Song of the Day: All You Need Is Love

When I was young, impressionable, and easily beaten to a pulp, my sisters ruled the record player with iron fists. There might have been arguments between them about what was to be played next, but my vote simply didn't count. I should probably pause here to clarify to younger readers that a record was what we played music on before 8-track, which is what came before cassette tape, which is what came before CD, which is what came before digital music which you call MP3s.

Anyway, at that time there were few things that my sisters, only about 18 months apart in age, agreed on. The Beatles, however, united them. It is because of that unique harmony that I grew up thinking that The Beatles are more important than Beethoven, Mozart, and even Elvis. I, 6 1/2 years younger than my youngest sister, figured all good in the world must begin and end with The Beatles.

It wasn't until I got to college, a time when you can be certain you know everything and certain you are correct, that I realized that The Beatles ARE the source of all good music and all harmony in the world.

Because "there's nothing you can do that can't be done," and because we're all amazed at the things Amacker has already done, today's song is:

The Beatles performing "All You Need Is Love"

Two Weeks

Oxygen: 40%
Peep: 5

Two weeks into this ordeal Amacker is doing great. Really, she's the best she's been.

She's sleeping, but stirs when you stir her. Her neck is starting to look normal sized (it was very swollen), and though it's in a brace (has been since her neck surgery... just one of those plastic collar things) her color around her neck looks completely normal. It's hard to tell, but the bruising appears to be gone.

Amacker's mid section is still not all the way closed. The muscle and stuff is closed, but I'm told the area is too swollen to close her skin completely. It's covered with dressing, so I don't know what that area looks like... not sure I want to. Every time I've seen her she's been dressed in a smart hospital gown, complete with a Stanford crest on the chest.

Where they took the skin graft from her right leg (to cover her left shin) is healing nicely, and the parts of her right leg that aren't bandaged look great, too. You can see some of her stitches from her shin, as well as the places where they had originally placed hardware to keep her leg in the right position. Those stitches all look good.

Her left arm is still not set correctly, and looks to be at a slightly weird angle. I don't want to think about what they'll have to do to get that just right, but that should happen early next week.

And finally it seems that Amacker is breathing well. They've really reduced the amount of work the machine is doing for her. She coughs a bit, and winces when she does (I find myself forgetting that all her ribs on her left side were broken -- a completely debilitating injury on its own!). Of course, she doesn't make any noise when she coughs, but you can see it on the breathing machines and in her face.

There are a million other little processes that go on in our bodies, and hers seem to be getting back closer to normal. I'll spare you the details, but it's all good news.

I think my Dad is going to spend Father's Day weekend with my sister Alden near Chicago. It must be tough being a dad when your kids spread themselves out across the country. He'll be here next week when Amacker starts to wake up... we'll all be at her side soon enough.

With two weeks of looking after my sister, I feel closer to her than I have in a very long time, and yet we haven't said a word to each other... none that she'll remember. Strange. I also find myself wanting to hold my own kids a little tighter than I usually do. They're back with their mom tonight -- a Super-Mom if there ever was one -- but we'll be at soccer games together this weekend, and of course some sort of wonderful brunch on Sunday.

In the words of the late President Ford, "I'm grateful for every sunrise." Thanks to the amazing work of talented doctors, the sweet thoughts and prayers of loved ones near and far (all of you), and an amazing fighting spirit, Amacker is going to have many more sunrises. (though she has to stay up through the night to see them... she never wakes up that early.)

Watch That Right Hook!

At 8am this morning Amacker looked very good and very lively. The reduction in breathing support from yesterday held through the night, and she's still at 40% oxygen and a Peep of 8. Everything looks good.

They had to increase her sedation a bit last night, as she's becoming more active. She wants to wake up. This morning they had reduced it back a bit to see how she reacted, and while I was there she looked like she was training for a prize fight. On several occasions I had to duck her right hand as it came flying at me.

She is unresponsive when you ask her to squeeze your hand. She doesn't follow commands. But Amacker is clearly very much in there and will be quite fit when she wakes up. I fear our biggest difficulty, as those who love her, will be convincing her to remain quiet and take her time getting back on her feet.

At the end of my visit Nurse Jane increased the sedation a bit, and as I was leaving Amacker settled back into her pillows for a good morning nap.

Song of the Day: Box of Rain

Back in the late 80s and early 90s I was in school in Florida, and Amacker started inviting me out to California for summer and eventually New Year visits. Every time I'd come out she'd take me to a Jerry Garcia or a Grateful Dead show. I fell in love with the area, the culture, the music, and pretty soon I was driving from Florida to California several times a year. In the summer of 1993 I just never went back to Florida. I've lived in Northern California ever since and always no more than a few miles from Amacker.

This is a song about care. It's not always clear what we can do to help someone who is under the care of talented physicians. Sometimes we wait. Sometimes we help fight the boredom while the body does what it does. Sometimes we advocate. Always we love.

The Grateful Dead performing "Box of Rain"

Slow Steady Progress

Amacker is resting peacefully tonight. Her oxygen supplement is reduced to 40% and her Peep is down to 8.

The dressings on her leg and abdomen are much smaller than they used to be, and the visible stitches look good. Her scrapes and wounds are all healing nicely while she sleeps.

Song of the Day: Comfortably Numb

This particular version is done by one of Amacker's favorite artists:

Dar Williams performing Pink Floyd's "Comfortably Numb"

The Southern Belle

Jamie sends this silly picture of Amacker...

Hang In There

At 4PM I spoke with Cindy, our newest nurse. She had a great deal of information for me.

Amacker acquired a staph-infection. Basically some bacteria that normally exists on our skin got insider her. It’s completely treatable, and they are giving her a course of strong antibiotics as we speak, but it takes a few days to get rid of the little bugger. Unfortunately, they can’t do the surgery to repair her arm until they get rid of the staph infection, and they can’t begin the process to wean her from the breathing machine until they fix her arm.

The long and the short of it is that they hope to work on her arm Monday or Tuesday. After that they’ll start trying to wean her from the ventilator. It could be a difficult and lengthy process to do that. It seems the longer one is on a machine like that, the harder it is to give it up. To be clear, though, the care providers are very confident she will achieve independence from the ventilator without too much difficulty. We just need to hang tight.

Everything else is progressing nicely. Amacker seems to be mostly comfortable, and animated at times.

I keep forgetting to mention it, but Amacker's hair is pulled straight up on her head, so that when you walk in you see a pink and blonde whale spout sticking straight up from her head. It's very cute... very Amacker.

Song of the Day: Suddenly I See

I know it's over-played, and maybe even a little trite, but just think of Amacker as it plays and tell me it wasn't written for her... or maybe how we all feel about her.

K. T. Tunstall - "Suddenly I See"

The Dancing Queen

Great news! Amacker is doing very well tonight, and she's groovin'!

Don (Amacker's housemate) and Luda (my girlfriend) and I went to go see Amacker at 10 PM tonight, and she was really animated. Both legs... BOTH were rolling side to side like she was swimming. Don thinks she's having dreams about riding horses. Whatever it is, she is really moving. Her eyes were also open for a lot of the visit.

We gave her some music to listen to. The nurse said it's no problem to put her iPod on from time to time. Don loaned her his iPod that Amacker filled for him, so it's all stuff she likes.

All the numbers are the same... Peep 10, Oxygen at 45%. Her fever is just a little high at 38c.

It was a great visit and charged me with hope that we can start thinking about weaning her from sedation and the ventilator over the next few days. I'm no doctor, but I play one on the Internet.

A Visit From Her Nephew

Boot and I went to go see Amacker at 4:00 today. (sorry for the late posting) We ran right through the gauntlet at the check-in, where they told us no kids allowed before, and the new nurse back in the room was really sweet to Boot.

Boot is 12, and his assessment of Amacker was, "She looked a lot better than I thought she would."

He's right. She opened her eyes several times, and she moved right-side limbs quite a bit. She didn't focus on either of us, or squeeze our hands when we asked her to, but she was animated. (She might have trouble focusing because she's blind as a bat and doesn't have her contacts or glasses.) ((Just to be clear, that was a joke. She doesn't have great vision, but she remains heavily sedated. She just opens her eyes and moves sometimes, as if dreaming.))

It is worth noting that cards and letters are piling up. You guys are cute. I know you just can't resist. The notes on the back of cards are always sweet, and some of the pictures of art-cars, art-bikes, and art-people are amazing. The nurses always hand me the stack, which goes in the back of my car until she wakes up. The minute she is conscious again I'll dump them on her lap.

Oh, and the daytime nurse (sorry, I can't remember her name... grr) says she's happy to put headphones on Amacker from time to time. We'll round up her iPod and some over-the-ear headphones. She'll be tappin' her toes in no time.

No Rollercoaster Bed Today

Oxygen: 45%
Peep: 10

Good morning,

The nurses today found that they could move Amacker around carefully and use pillows to support her in various positions, so they decided not to use the crazy rotating bed. She is running a slightly higher fever today, which they are treating with Tylenol, but they have decreased her oxygen level a bit.

Not much more to report.

When I was a kid I read a book called "The Day the Dikes Broke" about turn-of-the-century Amsterdam. During storms night-criers would walk through the streets and call out, "It's 3 AM and the dikes are holding." (Except, you know, they'd say it in Dutch.) Anyway, I feel a bit like a town-crier.

"It's 10:45 and Amacker is still sleeping."

More Trouble Breathing

At 10 PM Amacker is still having trouble breathing. They've had to increase her oxygen to 55% and her Peep to 10.

Technology to the rescue?
Tomorrow they are bringing in a special new-fangled bed that should help Amacker breathe. It's designed to hold her various extremities in place relative to her body, but rotate her. I'm not sure how that helps her breathe (so much for my passing for a doctor), but that's what it's supposed to do. I'm told it's quite a contraption to see. It also sounds like Stanford is bringing in this bed just for Amacker, because the nurse said she "talked to the company" about getting it here tomorrow morning.

Music While We Wait

Amacker is (obviously) an extremely musical person. So am I. So is her sister. So is her Dad.

... imagine that.

I've added a little button over there on the right. Press the play button to hear something that reminds me of Amacker. I'll add something new each day or so.

Today's song is Loudon Wainwright, III singing "Daughter." It's a cute one!

If you have a suggestion for a song, feel free to leave it in comments or send it along. If you have a favorite picture of Amacker, send it to me and I'll put it up for everyone to see.

My Meeting with Big Chief Fix'em

I had a good chat with the Chief of Surgery today. (The night nurse was more or less correct. ) Amacker continues to make progress, but until she is very stable they aren't going to make any big steps. They will not try for the arm surgery before Wednesday, and they won't wake her up or remove her breathing tubes until after that.

Her breathing slipped a bit last night, so they increased her Peep (pressure in her lungs from the breathing machine) from 5 to 8. They left oxygen at 50%. The machine gives her 20 breaths per minute, but she's taking 27, so 7 of those are all on her own. They are also tightly controlling her blood sugars at this point. The fever is holding, and I'm assured it's normal.

An interesting side affect of this experience is that I know much more about care than I wanted to. When doctors have told me various numbers, I follow their glances in the room and see where they're looking when they answer. Over time I've learned where to read all the settings on the machines, and I've asked enough questions as to what it all means, so now when I go in I say things like, "Oh, her Peep is up a bit, did her blood gasses slip?" Now the nurses say things like, "Oh, you're a doctor?" I haven't yet answered yes, but as soon as I have the confidence... If you see me running around Stanford in a white doctor's coat don't blow my cover. I promise I won't perform surgery until I ask lots of questions about that.

Better Breathing

At 10:00 PM tonight Amacker was doing better than she had the last few days. Her oxygen remains at 50%, but her Peep, a fancy term for the amount of pressure in her respirator, was greatly reduced (5 is the number). The nurse said they don't really go below 5, so she's out of the danger levels for that. (I'm told sustained high-pressure from a ventilator can cause problems.) By the way, the machine that goes "bing"... she's got one of those, except they don't go bing any more. Rather, they go bing when there's a problem and not when everything is as expected. It's amazing that reversing a bit in software makes for a much more pleasant experience and a far better user interface.

I don't know how much I trust the weekend night nurses as a source for any long-term care planning, but one said she heard they might work on Amacker's left arm on Wednesday. She also said they wouldn't wake her up until that was done. I'll go in tomorrow morning and ask to speak with one of the doctors. The ones with "Chief" in their titles seem especially smart... I just got a Chief in my title, and I don't feel especially smart. I'm easily distracted by shiny objects and machines that don't go bing.

A Tour of the Hospital

You might have images in your head of what a hospital should look like. Stanford U.M.C is different.

To give you, especially those of you who are far away, an idea of the country club in which Amacker finds herself, I snapped a few pictures this afternoon. You can click the pictures to make them bigger.

There are several fountains around the buildings, and plenty of shady spots to sit and read a book.

Dramatic landscaping helps give ambient light to rooms on every floor.

Flower gardens are well-tended.

The morning Tai Chi classes are well attended. The Stanford Jazz Ensembles and other groups often play in the afternoons.

Three-story windows provide ambient light throughout the hospital. Notice the window cleaner in the lower left of the picture.

Even the cafeteria is lit by a skylight and serves Starbucks coffee and food that is something better than institutional.

And well-behaved children are welcome throughout, but not in the I.C.U. In this case, the well-behaved children are mine.