August 31, 2007 - 8:30 p.m.   Karin did not sound very upbeat during the phone call this evening. She reported that she did not have much of an appetite nor much energy, undoubtedly the combined side effects of the pain medication for her back and three hours of dialysis. Earlier today Karin put on her brace (see reports for 8/30 and 8/29) and she sat up in the chair for about an hour, then she took a short walk down the hall using the walker. She only traversed about half the distance that she had been covering previously on each of her three daily walks before the spinal compression fractures. She deserves a lot of credit and sincere praise for being so gritty and determined. Karin said she did not get in any reading and had neither visitors nor special medical attention today. It promises to be a quiet weekend. I am sure she and Brandon would appreciate receiving e-cards expressing your support and encouragement, and of course, please pray, pray, pray..

August 30, 2007 - 8:30 p.m.   Karin received the brace for her back today (x-rays yesterday and today revealed that she has compression fractures associated with T-11 and T-12 [thoracic vertebrae] and also the L-1 and L-2 [lumbar vertebrae] in her spine).  Wow, those orthopedic folks at UPMC sure responded promptly! She was fitted yesterday afternoon and they delivered the brace around 10 a.m. this morning. It is a fiberglass clamshell that comes in two halves, a front and a back. The two halves are held in place with velcro. It is worn over the hospital gown and looks like a turtle shell when it is in place. Karin described it "like body armor." She only needs to wear it when she gets out of bed. The bad part is that now it takes two people to get her out of bed. Brandon said it is hard to get a grip on it so he joked about asking them to epoxy handles on it so he could lift her with it. When asked how it felt, Karin said "it felt pretty good." It holds her in a very upright posture and after wearing it she said it felt like being hugged for a couple of hours. Karin did take a walk wearing the brace today. They have cut back on the dosage of pain medication because Karin found it too difficult to stay awake to do her breathing exercises every hour. The med makes her groggy and has killed her appetite, so she waited until 5 p.m. today to take it so she could do her breathing exercises and take a walk, but pain control is important for overall healing. They want her to get up and get around as much as she can, so it is a delicate balance. Karin ate sherbet, yogurt, banana, and noodles today.

August 29, 2007 - 9:30 p.m.   Today Karin received the results of the x-ray of her back. She has a compression fracture associated with the L-1 and L-2 vertebrae in her lower back (Lumbar Spine) . No wonder she has been in pain! She recalls a recent incident when two of "the girls" were helping her to the edge of the bed to get up and she experienced sudden sharp pain; it could have happened at that time. No surgery is contemplated at this time, however she will be fit for a "clamshell" or corset-type brace around her mid-section to stabilize her spine and immobilize it. Her spirits were remarkably high considering this news. As we have been reporting, the pain medication makes her foggy and groggy so she did not take any walks today and did not even read her novel. She didn't have an appetite either.  As you continue to pray, please ask that Karin & Brandon will have strength from the Lord to endure yet another setback to her progress, and that He will heal her discs in record time and give Karin's medical team wisdom in treating her.

August 28, 2007 - 8:30 p.m.   Brandon said Karin finally got an x-ray of her back this afternoon. The doctors still think her pain is probably caused by a strained muscle, but it is one issue they would like to clear up because with the discomfort she is experiencing, Karin only got in one walk again today. Brandon discussed this with Karin's nurse practitioner because he feels like it is causing her to loose ground again. Another thing they discussed today was when they will start cycling the tube feeding off at night so Karin will have more of an appetite, but that is still unresolved. They also discussed whether Karin might eventually be a candidate to go to a rehab facility at UPMC-Montefiore Hospital across the street, Brandon said the nurse practitioner was not sure Karin would qualify at this time, Karin did OK eating today, Gram and Pap Freund visited today.

August 27, 2007 - 9:15 p.m.   10 o'clock this morning marked the six-month anniversary of Karin's transplant back on February 27th. She has made a lot of progress! She could not get comfortable last night, so she did not get a whole lot of quality rest. Then the back pain continued today so she took some pain medication late in the day which lulled her into an early evening nap after dinner. She fell asleep reading "The Order of the Phoenix." Meanwhile, they did do dialysis for three hours today and will evaluate later in the week if this is an effective time duration or not. Brandon said they were more focused on filtering her blood than on removing fluid today. Lunch consisted of chicken salad and applesauce. Later on, Brandon procured a fresh pineapple from another patient's gift fruit basket, he cored it and sliced it up, and Karin enjoyed some fresh pineapple for dinner. She is drinking close to 32 oz. of fluid a day, too. She only managed one walk thus far today. Various relatives are e-mailing pictures of her new nephew, Gage; however everyone has the very same picture of him so they keep getting the same photo over and over. It's a good thing he's a Cute Kid!

August 26, 2007 - 10:30 p.m.   Karin felt good enough this morning to "dress up" and to spend some time outdoors. In fact Karin was able to be out of her room for about an hour or more today. She & Brandon and Tim & Linda went out onto the pavilion on the third floor of UPMC-Presbyterian, then on to the Montefiore Bridge for some sightseeing and a look around.  They were having so much fun they proceeded on to the other garden at Montefiore and the atrium over there.  Karin had some peaches for lunch and then later some Swiss steak and parsley potatoes.  Her doll sized bites are only about 1/3 of what you would probably put on a fork or spoon, but she tolerated what she ate and that is the whole idea.  Dr. Bama checked in today and he said Dr. Ferson feels Karin will need to be on the trach tube for a while yet.  He said the tissues which were punctured during the innominate artery rupture are very fragile and still need time to heal.  He said everything in that area is fragile and he doesn't want any of those tissues to collapse.  They just need more time.  Also Brandon said they are not as concerned about her presumed weight loss after weighing her again today.  He thinks the last weigh-in was on a scale which might not have been calibrated or something because she weighed in today at 112.6 lbs.  She is still having some back pain and they may x-ray to rule out a hairline fracture if it doesn't get better.  Brandon says he feels the potassium level problems last week made it hard for Karin to get in all her breathing exercises.  He thinks that is why she needed and did get some supplemental oxygen assist today through a nasal cannula for much of the day.  She did manage to get in some walking today also and read about four chapters of "Order of the Phoenix" after Brandon propped the 900+ page book on two pillows for her.  He is not sure what other tests or procedures may be scheduled for this week but thinks a bronchoscopy and biopsy may be due since she is now off prednisone again. Monday at 10 a.m. will mark the six-month anniversary of her transplant back on February 27th. She has come a very long way!

August 25, 2007 - 7:15 p.m.  Karin reports that she has had a little back pain for a few days. She said it seems to be muscle related. They gave her some pain relief medication today so she was kind of "knocked out," as she put it. Even so, she managed to take one long walk. Karin said her appetite was pretty good today: can you believe she ate stuffed shells (rigatoni) and pears? And we are not talking baby food, either! She said she is trying to drink lots of fluids, too. They did reduce her dialysis session to three hours yesterday and hope they can maintain this lower target. Please pray she will be able to function without any dialysis and her kidneys will rebound completely in time. Karin said she was very happy to see her parents, Tim & Linda, return this morning to spend the weekend with her and Brandon. She said if the weather cooperates, she would like to go outside to the patient garden pavilion tomorrow (Sunday).

August 24, 2007 - 8:00 p.m.  There is much to report today. Karin's oxygen level was a little low this morning so they put her back on the nasal cannula off-and-on today. It does not appear to be anything serious. Brandon had a talk with the dialysis supervisor and she told him that Karin's kidney function numbers are improving and given Karin's overall condition, they are going to try to cut her dialysis back to three hours per session. So today they lowered the target and will monitor how she does over the weekend to see if they can reduce each session. Karin will really like it if they can be reduced. Karin's nurse practitioner told Brandon that the doctor in charge of Karin's trach does not want to take it out yet - something about it being needed to support the reconstructive surgery he performed last spring. However the good news is that they have remarked to Brandon a couple of times that Karin would not have to have the trach removed in order to be discharged, but first he would have to learn to suction her lungs. This represents a bit of a challenge for Brandon, who can be squeamish about some medical matters, but he is willing to give it his best effort if it means Karin can go home. Karin did not have much of an appetite today, but tackled some more macaroni and cheese and white cake for dinner. She is actually eating solid food now, being careful to take small bites and limit portions. The nurse said they are going to increase her feeding tube delivery gradually during the day, then shut it off altogether from 6 p.m. to 6 a.m. to give her more of an appetite during the day. Karin had not taken any walks yet today, but they plan on getting them in this evening after respiratory therapy comes by to suction her. Karin had visits from Chaplain Carol, who prayed with her, and a surprise visit from her dad's cousin, Marie, and her daughters, Nicolette and Alex. The hot weather in Pittsburgh taxed the air conditioning on her floor, so it felt a little sticky there today but it was not intolerable. If the weather permits, Brandon plans to take Karin outside again over the weekend.

August 23, 2007 - 9:30 p.m.  Karin had an uneventful day.  Some days tend to be somewhat routine. In addition to taking her usual three walks up and down the hallway today, her physical therapist took Karin out into the hall and had her work on her balance by doing a bunch of side-stepping. She was only holding on to the therapist's arm and did pretty well and she is getting good a standing on her own. Karin did not have much of an appetite at lunch time so she only ate some sherbet, but for dinner she had a good helping of macaroni and cheese and some more sherbet. They are still waiting to hear back from the doctor about discussing the possibility of removing Karin's trach. Karin wanted to be sure to include a special message for some of her mother's co-workers: "To Skylar & Taylor, thank you for the pictures.  They are on my closet door where I can see them everyday!!!  Also thanks to Aunt Joni (aka "Aunt Witch") for the picture of Gage.  It is also on my wall right where I can see it!!"

August 22, 2007 - 7:30 p.m.  Karin reports that all is well today.  Yes, Karin!  She answered the phone and gave the update today.  Dialysis ran from about noon to 5 p.m. so she only managed to get in two walks today.  She had some sherbet today and some other stuff not worth remembering!  Actually, Linda said they are considering cutting back on the feeding tube overnight so she has more of an appetite in the morning.  The nurse practitioner has been trying to reach the doctor who does Karin's trach work to discuss timeline for removing hers.  He seems to be difficult to reach. Brandon is feeling much better and will try to return to Karin's room tomorrow.

August 21, 2007 - 11:00 p.m.  Karin had a productive day today. She took three walks. Her grandparents were with her during the morning and her mother, Linda, arrived after lunch. Karin had a good appetite and enjoyed meals consisting of pasta noodles, peaches, banana cake - all highly softened, of course - and ginger ale. Karin really took it slowly today and she was able to tolerate all the food she consumed, praise God. Linda is spending the night with Karin tonight while Brandon is quarantining himself until he is over his cold.

August 20, 2007 - 9:00 p.m.  Karin had a slow day today, caused by a somewhat sleepless night and dialysis that started around 11 a.m. She did get to make one long walk, however. Today was the day Karin got to break her fast and resume liquids and soft foods, so she ate some lunch (don't know what it was) and for dinner she had some baby food pears and some mashed potatoes. Unfortunately, she was not able to keep the dinner down. Brandon, who is home with a cold, said he thinks maybe she didn't take time to rest between spoonfuls and probably ate too fast. About the time they got her cleaned up, Aunt Kathy and Uncle Jack stopped in to look after Karin for the remainder of the evening. Karin's nurse practitioner returned to work today after an extended absence herself. She was surprised and pleased to see how much progress Karin has made recently, even though today was a relatively slow day for Karin. Please continue to remember Brandon when you are praying for Karin, his sore throat seems to be much better today but he still has the head cold with nasal congestion. It is hard for him not to be there with her, and I am certain Karin feels the same, but both know they cannot risk introducing any setbacks into Karin's progress by exposing her to what he has right now.

August 19, 2007 - 10:30 p.m.   Karin had a pretty good day again today, considering her potassium was low when she awoke this morning. They hung an I.V. bag to give her some more and that seemed to do the trick. She took three walks today, including a L-O-N-G one covering the entire length of the hallway from end to end. Brandon says Karin has picked up the pace and really is covering ground with speed. The first long walk was using the walker but subsequent strolls were made only holding Brandon's hand (how sweet). Karin is wired with telemetry so during these walks all her vital signs are being transmitted to the nurse's station where they monitor alarms, and Karin's heart rate, oxygen levels, etc. are all quite normal and in the "good range." Again, she is completely off the supplemental oxygen. Tomorrow (Monday) Karin will resume a liquid diet. Her Aunt Marilyn stopped in to bring her some "Pudding in a Cloud" to break her fast. That's pudding layered with cool whip. Of course, the hospital has some more nutritious goodies for her to consume, too. Karin will need to take it easy at first to get her stomach used to food again, but she does need to get some good stuff in there to get stronger. They weighed her today and she is down to 103 lbs - that's a loss of 8 lbs in two weeks. She is still getting two breathing treatments a day for the bacterial infection in her lungs. Monday will be a dialysis day with visits from the occupational, respiratory, and physical therapists. When you are praying for Karin, please pray for Brandon, too, who has come down with a cold and sore throat and will not be able to be with Karin until he is gets over this bug. Also visiting Karin today with Aunt Marilyn were Uncle Bob, their daughter Melissa and her daughter, Mackenzie.

August 18, 2007 - 9:30 p.m.   Brandon writes: "Karin had a slow start again today. Her potassium was still low. I did bathe her and wash her hair. She did not even want to put on a designer gown. Then to our surprise, the Eckley's came from central PA to visit. We all went outside for about 45 minutes and enjoyed the lovely day (see the picture below). Bless the Lord for letting us enjoy those things in life such as close and caring, supportive friendships. Karin did three walks today. She sure is a speed walker. Her oxygen stats remain good. She did not use the bi-pap machine again last night. Karin made a few phone calls to Heather Eckley, her Mom, Dad & Hunter, and my sister Mandi. Everybody was surprised to hear Karin making the phone calls. We are going to call it a night ending with a movie. Love to All & Thanks for all the support! ~{;^)]  "

Lewis & Jodi, Kathy Eckley, and Mandy visit with Karin on the patio.

August 17, 2007 - 10:15 p.m.   Karin had a slow start getting out of bed this morning because her potassium was low, but once that was addressed she was raring to go. Great news! Karin passed the swallowing test today! She sure has worked diligently doing the throat muscle exercises every waking hour and it has paid off. This means after Sunday, she will be allowed to consume liquids and things with nectar-like consistency. She took three walks today in spite of the fact she had dialysis, too. She also played some games on the computer and devoted time reading your Post-a-Notes. Karin spent another day without oxygen and night without the bi-pap. These are big steps toward Karin getting released. Pray that Karin's lungs clear up of phlegm and mucous and that she will be able to cough up the loose stuff so the trach can be removed. Her transplant twin, Karen Arrowood, told her on Wednesday that she had to be able to stand on her own for five minutes as a prerequisite to being discharged. I am sure Karin will be working on that, too.

August 16, 2007 - 10:15 p.m.   Brandon reports that Karin had an all right night last night without the bi-pap machine so they will go without it again tonight. After an overnight rain cleared out some of the pollution and cooled things off a little today in Pittsburgh he decided to take Karin outdoors for a while. Since she is no longer on oxygen he was able to take her out without a nurse escort. (See pictures.) It has been a long time since Karin has been outside so it was a great adventure for them both. Tomorrow Karin is tentatively scheduled for another modified barium swallow test, however Friday testing schedules are often unreliable. Pray that she passes it. She has been doing all of her exercises with renewed zeal in an effort to strengthen all of her muscles and lungs. There has also been some discussion about removing her trach. The nurses seem to think it will be a lot easier for her to swallow and cough once it is removed. It is a hard call because it does enable them to be able to suction her lungs when coughing isn't productive. So that is another matter for prayer that they would make that call at the right time for Karin. Yesterday Karen Arrowood brought some frozen Popsicle style molds that Brandon said he is anxious to try once Karin is allowed to have nutrition by mouth again. He said it was especially hard to eat in front of her the last two days because she is feeling hungry and thirsty. Right now she is allowed only ice chips and the nutrition she gets through the feeding tube can't be increased since it makes her nauseous when they give her more.

August 15, 2007 - 10:45 p.m.  Karin has had an oxygen free day again today breathing only room air all day.   Last night she slept without the aid of the bi-pap and they will try that again tonight.  Karin was finishing up dialysis when Brandon called with tonight's report and it was a good session, but late.  Late evening dialysis seems to make getting a good night's sleep harder so they discussed the possibility of Karin going to the dialysis lab for treatment which might enable her to get treatments earlier in day rather than being scheduled for sessions in her room.  Being off oxygen completely would make that more practical also.  Brandon said Karin looked really good to him today after not seeing her for almost a week while he had to go home to take care of business.  Linda must have done an especially good job mothering, coaching, pampering and nursing Karin while she stayed with her the past few days.  Uncle Jack and Aunt Kathy also came by for a visit with Karin today.  Karin has also been anticipating today's visit from her fellow double lung-heart transplant friend, Karen Arrowood.  She and her husband Donnie traveled from Georgia again for another monthly follow-up.  She had some tests today and will have more tomorrow.  Brandon said he thought Karen A. looked really good.  Donnie said her appetite is returning and she is beginning to regain some lost weight.  You can see a recent family portrait in her blog (scroll all the way down to the bottom of her blog page).  Pray that she gets a good report again tomorrow and that she and Donnie have a safe trip back to Georgia.  Both "Special K's" would also want you to continue to pray for their organ donors' families who supported their loved one's decision to share the gift of life.

August 14, 2007 - 8:30 p.m.   Last night was an uncomfortable one for Karin.  Dialysis was cut short by 40 minutes because of a machine malfunction.  Total take was 1-1/2 liters.  Dialysis didn't end until 10:00 p.m. and shortly thereafter, she turned in for the night.  However about midnight, Karin awoke quite nauseous.  The nurse gave her medicine for the nausea, and she was fine for a short period of time.  She seemed to have a problem falling asleep and had a very hard time getting comfortable.  She mentioned that this happens when dialysis is so late in the evening.  Then shortly thereafter she awoke because her feeding tube leaked in bed  We changed everything.  She still seemed uncomfortable, so she asked to have the bi-pap cut short for the evening, stopping it about 3:00 a.m.  After that she did seem to sleep better.  So today started off slowly.  After she got up and bathed and into the chair, Gram & Pap Freund came over for a visit.  We took a walk the whole length of the hallway. The nurses came to take Karin to have her feeding tube unblocked.  She returned about 4 p.m., took another walk, and then laid down for a small nap.  We are now going to take another walk or two this evening before bed.  Respiratory therapy has said that they would like her to begin cutting her bi-pap sessions in half and then in a couple of days stop them altogether.  Karin has said that since she slept so well last night after the bi-pap stopped, she would prefer to try it tonight without bi-pap.  Respiratory thought that was fine and agreed that Karin is taking the necessary steps to get herself "outta here!"
     As I was finishing up this update, Karin asked if I could request that all of her family and friends also remember the newest additions to the family - Gage & Isabella.  She wants everyone to especially remember Gage in your prayers.  Brian (Karin's brother) & Kelly have found out that Gage (born July 30th) has a positive "marker" for Cystic Fibrosis.  This does not mean definitely that Gage has CF, it means that he could be a carrier or he could have it.  They are scheduled to go to Johns Hopkins on September 5th for more testing . Kelly & Brian have reported this week that Gage has gained 1-1/2 pounds and grew 1 inch since birth.  Their primary doctor said that his heart sounds great and lung functions are excellent.  She cannot definitively commit to a diagnosis, but says it looks good that he probably does not have CF.  She said most of the time you would know by now.  There would be signs and he would not be thriving so well.  Please pray for Gage, Brian & Kelly.
     Also, tomorrow is to be our visit from Karen Arrowood and we are so looking forward to it so very much.

August 13, 2007 - 10:00 p.m.  Karin's mother, Linda, writes: "Karin began the day by walking with physical therapy down the hallway.  The P.T. ladies were impressed how fast she walked and also that she was not on any oxygen when she walked.  We took another walk mid-afternoon without oxygen in tow again and Karin's oxygen level never fell.  This is a great indication that her lungs are getting stronger!  Dialysis was due in the afternoon, but never showed up until 6:30 p.m.  So right now, she is still being dialyzed and will continue for about another hour.  She is feeling fairly well during this session, but is still dealing with an increased heart rate and a little nauseous as we end the dialysis session.  She talked on the phone quite a bit today to various family and friends.  She was a little tired and at one point, when the phone rang she said "I'm not here".  That was a little of the Karin humor I saw return and it sure did make me laugh!!!  We had hoped to get in a few more walks this evening, but I'm sure that won't happen.  If we make it through dialysis, it won't be too long before we both turn in for the night. Thank you all for the prayers and support and hope everyone is enjoying a little bit of this lower humidity weather."

August 12, 2007 - 10:25 p.m. Karin's mother, Linda, writes: "Today was another one of those uneventful and routine but good days.  Karin went the whole day without oxygen again, and again she took four walks.  Aunt Marilyn & Uncle Bob stopped by to see Karin today and Aunt Marilyn brought me some home-made stuffed cabbage, real mashed potatoes, corn and rolls.  What a treat for me to eat something other than cafeteria food and as usual, the meal (as is any meal that Aunt Marilyn makes) was excellent. Karin read Post-a-Notes and played around some on the computer and we watched a movie or two on TV.  We also had the beauty shop open for business, which included a shampoo and curl!!  We are getting ready to settle in for the night and hopefully it will be a good sleeping night for Karin.  This Wednesday is when our friend Karen Arrowood comes in for a doctor visit and bronchoscopy.  We are so very much looking forward to seeing her and her traveling companion, whomever it may be.  Karen has such a positive outlook and has been such an inspiration to our family and Karin.  Safe traveling this week, Karen and we can't wait to see you!!! As always, please continue to remember the donor families in your prayers.  Believe me, when sitting here in this miracle hospital, I can certainly feel the prayers and good wishes that are being said daily for Karin. "

August 11, 2007 - 10:00 p.m. Karin's mother, Linda, writes: "Karin and I are watching TV right now.  She had a very good day today.  It started off a little slow by her sleeping in until about 8:30 a.m.  She actually slept from about 10 p.m. so she had a good night's sleep.  When she got up she seemed to be more rested and hasn't napped at all today. We bathed and put on one of Aunt Rosemarie's special "loungewear" outfits.  It is the green froggy outfit with velcro all down the side and she coordinated socks and shorts to match so she was stylin' today!   She and I then took a walk out past the elevators and turned around and went all the way to the nurse's station and back again.  Following that she did stepping exercises and throat exercises.  We waited about another two hours and took another walk and this time she decided to show off a little and had me push the walker while she did a "look, Ma, no hands" routine.  All told, we took four walks today and I'm working on #5!!!  She has been coughing a lot today but respiratory assured us that was a good thing.  Now for the big news......she has been only breathing room air today and has been off oxygen support since about 9 a.m.  Only when we walked did she have a little oxygen support. She is resting quite comfortably right now. Thanks for your prayers and cards and notes. Karin is definitely making progress."

August 10, 2007 - 10:20 p.m. Karin's mother, Linda, said that Karin managed to get in two walks today before dialysis began.  During dialysis Karin's blood pressure and heart rate went up so they cut the session short by one hour.  Karin's bronchoscopy results indicated the need for an antibiotic and they are still waiting for specific identification of the bacteria found in her lungs.  They still see indications of mild rejection in the lungs. Prednisone has now been added to Karin's list of medications.  Coughing in fits which cause her to be woozy continues to be a concern.  Since the MRA test which observed blood flow did not reveal any problems with the flow of blood under normal circumstances they are still at a loss to explain why this is happening when she coughs.  One theory has it that dehydration can cause this sort of thing to happen when extra pressure in chest during coughing spells causes blood vessels to collapse and restrict the flow of blood to the heart if blood volume levels drop too low.  Please pray that they can identify the cause and/or that Karin's cough clears up that this problem can be corrected.

August 9, 2007 - 11:00 p.m. Karin had a pretty good day today. She was able to complete several walks, one conducted by the folks from Respiratory Therapy. Karin has working diligently on her swallowing and throat exercises and someone who had not seen her for a while said she noticed that Karin's voice was indeed stronger. Way to go, Karin! We still do not know the results of the biopsy of her lung taken the other day, but the nurse came in this evening and hung a bag of antibiotic. We can only speculate at this time that they must have seen some signs of infection, perhaps the pneumonia, still lingering in there. She is coughing productively. As far as eating, she is still restricted to only ice chips by mouth right now, And as far as comfort is concerned, the air conditioning seemed to keep up today because it was not too humid and sticky in her unit.

August 8, 2007 - 11:30 p.m. In spite of this being a dialysis day, Karin managed to get in three good walks. Brandon said she has really been practicing her throat/swallowing exercises. Karin's nurse practitioner has been out sick so they do not know the results of the biopsy, however when they checked the right lung where the stenosis had been they said it looked good now. The air conditioning is still having trouble keeping up with the heat wave during the day, but the nights are more tolerable. After getting a beauty treatment from "Mr. Brandon," they called it an early night and went to bed around 10:30 p.m.

August 7, 2007 - 9:15 p.m. Karin was "wiped out" today. She was expecting to get her dialysis catheter replaced today because it had been clogging up since she is off the Heparin. They rousted her out of bed at 7:30 a.m. when patient transport showed up to take Karin, but it was for a bronchoscopy instead. They wanted to get another look at the recent "balloon" work they did to open her airway. Not sure if they took a lung biopsy at the same time or not, but a biopsy shows if there is any continuing sign of rejection. The results should be available in a couple of days. Karin did not get back to her room until 12:30 p.m. Brandon suggested that before putting Karin comfortably back into bed they check with the catheter people to see if it might be a good time to take her for that procedure. The response from downstairs was, "We are full-up today already." So Karin was put back into bed. Sure enough, it was only 10 minutes later when patient transportation came along to take her to have her dialysis catheter replaced! Karin returned to her room ninety minutes later, where she spent the rest of the day recovering from being sedated twice today. The weather in Pittsburgh is very muggy and hot and the air conditioning in the Cardio unit was not able to keep up today. Brandon said the A/C unit in her room is working, but it is still very "sticky" there. So Karin has been very thirsty today but can only have ice chips right now until her throat muscles get stronger and her swallowing improves (see yesterday's report below). So even though Karin has been wiped out a bit today, Brandon made sure she performed her special throat/neck swallowing exercises. A speech pathologist stopped by this afternoon to go over the battery of exercises with Karin and to coach her how to do them correctly. Grandma and Pap visited and also brought some clean laundry for Brandon.

August 6, 2007 - 12:45 p.m.  I am sitting at Karin's bedside at UPMC and Karin is receiving dialysis right now, but she is going to dictate today's report. From Karin's own lips ... "I want everyone to know that things are going good. I had a barium swallow test earlier today but I don't think I passed it because some stuff went into one of my lungs. So now I cannot eat at all until the results come back. I want to thank everyone for their thoughts and prayers and cards. I am looking forward to getting out of here by the end of the month." I assured Karin we will ALL PRAY that she is able to go "home" to her grandparent's house here in Pittsburgh by September 1st. By the way, if anyone has any of those old Tupperware popsicle makers, we could use them to freeze special treats for Karin. If you have some that you are willing to contribute to the cause, please contact Tim or Linda and they will let you know how you can get them to Karin. A staff person just delivered e-cards and we read them to Karin and she enjoyed them with many smiles. A speech pathologist came by to say Karin had some difficulty swallowing during the test earlier today. She even had trouble with the nectar-thickened products. They think is is just a matter of Karin not using the muscles involved for so long and they are week. So she give Karin and Brandon some swallowing exercises to do three times a day to strengthen her neck/throat muscles. Things like fake gargling, holding her Adam's apple and flexing her neck, doing chin tucks, vocalizing certain sounds, etc. They suspect it is just weak muscles that control the swallowing and these can be strengthened by doing the exercises. It won't take much to get her muscles in shape but she will have to give it some effort. So please add this to your prayer list. In addtion to Aunt Rosemarie and her Webmaster visiting today, her cousin Mike and his wife Angie are here from Ohio. (pictures in the photo gallery).

August 5, 2007 - 6:30 Karin had a visit from Aunt Rosemarie and Uncle Ralph early today before they went to a family reunion. Karin took a walk down the hall using a walker with wheels. She ate some sherbet and some applesauce, but then she had a coughing episode and produced some phlegm that got caught in her trach. When she finally got it up and out she said: "Man, that was a nasty loogie." We had an excellent chat with one of the respiratory physicians who did a marvelous job of explaining what the doctors are doing about identifying these episodes of coughing that cause Karin to pass out. They have not figured out why it is happening exactly, but they have a plan for identifying it. He told Karin to try to take a deep breath when she feels like she is going to cough and often that will suppress it from being aggravated. He also said that Dr. McCurry checked the results of Friday's MRA and said it did not reveal any abnormalities in Karin's arterial system. It is a great comfort to talk with these talented doctors who are caring for Karin. We will be posting more pictures of Karin walking with the walker later.

August 4, 2007 - 1:15 p.m. Karin had the MRA on Friday, followed immediately by a dialysis session to remove the contrasting dye agent from her blood stream. She said the MRA was uneventful, like having an MRI. We will not know the results until Monday or later. They did not do the modified barium swallow test to determine if she can have solid foods - that will likely happen next week now. Karin's Aunt Rosemarie and her Webmaster dropped in to visit from Ohio. Rosemarie made a new hospital outfit for Karin (see pictures in the photo gallery) and Uncle Ralph brought them three DVD's he made containing their wedding movies and some music that has special meaning for them. It is music they choose for their wedding day: "I Do (Cherish You)," "I Swear," and "Butterfly Kisses." Aunt Marilyn and Uncle Bob also stopped by to visit and bring Karin some of the tastier baby food treats for her to eat. Karin had taken some walks earlier, but because it was a dialysis day she rested much of the evening. Something to make a matter of prayer: Karin has been coughing up phlegm now and then, but it sometimes cannot get passed the trach, causing her to gag. Then this sometimes brings up whatever is in her stomach. Please pray specifically that her lungs settle down completely and permanently. Oh yeah, it was 95 degrees with 90%+ humidity - a typical hot, humid, and hazy August day in Pittsburgh - and the air conditioning on the 9th floor in Karin's wing of the hospital broke down! They finally did get it working again by evening.

August 2, 2007 - 10:00 p.m. Brandon reports that Karin was a bit tired today, probably because dialysis did not finish last night until around 11 p.m. However, she did get in 2-1/2 walks today. Additionally, they lengthened her oxygen line so she was able to walk from her room into the hallway and get weighed on the scale. She is down slightly to 111 lbs from 117 lbs earlier, but this compares to her pre-transplant weight of 146 lbs (she was on medications back then which favored retaining weight). Karin is scheduled to receive an MRA on Friday morning followed by dialysis to remove the contrasting dye from her system. Also scheduled for sometime tomorrow, Karin will be given a modified barium swallow test in order to determine whether or not she can tolerate swallowing solid foods - let's hope she can pass this test with ease. The liquid diet today consisted of yogurt and some lemon-lime sherbet. To Brandon's delight, he found another cot loitering in the hallway, so he is going to swap it with his current cot hoping the new one will be more firm and will give him a decent night's rest - the one he has been using is really "broken in," as they say.

August 1, 2007 - 3:30 p.m.  Brandon writes: "Today Karin is having a good day. She seems a little tired because she did not sleep well last night in spite of being on the bi-pap machine. Karin has taken two walks and is going for a third, and hopefully I will push for a fourth. Karin's kidney numbers are looking better. She has had to use the bathroom a little more. Karin and her nurse practitioner had talked about her kidneys and felt there is a chance they may be "waking up." She assured Karin that her output numbers are getting better and that she has seen it happen on a couple occasions before, even after this long of a period of time. I am trying to encourage Karin to drink fluids. To you and me 32 ounces does not seem like a lot to drink, but for Karin it is a start at increasing volume. She has been "producing more output" in the past two days than she has since transplant. Karin treated for sandwiches and cookies today for nurses, respitory therapists, physical theropy, and the doctor on 9th floor. I also took some cookies to the staff on 2nd floor CTICU. The picture of Karin I have included is from this past Sunday. She is wearing a new nightgown enjoying a lemonade shake. I picked out the nightgown, but everybody who has donated recently has contributed for it, Karin sends MANY THANKS `{:^)  I did save two peanut butter cookies to put in a blender with some ice cream for a treat after dinner. Hate to cut it short but Carol, a hospital chaplain, has stopped by to visit and pray with Karin."