October 28, 2008

Medical update from Melanie Culveyhouse (Jim’s wife)
On Monday, October 6th Jim was admitted to the Salem Hospital for, what we thought was a mild case of pneumonia.  We were instructed by his pulmonologist, Dr. John Silver, to go to the emergency room and have them evaluate Jim.  By the time we got him to the emergency room Jim was in respiratory distress; I knew we were safe because we were in the hospital, but I was really scared.  Emergency staff put him on his BiPap/AVAPS machine which assisted his breathing and allowed the doctor to get his heart rate down and his oxygen levels up.

Many tests were done and lots of antibiotics were given those first two days.  Dr. Silver told us Tuesday night “it was time for a trach to be placed.”  Because Jim’s lungs are compromised by ALS placing a tube in his trachea opens his airway and allows him to breath on his own or on a ventilator. 

A tracheotomy was done on Thursday, October 9th by Dr. Nicole Vander Hayden, a trauma surgeon at Salem Hospital .  She was wonderful!!  From surgery, Jim was placed on a ventilator and sent to ICU.  In ICU the goal was to get Jim off the ventilator during the day and only use at night while sleeping.  The first two days that worked great - then the bottom fell out!

Jim started to decline and decline fast.  He was unresponsive and his vitals were the pits.  I have to admit I thought we were losing him on Monday, October13th.  As we later found out Jim not only had a very severe case of pneumonia, he was battling sepsis (Sepsis has been dubbed the medical "perfect storm" because it is a medical crisis that can attack patients who are fighting off even seemingly nonfatal illnesses or injuries. Severe sepsis killed Muppets creator Jim Henson, who had been hospitalized for pneumonia, and recently took the life of actor Christopher Reeve, who was being treated for pressure sores of the skin.  With this insidious illness, the body attacks itself. Bacteria inside the body may grow out of control or invade the body from the outside through wounds or IV lines. Sepsis is not an infection; it is a systemic inflammatory response syndrome to an infection, which poses dire risk of organ damage and death.)  and kidney failure (due to the sepsis). 

By Tuesday night, October 14th Jim was showing signs of improvement but he was very disoriented and delusional from the disease and medications.  On Wednesday, I had not slept at the hospital and I arrived that morning at 7:30.  The respirator therapist came in at 8:00a for Jim’s normal treatments.  He turned to walk out of the room; I was standing at the bedside holding Jim’s hand.  Before the Respiratory (our hero Mike Phillips) therapist got to the door Jim starting struggling to breath and is oxygen saturation levels fell like a rock.  Mike acted with great care and precision in getting the appropriate help for Jim.  Mike called for Dr. Silver.  When Dr. Silver arrived he assessed the situation and cleared the room of unnecessary people and started to work on Jim.  A mucous plug had lodged in Jim’s airway (Dr. Silver said to tell Jim it was the size of a golf ball) and it needed to be cleared.  It took LOTS of medication to calm Jim down, so he rested most of that day.  When I was explaining what happened to my family, it was like a scene out of the television show ER.  It was like a perfectly choreographed dance, everyone knew what to do and when.

After Wednesday, Jim steadily improved.  We were told a date of Oct. 23rd was the target date for release.  In order for Jim to be released from the hospital, all caregivers had to learn to take care of his “new” medical needs.  We attended classes and passed our 24 hour test (we had to care for Jim for 24 hours.)  Last Thursday Jim was sent home in an ambulance accompanied by two very pretty blond, female paramedics!!

We’ve been home five days and Jim continues to regain his strength.  The ventilator is going well and we are creating a new “normal” around our house. 
As many of you know, Jim and I have a very strong faith in Our Lord, Jesus Christ.  He was with us at every turn.  The care and the people He placed in our path were nothing short of a miracle.  We felt every prayer and witnessed God’s power and mercy first hand. 

Jim and I want to thank you for the many prayers and calls of concern.  We especially want to thank my sisters Dee and Melinda and our friends Robin and Peter who spent numerous hours by our side in the hospital and with our family helping to keep things going. 
Much love to all,
Melanie