Coffee 11-22-14

Take about being glad the job is done, man smoothing out that textured paint really kicked my but. I was up and down the ladder working over my head all afternoon. Take my word for it NEVER ever use textured paint. I was able to get it smoothed out but boy did it make a mess. Fortunately, it's contained in the one room. I'll try to get it cleaned up tomorrow. Then I'll paint over the Thanksgiving weekend.

Here's hoping everyone is getting something done on their to do list, take care, Lisa

For me it is everything SHEEP now.

Katie and I took over the farm in March as the 9th generation here, and started increasing our flock considerably. We watched them all fall and when we saw our ram with his concubine and only 6 hoofs on the ground, we figured our lambs would start 12/29 of this year.

Nope...

Last Saturday Katie looked out and saw two lambs nursing on their mother. Despite 16 degree temps they managed to survive birth even though they were soaking wet. From then on it has been a constant drive to get ready for lambing season as we call it; the most intensive time of year for us. This year we are looking at between 100-125 lambs so we have had to make a lambing barn, lambing pens, a lamb creep and other areas all for our sheep. Its been a lot of work and must say Katie has been a trooper. Our boiler is still not installed yet, her kitchen is not even started and yet we are building sheep barns instead.

Oh what farmers do for their animals...

Sunday night already.. wow, where has the week and weekend gone??

This has not been a great week, or last week either. Bob, a good friend since high school, had some awful news for me last Saturday. On wednesday, 10 days ago, his wife, only 54yrs old, complained of chest pains, so off to the hospital they went. She was admitted, and checked over, but was NOT having a heart attack, or other cardiac problem. But the pain continued, so she would stay for a few days for more tests and observation. Thursday, tests, some results came in on Friday, Bob and wife had a meeting with the docs, and there were no answers, just more questions, but she was feeling better.
Then in early afternoon on Friday, she starts having difficulty breathing, nurses bring in the docs, her breathing is bad enough that they need to put her on a ventilator and breathing tube. A mask won't do it. So they try to put the breathing tube down her throat, no dice, there is an obstruction! Several tries, and someone runs off to get a special breathing tube that has a camera and monitor. Allowing a person using the tube to see inside the trachea as the tube is being inserted.
But everything takes too long, her heart quits. they get it going again, but she's been without blood flow and oxygen too long. She has zero brain activity. She's put on full life support.
The next week family members show up to pay last regards, even though she is in fact already 'gone'. Then this last Thursday, she is removed from life support and dies.
No info yet from Bob on funeral arraignments. So sad, Bob just got back to work from battling lingual cancer, Chemo, and Radiation, his face and neck swelled up like a five-gallon pail. He's recovered, and is back to work, now his wife dies in this peculiar situation. I want to ask him if the hospital will do an autopsy, to find out what might be the original problem. And if he feels that the hospital is negligent. Sounds to me like they are negligent.

So that's enough bad news, right?? NOPE, there's more. My good friend who's Mother lives in Auburn Indiana, right across the street from the ACD museum is probably going to pass away this week.
His Mom, who is 90, went in the hospital about 6 weeks ago for shortness of breath and exhaustion. The main reason was she was very anemic. Once she received 2 pints of blood, she felt MUCH better. She's gone through this mysterious blood loss thing before, with no conclusive answers.
This time it is noticed that her Aortic Valve in her heart is severely clogged and restricted. The 'leaves' of the valve and the surrounding tissues are all covered with plaque, with the result that the valve is only letting 5-8% of normal blood flow through the valve. Her heart is very strong, and is having to work very hard to push enough blood through the restrictions to supply her body and brain with blood and oxygen.
And it is determined that the forcing of the blood through the rough, restricted valve is damaging a lot of the blood cells, and then the damaged ones are filtered out by the kidneys, but her bone marrow is unable to keep up with red blood cell production, So she's getting anemic and needs extra blood.

There is much discussion about the heart valve, no less than 4 cardiac specialists and three vascular surgeons are brought in, and hold a pow-wow. It is decided to go ahead with a roboticaly-performed heart valve replacement, This is performed by accessing the aortic valve through the large blood vessels in the legs.

So last Monday the surgery is performed, and all goes well, they did not have any problems with her smallish blood vessels, and in fact the surgery was scheduled for '4 hours plus'. But she was in and out of surgery in two hours flat.
The surgery team met with us and told us it was 'text-book' perfect.
A few hours later we met her in recovery, she was really 'out of it' . General anesthesia is pretty rough on some people.

Then, a few days later, she's not improving much, her heart valve is 'looked at' via an ultrasound, and it's doing fine, the heart is pumping well.
But she has some water in a lung, that had appeared since the surgery. And her legs and feet are swelling, her body is retaining water and fluids.
The problem is her Kidneys are failing. Apparently the dye used in the blood to show the instruments during the surgery is not getting removed from the blood very well. The dye seems to have caused some damage to her Kidneys.

I check with two friends both medical doctors, both tell me that the dye is pretty rough on many patient's kidneys, but with a frail old person, the dye could be deadly.
And in this case the dye seems to have damaged her Kidneys past the point that they can recover from.
One cardiac doctor in the 'team' suggested that they may put her on Dialysis to clean out the dye, and give her kidneys a chance to recover.
So a Kidney specialist, a Nephrologist ? comes in, looks her over, looks through her charts and several years of past paperwork. This specialist's conclusion is that she will die during or just after Dialysis, that is very tough on younger, stronger patients, but most likely deadly to her.

So, with no other options. it seems she won the battle but will lose the war. The docs give her about a week.
Just today, she barely recognize her son, my good friend, when she woke up. And about noon, her daughter showed up and was not recognized at all. She is fading fast. On friday, just two days ago, she was able to converse and chuckle at a joke, today she's worse than she appeared 5 hours after surgery.

So, as Freddy says: HUG YOUR LOVED ONES !! INDEED!!

Yesterday morning, saturday am, we had freezing rain, about 1/8", just enough to make some roads slippery. It was worse south of me, some places near Detroit airport and the airport itself got about 1/4", enough to shut down the airport for many hours.

Then the temps kept rising, and all the snow around here is now gone.
Between rain showers, I made a lot of progress on the solar panel mount for my remaining 4 panes that HAVE to get up this next week. But right now it's pouring again, and tomorrow we are supposed to have 40-80mph winds.. what fun, huh??

Ok, time to go.
Take care everyone, and HUG 'em ALL !!

Greg L

Greg, I work in health care and just from what you gave us, I question the judgment of the older lady's family and MD's rather than the first. We have many interventions BUT its called medical PRACTICE for a reason. You are right Hug your loved ones regularly cause you just never know.
C.

Gosh Greg, Certainly sorry to hear of Bob's wife and your friends mother. Bob's wife.... 54 is much, much too young. Such a sad thing to have to say good bye at such a young age. My thoughts & prayers go out to all the family, be them family, or part of the family of friends. And your friends Mom.... 90 ...she's been blessed with many years. I hope she's comfortable in whatever days she has remaining.

Wow Greg that's some terrible news. Thoughts and prayers coming at them from here as well.

I got me a new chimney cap finally. Been nursing the stainless one I bought at Home Depot 7 years ago. Thing never fit right - had to cut the base off, and flare out the wire cage so it would grab the inside of the chimney ... which made flyash stick to it an inch thick, and rotted off all the welds. After I disturbed it during the chimney rebuild, the slightest gust of wind sent the thing sailing like a frisbee to the ground ... or to the porch roof depending on which way the wind was headed. I was NOT climbing up there to replace it every 10 minutes, so I left it down for a couple days. Then with rain in the forecast, I put it back on with a concrete block on top. Worked!

Now I've got a new one I bought from Efireplace. Has set screws with points that really bite into the brick and mortar. This will hopefully be the LAST chimney cap I'll need to buy for this place. If I got 7 years out of that piece of junk from H/D, then this one will last 4x as long. It's a really well built piece.

Hi Ga Cracker, Freddy and Smitty, Thanks for the replies.
Ga Cracker: the short version I put in the message only give a quick overview of the whole process Edith [the 90 yr old lady with a restricted aortic valve] went through before the decision was made to go ahead with the heart valve replacement.
First, she was given no hope at all, but a slow decline to a nursing home, followed by 24 hour care, then death due to her heart trying to pump through a valve that is unable to open.

Edith had a lot of tests done, including a heart catheter test, then a CT of her blood vessels for both blockages and size. It was assumed by the first doctors that since she was so thin that her blood vessels would be way too small to accomodate the cameras, tools etc that needed to be put into the femoral vessels and routed up to her heart.
This was NOT open heart surgery, it was completely inside the blood vessels,
The CT scan showed that Edith had quite large diameter vessels, one of the reasons the surgery was able to be performed so swiftly.

As the idea that the valve could be replaced with a relatively non-invasive procedure, then the questions started. What about the rest of her 90 year old body? What would the likely time for her recovery be?
Edith's parameters for her and the family's decision were based on this premiss: If I cannot be as independant and active as I was just 2or 3 months ago, then I don't want to do the surgery. If I have other issues that this will inflamate, I don't want to do the procedure.
If I have to have a nurse in my home, I don't want to do the procedure.

She eventually got all the cardiac doctors and vascular surgeons to confer with each other and come to a consensus: she would be better off with a good aortic valve, they saw no other issues with her other organs, and for a 90 year old person she had an excellent heart and lungs.
They told her she had a 95% likelyhood of having a successful procedure.

But, after the procedure, then several things popped up: she was having problems with keeping a good blood oxygen saturation level. A pulmonologist came in and said her COPD was most of the problem !!!! ???? !!! This is the FIRST time COPD has ever been mentioned in regards to Edith, EVER.
After the procedure, we are told that she also has an impaired and restricted mitral valve. This problem could have been masked by the very bad Aortic valve, but nobody mentioned even the remote possibility of this, and I don't know if they can't look at the mitral valve during a catheterization..
I'm not sure just how thoroughly Edith's kidney function was checked prior to the surgery, but it too could have been masked or assumed to be poor due to the very poor blood circulation.

What would make sense to me, thinking like a mechanic that even with lung issues, a poor Mitral valve, and slightly low kidney function, with a new aortic valve, the bloodflow from the heart would definitely make her much more vital, and help the lungs and kidneys work much better, since blood flow is a critical factor in both the lung and kidney function. .

So, the decision was made, and unfortunately Edith's kidneys were not improved by increased blood flow, but damaged by the dyes in her blood that were used during the procedure, and prior for the Catheterization and CT Scan .

Edith was a gambler, she point blank said, if they will do the surgery, I'm willing to gamble. I cannot continue to live like I am now, with no capacity to even get up and walk to the bathroom without feeling faint, and having no appetite, making it very difficult to maintain any body strength. She bluntly said I'd rather say all my good byes before the surgery and If I don't make it so be it, if I do make it hopefully it will make be feel better and I can have another year or two of decent activity and health.

As for my other friend with the wife who died in the hospital, well it smacks of malpractice. She was on the Cardiac floor, with cardiac and lung specialists, and yet it took 20 minutes to entubate a patient that had had CT scans, echocardiograms, and numerous Xrays Any obstruction should have been found and noted..
Again, as a mechanic, if a vehicle comes in with significant poor running issues, you look at the air supply, and if the air filter is clogged solid with dust, oil from blowby, leaves or from mouse nests in the air filter or on the airfliter element itself, well I'm going to have a replacement filter ready to install, not wait till the car quits and won't run any more.

Anyway, I do understand that unlike a machine or an automobile, each person is different, both inside and out. so there are no cookie-cutter answers or procedures. But there are proper and good practices to follow.

OK, off to bed, It's Thanksgiving morning.

Greg L

Greg,been away,so in the end,Thanx for being there for The Folks in Your Life that are taking this pounding! Running out or away has not been an option for you,and you're helping them as much as ever by being in their Lives. Get some sleep,then some Turkey,and stay with it,My Friend!