Impossible

Today was a tough day. Though in the end, Mom, Becky and I agreed that nothing had substantially changed, we all feel as though we've been through the wringer.

It started when we got a call this morning from Dad's doctor. He was concerned that he might have to put Dad back on the ventilator, and since Dad was doing poorly that way, the doctor also wanted us to revisit the issue of whether or not we would want them to resuscitate Dad if his heart should fail.

Apparently in the middle of the night last night Dad had another episode of very high blood pressure coupled with low oxygen saturation. He rallied and was fine for awhile, but this morning they were once again concerned about his oxygen levels (and other things, about which more later), so the doctor felt Dad might need the ventilator again. And then he brought up the resuscitation issue. Obviously they must have to ask this any time scary stuff happens, but it scares us even more because it seems like he must be so much worse if they're asking that.

The doctor was particularly concerned about this episode because since Dad's neurological function isn't 100 percent, he is not always able to control aspects of his breathing (his tongue tends to fall back in his mouth and cut off breathing a little, so it sounds like he's snoring) and coughing up mucous from the pneumonia. Today they cleared a significant amount of mucous that he should have swallowed but couldn't. Also, it's possible that because of this, he is continuing to aspirate some of the mucous, which could be reinfecting his lungs, hence why he can't shake the pneumonia. In order to deal with all of these issues, they put him back on the BiPAP, put a catheter down his throat to suck out mucous, and inserted a thingy (I forget the name) in his mouth to hold down his tongue and keep his airway open.

Within a half an hour of doing this, the doctor said Dad was doing much better. But he still wanted the family to meet with him so he could go over everything. Now, I know it's his job to call it like he sees it, and certainly it makes sense to err on the side of caution, but we spent the whole day waiting for some horrible news (not that the current news isn't horrible enough) that would necessitate us revisiting the resuscitation question. Instead, he told us what we already knew (their less-than-optimistic prognosis for Dad's "quality of life") and discussed the current situation, which at that time was resolving before our eyes (as the day progressed we saw Dad become more comfortable, animated and communicative).

Of course the doctor's ultimate concern is what Dad's neurological function will be if they are able to get him past these other health issues. (A special rehabilitation doctor will come in and assess Dad in the next couple of days.) They don't really see any encouraging signs, but many of the things the doctor mentioned as benchmarks for how a patient with this type of brain injury should ideally progress I've seen myself. I guess Dad just isn't doing them for the docs and nurses. (Case in point: today when Dad was started to become more alert and animated was when the doctor was leaving.) And of course he's not doing any of those things when all his energy is focused on being sick!

**Reader alert: The following comments are not meant to be construed as a medical diagnosis. I'm not a doctor, nor do I play one on TV.** I think all of Dad's health care providers are doing a great job. They can only go by statistics and averages and are basing their prognoses on available medical data. Fine. But they're just not seeing what I see. Dad is very, very sick and his body is struggling to heal on a variety of fronts. When he has used up all his energy and doesn't have the breathing support he needs, he becomes unresponsive and lethargic. When he gets breathing support, his eyes are open, he can blink and nod to communicate, and his limbs start moving a little again. The bottom line for me seems to be that if his body can ever get past fighting pneumonia, Dad will have a much better chance to show what's really going on with his brain. **End of uneducated non-medical opinion.**

This morning before we left to go to the hospital, I reached for the worn Bible on Dad's nightstand for some comfort. It fell open to one of the blank pages at the back where I found a yellow Post-it note. At the top Dad had written, "What is impossible with man is possible with God." Luke 18:27

So we take a deep breath and wait for possibilities.