Support for Pam (Menerey) Feltch

When is the last time you added an ICU number to your favorites/speed dial on your phone? I thought I'd never have to but let me take you through what the last few weeks have looked like for our family.

It was Tuesday, July 30th at 6 am that I received a phone call... it was my Mom that was calling, I missed the call but immediately called her back. She didn't pick up but then I saw her text messages stating that she came into the hospital the night before because she had severe stomach pains and was throwing up.  She stated that her pancreas needed to be removed. I immediately googled pancreas removal and why one would have to have this done... and then she called me back. 

She was surprisingly calm (I later found out it was the morphine drip she was already on) and stated that she had appendicitis... I asked her not to google anything while in the hospital and to confirm if it was her appendix or pancreas that needed to be removed. She called a nurse in to ask because she was confused herself... once she said appendix... HALLELUJAH! Much better than a pancreas removal. Or so I thought.

Later that morning I drove up to see her and she was in great spirits, for someone getting ready for surgery. Due to her blood clotting disorder, doctors had to wait about 18 hours to perform the appendectomy laparoscopically.  My Grandpa and I went to lunch in Saginaw and grabbed a peacock feather themed floral arrangement for her and went back to the hospital so we could visit & I could work from the room.  Shoutout to Covenant's WIFI service, it's superb.

At about 5 pm on Tuesday, July 30th, she went in for surgery.  She gave my Grandpa a hug, I gave her a high five and said "see ya in a couple hours!"  Her question to the nurses as they were wheeling her down to surgery was if she could still plan to see Reba McEntire on Friday night (she's always been a favorite of my Mom's, I think it's the red hair bond she thinks they have) and the nurses said, "Heck yea, you should be okay!"

4 hours later I received a call from her surgeon and he said her appendix was very inflamed but he was able to get everything with 2 incision points and it was very standard. I went back to the hospital to see her post surgery and actually saw her in the hallway going back to the room. She was still out of it from surgery but seemed calm, I told her I'd be back the next day and to take it easy for the night. She didn't respond but I knew she was going to rest.

Wednesday morning I woke up and called the hospital to see how she was doing, everything seemed copacetic so I did some work in the morning and drove up around lunch time. When I arrived, my Aunt Bonnie & Grandpa were there and my Mom was throwing up and extremely disoriented.

She was only able to answer a question clearly about once an hour.  Otherwise she would move around in the bed and hand me imaginary keys and tell me to call the manufacturer.  I figured it was the post-surgery medicine they were giving her that made her so out of it so I didn't think much of the confusion.  I did ask for her phone passcode to which she responded, "Ride right, pass left."  Great advice for rules of the road, but definitely no chance that's her passcode on her phone.  Again, didn't think it was a huge concern because she didn't seem in pain, in fact, when we or the nurses would ask if she was uncomfortable, she would say no.

Fast forward to Wednesday night after I drove back home, I received a call that Mom had tried to get out of bed, the aide was there and my Mom's knees buckled and they helped lower her to the ground but there was no sudden impact or injury.  The nurse mentioned that they may move her up to ICU to have more eyes on her and I asked if we should do that proactively and they said no. I called back a few hours later to see if there had been anything else that happened and how her vitals were looking, they said everything was good and they set up a video on her so that she's being watched at all times, they let me know that if anything happened, they would call me immediately.

Thursday morning I woke up and got ready to head up to Saginaw to work from the hospital again, I had been driving for about 45 minutes (it's roughly a 1 hour 20 minute drive one way) when I received a call from Covenant stating that my Mom had been moved to the ICU and her hemoglobin dropped to dangerous levels and her organs were starting to go into shock.

I proceeded to drive 90 mph the rest of the way and ran into the hospital. They wouldn't let anyone into the ICU because they were trying to get her stabilized but I found out shortly after arriving that she had internal bleeding that started sometime between 3 pm on Wednesday and 7 am on Thursday. When they put her on the blood thinner after her appendectomy, it made her blood extremely thin to the point where she lost 8 units of blood during that time.

Scared doesn't even begin to describe how powerless you feel to be in a windowless waiting room staring at every person that walks by hoping that they're giving you the 'okay' to go in and see how she's doing. 

After about an hour or so, we were able to go in and see her. She was sedated, restrained by her arms and legs and had multiple IVs going. She looked exhausted and slightly yellow.  They gave her 3 units of blood and a drug that cancels out the blood thinner that she had been on for 1.5 days.  

They start prepping her for a surgery later that day to stop the internal bleeding but they needed to get her blood to coagulate so that she wouldn't bleed out during the next surgery. So all we could do was wait and check in with the nurses to see how her vitals were doing. They gave her a lot of blood and her hemoglobin came back up but was still very low compared to where healthy people are normally.

She goes down for surgery around 5 pm and while we're waiting for the anesthesiologist, she starts getting really scared, confused and agitated. They give her something to sedate her a bit and it was the only time in the last 2 days that she actually looked at me and spoke clearly. She said, "Chelsea help me get out of here!"  with the most terrified look on her face. It's almost like she knew what was going to happen afterwards and that she wasn't going to be able to speak for weeks.

It was a paralyzing feeling to not be able to do anything besides tell her it was going to be okay.  I wasn't even sure if it was going to be okay, but it seemed like the only thing I could say.

She went in for surgery and it took less than an hour for the procedure. The area around the bleed was flushed out and the surgeon stated that it went well.   After her surgery, she was extremely delirious and agitated. The team in the ICU told us that they've got her under control and plan to sedate her to allow her to rest and we should also get some rest ourselves. We felt guilty but took off and stayed at my Mom's friend's house a few miles away.

I almost always keep my phone on silent, I think it was from all those years working in wireless.  When I hear a ringtone, I have a physical reaction. It's so loud and never pleasant. Anyways, reason I say this is because I turned my ringer on to the loudest setting so when Covenant called me in the middle of the night, I would hear it. (Sorry Oliver)  

Friday morning rolled around and we were back at the hospital, her nurse was starting to get concerned about fluid in the lungs and her oxygen levels. Turns out they dropped dangerously low and they had to intubate her (tube down her throat for ventilation)... she was now on a ventilator.  This posed a risk of pneumonia but it was the only option she really had.

Within 24 hours, we were informed that she had pneumonia and they were treating her with an antibiotic.  For the next 2 weeks, the ICU team tried striking a balance between having her heavily sedated (medically induced coma but they don't like to use that terminology) and lowering her oxygen settings to where she could attempt to breathe on her own.   

During all of this, she had spikes in her fever up to 103.6 and her blood pressure as well.  Multiple blood clots were found in her arm, they had to give her paralytics in between heavily sedating her, and she would continue to get agitated.

There were a couple times where she would come out of sedation and open her eyes. She immediately started to cry and we would tell her that she was safe and everything is being taken care of. We were hoping that she could shake her head and give us some signals that she understood what was being asked of her (squeeze a hand, for example).  She was able to wake up a handful of times and nod her head. She also tried smiling at us 3 times (the tube was still in her mouth but you could definitely tell in her eyes that it was a smile)! :-D 

Then boom, another infection. The team thought the fever might be blamed on the new infection but they were not sure, but they treated her with another antibiotic and would continue to monitor her levels hoping that they would normalize with the new antibiotic.

We didn't hear anything else about the pneumonia until Friday, August 17th when her surgeon came in and gave an update on how we were going to have to move forward with a tracheostomy because she had been on the ventilator for 15 days and that can cause extensive damage to the vocal chords and with the trach, it should help with waking her up out of sedation because she can actually breathe without a huge tube down her throat. 

I didn't realize that trachs aren't necessarily permanent, the idea is that they can help with breathing on your own and then they start weaning down the trach to hopefully remove it and be completely fine. You can also eat & talk fine after therapy so that helped with us coming to terms with it.

He also stated that her pneumonia is extremely bad covering a large majority of her lungs. This was news to us as we thought the pneumonia had been 'taken care of' but apparently that just means that they have the antibiotic that they're giving her. 

Saturday morning the tracheostomy was performed and according to the staff, everything went well.   She was able to follow some commands after surgery by nodding her head and acknowledging where she was having pain (abdomen).  Her lungs still looked very bad, liquid filled and a lot of pneumonia present.

On Monday a new critical care doctor came in and ordered a CT scan of her chest & abdomen to see what they're dealing with, we were nervous about blood clots in her lungs or near her heart prior to this scan. It doesn't appear to show any clots there but there are more in her arms.

This is where we're at now... they're trying to strike a balance between letting her breathe with little help from the vent but not letting her work too hard and get her heart rate out of control. Managing her sedation to  allow her to rest from time to time and not always be working so hard.  Keep the fever down.  Get liquid out of her lungs and work to get the pneumonia under control.  Manage the other infection.  Keep her safe.

There are more procedures to have done and when she's strong enough to get out of the hospital, there will be post-acute care & physical rehabilitation that she will have to go through before acclimating to normal life again. 

We're convinced that she'll get this chance and it's more apparent than ever that this lady is a beast and can take a lot that is thrown at her and continue to fight.

I have no idea what the costs are looking like so far or what is expected in the future for costs related to her care but we surely appreciate anything you can contribute. 

Much love and I hope to update with some good news soon.