(Karla’s) Real Time Reflections from Five Years Ago (#9)

Mike and Karla

February 26, 2014 (2009)

This is the ninth in a series of blog postings we are doing in real time plus five years post brain surgery. (click on the colored link to see a summary post Five Year Anniversary ).  Portions of these recollections will be included in the book I am currently in the process of writing. This is the day the music almost died.

(Karla writing)

Here are the posts from this day, five years ago.  If you take the time to read them, please notice how matter of fact and void of emotion they are.

Back to Surgery

Just a brief update.  Mike was up at 6 this morning and had a brief seizure.  This was followed by a longer seizure.  They gave as much ativan as they could and moved him back up to neuro ICU.  Somewhere in that process they discovered that his blood pressure was low and the heart was not working right.  The ultrasound showed blood clots in two parts of his heart and something else in a third.  They think that the filter may have broken loose and that is the unknown item.

I am posting this at about 11 a.m. on February 26th, and they have just taken him into surgery.  If it all goes routinely, it will be 4-6 hours long.  They will remove the clots, the other thing, and fix what they think is a hole in his heart, if need be.  The doctors use words like unstable, critical, and high risk.  Not good.  Our optimistic Dr. Fogleson said that this is an extremely serious situation.

We know that God has this entire situation in His control.  We ask that you would lift Mike and the surgeons up to our God, the father of our Lord Jesus Christ.

Out of Surgery

These next posts will probably be brief and to the point.  You might wonder why I even bother.  One reason is that we have such a great number of people following this, and then praying.  The other reason is that now I just have to wait.  I might as well let others know what’s going on here.  The surgery went very well.  They were able to do everything they wanted to do.  They removed one very large clot and several smaller ones.  The filter is in place, so they do not know where the clots came from.  He had very low blood pressure for four hours, so there are concerns regarding the kidneys from that.

There is also now an issue with the head wound.  It looks infected today for the first time.  The neurosurgeons will aspirate it and may end up going in again and clean it out.  That may happen as soon as the cardiac people allow it.  Dr. Meyer is dumbfounded by all this and said that he has never seen anything like it.  He also commended the cardiac surgeon’s quick work, saying that if it had not been so fast Mike would be dead by now. On the positive side, the swelling in the brain is almost gone and all the blood from the AVM surgery is gone, which explains the great progress he was making in rehab.

He will be on the ventilator for about the next 24 hours.  After that they will wake him up and see how his neurological functioning is.  Between now and then we can just wait and pray.

As I read what I wrote five years ago, my words do not even come close to conveying what I was going through.  If brain surgery day was hard, and blood infection day harder, heart surgery day was off the charts hard and almost unbearable.  One of the things that I repeatedly told myself during this whole ordeal was that there were so many more people who had it worse.  So many more wives and children suffering more than we were.  So many more people in worse condition than Mike was.  Especially at Mayo. On this day, I truly felt that I had it about as bad as anyone in the world at that moment in time.  I didn’t stay in that thought long, but for awhile I was there.

I never really relayed all the events of that day.  Before I go into it all, as you read this, please don’t judge me.  You never know how you will react in a situation until you are in it.  As I have looked back over the past few years, there are some things that I have felt extremely bad, even guilty, about.  I shouldn’t have.  I didn’t do anything wrong.  In retrospect it just looks like rather bizarre behavior to me.

Some background on the events of that day. Mike had wanted me to go home to see the kids the night before because a storm was coming.  I had told him that I would not go home until he could push the button himself to call the nurse.  When you are in rehab, nurses try not to bug you all night long.  Once you are in bed for the night, they do not come in again until 7 in the morning unless you call.  Up to this point, Mike had not been able to push the button.  So when he woke up during the night and asked me to call the nurse because he wanted something for his back pain, I not so nicely said, “If you want me to go home tomorrow, push the button.”  He did, and took a single Tylenol for the back pain.  Yes, a storm was coming for sure!

My initial post said that Mike was up at 6 and had a brief seizure.  It seemed like an eternally long seizure, not brief.  And I don’t really know that it was short.  I know that they gave him 4 doses of ativan, which was all they could give him, so it was probably really quite long and he was basically just knocked out afterward.  Oh, and his heart quit beating and he wasn’t breathing.  I don’t really know if that in and of itself would stop a seizure, but I would think so.  After imploring the nurse to move more quickly, asking whether or not he was breathing, and the crash team coming in after she had called a code, I left.

At this point you may have a few questions.  I know what they are because several people asked me these questions.  “Why did you leave?  How long did they work on Mike before his heart started beating and he could breathe again?  What exactly did they do to him?”

This is where you need to not judge.  I know people who stay in the room when this sort of thing happens.  I know people who do not leave the side of the person who is in the hospital.  I am not that person.  I figured that the ten or so people who were in the room trying to figure out what was going on did not need a hyperventilating wife around.  Hyperventilating wives is not a normal occurrence in the rehab unit.  So once again I had no place to go.  Since every spare person was in my husband’s room, they sent me to the nurses’ break room to calm down.  I eventually came out.

I also have no idea how long they worked on Mike.  I do know that they did CPR and broke ribs in the process.  A couple years after the whole ordeal, we finally asked for more details.  Specifically, the doctors all kept saying, “Well they had to use pressors on you, which is very serious.”  We had no clue what these were.  After the fact we learned that pressors were used to keep Mike’s blood pressure up.  Due to the clots that were in his heart and lungs, he hardly had a blood pressure.  We now know that most doctors would use a couple pressors, and if that didn’t work, the person died.  The critical care doctor working on Mike used 5.  Five is an unheard of number of pressors to use.  Every doctor we saw for several days commented on what amazing work this critical care doctor did.  I don’t even know his name.  He had a South African accent, but I only met him once.  So all I really know is what they did worked, and they quickly moved him back to the neuro ICU to figure out what was going on.

In the midst of all this, I was trying to get ahold of someone to come stay with me.  The friend from Iowa who was there was getting ready and didn’t hear her phone ring.  I finally got ahold of Connie Krueger, who I was staying with, to see if she would come up.  She called Denae Harder, a college acquaintance who became a good friend, and they both came to the hospital, even as the snow was bearing down and Denae’s kids were home from school because of the storm.  I also had the pastor who our Iowa friend was staying with show up, as well as my pastor from my childhood who now lives in Rochester.  So we had small army to gather to hold me up through all this and to pray for my dear husband.

I also made several other phone calls.  To my parents, who said they would leave immediately.  My sister took the older boys in to Des Moines and they came up too.  The husband of the friend who was already up there with me came up, as well as my father-in-law and friends from church.  All in a terrible blizzard.  I was very grateful they all arrived safely!  I also called several friends who told me afterwards that I sounded like I was in shock.  I am sure that I was.  I don’t know how else you get through something like that.  I will say that my calls left many of them very concerned.  One friend who is a doctor could hardly make it through the day, crying out of concern for us.  Our pastor friends talked to doctors in their churches and were told that Mike would likely die.  One friend told me that she was rehearsing in her head what she would say to me when she saw me at Mike’s funeral.  Do those words hit you anywhere close to how they hit me?  Mike’s funeral. I have tears running down my cheeks now.

After I made these phone calls, I went back in to talk to the doctors.  They were all visibly shaken, which is not normal for these doctors even in bad situations.  They still did not know what was going on, and would let me know when they did.  By this time Denae and Connie had arrived and were listening with me.  Always good to have extra ears!  I was also very shaky and weak feeling.  So any guesses as to what I did next?  Again, don’t judge.  Yep, I went to the cafeteria and had breakfast.

My husband is literally dying, and I went to eat.  Who does this?  I can’t remember if someone suggested this to me, but that’s what I did.  And this is what I have felt guilty about for 5 years.  Why would I leave my dying husband for food?  Granted, it took care of the shakiness, but someone could have gotten me food.  I vaguely remember saying that I would go get it myself, but it still seems bizarre to me.  I attribute it to being in shock, and having reached the threshold of intensity that I could handle. So Denae and I went and had breakfast.  We weren’t gone long, and it was enough of a break for me to catch my breath for the next round of stress.

And it began again immediately.  Upon getting back, I found out that the doctors thought surgery was the best option.  There were two surgeons in the country who do the surgery Mike needed, and one of them “just happened” to be at Mayo.  He also “just happened” to be the surgeon on call that day.  And “just happened” to be between surgeries so he could operate on Mike.  Dr. Meyer came in with a surgical fellow that I could barely understand who explained what they planned to do.  He explained the risks involved, that if Mike survived the surgery, which was a big if, he could end up permanently paralyzed on the right side as he currently was, completely paralyzed, or even in a vegetative state.  They did not know how long he had been without oxygen or if the surgery would be successful.  They did know that his kidneys had shut down, which is the first in the order of organs that shut down when there is a lack of oxygen to the body. They needed my permission to do the surgery.  I asked Dr. Meyer what he thought and he said that Mike was young and they should do everything possible.  I then signed the long form without reading a word of it, something I never do.

After they left, I broke down.  I explained to my friends that before the brain surgery, Mike and I had talked about what I was supposed to do in a situation like this.  Well let me tell you, there is no such thing as “A situation like this.”  It is not a black and white issue, which is how I like issues to be.  Mike had told me that if a situation arose that would leave him in a vegetative state, I was not to pursue medical treatment.  I wondered out loud if that is what I had just done.  The pastor, who was the friend of a friend, Randy Charlton, gave excellent counsel.  He told me that Mike had never envisioned this situation and could not have known what he was asking of me.  He told me that Mike’s days were in God’s hands, which is exactly what Mike and I believe, and that it was up to God to take care of it.  If this was the day when Mike’s number of days were complete, God would take care of it.  So I was at peace with the decision that I had just made.  I then asked if I could have a minute with Mike before they took him to surgery.  They said to make it quick.

So I went in and laid hands on my husband and asked God to heal him.  And if he was not to be healed, please take him quickly and painlessly.  And then I left Mike in God’s hands, which is where he was whether I verbalized it or not.  I was very thankful for the small army that sat with me throughout the day and the group that arrived that night.

As you know, since Mike is still alive, the surgery was successful.  Mike is not upset with me for my bizarre behavior, and didn’t even know about till last week.  Once he was settled in his room by late afternoon, I was hungry again, so my parents took us to the Canadian Honker for supper.  Yes, once again, I know where I ate.  My parents, Luke and Benj, my sister Betsy and brother-in-law Brandon, and a friend from Iowa.  We had a brief respite from the stress and then back to the hospital we went.  I will say that it was hard to leave Mike there that night.  He was on a ventilator and looked like he was not alive.  There were two nurses monitoring him all night.  And my parents had gotten a couple hotel rooms across the street from the hospital, so I would be close.  I was able to sleep and be back there first thing the next morning.

I am worn out after writing this.  We have said it before, but it all feels so real to us still.  I remember things as I see them, so I can still see all these events unfolding in my mind.  The pain is different now, because of all we have been through since, but I understand it more.  It has shaped me and is a part of my life.  And now I can cry and move on.  Today Mike and I went out for lunch to celebrate five years of life that looked like it wasn’t going to be.  One of our kids asked why they didn’t get to celebrate too.  So we said we’ll do that this weekend.  I am so thankful that God miraculously spared Mike’s life and that we are where we are today!  I love you, honey!

Mike’s take on that day: An amazing mercy from God and an amazing wife! I love you too honey!

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2 thoughts on “(Karla’s) Real Time Reflections from Five Years Ago (#9)”

  1. Karla – no one should judge you and I’m sure no one will. I can’t put it into words, but I think somehow in those situations God protects you and you don’t quite understand or comprehend it all, but you just get through it…because really, in your situation, all you could do was just get through it. And if going for breakfast was how you got through it, that’s how it was supposed to be. So many miracles that day…thankful that you both are able to tell the story five years later.

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  2. I agree with you Jeri! Just getting through was the most important thing to do at that time. Thankful to be here as well. Mike

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