2005

JANUARY UPDATES

Mon. 1/31

Kathleen had some breathing difficulties this morning
and her heart rate also shot up.  She had lots of
secretions and desatted (her oxygen % went down) to
about 86 twice.  She was, however, able to cough the
mucous out of her trach when the plug was opened. 

Kathleen had the blue dye test this morning to confirm
the swallowing difficulties she had on the video
endoscopic test last week.  During the test Kathleen
appeared to chew and swallow the blue ice chips and
the test showed that she swallowed them correctly. 

The doctors, therapist, and case workers are meeting
today to prepare for Kathleen's discharge.  Kathleen
is currently scheduled to return home on Friday.

Sun. 1/30

Kathleen's family and caregivers were trained by
nurses on the best ways to care for her at home.

Doctors and nurses agreed that Kathleen's breathing is
much better and she will be cleared to go home sometime
between Tuesday evening and Friday

A nurse, a nurse's assistant, and Kathleen's sister
Sheila saw Kathleen smile today...her first since the
injury. The family had mixed results trying to keep
Kathleen awake today to help restore her day and night
cycles.

Another promising article.

Sat. 1/29

Kathleen had a fairly uneventful day.  She slept
through the planned Blue Dye test yesterday so it was
postponed to Monday.

Kathleen's day night schedule is still off so the
family plans to try and keep her up during the day on
Sunday

Fri. 1/28

New technique may help both babies and adults after
brain injury (unfortunately too late for Kathleen)
http://www.nzherald.co.nz/index.cfm?c_id=1&ObjectID=10008486

Kathleen did not fare well on her fairly invasive
video swallow test.  Another, less invasive, yet less
accurate test will follow today (blue dye test).

Kathleen's day night schedule is again completely off.
She is receiving several new medicines which might be responsible.

Thu. 1/27

Kathleen had a video swallow test to determine 

whether her she is aspirating when she swallows. Results forthcoming.

Wed. 1/26

To facilitate going back to bolus (more all at once)
feedings rather than continuous feeds, Kathleen will
temporarily take Reglan.  This drug will facilitate
the digestion process and also serves as an
anti-nausea medication but the side effect is
sleepiness (particularly in patients with parkinson's
type conditions).  Kathleen's feeding times were
changed from 2 1/2 hours to 2hrs 10minutes.

Tue. 1/25

Kathleen was very relaxed and slept all morning.

Kathleen moved to a new room, 624, because ICU is
filled.  She left on the condition that she will
continue to have an ICU nurse.

Kathleen had her trach plugged today and made at least
a dozen sounds in response to questions and talking.
She moved her lips a lot and appeared to try and communicate.

Mon. 1/24

Kathleen handled her food very well yesterday and the
length of time over which it will be given should be
reduced tomorrow.

Kathleen who was on oxygen after coughing up some
phlegm and briefly plugging her airway and the emesis
episode on Sunday was doing much better today and
taken off oxygen.

Kathleen looked beautiful today.  One of the doctors
and several nurses came in and cried with Mike during
the morning hours.  One of the visitors commented, "I
saw Kathleen yesterday, my friend Mary Ann and I did
Reiki on her for a couple hours... We both commented
on how her face and presence just felt so angelic.
Regardless of what her body may be doing at the
moment, her Spirit is Brighter than ever!!!  She is
truly a precious Gift.:

After 34 hours without eating, doctors began
Kathleen's feeding again at 10AM this morning.

Today marks one year since the worst day in our
collective lives.  Please question your doctor
thoroughly and don't accept their viewpoint on
important medical conditions without researching it
first.  Here is the letter Mike wrote to Kathleen and
read to her last night.

Sun. 1/23

Kathleen had another small emesis episode in the early
morning after struggling with her breathing during the
night.  She desatted a bit in the morning hours and
had to be put back on 28% oxygen for the day.
Kathleen's feedings were held for 12 hours during
which she slept most of the time trying to recover her
strength.  Kathleen's HR was lower again today

Sat. 1/22

Kathleen started the day by throwing up a huge feeding
(much larger than her normal amount).  Afterward the
family asked the doctors to return her to her normal
feeding schedule 375 instead of 440ml a feeding.

Kathleen's HR was lower today but still borderline
tachycardic

Kathleen received physical therapy from the Kaiser
staff today and stretched her out well with a series
of range of motion exercises

Fri. 1/21

Kathleen's heart rate lowered significantly today and
3 of the four braces were delivered.

Kathleen has been abnormally sleepy since she strated
her new medicine, dantrium,  but has been much looser.  

The family will watch longer before deciding how to proceed.

The family had a good discussion with a different PCC
(Patient Care Coordinator - discharge manager) who has
ordered equipment in advance this time and will train
family members and care providers on Kathleen's care
before she goes home.  Kathleen will go home with her
trach plugged for awhile before it is pulled again.

Thu. 1/20

Doctors continued to be baffled by Kathleen's heart
rate and tried to give tylenol to Kathleen because she
might be in pain.  There was no response to the
question "What is the cause of the pain?"  Family
members were told today that Kathleen was almost ready
to go home  despite the fact no cause has been found
for the tachycardia and just yesterday the Davey's
were told  2-3 weeks.

Despite doctor and ethics committee recommendations for
physical therapy,  the PT Dept refused to see Kathleen
and said that the family could do the therapy instead.
The Kaiser Thrive campaign states "We  stand for
broccoli, for pilates and dental floss" "physical
therapy and even music therapy" The list of  approved
items goes on for 20 seconds, coupled with a barrage
of  "healthy" images, such as cigarettes being flushed
down the  toilet. The commercial ends with the
message, "We are Kaiser Permanente and we stand for
health. May you live long and thrive."  From start to
finish Kaiser lets you thrive unless you are sick.
Especially for Kathleen.

Kathleen got up in the chair this morning for the
first time in several days.  Apparently sitting up in
the chair was accidentally cancelled as a daily event.

Kathleen's high heart rate (tachycardia) baffled and
concerned the doctors today who decided to do a
battery of tests including an heart echo and
temporarily take her off the trach plug to see if her
heart rate went down.

Wed. 1/19

Kathleen has continued to be plugged since 2:04pm on
Wednesday and is doing very well on her breathing.
There is continued concern about her heart rate which
is now regularly above 100 and sometimes peaking
around 130

Kathleen's heart rate began to decline near the end of
the day though it was still at higher than normal
levels and she began to run a low grade fever (which
is most likely from her unbearably hot room).

Still no word on when Kathleen's new braces are
coming in.

Tue. 1/18

Kathleen had her size 8 trach switched to a size 6
without a problem.  Shortly after she went on the
trach plug seamlessly

Bean's discomfort level seemed to climb today as
exemplified by shaking in her left arm and a much
higher than normal heart rate.

After discussions with the physical medicine and rehab
doctor, the Davey's agreed to try Kathleen on a small
dose of dantrium to relax her muscle tone.
Reportedly, dantrium is less likely to make Kathleen
groggy.  After dantrium is introduced, the doctors
agreed to lower and eventually eliminate Kathleen's
keppra dosage since the threat of seizures is now so
small.

Kathleen vocalized about 20 loud coos today.

Here is some new medical news.

Mon. 1/17

Kathleen was unable to continue her trach plugging
trials today.  The respiratory therapist thinks it
will go much better after switching to a size 6 trach
tomorrow.

Kathleen who has been very loose as of late seemed
tight and uncomfortable today. Kathleen has been rigid 

and her left arm has been shaking.  These are often 

signs of upcoming sickness or discomfort.

Kathleen's feeding schedule has been corrected.
Instead of 120cc 4 times a day over 4 hours, she is
back to getting 375cc 4 times a day over 2 hours and back
to her needed calorie amount of about 2000 a day.

Kathleen's new hospital bed has arrived.  If anyone is
in need of an older electric model please contact the
Davey family imperialpref@yahoo.com

Sun. 1/16

Kathleen was able to commence trach plugging today and
breathed very well on her own out of her mouth and
nose for 8 hours.  Kathleen's trach size will be
reduced from an 8 to a 6 on Tuesday to make this
process go easier.

It was discovered by the Davey's Sunday evening that
Kathleen's calories had been reduced from 2100 a day
to 640 a day while she was moving from continuous
feeding (all day long) back to bolus (4 times a day
over the course of 1 1/2 hours).  Apparently there was
either a mistake in calculation or in writing it in
the charts.  The nurses who were also concerned
because they had noticed a reduction in her urine
output could not increase her feeding without a
doctor's order.  Until Monday morning when the
doctor's return the nurses agreed to give her extra water.

If anybody can help fill-in the gaps in the visitation schedule 

it would be very much  appreciated! Please contact Cece if you can-

thanks again! 

Sat. 1/15

Kathleen got up into the cardiac chair for the 1st time. She 

at up for 2 hours. This is the first time since she came back 

to the  hospital. The Davey's talked to the doctors about her 

progression of breathing so doctors plugged her trach this 

morning. The family is saying prayers for Kathleen's cousin, 

Peter, who is having his kidney removed due to cancer. 

Here is a letter from Geoff, a former basketball player

Mike coached and Kathleen thought was one of "sweetest".

Fri. 1/14

Kathleen first new day in step down also involved some
new orders.  Doctors have upped her blood thinners
again since her bleeding has stopped, she increased
her blood pressure/heart protective medicine back to
previous levels and Kathleen was taken off the mist.
Now she is breathing out of her trach entirely on her
own.  The next step is to reduce the size of her trach
and then try plugging it again so she can breathe out
of her nose and mouth.

The Davey's usually spent some time to reflect on the
goodness that Jeff Swanberg brought to our lives on
January 14th.   Jeff was a wonderful student and
basketball players of Mike's who died this day four
years ago.  Mike thought of Jeff as a future senator
and his early passing shocked and saddened Mike and
the Saratoga community for many months.
 Kathleen was also affected by Jeff's death and wrote
three days later the following.

Kathleen's thoughts are not far from our own. Nearly a
year after her tragedy Mike, Rachel, Samie and our
family still find it hard to imagine what to do
without the active influence of the centerpiece of our
world, Bean.   All we can do is hope, pray, and fight
for the restoration of her rightful place in our lives
and the return of that wonderful smile to her face.

Thu. 1/13

Kathleen was switched to room air 21% today.

Kathleen moved to room 633 (the old ICU) on the sixth
floor Thursday night at 11pm.  The move went well and
Kathleen received numerous visits from the nurses who
cared for her so long on that floor.

Wed. 1/12

The bleeding in Kathleen's trach area stopped today
and she appeared to be feeling much better.

Bean will be going to step down Thursday or Friday. 

Though people have given so much already and we 

understand if they are unavailable now (and we are 

still thankful for what they are done). If you can help 

watch her while she is at stepdown please  contact 

Cece.  

A Guestbook has been added below. If you have a minute, 

please leave  Kathleen and family your thoughts. 

Tue. 1/11

Kathleen was doing so well on her trach collar (oxygen
mist without pressure but oxygen @ 28% rather than 21%
- room air) that doctors have decided to see if she
can stay on it rather than get pressure support.  Her
performance has been so strong that they moved up the
decision to let her try it 24hrs early.

The Davey's had a good visit with doctors and an
occupational therapist today.  They decided to change
her bi-valves braces to a more dynamic brace and allow
Kathleen to wear her bi-valves until they are complete.

Kathleen is moving to the Step Down level from ICU on 

Thursday or Friday for an unspecified amount of time before 

returning home. 

Kathleen was incredibly relaxed and loose today.. Her
body felt almost  as pliable as before the injury and
she slept soundly most of the day.

Kathleen had some significant bleeding out of her
trach hole in the late afternoon and evening.  Doctors
cut one of her blood thinners, tested her for
anemia, and will call specialist in the morning if the problem continues.

Mon. 1/10

Kathleen was very relaxed on Monday.  She was shooting
for 18hours of breathing completely on her own after
completing 16 hours on Sunday.

Kathleen's bi-valve braces (casts cut down the middle
and wrapped with ace bandage) which have been on/off
for 2 hour cycles for 4 1/2 months were discontinued
by Kaiser doctors yesterday without discussion with
the family.  It is understandable that the doctors
were concerned with potential skin breakdown caused by
the casts, but discussions with the family will take
place tomorrow about the best course of action for
protecting her skin and maintaining her range of motion.

Sun. 1/9

Kathleen continued to wean effectively today and is
breathing well.   The next step will be to get her
entirely on room air, followed by trials of blocking
her trach so that she has to breathe out of her nose
and mouth.

The Davey family request for a phenol block
to help Kathleen's tone in her left hamstring was put
on hold by the doctor's because of a risk of bleeding
while she is on blood thinners and to get her more stable.

There was an article on the Wishbook that mentioned
Kathleen and had a cute picture of Samie yesterday in
the San Jose Mercury News.

Sat. 1/8

Kathleen jumped from 2hrs of weaning (which is 

now completely on her own with an air mist) to 

14 1/2 hours before she rested in the evening.

Kathleen's tone was very low today and her joints were
not stiff.  Her skin coloring was also completely
normal and she again looked beautiful.

Fri. 1/7

Many people commented that Kathleen looked absolutely
beautiful today. 

Kathleen's stomach feeding tube (g-tube) was replaced
today.  The procedure was very painful but brief.

Kathleen continued weaning from the vent today in
on/off two hour shifts.  The vent was turned off
completely for two hours and then she was allowed to rest.

Thu. 1/6

Kathleen slept better last night (not so well the
night before) and was so relaxed and sleepy this
morning that her heart rate touched the 40s (which can
be a bit too low).  She started strong today on her
weaning from the trach at the setting of 0 extra
breaths a minute and 3 for pressure support.

Encouraging clinical research: http://news.bbc.co.uk/1/hi/health/4134343.stm

Wed. 1/5

Kathleen received a new hand brace from therapist at
Valley Med for her left hand.  Requests for hand
braces, though covered in writing on the Davey's
"Kaiser evidence of coverage packet" were denied and
deemed "luxury items."

Kathleen's weaning continued to be effective today
going 12 hours.
Her pressure help was lowered from 5 to 3 and the
machine was still one breath a minute.

Tue. 1/4

Kathleen's blood pressure was low this morning.
Kathleen began the weaning process from her respirator 

for 10 hours today.  The machine helped her with one breath 

a minute and the air pressure to help her lungs expand from the
respirator was lowered 8 to 5 which means that Kathleen is 

doing more of the work. The blood clot in Kathleen's arm is 

significant. Her left arm brace cannot be put on and Valley Med 

therapists will working on a solution so that her hand doesn't 

become contracted.

Mon. 1/3

10AM:
Doctors told Mike that Kathleen's lung seemed healthy
enough to practice weaning from the vent, but the tube
in her mouth was too small (size of a straw) to be
successful breathing normally on her own.  They
advised re-opening her trach tube to provide a safer
way to wean her off the vent.  The Davey family
agreed.
For a third time, the Davey's brought up the swelling
in Kathleen's left arm and her arm jerks which seemed
like a response to pain.  Doctors said the jerks were
myoclonus (http://www.myoclonus.com/whatis.htm) as a
result of her brain injury and that they had confirmed
it with the neurologist.  The Davey's disagreed saying
that she hadn't had myoclonus for five months and that
such a diagnosis ignored the swelling.  The docotors
agreed to do an ultrasound.

2PM
Ultrasound shows 2 small blood clots in Kathleen's
left shoulder region.

6PM
Kathleen has successful surgery by a kind and skilled
doctor to reopen her trach. 

10PM
Kathleen begins taking heparin in response to her
blood clot and seems much calmer after the removal of
her intratracheal tube.

Here is an update on a story involving a "miracle" for 

another family dealing with brain injury

Sun. 1/2

Kathleen received an unexpected visit from Samie last
night in ICU.  Samie said she wanted to go see her
mommy.  She was told how her mommy is on a vent, has
tape on her face etc. and that her mommy would
understand completely if she was scared to come see
her.  Samie thought about it for nearly five minutes
and said, "Daddy, she is my mother, I love her, I want
to go."  Kathleen turned to Samie immediately when she
walked in and said "Hi mommyyyyy."

Kathleen was not weaned from the vent today because of
her tough day yesterday.  To get off the straw sized
vent Kathleen would have to be at room air level
oxygen %  and have pressure supported breaths of 5
or less a minute for quite sometime.  Kathleen has
declined from 60% and 20 breaths a minute to 25% and
10 breaths a minute but did not practice today on 1
breath a minute support.
Kathleen was less sweaty and shaky today but still
seemed uncomfortable.

Sat. 1/1

Kathleen had a rough day today. She was shaking in pain 

probably from the tube in her throat. Her left hand is swollen 

(could be from the fluids). She is also sweating and she is having 

a hard time going to sleep. Doctors have given her sedatives 

including Fentanyl.