
-Bowel regularity
Vitamin C 500 mg/5ml syrup
Take by PEG tube 2 times daily
-To help absorb acid
Brief History of Illness:
Mike is a 38 yr-old previously healthy gentleman admitted to Regions Hosptial for new onset ARDS in setting of blastomycosis pneumonia. During initial presentation at Regions, patient treated for CAP w/ Azithromycin and Ceftriaxone (commonly treated pneumonia) with no improvement in respiration. Patient represented on March 14, subsequently found to have positive blastomycosis in sputum and started amphotericin therapy. However, on March 18 patient found to have worsening respiratory distress, requiring intubation. Patient remained hypoxic despite ventilator therapy, undergoing pronation and eventual transfer to U of M for ECMO.
Hospital Course:
Blastomycosis pneumonia and ARDS. Patient initially diagnosed with this at Regions Hospital and subsequently started on Amphotericin IV on March 18. Previous exposures noted upon further history with no immunodeficiency noted on further work-up (HIV negative). Due to worsening respiratory distress, patient intubation on March 18 and reclassified as ARDS due to new chest x-ray findings. However, patient remained persistently hypoxic requiring pronation and on March 21, due to worsening hypoxia, patient started on Hydrocortizone and transferred to U of M for ECMO therapy.
Patient completed ECMO on April 3 with continued improvement in oxygenation on ventilator with additional diuretic therapy and flolan. Patient weaned of flolan and on April 8 underwent tracheostomy placement and started on intraconazole therapy. On day prior to discharge, patient tolerated 6 hous of pressure support therapy.
Drug Rash:
Course complicated by drug rash due to intraconazole on April 12. (This is my son's birthday) Symptoms resolved with supportive cares, undergoing successful intraconazole desensitization therapy on April 17. Patient continued on amphotericin therapy from March 18-present (date of this discharge) with plans to monitor intraconazole levels on current therapy until therapeutic. Will then plan to discontinue amphotericin and continue intraconazole with plans to follow-up to monitor drug levels. Will continue vitamin C at time of intraconazole for further absorption.
Subarachnoid Hemorrhage:
On March 25, patient increasingly agitated with difficulty weaning from additional sedation. CT head demonstrated a small subarachnoid hemorrhage involving the right high parietal sulci. Repeat imaging on March 26 revealed minimal change. Hemorrhage considered secondary to ongoing ECMO therapy in setting of therapy. Patients platelets maintained above 80K, per neuro ICU recommendations. Angiogram on April 18 revealed no additional aneurysms or concerns for mycotic processes.
Acute Kidney Injury:
Patient's creatinine elevated by two. Creatinine continued to increase with contrast exposure on March 14 and initiation of amphotericin on March 18 to peak of 3.6 and new onset of oliguria (low output of urine). Given worsening renal function and oliguria, patient started on CRRT from March 23 - April 5 with subsequent improvement in creatinine and UOP. On day of discharge, patient's creatinine 1.5 with stable urine output of past 24 hrs.
Hypercalcemia: (high calcium in blood)
Elevated during admission, considered secondary to underlying immobilization. Vitamin D low and PTH appropriately low. Per discussion with nephrology, patient started on calcitiol with improvement in hypercalcemia. Continued improved therapy with additional physical/occupational therapies. Will plan to continue to monitor. Start Vitamin D 3 times weekly for 4 weeks.
Nutrition:
Patient started on tube feeds during ECMO therapy for additional nutrition. PEG placed with plans to continued tube feeds with goal rate of 70 mL / hr. Will plan to follow nutrition needs, consider additional swallow evaluations when tracheostomy removed.
Condition at discharge:
Improved, stable.
Alert, interactive, fatigued affect.
Trach in place.
Respiratory crackles, no wheezes. Mild tachypnea.
Abdomen - soft, tender LUQ surrounding g-tube site through no erythema or drainage. Midly distended. No masses, no rebound or gaurding
Skin- Improved rash with dequamation bilaterally, decreased erythema from presentation.
Alert, interactive, communicating non-verbally with mouthing words. Moving extremities against gravity.
Discharge Instructions and follow up:
Diet: Tube feeds
Activity: As tolerated
Follow up with infectious disease in 3-4 weeks
Discharge to rehabilitation facility (Bethezda)
I was transferred to Bethezda on April 19 by ambulance. (No memory of this, but have pictures) My beautiful daughter Scarlett was born April 13.
This is my Fairview (U of M) Hosptial Discharge Summary. Dates: 3/21/14 - 4/19/14
I had been at Regions since March 13 until I came [here] to U of M.
Discharge Diagnosis:
Blastomycosis Pneumonia
Acute Respiratory Distress Syndrome (ARDS)
Subarachnoid Hemorrhage
Procedures:
Extracorporeal Membrane Oxygenation (ECMO) - March 21-April 3
Intubation (Breathing tube down my throat) March 18 - April 8
Tracheostomy (Breathing tube now cut into my throat) April 8 - May...? Exercises to help breathe
Percutaneous endoscopic gastrostomy (PEG) Tube Placement -Feeding tube into my belly. April 18 - until mid-June.
CT Scan - Head (Brain) March 25:
Small amount of subarachnoid hemorrhage involving the right high parietal sulci. There is associated scalp hematoma (bleed) just anterior to the vertex.
Critical Result: Subarachnoid hemorrhage involving the right high parietal lobe.
*On a more recent side note to this my latest MRI revealed up to 30 brain bleeds revealed in my brain. I go back Sept 16 and 23 for further testing and consulting.
MRI/MRA April 15:
1. Resolving small amount of high right parietal subarachnoid hemorrhage.
2. No intracranial aneurysm is identified.
Discharge Medications:
Amphotericin B lipid 500 mg
Inject 500 mg into the vein every 24 hours
-This the anti-fungal: Extremely toxic, 2nd to chemo
Cetirizine 5 mg tablet
1 tablet by PEG tube route daily
-For allergy, I was allergic to the Amphotericin
Cholecalciferol 50,000 units capsule
Take 1 capsule by mouth three time a week
-Vitamins (Vitamin D) For help with medicine absorptions
Docusate 50 mg liquid, 50 mg by Feeding Tube
Take two times daily
-Bowel regularity (diarrhea)
Guaifenesin-Codeine 100-10 mg/5ml
Take 5 mls by mouth every four hours
-For pain
Hydroxyzine 25 mg tablet
1 tablet by mouth every 6 hours
-For pain and itching
Ipratropium (Albuterol) 0.5 mg
Take 1 vial by nebulization four times daily
-For help with breathing
Intraconazole 10 mg solution
Take 200 mg by PEG Tube two times daily
-Anti-fungal
Labetalol 100 mg tablet
Take 0.5 tablets by mouth every 12 hours
-For blood pressure
Multivitamins with minerals, liquid
Take 15 mls by oral or Feeding Tube daily
Ondansetron (Zofran) 4 mg tablet
1 tablet by mouth every 8 hours
-For nausea
Polyethylene Glycol packet
Take 17 g by Feeding Tube daily
-Bowel regularity (constipation)
Prochlorperazine 5 mg tablet
Take 1-2 tablets by mouth every 6 hours
-For nausea or vomiting
Quetiapine (Seroquel) 500 mg tablet
1 tablet by oral or Feeding Tube 3 times daily
-Sleep aid, anti-psychotic
Ranitidine 150 mg/10 ml syrup
Take by Feeding Tube 2 times daily
-Reduces stomach acid
Sennosides 8.8 mg/5 ml syrup
Take by Feeding Tube 2 times daily
-Bowel regularity
Vitamin C 500 mg/5ml syrup
Take by PEG tube 2 times daily
-To help absorb acid
Brief History of Illness:
Mike is a 38 yr-old previously healthy gentleman admitted to Regions Hosptial for new onset ARDS in setting of blastomycosis pneumonia. During initial presentation at Regions, patient treated for CAP w/ Azithromycin and Ceftriaxone (commonly treated pneumonia) with no improvement in respiration. Patient represented on March 14, subsequently found to have positive blastomycosis in sputum and started amphotericin therapy. However, on March 18 patient found to have worsening respiratory distress, requiring intubation. Patient remained hypoxic despite ventilator therapy, undergoing pronation and eventual transfer to U of M for ECMO.
Hospital Course:
Blastomycosis pneumonia and ARDS. Patient initially diagnosed with this at Regions Hospital and subsequently started on Amphotericin IV on March 18. Previous exposures noted upon further history with no immunodeficiency noted on further work-up (HIV negative). Due to worsening respiratory distress, patient intubation on March 18 and reclassified as ARDS due to new chest x-ray findings. However, patient remained persistently hypoxic requiring pronation and on March 21, due to worsening hypoxia, patient started on Hydrocortizone and transferred to U of M for ECMO therapy.
Patient completed ECMO on April 3 with continued improvement in oxygenation on ventilator with additional diuretic therapy and flolan. Patient weaned of flolan and on April 8 underwent tracheostomy placement and started on intraconazole therapy. On day prior to discharge, patient tolerated 6 hous of pressure support therapy.
Drug Rash:
Course complicated by drug rash due to intraconazole on April 12. (This is my son's birthday) Symptoms resolved with supportive cares, undergoing successful intraconazole desensitization therapy on April 17. Patient continued on amphotericin therapy from March 18-present (date of this discharge) with plans to monitor intraconazole levels on current therapy until therapeutic. Will then plan to discontinue amphotericin and continue intraconazole with plans to follow-up to monitor drug levels. Will continue vitamin C at time of intraconazole for further absorption.
Subarachnoid Hemorrhage:
On March 25, patient increasingly agitated with difficulty weaning from additional sedation. CT head demonstrated a small subarachnoid hemorrhage involving the right high parietal sulci. Repeat imaging on March 26 revealed minimal change. Hemorrhage considered secondary to ongoing ECMO therapy in setting of therapy. Patients platelets maintained above 80K, per neuro ICU recommendations. Angiogram on April 18 revealed no additional aneurysms or concerns for mycotic processes.
Acute Kidney Injury:
Patient's creatinine elevated by two. Creatinine continued to increase with contrast exposure on March 14 and initiation of amphotericin on March 18 to peak of 3.6 and new onset of oliguria (low output of urine). Given worsening renal function and oliguria, patient started on CRRT from March 23 - April 5 with subsequent improvement in creatinine and UOP. On day of discharge, patient's creatinine 1.5 with stable urine output of past 24 hrs.
Hypercalcemia: (high calcium in blood)
Elevated during admission, considered secondary to underlying immobilization. Vitamin D low and PTH appropriately low. Per discussion with nephrology, patient started on calcitiol with improvement in hypercalcemia. Continued improved therapy with additional physical/occupational therapies. Will plan to continue to monitor. Start Vitamin D 3 times weekly for 4 weeks.
Nutrition:
Patient started on tube feeds during ECMO therapy for additional nutrition. PEG placed with plans to continued tube feeds with goal rate of 70 mL / hr. Will plan to follow nutrition needs, consider additional swallow evaluations when tracheostomy removed.
Condition at discharge:
Improved, stable.
Alert, interactive, fatigued affect.
Trach in place.
Respiratory crackles, no wheezes. Mild tachypnea.
Abdomen - soft, tender LUQ surrounding g-tube site through no erythema or drainage. Midly distended. No masses, no rebound or gaurding
Skin- Improved rash with dequamation bilaterally, decreased erythema from presentation.
Alert, interactive, communicating non-verbally with mouthing words. Moving extremities against gravity.
Discharge Instructions and follow up:
Diet: Tube feeds
Activity: As tolerated
Follow up with infectious disease in 3-4 weeks
Discharge to rehabilitation facility (Bethezda)
I was transferred to Bethezda on April 19 by ambulance. (No memory of this, but have pictures) My beautiful daughter Scarlett was born April 13.
Wednesday, September 10, 2014
March '14
This is how I recall what had happened to me. I will follow it up with exactly what had happened to me with the help of Sarah and other family members as well as hospital documents at a later date.
March 6th-9th (Thurs-Sun) I wasn't feeling very good - and in fact felt worse and worse until I finally asked my 8 months pregnant wife to bring me to the hospital ER on that Sunday. I feel like I have been relatively healthy person in my life and tend to 'make it through' sicknesses that I generally have had the best I could. Now since working in smokeless bars for about 8 years my lungs have probably healed themselves pretty nicely over that time. But with having a family now and well, getting older (smarter?) I decided enough was enough, I felt like crap and could hardly breath so it was time to go in.
At Westfields in New Richmond I was diagnosed with pneumonia and sent to the pharmacy for a prescription. I vaguely remember much of any of this. Well Monday (or Tuesday?) come around and I still feel like hell and I'm on my way with Sarah for our OB appointment. Well things I assume went fine there but our baby Doctor said I looked terrible and needed to stay and I was then omitted into Westfields. I recall being hooked up to whatever machines and was finally getting some air to breathe for a little comfort. Not sure when at this point, but I had a few visitors, good friends of mine, stopped to say hello and see how I'm doing and maybe spread a little cheer to go around - I mean who is really that sick here at Westfields after all.. Anyway, my friends show me a small bottle of Crown Royal and jokingly ask if I wanted some. Well as sick and drained as I was I think I cracked a smile, but I do know that the booze got confiscated by the medical staff and then the nurse asked me if I needed a drink. Ha! The strange part was I could tell that someone was here because I could smell smoke and it really bothered me, made it harder to breathe and I had asked Sarah for no more visitors until I felt better...
Later that day (which was actually 2 days later!) one Doctor said I appeared to be getting better, but Sarah asked for another opinion because of how I was looking and another Doctor said I should go to Regions hospital in St. Paul. I remember some of the ambulance trip as I knew who the 2 first responders were and they talked to me on the way. I got to Regions and I believe I was moved to at least 2 different rooms before settling me in. I don't recall much more, I couldn't breathe and not sure if I could talk. The next 2 months were very, very cloudy to say the least. l know I missed my first St. Patrick's Day in New Richmond since I could remember, and my family tried to make it the best they could for me, bringing me a shirt and few other fun things. I know I talked to Sarah a little bit and I remember being scheduled for a PICC at some point as well as a getting rigors from my first dosage of ampho.
Then.. SLEEP
KEY
PICC - Peripherally Inserted Central Catheter
Ampho - Amphoteracin B (anti-fungal, extremely toxic, extremely painful. Intravenously given over 4 hours every day)
Rigors - Uncontrollable shakes
Crown Royal - an awesome whiskey with a fun history
St. Patrick's Day - my favorite holiday :)
March 6th-9th (Thurs-Sun) I wasn't feeling very good - and in fact felt worse and worse until I finally asked my 8 months pregnant wife to bring me to the hospital ER on that Sunday. I feel like I have been relatively healthy person in my life and tend to 'make it through' sicknesses that I generally have had the best I could. Now since working in smokeless bars for about 8 years my lungs have probably healed themselves pretty nicely over that time. But with having a family now and well, getting older (smarter?) I decided enough was enough, I felt like crap and could hardly breath so it was time to go in.
At Westfields in New Richmond I was diagnosed with pneumonia and sent to the pharmacy for a prescription. I vaguely remember much of any of this. Well Monday (or Tuesday?) come around and I still feel like hell and I'm on my way with Sarah for our OB appointment. Well things I assume went fine there but our baby Doctor said I looked terrible and needed to stay and I was then omitted into Westfields. I recall being hooked up to whatever machines and was finally getting some air to breathe for a little comfort. Not sure when at this point, but I had a few visitors, good friends of mine, stopped to say hello and see how I'm doing and maybe spread a little cheer to go around - I mean who is really that sick here at Westfields after all.. Anyway, my friends show me a small bottle of Crown Royal and jokingly ask if I wanted some. Well as sick and drained as I was I think I cracked a smile, but I do know that the booze got confiscated by the medical staff and then the nurse asked me if I needed a drink. Ha! The strange part was I could tell that someone was here because I could smell smoke and it really bothered me, made it harder to breathe and I had asked Sarah for no more visitors until I felt better...
Later that day (which was actually 2 days later!) one Doctor said I appeared to be getting better, but Sarah asked for another opinion because of how I was looking and another Doctor said I should go to Regions hospital in St. Paul. I remember some of the ambulance trip as I knew who the 2 first responders were and they talked to me on the way. I got to Regions and I believe I was moved to at least 2 different rooms before settling me in. I don't recall much more, I couldn't breathe and not sure if I could talk. The next 2 months were very, very cloudy to say the least. l know I missed my first St. Patrick's Day in New Richmond since I could remember, and my family tried to make it the best they could for me, bringing me a shirt and few other fun things. I know I talked to Sarah a little bit and I remember being scheduled for a PICC at some point as well as a getting rigors from my first dosage of ampho.
Then.. SLEEP
KEY
PICC - Peripherally Inserted Central Catheter
Ampho - Amphoteracin B (anti-fungal, extremely toxic, extremely painful. Intravenously given over 4 hours every day)
Rigors - Uncontrollable shakes
Crown Royal - an awesome whiskey with a fun history
St. Patrick's Day - my favorite holiday :)
Daily Medicine (+2)
This list is only what I've been taking since I have been home. (May 9, '14) There were much more while I was in the 4 hospitals I was cared at.
6:00 AM - Hydrocodone (Vicodin) 2 pills @ 325 mg
Gabapentin (Neurotin) 2 pills @ 300 mg, later upped to 450 mg
Cymbalta - 1 pill, have now gone up to 2, and soon to 3/day
10:00 AM - Daily Vitamin - 1 pill - OTC
Vitamin C - 1 pill - OTC
Intraconazole (anti-fungal) 2 pills @ 100 mg
Metoprolol (blood pressure) 1 pill @ 25 mg - since discontinued
Potassium - 1 pill @ 20 mg
Furosemide (swelling) (makes me pee a lot) 1 pill @ 20 mg - going to try every other day
Vitamin D3 - 1 pill @ 5000 units (Sunday, Tuesday, Thursday)
2:00 PM - Hydrocodone - 2 pills @ 325 mg
Gabapentin -2 pills @ 450 mg
10:00 PM - Vitamin C 1 pill
Intraconazole - 2 pills @ 100 mg
Metoprolol - since discontinued
Potassium - 1 pill @ 20 mg
Cetirizine (allergy) 1 pill - OTC
Hydrocodone - 2 pills @ 325
Gabapentin - 3 pills @ 350
I need to keep on a good schedule for this or it takes its toll on my body..i.e. worsened pain, vomiting, more more tired. They say if I were to stop taking several different types of these instead of weaning off I could get seizures. Either way I keep Ibuprofen near by for days I need some extra pain relief.
* I plan to list my other medicines while in my hospitals at a later date.
-Cheek
9-19-14
Not sure if this was a case of mixed medicine or what but I had quite the experience today. I was out on my scooter running errands today, and as I got home I felt this yucky feeling in my belly and I all of a sudden felt dizzy, sick, lightheaded and I started to sweat really bad. I realized I had taken my 10:00 daily morning medicine a half hour later but that's not overly abnormal or concerning. I ended up going into the bathroom, sat down on the toilet and held the garbage can waiting for the worst. I hadn't had much to eat during the morning, I wasn't hungover from the previous night and nobody else in the family has been sick. Well nothing happened in the bathroom besides I lost like a gallon of sweat, I couldn't believe how much I was sweating, it was unreal. Anyway, my legs are week to start with along with my horrible foot pain and as my sore tush, so I started worrying if I could even get up on my feet if I wanted to. (Anybody remember Danny Glover in Lethal Weapon 2?) Well I started feeling a little better and heard my baby girl fussing upstairs so I forced myself up. As I felt better to an extent, I was still not right, my belly hurt bad and had asked my dad for a puke bucket. Well Sarah had now just gotten home from college and noticed right away I looked like hell and she started feeding me water. I do drink a fair amount of water per day, but since taking my medication from my illness I should know better and be drinking more. So needless to say I was most likely dehydrated as well as not reacting well to the meds I took. I did end up not taking my 2:00 meds until 5:30 and took my 10:00 PM meds slightly early and my night has been fine ever since. I have, however, loaded up on my water intake on the evening though. Moral of the story, listen to your wife lol.
Sorry if this story was boring. I'm tired and off to bed, so tonight's 'story' is kind of a daily diary ;-)
Believe me I have plenty Moore stories :-)
6:00 AM - Hydrocodone (Vicodin) 2 pills @ 325 mg
Gabapentin (Neurotin) 2 pills @ 300 mg, later upped to 450 mg
Cymbalta - 1 pill, have now gone up to 2, and soon to 3/day
10:00 AM - Daily Vitamin - 1 pill - OTC
Vitamin C - 1 pill - OTC
Intraconazole (anti-fungal) 2 pills @ 100 mg
Metoprolol (blood pressure) 1 pill @ 25 mg - since discontinued
Potassium - 1 pill @ 20 mg
Furosemide (swelling) (makes me pee a lot) 1 pill @ 20 mg - going to try every other day
Vitamin D3 - 1 pill @ 5000 units (Sunday, Tuesday, Thursday)
2:00 PM - Hydrocodone - 2 pills @ 325 mg
Gabapentin -2 pills @ 450 mg
10:00 PM - Vitamin C 1 pill
Intraconazole - 2 pills @ 100 mg
Metoprolol - since discontinued
Potassium - 1 pill @ 20 mg
Cetirizine (allergy) 1 pill - OTC
Hydrocodone - 2 pills @ 325
Gabapentin - 3 pills @ 350
I need to keep on a good schedule for this or it takes its toll on my body..i.e. worsened pain, vomiting, more more tired. They say if I were to stop taking several different types of these instead of weaning off I could get seizures. Either way I keep Ibuprofen near by for days I need some extra pain relief.
* I plan to list my other medicines while in my hospitals at a later date.
-Cheek
9-19-14
Not sure if this was a case of mixed medicine or what but I had quite the experience today. I was out on my scooter running errands today, and as I got home I felt this yucky feeling in my belly and I all of a sudden felt dizzy, sick, lightheaded and I started to sweat really bad. I realized I had taken my 10:00 daily morning medicine a half hour later but that's not overly abnormal or concerning. I ended up going into the bathroom, sat down on the toilet and held the garbage can waiting for the worst. I hadn't had much to eat during the morning, I wasn't hungover from the previous night and nobody else in the family has been sick. Well nothing happened in the bathroom besides I lost like a gallon of sweat, I couldn't believe how much I was sweating, it was unreal. Anyway, my legs are week to start with along with my horrible foot pain and as my sore tush, so I started worrying if I could even get up on my feet if I wanted to. (Anybody remember Danny Glover in Lethal Weapon 2?) Well I started feeling a little better and heard my baby girl fussing upstairs so I forced myself up. As I felt better to an extent, I was still not right, my belly hurt bad and had asked my dad for a puke bucket. Well Sarah had now just gotten home from college and noticed right away I looked like hell and she started feeding me water. I do drink a fair amount of water per day, but since taking my medication from my illness I should know better and be drinking more. So needless to say I was most likely dehydrated as well as not reacting well to the meds I took. I did end up not taking my 2:00 meds until 5:30 and took my 10:00 PM meds slightly early and my night has been fine ever since. I have, however, loaded up on my water intake on the evening though. Moral of the story, listen to your wife lol.
Sorry if this story was boring. I'm tired and off to bed, so tonight's 'story' is kind of a daily diary ;-)
Believe me I have plenty Moore stories :-)
Tuesday, September 2, 2014
Blastomycosis
This could be a long ongoing topic. Some stories I have are grizzly, some sad, some funny, some never happened because of the medications I was under, some a mixture of many. I think this will help me get things out for my own self worth as well as for my family and friends. I would like to write about my time dealing with this fungal pneumonia I was diagnosed with this past March. Any questions you may have or comments, please feel free to post. Sarah knows much better what happened to me as I was out of it for most of the months in the 4 hospitals I was in, so some posts may be going off what she tells/reminds me of. I'm probably going to do some sort of scrap book in chronological order of things that happened with pictures, but for this section, my posts will probably just be random.. Like this one,
Here I believe I was early on in my time at my last hospital, Bethezda.
I was freaking out for 2 days and 2 nights in a row because I had strict orders from the Doctors to attack the Russians. To accomplish my apparent mission, I was to secretly receive football shaped balloons that were going to be dropped to me from the sky into my hospital bed and I was to fill them up with flavored jello. My time frame I was unaware of but I knew I had to hurry. When the balloon shaped footballs started landing in my room I frantically called for a nurse for help because I couldn't reach them, well needless to say, this didn't go as planned.. (I should back up quickly and say that I could not walk, barely move my legs and my upper body was very weak at this point) Ok, so the nurse comes in and she had to put me back into place in my bed because I was searching for these balloons, messing up my tubes and nearly falling off the bed. Then I asked how many ounces of jello the balloons would hold, because apparently I've been filling them up too much and they have been exploding on me. The nurse would play nice and tell me to go back to bed, but I kept trying to find the balloons. This got very frustrating because I thought I really, really needed to take care of this 'mission.'
For whatever reason, I got over it after these 2 days and went on to plenty of other wonderfully interesting memories. Oh, turns out that there were obviously no balloons and the explosions were, well lets just say I wet myself.
I have more stories about Russians later,
-Cheek
Here I believe I was early on in my time at my last hospital, Bethezda.
I was freaking out for 2 days and 2 nights in a row because I had strict orders from the Doctors to attack the Russians. To accomplish my apparent mission, I was to secretly receive football shaped balloons that were going to be dropped to me from the sky into my hospital bed and I was to fill them up with flavored jello. My time frame I was unaware of but I knew I had to hurry. When the balloon shaped footballs started landing in my room I frantically called for a nurse for help because I couldn't reach them, well needless to say, this didn't go as planned.. (I should back up quickly and say that I could not walk, barely move my legs and my upper body was very weak at this point) Ok, so the nurse comes in and she had to put me back into place in my bed because I was searching for these balloons, messing up my tubes and nearly falling off the bed. Then I asked how many ounces of jello the balloons would hold, because apparently I've been filling them up too much and they have been exploding on me. The nurse would play nice and tell me to go back to bed, but I kept trying to find the balloons. This got very frustrating because I thought I really, really needed to take care of this 'mission.'
For whatever reason, I got over it after these 2 days and went on to plenty of other wonderfully interesting memories. Oh, turns out that there were obviously no balloons and the explosions were, well lets just say I wet myself.
I have more stories about Russians later,
-Cheek
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