Vascular Lab 3/11/2011

I took James to his follow up appointment at the Vascular Lab.  The PA Davidson explored the incision site with hands, looked at the fading purple and read the CT reports.  He recommended 6 more weeks of recovery before Jim could participate in Physical Therapy.  I had him complete FMLA papers for the follow-up appointment so that I would not be docked after returning to work.  I asked him about the last Aorta Aneurysm that was measured at 5.1.  He said that within 6 months to a year the aneurysm could grow the last CM that would require surgery.  James has an appointment in July with the Thoracic Surgeon to discussion the Aorta Arch aneurysm.  Open Heart surgery will be necessary to correct the Aorta arch aneurysm. James came through Open Heart surgery and cranial surgery really well in the past and this last aneurysm surgery went really well so hopefully he will bounce back from the next one, however all of us are worried.

3/23/2011-3/25/2011 VA Hospital

James spent the first night in SICU with close supervision by the nurses and good doctor updates.  The doctor was concerned about the excessive bleeding on the right side due to calcification of the iliac artery. The surgeon said two doctors applied pressure for 45 minutes trying to stop the bleeding and there is a chance that they may need to go back in if the bleeding began again.  He was hungry and awake.  The lounge on 5th floor has soft recliners and couches with wide screen TVs.  The next day he was moved to 4th floor.  Past experiences had me recommending James' IVs and catheter being removed as soon as possible.  Also I requested a patch, but James was up roaming before the patch could be approved,  He sent me to get him coffee.  When I took the elevator to the basement canteen, I found him walking down the hall.  His pants were wet.  I guess when he got on the elevator the downward pressure forced the urine out for the first time since the catheter was removed.  I took him back to the room and told him I was going to get coffee from the vending machine down the hall.  I found him walking again on my way back. I asked his nurse if I could push him outside to smoke and maybe he would settle the nurse agreed.  They assigned him 1-1 care but James told me to lean back in a chair and put my feet up on the other, so I spent the night assuming he wanted me near.      On 2/25/2011 they dismissed him around 1:00.  Yep, we are all relaxing at home.    He wanted to go to the Waffle House and spent a couple of hours talking to a friend.   He slept until dinner and now is on the phone talking to a friend in Mt Vernon.   He's Very purple moving slowly or very little but acting normal.

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2/23/2011

James had an upside down Y shaped stent combination placed in his abdominal aorta to improve blood flow and to enforce the blooming walls.   He is alert, ate dinner, and already wants to come home.   He will spend 24 hours in the SICU at the VA then may be moved to the 4th floor if no complications develop.   Michael and I came home tonight.   She plans to go to work tomorrow and I plan to spend the day at the hospital until he is dismissed.

3/3/2011 Home again

James came home on Thursday and the stent implants are looking good with no pseudoaneurysms shown on the CT scan .   The purple colors are less vibrant..   He is feeling better.  I am still placing pain pills and stool softeners in both his morning and afternoon meds because it hurts to move around and pass BMs.  The doctor signed for me to provide continuous care for him until his doctor appointment on 3/11/2011 so I am FMLA.

3/1/2011

Yesterday, James went to the VA ER for groin pain on the right side.   The vital nursing assistant ask the RN why she was hooking Jim up to the Heart monitor just for groin pain.   The nurse told her his groin hurts because of surgery.   They admitted him when the Doppler ultrasound reviled a possible pseudoaneurysm.   The left side was still purple from the Hematoma that occurred during the original surgery due to the calcification of Jim's iliac vein.   The DR said that they had to hold the left side for 45 minutes to stop the bleeding.   Today they took a CT SCAN.   The 3rd year South Western Medical Student assigned to Jim's case for the next two days, met with Jim and me this evening.   I teased the girls about the 4 young med students who came to take him for tests. pseudoaneurysm, also known as a false aneurysm, is a hematoma that forms as the result of a leaking hole in an artery. Note that the hematoma forms outside the arterial wall, so it is contained by the surrounding tissues. Also it must continue to communicate with the artery to be considered a pseudoaneurysm.   Abnormal AV fistulas like the one that caused Jims brain hemorrhage are usually the cause of pseudoaneurisms. Femoral pseudoaneurysms may complicate up to 8% of vascular interventional procedures.