The Resemblance is Uncanny!

I was going through some family pictures and couldn't help notice the resemblance in the family. Even Jamal has started to look more like Dad. Jamal did go for the wild tie ;-)... I guess Ed still has the closest resmblance.

Reflecting - A year Later now

Hi all, I was looking over the blog and have been thinking about Dad alot this week. I remember one of the best visits I had with Dad and Mom during the first hospital stay was when Mom and I came in, and Dad was at the window sunning himself. It was such a funny sight. Dad said he remembers being told as a young kid for any ailment all you needed was a little "bano de sol" and all would be better. I am taking some small bano de sols these days to help with my sadness.

I am missing you and thinking of you Dad... Vivian

Call to the Hospital Am June 1st

I called in to speak with Richard his nurse. He stated not much change to speak of. The blood works and Xray were still processing. His vitals were still stable. I guess that is good news to be stable and unchanged.

Dr Sorathia was just stopping in to see him and going over the charts.

Dad has been completly off sedation now for about 36 hours. Arcot said about 48 to 72 is more likely the time frame when he might come too. They thought maybe Friday would be possible for the trcheostomy now. As of this morning though there was no surgical consult.

They are still treating him for (Vancomycin-resistant enterococci (VRE) also refered to as Mersa.

XXOO

Vivian

Call to the Hospital

I spoke with Jennifer today who was not the most talkative type. His status is about the same as yesterday. The chest X-ray was still showing pnemonia.

He is still breathing over the ventilator by 2 breathes, the Ventilator is back to 55% and he is stable on that.

They have stopped all sedative medications to bring him out of the sedation. I think some whiffs of Hershey's Chocolate with almonds or a Manhatten might bring him right out. ;-)

His kidney's continue to improve in small amounts.

He did get his urine culture back and his latest infection is Vancomycin-resistant enterococci (VRE). Not sure about the spelling. He is taking Chlrythromyacine for it. This is not a good baterial infection it is very resistant to treatment.

Mom was getting in shortly and will call me.

When mom came in, she met with Dr. Arcot and he told her Dad was set for the tracheostomy. Possibly tomorrow. This requires surgery and since dad is Crtically Stable (oxymoron or what) he would be fine to do the procedure. He said we are not at any decision points at this time.

The pulmonary Dr said things looked fine to day and no changes at this time. Mom was waiting to see Dr. Sorathia the last time we talked.

XXOO

Vivian

Tuesday - Mom's Visit to Hospital

Dad had a small leak in his air line and it required the ventilator to be increased back up to 60%. As well they had to re-sedate him. This will prolong the process for the Tracheostomy. They will need to start the weening process again.

HR - 79
BP - 146/82
Sat - 96%

Kidneys and X-ray were about the same. They will change the catheter today and the air line. Dad's swelling is almost completly gone, his hand are still a little swollen.

Mom Played tennis lost the first 2-6 and won the second 6-0.

XXOO

Vivian

Memorial Day - Mom's Hospital Visit

Dad seems to be the same, with some slight improvement in the lungs. Dr Arcot, the intesivist, is recommending we do a tracheostomy. He seemed very positive. His lungs have improved enough to where they think he would benefit.

Since the tracheostomy is temporary, the tube will eventually be removed. Healing will occur quickly, leaving a minimal scar.

His vitals are otherwise normal and the fever is completly gone today.

After Dr. Arcot left the nurse came by to mom and gave the vitals:
White Blood Count 12.6 - down
ATGB - 11.1 / 32.8
Blood Sugar is high @ 100 expected with the fluids
Neurological - wheening sedation and may take some 48 hrs -72 hrs to come.
Pulomonary - slight improvement they will be making some adjustments including tracheostomy.
Blood gases are in normal limits based on sedation levels
Tube feedings will increase , doing well w/them
BM normal
Urinary/Renal BUN 99 Creatininie 1.7 Output is good
Cardiac - HR 60-70.5
BP - 120/70 - 130/80

XXOO

Vivian

Sunday May 28th - Hospital Visit

I spoke this morning with Mom and Joanne, his nurse. Dad's condition is about the same with slight improvments.

He was breathing over the ventilator yesterday by 11 breaths and they made some adjustments to the ventilator to get the breathing to work better. They also gave him one additional sedation medication to see if that would help. He is now breathing only 2 breaths over the vetilator. They increased the time the oxygen would stay in his lungs so he would expel more to the body.

Mom is on her own today and is doing well. She has a great network friends in both in Florida and around the country and Brasil that we really appreciate knowing that they are there for her to call. Virginia gave her some instructions on the computer for email and Google. She is monitoring Dad's email account.

Joanne is really a very informative and accommodating nurse, as far as his nurses go. She explains alot and has no problems receiving calls and telling you what she knows.

His kidneys continue to improve, the Creatinine dropped to 1.8 and the BUN continues to drop as well.

The white blood cell count is at 13,000. Hemoglobin's are low so they will give him 2 more units of blood today. Visitors still need to wear gowns.

HR, BP and oxygenation are about the same as well. No fever today. One note, the nurse made, was that Dad doesn't cough when she tries to clear his throat with the aspiration. But I don't recall him ever coughing at all in the last 2 weeks. The sedation medications they are giving him is quite a bit. The coughing and eyes dilating are neurological signs. His eyes do dilate when they have a flash light shined in. He seems to really fight the ventilator when his sedation is not as high. I think that's a neurological sign as well.

Love you Dad and Mom

Vivian...

====

Eu falei esta manhã com a Mamãe e o Joanne (enfermeira). A condição do Daddy é mais ou menos idêntica de ontem. Estava respirando encima do ventilador ontem por 11 respirações e fizeram alguns ajustes ao ventilador para começar respirar a trabalhar mais melhor. Deram-lhe também um remedio a mais para fazer a sedação para ver se aquele ajudasse. Está respirando agora somente 2 respirações sobre o vetilator.

Aumentaram o tempo onde o oxigênio permaneceria em seus pulmões assim que expeliria mais ao corpo. A Mamãe está sozinho hoje, mas está fazendo bem. Têm amigos grandes de uma rede em em Florida e em torno do país e Brasil que nós apreciamos realmente saber que estão lá para que se chame. Virgínia deu-lhe algumas instruções no computador para o email e o Google.
Está monitorando o cliente do email do Dad.

Joanne é realmente uma enfermeira muito informative e obsequiosa, tanto quanto suas enfermeiras vão. Explica muito e não tem nenhum problema receber chamadas e dizer-lhe o que sabe.

Os rins continuam a melhorar, o Creatinine deixado cair a 1.8 e o BUN continua abaixar, também. A contagem branca da pilha de sangue está em 13.000. O Hemoglobin é baixo assim que d-lhe-ão 2 mais unidades do sangue hoje. Os visitantes necessitam ainda desgastar vestidos.

A bate do coração, BP e o oxygenation são mais ou menos como o poço. Nenhuma febre hoje.

Uma nota, enfermeira feita, era que o Daddy não esta tocendo quando tenta ao espaço livre sua garganta com o aspiration. Mas eu não o recordo sempre tocendo em tudo nas últimas 2 semanas.

Os remedios do sedação estão dando-o são completamente um bocado. Tocendo e os olhos que dilating são sinais neurological. Seus olhos dilate quando têm uma luz brilhada perto. Parece lutar realmente o ventilador quando seu sedation não é como elevado. Eu penso que é um sinal neurological também.

Amá-lo Papai e Mamãe

Vivian…

Morning Call to the Hospital 10:00am

I called into the hospital this morning. Joann, his nurse, said it was a rather uneventful night. The only concern this morning would be the breathing over the ventilator. The ventilator is set at 20 bpm (breaths per minute) and dad is breathing 11 breaths over that. He is running a very low fever 99.7, and that could be the cause. She is waiting for the intensivist to stop in a have a look.

His oxygenation in his blood work looked very good Po2 = 73% (normal range >60%). PC02 - Carbon elimination is 33 a little low (possibly due to the extra breaths according to Joann). Ventilator is set at peep of 10, running @ 45% and set to 20 bpm. (unchanged from yesterday).

Kidneys are continuing to improve, Creatinine level has dropped from 2.4 to 2.0, and BUN from 123 to 107. Potassium is in the normal range. This means he is not only producing lots of urine but it has become higher quality urine... boy I never thought I would use quality and urine in the same sentence.

His white blood cell count has gone up to 18.7 slightly higher than yesterday, I think was 18.5.

They have changed his catheter from the right side earlier this week to the left and all tests of the catheter for infection were negative.

There are still some results for infection that they are awaiting the results on. He is on several antibiotics still for an infection they have not fully cultured yet. They should know more after the weekend on the cultures, and then should be able to cut back on the antibiotics.

Joann has not seen the results of the Chest X-ray today, but is expecting the results later.

Mom and Virginia were just getting in when I spoke to the nurse, so we might have little more info as well.

Love you Dad, XXOO

Vivian

=========

Eu chamei-me no hospital esta manhã. Joann, (enfermeira), disse que era uma noite menos noticas novas. O único interesse esta manhã seria respirar sobre o ventilador. O ventilador é ajustado no bpm 20 (respirações por o minuto) e o Daddy está respirando o excesso de 11 respirações isso.

Está funcionando uma febre muito baixa 99.7, e aquela poderia ser a causa. Está esperando o intensivist para parar ter um olhar. Seu oxygenation em seu sangue olhou muito bom Po2 = 73% (escala normal >60%). PC02 - O elimination do carbono é 33 um pouco baixo (possivelmente devido às respirações extra de acordo com Joann).

O ventilador é ajustado em um peep de 10, funcionando @ 45% e jogo ao bpm 20. (não troco de ontem).

Os rins estão continuando a melhorar, o nível do Creatinine deixou cair de 2.4 a 2.0, e de BUN de 123 a 107. O Potassium está na escala normal. Isto significa está produzindo não somente lotes do urine mas tem mais de alta qualidade tornado do urine…

I nunca pensaram que eu usaria a qualidade e o urine na mesma sentença.

Sua contagem branca da pilha de sangue tem até 18.7 ido ligeiramente mais altamente do que ontem, eu penso era 18.5. Mudaram seu catheter do lado direito no começo dessa semana à esquerda e todos os testes do catheter para a infecção eram negativos.

Há ainda alguns resultados para a infecção que estão esperando os resultados sobre. Está em diversos antibióticos ainda para uma infecção que não cultivaram inteiramente ainda. Devem saber mais após o fim de semana nas culturas, e devem então cortam para trás nos antibióticos.

Joann não tem visto os resultados do raio X hoje, mas está esperando os resultados mais tarde. A Mamãe e a Virgínia eram começar justo em quando eu falei à enfermeira, assim que nós pudemos ter pouco mais info também.

Amá-lo o Daddy, XXOO
Vivian

May 26th

Virginia and Mom are at the hospital now. They are cutting back on the sedation medications to see if they can wake dad up. They have the TV on and are trying to talk to him to see if they can check on his neurological function.

He has a new bacterial infection that is some what resistant to medications. Everyone needs to wear gowns and masks for Dads protection. No more than 2 visitors at a time.

Vitals are all stable and about the same as yesterdays.

=========
A Virgínia e a Mamae estão no hospital agora. Estão cortando para trás nos remedios do sedacao para ver se puderem acordar o Papi. Têm a tevê sobre e estão tentando-a falar-lhe para ver se puderem verificar em sua função neurological.

Tem uma infecção bacteriana nova que seja alguma que resistente aos remedios. Todos necessita desgastar vestidos e máscaras para a proteção do Papai. Não pode ter mais de 2 visitantes de cada vez.

Vitals é tudo estável e mais ou menos como ontens.

Some good news

Dad's Creatin level has come down from a high of 4.0 two days ago to 2.4 today. While still elevated it is the first good down ward trend in over a week. His BUN (not his tushie :-) is down from a high of 147 to 123. So for the first time in over a week we have seen improvement with his kidney's. Dad continues to fight. Personally I think he is pissed he will be missing Paulo's wedding! I know they will dance a samba in his honor. I need to check his white blood cell count today and his chest x-ray. But for now we have some good news. Love Virginia

P.S. I will be going home tomorrow. Mom will be going at it alone. I am hoping her incredible network of friends will help as they did in the early hours of this hospitalization. Her friends here are just so wonderful and I have enjoyed many wonderful visits as well as some great meals. Thank you all so much. V

Alguma notícia boa

O nível de `Creatin` do Papai (Daddy) foi para baixo hoje, era as 4.0 para dois dias há a 2.4 hoje. Quando seja alto, mas foi o primeiro dias indo para baixo e uma tendência boa para o fim da semena. O BUN (não seu bumbum :-) tbm foi para baixo ... de 147 para 123. Assim para a primeira vez dentro sobre uma semana nós vimos a melhoria dos os rins. O Papai continua a lutar. Pessoalmente eu penso que é mijado ele estará faltando o casamento de Paulo! Eu sei que dançarão um samba em sua honra. E necessito que eu verificar hoje a contagem branca da pilha de sangue e o raio X do o pulmao. Mas para agora nós temos algumas notícias boas.
Amor Virgínia

PS. Estou indo para casa amanhã. A Mamae estará indo aqui sozinho. Eu estou esperando que a rede incredible dos amigos dela ajude como fizeram nas horas adiantadas desta hospitalização. Seus amigos aqui são justos assim que maravilhoso e mim apreciaram muitas visitas maravilhosas assim como algumas refeições grandes.
Obrigado todo tanto. V

Virginia and Mom's Visit - May 25th 2:40pm

Mom and Virginia spoke with the Intensivist Dr Arcot, earlier and said that although the condition was unchanged we might need to make a decision about dialysis and a trachiotomy.

The nephrologist, Dr. Patel, stopped in to see them this afternoon and said there would not be any need for dialysis at this time. He also said not to get caught up in the numbers for the BUN and Creatinine as there are many other factors in considering dialysis.

Dad's Creatinine level did drop today from 4.11 to 3.2. His BUN -147 (Blood Urea Nitrogen) was high. Dad's Potassium was low, not necessarily an indicator of any problem.

Dad's vitals continue to be stable at
HR - 79
BP - 169/70
SAT - 93

Ventilator - running @ 45%
- breaths per minute @ 20
- peep @ 10

They did say his WB count was elevating from 14,000 to 16,000 requiring the need to use protective gloves, mask and gown. ;-(

Vivian...

May 23 9:20pm

I decided pictures are better than words sometimes...

Tuesday May 23 - 12:00 noon

Vitals
HR- 75
BP - 160/65
SAT - 98% (Schweet)

Ventilator - running at 45%, Peep 13, breaths / minute 24

These are good vitals for today as well as the ventillator machine has once again been lowered to getting him closer to being removed from the ventilator.

I called into the Hospital this morning and spoke with Dad's nurse Christi. She said it looked good now that they have moved him to the new bed. He is still listed in Critical condition.

He is now on the bed he was on previous to the Roto-Prone, the TriaDyne. This one will keep him rotating right to left while laying on his back. They will replace his central line today and keep the bed moving.

Virginia is there with Mom and Paul and Ana today. Pat was leaving early today to return to Denver.

Love you Dad and keep up the progress.

xxoo

-Vivian

========

Os Numeros do dia:

Bate de Coracao= 75

Pressao de Sangue= 160/65

SAT= 98% (Muito Bom)

Ventilador - funcionando em 45%, Peep 13, respirações/minuto 24

Estes são numeros bons para hoje assim como a máquina do ventillator foi abaixada uma vez outra vez a o começar mais perto de ser removido do ventilador. Eu chamei-me no hospital estes manhã e encountrei com enfermeira `Christi` do Papai. Disse que olhou bom agora que o moveram para a cama nova. É alistado ainda em condições críticas.

Está agora na cama que estava em precedente ao Roto-Prone, o TriaDyne. Este mantê-lo-á girar para a direita à esquerda ao colocar em ele para trás. Substituirão sua linha central hoje e manterão mover-se da cama. Virgínia está lá com Mom, Paulo e a Ana hoje. O Pat saiu hoje demanha para ao retorno o Denver.

Amá-lo Papai e proseguir o progresso.

Monday May 22nd - Morning Visit

Dad is having a tougher time today staying stable. They want to try and move him to another bed and see if he can stay the course. The last time they moved him it was also very unstable for some time before they could continue therapy. Lets hope he just needs a little time. His SATS and BP are fluctuating alot today. Sometimes, it is machine related where they just don't have a good connection or the positioning of the contact on his finger.

Virginia will give me more information when she gets it.

Evening update

Vitals:
HR - 100

BP 104/90

Saturation 95

Oxygenation:

peep 15
50 % oxygen
breaths per minute = 24

Nurses are optimistic and said Dad had another relatively stable day. As stable as you can be in an ICU.

We will see him again tomorrow Love <3 V

Sunday may 21-2006

Vitals:
HR - 83
BP - 137/69
Saturation - 92
Oxygenation - peep 17, 50 % oxygen breaths per minute = 24

Swelling has come down, with the diuretic. White Blood cell count 21,000 (Normal range 5-11,000). Creatinine 3.6 (No Change)

He had a nice shave by the barber nurse. Mom owes the good news to the fact that Virginia went to church today.

Dr White is optimistic about the low oxygen levels causing little or no neurological damage. Due mainly to the fact that he has had good blood pressure and Heart rate.

Also the chest x-ray was described at improved from yesterday.

From Virginia's morning visit to hospital with Mom, Paulo, and Ana.

Dad's Night Report - 05/17/2006 4:00pm and 9:00pm

Dad's Vitals at 4pm
HR: 89-94 bpm
BP: 164/71
SAT: 92-96%
Ventilator @ 70% Oxygen, peep (the pressure) @ 15 cm of H2O and the rate is 26 breaths/min

We spoke with the Intensivist, Dr. Arcot at 4pm and he mentioned the Nephrologist (kidney specialist) Dr. Patel said that based on his blood chemistries dad did not need any dialysis at this time. Dr. Arcot said dad's BUN was 93 (10-20 is normal) and the high creatine of 3.76 is an indication of renal problems and his inability to remove the toxins from his body. Dad has been receiving albumin to help him urinate and he has been putting out ~1400ml per 8 hour shift. The albumin also helps to elevate his blood pressure. His blood gases were also described as "real good". His nurse Rebecca said, "we are taking baby steps for improvment."

Dad was also given two units of blood today and more platelets yesterday. Dad's temperature was 101 at 4:30pm and the nurse attributed that to being strapped into the bed which covers his body almost completely.

We left Dad at 5:30pm to go to dinner with friends Bob and Joy from their old condo in New Smyrna. They treated us to a very nice dinner at an Italian restuarant in New Smyrna. We toasted to Dad and had lots of garlic, just like he would have done.


Dad's Vitals at 9:30pm (call in to nurse in the ICU)
HR - 119
BP - 123/72
Oxygenation level 93
Ventilator working @ 70% peep @ 15

He is maintaining a very good blood pressure and HR. He is developing small blisters on the prone postition just below the shoulders. One more on the right knee. They have all been covered with a special band-aid to help keep the blister low. His eyes are good as well.

Have a good night dad. Love you, Patrick and Vivian XXOO

May 17th 2006 - Visited Hospital

Vitals
HR - 97
BP - 137/71
SAT - 95%
Ventilator is running at 70%, peep is at 16

Chest X-Ray shows improvment in oxygenation. Dr. Arcot believes this is primarily due to the bed but could also be due to the infection receeding, but not conclusive. We will know better in future x-rays if the infection is receeding.

Kidney - Creatinine level increased to 3.76. Although the Urine production is adequate, it still is not eliminating all toxins.

We are awaiting direction from the kidney specialist, Dr Patel, on whether dialysis may be necessary. He will call us here today to give his opinion.

His platlets are better today (he recieved platelets yesterday). He will receive 2 additional pints of blood today.

He is receiving 4 antibiototics - 2 are for the pseudomonous. They still don't know dad's sensitivity to the antibiotics (except pseudomonous), the other 2 are to cover the other bacteria, not yet determined.

Dr. Crossman - (infectious disease doctor), is still trying to determine the exact bacteria type he is infected with. The cultures can cake some time to grow and thus the delay in determination (up to 2 weeks, about 1 week to go).

Dr. Arcot - ICU Doctor (intensivist) - believes that the bacteria that we have identified, pseudomonous, is the primary cause of the infection. Which could mean that determining the other infections may not be as important.

Tentatively:
Chello is leaving today. Virginia is coming in on Thursday the 18th and returning the 27th. Paul and Ana are arriving on Friday. Vivian is thinking to go back on Sunday 21st and Patrick returning also on Tuesday the 23rd, to Denver.

We need to try and schedule the travel so that Mom has family here throughout Dad's intensive care.

Another Call to the Hospital 5:41 pm - 5-16-2006

We spoke with Rebecca, dad's nurse, and she said earlier today they tried to move him to different positions to see if his oxygen readings would change. They did change enough to where they thought he could benefit form the Roto-Prone bed. Since he has been in the prone position they have been able to reduce the ventilator to 80 percent and dad is now maintaining his oxigenation level at 95%. All vitals are good and stable. He is prescibed to be in the prone position for 18/24 hours. They will routinly check his skin and eyes to make sure everything is ok. The next step is to talk with the Doctor in the Am to see what he believes dad's neurocologcal function is.

He could have been at a low oxygen level or had a bad reading. We noticed earlier today when they tried to do the reading from his ear, but with the same machine and a different measurement point on his body, the reading was dropping quickly. We pointed this out to his nurse and she changed the reading back to the finger and the reading again stabilized to a higher level of 65 (still not the best) . We are not doctors, just observers.

Update this afternoon

Well the roller coaster ride continues. Viv just called the hospital to check on dad. His vitals have improved dramatically. Below you read pat's Blog but they were able to get dad in the roto bed finally and everything has improved. His vitals are all back to normal his oxygen level is up to 95. The nurse I spoke to said dad was very close to death this morning but God seemed to intervene and he is still here with us. Love <3 V

Evening Update

Dad's Vitals this evening are looking a lot better.

Sat 97
Heart rate 86
BP 157/67

Dad will be getting a roto prone bed which suspends him in a prone position and may have a positive effect. It is pictured to the right.

this is the latest. V

Monday May 15 - 6:30am

I called into the nurses station this monring to speak with Dad's nurse. She said that the oxygen levels were stables and good, but the creatinine and albumin were not improving. The critical Care specialist will be in shortly and we should see her when we get in this morning.

Update from Vivian and Chello - 05-14-2006

We spent the day in the hospital today with Dad after we learned that his kidneys were not working well. They are unable to determine if it was the antibiotics or the ARDS (Acute respiratory distress syndrome) or the Lymphoma is causing the kidney issue.

The creatinine levels doubled overnight indicating a poor kidney function. (1.4 to 2.3).

We have determined that the bacterial infection is caused from psuedamonous, which is not an acid fast bacteria.

They gave him 2 new antibiotics today - azactam and tobramycim (1 dose) which target this particular bacteria. He stopped the following 2 antibiotics bactrim, and primacin.

They continue to give him Levaquin and Zithromax. (antibiotics). No additional news on the viral infection.

They continiue to give him Bicart and today they gave him Albumin to help stimulate his kidneys. It did not work as well as they had hoped. His breathing seems to be maintaining a high oxygen level around 90. But his blood preassure and heart rate were pretty high from the Albumin. They are having troubles removing the medications that were stopped due to the poor kidney function.

They still hear fluid in his lungs.

We are hoping the extreme sedation will help him recover. It is hard to really say.

update

Today we recived the news that Dad's kidneys are failing. We are praying for him to go peacfully and we are not optmistic.

An interesting link

This is a link to an article about sedation. It was helpful to me in understanding what dad is going through. It is written by a nurse and is designed to be a manual for other nurses. Love <3 V

Update 5/13/06

Dad spent yet another night in intensive care. He still is in critical condition but no changes are occurring. Doctors and nurses have hinted that he seems to be fighting. Which is an good sign. Mom is cautiously optimistic even though we all realize that Dad is in a very serious situation.

Dad still is in Isolation in the ICU and there seems to be no consensus on what his infection is. They keep coming up with theories but no hard science or test results. They continue to give him antibiotics that hopefully cover what he has.

there has been some experimentation with lowering his oxygen in take but he is not able to breathe enough oxygen on his own. He continues to be sedated which keeps him peaceful.

The realization of this has been hard on all. Two weeks ago dad was so vibrant and his old self and how quickly this all changed has been difficult to accept. We all are fast becoming knowledgeable about his condition.

Thanks for all your prayers my Mom especially has felt the love and kindnesses and thanks you. Love <3 V

(for those of you who are wondering what <3 is. It is a sidways heart :-) god I am so visual!!)

O Papai passo uma outra noite no cuidado intensive. Está ainda em condições críticas mas nenhuma mudança está ocorrendo. Os doutores e as enfermeiras sugeriram que parece qe ele esta lutando a duenca. Qual é um sinal bom.

Mamae ésta tentano ser optimistic mesmo que nós todos realizemos que o Papai está em uma situação muito séria.

O Papai está ainda na isolação no ICU e não parece haver nenhum consenso em o que sua infecção é. Mantêm-se vir acima com teorias mas nenhuns ciência ou resultados de teste duros. Continuam a dar-lhe os antibióticos que cobrem esperançosamente o que tem.

Houve alguma experimentação com abaixar oxigênio dele na tomada, mas ele não pode respirar bastante oxigênio no seus próprios. Continua ser sedated que o mantem calmo. O realization deste foi duro em tudo. O Papai de duas semanas atras há era vibrant e era o Papai qe nos todos lembramos. Como rapidamente o este mudado toda foi difícil de aceitar.

Nós todos somos tornar-se rápido sobre sua condição. Os agradecimentos para todos seus razarmentos meu Mane especialmente sentiram o amor e as bondades e agradecem-no.

Amor <3 V (para aqueles de você que estão querendo saber o que <3 é. É um coração virado do lado :-) Nossa eu sou tao visual!!)

5/12/06

Dad spent another night in the intensive care unit. When I spoke to the nurse taking care of him this morning she said his status has not changed. He is still in critical condition. It is taking some time to get used to this but for the moment he is not getting worse. Marcelo Vivian and Patrick visited him late last night. Hopefully we will get an update this morning from his doctors. Mom is getting lots of support from family and is holding up well.
Love <3 V


O Papai ficou uma outra noite na unidade de cuidado intensive. Quando eu falei com à enfermeira desta manhã ela dita o status do Papai não mudou. Está ainda em condições críticas. Por enquanto o Papai esta bem, e não está pior. O Marcelo, a Vivian e o Patrick visitou o Papai ontem de noite. Vamos ligar hoje de manhã para pegar novos noticias. A Mamae tem muito supporte da família e está bem.
Com Amor
<3 (um coracao)
Virginia

Update 5/11/06

Marcelo drove to Florida last night to be with Mom. Vivian will follow and arrive at 3:00pm Thursday. Dad continues to be in critical condition he is sedated and is peaceful. We are praying for the best. Love V.

Marcelo dirigiu para a Florida nesta madrugada para encontrar com a Mamae. A Vivian tambem esta indo para la, e chegará hoje as 1500 da tarde (quinta-feira). O Papai continua em condições críticas, esta sedado por causa dos aparelhos para ajuda-lo com a respiracao.

Nós continuamos a rezar por sua melhora. Amor V.

Update 5/10/06

Dad has pneumonia so this is very serious. Mom is getting a lot of support from friends. Vivian Will be there tomorrow by 3:00 and Pat will follow next week. Love V

O Papai está com pneumonia e assim estar muito sério. A Mamae está com muitos amigos para ajudar ela. A Vivian será lá amanhã (11 de Maio) as 1500. O Pat vai chegar a semana que vem.

Amor Virginia

Update

Sadly Dad has been moved to the ICU and he is in critical condition. Please pray V

Tristament O Papai foi movido para o cuidado Intensive e ele está em condições críticas. Razar por favor V

Dad's Progress 5/10/06

Hey all,

Dad is still in the hospital but a routine seems to be forming. He is still having temperature spikes usually at 4 AM. Which necessitates oxygen. While this is worry some it is the natural course of infections for chemo patients.

According to the doctor Dad very much needs to lay low for 6 months. No crowds no eating out and sadly the Brazilian custom of hugging and kissing is out for at least 6 months. The infections are the most dangerous parts of this illness and dad need to avoid them. Apparently flowers are even banned from his room.

Mom seems to be dealing with it all very well and seems to understand it all much better than I could. She has been at his bed side day and night and is helping him greatly.

Mom has been touched by all the support and greatly thanks all.

Because of dad's weakened immune system I am asking respectfully that if you can coordinate visits to the hospital so only one friend visits a day it would be best for my Dad. Please remember that any bacteria is life threatening at this point and while Mom needs your support she is too polite to say no.

I hope you can all understand and I would like personally to thank all for their prayers and support and comments during this difficult time. My Dad reads them all and is so very touched. He cannot get over so many friends and family well wishes. Please remember you do not need a site id to comment.

Love and Kisses Virginia

Queridos e Queridas,

O Papai está indo para o hospital, uma jeito que parece vai ser normal. Ele tem ainda uma temperatura alto geralmente as 0400 da manha. Ele esta precisando ter ajuda com oxigênio. Nos estamos com preocupação, mas conhece que isso é natural para pacientes do chemo.

De acordo com o medico, o Papai preciar descansar para 6 meses. O Papai nao pode encontra com os amigos, nao pode sair para comer, e mas triste nao pode fazer o costume dos Brazileiros, de abraçar e de beijar. As infecções são os partes mais perigosas desta doença. Ate que "flores" são proibidas aparentemente no quarto dele.

A Mamae parece que esta aceitando as coisas, e dise que entende melhor o que esta acontecendo (melhor que eu podia). A Mamae esta com Papai tudos os noites, no lado dele e está ajudando-lhe extremamente.

A Mamae esta cheio de carinho de voces..... e queria agradece tudo mundo.

Por causa do sistema imune enfraquecido do me Pai, eu estou perguntando que se você puder coordenar visitas ao hospital assim somente um amigo visita um dia onde seria o melhor para meu Pai. Se lembra que todas as bactérias são vida - ameaçando neste momento e quando a Mamae precisar de ajudar, ela as vezes nao sabe diser.... Não.

Eu espero que vocês compreender tudo e eu goste pessoalmente de agradecer tudo para seus razas de suportar e comentários durante este tempo difícil. Meu Pai lê-os todos e é-o tocado fundo com ele. Ele não pode começar de diser "obrigado" para o excesso de amor e carinho de tantos amigos e nossa família.

Lembra-se, que você não ter um "Blog ID" para colocar comentarios no blog.

Amor, u grande abraco e beijos, Virgínia

Update 5/9/06

Hey all,
Dad spent another night at the hospital. Things are not clearing up as fast as we had hoped. Dad is now on oxygen and had some speed bumps last night his temp keeps spiking. Mom is of course very concerned but is being very brave and staying by Dad's bed side. One of the nurses has been very helpful explains what is going on to mom and is making it a bit easier. They expect Dad to be in the hospital for at least 1 week or even 10 days. It is a bit frightening but as of this morning dad was more coherent and sounded more like himself. Lets hope the fever breaks.
love V

Querida e Queridos,

O Papai esta no hospital. As coisas não estão melhorando como nós tínhamos esperado. O Papai está agora no oxigênio e teve algumas temperatura altos neste noite. A Mamae é naturalmente muito precupado, mas está sendo muito forte e está sempre no lado da cama do Papai. Uma das enfermeiras conversa com a minha Mae para explica o que está aconecendo com ele. Iso dar um pouco para a minha Mae sabe um pouco mais como ele esta. Os medicos disse que o Papai devia estar no hospital no mínimo uma semana, mas ate 10 dias. Estamos com medo, mas hoje de manha meu Pai estava conversando e estava bem. Temos esperanças que o febre vai abaixar.
Amor V

Dad's Progress

Tradução em português abaixo


Dad spent the day in the hospital. He has been running a fever and the doctor is concerned dad may have a viral infection. Dad is on heavy antibiotics. While the doctor had said that Dad could resume normal activities he didn't realize to dad it meant playing tennis and going out dancing. Mom and Dad have been told by the doctor they need to make some changes in their life style. Apparently the doctor didn't understand that Mom and Dad lead a very active life style for 70 year olds! Mom is handling the changes with grace and courage and I am sure she will be able to slow Dad down a bit. She spent last night at the hospital and plans to spend tonight there also.
For those of us that would like to read some information about chemo here are some links.

Patient Care During Chemo

Preventing infections during Chemo

When to call the doctor

Eating instructions during Chemo


Love and kisses V

tradução

Papai passo o dia no hospital. Ele tem uma febre e u médico esta proucupado que ele tenha um infecção viral. Papai esta tomando antibiotico forte. O médico tinha dito para Papai que ele podia commeca actividades normal. O médico disse que jente com a idage de Mamãe e Papai normalmente nao sai para dancar ei jogar tennis. E o médico esta pedihindo para os dois troquar o jetio "normal". E apparente que a Mamãe e o papai nao sao "normal" jente com idade de 70's!
Mamãe esta aceitanhdo essa informação con corragem. Eu esspero que ela vai poder ajudar Papai "slow down"! Mamãe passo ontem a noite no hospital e ela vai passa essa noite. Acima tenha links para sites de informação. Todos sao em ingles. Uma vez mais desculpa do tradução. Eu nuca tevi lição para aprendar português! Bejios Virginia

Dad's Visit to the hospital

Hey all,

Dad has finally gotten his private room with an extra bed. Mom is thrilled because she was able to take a nap this afternoon with Dad. Dad continues to have a fever and his blood cell count is down. When the doctor visited with them this afternoon she mentioned this is very common after a patient's first chemo treatment. love V

On a lighter note it is spring in syracuse and we are enjoying the flower's. I have some pictures of my garden's and couldn't resist showing the tree dad planted from a seedling. It is getting so tall

Alo

Papai finalmente tenha um quarto private. O quarto tenha uma cama extra. Mamha esta contente por que ela podi cochela com Papai. Papai continoha com febre e a conta de sange esta muntio baxio. O medico qui attendehlo disse que isso e normal e acontesse deposi da primera tratamento de chemica. ( eu espero que eu nao traduzei tao mal) Beijos Virginia

Agora para nos aque em syracuse e primavera. Estamosgostando ver as flores! Tenho fotos do meu jardem e eu nao pode resistar mostra a avore que o papai planto de sememnte! A avore esta cresendo taho grande.

Sunday

Hey all,

(Abaixo eu vao tentar a traducao desculpe do mal portugues. Eu espero qui Papai correge depois) O papei fico com febre ontem a noite. Ele teve que ihir par emergencia do hospital Halifax em Daytona.

It is Sunday Morning about 8:15 Syracuse and Florida time. Mom stayed till 1:00 AM with Dad at the Halifax emergency room last night. As of this morning dad spent the night there and is still there in an observation room awaiting a private room. Mom took Dad food this morning apparently he is hungry, (a good sign) and he seems to be awake and they are awaiting word from the doctors.

I will keep you posted Mom promised to call when the doctor visits. Love V

Hoje e Dumingo 8:15 de amanha em horaiho de Syracuse e Florida. A Mame fico no Hospital ate 1:00 AM con Papei. Elehes estao no emergencia do Hospital Halifax em Daytona. Ainda nao tenha um quarto para Papai. Ele esta nom quarto de obeservason em emergencia. Mame levo comida para Papai porque ele esta com fomei. ( uma boa signa) e ele esta acordado e lucido. Os dois esto esperando o Medico.

Eu vao tentar repostar quando a Mame me telepona. Desculpe de novo do portugues Beijos Virginia

Dad Update

Dad came down with a slight fever today and as of 9:00 pm he will be spending the night at the hospital. It seems to be a precautionary measure. I will be calling Mom at 10:00PM and check in with her. I will post more if need be Love V

I spoke to Mom and they are awaiting a room to open up and Dad is on antibiotics. All this seems to be a precaution both Mom and Dad seem to be taking it well.
Love V

Reports from the Doctors

Below are links to medical records for dad for those of you who wish to read the reports. While this is a very serious form of Lymphoma dad seems to be weathering the chemo very well.

Dad's diagnosis

Lab Reports

Physicians Report

Meet dad's doctor

hope this is helpful.

Love V

Nerds rule!

Ok I couldn't resist one more set of pictures! This one is funny the generations blogging! What you don't see is I am taking this picture while on my laptop all three Perini's being Geeks. Nerds rule!V

Here is a photo of a Paulo and dad if you are wondering about the crutches he had an accident before he left Brazil. He fell off a ladder but he is hobbling around pretty good. Ok I have to brag now. These pictures are a courtesy of my two wonderful son's who gave me the most amazing digital camera. I carry it every where and can document anything! Later I will post copies of all of dad's medical records. Love V

Dad is Feeling Better

Dad is full of energy! We went this morning to the tennis courts and it was difficult to convince him he had to take it easy! We had coffee with mom and the ladies Were swarming ! Ladies were coming out of the wood work to hug and kiss dad! Still a ladies man! Mom looks great in here tiny skirt! Both are in great spirits. Love <3 V

Paulo and Virginia Visit Dad

Hey all,

Paulo and I are here visiting Mom and Dad. Dad is in great spirits and running circles around everyone! I would venture that chemo so far is agreeing with dad he is hard to get to sit still!
We all feasted tonight on Zuppa Toscanna and Empanada's that mom made. Of course we have had a three course desert buffet after dinner! I don't know how these two stay so slim!
It is really heartening to see how well dad is doing! <3 V

Dad is visiting the doctor today

Hey all,

We are waiting to here from the doctor. When I soke with dad this morning he was very talkative and excited about our Blog! He has promised to keep us updated and we all look forward to hearing from him! <3 V

High grade Lymphoma

When Pat posted today that doctors suspect that dad may have high grade lymphoma I was very sad and worried. But after doing some research I have found that this could not necessarily be very bad if you read the links to the site below the prognosis for high grade lymphoma is not so bad. <3

http://health.allrefer.com/health/burkitt-lymphoma-prognosis.html

An excerpt below from another site. I'm not sure if these are the types that dad has but from what I am reading high grade has a better cure rate.

High grade lymphomasThese lumpiness generally need more aggressive treatment than the low grade types. But they are often respond well to treatment. Many people are cured. The commonest type of high grade lymphoma is diffuse large B cell lymphoma. About 1 in 3 of all lumpiness diagnosed (30%) are this type is difficult to be specific about prognosis as there are so many different types of high grade lymphoma. And they do not all behave the same way. Generally speaking, about 60 out of every 100 people diagnosed (60%) are cured.

Vivian's Stay

Thursday April 13th, 2006 Dad was Admitted to Hospital – Halifax Medical Center – 386 254 4000 room 707 Dr Abdul J Sorathia – Oncologist - 904 – 254-4211 Dr. Donfraid – Infectious Disease

Friday 4/14/06 Arrived at 4:30 Dad had just come out of surgery for the 2 Biopsies and a port. Skin what pretty hived and scabby from the rash, Neck was pretty swollen still from the lympnodes behind the ear.

Blood Work- White Blood Counts were very high
04/15/2006 - 29.2 5-20 normal range
04/14/2006 – 31.3 5-20 normal range
04/13/2006 – 30.4 5-20 normal range
04/10/2006 – 20.7 4-10.5 x10E3/ul normal range
03/31/2006 - White blood cells count was pretty high 16.100 should be between 3.90 and 11.40 units X10 3 Alkaline Phosphatase was 432 U/L should be 26 -130 SGPT (ALT) 54.00 U/L should be 0-50



Dad was pretty sedated and tired. he had a rough night of sleep.
He had some pretty red skin.





Dad's Sexy legs, ok they are a little red.








Medications were – Teslaon pearl for Cough every 4 hours?
Steroid Salumedrol – every 6 hours
Ambien at night at nine and by 10pm he was very disoriented all evening. They did the cat scan of his head on Thursday am was clear.
We stayed until 10:00 pm
The Night Nurse Kathy, Day Nurse was Briana



The weekend nurse was Karen day – Maureen Night (she was really good)




Saturday – Was a pretty good Lots of hallucinations
Like the Queen Mary Ship came in and the Queen Mary was on it and waved to him. Pretty much everything out of his mouth was a hallucination. Bugs, lights, lots of birds. We called the On call Doctor Dr. Durkin and he said it was not unlike an elderly patient to have hallucinations while on steroids. We got the nurse to get a walker so we could walk around the block with the walker. They did not give him any sleep aid. He was not as disoriented as Friday but did not sleep a lot either. Brought in some home food and he/we really liked that.

Sunday – Easter – was more calm, and not many hallucinations. We walked a lot about 25 minutes total. In about 3-4 walks. We called Maureen in the am to see how his sleep went for Saturday night and it was not as bad as the night before. Brought in his PC and he seemed to enjoy that. A lot of swelling went away in the neck.

Monday – Am I called Maureen about his sleep. They still did not give any sleep aid. Did not sleep all that great but dad did think he slept a little better. Met with Dr. Sorathia (Oncologist) He spoke of a "rare Immune disorder" that he suspected. But would like to confirm this information with the biopsy results first. We asked about trying to get a second opinion and he did not have any problems with this. Thought he would suggest as well the Moffet center in Tampa.

"He said dads lymph nodes or immune system were on over load. The problem was definitely with the immune system as the lymph system is the immune system". Then asked if dad had any transfusions, was exposed to pesticides, or chemicals.

Dad is now on a steroid pill for the rest for the rest of the day. He may go home and recuperate until the results come in on Thursday.

They did one more test on dad to see if his heart was able to withstand the chemo therapy. They basically drew his blood did something with it, then re injected it in Dad, and did about 24 x-rays.

Pat is coming in this afternoon at 4:30 I need to leave around 3:30.

I am glad to see that Dad was almost back his routine before I left.

I Love you Dad! And everything will be fine.

Jose Perini

This site is created for my family to keep updated with my fathers health! On April 7th we got the news that my dad was diagnosed with lymphoma. Because we are a large family and all computer geeks I came up with this Idea so we can keep up to date! Please feel free to post your thoughts and ideas we all need to communicate!
Here is a link to a site with lymphoma information

Paulo thanks for the picture