New Year's Eve, 2007 - 7:45 p.m. Brandon reports this evening that Karen fell out of her chair, but apparently was not injured. It occurred during a "quite period" when visitors are not allowed in the unit, but he speculates she might have been leaning forward in the chair (like all of us, Karin likes to shift positions every so often) and lost her balance and tumbled forward. The nurse heard the commotion and was in the room immediately. They X-ray'd her from her hips to her toes and observed no damage, but she is bruised and sore. Understandably, Karin skipped her daily walk today. Her Critical Care nurse, Penny, told Brandon they intend to move Karin upstairs on New Years Day. He went upstairs to scout out rooms and announced himself to the nurses station as "Mr. Bordner, Health Inspector for Karin B." They all got a chuckle out of that. More good news today is that they got a good amount of fluid off during dialysis. Karin had been breathing with the trach mask since 6:30 this morning. Gram & Pap Freund visited Karin today and Brandon is invited to Kathy & Jack's Tuesday for a traditional New Years Day dinner of pork and sauerkraut.

December 31, 2007 - 10:45 a.m. On this last day of 2007, Brandon reports that Karin had a good day yesterday. She breathed on the trach mask for about 16 hours! When Brandon got there yesterday she was already sitting up in chair. The nurse had washed her hair and had put it in braids. At about 1:30 p.m. she went back into bed to have a full dialysis session which went well. Brandon and Karin had a quiet afternoon, then during the last visiting session about 8:30 p.m., Aunt Kathy & Uncle Jack came by to visit. They all became so engrossed in watching a mystery movie they stayed until about 11:30 p.m., then decided it was too late to phone in an update report for the web site. As we close the calendar on 2007 and start 2008, we are thankful to the Lord, and grateful for all of Karin's many supporters and caregivers, that Karin has successfully made it through many challenges these past 10 months. Let's hope and pray that there is continued improvement during the new year and that Karin will be able to return home as soon as possible.

December 29, 2007 - 6:00 p.m. Brandon reports: "Thank You, Lord! We received word today that Karin has no organ rejection and there were no signs of bacteria! Of course, she is still on antibiotics.! I am feeling much better so I decided to come to the hospital today. Good thing I did because I surprised Karin by catching her in bed. Needless to say I began the task of getting her up. She was glad to see me and I was glad to see her. I think since I was not around for two days she thought she could get away with some leisure time. I noticed when I got her out of bed she seems noticeably weaker in the two days I have been gone. I questioned Karin and she did not do any walking like we were previously doing at her bed side. Breathing with the trach mask is going good, along with taking some fluid off by dialysis. She was on the ventilator when I got here today and the staff said it was because the trial on the mask did not go so well. I think she knows how to make things look not so good, but since her dedicated personal care person is back on the job, she is doing fine on trach mask. I also asked CTICU if they would consult with Vascular about removing the stitches in her left arm, which have been there for about 5 weeks now. I do plan on getting her out of bed for a while after dialysis, and take her on a short walk to the entrance of her room and back to the chair. The Critical Care doctors told Karin if she does fine on the trach mask she could be moved upstairs by Tuesday. Of course, that is dependent on bed availability, too. I am looking forward to getting Karin upstairs and then back to the Rehab Unit. I know upstairs we have a little more freedom to work on taking walks and a leisurely stroll sometimes to the waiting room or even just to the hallway. Thank You all for your prayers and your continued support.   :-) "

December 28, 2007 - 9:45 p.m. After dialysis, which went fine today, Karin sat up in her chair for some time. She did not tolerate the trach mask very well, so she has been breathing on bi-pap instead. Brandon, who is still under the weather with the flu, called around 7 p.m. and talked to her nurse, Josh, who said Karin wanted to get back into bed. Actually Karen had wanted to get into bed since 5 p.m. but they wanted to keep her awake as long as possible. When they finally got her bedded down, she fell asleep immediately. Given that today is Friday and there is a long holiday weekend ahead, it is not clear when the results of her bronch/biopsy will be known. Furthermore, Karin will have to wean off the bi-pap again and be breathing with the trach mask all day before they will move her back upstairs to 9-D. Tim and Linda are scheduled to return this weekend, which will be a comfort to Karin since Brandon is sidelined with a cold.

December 27, 2007 - 9:30 p.m. Today marks TEN months in the hospital for Karin. They performed the bronchoscopy today at the Bronch Lab across the street at Montefiore Hospital, including a biopsy to assess whether or not there is any organ rejection. It will be a few days before the lab results are known, but they said things looked good visually, for which we thank God. Following the procedure Karin is resting while breathing on a ventilator. Karin received two units of blood and also had a dialysis treatment today. There is not much else to report because Brandon spent most of the day in bed at Gram & Pap's with a cold and the flu. He is staying away from Karin because he does not want to expose her to the bug while her immune system is suppressed by the anti-rejection medications.

December 26, 2007 - 7:30 p.m. Brandon reports: "Karin and I would like to thank everybody for their Christmas cards, gifts, and prayers over the holiday. Karin really looks forward to when the mail is delivered. I talked to Christina Calkins-Mazur and she gave me an update on repairing our van. Karin and I are also very grateful for those who helped to transport it and especially for helping with the finances to pay for getting it fixed. This morning I phoned the nurses station and told the nurse to tell Karin I was going to be later than usual. I felt better today, but not up to steam. When I got to Karin's room at noon they told me that Karin's bronc/biopsy was cancelled today. They said it was because of dialysis however as of 6:30 p.m. dialysis was nowhere in sight. Karin did sit in the chair today and is breathing comfortably using the trach mask. I am no "doctor" but I sure learned more than I ever wanted to, but I believe Karin is ready to go back up stairs to the step down unit on 9-D. We are just waiting for her bronc/biopsy because Karin usually does not bounce back on her stats too quickly."

December 25, 2007 - 11:30 p.m. Unlike the early hour at which many families arose this morning to see if Santa had come, Gram and Pap and Brandon all arrived at the hospital around 10:30 this Christmas morning to find Karin still asleep. The anti-rejection medications have a laundry list of side effects. Some of them can be pretty bad and Brandon said he's learned that what you don't get as a side effect from one medication, it seems you get from another. Diarrhea, nausea, and& sleeplessness are some of the prominent side effects and last night Karin experienced sleeplessness. She did not fall asleep until about 7:30 a.m. She finally awoke about 1:30 p.m. but still didn't feel well rested. Brandon helped her to freshen up hoping it would help her to feel more wide awake. She was breathing with the trach mask and they decided to watch a movie. She managed to stay awake through about half of "Christmas Story." She slept a good bit between 4:00 and 6:30 p.m., but did manage to be awake to visit with Uncle Jack and Aunt Kathy, who brought her special gift. Aunt Kathy pampered her a bit by applying some lotion which Karin finds very relaxing. Karen also enjoyed looking at her web site with Brandon today and particularly enjoyed the special Christmas touches and the cheery Post-a-Notes. Brandon was on his way home after 11 o'clock tonight when he phoned in this report. He mentioned that he is beginning to feel like he may be coming down with something --- a tickle in his throat, a runny nose, and some pressure on his sinuses. Brandon would really like to be on hand for the bronchoscopy and biopsy Karin has scheduled for tomorrow (Wednesday), but he doesn't want to needlessly expose Karin and others to any new germs, so please pray that he can shake this bug.

December 24, 2007 - 8:00 p.m. Karin had a pleasant Christmas Eve in spite of being in the CTICU. The bronchoscopy was cancelled when the doctor "called in sick." Karin was somewhat disappointed because a "clean bronch" would have meant she could move back upstairs - it would have been an excellent Christmas present for her. The hospital seemed to have lower than usual holiday staffing in general today, even in the CTICU. Tim and Linda had Hunter with them again when they visited today and the boy genius entertained everyone by playing Santa's helper. After Karin opened the first present, Hunter talked her into letting him open all the remaining presents for her. Aunt Rosemarie sent a Christmas stocking that gave Karin a real chuckle - it was full of gadgets she will need when she gets back to the Rehab Unit. Except for dialysis, Karin got out of bed and for a while she sat on the edge of the bed with her feet hanging over the side and was breathing with the trach mask all day. Visitors today included Aunt Marilyn, Uncle Bob, their daughters Brittany & Melissa, with her daughter, Mackenzie. Judy Brust Doby also visited and brought a card and book for Karin. Judy's husband is waiting for a heart transplant. Tim and Linda brought a gift for all the patients on the 9th floor - a hair dryer to replace the one that "disappeared" recently; Brandon took it upstairs and presented it to the nursing staff on 9-D. Putting a damper on the cheery holiday spirit in the CTICU was the passing of one of the patients with heart complications. She had been there about four months. Brandon had become friends with her husband, occasionally going to the cafeteria together, and Brandon will be in touch with him on Christmas day to express his sympathy and condolences. Brandon asks you remember him in your prayers. Finally, Brandon said Karin has been enjoying the many, many cards she has received for her birthday and for Christmas. The abundance of good wishes and personal greetings have lifted her spirits and greatly encouraged her as she passes the 300th day in the hospital. Thank you.

December 23, 2007 - 10:00 p.m. Brandon's teeth were beginning to chatter when he phoned in this report on his way out of the hospital tonight. He was surprised to find that the temperature in Pittsburgh had fallen more than 20 degrees since this morning and it was windy with flurries of snow swirling all around. Real Christmas weather! He said Karin had a good day with a bit of a late start getting out of bed, but making up for it later. She managed to walk to the door of her room and back to the front of her bed then back again before sitting in her chair for a while. Tim had dropped Linda off so she could visit with Karin first. He and Hunter then drove the trailer they used last weekend to tow Karin's van back to Burnham for engine work and returned it to Bill & Marguerite Schmidt before visiting Karin at the hospital, too. (Brandon & Karin wanted me to be sure to send the Schmidt's a special "thank you" for helping to get the van back to the dealership where it is being repaired, and for their other kind gifts this year). Karin was able to use her speaking valve for about ten minutes while her visitors were there today. There seems to be a problem possibly having to do with the cuff on the trach tube when she wears the speaking valve. Hunter, who Brandon described as the most advanced 2-year old he's ever known, got to gown up and see Karin for about 15 minutes. He told people he is "on a road trip to see Karin." One of the nurses on the unit brought in a DVD player so Karin got to watch the movie "Cars" and then "Radio" while on dialysis. Dialysis went fine with a removal of about 1.8 liters. Afterward, her heart rate was up a little and so she received a dose of Lopressor for that. This evening after dialysis Karin asked to sit up for a while and did so on the edge of the bed, dangling her feet off the side of the bed while sitting next to her dad. Brandon promises some candid pictures from today. There is a bronchoscopy and biopsy pending on Karin's schedule for Christmas Eve.

December 22, 2007 - 10:45 p.m. Karin had a fairly good day today. She was up and breathing with a trach mask around 6 a.m. and remained on the mask for most of the day. They did not want Karin to over do it, so they put her on the bi-pap machine for 90 minutes in the afternoon. She did use a speaking valve for about 2-1/2 hours, too. The dialysis session for fluid removal lasted 2 hours. Karin wanted to show off for the doctors during rounds, so she walked to the door then back to her bed where she did some marching in place. Anything to get herself promoted back up to the 9th floor. Brandon washed her hair then Karin made him go up to the 9th floor, where they have her belongings stashed, to get the jar of Aunt Rosemarie's custom blended skin cream so Brandon could pamper her with a deep skin massage. Karin's respiration numbers look good, but they will not really know if they have knocked out the infection of diphtheriods until after the bronchoscopy and biopsy now scheduled for Monday at UPMC Montefiore. Please pray for good results. Thank you.

December 21, 2007 - 7:10 p.m. Brandon spent the night on the couch in the CTICU waiting room because he wanted to be there in case they did the bronch and biopsy on Karin early today. However, it had to be postponed again because Karin's PTT levels were still high (indicator of how well her blood can coagulate). They are reluctant to give transplant patients too many blood products so additional plasma was not an option and Karin was also scheduled to have dialysis today. So the bronch will be rescheduled most likely for Monday. Karin was sitting up in her chair and back on her trach mask early this evening when Brandon left for quiet time on the unit. On the lighter side of things, Kevin Speiglemeyer stopped by this morning to visit. He is a friend who lives on the top of the mountain near Brandon's parents. When he arrived he was wearing a Santa hat and he brought a comical Christmas card. It was a welcome diversion for Karin and Brandon to visit with him. Brandon also mentioned that Karen Arrowood, heart-lung transplant recipient and dear friend from Georgia, needs prayer. Even though she is out of the hospital and at home in Georgia, Karen is not out of the woods yet. She faces a surgical procedure to address a liver problem she is having post-transplant. She longs to spend Christmas at home with her husband and two little boys, so please pray this doesn't prevent her from doing that. Thank you.

December 20, 2007 - 7:00 p.m. Brandon reports from the CTICU that Karin did not have the bronchoscopy today but will have it tomorrow (Friday). The reason is because her Heparin levels were too high. They administered four units of plasma which will help to bring her PTT levels down (indicator of how well her blood can coagulate). That's also getting four bags of extra fluids so they performed dialysis to remove some of the excess fluid. Right now Karin is receiving some form of dialysis every day but Sunday; on Tuesday-Thursday-Saturday they just pull off fluid without detoxifying Karin, and the detox dialysis is done on Monday-Wednesday-Friday. Karin is feeling better today and is more awake. She has been breathing with a trach mask since 2 p.m. and has been sitting up in the chair since 4 o'clock. Brandon spoke with Dr. Murray today hoping to get some answers as to why this bacteria keeps coming back (see yesterday's report), but there really is not a clear, certain explanation. Gram & Pap Freund visited today.

December 19, 2007 - 8:00 p.m. Brandon reports from the CTICU that Karin had dialysis today and it went alright. One of the cultures taken from her lungs indicates that she has diphtheroids (but we don't know which of the variants it is, i.e., it could be C. pseudodiphtheri´ticum, a nonpathogenic species present in the respiratory tract, or it could be another of the Corynebacterium) which they are treating with Tigecycline. Brandon has been making sure all the new staff attending Karin are aware she is not to be stuck in the area of the new fistula. Brandon said that when he goes back into the CTICU tonight he will try to get Karin to sit up in a chair for a while. She has been more awake today. Karin is scheduled to go to the bronch lab tomorrow for a biopsy and a bronchoscopy and a good look at the stenosis where her new lung was sutured into her airway. Brandon plans to accompany her so he can speak personally with the physician who will perform the procedure. Karin's attitude today was so-so until she received a birthday card from Brandon's Uncle Brad which said, "Happy Birthday! You deserve it . . . you've survived darn near everything!" and it cracked her up when she read it.

December 18, 2007 - 8:00 p.m. Brandon reports that Karin is being moved back into CTICU where she has been assigned to Bed #2. Karin was supposed to have been transported to the bronch lab for a bronchoscopy procedure today, however they thought is was too risky to move her so they decided to perform it at bedside instead. Karin had been breathing with the aid of the bi-pap machine all day, but has been having increasing difficulty with sleepiness and barely able to keep her eyes open. Dr. McCurrey, her transplant surgeon, stopped in and ordered testing to determine whether the bacterial infection is being resistive to the more aggressive antibiotic she has been receiving. Blood, sputum, and urine samples were taken and one particular sample was taken from an artery in her wrist in order to read her blood gases. This revealed that her CO2 (carbon dioxide) level is elevated - her lungs are not expelling it as they should. This is probably what is making her so tired. Dr. McCurry concluded she should be back on a ventilator and that is why she is going back down to the CTICU. Brandon advised Gram & Pap Freund not to visit today, however Kathy and Jack did visit earlier. It has been a rather exhausting day for Brandon and Karin - he fell asleep sitting out in the hall reading a "women's magazine" his sister sent for Karin, and the staff just let him "crash" out there. This is not the direction we were hoping to see Karin take, but the important thing is to make sure the bacteria is completely destroyed and Karin's new lungs are able to function perfectly again.

December 17, 2007 - 9:20 p.m. Brandon got a late start returning to Pittsburgh today and found Karin doing well when he arrived about 3:30 p.m. Karin had walked already and had been sitting up in the chair. She had a dialysis session today and by early evening she was napping - she lipped that she had not gotten much sleep the night before. Brandon brought six weeks worth of mail back with him so he has plety to keep himself occupied while Karin naps. He said they have been trying to keep her awake during the day to get her days and nights re-established, but he said you can tell that she was really tired so he was letting her catch a few winks while filing this report. Brandon seemed to really appreciate having a chance to look after things at home for a day in spite of there being a power outage because of an ice storm. There was no electricity, no heat, he could not even take a shower, and laundry had to be postponed . . . but it was still HOME where he could sit down at a kitchen table to eat instead of hospital food caught on the run in a cafeteria, etc. We can't wait until Karin gets to go home, too. We are not sure if the bronchoscopy is still scheduled for tomorrow (Tuesday), but please pray things will go well when it is done. Thank you.

December 16, 2007 - 7:20 p.m. Tim dropped Karin's van off at Christina Calkins-Mazur's dealership in Burnham, PA. this morning to have the needed engine work taken care of this week, and Brandon drove to Tim and Linda's to drop off his truck and pick up Linda's jeep to take back to Pittsburgh. Brandon ate dinner with Tim and Linda then traveled back home to Mechanicsburg for the evening and will drive to Pittsburgh in the morning. He wanted to do some laundry if their power comes back on! They didn't get the snow they were expecting but did get ice that caused power outages. Aunt Marilyn was unable to visit Karin today because of the snowy weather in Pittsburgh so at 7 p.m. Brandon called the nurses' station to see how Karin did today. Jerry reported that she had a restful day and spent some time sitting in the chair and took a short walk but mostly rested. He did note that she only requested pain medication twice today. We noticed over the weekend that Karin seems to have her nights and days mixed up and the nurses agreed so we hope to try to get her back on schedule, but we also realize that some of this may be intentional on Karin's part. We think she feels more comfortable dozing when family is in the room during the day and a little reluctant to sleep through the night. She did have a happy birthday and enjoyed all the company, presents, and greetings!

December 15, 2007 - 10:30 p.m. Karin's mother, Linda, reports: "Tim and I were first to arrive at the hospital this morning and the dialysis nurse was there getting Karin ready for a 2-hr fluid removal session.  That went pretty well.  It was cut short by about 15 minutes as Karin was feeling a little dizzy, but they were able to remove about 1.7 liters of fluid.  Brandon, Brandon's mom & dad, Pat & Jack, Brandon's sister, Kelli, and Kola all arrived within minutes of us.  We visited with Karin during her dialysis session.  Brandon & family headed out about 2 p.m. back to Mechanicsburg.  They were hoping to beat the bad weather and they accomplished their mission.  Tim left next and met up with Uncle Jack.  They were able to borrow a car trailer and they loaded up Brandon & Karin's van and we transported it home.  Tim will deliver it to Karin's good friend Christina Calkins-Mazur dealership in Burnham, PA. for the much needed work on the engine. [See reports from Dec 10th & 12th]  Before I left Karin this afternoon, I was delighted to be able to give her a little more TLC in the form of hair washing.  She seems to relax quite a bit when getting her hair shampooed.  I got her situated comfortably watching a little TV.  Pray that she has a smooth couple of days until Brandon returns on Monday night.  The nursing staff was so wonderful telling me that they would keep a watchful eye on her and check on her often.  I know that they do this as a matter of their routine anyway, but it made me feel better leaving her."
   

December 15, 2007 - 2:00 p.m. Brandon's Report of Karin's 32nd Birthday: When I arrived at the hospital, Karin was already enjoying a visit from a therapy dog. This caused her to be bright-eyed and eager to get the day started. I had asked her if she would like to put on a nice gown after I had given her a bath. She lipped that she wanted to wear her Mickey Mouse bed pants and of course it took me three times to understand that because I thought she wanted a bed pan. So we both got a little laugh from that. She had a Mickey Mouse shirt on with her walking sneakers on. After getting her dressed for the day, Karin had a visit from Occupational and Physical Therapy. Part of her therapy was opening a gift from the two young ladies that help her in her daily walk. The box contained a snowman tea light and a Santa Claus sun catcher. She then proceeded to take her walk towards the nurse's station and beyond. She took a look at her poinsettias and a bunch of balloons that were delivered for her from Bill and Marguerite Schmidt. Once settled back in her chair the staff came and sang Happy Birthday and presented her with a cake and some gifts. Gram and Pap showed up just in time to join in the singing and watch as Karin opened her gifts from the staff,, which was a calendar, a hardback book about dog breeds, and several bookmarks placed appropriately in the pages describing the Irish Setter and the Dachshund. Tim and Linda had arrived around 1:30 p.m. bearing gifts from friends back home. Shortly after, I went to meet my parents and my sister Kelli outside so I could get Kola and bring her into the hospital. Karin was happy to see her but the first thing she had lipped was that she was fat. I guess Kola is eating good with our nieces around. After opening a few more gifts, Karin was ready for a snooze. So I decided it was good time to go pick up a cake I had ordered earlier in the week and some pizza to take back for dinner. When we got back to Karin's room it looked like Tim and Linda had gotten some nap time in, too. To our surprise we had a visit from Tammy Crawford from Williamsport. Tammy had two liver transplants seven years ago that occurred two months and two days apart. Tammy knew of Karin through her daughter who worked with Karin's cousin, Melissa, at PNC. Her husband Rich, and soon to be son-in-law Jamie, had accompanied her. It was nice meeting Tammy and family, and knowing she is doing well. Tim's cousin Jeannine Space and her husband Rich stopped by and brought Karin both a birthday and Christmas gift. Jeannine's father, Tim's uncle George, recently passed away and the family requested that in lieu of flowers, donations be made to a local Lions club. We told Karin the Lions club then decided to pass these substantial donations on to her fund at the NTAF. This brought a tear of appreciation to Karin's eye! Other visitors, all bearing gifts, included Uncle Bob, Aunt Joni, Uncle Jack,Aunt Kathy, Uncle Bob, Aunt Marilyn, cousin Mellissa and her daughter Mackenzie. They started a dialysis session around 8:30 p.m., so all and all Karin had a very good day and enjoyed all the visitors, calls, cards and gifts she received from too many people to mention for fear of forgetting to mention someone. Our deepest thanks to each and everyone who made this a very special and most memorable day for Karin. (See birthday pictures in the Photo Gallery)

December 13, 2007 - 8:45 p.m. Karin had another good day. She spent some of it sitting up in a chair. Her blood is running a little thin today so they decided not to have her walk. She is on Heparin to prevent clots from forming while she is less active right now. Because tomorrow is her birthday Karin would like to be talking. So they discussed putting her custom trach or her speaking valve back in today but it was decided to postpone replacing the trach until after she has a bronchoscopy on Tuesday. The reason is that her custom trach would have to be removed again in order to do the bronch. Respiratory may try putting a speaking valve on the trach she currently has tomorrow. But her lungs need to be clear for them to do that and today they were still a little congested. Behavioral Services sent someone in to interview Karin today. As a result they will probably up the dosage on her anti-depressant medication and will try to arrange for her to get some visits from a therapy dog and the massage therapist. The manager from the Credit Union where Karin once worked sent greetings today along with a stuffed rabbit. Not to be outdone by the "Easter" bunny, Santa sent some goodies, too, including a Birthday Bear, an angel trinket, a book "God Thinks You're Wonderful!", a Willow Tree ornament "The Birthday Girl", and an authentic letter from the jolly elf himself. Yesterday Mrs. Acosta, Myra's mother, also brought a poinsettia and some chocolates for Karin to enjoy later. Looking forward to when she can eat & drink again, Aunt Pat also sent Karin some medicinal ginger and lemon herb teas which are very effective for sore throats and upset tummies. Candied ginger was sometimes the only thing which gave Karin some tummy relief prior to the transplant. So it's something Brandon has been wanting to have on hand for when Karin begins to eat again. Tomorrow is going to be a big day for Karin and he says they have talked about the need to pace her so she doesn't get too tired. Pray that Karin has a wonderful 32nd birthday without getting overly tired.

December 12, 2007 - 9:45 p.m. Brandon phoned in today's report as he was catching the second of two buses he has to take to get home from the hospital. In fact we even talked after he got off the bus and walked a mile from the bus stop to Grandma & Grandpap Freund's house. There are some serious problems with the engine in the van and it is supposed to go into the shop over the weekend, thanks to dear friend, Christina Calkins-Mazur and her husband, who will have it checked out at their dealership in Burnham, PA. (They have been supporters of Karin and Brandon for many years). Now to Karin . . . she had a sleepless night. This is most likely a side effect of the Prograf anti-rejection medicine. Karin was so tired she could hardly keep her eyes open when Karen and Donnie Arrowood came to visit this morning. Karen A. is back for a routine, periodic bronchoscopy and biopsy scheduled for tomorrow. Karen A. brought our Karin presents for Christmas and for her birthday this Friday, including a personalized oversized handbag for when she is discharged. (I think we might have some pictures for the web site in a few days). Brandon said Karen A. looked terrific and he told Karin to take a good look at her because she would be doing just as well some day. Karin did sit up in her chair for a while before dialysis came in, then again after dialysis, when more visitors arrived. Mrs. Acosta, from Lewistown, came by with her daughter Myra and her two young daughters who live in Pittsburgh. The younger girl was born the night Karin received her new heart and lungs, and Karin was notified of the birth via cell phone while she and Brandon were driving to the hospital for the transplant. By this time of day Karin was caught up on her sleep, more alert, and really enjoyed the visit.

December 11, 2007 - 11:00 p.m. Hallelujah! Karin walked 120 feet today!!! She was up and in the chair when Brandon got to her room this morning. He said Karin was sending him the look which said, "Okay, now get in here and please show them how to make me comfortable" look. He said the nurse explained that she was having so much trouble getting Karin arranged comfortably in bed last night that she almost called Brandon at 4 a.m. to ask him for the secret. Brandon said there was one special nurse early on who was the only one who had the key to getting Karin in a comfortable position. So he just watched her very closely until he figured it out too. Right now Karin is mouthing requests or instructions but her lips move so fast it is hard to lip read, so communicating can have its challenges for Brandon and the nurses. Infectious Control made some recommendations for treatment of a bacteria that has begun to grow in cultures taken several days ago. It is a bacteria in the lungs which they have seen before and treated before but they will try a new more aggressive antibiotic to try to kill it this time. Dialysis gave Karin a two-hour treatment today just to remove fluid. Tomorrow will be a regular dialysis day. Karin did not have her usual Tuesday visit from Gram & Pap Freund today, but she received several fun packages in the mail. The 5th graders at Hillcrest School in Tennessee sent her a package filled with handmade greeting cards. Karin really got a good chuckle out of some of them. Another package contained a Boyds Bear a gift from a radio station in Karin's hometown. Jodi Eackley Sadler had sent the station a letter telling them about Karin. They forwarded the letter to Karin along with Bear Hug Bear. Karin really ap

December 10, 2007 - 9:50 p.m. Karin had another decent day. When she awoke this morning she requested help to get out of bed and into her chair. This was really good to see her initiate getting into the chair, instead of being coaxed. She remained in her chair for quite a while, breathing through a trach mask. Again later this evening around 7:30 p.m. she wanted to get back into the chair just as dialysis showed up to begin today's session. They are using the new tunnel catheter with good success. Karin's Nurse Practitioner has been talking with Dr. McCurry and the respiratory physicians who do Karin's bronchoscopies about the possibility of installing a stent at the site of the stenosis in her right lung. A stent would reinforce this area where the new lung was sutured into Karin's body and tend to hold that passage open. Karin had a courtesy visit from Dr. Ferson today (tracheostomy doctor) who just wanted to look in on Karin to see how she is doing. Brandon went to pick up his van after the thermostat was replaced and the van barely ran - in fact, he had trouble moving it in the lot. It still needs a new head gasket. Brandon did receive very grateful news today from friends who said they, and a small group of friends, are going to chip in to help cover some of the expense of getting the van's engine repaired so Brandon has "wheels" again.

December 9, 2007 - 7:50 p.m. Karin had a pretty good day, but she was pretty sleepy. In fact, she dozed off while sitting up in her chair, so Brandon traded places and he caught a 45-minute nap lying in her bed. The pain medication is most likely what is making Karin so sleepy, but she is using less and less of it and has begun moving her left arm a little bit more. Brandon is hoping that Karin will be able to do some walking on Monday, which is the day each week for setting short-term goals for the week. Karin's long range goal is to get back into the Rehab unit. Tapering off the pain medication is good because getting off the pain medication and being more alert means she is better able to accomplish the tasks needed to get to Rehab. Karin seemed to especially enjoy watching Brandon decorate a 2-ft high Christmas tree he brought in today. She is still very much in a Christmas and birthday mood and is determined to celebrate both as best she can in spite of being in the hospital. Brandon received some unpleasant news today about their van that he has been depending on to get back and forth to the hospital. The reason he has had no heat in the van is that the engine has "a blown head gasket." If anyone feels led to assist in meeting the $1,000 expense to have it fixed, I am sure any help would be most welcome and deeply appreciated.

December 8, 2007 - 6:00 p.m. After a rough night, Karin had a much better day today. She continued to complain about being short of breath during most of the night. They performed another bronchoscopy on her last night but did not find anything really significant. Again, the area in her lung where she has some stenosis was discussed (this is where her new lung is sutured to her old plumbing). Because Karin ran a fever last night they took some sputum samples to culture to rule out any infection. They also put her on Lasix to encourage her kidneys to remove more fluid from her body, and it is possible they will do another dialysis today to remove additional fluid. Brandon spent the night in the room with Karin because she was so distressed, and he reported that she finally fell asleep about 6 a.m. this morning and slept until about 10 a.m. Karin stayed in bed most of the day. Some good news is that her oxygen level is now at 97% and her heart rate is now down to 115 bpm, more than 30 points lower than it was yesterday.

December 7, 2007 - 9:20 p.m. Karin had a rough day today. She has not rested well. Her heart rate has been elevated so they have given her Lopressor and it seems to be bringing her heart rate down slowly. She has had to be suctioned with unusual frequency today, but they gave her an EKG, did blood work, and x-rayed her chest and everything was fine. Karin did spend some time sitting in the chair today and tried walking to the door, but Brandon said that as her was putting her back into bed, it was almost as if she could not hold her own weight. She just does not seem to be herself today. Karin is having dialysis right now using the new tunnel catheter she received yesterday and we are praying that they can get a quantity of fluid removed so that it will bring down her hear rate.

December 6, 2007 - 7:30 p.m. Karin was taken to Interventional Radiology at 7:45 a.m. where they moved her pick line to her right groin because it could not be moved to her right shoulder. While she was there in I.R. they also gave her a new tunnel catheter, which went into her left groin. All of this was done without general anesthesia by using only a "local". Karin was back in her room close to 12-noon. Needless to say, she is sore and has been taking pain medication every time it is offered. There is some light bleeding, so Karin has been resting comfortably in bed the rest of the day. The girl is a sight with both arms wrapped in gauze and big bandages on the tops of both legs. Fortunately the nausea is under control. She does not have the speaking valve connected and is using the trach mask for breathing assistance. Karin received a huge surprise package in the mail today. It contained a stuffed bear from the Sheriff of her Arizona Prayer Posse. It was specially created just for Karin at a Build-A-Bear Workshop and it bore a note: "Someone in Arizona Loves You!" Karin and Brandon were very touched by this thoughtful, uplifting gift. They are so encouraged when they receive mementos like this reminding them there are people out there who are indeed praying for them and thinking about them. On a chilly note, a record low temperature of 7 degrees was set for Pittsburgh last night, and it occurred when the heat is not working in Brandon's van. Fortunately, Uncle Bob is going to take the van to the shop where he works and try to fix it over the weekend.

December 5, 2007 - 8:15 p.m. Our tough little Karin walked about 80 feet today!!! Physical Therapy had her using a walker and it was a struggle for her, but she did it. Karin's pick-line has been a problem to those who need to draw blood so the next procedure Karin will probably get will involve that. She will probably be taken to I.R. (Interventional Radiology) so they can put in a new line within the next day or two. Dialysis began about 7:15 p.m. tonight so it will be about 10:15 before they finish. But Karin couldn't wait to get to sleep! When Brandon phoned in this report about 8:00 p.m. he said she was already sleeping through dialysis at that time. In fact, he said with the stomach ache and pain medication for her arm where they surgically made the new fistula she has been sleepy and very hard to motivate the last few days. Saturday was actually the last day she was wide awake for most of the day. She is drug-tired mostly, but understandably says she is just feeling downright "tired of it all" right now. Yet she continues to tough it out. By the way winter weather lovers: Pittsburgh got about 2 inches of snow overnight and expects temperatures in the teens tonight. The thermostat on the van is broken and so Brandon is driving without heat right now. (Uncle Bob is going to work on it some more tomorrow. Prayer request is for a good repair/replacement.) Meanwhile Brandon said when he arrived this morning his hands were so cold he couldn't touch Karin for a while until they warmed up to room temperature. Brandon had hoped to find Karin already up in her chair because it was about 10:30 a.m. when he got there, but she was still in bed. He said it didn't surprise him because the floor is operating about 4-6 nurses short and that is when no one calls in sick!!! It seems some nurses have moved and others have transferred recently and replacements are in short supply. Since it takes two people to help Karin out of bed she often doesn't get moved in the morning until he can help when he gets there. We really need to pray a blessing for the dedicated nurses who work in understaffed circumstances and for more skilled nurses to fill this shortage. We are so very grateful, too, that Brandon has been so faithful in spending each day right there with Karin as her advocate, helper, and encourager.

December 4, 2007 - 9:30 p.m. When Brandon arrived at the hospital today they had just put Karin back into bed. She had just returned from having doppler ultrasounds done on both arms, The doppler ultrasound lets the doctors check the new fistula area and other blood vessels for possible blood clots. Praise God, the vascular specialist came in later to report that everything looked fine! When Physical Therapy came in just after she got back into bed Karin was not excited getting right back out of bed to do any walking. P.T. agreed to return after lunch instead. When they did Karin walked to the door of her room and back and said she felt "all right -- that it was good!" So tomorrow they will plan to do some more walking. This is another big step for Karin (no pun intended). It has been several weeks since she has walked except for the few steps she has taken to transfer from bed to chair. Gram & Pap Freund visited despite the snow flurries. Karin's tummy is still upset but they have put her on Haldol, which is usually used for psychiatric patients, but in low doses it has been found to be effective in alleviating nausea. Actually it is a medication she has taken with successful results before, so pray it works again. Karin certainly has taken more significant steps in the right direction today. Please pray she can continue to make progress, move back into rehab at Montefiore to rebuild the strength she needs to leave the hospital and to go home.

December 3, 2007 - 9:30 p.m. Brandon reported tonight that Karin had a pretty good day, however her stomach continues to bother her. They give her medications to keep it from being up too upset but it still aches. Nevertheless she did spend a short time in her chair today before starting a dialysis session. The session was cut short because the system clotted up twice. So she got in 3 hours instead of 3-1/2 hours and 1 liter of fluid was removed. Karin received 2 units of blood and some iron today also. Brandon said they take so much blood out of her every day she deserved to get some back. Seriously, they take two 12 cc samples at a time for testing and she loses some to dialysis, so eventually it does seem like she deserves a refill. She has had the speaking valve in since 11 a.m. today. They are waiting to see how well she does with it before setting a date to replace it with her custom mini-trach. The Haven Heights United Methodist Church Sunday School students surprised Karin today with some wonderful mail. Karin loved receiving the cards and paintings children sent her. This evening Karin was feeling sleepy after watching from her window some snow flurries blanket the Pittsburgh rooftops. She will probably be asleep before this is posted and we pray that she gets a good night's sleep. Brandon is anxious to get Karin to take a few steps in the room tomorrow. So please pray she has some more relief from this stomach ache when she awakens and that tomorrow will be another day of significant forward progress for Karin.

December 2, 2007 - 8:20 p.m. Brandon got Karin out of bed at 11 a.m. and put the speaking valve on her trach tube. Tim, Linda, and Hunter returned again today and visited with Karin until around 1 p.m. before having to head back home. Their visit yesterday and today pretty much wore Karin out and she was tired today. The vascular surgeon returned again today to check on the new fistula he made for her and was satisfied she has feeling in her fingers and is able to move her left arm a little better today. They also did a doppler ultrasound on the fistula. Karin has been squeezing a foam hand exerciser (in the shape of a cow) to promote strength and circulation in that arm. They put Karin back into bed at 7 p.m. since she was feeling tired and she was not sure if she could stay awake long enough to watch the Steelers on Sunday night football. Brandon hopes to get Karin back to taking daily walks starting Monday, and they are still planning to reinstall her custom trach later this week. If/when that happens, Karin will be able to take nourishment by mouth again.

December 1, 2007 - 8:40 p.m. Brandon reports this evening: "When I arrived at the hospital, Karin was still in bed. When I asked why she was still in bed, she lipped that her stomach was upset. I could not convince her to get out of bed, put on an outfit, or even get her hair brushed. Her Mom & Dad (Tim & Linda) arrived around 2 p.m. with grandson Hunter. We all tried to persuade her to get out of bed. She still had an upset stomach. After receiving medicine for her upset stomach, we finally got her out of bed by direct order of her nurse. After sitting in the chair for a while, Respiratory showed up and put her speaking valve on. Karin has not been able to utter a word since her trach was changed out in the beginning of November. Hunter was very surprised to hear her voice. It is about 8:30 p.m. and Karin is still in her chair along with her speaking valve connected. If you remember reading in an earlier update, Karin was only able to speak her name and date then had to remove the speaking valve. She got winded back then, too. Today she has been using the speaking valve for 4 hours and is still going strong. Hunter entertained us all and put many smiles on Karin's face. Hopefully tomorrow she will do even better than today using the speaking valve."