James Moberg

First post: 9/21/2016 Latest post: 11/7/2017
Welcome to the CaringBridge site for James Moberg. Let us
begin by saying that we are glad you have found this site; we, James’
daughters, will continue to share updates on his health and condition as we
have them. If you are here, it means you are somehow connected to Dad, and we
are grateful for the care, concern, and support you have given and continue to
give him.

Allow us to start from the beginning.

In 2013, Dad was diagnosed with prostate cancer. Now, this
is often a cancer that does not require treatment, but Dad’s form was a bit
more aggressive necessitating surgery. In the preparations for the surgery,
doctors found some abnormalities that suggested Dad had a silent heart attack
at some point in the past. The effects were minor and Dad was still a good
surgical candidate. The surgery went smoothly, but there was a positive margin.
In the spring of 2015, doctors recommended radiation because the cancer was
spreading.

For months after the radiation, things seemed to be going
well and Dad seemed in great health. In February 2016, Dad started experiencing
side effects from the radiation. Specifically, he started having unstoppable
bleeding in his bladder. The diagnosis was radiation cystitis; the bladder had
been radiated because it was in the proximity of the radiated site and it was
damaged. Dad spent months getting treatments and blood transfusions, each of
which would alleviate the symptoms for a short time. However, the bleeding was
persistent and the impact of all these treatments and blood loss was that Dad
spent a lot of time over the ensuing 6 months at Mayo, trying to heal but also ultimately
losing strength and revealing further damage to his heart. During one of the
many hospital stays, Dad was diagnosed with heart failure that requires him to
take diuretics to maintain heart function.

By August 2016, the doctors had tried all the treatments and
experimental treatments they could and still Dad’s bladder was not healing. At
this critical point, Dad made the difficult decision to have major surgery to
remove his bladder. Already his system had been weakened by all the procedures,
blood loss, blood transfusions, and time in the hospital, but this was the only
remaining viable solution.

On August 17th, 2016, Dad had surgery to have his
bladder removed. And the surgery was a success. However, complications
followed. In the evening after the surgery, Dad had severe internal bleeding.
He was moved rapidly to ICU and given several units of blood; they managed to make
him stable once again. The bleed clotted itself off and so the doctors did not
have to do any further procedures which was a blessing given Dad’s precarious
condition.

A week later, Dad was released from the hospital. At home,
he was working to recover in the comforts of his own space. He was also well
enough to attend Laurie’s wedding and walk her down the aisle.

In the week after the wedding, Dad had an elevated heartbeat
and shallow, rapid breathing. When the symptoms didn’t subside, Jennie took him
to an impromptu/emergency appointment with his cardiologist at Mayo. The doctor
examined Dad and admitted him to the hospital.

Initially, the doctors were concerned about Dad’s heart. His
heart failure is a chronic condition that will continue to get worse over time;
the collection of fluids on his lungs is also likely to recur and require
future hospital stays. There is no way to make his heart healthier. Dad’s
doctor was clear about the prognosis: the objective is quality over quantity,
to get him out of the hospital to thus have a better quality of life. The
doctors gave him medications to remove the fluids accumulating in his lungs and
put him on oxygen. He spent one night on a bipab machine to help him get the
oxygen he needed. Tests also showed that Dad did not have enough blood
circulating in his system. He was given blood. Again.

While they were able to effectively treat the acute
conditions, we were concerned about why the fluid had accumulated. The doctors
suspected infection. A CT confirmed that the hematoma (collection of blood that
had clotted after the surgery) had grown a bit suggesting that dad had bled
internally again. While his blood cultures came back clean (no bacteria
colonizing), the urology and cardiology teams decided to drain the clot and
test the collection of blood in his abdomen.

As if things weren’t already messy and unstable enough, this
testing revealed that the clot had bacteria in it, specifically VRE
(vancomycin-resistant enterococci), a difficult to treat bacteria that is antibiotic
resistant. The doctors had drained as much of the clot as they could without
resorting to major surgery and put a drain in place to allow the rest to empty.
Dad was put on a particularly aggressive antibiotic to combat the VRE as well.
Shortly after, his red blood cell counts and hemoglobin dropped once more.
While the cause is a bit uncertain, it is likely a side-effect of medication
(one of the known side-effects is that this medication suppresses the
production of blood in the bone marrow; since dad had his spleen removed over
35 years ago, it is likely his body just cannot produce enough blood). After
consulting with the infectious diseases doctors, Dad was switched to different
medication in the hopes that this might help him maintain better blood
production.

At this point, we are in a holding pattern of hoping and
praying. Currently the bacteria has not spread to his bloodstream; it is
contained in the remnants of the hematoma in his abdomen. The doctors put in a
larger drain on Monday, September 19th to facilitate the removal of
the remaining clot and thus the bacteria. However, if the bacteria manages to
spread beyond this clot, Dad will be in a much more severe and precarious
position. His doctor framed it this way: we are walking a tightrope and there
is every possibility that Dad could decline and decline rather rapidly.

The situation is complicated and uncertain, but we are
hopeful that Dad will remain his ever-positive, strong self and see a better
quality of life soon. Please keep sending your thoughts, warm wishes, and
prayers his way. We will continue to update this page as we learn more about
his ongoing condition and prognosis. Thank you again for your love and concern.
All of us and especially Dad are grateful for the support and care of friends
and family. 

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