Saturday, August 11, 2018

Long time no post


                                                           

I know it has been a while since I wrote a post so sorry it it is long.
May 1st was moving day, Cathy and Ed (my sister and brother in law) came down from Wyoming to help me finalize packing and to help with the move.  Bonnie and Dee (Lee's sister and brother)also came to give us a hand with the final day with cleaning and getting us out the door.  I now wish I would have snapped a couple of pictures of moving day but it was so hectic that was the last thing I was thinking about.  Here is the last photo I snapped in our Hurricane house.

You can see I had boxes packed and some things ready to go.  I was able to hire a moving company they gave me a great rate and was only $500 more then I estimated the cost of renting a truck and the gas would have cost.  I also would have to hire movers on the Provo side to help unload.  I had plenty of help to load but no help to unload.  
Photo of Crown Moving & Storage - Saint George, UT, United States
https://crownmoves.com/
The movers were awesome to work with they did not think they would be able to fit all of our stuff in their trailer but they worked extra hard to fit everything. There was only two things they could not fit or move.  One was our safe although small they still needed special service fee that would have been an extra $500 we decided that it was small enough to fit on the back seat of our truck so we just slid it right in.  It really is just a small safe I am able to slide and move it by myself once it was in our house.  Our freezer also would not fit, we were also able to get that in our truck along the side of our motorcycle.  It is also a small chest freezer that belonged to my grandpa Pruitt.   We got to Provo and wow I did not realize how much stuff I really have.  I am still working on boxes and where to put everything.  I have made several trips to donate items and have sold several on Facebook.  I think the minimalist life style is looking good.  Although not to an extreme, I just don't need so many things that I do not use.   Here are a few shots from our new home, the mountains are just out my back door and there is a nice green space that is close to take Sadie on a walk.  

May 8th  Was my start date for my new job at Utah Valley Hospital on their Neuro Shock Trauma Unit.  I had a 10 Week orientation wow it was a long 10 weeks the first 8 weeks were on day shift.  Anyone who knows me knows I do not do mornings.  I love my orientation time, I felt that I did not see or do enough, I did not take care of many Neuro surgery cases, all in all I learned a ton but I still have a ton to learn.  I realize nursing school was 14 years ago but you never realize just how much you loose when you do not use it.  
Image result for Utah Valley Hospital Neuro shock trauma ICU
This is the plan for Utah Valley Hospital, it is currently under construction.  I am currently working in the building in the right front which will be converted to lab and other services and my unit will move to the new tower in the right rear of the picture.  it is proposed to open in January.  right now it is a mess with all the construction the plan is to demolish the current patient tower that sits where the water feature is in this picture.
Lee had developed some swallowing difficulties over the course of the preceding few months so he had a EGD on May 15th.  We also go him set with a few other doctors here in Provo so it was a month of orientation, unloading boxes and Doctors appointments.  
June 4th Lee had an MRI of his liver, on his previous labs his cancer markers had increased, one of the main complications of liver failure and cirrhosis is liver cancer so his markers are checked every 6 months.   His MRI came back negative for cancer, but his MELD score went down to 15.  Lee was so upset he feels terrible but his MELD score does not reflect that.  
Lee also continued to have swallowing issues so he was scheduled for a swallow study, this showed that food goes to the bottom of the esophagus and sits there slowly trickling into the stomach.  He was scheduled for another study that will show if there is strictures or if it is motility problems.  Lee is also set up with speech therapy to help him with his swallowing and decrease his risk of aspiration. 
Neurology appointment Lee has slight confusion at times, problems with memory and balance problems so his liver team wanted him to see a neurologist.  The neurologist was unsure what was causing all the issues so he ordered an MRI of Lee's brain and to see a neuropsychologist.  The MRI of the brain showed normal brain (Who Knew. Just kidding) and showed a Thornwaldt cyst.
"Tornwaldt's cyst is a benign cyst located in the upper posterior nasopharynx. It is a relatively rare lesion and most are small and asymptomatic whereas some cause nasal obstruction, postnasal drip, occipital headache or eustachian tube dysfunction."  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4190747/
July  continued with more doctors appointments and finishing my orientation. 
 July 11 Lee met with the neuropsychologist through this appointment we learned that Lee's memory issues were due to medication, metabolic issues and just being sick.  The Neurologist felt that Lee may have a form of early dementia called Lewy Body Dementia.  
"Lewy body dementia (LBD) is a disease associated with abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the brain whose changes, in turn, can lead to problems with thinking, movement, behavior, and mood." https://www.nia.nih.gov/health/what-lewy-body-dementia
Lee also started working with a chiropractor to see if some of his back and Joint pain
 could be resolved.  The place is called the JOINT it is a walk in clinic and you do not
 have to make an appointment.  
https://www.thejoint.com/utah/orem/university-mall-45006
This has helped in his standing up straight and a little with his balance.  July 26th
 was Lees appointment with the ENT Dr. Money  he felt that Lees tornwaldt cyst
 was small enough that is should not be giving him any problems.  Dr. Money did 
set lee up with the audiologist for a hearing test.  This was done on August 9th it 
showed lee dose  have some hearing loss and that he would be a good candidate for
 hearing aids, hey also feel that this could decrease some of his confusion and help 
with some of the balance issues.  Lee is also convinced I have hearing loss from a 
ruptured ear drum several years ago so I will be going to get my hearing tested also. 
To back up just a little on August 4th  Lee went into the ER for increased abdominal 
pain and nausea, at this time his ammonia levels were 95 the normal range for ammonia 
is15-45 so Lee's were way up there the CT also showed a enlarged spleen and of course
 liver inflamation.  They could not find a real cause for the pain besides enlarged organs
causing pressure, the next couple of days were spent taking lactulose and getting the
 ammonia levels under control.  This weekend our AC also went out, luckily we have
 a small window unit that we used in Hurricane that we put in our bedroom
window and huddled in there for a few days to keep cool. 
Lee also got his labs drawn and an updated MELD score was 21.
August 10th Lee went in for a follow up EGD to see if there was a stricture or 
somethingelse happening with his swallow. Dr, Harmston did this procedure along 
with the previous EGD.  He fells lee has a disorder called Achalasia. "Achalasia is a
 rare disorder that makes it difficult for food and liquid to pass into your stomach. Achalasia occurs when nerves in the tube connecting your mouth and stomach (esophagus) become damaged. As a result, the esophagus loses the ability to squeeze food down, and the muscular valve between the esophagus and stomach (lower esophageal sphincter) doesn't fully relax — making it difficult for food to pass into your stomach."
https://www.mayoclinic.org/diseases-conditions/achalasia/symptoms-causes/syc-20352850
I keep thinking why does he have to have all there rare disorders the tornwald cyst is rare and then achalasia.  These are wall things that I have never heard of along with orientation to an ICU my husbands disorders have taught me a ton.  I am hoping to keep up better on this blag and do post in real time now that we are a little more settled maybe I will be able to do that.  

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