April 23 update

Alan had his 64th birthday at the hospital where he was born.  I had thought that we would have a belated celebration when Alan came home, but  he was wished happy birthday by everyone he saw all day, including the doctors, and he seemed to enjoy it.  (When it is someone's birthday, a birthday cake shows up on the screen when someone pulls up their medical records.) When Charlotte came on for her night shift with Alan, she brought cards from Bill and Anna.  The nurse insisted that the four of us sing happy birthday to "Alan and Rhoda," which Alan joined in happily. (We share a birthday.)  Charlotte told about remembering when Alan was born.  She was too little to go into the hospital, but his mom came to the window of the hospital and waved to Charlotte, who was standing outside on the grass with her grandmother (I think).

Alan is still in ICU, but as you can tell from the above, he is doing much better.  The pneumonia is almost cleared and other issues with blood pressure and temperature spikes are mostly resolved.  He is still extremely sick, but is on the lowest dose of oxygen, and they have been able to get him off all IV drugs except for the antibiotics. He had a lot of fluid around his lungs, and they drew off about 800 cc's of that a few days ago.  A sample of the fluid is being cultured to see if the antibiotics being used now are the best in his case.  He is getting most meds through the feeding tube in his stomach.  The newest wrinkle is that he has gout, which is causing some discomfort on top of the pneumonia and weakness.  They did not want him to have the swallow test for at least a week because he was so weak and out of it most of the time.  For the last two days, though, he has been very lucid, very much like the Alan we know.  I'm not sure of timeline on doing the high-contrast swallow test, which shows exactly what is happening when he tries to swallow. 

In case you are wondering where the swallowing problems came from, it is one of the possible side-effects of surgery on the 9th cranial nerve. We were given a sheet listing all the things that could go wrong (a whole long paragraph of things), but you never expect the bad things to happen, even though warned. Consequently his voice is very hoarse and difficult to understand. You have to put your ear right next to his mouth to figure it out, and it takes him a while to put together a sentence.  The first one that I heard clearly from across the room was a comment he made to the respiratory therapist, "I would love a Coke!"  Of course, he can have nothing by mouth, including water, because it will all go into his lungs and cause more aspiration pneumonia.  This is a very difficult time because of that for him and for his caregivers.  We can only give him a tiny one inch sponge on a stick squeezed almost dry, swabbed around in his mouth once an hour, as well as a very small amount of a mouth moistening spray.  He doesn't dare swallow it.  Charlotte and Susie have been wonderful to be here to  take shifts with me, so he has had someone with him 24/7 for the whole time he has been in the hospital.

As soon as he is well enough from the pneumonia to leave ICU, which we expect will be in a few days, he will be transferred to a regular room, where he will start getting physical therapy to get his strength back, plus concentrated speech and swallowing therapy.  When he is able to leave the hospital, he will probably go to a rehab hospital for more speech and swallowing therapy.  This will take a long time.  The good news, is that the headaches are probably gone, although he has complained about them a few times.  I certainly hope they are gone, given all the difficulties he has had.  

So progress has been made, and I do think that we are "out of the woods."  But we still have a long way to go to get home.