Thanks everyone for your love, support, and prayers that have been pouring in everyday. Know that every single wish, thought, prayer, text message, and email has helped our mom and us so greatly.
After a courageous struggle, Dad passed away peacefully today at 2:37pm with all of us at his side. We take comfort knowing that Dad had accomplished so much of what he set out to do, and touched so many lives.
We enjoyed so many of the stories that were shared with us - which we also shared with Dad. We're sure he is smiling down on us now playing his harmonica with his father.
We are tentatively planning a celebration of his life the weekend of October 11th in Michigan.
Love, Caroline and Kelly Huang
Friday, September 25, 2009
connecting
Dad's eyes were brighter today. We told him about all the well wishes we've received via emails and this blog for the many requests he received for car repair advice and services!
Good thing I have not let out the word that Dad also fixed my refridgerator in mid-July - I had to send away the delivery guys who brought the new fridge I ordered! He actually established a commercial account with some manufacturer company to get the necessary parts for my GE fridge.
He also fixed my washing machine 3 weeks ago - he figured out and fixed the problem with the timing switch in less than 5 min. Of course this was after I had spent 3 hrs on the internet trying to figure it out on my own. Good thing there was no penalty for cancelling the service repair people I had scheduled to come out....I always feel bad that Dad's wish for repayment was "just make sure you get enough sleep".
The nurses have done a great job with keeping Dad looking handsome and skin moisterized - I also suspect someone trimmed a few of his flyaway gray hairs on his balding head. Only today by looking at him so closely did I realize that Dad has no wrinkles - I hope I got that gene.
Good thing I have not let out the word that Dad also fixed my refridgerator in mid-July - I had to send away the delivery guys who brought the new fridge I ordered! He actually established a commercial account with some manufacturer company to get the necessary parts for my GE fridge.
He also fixed my washing machine 3 weeks ago - he figured out and fixed the problem with the timing switch in less than 5 min. Of course this was after I had spent 3 hrs on the internet trying to figure it out on my own. Good thing there was no penalty for cancelling the service repair people I had scheduled to come out....I always feel bad that Dad's wish for repayment was "just make sure you get enough sleep".
The nurses have done a great job with keeping Dad looking handsome and skin moisterized - I also suspect someone trimmed a few of his flyaway gray hairs on his balding head. Only today by looking at him so closely did I realize that Dad has no wrinkles - I hope I got that gene.
Thursday, September 24, 2009
dad
I just realized when you google Matthew Huang - his book comes up in the automatic google search function. I'll have to tell dad later today. I think that is pretty neat.
http://www.amazon.com/Vehicle-Crash-Mechanics-Matthew-Huang/dp/0849301041
http://www.amazon.com/Vehicle-Crash-Mechanics-Matthew-Huang/dp/0849301041
Day #4 - Sept 24
If you're wondering why this post is written so poorly, it's Kelly posting from a non-physician point of view! Dad's condition is stable, he made big improvements yesterday so we remain "cautiously optimistic" (good news but I am starting to really dislike that term). His pressors are way down -- only on one drug now -- and his ventilator support is at 60 percent -- which means he is breathing more on his own. We are still waiting for dad to respond to us and have been chatting with him and playing music. I told him this morning that David needs help with his Ford Explorer and that Mr. Cherng got his dishwasher working again. Thank you so much for the love, support, and prayers, really means the world to all of us -- especially mom.
Wednesday, September 23, 2009
Day #3 - Sept 23 PM update
Dr. Thomas Butler (hematology) saw Dad today - feels confident that the low platelets are a result of the overwhelming sepsis (infection) that Dad has endured. As the sepsis improves - so should his platelet count. Meanwhile - will continue with the platelet transfusions to keep him out of the dangerously low level (especially since he is on Xigris medication - which can make him more prone to bleeding). He has ordered other tests to ensure it is not related to something else (i.e. thrombotic thrombocytopenic purpura, heparin-induced thrombocytopenia).
The good news is that his bone marrow is responding and now his white count is very high (WBC 22K) - which is a more appropriate immune response to the sepsis.
The levophed pressor medication dose is even lower...12 mcg/min - and Dad's BP (blood pressure) is holding which is great!
We will continue with all his treatments - mechanical ventiltion for his lungs, continuous dialysis for his kidneys, antibiotics, Xigris, Calcium, Bicarbonate, and amiodarone infusions. Dad is even tolerating nutrition tube feedings which started late yesterday - and has been gradually increased.
Our nurse Mickey (the best nurse ever - he trained me when I was an internal medicine resident) tried to stimulate Dad for a response today - not much but maybe some basic reflexes - (eye flickering when Dad was turned or gagging when they suctioned the back of his throat). Mickey had a great impact on our mood today - especially on mom with his sense of humor and compassion. We are so lucky to have the excellent physician and nursing care that is being provided to Dad. (Mickey performed CPR on one of my friends who was severely ill and had a cardiac arrest - helped save his life with his monster-effective chest compressions - we will never forget him for that.)
Meanwhile - we brought in a portable CD player to play Dad's favorite music for him. He heard a little Iz (Somewhere over the Rainbow), other Hawaiian music that we played at Kelly's wedding, and a Johnny Cash album. Unfortunately we couldn't get his MP3 Chinese folk songs that he loves so much to play on the CD player.
Nurse Carol Marsh is on again tonight taking care of Dad - which makes me feel good. She was the one that took care of Dad the first night he came in...as well as last night during which she gave him a nice shave!
We will reassess again - taking Dad's condition one hour at a time...
The good news is that his bone marrow is responding and now his white count is very high (WBC 22K) - which is a more appropriate immune response to the sepsis.
The levophed pressor medication dose is even lower...12 mcg/min - and Dad's BP (blood pressure) is holding which is great!
We will continue with all his treatments - mechanical ventiltion for his lungs, continuous dialysis for his kidneys, antibiotics, Xigris, Calcium, Bicarbonate, and amiodarone infusions. Dad is even tolerating nutrition tube feedings which started late yesterday - and has been gradually increased.
Our nurse Mickey (the best nurse ever - he trained me when I was an internal medicine resident) tried to stimulate Dad for a response today - not much but maybe some basic reflexes - (eye flickering when Dad was turned or gagging when they suctioned the back of his throat). Mickey had a great impact on our mood today - especially on mom with his sense of humor and compassion. We are so lucky to have the excellent physician and nursing care that is being provided to Dad. (Mickey performed CPR on one of my friends who was severely ill and had a cardiac arrest - helped save his life with his monster-effective chest compressions - we will never forget him for that.)
Meanwhile - we brought in a portable CD player to play Dad's favorite music for him. He heard a little Iz (Somewhere over the Rainbow), other Hawaiian music that we played at Kelly's wedding, and a Johnny Cash album. Unfortunately we couldn't get his MP3 Chinese folk songs that he loves so much to play on the CD player.
Nurse Carol Marsh is on again tonight taking care of Dad - which makes me feel good. She was the one that took care of Dad the first night he came in...as well as last night during which she gave him a nice shave!
We will reassess again - taking Dad's condition one hour at a time...
Day #3 Wed, Sept 23, 2009
Some brighter news this morning.
Dad's atrial fibrillation rhythm converted back to a normal heart rhythm this morning which has greatly helped his blood pressure. He is been able to go down on 1 of the 2 pressor medications and is completely off the neo-synephrine! He is still requiring levophed at 20mcg/min - but this is certainly progress.
Dad has received his 3rd platelet transfusion this morning - unfortunately his platelet count did not go up - so another specialist from Hematology- will be added to Dad's team to evaluate and assist with this management. So far - he does not show signs or symptoms of bleeding problems.
Right now - it's a waiting period to see how things progress. We are cautiously optimistic. If there is one thing we know - Dad never gives up and will certainly put up his best fight. thanks for all the well wishes we've received - although we may not get a chance to respond - do know that it helps so much.
Dad's atrial fibrillation rhythm converted back to a normal heart rhythm this morning which has greatly helped his blood pressure. He is been able to go down on 1 of the 2 pressor medications and is completely off the neo-synephrine! He is still requiring levophed at 20mcg/min - but this is certainly progress.
Dad has received his 3rd platelet transfusion this morning - unfortunately his platelet count did not go up - so another specialist from Hematology- will be added to Dad's team to evaluate and assist with this management. So far - he does not show signs or symptoms of bleeding problems.
Right now - it's a waiting period to see how things progress. We are cautiously optimistic. If there is one thing we know - Dad never gives up and will certainly put up his best fight. thanks for all the well wishes we've received - although we may not get a chance to respond - do know that it helps so much.
Tues - sept 22nd update
The cause of his illness is from a very potent bacteria called Streptococcal pneumoniae. Likely started off as a pneumonia, and then spread to the blood stream - causing dad to be weaker than usual --> fall and suffer an aspiration event in which stomach acid "burned" his lungs.
The bacteria has been identified and is being treated with the correct antibiotics - but now Dad is dealing with the aftermath of inflammation that this bacteria caused on his body (like the destruction that a tornado leaves afterwards).
Today started off on the lowest dose of pressor medications (still two pressors being used) since he was admitted - which was cautiously encouraging - Dad's BP (blood pressure) and oxygen status have been where they need to be.
He needed two transfusions of platelets today for his very low platelet count. but his white count has gone up from 2K -->10K today which is a good sign - means his bone marrow is now responding.
Unfortunately - dad went into an atrial fibrillation rhythm today - not unusual when someone is in septic shock. but the atrial fibrillation can affect the heart's ability to keep the BP up - which dad experienced later today.
Dad is suffering from severe cyanosis (blue hands and feet) due to the high doses of pressors he is on - so it's even more imperative we get the pressor medication off as soon as possible to prevent possible long term damage to his hands and feet. But understand that the pressor medication's use is keeping the blood flow to his heart and brain as first priority.
As his doctors stated: He is in a better clinical status than he was yesterday morning -but clearly not out of the woods by any means. Dad is tolerating all the treatments but clearly still on maximum support. However, many people do not survive what Dad is going through.
We know that Dad is tough, as my mom calls him: IronMan for having tolerated his parkinson's disease for the last 2o years - slowly robbing him of his motor function, particularly his balance.
Dad is persistent and stubborn and had plans "to live a long life"...so we are hoping his body can pull through this with our encouragement and support.
We are lucky that Dad, besides his parkinson's, was generally very healthy before this - we know his heart and lungs were in excellent shape - so these are things in his favor.
Current diagnoses - for our family and friends versed in medical knowledge:
1. Septic shock from Streptococcal pneumoniae (penicillin sensitive) bacteria that started with pneumonia and spread to bloodstream (on Zosyn, vancomycin, tamiflu, Xigris. Also on levophed 20 mcg/min, phenyleprine 200 mcg/min, hydrocortisone 100 mg IV q8. vasopressin tapered off)
2. Acute kidney failure due to profound shock (max creatinine 2.7) on CVVH.
3. Acute respiratory failure due to profound shock on maximal ventilator settings
-- (FiO2 100%, PEEP 16).
4. Rhabdomyolysis (CPK peaked at 5400 U/L)
5. Severe lactic acidosis (peak 9 mmol/L).
6. Encephalopathy due to sepsis - (not on any sedation - morphine as needed for pain).
7. Bilateral cephalic vein thromboses (from sepsis?)
8. Cyanosis of extremities related to shock and pressors - on topically applied nitropaste.
9. Thrombocytopenia - 13,000 - s/p 2 platelet infusions.
10. New atrial fibrillation (9-22-09) - started on amiodarone infusion. (depressed EF 35% due to septic shock -based on yesterday's ECHO).
Dad's team of medical doctors:
Pulmonary/critical care: Dr. Duhamel, Dr. Kruger, Dr. Wyckoff
Infectious disease: Dr. Michelle Ritter (dr. holman's group)
Nephrology (kidney): Dr. Thomas Rakowski, Dr. Kevin Lowery
Cardiology: Dr. Tony Parente
Vascular Surgery: Dr. John Garrett/Joe Kirby PA-C
Internal medicine: Dr. Anthony Rimicci
His wonderful ICU nurses thus far:
Carol Marsh (2 nights)
Jenny Beutler (2 days)
Leah Marks
The bacteria has been identified and is being treated with the correct antibiotics - but now Dad is dealing with the aftermath of inflammation that this bacteria caused on his body (like the destruction that a tornado leaves afterwards).
Today started off on the lowest dose of pressor medications (still two pressors being used) since he was admitted - which was cautiously encouraging - Dad's BP (blood pressure) and oxygen status have been where they need to be.
He needed two transfusions of platelets today for his very low platelet count. but his white count has gone up from 2K -->10K today which is a good sign - means his bone marrow is now responding.
Unfortunately - dad went into an atrial fibrillation rhythm today - not unusual when someone is in septic shock. but the atrial fibrillation can affect the heart's ability to keep the BP up - which dad experienced later today.
Dad is suffering from severe cyanosis (blue hands and feet) due to the high doses of pressors he is on - so it's even more imperative we get the pressor medication off as soon as possible to prevent possible long term damage to his hands and feet. But understand that the pressor medication's use is keeping the blood flow to his heart and brain as first priority.
As his doctors stated: He is in a better clinical status than he was yesterday morning -but clearly not out of the woods by any means. Dad is tolerating all the treatments but clearly still on maximum support. However, many people do not survive what Dad is going through.
We know that Dad is tough, as my mom calls him: IronMan for having tolerated his parkinson's disease for the last 2o years - slowly robbing him of his motor function, particularly his balance.
Dad is persistent and stubborn and had plans "to live a long life"...so we are hoping his body can pull through this with our encouragement and support.
We are lucky that Dad, besides his parkinson's, was generally very healthy before this - we know his heart and lungs were in excellent shape - so these are things in his favor.
Current diagnoses - for our family and friends versed in medical knowledge:
1. Septic shock from Streptococcal pneumoniae (penicillin sensitive) bacteria that started with pneumonia and spread to bloodstream (on Zosyn, vancomycin, tamiflu, Xigris. Also on levophed 20 mcg/min, phenyleprine 200 mcg/min, hydrocortisone 100 mg IV q8. vasopressin tapered off)
2. Acute kidney failure due to profound shock (max creatinine 2.7) on CVVH.
3. Acute respiratory failure due to profound shock on maximal ventilator settings
-- (FiO2 100%, PEEP 16).
4. Rhabdomyolysis (CPK peaked at 5400 U/L)
5. Severe lactic acidosis (peak 9 mmol/L).
6. Encephalopathy due to sepsis - (not on any sedation - morphine as needed for pain).
7. Bilateral cephalic vein thromboses (from sepsis?)
8. Cyanosis of extremities related to shock and pressors - on topically applied nitropaste.
9. Thrombocytopenia - 13,000 - s/p 2 platelet infusions.
10. New atrial fibrillation (9-22-09) - started on amiodarone infusion. (depressed EF 35% due to septic shock -based on yesterday's ECHO).
Dad's team of medical doctors:
Pulmonary/critical care: Dr. Duhamel, Dr. Kruger, Dr. Wyckoff
Infectious disease: Dr. Michelle Ritter (dr. holman's group)
Nephrology (kidney): Dr. Thomas Rakowski, Dr. Kevin Lowery
Cardiology: Dr. Tony Parente
Vascular Surgery: Dr. John Garrett/Joe Kirby PA-C
Internal medicine: Dr. Anthony Rimicci
His wonderful ICU nurses thus far:
Carol Marsh (2 nights)
Jenny Beutler (2 days)
Leah Marks
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