May 17, 2011 Update

We saw Trevor the PA at Dr. Nichols office. He had some interesting insights on Dad’s health issues. After describing Dad’s health status before the biopsy and his status now, he did seem to agree that the information we could have determined from the tests was not worth the procedure. His feeling is that a bone marrow biopsy is needed and the two main diseases that could be determined from that are not treatable, so why bother.

Dad’s wound is healing nicely. The HH nurse yesterday had to use the wooden end of the Q-tip to get the wicking material in. Tonight we remove the wicking material for good and see what happens. The HH nurse is scheduled for tomorrow morning and I’ll be there to see if we might be able to discontinue that service. Dad is anxious to get back to tennis and with the nurse coming M-W-F that is difficult. The PA prescribed one more week on antibiotics as insurance against another abscess.

On the anemia front, while Dad’s numbers are low, they are not catastrophic. If they do get low enough for him to have a transfusion, then a nephrologist (kidney specialist) would prescribe epoitein(?), a hormone to stimulate the bone marrow to produce more red blood cells. The PA’s feeling was that the anemia is caused by Dad’s renal insufficiency. We will monitor Dad’s Red Blood Cells and kidney functions every three months. As for future doctor visits, he has one with Dr. Chang near the end of the month. No more with Dr. Nichols (unless the wound starts acting up again) for three months.

We got to spend some time in conversation while waiting for the doctor. Dad says he is eating well. He is feeling good and wants to get back to his routine. I think he is looking forward to living and not constantly going to the doctor. He is looking forward to the Boston trip in the fall. And, as a by-the-way, feels that Boston Rob did a great job on Survivor and deserved to win the million bucks.

Love,

John

May 16, 2011 Update

Dad’s home health nurse came by. It was a different person, Donna. The wound is closing up quickly now. She could barely get any wicking material in the incision. She also was able to forego the large pad bandage and just use the 4x4 gauze pads. Dad is talking about playing tennis soon. We see Dr. Nichol at 7:45 am tomorrow. Look for the next report then.

Love,

John

May 13, 2011 Update

Yep, I can make the Tuesday appt. I'll talk to Dad this weekend and see if
he wants to meet there or have me pick him up.

Thanks again, Jim for being around this week.

John

-----Original Message-----
From: Jim Harrer
Sent: Friday, May 13, 2011 2:04 PM
To: John Harrer; Tom Harrer; Bill;
Subject: Dad update...

Dad and I just finished another long walk. He's doing great. He
really wants to be in good condition for the Boston trip, so he's
motivated to stay on a program.

Dr. Nichols had an emergency with a patient today and couldn't see us.
I rescheduled for:

5-17-2011 @ 7:45am - assuming John could make that. I know it's
early, so if you would like another time their number is 323-8477.

The only question I really had for Dr. Nichols is how often he wants
the packing changed and how deep he wants it based on what the home
nurse is saying (ie. don't use so much and don't clean as deep with
the q-tip). The home nurse from Mercy used way more than I use, so I'm
not sure which procedure is correct. I see both points. We need to
find out what is best. One question I was going to ask is, if the
packing only needs to be re-packed once a day, then Dad could change
the outter dressing himself.

Central Methology called to remind us of an appointment on 5-17-2011 @
2:15pm. Dad doesn't know what this is for? Is this the kidney
follow-up that we want to cancel?

Dad is eating great, he's been eating three meals a day with me and
likes being on a schedule. I have been teaching him my old routine on
how to cook for one. He has been a good student and open to new
ideas. He has really been wonderful to be around ALL week. I just
have to be careful to not waite on him too much, he doesn't like it.

Let me know if I missed anything or if you have any questions.

Love,

...Jim

May 11, 2011 Update

Dad is going GREAT!

Medicare has agreed to pay for Optimum Health Care to come by Mon,
Wed, Fri at 8:30am to change his dressings and repack. The male nurse
who came by today said he will be the same person who comes by each
time. His name is Manuel. He left his cell # with Dad and told him
he could also call him 24x7 if he needed help. He seems to think he
won't need to come by for more than 2 weeks - but said Medicare will
pay for as long as Dad needs him. Optimum has John, Tom and my cell #
numbers as contacts.

Dad is eating great, and doing well. We went and had coffee with this
tennis buddies today at 9:30am and everyone was happy to see him.

The next follow-up appt is Friday with Dr. Nichols.

I honestly think Dad could easily get to a point where he changed his
dressing (not packing) once a day and you just change the packing
daily if you wanted to go to that schedule after I leave. That would
get you down to one visit a day if you wanted. Whatever Tom and the
doctors decide is fine by me, I'm just throwing that idea out there
since the nurse seem to think twice a day (at this point) may be a bit
overkill. I do think the top dressing should be changed more often
then he suggested however.

Hope this helps. Like I said, he is doing well. He also told me he
did go to the dentist recently, but couldn't tell me exactly when. He
changed dentist when the last one charged hum $1,000 for a deep
cleaning - that was 18 months ago. A call to his current dentist
might be in order just to check the facts. I'll try and dig more.

...Jim

May 5, 2011 Update

Update for Thursday morning. Health care nurse came and showed Tom how to change the dressings, yes I said Tom, and he did a very good job.

Heart rate 60
Temp 98.6
B.P. 136/68

He sleeps good, eats good, and looks good.

All is going good here.

Mary

May 4, 2011 Update

I just talked to Mary. Dad is awaiting to be wheeled out of the hospital (that should only take an hour or two ;>))

John

Dad is being released today into Tom & Mary’s custody. He is looking good. I got to meet Dr. K and watch him clean and repack Dad’s abscess. We will have to do this once a day (although I think Tom is trying to negotiate a home-health nurse). The abscess is much improved. Dad’s original incision was 6-7” long. The current incision is about ¾” – just big enough to let the fluid out and be packed by ¼” wicking ribbon. The fluid coming out is yellow, lymphatic fluid. It could take weeks for this thing to heal completely.

Dad is stronger than he was yesterday. Tom took him around the floor and that tired him out some. He did shower himself this morning. The antibiotics have given him diarrhea even though we started him on some probiotics on day one. He is still in some pain but refuses to take morphine (even though I told him it would be helpful for the diarrhea too). The kidney doctor was in at 6:30 am so we missed him.

I am leaving for Sacramento tomorrow to see Bill and go to a horse training demonstration. I’ll be back Sunday night. I hope to give you one more update this afternoon. As always, feel free to call me at the store or on my cell.

Love you,

John

May 3, 2011 Update

I saw Dad this morning. He looked well…for being in a hospital. They changed his dressing at 2am. The kidney doctor returns today.

Enclosed is the link to two audio files. One is Dr. K and the procedure done in Dad’s hospital room to drain the abscess. I think it is elf-explanatory. Tom and Mary provide some great commentary as well as insightful questions. Dad talks about it at the end and Mary recaps the episode. It’s about 20 minutes long.

The Kidney Specialist (Dr. Psyche (sp)) is about 15 minutes and there is a lot of talk of Dad’s kidney function. The Dr. Talks about high blood pressure and tries to clarify if Dad has it or not. This is important because if Dad’s blood pressure was high before he started taking medication that could have impaired his kidney function. Keep an eye on your blood pressure people! I think one of the more interesting pieces of info was the doctor saying that as kidney function goes down you cannot concentrate your urine and that causes frequent urination…one of the complaints Dad has.

Dr. K Visit

http://www.mediafire.com/?mo6mm4300vk7xqj

Kidney Specialist

http://www.mediafire.com/?ojfaa54f2uhxv7x

As always if you have any questions, feel free to call.

Love you,

John

May 2, 2011 Update

Dr. K just finished lancing Dad’s abscess. Mary said there was a lot of fluid inside. They did it right there in the hospital room and then packed it with some wicking material to draw out the infection. Dad was under a small amount of morphine for the pain and he tolerated the procedure well. If I had to speculate on what the next few days hold, I would say Dad will stay in the hospital, remain on antibiotics, and have the nurses change his dressing. There is some concern over his kidney function and there may be more on that in the coming days.

His blood pressure remains good and his temperature is back to normal.

That’s it for now,

John

Tom called with Dad’s recent vital signs:

Temp 97.1 down from 100.2 last night

BP 130/61

O2 Sat rate 97

Heart rate 60

There is fluid coming out of the incision that was done to remove lymph nodes. Doctors are supposed to come by this afternoon to evaluate and recommend solutions.

Mary was going to bring Dad some food from the outside so at least he would have a good lunch.

That’s it for now.

Love you,

j