Mid-day update:
Epinephrine was discontinued as of 6am this morning. That's one goal achieved. Next, they're pursuing the second goal of weening Naomi off of the heart pump by setting the heart pump to make Naomi's heart do more of the work. Yesterday the ratio was stated as 1:2 (1 machine pump, 2 heartbeats). Today Lisa said it's 4:1. I was alarmed at first, but she clarified that it's 4 heartbeats, 1 machine pump. We'll get the proper notation of the ratio solved sooner or later (hopefully sooner). Next 24 hours will be very telling, so pour on the prayer for the cardiac status and blood pressure to stay favorable.
Lisa wanted to pass on her thanks to the staff at Desert Valley and Loma Linda, as well as for the encouragement and support from so many.
Phil, on behalf of Lisa.
Wednesday, June 30, 2010
Tuesday, June 29, 2010
Baby steps
Phil here, typing for Lisa. Here's the update she wants to communicate to all of us that are pulling for Naomi. Her update came in this afternoon but I wasn't able to retrieve voicemail until tonight. Sorry for the delay.
Cardiac: Epinephrine was lowered from yesterday (4 to 2.67) and Naomi's tolerating the change well so far. Her blood pressure is steady, even a little high (which in her case is a good thing). She's on 2ug (micrograms) of Dobutamine, which is used to get stronger heart contractions, but we'd like to see the need for this drug be lowered (or better yet, eliminated). Stronger contractions are what she needs, but the drug can sometimes cause the heart to pump too fast (tachycardia) and when the heart's pumping too fast, the contractions aren't strong and forceful enough to get blood out to keep vitals organs perfused with oxygen (make a strong fist, then open your hand wide 5 times slowly and then try doing the same thing as fast as you can... see how your fingers flutter and the fist isn't strong? Same idea with the heart). In addition to weening Naomi off the meds, there will be an attempt made to ween her off of the heart pump. Right now the ratio is 1:2 (1 pump of the machine, 2 pumps of her heart). This helps give Naomi's heart a rest so it can heal, as the machine is doing 1/3 of the work right now. The next goal is 1:3 (machine doing 1/4 of the work), then to 1:4 and so on. In order for this to happen, the heart muscles have to become strong. The doctors, even with their skill & application of meds & mechanics, can't do this for Naomi. So pray fervently for healing & strength of the heart.
Respiratory: no change from yesterday.
Nephrology: Kidneys are still functioning as well as they were yesterday, so the dose of the diuretic (helps the kidneys produce more urine) was lowered. Wait and see, and pray for pee (that's from me, not Lisa).
They started feeding Naomi yesterday. I don't know whether this would be TPN (total parenteral nutrition via a needle) or if a feeding tube was inserted. A downside of TPN is that it has infection risks. But when there's multiorgan failure, TPN may be a better choice than trying to do surgery to insert a feeding tube. Either way, this should give Naomi the extra energy she so badly needs to keep up her fight.
As I think about today's concerns (Dobutamine and the risks, TPN versus feeding tube), I am reminded of the mind-blowing balancing act that is necessary to stay alive and healthy. Tweak one little thing to help this organ, it can throw off the function of that organ. Increase the oxygen percentage to get more oxygen into the blood, it can make the lungs brittle and blow a hole, causing loss of oxygen in the long run. The examples are endless. It seems at times that practicing medicine can be as much art as it is science. As I wrote for the last post, toss up prayer for an extra dose of wisdom & insight for the medical pros. Also, toss up prayer for those in Naomi's family that are also getting a crash-course in medicine so that they can keep on top of what's going on and make the best decisions for Naomi's care when called upon to do so.
Cardiac: Epinephrine was lowered from yesterday (4 to 2.67) and Naomi's tolerating the change well so far. Her blood pressure is steady, even a little high (which in her case is a good thing). She's on 2ug (micrograms) of Dobutamine, which is used to get stronger heart contractions, but we'd like to see the need for this drug be lowered (or better yet, eliminated). Stronger contractions are what she needs, but the drug can sometimes cause the heart to pump too fast (tachycardia) and when the heart's pumping too fast, the contractions aren't strong and forceful enough to get blood out to keep vitals organs perfused with oxygen (make a strong fist, then open your hand wide 5 times slowly and then try doing the same thing as fast as you can... see how your fingers flutter and the fist isn't strong? Same idea with the heart). In addition to weening Naomi off the meds, there will be an attempt made to ween her off of the heart pump. Right now the ratio is 1:2 (1 pump of the machine, 2 pumps of her heart). This helps give Naomi's heart a rest so it can heal, as the machine is doing 1/3 of the work right now. The next goal is 1:3 (machine doing 1/4 of the work), then to 1:4 and so on. In order for this to happen, the heart muscles have to become strong. The doctors, even with their skill & application of meds & mechanics, can't do this for Naomi. So pray fervently for healing & strength of the heart.
Respiratory: no change from yesterday.
Nephrology: Kidneys are still functioning as well as they were yesterday, so the dose of the diuretic (helps the kidneys produce more urine) was lowered. Wait and see, and pray for pee (that's from me, not Lisa).
They started feeding Naomi yesterday. I don't know whether this would be TPN (total parenteral nutrition via a needle) or if a feeding tube was inserted. A downside of TPN is that it has infection risks. But when there's multiorgan failure, TPN may be a better choice than trying to do surgery to insert a feeding tube. Either way, this should give Naomi the extra energy she so badly needs to keep up her fight.
As I think about today's concerns (Dobutamine and the risks, TPN versus feeding tube), I am reminded of the mind-blowing balancing act that is necessary to stay alive and healthy. Tweak one little thing to help this organ, it can throw off the function of that organ. Increase the oxygen percentage to get more oxygen into the blood, it can make the lungs brittle and blow a hole, causing loss of oxygen in the long run. The examples are endless. It seems at times that practicing medicine can be as much art as it is science. As I wrote for the last post, toss up prayer for an extra dose of wisdom & insight for the medical pros. Also, toss up prayer for those in Naomi's family that are also getting a crash-course in medicine so that they can keep on top of what's going on and make the best decisions for Naomi's care when called upon to do so.
Monday, June 28, 2010
Monday night update
Lisa just left a voicemail for us (Phil & Denise). Here's what she had to say. More good news than bad, so let out a cheer!
Cardiac: Epinephrine (used to increase heart rate, contract blood vessels) was lowered from yesterday's dose. Naomi's heart tolerated the reduction well. She's still on the cardiac pump at a 1:2 ratio. Her heart is still functioning at 20% while most of us are about 65%. I'm not sure, but based on what I know from a lengthy hospital stay that my wife had, I believe this number refers to the "ejection fraction" which means the amount of blood pumped out of the vetricles with each contraction of the heart (some blood swirls around in the chambers, which is normal, and thus 65% is fine, but 20% is a problem). So toss up some prayer for that cardiac status (stronger contractions, lowering of meds, better ejection fraction).
Respiratory: Her breathing seems better. While only being given 30% oxygen, her oxygen saturation is around 100%. Her blood gas numbers are normal. This is phenomenal! She is still intubated (and heavily sedated), and of course it would be nice for her to get to the point where they can remove the tube and perhaps just use the nasal canula for any extra oxygen.
Her PH is normal (too much acidity = bad news for the body). This is a very good thing.
Kidneys seems to continue to do their job, and this is a big thing working in Naomi's favor.
WBC (white blood cell) count is between 7-8 (normal between about 4 & 11). When WBC is elevated, it means there's an infection raging somewhere. Nice to hear that her WBC count is within the normal range.
About 4 liters fluid were removed. When there's fluid buildup, there's something wrong (infection, congestive heart failure, hard on the kidneys), so we want to see less and less fluid being drawn out of her.
Lisa also wanted to say a special word of thanks to the doctors, nurses, RTs (respiratory therapists), and others (secretary, etc.) that have sustained her sister thus far. If you're the praying sort, please join me in lifting up these medical professionals in prayer. Their hours are long, their work is stressful, and they are expected to have the right answers all the time. She also appreciates the encouragement and expressions of caring from so many of us, and asks for your understanding if she's not able to reply promptly.
Cardiac: Epinephrine (used to increase heart rate, contract blood vessels) was lowered from yesterday's dose. Naomi's heart tolerated the reduction well. She's still on the cardiac pump at a 1:2 ratio. Her heart is still functioning at 20% while most of us are about 65%. I'm not sure, but based on what I know from a lengthy hospital stay that my wife had, I believe this number refers to the "ejection fraction" which means the amount of blood pumped out of the vetricles with each contraction of the heart (some blood swirls around in the chambers, which is normal, and thus 65% is fine, but 20% is a problem). So toss up some prayer for that cardiac status (stronger contractions, lowering of meds, better ejection fraction).
Respiratory: Her breathing seems better. While only being given 30% oxygen, her oxygen saturation is around 100%. Her blood gas numbers are normal. This is phenomenal! She is still intubated (and heavily sedated), and of course it would be nice for her to get to the point where they can remove the tube and perhaps just use the nasal canula for any extra oxygen.
Her PH is normal (too much acidity = bad news for the body). This is a very good thing.
Kidneys seems to continue to do their job, and this is a big thing working in Naomi's favor.
WBC (white blood cell) count is between 7-8 (normal between about 4 & 11). When WBC is elevated, it means there's an infection raging somewhere. Nice to hear that her WBC count is within the normal range.
About 4 liters fluid were removed. When there's fluid buildup, there's something wrong (infection, congestive heart failure, hard on the kidneys), so we want to see less and less fluid being drawn out of her.
Lisa also wanted to say a special word of thanks to the doctors, nurses, RTs (respiratory therapists), and others (secretary, etc.) that have sustained her sister thus far. If you're the praying sort, please join me in lifting up these medical professionals in prayer. Their hours are long, their work is stressful, and they are expected to have the right answers all the time. She also appreciates the encouragement and expressions of caring from so many of us, and asks for your understanding if she's not able to reply promptly.
Sunday, June 27, 2010
White blood count 9, kidney function good
(From Ashley, on behalf Lisa & the rest of Naomi's family)
Hi everyone,
Just spoke to Lisa, here is the most recent info on Naomi:
Praise and glory to God and his son Jesus and the Holy Spirit forever and ever! Naomi is still in critical condition but is heading in the right direction. Her white blood count is now 9 which is where it should be so the infection is going away. They are currently using a diauretic and her kidney function is good. They are planning on weaning her off the norepinephrine for her heart. She is currently still on a ventilator but they are hoping to wean her off of that as well.
Lisa's prayer request is for total restoration for Naomi's brain, heart, lungs and that she no longer has to be dependent on anything. Also that her children can be around her when she wakes because they really miss their Mommy!
Special thanks: Phil, Denise and Margaret for setting up and posting on the Pulling for Naomi blog. Sherry for being able to visit and pray over Naomi twice. And for everyone gathering together and praying over Naomi! Thanks also for the doctor, nurses and medical staff for providing Naomi with excellent medical care.
Bible verses from Lisa:
Matthew 21-22
Matthew 8:1-3
Matthew 8:5-17
Matthew 8:23-27
Thanks everyone, praise God that Naomi is on the mend!
Love,
Ashley
Hi everyone,
Just spoke to Lisa, here is the most recent info on Naomi:
Praise and glory to God and his son Jesus and the Holy Spirit forever and ever! Naomi is still in critical condition but is heading in the right direction. Her white blood count is now 9 which is where it should be so the infection is going away. They are currently using a diauretic and her kidney function is good. They are planning on weaning her off the norepinephrine for her heart. She is currently still on a ventilator but they are hoping to wean her off of that as well.
Lisa's prayer request is for total restoration for Naomi's brain, heart, lungs and that she no longer has to be dependent on anything. Also that her children can be around her when she wakes because they really miss their Mommy!
Special thanks: Phil, Denise and Margaret for setting up and posting on the Pulling for Naomi blog. Sherry for being able to visit and pray over Naomi twice. And for everyone gathering together and praying over Naomi! Thanks also for the doctor, nurses and medical staff for providing Naomi with excellent medical care.
Bible verses from Lisa:
Matthew 21-22
Matthew 8:1-3
Matthew 8:5-17
Matthew 8:23-27
Thanks everyone, praise God that Naomi is on the mend!
Love,
Ashley
Blood Pressure and More Prayer
Lisa has a brief update. She said that after they lowered Naomi's heart medication, her blood pressure dropped. So she was unstable for a little while today. She is still in critical condition. But overall, the doctor is hopeful for Naomi!
Lisa was so grateful and blessed that God is causing huge progress towards Naomi's healing. Let's have faith together with Lisa that God will fulfill His purpose for Naomi (Psalm 138:8).
Please continue to pray...
1. For Naomi's heart to heal and strengthen, a complete resoration.
2. For Lisa and her parents; it's hard to have your loved one in critical condition.
3. For God to rejuvenate Lisa as she labors in prayer for her sister: "Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day" (2 Cor 4:16). And as Epaphras served the saints of Colosse (Col 4:12b), let's serve Lisa (and Naomi) in the same way: "always wrestling in prayer for them, that they may stand firm in all the will of God, mature and fully assured.
Until we are able to give more specifics and lengthy updates, know that God knows the details. "We do not know what we ought to pray for, but the Spirit Himself intercedes for us with groans that words cannot express" (Rom 8:26). What a blessing to know that God is the One in control!
Waiting and praying with you,
Margaret (for Lisa and her family)
Lisa was so grateful and blessed that God is causing huge progress towards Naomi's healing. Let's have faith together with Lisa that God will fulfill His purpose for Naomi (Psalm 138:8).
Please continue to pray...
1. For Naomi's heart to heal and strengthen, a complete resoration.
2. For Lisa and her parents; it's hard to have your loved one in critical condition.
3. For God to rejuvenate Lisa as she labors in prayer for her sister: "Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day" (2 Cor 4:16). And as Epaphras served the saints of Colosse (Col 4:12b), let's serve Lisa (and Naomi) in the same way: "always wrestling in prayer for them, that they may stand firm in all the will of God, mature and fully assured.
Until we are able to give more specifics and lengthy updates, know that God knows the details. "We do not know what we ought to pray for, but the Spirit Himself intercedes for us with groans that words cannot express" (Rom 8:26). What a blessing to know that God is the One in control!
Waiting and praying with you,
Margaret (for Lisa and her family)
Saturday, June 26, 2010
Hope
I briefly spoke with Lisa. The doctor has a lot of hope for a soon recovery. Lisa will call later with more specifics. Praise the Lord!
"Let Your mercy be upon us, just as we hope in You" Psalm 33:22.
Hoping and trusting in the Lord together,
Margaret (for Lisa and her family)
"Let Your mercy be upon us, just as we hope in You" Psalm 33:22.
Hoping and trusting in the Lord together,
Margaret (for Lisa and her family)
Cardiac Care at Loma Linda
Naomi was safely transported to Loma Linda Medical Center. Praise God!
Regarding Naomi's heart...
Sherry said it is being weaned off the heart pump. Before the heart was at a 1:1 ratio with the heart pump pumping once, and then Naomi's heart pumping once. Now it is a 2:1 ratio, with the heart pump pumping once and Naomi's heart pumping twice. This is good; her heartbeat is closer to normal. However, she has a fever again. Her head was hot so they put ice packs around her. Her heart is functioning around 25-30%, but still needs to be at 60-70%. In addition, Naomi's lungs are stiff and contain fluid.
Lisa's prayer requests:
1. For Naomi to get the rest she needs.
2. Complete restoration of Naomi's health.
3. Miraculous healing of Naomi's heart.
4. For Lisa's family to remain strong, healthy and to not grow weary.
Praise:
Before being transported, Naomi was able to spend some time with her adorable baby boy. A teary-eyed moment for sure!
When Ashley spoke with Lisa, Lisa expressed deep gratitude for your support and prayers.
Regarding Naomi's heart...
Sherry said it is being weaned off the heart pump. Before the heart was at a 1:1 ratio with the heart pump pumping once, and then Naomi's heart pumping once. Now it is a 2:1 ratio, with the heart pump pumping once and Naomi's heart pumping twice. This is good; her heartbeat is closer to normal. However, she has a fever again. Her head was hot so they put ice packs around her. Her heart is functioning around 25-30%, but still needs to be at 60-70%. In addition, Naomi's lungs are stiff and contain fluid.
Lisa's prayer requests:
1. For Naomi to get the rest she needs.
2. Complete restoration of Naomi's health.
3. Miraculous healing of Naomi's heart.
4. For Lisa's family to remain strong, healthy and to not grow weary.
Praise:
Before being transported, Naomi was able to spend some time with her adorable baby boy. A teary-eyed moment for sure!
When Ashley spoke with Lisa, Lisa expressed deep gratitude for your support and prayers.
Let's remain focused on Him. As we see some signs of improvement, let's continue to ferverently pray. As you read the updates and pray, remember "Who was, is and will always be." With Him as our focus, we shall remember that nothing is too hard for our God. "Now to Him Who is able to do immeasurably more than all we ask or imagine, according to His power that is at work within us, to Him be glory in the church and in Christ Jesus throughout all generations, forever and ever! Amen" Ephesians 3:20-21.
Serving in prayer together,
Margaret (for Lisa and her family)
Friday, June 25, 2010
From Victorville to Loma Linda
Ashley and Andrea (friends of Lisa) said that Naomi will be transferring shortly (probably within 30 minutes) to Loma Linda for cardiac care. Please pray that Naomi will remain stable during the transport.
Heart Pump and Lowered Temperature
They installed the pump for Naomi's heart. It pumps the blood for her so the heart can rest. So far, there are no complications. Naomi needs to be stable for 24 hours.
Praise the Lord...Naomi's temperature is 98.6. What an answer to prayer! Speaking of prayer, Lisa thanks you for praying and interceding on behalf of Naomi and her family. There are so many of you praying, even at the hospital where Naomi is at. The nurses there have been such an encouragement.
Before Sherry left the hospital, she went to see Naomi's baby boy. And survey says...he's a cutie! Also, the nurses say he's a good baby.
Let's continue to trust the Lord. He has already answered our prayers to lower Naomi's temperature. That brought tears to Lisa's and Sherry's eyes. Brothers and sisters, the Lord is our strength and our song, our salvation (Psalm 118:14). Psalm 112:7 says "he will have no fear of bad news; his heart is steadfast, trusting in the Lord."
Depending on the Lord with you,
Margaret (for Lisa and her family)
Praise the Lord...Naomi's temperature is 98.6. What an answer to prayer! Speaking of prayer, Lisa thanks you for praying and interceding on behalf of Naomi and her family. There are so many of you praying, even at the hospital where Naomi is at. The nurses there have been such an encouragement.
Before Sherry left the hospital, she went to see Naomi's baby boy. And survey says...he's a cutie! Also, the nurses say he's a good baby.
Let's continue to trust the Lord. He has already answered our prayers to lower Naomi's temperature. That brought tears to Lisa's and Sherry's eyes. Brothers and sisters, the Lord is our strength and our song, our salvation (Psalm 118:14). Psalm 112:7 says "he will have no fear of bad news; his heart is steadfast, trusting in the Lord."
Depending on the Lord with you,
Margaret (for Lisa and her family)
Thursday, June 24, 2010
June 25th Update
Hi Everyone,
It's Lisa's friend, Margaret. Here's what is going on...
Naomi's infection has slightly decreased with her temperature going from 104-101. White blood cell count has decreased. Vital signs continue to be stable. Blood in her urine is lessening. Naomi's kidneys and liver are better. The lungs are slightly better.
Regarding the heart, they're decreasing the heart medication; her heart has been responding positively to that. However, the doctor wants to put a pump in the heart to stabilize it, as this would give the heart a rest. It's been found to help people improve. They hope to stabilize the heart within 24 hours with this "pump" treatment. IF there are no improvements, they recommend a heart transplant.
Lisa's prayer requests:
1. That Naomi's heart would heal on its own.
2. Or for the treatment to make her heart improve within 24 hours.
3. That there would be no cardiac arrest or complications. 4. That the infection would go away.
It's Lisa's friend, Margaret. Here's what is going on...
Naomi's infection has slightly decreased with her temperature going from 104-101. White blood cell count has decreased. Vital signs continue to be stable. Blood in her urine is lessening. Naomi's kidneys and liver are better. The lungs are slightly better.
Regarding the heart, they're decreasing the heart medication; her heart has been responding positively to that. However, the doctor wants to put a pump in the heart to stabilize it, as this would give the heart a rest. It's been found to help people improve. They hope to stabilize the heart within 24 hours with this "pump" treatment. IF there are no improvements, they recommend a heart transplant.
Lisa's prayer requests:
1. That Naomi's heart would heal on its own.
2. Or for the treatment to make her heart improve within 24 hours.
3. That there would be no cardiac arrest or complications. 4. That the infection would go away.
Lisa is still at the hospital, praying with loving devotion for her sister. I wish I had a picture of her to show you.For those of you who have never met Naomi or seen a picture of her, she has the same warm and fun-loving smile as Lisa.
Lisa wants you to know that your prayers at this time mean everything to her. Lisa once told me that is one of the best ways to demonstrate love to someone is to pray for them. So let's keep praying together, knowing our God is in control. Remember, "He can move the mountains; our God is mighty to save." If we feel weak (to have faith or pray), note that "in all these things we are more than conquerors through Him Who loved us"
Romans 8:37.
Blessings upon blessings to you for your love, friendship and prayers at this time,
Margaret (for Lisa)
Naomi in the hospital
This is Phil , friend of Lisa. I set up a blog to get out important info about Lisa's sister. Yesterday (Wednesday) Lisa called us to say that her sister Naomi went to the hospital for a scheduled c-section, but something went wrong (baby is fine).
Naomi is in ICU, sedated, on a vent, lungs filling with fluid, high fever (there's an infection somewhere), very poor cardiac status (15-20% function, needs to be up at 60%). Vitals were stable overnight, but are very bad and need to improve. Also, to help the cardiac status, blood flow has been restricted to the legs, which could have a negative impact. There are also concerns about the use of morphine to calm her.
My understanding is that a code blue was called. There is concern that if she codes again, her systems will have suffered so much damage that trying to resuscitate her will not help.
Please add Naomi to prayer chains. Her young children need their mommy to survive.
Naomi is in ICU, sedated, on a vent, lungs filling with fluid, high fever (there's an infection somewhere), very poor cardiac status (15-20% function, needs to be up at 60%). Vitals were stable overnight, but are very bad and need to improve. Also, to help the cardiac status, blood flow has been restricted to the legs, which could have a negative impact. There are also concerns about the use of morphine to calm her.
My understanding is that a code blue was called. There is concern that if she codes again, her systems will have suffered so much damage that trying to resuscitate her will not help.
Please add Naomi to prayer chains. Her young children need their mommy to survive.
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