September 30th, 2007 by shahin

I know I said I’d do the updates every other day, but the good news keeps pouring in!  Shahin’s white blood cell count is down to 13,000!!!!  Finally in the normal range!    They will continue administering the medication intravenously, through the tube in his intestine, and via enema until he gets to the stage where his bowls are functioning properly and oral medication can pass through the entire system.  Hopefully very soon. 

I’m going to give him a half point promotion and save the other half for when we hear the rumbles of gas being passed!

His score for the day 6.5. 

Power of prayer, positive energy, crossing fingers, great medical care and fantastic technology at work! 

September 29th, 2007 by shahin

Shahin breathed for over 6.5 hours  (per the last phone report from OKC) on his own today.  Vitals are holding steady and so is his white blood cell count.  We’d like to see this  number go lower a bit faster, but we’ve been told that it may not, and that’s OK (per the doctors).

Holding at a 6.

September 29th, 2007 by shahin

Shahin actually spoke (one word) for the first time in weeks yesterday!  They removed the tube going to his tracheotomy plug, causing him to breath by himself instead of the machine doing the work for him.  After a little bit of discomfort, he started doing OK.  Initially they wanted to get him to breathe by himself for 15 minutes but ended up letting him go for an hour.  This is the first step in weaning him off the machine.  The hope is to have him completely off of it and the trache tube removed by the end of this week.

Anyway, while he was breathing on his own, the doctor asked him to say one word while he covered the hole in his throat (so that the air will come out of his mouth and not the hole) with his finger.  The word was a very rough sounding “MOM”, which drew quite a few tears out of mom.

His white count is 21,500.  Not bad at all!  It is down from 26,000 from yesterday.  Remember, the normal range is 10,000 to 15,000, so he is close.  All other vitals are keeping very steady.

One other goal for the week is to have him off the continous dialysis and on the normal - 3 times a week - version.  This sould give his kidneys a nudge to wake up.

We are still awaiting the arrival of gas and urine!!!!

I will probably start doing the updates every other day, unless there are dramatic changes.  This is certainly a good sign that he is on his way to getting better and stronger every day.

His score for the day…..  Holding at a 6.

September 27th, 2007 by shahin

Being the last update I do before I head home, it gives me so much joy to tell you that Shahin has officially been taken off the ‘critical’ list and moved to the ‘stable’ list.  Makes my departure a little more tolerable.

His white cell count is now at 27,000.  His doctor tells us that getting him in the normal range will probably take a while, but he is very optimistic he will be getting there soon enough.

Beside the white count, the next two big events we are looking for are for Shahin to pass gas and urine.  My mom and I laugh every time we talk about this as we have never prayed so hard for the sound of gas being passed!!!

We still have the bleeding and the kidney issues.  But the doctors are not going to address those right now at the cost of destabilizing him.  Probably next week or so before they really dig into it.

The future updates may not be as regular or frequent as they have been, but they will be coming.  Just do not worry if one doesn’t get posted on any given day.

I was lovingly threatened by close friends of Shahin’s to promote him to a 6 because of him being off the critical list.  I was saving it for when he hit the teens with his white cell count.  So, expect him to stay at a 6 for a while! OK Paul and Kathy???!!!!

Official score…. SIX!

September 27th, 2007 by shahin

The tracheotomy went well.  He was back in his ICU room in less than half an hour.  The bleeding was very minimal and not a concern at this point.  It is so good to see him without that big tube in his mouth.  He is so much more comfortable and we can actually see him smile at times!   He is still very weak from the long-term paralysis and sedation.  Even trying to mouth words is difficult for him and very hard to understand.  But I did see the unmistakable “I love you” yesterday.  Certainly a tear-jerker. 

September 26th, 2007 by shahin

Shahin was wide awake this morning and his white count was down to 30,000… Down 3,000 from 4pm yesterday.  At 12:30 (about 5 minutes ago) he was rolled away to the operating room for his Tracheotomy.  The actual procedure takes about 5 minutes, but he will be in the OR for about 30 minutes.  They will have him under full anesthesia and it will take him about an hour to come back around.  It will be good to see him without a huge tube in his mouth.  He won’t be able to talk, but he will be able to mouth words. 

I will send an evening update once his new blood results are back.

September 25th, 2007 by shahin

Just got done talking to his gastro doctor, and it’s the first time I heard him say that he is very optimistic.  Shahin was awake and very much aware of his surroundings and the people around him.  He will have amnesia for many weeks.  In fact, what you tell him at one time will be gone from his memory in a matter of hours.  This is all normal, and as my mom put it, it is a natural defense system. 

His white count is down to 33,000, heading the right direction.  We measure it every twelve hours and it has been on a steady decline since they put the tube in his intestine.  I’m optimistic that he’ll be back in the normal (10-12,000) range in two to three days. 

He is going to get a tracheotomy tomorrow at noon.  They just have to remove the tube from his lungs, as the prolonged use of it can cause very serious issues, including permanent damage to the vocal cords.  He will be moved to an O.R. and operated on by the best ENT doctor in this hospital.  This will allow the doctors to experiment with weaning him off of his ventilator.  The prognosis is that he will remain on the ventilator for at least one more week. 

According to the doctor we talked to last, he will be the guest of the ICU for another month.  Followed by intense rehab and continued medication to make sure the CDIFF is really dead. 

His score for the today is a 5. 

It’ll be a while before he gets a six.  I’ll save that one for when he gets his blood count down to normal levels.

September 25th, 2007 by shahin

Before I get to the good news, let me just say that I am so surprised and feel blessed at the outpour of love and support for Shahin.  From his old Navy (not the store in the mall) buddies to his new(ish) Boeing friends, he has so many friends – good friends -  many of whom are here almost daily.  Not only are they here for Shahin, they are providing a tremendous amount of support to us as well.  Just very very touching and appreciated.  He (and by extension, us) are truly blessed.  His white blood cell count is down to 40,000.  He has gone from the high 80’s to 60’s and now down to the low 40’s in 3 days!  Just an amazing turn-around and a good sign that the medication being administered to his intestine from above is working well.  He is also more awake and aware of the people around him.  He gave me such a surprised look today (as in, “what the heck are you doing here?”).  He didn’t know why he was in the hospital either.  They are saying that he probably won’t remember anything for up to 3 months prior to his 2^nd operation.  Maybe not a bad thing.  He’s been through a lot. 

The bleeding in his stomach has not stopped and his blood platelets and hemoglobin levels are still in the undesirable range.  They are constantly giving him plasma, platelets, and pure blood to keep him going.  Keep in mind that the dialysis machine does eat platelets fairly rapidly.  This is a point of concern and being watched very closely by the doctors.  Hopefully, with him being more awake and his body being more active will lead to a quicker recovery from this issue. Kidneys are still asleep.   

I’ll keep his score at a 4.  Maybe, if his white count goes to the 20’s we’ll promote him to a 5. Thank you and bless you all. 

September 25th, 2007 by shahin

Again, I apologize for not sending an update yesterday.  We were pretty much in status-quo. However, today I have some positive news to report.  His white blood cell count is at 47,000, down from 62,000 of last night.  A very positive sign that the medication being administered through the tube in his upper intestine is beginning to work.  He also is more awake and does communicate with nods and shakes of his head.  The awake moments are very sporadic, and when he is awake he obviously is in a lot of pain and they usually end up sedating him, so he goes back to sleep.  But, we still think of this as a very positive step. 

Most all of his vitals are holding steady.  Some bleeding is being noticed in his stomach.  One of the two tubes going in through his nose is in the stomach area to drain any fluid build-up.  That fluid is the one showing signs of some bleeding.  Although it is not a whole lot of blood, it is not a good thing as he is low on hemoglobin and blood platelets, causing his body not to be able to heal/clot any areas of bleeding.  The doctors are keeping a very close eye on this and are administering more platelets and plasma. For the first time in days I’m gonna give Shahin a promotion.  He is now at a 4. 

Please keep the phone calls to a minimum.  I will try to be more regular with the emails, even if there are no changes. Thank you for your prayers and support.  It is truly appreciated. 

September 25th, 2007 by shahin

This is going to be another short one.  Remember that short ones are good ones. All vitals are holding steady.  The white count shot up to the 80,000 range but settled back down to 66,000.  BUT… According to one of the doctors, the white cell count is just one indicator on how Shahin is doing (especially in the case of the CDIFF virus).  As long as his other vitals are doing good, even if he hits the 80,000 range, we have hope. 

There are two worry points right now.  One is that the medication being delivered directly to his upper intestine needs to work and work fast.  The other is, if his inflammation of the upper intestine causes a portion of the intestine to ‘die’ or cause a self-perforation Shahin will need another surgery.  The general consensus amongst his many doctors is that, in his state, he will likely not survive another surgery.  So, we are being very positive and hopeful that by Monday or so, we will see some good results. He did manage to give my sister’s hand a little squeeze this morning, and he still does seem to open his eyes and acknowledge our presence from time to time, but we’d like to see him be more awake as he has been off of his paralysis and sedation medication for over 48 hours. 

Today’s score: holding at 3 (out of 10). Keep the prayers and crossed fingers going. 

Thanks again for all your support. PS.  So, it wasn’t exactly a short one!

September 25th, 2007 by shahin

Today at about 4:30 they SUCCESSFULLY placed the tube in Shahin’s intestine and started administering the CDIFF killer.  So the danger of any perforation or tearing has passed.  It will probably be 3 to 5 days before we know if the medication is making it throughout the infected portion of the intestine.  Our hope is to see the white blood cell count either slow down or stop from going higher.  The magic number for how high the white cell count can go before we hit the point of no return is 85,000.  We are still in the mid 60,000 range. He actually did wake up today.  I use the term ‘wake’ very loosely, as he basically responded to my voice and opened his eyes a few times to look at me.  He also is moving his head a little bit, but as hard as we tried to get him to squeeze my hand we did not succeed. 

They had to take Shahin off the dialysis machine to perform the procedure and there were signs of his own kidneys doing some work.  So there is hope that once he is on the road to recovery his kidneys will function normally.  All his vitals are holding steady, which is wonderful.  The doctors told us that if it wasn’t for his age and his physical strength he would not have survived the trauma he has been subjected to.  I’m sure his strength will see him to full recovery. Today’s score – still a 3 (for those whom I’ve just added to this distribution list the scale is a 1 to 10 scale, with 10 meaning he is out of the Intensive Care). 

September 25th, 2007 by shahin

I’m sorry about not sending an update yesterday.  By the time we talked to one of the key doctors it was very late at night.  I know a lot of you got worried. Shahin has been off of his paralysis and sedation medication for over 24 hours but he is still asleep.  Because his kidneys are not functioning yet, it takes a while for the medication to leave his body.  He has moved his head a few times and last night he opened his eyes briefly but he went right back to sleep. 

His white blood cell count is now in the mid 60,000 range.  Not a good thing as it is indicating that the infection is getting worse.  The good news is that they are fairly confident that they have found the source of the infection. There was a bit of misinformation due to one of the family members not understanding one of the doctors clearly and communicating erroneous data to the rest of us.  There is not an 8 inch section of the intestine that is going dead or is highly infected.  In fact the whole upper intestine is swollen and thickening.  Clear sign of CDIFF at work.  The doctors believe that the antibiotics being administered through enemas is not reaching far enough into the intestine, as the lower intestine is just fine.  They do administer the same medication through his nose tube into his stomach, but because of the swelling of the intestine at the point it connects to the stomach, it is not making it into the upper intestine. 

After several consults with some of the best specialists in this city, it’s been decided to insert a tube through his nose, into his stomach and then into the upper intestine and administer the medication directly to the source of infection.  This is a very risky and uncommon procedure.  If they puncture the intestine during the procedure, two very undesirable scenarios can happen.  One, the intestine will not heal because of the infection; and two, the CDIFF will leak into his abdominal area and there will be no way to control it at that point.  But since the procedure is being done by one of the best doctors around, our confidence levels are very very high.  The other good news is that they don’t have to move him (as originally anticipated) to do the procedure.  Moving Shahin is very high-risk. The procedure is scheduled to take place at around 3:00pm Central time.  Once we are passed placing the tube in place, we will be back to the wait-and-see mode to see how fast the medication will kill off the CDIFF and get the intestine back to normal.  The first indication of success will be the dropping of the white cell count.  

Because Shahin’s vitals are still holding steady (beside the white cell count) I’m still giving him a score of 3.  I’m very optimistic that he’ll be at a 4 or beyond by this time tomorrow. I’ll send another update tonight to let you know how the procedure went.  This could be that miracle we’ve been praying for. 

September 25th, 2007 by shahin

Shahin’s white blood cell count is way up.  It’s now up to 54,000 (normal being around 10,000).  They are trying different medications to try and get the infection under control without giving the CDIFF a chance to come back. They did a cat-scan on him at about 5 this morning to take a closer look inside his abdomen.  It revealed an 8 to 10 inch stretch of his small intestine, which is either dead or dying or still heavily effected by the CDIFF and is still swollen.  We are hoping it’s the later, as if it’s truly dead/dying then we have to have it removed immediately before it becomes septic. Obviously, going under the knife for a third time in two weeks, along with his current state is something that nobody wants.  They are going to do another scan tonight to determine what’s going on and determine a course of action. 

Now some good news.  His vitals are all in the acceptable range.  He is still completely off ALL blood pressure medication and holding steady.  As of one hour ago they turned off his paralysis medication and he is behaving very well and is not fighting the breathing machine too much.  This is the first step to removing the breathing tube.  Next step, which is the least fun for him and all of us, is to bring him out of sedation.  This is where he had the most traumatic experience after his first operation.  But a necessary step, prior to the removal of the tube.  I’m still not ready to promote him from a 3 to a 4.  I wish I could. Today is our mom’s birthday.  I was really hoping for some fantastic news about Shahin’s condition to make her day a little more special.  But we all still have the gift of having him around and have hope.  I’m sure mom will take a belated birthday present.

September 25th, 2007 by shahin

We started the day on a bad note.  His white blood cell count doubled over night to about 48,000 and is keeping in that range as I type.  Again, we are hearing “we don’t know” from the doctors who are treating him.  They have taken blood cultures from just about everywhere suspicious, but cultures sometimes take 2 to 5 days to show any results.  We are again anxiously awaiting the results.  The down side is that, even if they do find the source, the treatment options may be limited.  Why?  Because of that CDIFF virus I told you about a couple of days ago.  If they put him on other antibiotics to address the new infection, the opportunistic CDIFF virus will again start its havoc-raising. We also started the day with the blood pressure being all over the map.  The nurses (aka angles) were playing the balancing act between blood pressure medication, liquids, etc. all night long and throughout today.  However, as of right this minute he is holding steady at a very nice 120 (the lower number for some reason does not matter right now). 

His liver enzymes are on the rise.  Yet another positive sign. His kidneys are unfortunately are not doing well.  But, they say that they can take up to six weeks to start going back to normal.  So, there is hope that they may kick in once he starts getting better. 

His ventilator is down to 45% oxygen.  Again, a positive sign that his lungs are absorbing and distributing more oxygen by themselves, indicating that his pneumonia is getting better.   There is talk amongst the doctors to start to bring him out of paralysis some time over the next couple of days.  Mostly due to the fact that his lungs are doing better.  They will bring him out of it long enough to make sure that he can breathe by himself.  Once they establish that, they will take his breathing tubes out, which is a good thing, as it can be a cause of ulcers and infection having been in his lungs for over a week now.  There is also talk about giving him a tracheotomy to enable them to take the tubes out and be able to better ventilate him. 

Bottom line is that there is a lot going on, but NOBODY is sure what the best course of action is due to his very weak condition. WE NEED A MIRCALE.  Please pray for one.

September 25th, 2007 by shahin

First the not so good news… 

His white blood cell is back up to 28,000 (was down to 12,000), indicating that there is another infection somewhere.  So, we are back to playing detectives to find this one.  His blood pressure dropped dramatically in the morning, but since he was almost completely weaned off of the medication which helped him with it, they upped his medication and he’s back to an acceptable range. 

The sorta good news… 

He is still on 60% oxygen.  This is the 2^nd day they have kept him at that level.  We’d like to see this go down slowly to get his own lungs to kick it in.  The blood they found in his stool is no source of worry, eliminating the possibility of having to deal with internal bleeding issues.  His platelets are on the rise also.  This is good, as it does help with coagulation in case there is any bleeding at all.  The rest of the vitals are basically the same.   

As of right now (5:45pm) his main doctor has not been around, which is unusual (maybe he’s golfing or something!).  We are all eager to talk with him to find out what the plan of action is for the next few days (obviously a lot of it depends on how Shahin is doing on any given day). 

I’m going to give you a daily score on a scale of 1 to 10, with 10 meaning Shahin is out of intensive care. 

Today’s Score:  3  

Special Request:If you are going to call us or any of the family members to get updates on Shahin, please keep the time difference in mind.  Getting calls at 1 or 2 in the morning during the situation we are in can cause extreme amounts of anxiety.  Thank you.

September 25th, 2007 by shahin

Another good day!   This is gonna be a short email.  Short ones are good ones! 

Very little change in his condition, but the little changes we’ve had are all positive ones.  The doctors are unanimous in their thinking that he is getting better all around.    He is still heavily dependent on machines to keep him alive, but we are hearing murmurs of trying to bring him out of paralysis and sedation over the next couple/three days.  This is the time we find out if his own organs are capable of supporting him.  First to go is the dialysis machine, followed by the ventilator.   Thanks again for all your support and well-wishes.

September 25th, 2007 by shahin

Today started off very nicely.  Again, everything had improved ever so slightly over yesterday and he was holding steady throughout the day until about 4pm. The nurse on duty was giving him a bed bath and oral cleaning and found that there was a little bit of bleeding from the gums and the rectal areas.  Because Shahin is still on dialysis they have to thin down his blood for the machine to work effectively.  As a result he is susceptible to bleeding.  The biggest concern is internal bleeding.  If he does end up with internal bleeding there is basically nothing they can do for him, as he will not be able to sustain another surgery.   They have put him on a drip to bring his blood platelets higher to give his body a chance to recover from any potential bleeding.  We really are not sure what is going on right now, and yet again we are in a wait-and-see mode.  All of the other vitals, i.e. blood pressure, oxygen levels, white blood cell count, etc., are all good.    News Flash —– We just had one of the doctors stop by and he has given us some good news by telling us that he is really not too worried about the bleeding he has seen on Shahin’s extremities.  He thought that the visible bleeding was due to the breathing tube in his mouth and the administration of rectal antibiotics. Definitely welcomed news. As I mentioned, most ALL of his vitals are looking good, so by tomorrow we are again hoping for better news.   Stay tuned for good news tomorrow.

September 25th, 2007 by shahin

Today was relatively a better day. 

We were hoping for much better news than we got, but there are no complaints… No bad news is certainly GREAT news, given the situation. It turns out that Shahin is more unique than we all thought!  This CDIFF virus is ALLWAYS found in the colon, which, because Shahin no longer has one, explains why it took the doctors so damned long to discover it in his small intestine.  It really was pure luck that it was found.  Turns out that about 30% of us have this virus, but because of the typical enzymes, good bacteria, etc., that we have in our system the virus has no chance of multiplying and causing such a nasty infection.  But, due to the fact that antibiotics in general do not discriminate between the good stuff and the bad stuff, and Shahin was on some heavy-duty antibiotics for his pneumonia, all of the ‘good stuff’ were killed along with the bad stuff leaving the CDIFF virus free to go crazy.  It causes tremendous pain, swelling of the intestine, diarrhea, etc. The latest stats:

His respirator is now set at 75% oxygen, indicating that his lungs are very slowly picking up more of a load.

He is now down to just one blood pressure medicine – versus three – but his pressure can certainly be better.  

Not too bad though.His white blood cell count is on the decline (down from 47,000 to 22,000 – normal being around the 10,000 level), indicating that the body is having some success in fighting the infection.He is still in dialysis but they are planning on taking him off of it once-a-while to see if his kidneys can start doing more of the job.  The good news is that when (not if) he recovers, and he ends up with some sort of kidney issues…  Between me, my sister, and his oldest son (20 year old) there are plenty of spare ones to go around.   

Bottom line is that the machines are still keeping him alive and he is far from being out of the woods.  But my personal optimism is cautiously growing. 

If you’d like to send Shahin a personal message (keep it short, as we will have to read them to him when he is brought out of paralysis and sedation!) you can.  Go to http://www.mercyok.net/email/mhc/default.asp.  His room number is ICU#25.  The hospital will print it and put it in his room.There have been literally dozens of people who’ve come here to see Shahin.  His old Navy buddies, his co-workers and bosses from Boeing, etc.  He is a tremendously loved person.  The stories we hear about him form most all of these folks are heart-warming and special. He has touched a lot of lives in a very special and profound way.  He just simply needs to stay around and keep the legacy going.

Better news tomorrow! 

September 25th, 2007 by shahin

Hi again… and now the latest. 

OK… For the first time in 2 days I have some promising news.  As of about 4pm our time we had resigned ourselves to saying goodbye to Shahin one more time. Because of his low blood pressure, his organs were shutting down one by one.  The most important ones… his kidneys.  Suggestion was made to give him a dialysis but we were taking a chance that the dialysis itself could literally kill him.  But, if we didn’t do it, he would be gone within 24 hours as his kidneys would have shut down and it wouldn’t matter how the rest of his body was doing. 

Anyway, long story short, we did opt to take somewhat of a chance to do the dialysis, as we basically didn’t have anything to loose.  The worse we would have done was to expedite his departure from our world.  HOWEVER…  It’s 10pm right now and he is in the final minutes of a 4-hour dialysis session.  His blood pressure is up to about 130 (he was at 60 earlier).  His color is better.  His oxygen levels are coming up (although he is still on a respirator, and probably will be until the doctors show up tomorrow). AND… They are slowly removing some of the 10 bags of different medications that have been dripping through many IV’s in his veins. So… our hopes went from a 1 to a 5 on a scale of 10.  By no means are we out of the woods yet, but right now, we are all in the ICU with what resembles a smile on our faces.I’ve had 45 minutes of sleep in about 40 hours, and feel like I just woke up from a very long winter hibernation.  Just feel very very good and hopeful.  If you believe in God, pray… If you don’t, cross your fingers, legs, etc.Updates will be coming soon.