January 31, 2008 - 8:30 p.m. Brandon called this afternoon to report that Karin was moved back down into CTICU this afternoon to allow her to continue using the bi-bap machine during the day and to be monitored more closely. She had been experiencing an increased level of discomfort breathing with shortness of breath since the bronchoscopy was performed on Monday. So they did another "bronch" at her bedside in CTICU today to rule out any bleeding, which can sometimes be caused by an examination of her lungs. However they did not see any bleeding and no serious mucous plugs. They also feel as if an excess of fluid could be contributing to her shortness of breath but they were unable to remove much again today because her blood pressure began to drop a little low during dialysis. Oddly her oxygen levels seem fine but her heart rate rose to between 145-146 bpm. It has dropped back down to about 137 but her legs are restless and she is not feeling especially comfortable yet this evening. Tim and Brandon indicated that they are still awaiting results from the biopsy done on Monday, and even though the report on the sputum sample is incomplete, the lab reports seeing evidence of something beginning to grow that has yet to be identified. Pray that Karin gets the care she needs to be able to pull out of this slump. Pray also for Karin's grandfather, Rege, who remains at UPMC Southside. Brandon called again this evening to report Karin is in Room #1 in the CTICU. Vacuolar is supposed to perform a doppler ultrasound on her arms tomorrow (Friday). And because all the lab work and tests have come back negative up to now (show nothing conclusive) they have ordered an echo cardiogram to take a look at her heart to see if perhaps it might be contributing in some way to Karin's breathing issues.

January 30, 2008 - 8:30 p.m. Brandon faced a cold start this morning when he awoke to find the power off at Gram & Pap Freund's house. He said the 56-degree temperature was the result of some very high winds causing power outages. When he arrived at the hospital, Karin had already received a bronchoscopy at her bedside. She had been complaining that she was short of breath and her breathing was labored. She was running a temperature of about 100 degrees with her heart rate elevated to 120 bpm. Bleeding can be experienced after the kind of "bronch" procedure she had yesterday, so this one was done in order to rule that out. Although Karin's oxygen levels measured OK, she has been very tired and her her lungs looked little wet inside. Brandon thinks this may be caused by the additional two units of plasma she received yesterday, while dialysis only removed 800 ml of fluid. She did receive another unit of blood today and had a good dialysis session which removed about 1.6 liters. Karin was up out of bed for a while this afternoon while hooked up to the bi-pap machine (to rest her lungs today) until after dialysis. She does seem more comfortable, but basically she has had a day of rest. Karin's nurse was able to procure two more pillows for her, so that adds to her comfort. They are still waiting for the results of the bronchoscopy and biopsy done yesterday, nevertheless her custom trach is tentatively scheduled to be reinsert on Wednesday of next week. Vascular stopped in today and they would like to perform a doppler ultrasound re-map of her arm and fistula. They mentioned the possibility of putting in an artificial fistula. In fact, they called three times today for Karin to come down for the mapping, but the staff on the floor did not think she was stable enough to be moved right now. Brandon anticipates they will also be relocating her I.V. "pick line" and her dialysis tunnel catheter again. They are considering putting them in her abdominal area because they do not want to put them in her groin. Ellen, Karin's psychologist, visited and practiced some "relaxing" techniques which required Karin to think of being in a calm and comfortable place. Karin said she visualized herself being at home in her living room relaxing in a comfortable chair. Brandon found himself caught up in the whole procedure and fell off in a trance and Ellen had to snap him out of it. After a good laugh, everyone agreed he needed it as much as Karin did!

January 29, 2008 - 8:15 p.m. Karin received two units of plasma this morning before going to the bronch lab around 2 p.m. for a bronchoscopy and biopsy. While she was there they cleaned some "junque" out of her left lung and they ballooned open the stenosis in her right lung (this is where her new right lung was mated to her existing plumbing). Brandon said Dr. Cresbo showed him pictures taken before and after and he said it made a 100% difference. This is the third time she has had a balloon treatment on that stenosis so Brandon discussed with Dr. Cresbo why don't they just put stent in there. This is something she will discuss with Dr. McCurry, Karin's transplant surgeon, but the bottom line is there are some good reasons why they are hesitant to insert a stent. The reason for the unscheduled bronchoscopy today is related to the fact that yesterday Karin was having some very thick secretions and her oxygen stats were dropping all day. Her oxygen levels usually run 97% or better but they were ranging between 90%-94% and she seemed to be getting a little fever. So they made a decision to get a look inside today as early as possible. Karin had a local anesthetic for the procedure so she is pretty much drugged and is sleeping it off right now. Brandon noticed while we were talking that she lost two pillows while in recovery - pillows he has faithfully guarded since November (pillows are as scarce as hens' teeth in the hospital). Brandon expects they will put her on the bi-pap machine for the evening, but she still has not had dialysis. which also means Karin has not received all of her meds today. Chaplain Rebecca from Pastoral Care stopped by while Karin was out of the room and she left a nice note for Karin.

January 28, 2008 - 9:30 p.m. Karin slept until noon today, then she spent some time sitting up, then she took a walk of 150 feet. Chaplain Carol and Karin's psychiatrist, Ellen, both visited this afternoon. Karin was back into bed by 6 p.m. Dialysis arrived about 7:30 and they were still working on her when Brandon left. The medical staff did a sputum sample today to make sure her lungs are clear, but it will be couple of days before any results are known. Everyone is invited to the spaghetti dinner fundraiser being conducted by Paul Baumgardner and Scott Leiser will be held at the First Christian Church, on the corner of So. 5th & Hummel Avenue in Lemoyne, PA, not far from Karin's home near Harrisburg. It is scheduled for February 16th from 4-7 p.m. for a donation of $6. Please make plans to attend.

January 27, 2008 - 9:10 p.m. Today was the 11-month anniversary of Karin's transplant! She had a quiet and uneventful Sunday. Brandon arrived mid-afternoon and Karin was sitingup in her chair. She took a nice long walk covering about 150 feet round trip. Karin wanted to get back into bed when she got back to the room, and so she did. She was going to take a nap but Brandon put "Pirates of the Carribean" (#3) in the player and they watched it until Karin drifted off to sleep about half way through it. When she woke up later she watched the Men's U.S. Figure Skating Championships on TV. Don't know if that had any effect or not, but she is now able to move her right leg just fine; Brandon thinks it was just a temporary muscle thing. The spaghetti dinner fundraiser being conducted by Paul Baumgardner and Scott Leiser will be held at the First Christian Church, on the corner of So. 5th & Hummel Avenue in Lemoyne, PA, not far from Karin's home near Harrisburg. It is scheduled for February 16th from 4-7 p.m. for a donation of $6. Please make plans to attend.

January 26, 2008 - 9:30 p.m. Today was a rather routine day for Karin. Linda arrived around 11 a.m. after first having visited with her Dad at the UPMC hospital on the South Side. Karin was already up and seated in her chair. Linda decided to give Karin a fresh bright purple nail job. Just as she got Karin's toe nails painted, dialysis arrived. They wanted her in bed wet nails or not, so now the hospital has one set of bed sheets with bright purple polka-dots. Karin's dialysis was cut short about a half an hour because her blood pressure was dropping and she felt a little dizzy. They only removed about 700 ml today. The dizziness was only temporary and later Karin took a nice walk covering about 100 feet. About half way through the walk, Karin got this "Uh, Oh!" look on her face - she needed to use the bathroom quick! So she "hit the gas," so to speak, and made tracks for her room. At one point she got out of rhythm with the walker and it got ahead of her and she got unsteady. Fortunately Linda was right there to catch her and she got some help to properly position Karin back behind the walker (pictures from last weekend). After spending the rest of the day sitting in her chair, Karin went back to bed around 7:30 p.m. and was ready for a good night's sleep. Tomorrow (Sunday) at 10 a.m. will be the 11-month anniversary of Karin's transplant!

January 25, 2008 - 9:30 p.m. Linda arrived around 11 a.m. after first having visited with her Dad at the UPMC hospital on the South Side. Karin had already been taken down for a doppler ultrasound on her right leg. Linda used the time to tidy up Karin's room. Physical Therapy showed up at 2 p.m., and they happened to have the results of the ultrasound, which was negative for blood clots. Just as they were ready to get Karin up for a walk, dialysis showed up. Linda told dialysis to hang around and set up the machinery while Karin took a walk of about 72 feet. At about the same time, Aunt Marilyn, Uncle Bob, and their daughter Brittany showed up. They all had to go to the cafeteria while dialysis was getting Karin connected and starting the process. The guests brought Karin a stuffed Mickey Mouse that is about two-feet tall that she can use as her huggie pillow when she lays on her side. They also brought her a heart-shaped pin with wings on it and visited with Karin until around 4 p.m. After they left she napped about 45 minutes. Then Linda shampooed her hair before Karin spent some time sitting in her chair. They watched a few game shows then Karin got back into bed. The staff on the floor was too busy to assist Linda with taking Karin for another walk this evening, but they plan on taking a couple of strolls down the hall tomorrow.

January 24, 2008 - 7:45 p.m. Linda sends this report: "Brandon said that he had Karin up in the chair this morning and she had used her speaking valve for awhile today. That was good news!! I arrived here at the hospital at the same time the dialysis team arrived....good timing, don't ya think! She was already in bed and settling in for a nap while dialysis was going on. Her blood pressure was running a little low again, so they didn't remove any fluid, just filtered. The nurse practioner came in to talk to me for a little bit. They are giving Karin an inhaled antibiotic as explained in yesterday's report. Her right leg is bothering her some, so they want to do a dopplar on it to be sure there are no blood clots. Although her PTT (measure of blood clotting ability and heparin level, which is blood thinner) levels are back within normal limits, they will have to put off the trach replacement until after the leg dopplar is done. Dr. Ferson, who would insert Karin's custom trach, is not in a few days next week, but they will definitely do their very best to get her on his schedule next week anyway, because then they can try to get her back to eating, which is another giant step closer to rehab. Chaplain Carole was in to visit Karin today and took some time to visit with Karin and me and also pray with us. The other very "Special K," Karen Arrowood, stopped by to visit Karin while she was on dialysis (Karen A. celebrated the first anniversary of her heart-double-lung transplant on January 4th). I know that Karin & Karen were able to spend a few minutes with each other, even though Karen A. was probably still on the mend from the battery of tests she had today. Please say a prayer for Karen A. that they can clearly chart a course for her liver problems (scroll to botton of her page) that she is experiencing. I missed seeing Karen and Donnie because I was visiting my dad over at the other UPMC hospital in South Side. I did get a chance to talk to her on the phone though and she seemed optimistic that they will be able to figure out what is goin on. As I write this, Karin is napping again....deeply, probably for the night!" [New pictures posted in the Photo Gallery] Brandon also reported that a spaghetti dinner to raise funds for Karin is going to be held, thanks to Paul Baumgardner and Scott Leiser. It is scheduled for February 16th from 4-7 p.m. at a church in Lemoyne, PA, not far from Karin's home near Harrisburg. For a donation of $5 it promises to be a great winter supper and a great source of encouragement and support for Karin, Mark your calendars. We will post the church's address later. Thanks Paul and Scott, and to everyone who has given a donation to help replenish Karin's fund, which is rapidly depleating, and for your prayers of support.

January 23, 2008 - 8:45 p.m. Karin was awake and cleaned up but still in bed when Brandon arrived at the hospital this morning. He got her out of bed and into the chair but later when he tried to get her up to take a walk he noticed she had some difficulty moving her right leg. It was as though it had "fallen asleep." Karin did absolutely fine when PT took her for as walk, in fact she covered a total distance of 120 feet today without any difficulty. However when sitting in her chair or lying in bed her right leg is terribly lazy. There is no numbness, no tingling, no pain, and she has feeling, but it just does not want to respond very well to her commands to move it. This all started yesterday, so we'll have to give it a few days to see how it plays out. PT said they would take a closer look at it tomorrow (Thursday). Dialysis only removed about 400 ml today and her blood pressure dropped really low during dialysis, but rebounded later. Her potassium was low so they gave her refill via an intravenous infusion. Tonight Karin will start receiving inhaled antibiotics to combat the bacteria in her lungs. It will be administered twice a day for 3 months. Neither Karin nor Brandon have received any follow-up feedback from the meeting with the Patient Advocate. Vascular is holding off doing anything with Karin's fistula until her custom trach is re-installed. No specific date has been set for Dr. Ferson to put the custom trach back in, but Karin's PTT levels have returned to normal.

January 22, 2008 - 9:45 p.m. After a day of rest yesterday, Karin was back in top form today. She was definitely more energetic. Physical Therapy took her for a walk first thing this morning. About 11 a.m. she asked Brandon if she could take a ride off the floor. Brandon received permission from the nurses, who told him he had to first hand over his car keys to them (they were just kidding), and proceeded to put Karin in a wheelchair and took her down to the glass bridge that leads to Montefiore hospital across the street. She spent about 30 minutes there enjoying the view and especially seeing the American flag starched out in the brisk winter wind. It had just snowed about an inch, too. One of the nurses who has dialyzed Karin happened to come across the bridge and spotted Karin. She said to get back to the 9th floor because a dialysis nurse was on his way there to start her daily dialysis session. They got back to the room just in time for her to get hooked up to the machine. Dialysis went fine; they removed about a liter of fluid. Karin got in a total of three walks today covering a grand distance of 362 feet. She also played a board game with Brandon. Later he got up the nerve to risk making Karin's room look a little more "settled in," so he gathered Karin's personal stuff that he had been storing in her Nurse Practitioner's office and he hung pictures and added some personal decor to the room she occupies. Karin is looking forward to seeing her "transplant twin", Karen Arrowood, who will be back in Pittsburgh on Wednesday for a second opinion on a possible liver procedure (see Post-A-Notes).

January 21, 2008 - 9:30 p.m. After the extensive walking Karin did yesterday she took a well-deserved holiday for Martin Luther King day. There was limited staffing at the hospital today anyway, so it was a good day for her to rest and rebound. Karin took a pain pill last night so she slept deeply through the night. It took Brandon a little longer to get her up this morning but she did get into her chair and did some exercises. Tim & Linda showed up after visiting Grandpap Freund at UPMC-South Side. Karin was happy to get back into bed for dialysis around 2 p.m. and she slept throughout the procedure. Brandon got her back out of bed around 7:30 p.m. and Karin proceeded to take a walk. It was a "short" (compared to yesterday) 70 foot walk. Karin admitted she was a little sore today after doing yesterday's marathon. Brandon wanted to make sure Karin was not tired because of excess carbon dioxide in her lungs - a problem she had a few weeks ago. So he connected her to the monitor and measured the CO2 in her lungs and it was fine, so it seems she is just tired from all of yesterday's activity. They are drawing blood every morning and checking her PTT levels and we expect they will schedule her to receive her custom trach as soon as it is safe to do so. Karin went back to bed around 9 p.m. and she fell asleep immediately. Let's hope she continues to sleep well all night.

January 20, 2008 - 8:20 p.m. Karin had a most excellent day. She walked a total of 496 feet! It's amazing what one do when there is no interruption for dialysis. But she really did push it today, considering she also does other exercises throughout the day. Some of the additional walking included a trip to the family waiting room where she sat and visited with her parents for about an hour before walking back to her room. Karin earned a well-deserved 1-hour nap before taking yet another stroll. Karin spent much of the remainder of the day doing some Sudoku puzzles and looked at her web site while sitting in her chair. Karin's Grandpap Freund, who faithfully visits Karin every Tuesday with Grandma, has been hospitalized at another UPMC facility while they try to find out why he is experiencing back pain.

January 19, 2008 - 8:30 p.m. Karin got a late start today because she did not sleep well last night. She took a short walk of about 36 feet then spent some time sitting in her chair. Dialysis showed up mid-afternoon and just before the session ended around 5 p.m., Karin's parents showed up. They all wanted to take a walk but there was an emergency on the floor and the hallway was crowded with medical staff so they held off walking until things quieted down. Karin then proceeded to achieve a new milestone by walking all the way from her room to he nurse's station, a round trip distance of 200 feet (see pictures)!! After she returned to her room she worked two Sudoku puzzles then checked her web site on the computer. She fell asleep in her chair and Brandon thinks it will be an early night to bed for Karin this evening.

January 18, 2008 - 3:30 p.m. Today's report is early because of the webmaster's travel schedule. Karin did not have her custom trach installed. It seems her PTT levels were out of limits (indicator of how well her blood can coagulate). Not wanting to take any risks, they postponed the trach replacement procedure for today. They gave her some plasma and will monitor her to see when they can proceed safely. Probably not before Monday. Karin took advantage of the respite to take a hike down the hall almost making it to the nurse's station before turning back, a rounds trip distance of 184 feet. You GO, Girl! She is receiving dialysis now but intends to go for another walk later today, aiming to make it all the way to the nurse's station and back. Seems Karin is working hard to get back to her mid-summer form and transition to the Rehab. Unit as soon as she can.

January 17, 2008 - 8:15 p.m. Karin was sitting in her chair when Brandon arrived this morning, but was not wearing a speaking valve. When respiratory arrived to put it on her, Brandon questioned that because of the problem she had with back pressure a couple days ago and the ordeal of switching trachs, etc. However the specialist decided to put it on her anyway. Karin was very uncomfortable and after about ten minutes said she wanted it removed. The specialist tried to talk her into keep it on, but she said, "Look, I know my rights! TAKE THIS OFF!!!" He just walked out of the room on her. Brandon then got a nurse practitioner, explained that Karin was distressed by having the valve on, and she came in and removed it immediately. Karin is scheduled to have the custom trach put back in by Dr. Ferson tomorrow (Friday) at 1 p.m. Brandon and the PCP took Karin for a walk around noon and he traversed a distance of about 180 feet. Around 2 p.m. P.T. came by and they repeated the walk, so she covered about 360 feet today. Palliative Care stopped in today, too, and dialysis arrived at 7:45 p.m., another late start on her 2-1/2 hour session. Karin also did a Sudoku puzzle today. Please pray Karin does well during the procedure to install the custom trach.

January 16, 2008 - 9:15 p.m. After sleeping OK last night, Karin had another good day. Brandon got her into her chair shortly after arriving this morning. Ellen, her psychologist, stopped by for about 45 minutes. She introduced Karin and Brandon to some tension-relieving exercises (how many of us would like to know what those are, huh?) The Patient Advocate also stopped in to give the some feedback and she left some meal tickets to the cafeteria with Brandon, which I am sure will help defray his on-going expenses of being there for almost 11 months now. A little after 1 p.m. Brandon asked the nurse if she could help him take Karin for a walk, so Karin took a trek of 82 feet down the hall! Shortly afterward, dialysis showed up. It went well and they gave Karin a unit of blood, as planned, but it made Karin tired so she took a short afternoon nap. Brandon got her back out of bed from 6:30 to 8:30, during which she viewed her web site and read Post-A-Notes which gave her much delight and encouragement. She also found out on the internet that her dachshund (Kola) is rated the #6 most popular breed among American dog owners, and that produced a big grin on her face. Brandon's dog's breed, Irish Setter, did not make the top 10 list, even though Shunka is #1 on Brandon's list.

January 15, 2008 - 9:45 p.m. Brandon got to the hospital today around 10:45 a.m. and helped finish getting Karin cleaned up and out of bed. She was anxious to get out of bed and into her chair. She took it easy for a while, then around 2 p.m. she took a long walk with Brandon covering a whopping 76 feet. Before she was done P.T. showed up and they took over to help her finish it off. Following the walk she got back into her chair and was visited by Gram and Pap Freund. Palative Care checked in with Karin and admired her painted nails. Around 3 p.m. she was ready to get back into bed and fell asleep for a short nap while Brandon read a book to her. Dr. Ferson's Physician's Assistant came by to say Karin was on Friday's schedule to have her custom trach put back in. That will be confirmed Wednesday. Brandon also got to meet with the Patient Advocate today and felt he was able to communicate his concerns very clearly. She will look into the issues he raised and promised to follow through. About 5:30 p.m. Karin took another walk, this time a distance of 105 feet! She walked "on her own" relying only the assistance of a deluxe walker. Then it was time for dialysis. Karin did some coughing during dialysis which caused her to aspirate and she had to be suctioned. Dialysis finished at 9:45. They intend to give Karin a unit of blood during dialysis tomorrow.

January 14, 2008 - 9:00 p.m. Brandon got to the hospital around 10:45 a.m. and got Karin dressed and out of bed. He noticed she did not have her speaking valve on. When he inquired about it he was told she was not tolerating it very well. Brandon summoned a respiratory specialist who suctioned Karin and tried to attach the speaking valve. He noted some "back pressure" escaping from her trach. It happened that Dr. McCurry, the surgeon who did Karin's transplants, was making rounds at this time and had stopped in to see his special patient, Karin. He said he would get Dr. Ferson to remove the #6 size trach and put in a smaller #4 trach. Shortly afterward, the respiratory specialist returned to downsize Karin's trach. So right there in the room he pulled out her #6 trach and put in a #4 trach, just like that! Shortly after dialysis started around 2:15 p.m., the respiratory tech returned saying Dr. Ferson wanted to keep the #6 in place until he could install her custom trach, so the procedure was reversed and the #4 trach was pulled and Karin was given another #6 trach again. Dr. Ferson is supposed to come by tomorrow and consult about putting her custom trach back in. Karin seemed to tolerate all this trachtrading during dialysis, but was a little traumatized by the in-room procedures. Karin had a visit today by the psychiatrist assigned to her case. Brandon expressed his concern about how much ground Karin has lost compared to all the activity they were able to accomplish this summer - long daily walks, visits to the atriums, etc. He also voiced his dissatisfaction with the fact the unit is short six nurses and the current staff are stretched too thin. The psychiatrist directed Brandon to communicate Karin's and his concerns about insufficient staff,etc., with Karin's Patient Advocate, who Brandon will attempt to locate. OT/PT came by today and took Karin for a walk of 24 feet, round trip. Dr, McCurry decided to put Karin on an inhaled antibiotic to discourage bacteria from causing recurring infection in her lungs. Karin received a visit today from Judy Brust Doby whose husband is awaiting a heart transplant. Judy stopped in to visit Karin while her husband was at the hospital for a heart cath procedure. It was quite a day for our Wonder Woman!

January 13, 2008 - 9:15 p.m. Karin had a full day. Brandon got to the hospital around 9:45 a.m. and got her dressed in a regular feminine nightgown so she would feel good about receiving visitors. It was just in time, too, because Brain, Kelly, and Gage got there shortly thereafter and stayed until about noon. Her next visitors were Tim, Linda, Scott, Crystal, and Hunter who arrived about 11 and stayed until 1:30. Karin had her speaking valve on for about 12 hours today, until about 7:30 p.m. She took two walks today. Her first one was about 64 feet out into the hallway and back to her chair. Before Tim and Linda left she got back into bed and took a nap. In mid-afternoon Respiratory came by to cap off her trach and fit Karin with a nose cannula as a test to see if she could tolerate it. She was not able to tolerate it well enough for them to be able to continue the test so she went back on the trach mask. But now that she is wearing a speaking valve she is able to resume breathing exercises and those will be on tomorrow's agenda. At about 5:30 Brandon had her up again to take a short walk of about 24 feet then back to sitting up in her chair. She is not very stable on her feet yet, but considering it was a long time that she was in CTICU and has not walked again until very recently, she is doing OK. By 8:30 p.m. Karin was back in bed and Brandon is hoping she gets good night's sleep. She did not sleep very well last night, possibly because they stopped her mood booster medication yesterday because of elevated liver function levels. Brandon reports that about 2/3rds of Karin's NTAF transplant fund has been used up now so if anyone has any ideas for fund raisers to help with continuing expenses please contact Tim & Linda at skid@embarqmail.com (also see the Fundraisers page)

January 12, 2008 - 9:15 p.m. Karin had an early start today and began wearing her speaking valve around 6:30 a.m. Brandon did not arrive until around 12:30 because he had to go home to attend to important business on Friday (hence no report yesterday because he could not reach the nurse's station to get an update by phone). When he arrived this afternoon Karin was still in bed and her Nurse Practioner was there to see her. Brandon found out Karin had not been out of bed all day yesterday and he was upset. Then dialysis showed up and Brandon asked the dialysis nurse to just stand by and wait while he and the Nurse Practitioner got Karin up and took her for a walk. They took Karin out the door into the hallway then back until the room, a distance of about 20 feet each way, then put her back into bed for dialysis. Thankfully, the dialysis nurse did wait. As she was about two-thirds the way through dialysis Karin's blood pressure dropped but they continued on to finish off filtering her blood. Brandon intends to meet with the Medical Director on Monday to express his intense dissatisfaction with the lack of coordination and the standard of care when he is not present. Her care should not depend on him being there to see she receives the proper attention necessary to get her back into rehab. Now that Karin has a glamorous "nail job" to show off (see photo gallery), she is wearing her "Past, Present, & Future" ring. She tried on her engagement ring but it would not fit in spite of her shedding some weight while in the hospital. Today there was a big surprise birthday party for Uncle Bob so Tim, Linda, Scott, Crystal, and Hunter drove to Pittsburgh to help him celebrate and they will all visit Karin on Sunday.

January 10, 2008 - 8:30 p.m. Karin had fairly busy day. Karin got out of bed around 10 a.m. and walked to the scale and back to her chair, with Physical Therapy at her side. Karin only weighs 98 pounds. After her exercise, she got cleaned up for the day. She seemed more spunky today, perhaps because of yesterday's change in mood medication. Karin spent some time looking at her web site and reading Post-a-Notes. Brandon filled the "prescription" ordered by Palative Care yesterday - he painted Karin's nails. She LOVED it! She received visits today from Pet Therapy and Music Therapy (see photo gallery). Karin started wearing the speaking valve around 4:15 p.m. and is still wearing it at 8:30 p.m. With the valve in place Karin was able to phone her Mom and Dad to chat with them. Brandon said she spoke with greater ease and less breathlessness today. Dialysis started at 6:30 p.m. and was going well at report time.

January 9, 2008 - 9:45 p.m. Karin had an almost routine day. Brandon had her up in her chair when Physical Therapy arrived to take her for a walk, however dialysis showed up at the same time and you can guess who won out - DIALYSIS! So Karin did not get to do any walking today. But before Brandon arrived at the hospital Karin had a visit from Palative Care. Karin's nurse told Brandon that Palative Care said Karin is supposed to have her nails painted. When Brandon asked who was going to do it, the nurse told him, "YOU are!" Don't know if it is fingernails only or includes toe nails, too, but Brandon said he only has a 2-1/2 inch tapered brush for painting window sashes. (Good luck, Karin). The doctor changed Karin's anti-depression medicine and added a "mood booster" for Karin then prescribed Iron City for Brandon. Karin had a most interesting visitor today. Her name is Karin Gorel and she received a double lung transplant in October 2007 and was discharged and went home in several weeks. Karin (named spelled the same) is believed to hold the record for shortest stay in the hospital after a double lung transplant. She returned to UPMC nine days ago to have something removed from one of the lungs and is about to be discharged again so she wanted to stop in and visit with our Karin today. It was a very nice and encouraging visit. We have been told there were four heart-double lung transplants at UPMC in 2007 and only our Karin and Karen Arrowood are surviving. Thank you, Lord, and please comfort the families of the non-survivors. On a lighter note, when I asked Brandon if they had figured out why the "Check Engine" light illuminated on the van, he said "They performed a dialysis on it, and found a bad sensor in the exhaust." Performed a DIALYSIS??? I think both of these guys have been in the hospital tooooo long!

January 8, 2008 - 9:45 p.m. Karin is making a good transition to the unit on the 9th floor. Brandon got her out of bed around 10:45 this morning. She managed a few hours in the chair but just could not seem to get comfortable sitting today. Occupational Therapy came by and had Karin marching in place and said they would start her taking walks again tomorrow. Physical Therapy had Karin sitting on the edge of the bed and doing leg lifts. Karin had not been using her back brace because it does not fit her very well - not as well as the first brace did - but she is having none of the previous pain or discomfort. Vascular is holding off doing anything with the fistula until Karin has completed her course of antibiotics. The consultants from Behavioral Services came by to check on Karin's mood and have scheduled a therapy dog visit on Thursday. Karin wore a speaking valve for about 1-1/2 hours and it made today's visit from Gram & Pap Freund even more enjoyable.

January 7, 2008 - 9:30 p.m. Karin has moved upstairs to room D-950! This room is more spacious than the last one she was in on this floor. The transfer took place around 6 p.m. following a good dialysis session downstairs in the CTICU. She had been in and out of her chair earlier in the day and the move was made as Karin sat in the chair and was wheeled upstairs. It is interesting that before she took occupancy of D-950 all the furnishings in the room were steam cleaned. A good precaution against spreading infection. After she got settled in her new room they put the speaking valve on her trach and she talked to her mother-in-law over the phone. Karin's Nurse Practitioner said the vascular people are supposed to see Karin tomorrow to determine what to do with the fistula and future dialysis sites. Brandon thinks Karin's overall long-range management plan will involve her doing well with the speaking valve first, then would come reinstalling her custom trach so she could take nourishment by mouth again, then if all that goes well, move her to the Rehab Unit before discharinging her. Brandon thinks that would be the logical progression for her care.

January 6, 2008 - 8:00 p.m. Karin had a pretty routine day in the CTICU, except that there was no dialysis because it is Sunday. Although she did not sleep well last night, she was quite alert and awake all day. She got out of bed and marched in place then sat up in the chair for over 5ive hours. Karin breathed all day on the trach mask and Brandon thinks that she may have been using the trach mask all last night, not the bi-pap machine. Karin is still receiving two antibiotics for the pneumonia and UTI. There were no visitors this weekend. The Critical Care nurse indicated that Karin will likely be moved back upstairs early next week, perhaps even on Monday. All in all it was a quiet and uneventful weekend for Karin and Brandon.

January 5, 2008 - 7:45 p.m. Brandon got Karin out of bed today and she sat in her chair for 5-1/2 hours until it was time for dialysis. The dialysis session lasted for 2-1/2 hours and it was about to end at the time Brandon phoned in this report. Karin also did some marching in place today. This was great because she had not been out of bed for several days. The nurse said her charts reported the bronchoscopy revealed bacteria in her lungs producing same pneumonia. However, she is breathing fine and her numbers look good. Karin does have a UTI, probably from the catheter, which may be removed. Linda had good intentions of driving Karin's van back to Pittsburgh today, but about 30 miles from home she got a "Check Engine" light so she decided not to gamble on making the trip until it gets checked out.

January 4, 2008 - 8:45 p.m. Karin is still in the CTICU and is doing OK. She had a sleepless night, most likely caused by the medications she is taking, so she spent most of the day sleeping in bed. Karin has not been out of bed for two days now, and not since she fell out of the chair. She claims she is not sore, but Brandon says she sure is badly bruised. Karin had a 2-1/2 hour dialysis session which went well today. We have not yet received any results from the lab cultures, They tried to draw more blood today but Karin's veins would not cooperate. Fortunately, Karin has not experienced any stomach nausea for two days now, and her fever seems to have broken last night. Yesterday she was breathing on the ventilator but today she has been using the trach mask all day with excellent oxygen saturation levels (she is receiving 33% supplemental oxygen). Tomorrow, Karin's mother, Linda, will drive Karin's van back to Pittsburgh for Brandon. It has been repaired by Christina Calkins-Mazur's dealership in Burnham. The technicians had to do a lot more than "just" repairing and replacing the head gaskets - the catalytic converter was damaged by the antifreeze which got into the cylinders and it had to be replaced in addition to other work that needed to be done. Christina has been a huge blessing to Karin and Brandon for a long time. We hope and pray Karin will have a good weekend with good news from the lab results.

January 3, 2008 - 7:30 p.m. Karin was readmitted to the CTICU today. She is in the same Bed #2 again. Her heart rate became high during the late dialysis last night and she spiked a fever so they decided to move her back to the CTICU where she would receive closer monitoring compared to the Cardio-transplant Unit on 9-D. Another factor in moving Karin back into CTICU was the suspicion she might have "C-diff", according to Brandon, but now they are not so sure. They are still waiting on results of cultures taken last night and today. A vascular surgeon who worked on Karin's second fistula came by to remove the stitches. They also performed an ultrasound on the fistula and are not sure it will be usable - they are still consulting about that. On the good side, she had none of the upset stomach today and her heart rate, although high at 118 bpm, has come down in spite of the stress of moving today. Karin did not undergo dialysis today because of her elevated heart rate.

January 2, 2008 - 10:45 p.m. Karin was sick to her stomach almost all day today. Not sure what the trigger was, perhaps a change in medication? It sure was not caused by eating anything because nothing is going in by mouth. Brandon is somewhat upset because Karin is not on a regular daily schedule of medication. The meds are not being given to her on a consistent schedule because the time at which dialysis shows up each day is unpredictable. They want Karin to retain the medications and not have them dialyzed out of her system, so they hold off giving them to her until dialysis is over. She may go most of the day without medication when dialysis shows up late in the day. Consequently, Karin is not receiving medications consistently. Karin finished off the day with dialysis late this evening and is not expected to be finished until around 11 p.m. Her hear rate was up a little today, which may also be dialysis related. They have discussed the possibility of giving her "full-blown" hemo-dialysis for 2-1/2 hours every day except Sunday. The reason being there might be less chance of clotting and a more stable heart rate. Vascular did come in today at Brandon's request and said they would return tomorrow to probably remove the stitches from her fistula. Chaplain Carole stopped by to make a pastoral call. The people from Wound Care dropped in to inquire if there was anything they could do to make Karin more comfortable after lying on her back so long in CTICU. Written orders for Physical Therapy to start back up were requested today. Please pray that Karin gets a good night's sleep every night.

New Year's Day 2008 - 10:00 p.m. Karin was moved upstairs from the CTICU to Room D-942 on this first day of 2008. Initially, they were not going to move her because they are short on staff, however necessity forced their hand when they had another patient admitted to the CTICU from another hospital and they needed bed space in the ICU. So they moved Karin upstairs shortly after 8 p.m. Brandon has decided he will stay with Karin in her room for the night so he is scouring the unit looking for a reclining chair he can use. He said it is snowing and blowing and very cold in Pittsburgh tonight but he enjoyed a traditional New Year's Day dinner at Kathy & Jack's. Karin did not have dialysis today.

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 Year's Day dinner of pork and sauerkraut.