Sunday, November 09, 2008
My father's in "guarded" condition (better than "serious," but not as good as "stable") in the ICU. He has low blood pressure, and his kidneys aren't working right, and the meds that would raise his blood pressure would also "nuke his kidneys," to quote the doctor's colorful phrase.
Ideally, the next step will be a cardiac catheterization to see what's going on other than the bad valve (which they know he has, and which could have caused the heart attack). However, at the moment his BP's too low for him to tolerate that procedure, so they can't go in until both the BP and the kidney issues have improved.
After he goes to the cath lab, the ideal next step would be valve replacement -- open-heart surgery -- which the doctor estimates he'd have a seventy percent chance of surviving. The problem with that, of course, is that they'd have to crack open his chest. He had a really tough time recovering from his four-way bypass seven years ago, and he's frailer now than he was then.
If they do the surgery, he'll be care-flighted to the San Francisco VA for it, since Reno doesn't have the proper facilities. But there are a lot of "ifs" floating around here, and the doctors have no idea what will happen. We're taking it day by day.
He was in excellent spirits this morning. This afternoon, he conked out and slept so deeply that neither the nurse nor I could rouse him when it was time to take his meds (the nurse was less worried about that than I'd have been if she hadn't been there). I like the medical staff, and I think he's getting good and appropriate care.
This morning, he decided that he wants to be DNR ("Do Not Resuscitate," medicalese for "if my heart stops, let me go"), so he's now wearing a bright blue bracelet announcing his code status. While the doctor, intern and resident were briefing him and me and Fran on all the steps and permutations and complications, Dad kept waving at the ceiling and saying cheerfully, "Hi, heaven, I'm on my way!"
This was purely a figure of speech; he's a devout atheist who believes neither in heaven nor hell. But later, when one of the doctors told me that he wasn't sure Dad understood his situation, I said, "He understands his situation exactly. That's why he was saying hello to heaven." (Don't these people listen?)
But with any luck, we can delay that for a little while.