UPDATE 4/18:

It has been a few days since I have posted an update about Josh. He was able to be discharged on Monday 4/15. 

 

During Josh’s hospital stay (4/9-4/15), he was on a heparin drip, and his Coumadin dose was slowly adjusted to help thin his blood. He had an echocardiogram (TEE) to look at his heart and valves. No clots were visualized, but his cardiologist (Dr. Turk) suggested his therapeutic INR range be increased from 2.0-3.0 to 2.5-3.5., to help prevent any blood clots in the future. This was the main goal during his hospital stay, in addition to pain management. 

On Monday, 4/15, Josh’s INR reached 2.6, so his hospitalist felt that he was ready for discharge

 

We, unfortunately, didn’t have many answers to our questions upon discharge. However, after following up with specialists on Tuesday and Wednesday, we do have some answers to our questions. 

 

On Tuesday 4/16, Josh saw the nephrologist ( Dr. Saffarian), as he did go into acute renal failure during his hospital stay. Josh actually has a fairly large part of his right kidney affected by the renal infarct (most likely due to a blood clot that originated in his heart). This infarct is what has been causing him significant pain. It could take up to 6 months for this infarct to resolve. 

Josh will have repeated imaging of his kidney in 6 months, and a follow up visit with the nephrologist. 

 

Yesterday 4/17, Josh saw the urologist in regards to some issues that he is having with urinary retention. Because of the urinary retention, Josh is needing to wear an indwelling urinary catheter for roughly 2 weeks. Josh will see the urologist again next Tuesday. 

With a little luck, Josh will be able to have the foley catheter removed at this appointment ……if he can pass a voiding trial. He was ready to lose the catheter about a week ago!! In two weeks he will follow up again with the urologist for another procedure to better visualize his bladder/urethra (cystoscopy). 

 

Today, 4/18, Josh has an INR lab draw. Hopefully he is still in a therapeutic range. Cardiac Rehab is on hold at this time, due to Josh’s recent complications. He is attending a cardiac rehab/nutrition class today, however. 

 

We have reached out to the surgeon in Minneapolis who performed Josh’s open heart surgery. He is encouraging us to continue follow up care in Minot at this time. Josh will see an internal medicine doctor next week, and then the cardiothoracic surgeon in Minot the following week. 

 

The calendar is quickly filling up with appointments and procedures, but we hope Josh’s plan of care can quickly be ironed out….. and he can feel better. Summer is coming, and there are fish to be caught!! 😉 🐟 🎣 🐠 

 

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UPDATE 4/14:

Josh is still hospitalized on medical floor at Trinity Health. Yesterday seemed to be a better day for him. His kidney functions (GFR) improved, and he is making more urine. He is still having quite a bit of pain from the kidney infarcts, and is getting pain meds quite regularly. Unfortunately, he has been having trouble urinating, and most likely will have to go home with a urinary catheter for 2 weeks. (He’s not too excited about this😩). His heparin dose and Coumadin were both increased again today, in efforts to increase his PT, PTT, and INR (clotting factors). We are still waiting on some lab values that were drawn earlier in the week, to help explain why the infarcts may be happening. 

Hoping for a better day, today. 🙏🏼🙏🏼🙏🏼

 

UPDATE 4/12:

Josh is still hospitalized, and on a heparin drip to thin his blood. (Was admitted on 4/9). 

He is still having issues with his kidneys and bladder, as well as significant pain. The TEE that was ordered (to look at his heart and new valve) has resulted, and everything regarding his heart looked normal. (Thank goodness). 

Additional labwork was obtained today; still waiting for some results to help with a diagnosis. 

The doctors are not exactly sure what is going on with Josh. Hoping we can get some better answers tomorrow. 

 

UPDATE 4/10:

We still don’t have many answers today. 

Josh was having significant right flank pain and blood in his urine yesterday. This led to a lengthy ER visit, and he was eventually admitted to the 4th floor 12 hours later. While in the ER, he was found to have several infarcts to his right kidney. These infarcts are most likely from blood clots the doctors have said. They are concerned the blood clots are stemming from his new, mechanical aortic valve. A trans-esophageal echocardiogram (TEE) was ordered, to take a closer look at his heart/valve. 

We are anxious to hear what the TEE report suggests. 

He has been on a heparin drip to help thin his blood since 10 pm on 4/9. His clotting factors (PT and PTT) didn’t really change after 16 hours of heparin, so his rate was increased. 

He also now getting heparin injections as well. 

 

4/9:

It’s been LONG day!!!!

It didn’t end quite like we had planned. 😩

Say a few extra prayers for Josh, as he could use them.  

🙏🏼❤️‍🩹🙏🏼

He’s back in the hospital with some complications. 

We don’t know many details at this time. 

We will find out more after further testing, tomorrow.