All is Well

CaringBridge journal entry by Stephanie Fay — 8/9/2016

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Nancy slept off and on overnight after a sweet, laughter filled day. Sounds like the plan today is to have two MRIs — one of her heart and the other of her brain. Then we’ll go from there. Still no clear answers about why this happened. The MRIs may shed some light. The main cath lab doc who worked on her right after she arrived on Friday said it may just remain a mystery. Either way (explanation or no explanation), she will likely leave the hospital with an internal defibrillator which will automatically shock her heart should she ever go into VFib again.

Another of her docs today said folks with her sort of cardiac arrest often spend two weeks in the hospital and then two more weeks in rehab. He then said he expects Nancy’s trajectory to be shorter. It’s nice to have some sort of expectation but, naturally, we will take it day by day.

Nancy’s voice is returning, and she’s been busy schmoozing her nurses, especially in her quest for ice chips. Nothing by mouth until she has a swallowing assessment — standard procedure after ventilator removal. But she has been able to have a few ice chips, which she savors like crazy.

We both thank you for all your love and support. I’ve been reading a few of your posts to her. And we will definitely read them all in the days ahead. Together. I like that together idea a lot.

More as we learn it. Steph & Nancy

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She’s awake and talking!

CaringBridge journal entry by Stephanie Fay — 8/8/2016

They removed her respirator. She’s doing SO well!!! Whispering to us. Her voice is hoarse from the tubes. She is an amazing patient. Her nurse will get her up and moving about in a few hours. We can hear you all cheering from here!!!

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Best. Birthday. Present. EVER!!

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Sunday Evening

CaringBridge journal entry by Stephanie Fay – 8/7/2016

This is Stephanie again, and this part of post is from earlier today. It was a comment to Tonya’s post and Robin requested that I move it to a journal entry….

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

It’s now coming on 8 pm. All going smoothly. A day of deep rest for Nancy. Our favorite overnight nurse, Jordan, is on with Nancy tonight. He’s especially wonderful and this makes us all extremely happy. Tina and Jess and Tonya will stay overnight in the hospital w Nancy tonight. Jen and I and others will sleep a deep sleep and then all be back in the morning for the all important ventilator removal. Ask the universe and God and anything you ask such things of to keep Nancy from being too afraid. Jen and I will be in the room while they do this maneuver. Hopefully to help calm Nancy. Tomorrow Nancy talks to us again. Yes!!! Good night, sleep tight. Oh, and we can feel all your love and support washing over us. Thank you so much. We love you all right on back.

Stephanie

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Sunday on the Journey

CaringBridge journal entry by Tonya Katcher – 8/7/2016

Hi everyone,

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!)

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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.

Much love,
Tonya

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My sweet Nancy

CaringBridge journal entry by Stephanie Fay – 8/6/2016

Dear Friends and Family,

Stephanie writing now. Other family members will also update on this site as we go along.  I know many of you are waiting patiently for an update.

Nancy’s current status: She is resting comfortably in the Cardiac ICU at the University of Minnesota Hospital (East Bank). She is sedated now and has been all along. She has a breathing tube and as well as other machines, including one to support her heart. Occasionally she wakes up a little bit, can look at us, squeeze a nurse’s hand, etc. They want her to rest and remain calm. This has been her main job since yesterday late afternoon after they got her stabilized. Tomorrow it is possible they will begin to remove some of her machines. The goal eventually is to remove everything necessary to MRI her heart.

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No one knows why she went into cardiac arrest twice yesterday. She does not have a blockage of her heart; she did not have a heart attack..They knew that pretty much right away in the cath lab. So no explanation of why this happened. At least not yet.

The doctors have been very positive about how she is faring so far. Most everything has gone her way, I believe one doctor said today.  I’ll have my niece Tonya (who flew in from the east coast last night) update more about the medical aspects later tonight or tomorrow.  She’s an MD. My sister Cynthia is an MD, too, and has been here a lot yesterday and today with her spouse Kit.

So who else is here? Nancy’s son Dre, who lives in MN now, arrived almost right away yesterday. Nancy’s daughter Tina and her fiancé Jess flew in from Seattle yesterday early evening.  Nancy’s sister Jennifer arrived from California later last evening and pretty much sat up with Nancy all night while several of us caught a few winks in the family lounge just down the hall. Other friends and family have been in and out as well, including Tina and Dre’s dad Bruce. And our Pastor visited Nancy last night.

Tonight Jennifer and I will try to sleep all night at our house while Tonya stays in the ICU room with Nancy overnight. At least until Nancy is off the respirator, I’d like her to have a family member here with her in the room. Comfort for me for sure and, I believe, comfort for Nancy, too. She may not remember later, but she knows we are here now. Nancy’s nursing care here in the ICU is one-on-one. Amazing. Just incredible.

So what happened yesterday? Nancy and I have both had kinda nasty colds all week. Yesterday I woke up after her and she was sitting at the kitchen table working on her textbook. She looked like she was feeling better and reported feeling pretty good. We had coffee together. An hour or so later she was in her recliner in the living room, still working on her puter. She complained twice of feeling nauseated. We talked about that a little. I was getting ready to go out for about an hour or so. Then she said “I’m going to throw up” and came forward out of her chair. She wound up face down on the floor, and I couldn’t rouse her. I could see she was getting blue in the face, so I called 911. That was at 9:45 AM. After opening the front door, I flipped her over and, with the coaching of the 911 operator, began chest compressions. Her color improved almost immediately. The paramedics where there under 10 minutes is my guess. They took over and had to shock her heart 5 times to get it going again, which happened, as I understand it, in the ambulance just as we were leaving the house.

She went directly to the cath lab upon arrival at the U of M Hospital. No blockage found. Stabilized her and moved her to the Cardiac ICU. Around 3 o’clock she went into cardiac arrest again. There was very brief but very furious activity in her room (15 to 20 people in here!), and they got her heart going again. But her blood pressure was poor. So they prepared to take her back to the cath lab. The doctor said they would likely need to put her on a bypass machine to pump her heart for her. But she improved while they were prepping her, so they were able to use an intermediate intervention with a balloon pump up near her heart.  I’ll let Tonya tell you more about all that.

Then back up to the ICU unit by 6 pm or so. They worked to get her calm and sedated and things have been real calm for her ever since.

So we’ll see what tomorrow brings. She is not clear of the cardiac woods yet. Yesterday I thought three or four times, this is going to be the day my sweet Nancy dies. Today my feeling is that she will live. She’s tougher than you might know or think. Pray for her to be strong. Pray there are no insurmountable setbacks. The doctors say this will be a marathon, not a sprint.

More tomorrow or the next day from me. More from others soon, too, probably. We thank you for all your love and support.

Love, Stephanie

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