I've stayed away from posting as family and friends visiting Dad at the rehab facility would typically post something on Facebook that would give everyone an idea of how he was doing. Today, however, I need to come back to this venue to update everyone with something that has been occurring the past few weeks, but really took a toll on Pops and has changed the course for the time being.

Friday morning, while I was in Madison, Dad left me a voice-mail message that I did not get due to the fact that I had to have my phone on silence and away from me for a test I was taking.  Once I finally saw that I had a message I called him back only to find out that he had been dealing with his heart racing since 6 am. Now it's 10 am and apparently they are trying something different.  By the time I was able to get to the rehab facility they had already tried medications that did not appear to be doing what he needed them to do.  After some discussions with the Nurse Practitioner and seeing how Dad was actually doing, he was symptomatic enough in my opinion to no longer wait in getting him to the hospital.

Once in the emergency department and knowing that he had already had two medications delivered by mouth that had been in his system for over 90 minutes, they chose to start an IV drip of amiodarone, a heart medication that helps to regulate extremely high rates.  Dad had actually been given this earlier in pill form and had been on it prior to all his abdominal issues escalating in Florida.  Unfortunately, this medication also has the effect of dropping blood pressure which is what happened soon after they started the IV.  So they stopped the drip and gave him some fluid to get his blood pressure back up and then the pill form of amiodarone.  From that point it was admit and monitoring.

So that is where we are at.  He is currently in the ICU at Aurora Summit and is actually feeling much better as the medications have finally taken some effect.  What has happened is that when he does start to move around or sit at the side of the bed to eat a meal, then the A-Fib, with it's fast ventricular response, starts up again and he ends up with a HR in the 130-155 range with his blood pressure bottoming out.  Once that settles itself down, then he is zapped of energy and needs a nap.  This is what I meant earlier about something that has been occurring for the past few weeks...

Well, this scenario's re-occurrence was prohibiting Dad from making the necessary gains to stay at the wonderful 3 Pillars, Hickory Suites rehab facility.  On good days he could walk a fair distance, ride a bike for around 10-15 minutes with nominal resistance, and complete all his activities of daily living that were necessary for Medicare to allow him to stay.  Unfortunately, too many times his atrial fibrillation would take the same toll it has today, and he could not complete his physical or occupational therapy sessions.  This led to the need to find a place for him to stay where he could continue to receive the appropriate care necessary for his condition, yet continue on some type of outpatient rehab and wound care program necessary to continue along. He was actually supposed to have been evaluated for movement to the Brookfield Regency Assisted Living facility that his Mother-In-Law resides.  However, that was also supposed to take place on Friday but couldn't because of his condition. 

What does this all mean and where do we go from here?  Well, actually now we face the double-edged sword that we just feel needs to be discussed.  Does he need to have either open heart surgery, or an ablation to slow down the rhythm coupled with pacemaker insertion to make sure it stays above a certain rate.  Or does he just move on to assisted living and continue on like this, hoping that he gains strength over time and can manage the above.  As far as Dad is concerned, enough is enough and he wants to sit down with cardiology, electrophysiology, and cardio-thoracic surgery to discuss all his options and do something other than continue living like he is.

In the case of open heart surgery, the risk is obviously much higher and the feeling is he wouldn't even make it through the procedure, and even if he did doesn't have enough reserve to manage the additional rehab required for it.  However, even the ablation and insertion of a pacemaker carries a pretty high risk and also requires some rehabilitation.  That coupled with the fact that he would still require open heart surgery to repair or replace his mitral valve and possibly his aortic valve, are really presenting quite the conundrum for his care team and for him in the decision making process.  However, Dad feels more confident in trying to go through one of those procedures than continuing with the present course and dealing with the frequent episodes that drain him, not just physically but emotionally.  He commented that  he would prefer not to deal with dual procedures as he doesn't understand why you wouldn't just repair the bad valves and get it over with.  But as I told him, there may not be an option and just getting the chance to keep this under better control could give him the boost necessary to get back to PGA form and allow him to work out with the front line of the Badgers to get ready for the other surgery.  I think he is starting to get it now, but if not I'll just have to be a little more informative with stick figure pictures and GIF's and Meme's.  Half of you reading this just got lost in my comedic attempt! :)

Well, that's it in a nutshell.  Big Bill is not the easiest patient in the world to figure out, as all his physicians have commented, but nursing absolutely adores the big lug and feels he his one of their favorite patients as he always thanks them for everything they do while trying to sneak in a smooch here and there...and you wonder where I got it from, right!!  Come Monday, we may have some more direction with this whole reality escapade, but until then the room at 3 Pillars, Hickory Suites is now empty and Pops is happy that he does get the Golf Channel back for a period of time.  Go figure, has to get admitted but finds something positive that he appreciates more than me ;).  Love you Pops!!