CaringBridge journal entry by Tonya Katcher – 8/7/2016
This is Tonya writing – I’m Stephanie’s niece and a pediatrician who trained in this very hospital not too many years ago. I’m so glad to be here with all of the family, surrounding Nancy and Steph in a web of love and support. Thank you to all who have commented so far.
I’m going to give a little more medical overview of what we know so far, hopefully translated into plain English (which docs are notoriously bad at doing!)
Nancy had a cardiac arrest on Friday morning, which means her heart stopped effectively pumping blood to her body. It seems that she had an arrhythmia called ventricular fibulation, or V-Fib for short. At this point we don’t know what caused this event to happen – most of the time it’s due to a blockage of the blood vessels that feed the heart muscle (aka a heart attack or myocardial infarction) but Nancy does not have any of this blockage, so that’s not the cause in this case. We’re going to investigate further as time goes on, but need to help Nancy get through the aftereffects of this event first. Luckily, Stephanie was with her, and called 911 right away, and started CPR right away – all of which are needed for good outcomes after an event like this. She had a second brief episode of V-Fib in the ICU and was resuscitated again on Friday afternoon with Steph and Dre and Cynthia bearing witness. At that point it looked like she might need to go on cardiac bypass to take over for her heart for a while, but her heart stabilized and that wasn’t necessary. She did have a balloon pump placed in her heart to support its pumping, and that has been in since Friday afternoon.
Things quieted down Friday afternoon and evening, once the pump was in, and all of the things supporting Nancy’s body were in place. She was awake some then as they worked to find a recipe for sedation that would keep her comfortably asleep. She’s been mostly sleeping since then, though opening her eyes at times and responding to directions from the nurses (like squeezing hands, coughing, etc). She’s had amazing, attentive, loving nursing care, and has been surrounded by family and support.
Nancy has needed a lot of support – to support her heart’s pumping, to keep her blood pressure up, the ventilator to breathe for her, oxygen to ease the work on her heart and brain. However, her body has been giving steady signals all along that it’s ready to do all of the things bodies do all on her own, so the process now is one of gradually reducing the supports and letting her body take over.
- Her heart function is normal, meaning it’s beating with a normal rhythm and is effectively pumping blood throughout her body. The doctors have turned off the balloon pump for brief episodes as a test and her rhythm and blood pressure were steady. They’re planning to take the pump out this morning, which is a bedside procedure. They’re also going to take the big fancy IV’s out of her groin/femoral arteries now, once they get another fancy IV placed in her wrist (that they’re using to monitor her blood pressure).
- She is on a ventilator to help her breathe, but the nurses are steadily turning down the amount of support she’s getting from the vent, and she’s tolerating that just fine. They’ve also been able to turn down the oxygen. All of which means her lungs are functioning well. She has had a fever off and on, and think she may have a little pneumonia – but she is on strong antibiotics and her lungs are not showing signs of distress, so I think this is not a big worry right now.
- She has been on medications to keep her blood pressure up, as it was too low right after the cardiac events on Friday. These “drips” have been regularly turned down, and now she’s getting minimal support – also a good sign that her heart and her vascular system is working properly.
- It took a while to find a good level of sedation to keep Nancy comfortable, but she’s been sleeping comfortably since Friday evening. All of the indicators of her neurologic function have been reassuring. She has been on a continuous EEG brain monitor, and hasn’t had any seizures. The doctor expects that she may have a little bit of injury to her brain due to the periods of cardiac arrest (when the brain isn’t getting as much blood flow as it really needs) but he expects that she will recover. She may have some short-term memory problems or coordination problems initially, but this will likely improve with time.
All in all, despite a terrifying acute cardiac event, all signs are pointing us to be hopeful. The doctors have been really clear that there is still possibility of setbacks and complications, and that this is going to be more of a marathon than a sprint. The immediate next steps are to take out the heart pump and the big IVs in her groin (after which she needs to rest for 6 hours before taking next steps). Then we hope to turn down the sedation so she can wake up a bit and get the breathing tube out. The doc thinks the breathing tube MAY come out tonight, or more likely tomorrow morning. Once those two things are out, the team wants to get an MRI of Nancy’s heart, and possibly a biopsy of her heart tissue, to further investigate the underlying cause of the initial event.
But that’s a day or a few days down the road at least. At the moment, we remain here at Nancy’s side, holding her in love and light. We are grateful for the skilled and kind care we have received, and for Nancy’s strong and beautiful spirit. We are celebrating the many small blessings and victories that have happened so far, and the many ways that Nancy’s body is responding and healing already.
Thank you for following along, for praying and sending woo, for reaching out and holding Nancy and Steph in your hearts. Many people have asked how they can help – we will definitely send out a call if we ned some material support (food, rides, etc). I will update again as I have more information, and am happy to respond to questions if folks want to post them in comments.
Mary Carlsen | Aug 8, 2016 10:30am
Just heard today about this and have been praying for calm, continuous improvement and recovery. Much love and light to all of you, esp, Stephanie and the “kids”. Family is such a gift. thank you for keeping Nancy’s wider community of friends updated.
marguretta yaeger | Aug 7, 2016 9:15pm
Our prayers are with you, Nancy, and your whole family. God is there with you, May you feel His presence! We will watch for updates and hope for a full recovery for you!
Amanda Ellertson | Aug 7, 2016 8:08pm
We are so relieved to read that there is progress in the right direction! LOVE and HUGS and many healing thoughts sent across the rockies and the great plains to Nancy.
Georg Ann Burns | Aug 7, 2016 7:49pm
Thanks, Tonya. Knowing what has gone on and is now going on is very helpful in keeping me and their many worried friends in the loop. Prayers and best wishes to Nancy and Steph and a gigantic hug to Steph.
Pat Saltsman | Aug 7, 2016 7:48pm
Much love and prayers to you, Nancy and the family. Be strong.
Jane Anglin | Aug 7, 2016 7:47pm
So shocking to hear about this terrifying event! I am thinking about all of you and sending love and light. Jane
Connie Ford | Aug 7, 2016 7:46pm
Sending boundless love and endless prayers.
norma aarsvold | Aug 7, 2016 7:12pm
Andreas and Tina, Thinking of you with love and concern…I know how much you love your Mom! God`s Blessings to you all. Grandma Norma
Kristi Pesek | Aug 7, 2016 6:58pm
Sending out good thoughts and prays.
Bobbi Baker | Aug 7, 2016 6:27pm
Thinking of you all and hoping for a full and speedy recovery.
Ann Dyellig | Aug 7, 2016 6:26pm
Thanks for the update, and for Stephanie’s note yesterday too. I’m so happy that things are looking more positive and that there are signs of healing. Prayers at Pilgrim today were said and everyone is pulling for Nancy! She is so loved!
John Eric Rolfstad | Aug 7, 2016 6:23pm
Much love to all of you at this challenging time. I will be sending up prayers for a quick and complete recovery.
Aimee Brown | Aug 7, 2016 5:50pm
Thank you for the update Tonya.
Nancy and Steph – I’m keeping both of you in my thoughts and wishing for a full and speedy recovery.
Jean Hay | Aug 7, 2016 5:42pm
Thank you, Tonya for the wonderful and clear description. Jan and I are praying with you (all) and will happily help with whatever you need.
Vicki (Fay) Ostert | Aug 7, 2016 5:37pm
Thank You for letting us know. Prayer’s for Nancy and Stephanie. Great to know that Cynthia is there for support.
Samantha Bavage | Aug 7, 2016 5:29pm
Sending all my love and prayers!!
Katie Eschenbauch | Aug 7, 2016 5:13pm
Sending you lots of love; our thoughts and prayers!
Katie, Croix and Eli
Hanna Emerson | Aug 7, 2016 5:12pm
Thank you for the detailed update, Tonya. I am glad she is getting such a good care. She, Steph and family are in my thoughts and prayers.
Betsy Ellis | Aug 7, 2016 4:59pm
Tonya, thank you for taking the time (lots of time!) to write that post. It was so clear and detailed. It left me with the impression that Nancy is in excellent hands and has excellent chances of pulling through this in good shape. Please let Stephanie know that my arms are around her in a hug as she processes all that has happened in such a short time.
Patricia Sween | Aug 7, 2016 4:33pm
How wonderful to have a physician give us this info! Thanks, Tonya, and blessings to all of you. We love you, Nancy and Stephanie!
Kris Davis | Aug 7, 2016 4:31pm
Thinking of ALL of you and sending love and strength…. There’s a lot of love surrounding Nancy, which will help in every way! Praying that it’s a smooth road to better…
norma aarsvold | Aug 7, 2016 4:22pm
Thoughts and Prayers Nancy, I Love You, Norma
Lynda Hirschboeck | Aug 7, 2016 4:17pm
Thank you for this detailed report. Nancy, you are certainly in my prayers for a full and speedy recovery. Stephanie, please know that I’m thinking of you, too! Wishing the best to you both.
mona Olson | Aug 7, 2016 4:13pm
Stephanie, please know that Guy and I are holding you in our prayers. We are so saddened by this event but extremely happy that you were there for her. Nancy’s spirit is one of a kind and if anyone can push through this, she can. She is so blessed to have you by her side. Godspeed, Mona and Guy Olson
Louis janus | Aug 7, 2016 4:12pm
Nancy — hard to believe… thanks for the notification!
Beth Christensen | Aug 7, 2016 4:11pm
Thinking of you all, and especially Nancy. She is a strong Scandinavian woman, and we know that will continue to do her well.
Gay Hadley | Aug 7, 2016 4:07pm
Oh, Tonya, your extensive letter explaining to all of us what has happened is a real gift!
I cannot thank you enough! Nancy and Steph are perched right here in my heart. Now I feel even closer because of you. Thank you, Tonya, and love to you and your family. Gay Hadley
Donna Dingle | Aug 7, 2016 3:57pm
We are thinking of all of you Tonya. Thank- you for the update. Support and love coming from the Swingles to. Nancy and Stephanie and family.
Lisa Cohen | Aug 7, 2016 3:52pm
Thank you Tonya. We are thinking about all of you and glad you can all be there for Nancy. Lisa and Amy
Kathy Tegtmeyer Pak | Aug 7, 2016 3:46pm
So glad to know that she’s getting such good care, and responding so well. Thank you so much for sharing this news so clearly to the wide, wide circle of people who love Nancy.
Karil Kucera | Aug 7, 2016 3:41pm
Many thanks for a very clear and yet thorough explanation of what’s going on, Tonya. We all appreciate it. I am keeping Nancy in my thoughts. If anything is needed, just let me know!
Keith Homstad | Aug 7, 2016 3:41pm
Healing prayers for you!
Susan Hadley | Aug 7, 2016 3:26pm
Thank goodness Nancy is surrounded by the very best, most caring family and friends. We are holding you all in our hearts. Susan and Bradley
Mary Ellen Erlandson | Aug 7, 2016 3:25pm
Thank you Tonya for the clear and thorough update. My thoughts and prayers are with Nancy, all her family and loved ones, and the professional caregivers who are helping her to heal. Take care all of you. My love to all.
Kari Lipke | Aug 7, 2016 3:24pm
Thank you for the time and attention crafting such a thorough update for all of us at a distance. Sending much love to Nancy, Steph, Dre, Tina, and all who are gathered offering care and support.
Ragnhild Jepsen | Aug 7, 2016 3:23pm
Please tell Nancy and Stephanie that they are in my prayers! Love, Ragnhild
susan Donohue | Aug 7, 2016 3:16pm
Tonya, this is a wonderfully clear recap of all the events. I cried with relief the whole way through it. Thank you for explaining so well. I celebrate with you and your families Nancy’s remarkable progress and the love and support that surround her. G-d bless.
Sveinung Moesgaard Skjesol | Aug 7, 2016 2:38pm
Thanks Tonya. I am so sorry this happened. Dear Nancy and dear Stephanie, you are in our thoughts – I have updated my parents and siblings, they send their love.
Hilary Crook | Aug 7, 2016 2:38pm
Thinking so much about Nancy and family!!!
Kristin and Jean Kristin and Jean | Aug 7, 2016 2:37pm
Thanks for the update. Stephanie and Nancy: prayers to you both.
Laura Secord | Aug 7, 2016 2:36pm
Sending healing energy for Nancy and support and care for Steph and all of you.
Chuck Heller | Aug 7, 2016 2:32pm
– Good thoughts your way Stephanie.
Mary Jahnke | Aug 7, 2016 2:27pm
We will continue to hold you both in our prayers.
Jonathan O’Conner | Aug 7, 2016 2:20pm
Thank you, Tonya, for this great explanation. We are glad to read in Stephanie’s comment that the tubes were removed successfully. Eric and I continue to send love and thoughts for Nancy and the entire family.
Maria Kelly | Aug 7, 2016 2:18pm
Thank you, Tonya, for this helpful update. One of the many reasons why I am so glad you are able to be there now.
Liz Hawkinson | Aug 7, 2016 2:07pm
Thinking of you all. Sending love.
Stephanie Fay | Aug 7, 2016 1:54pm
Hello again all, The removal of the tubes went very well this morning. Now Nancy will rest under heavier sedation for 6 hours. Until 6 or 7 pm. Then she will return to her previous level of sedation until tomorrow morning when they will remove her ventilator. Then she will be able to talk with us again. Although they said it will be normal for her to be quite confused early on, I can’t wait for that! So lots of good, deep rest today for my bride. Thank you for all your kind words. I was telling my bff Maria that our grandniece Evie really loves her Besta (Evie’s name for Nancy, short for Grandma in Norwegian). Maria reminded me that EVERYBODY loves Nancy. Which is just so true, isn’t it? More tomorrow. Steph
Debbie LeFever | Aug 7, 2016 1:44pm
Continued prayers for Nancy
Abby Brogden | Aug 7, 2016 1:22pm
Beautifully done Tonya. Both yours and Steph’s entries are hughly appreciated. JoAnn and I are so relieved to hear about Nancy’s positive progress and send all good thoughts and energies to all of you. with much love, Abby
Michele Whetstone | Aug 7, 2016 1:16pm
Our thoughts are with you all! Sending lots of love!!!
JoAnn Johnson | Aug 7, 2016 1:06pm
Tonya, your summary of Nancy’s condition is not only enlightening but is brilliant in condensing such complex care into clear and concise language. From your words we take a spirit of hope as you describe so well how Nancy is slowly regaining cardiac and respiratory function. For our dear Nancy and her exquisitely kind and beautiful spirit we send our greatest love. We are thinking of all of you as your surround her with your strength and love. JoAnn
Jason Menard | Aug 7, 2016 1:05pm
Well explained! I’m so glad Nancy’s over the immediate crisis. Thanks to you and Steph (and Kari!) for keeping us all informed. While it certainly sounds like the recovery time won’t be quick, I hope this is the fastest marathon ever.
karla jean miller | Aug 7, 2016 1:03pm
Thank you for this update and explanations. Am so glad that you are there for dear Stephanie and Nancy. I know your presence must be healing balm for both of them. Continuing prayers and energy and love and light surrounding all of you. With deep care, Karla
Anne Sabo | Aug 7, 2016 12:59pm
I second Kari; thank you so much for the update and for so carefully explaining to all of us who feel so helpless yet care so much for Nancy. Sending heaps of love and light and big hugs.
Kari Dorer | Aug 7, 2016 12:40pm
Tonya, you did a great job of explaining this at a level I can understand. thanks! Hugs!