Pics from Dad's Birthday

The birthday boy himself- always ready for

a party!!

Dad with his "girls"- Mom, Liz, & Aunt Sue


Dad and Mom with the "60" cake Mom baked for him- chocolate,

with white frosting, as requested. :)
Dad showing off the Iowa Bird House from the

Espinoza family. It will look great hanging

in front of the Michigan stuga.

The sweets table! Chocolate cake, Blueberry pie,

and cupcakes from Sweet Mandy B's!
Up close of the cake- the candles say "Oh No,

The Big 6-0!" You can see we have already been

enjoying the cake.
Balloons and banner behind the bed.





Here are some pictures from the big birthday party yesterday!

These pictures show the room decorations.

To the left, you can see the decorations on his door. The signs say "60.... the party continues." The big 60 at the bottom is a sign-in for all his doctors and nurses to write him a birthday message!

What a Great Birthday!!!

Well everyone, the cards were a hit!!! We are still opening them up and enjoying each and every one! Thank you, thank you, thank you, to all our wonderful friends!!! You mean so much to us.

Bob's room is decorated with a party atmosphere. He has enjoyed family and friends visiting, phone calls, gifts, cake and more good news from his doctors. His trach is out and they are looking for a bed for him at RIC. (Rehabilitation Institute of Chicago) This is just down the street from Northwestern Hospital and Prentice Hospital which means that his wonderful oncologist will be able to check in on him. He has been a fantastic advocate for Bob throughout this entire journey.

It was suggested that we get a flip video camera so Bob can see all of the progress he is making. So, today I recorded him exercising and standing. Bob still doesn't realize how far he has come so this video camera can show him his progress. Great suggestion!

Elizabeth will be posting pictures from the birthday. Bob is looking great!

Speaking is much easier for Bob because today they put a cap on his trach and now he only gets a bit of oxygen through his nose. He sat in a chair most of the day and when his physical therapist came they practiced pushing up from a chair and with her help, standing. This takes a great deal of energy. Bob's feet, ankles and legs are very weak. She gave him a few exercises to practice throughout the day. Bob is very eager to practice so he'll be walking before we know it. She felt he had made great progress since Friday. For supper he ordered meatloaf, mashed potatoes and carrots. Yesterday he thought he needed a few snacks in his room! His appetite has returned!

Tomorrow is the big birthday. Bob got a card from our niece today that he opened and we hung up. I said we wouldn't be able to hang up all of his cards and he said he probably wouldn't get that many! Little does he know! Tonight I wrapped up a box of 67 cards! It will be fun to see his face when he opens up that present. We will enjoy chocolate cake and blueberry pie! Will post some pictures tomorrow night!

Updated Photo!

Mike and I are hanging out with Dad today at Prentice. He had grown quite the mustache so Mike helped him shave it, and afterwards we took a picture of his new look. Starting to look like the same ol' Bob again. :) He can't wait to be able to wear his own clothes!

Spaghetti and Pears for Dinner??!!

Wow, has Bob's appetite improved. Saturday he ate an omelet and blueberry muffin for breakfast, spaghetti, pears and broth for a late lunch and yogurt and cereal to hold him over until Sunday morning! What a way to build up his energy! There is no physical therapy over the weekend but Bob is sitting in a chair, sitting up for meals, and eating meals! He still wants to know what's next and I'm reminding him that practicing the above is his work for the weekend. He wants to be ready for Monday. The doctors are so surprised how Bob is able to speak so clearly over the trach. They are thinking about capping that on Monday so speaking will be even easier for him. Bob continues to amaze everyone!! We know he is God's miracle!

Don't Forget- Birthday Cards for Dad!!!

This is Liz again. Dad's birthday is fast approaching but there still is time to send a card! We would love to collect 60 cards for him to celebrate his 60th birthday. You can mail them to either my mom's address or mine. If you need an address, email me at etespinoza@gmail.com and I will be happy to send it to you!! We know he will be surprised to receive so many cards and well wishes. He has already decided he would like a pie for his birthday dessert!!

When I came to the hospital on Friday, Bob was very tired. They said he had had a good night sleep. It seemed like he was more tired than he had been all week. I think maybe he was just relaxed now that he was over at Prentice. He had cereal for breakfast, soup and jello for lunch, but this time he ate it all and for dinner he ordered a baked potato and soup and jello. Again he eagerly ate the soup and jello but didn't think the potato was so good. By night time he felt that his energy was coming back.

Physical therapy worked with Bob. He already new the therapists from when he had been at Prentice and they were thrilled to be helping him again. They were impressed that he already could sit at the edge of his bed on his own. So now it was time to try and stand up. Bob did well, but he realized it was a lot harder than he thought. In fact, it really was a BIG deal!! Two times they helped him stand by putting a belt around his middle and then he pivoted his feet to a near by chair. This was a lot of work! He was able to sit in the chair for four hours which was fantastic! He thought it was really comfortable and a great way to spend the day. PROGRESS!!

When I left last night Bob was completing another breathing treatment. Everyone can't believe how well he is doing. These therapists also saw him in the ICU! Bob is able to speak a little over the trach so communication is much easier. He told me he had had a great day. He also said, "When it is easier to speak, I've got a story to tell you!" I'll keep you posted!!!!

Big Day!

Bob passed the swallowing test and was transferred out of ICU. Five weeks to the day! This certainly was progress and he was satisfied! Hopefully he will be able to sleep better tonight. He is back on the 15th floor of Prentice Hospital, across the street from Northwestern Memorial Hospital. His lungs had improved with the treatments yesterday so they continued with a few more today and again tomorrow. You should have seen how excited he was when he was able to drink some water! For dinner he ate a few spoonfuls of chicken broth, a little red jello (Bob never liked plain jello but it became a favorite when he was there for the transplant) and a teaspoon of chocolate pudding. This was really his first meal in six weeks! You can only imagine how much weight he has lost. Boy will he enjoy those chocolate shakes! I heard about a place close to the hospital that is suppose to have the best shakes. That might be a fun birthday treat. Tomorrow he is eager to get going with the physical therapy. A new day, so much to be thankful forl

Slow Day

Many of us would be grateful for a slow day, but not Bob! All day he wanted to know what was next! The plan was a resting day. Bob thinks he has had enough of those kinds of days. He was off the vent for 24 hours and so today, the doctors wanted to see if he could be off it for another 24 hours. They are doing some lung exercises with him to improve lung function and hopefully tomorrow Bob will be able to move back over to Prentice Hospital. Tomorrow could be a big day because they are also going to do the swallowing test. He now has a time for that. Bob really wants to be able to eat so hopefully he passes the test. He wanted me to give him some of my coffee and granola bar this morning. I reminded him that I was a real rule follower so he had to wait! Tonight he wanted his cell phone just in case in needed to call me. He gets a little anxious during the night so we told his nurse it was okay to call at any time. He felt better when I left but said he can't wait until morning. (Me too!)

It's A Big Birthday

Next Tuesday, March 29, Bob will be celebrating his 60th birthday. It is a special birthday for MANY reasons. I was thinking that it might be fun for him if all of his blog followers sent him a birthday card. It probably would be best if you sent it to our home because I don't want to overload the Northwestern mail staff!! :) I'd bring them all down there on Tuesday. I don't know if Bob will be enjoying birthday cake on the 29th but I do know that he will love reading all of your birthday wishes.

Today Bob was off the vent all day again and they are going to see if he can be off it tonight too. Tomorrow afternoon they will do a swallowing test. Keep praying.

Each Day More Progress

Bob was able to be off of the vent for 12 hours today! That was the goal that his doctors had set for him and then overnight he will be on the vent to rest his lungs. Communication was easier today because Bob can write. He took notes as the doctor talked about different goals. We are also getting better at lip reading since he enunciates more clearly. We watched The Unsinkable Molly Brown and Mary Tyler Moore on CD's brought from home. We even worked a crossword puzzle together. Bob, the editor, is very good with words! I'm grateful for his help because I'm much better at Sudoku. This afternoon he was lifted to a special chair. While sitting there many of the nurses had to stop by and introduce themselves to Bob. Being in ICU for almost five weeks, I think every nurse has helped him in some way and wants to see his unbelievable progress. Today Bob was also planning his first meal. He actually had a taste for certain foods but he said he would settle for soup! Hopefully they will do a swallowing test tomorrow. His doctor reminded him that each day he is getting stronger and it will be easier to pass the test on the first try. Bob liked that idea!

Bed Alarm

Bob had another good day today. He was off the vent for around five hours, we listened to an audio book for awhile and we were able to have a good conversation about his progress. (One sided but we both understood what each one was thinking) He still thinks he should be able to get up and walk so when we are not in the room, they put a bed alarm on which has a voice that reminds him to stay in bed. A friend, who is a physical therapist, suggested that if two physical therapists came to the room they could help him get out of bed and then he would be able to see for himself that he needed to exercise his muscles before he takes off and walks on his own. Hopefully this will happen tomorrow. He doesn't remember anything from the last four and a half weeks so the idea of not being able to just get out of bed is hard for him to accept.

When we were ready to leave tonight I knew my Bob was back. He said to us, "Drive carefully!" Thank you God!

"When Can I Get Out of Here!!!"

Well, today was a great day. Bob's fever was down, he was off the vent for eight hours (weaning) and he wanted to know "When am I going to get out of here!" He seemed to think he should just be able to pop right out of bed. I needed to remind him he had been in bed for a month. He didn't think that should matter! He was moving around lots in his bed. I told him that was good physical therapy! :) He was also concerned about where his clothes were and how we were going to get the stuff moved from his room. There really isn't much in his room and as for his clothes, I told him I'd bring them back A.S.A.P. That made him happy. He wants socks and slippers for tomorrow. (I think he might be planning an escape!) It's great to see his determination and spunk!

Fever

Bob was still bothered with a fever today. It was a little lower than yesterday so maybe tomorrow it will be gone! The fever takes a lot of his energy so he remained on the vent today. He is restless and finds it difficult to find a comfortable position in his bed. He has mouthed very clearly that he just wants to leave this place! Any suggestions for making the day go quicker? He listens to great music on his computer. In fact the nurses have said they like to come into Bob's room because of the great tunes. We watch jeopardy and today I asked him if he would like to listen to a book on CD. He said he would try that so tomorrow morning I will stop at the library. I told him to pray that the fever will leave his body and that they will be able to do the swallowing test on Monday. That would hopefully allow him to have some food. (eating passes the time too) I will also pray for patience for Bob and me.

Thursday, March 17

When I came today, Bob clapped his hands. He was either very happy to see me or just glad it wasn't a medical person visiting! :) Today Bob needed to be on a small amount of vent support. They think he might have worked too hard yesterday. That would be Bob! The doctors are very encouraged by his progress though. He has been completely awake today and has told me very clearly that he wants to eat! He is even a little cranky when he is mouthing these words! I explained that maybe tomorrow the speech therapist would be able to do the swallowing test. He understood but... He is really moving his arms and legs and even seems stronger than yesterday. He has a little fever again so please pray that the fevers disappear. 101.5 It didn't seem to affect his spirits today though!

Those of you that know me well, know that I love little quotes. In fact, Bob said Anna will learn to read at our house with all the little sayings I have around. Recently we got a card from a friend which included a phrase about hope. "Of all the forces that make for a better world, none is so powerful as hope. If you have hope... you have everything. " I am filled with hope, I guess I have everything. :)

Miracles Do Happen

Our family has certainly witnessed a miracle these last two days. Bob has truly experienced the healing arms of our Lord. We are so grateful!

After twenty days of staying at the Double Tree Hotel, about a block from the hospital, I went home to Park Ridge. I knew it was time to go home on Sunday night when I was at the hotel because it was just making me feel so sad. I knew Bob was getting a little better and for me the hotel meant he was still very critical. Not the case on Sunday night. He was making slow but steady progress. So I checked out of the Double Tree on Monday morning, spent the day with Bob, who now was off sedative drips and becoming a bit more awake. I was feeling hopeful as a friend drove me home. It was sad to come home to an empty house but little Wes was there to greet me. Boy was he happy that I was home. I'm even able to write on the blog again!

I got up early Tuesday to head down to the hospital. As I walked into Bob's room, he was sitting up in his bed with his eyes wide open. Immediately I started talking to him. Now he was just on vent support and 40% oxygen. He couldn't talk because of the trach but he did nod and mouth words. This was very emotional for me so naturally I cried. Bob knows I cry easily. Maybe I'm sad, happy, tired, maybe it's a movie, maybe it's music, who knows, but Bob knows I cry easily. Throughout the day Bob interacted with Elizabeth, Sue and me. He laughed when we told some stories, he smiled when we showed him the latest picture of little Anna and he cried when I read the Lenten devotional to him. It had such meaning for all of us. Bob even rolled his eyes and smirked when brother Wylie was telling a few of his stories. The old Bob was back. Tuesday night I got my best night sleep in 21 days! Miracles do happen!

Today I drove to the hospital and when I reached Bob's room his bed was facing the lake and he was sitting in his bed with the end of the bed down like a chair. The TV was on to a morning news show. I thought he looked great the night before but this morning he looked incredible. I asked him if he wanted his glasses and he mouthed "sure"! He communicated by moving his mouth and head, he wanted to try to write, but that is still too difficult, and the speech therapist gave us a sheet with some words and the alphabet but his fine motor isn't strong enough to point out letters. He did mouth "I want food!" The speech therapist evaluated him today and in a couple days she will do a video of his swallowing to make sure he is safe to eat on his own, without the tube in his nose.

Today the vent was off all day! He just had a trach band that gave him a little oxygen. This evening he was sitting in a chair for two hours!!! The doctors are amazed! When I left to go home, they put him back on the vent with just the smallest amount of support so that he could rest over night and be ready for tomorrow! Miracle do happen and we have seen it! Praise God!

Progress!

Sorry for the delay in posts! There have been some ups and downs (to be expected) in the last week, but overall, some great progress. Yesterday, Dad opened his eyes up for the first time spontaneously and since then, he has been awake off and on throughout the day. Today, he was able to squeeze my hand on command, although he is still very weak and it is hard for him to get up the strength to move it. As Mom just said, "Today has been a great day of eye contact and hand squeezes!". He tolerated the trach procedure well. They are still having some fluctuation in the amount of oxygen he needs (FiO2), but they believe that is too be expected at this point. He had a CT of his brain to check for stroke which was normal, as well as a 24-hour EEG to check for seizures which was also normal. He is almost off of the Ativan for sedation, and they have also been weaning down the Fentynl. Overall, we are very encouraged about his progress!!

Trach Today at 1pm

Dad will be getting his trach today at 1pm. They will do it at his bedside. They will increase his sedation, as well as using the paralyzing medication just for the duration of the procedure. He had a mostly uneventful night, although at one time he did become agitated and need a brief increase in his FiO2 (oxygen). Hopefully, with the trach, these agitation episodes will be less frequent. Please keep him in your prayers today.

Trachestomy Tomorrow?

Dad has remained about the same the last 2 days. The best thing that is happened is that the fevers overnight have stopped!! Two nights ago, he only spiked to 101.4, and last night he did not spike a temperature at all. He seems much more comfortable when is does not have a temp, so we are happy for this improvement. They cultured him again for the flu and he still came back positive, which was not completely unexpected as the stem cell doctors and infectious disease doctors both said that a stem cell patient with a new immune system may continue to test positive for the flu for up to 4 weeks, even if they are no longer have symptoms. His blood pressure has been stable for the past 2 days and they have not had to use the medication to keep his blood pressure high enough, plus they have been able to use the medication to help take the excess fluid off (a diuretic called Bumex) without him dropping his blood pressure. Yesterday, they were able to take over 3L of fluid off of him, which should definitely be helping his lungs. The biggest problems remain sedation and weaning of the vent. He continues to make progress, however, it is very slow. Yesterday, they were finally able to get him down to 45% FiO2 (oxygen), which is almost to a place where he can be weaned from the vent. However, when they lightened his sedation he became very agitated and started fighting the vent again, which caused him to desat (drop his oxygen levels) and eventually required the vent to be turned all the way back up to 70% FiO2. So, we basically had to start all over with the weaning down to 45% again. This time, they were unable to get him to 45%, and instead have had him hanging out at 50% since last night and all day today. They were hoping that his oxygenation (exchange of oxygen from his lungs to his blood) would have improved more than it has. Because he has been intubated (with the breathing tube down his throat) for almost 2 weeks, the decision was made today to place a trachestomy tomorrow. A trachestomy is a small hole surgically created in the neck to help a person breath. It is often done for patients who are having difficulty weaning off of a ventilator. The hole is not permanent- when it is no longer needed, it can simply be allowed to close up again on it's own. The doctors are hopeful that my Dad will only need it short-term in order to help him wean more comfortably off the vent. Being intubated is very uncomfortable, and unfortunately, every time they try to decrease his sedation and wake him up more, he gets agitated. The doctors are hopeful that he will be more comfortable with the trachestomy and therefore they will be able to lighten up the sedation and wean the ventilator without him getting as agitated. They can do the procedure at the bedside in his room. The bad thing about having a trach and being on a ventilator is that you are unable to talk. If the trach is needed long term, a speech therapist can work with the patient to help them learn how to use a special speaking device for their trach (but we are hopeful Dad will not need it for that long!!). I am attaching a link to the Mayo Clinic website regarding trachestomies for those interested in more information: http://www.mayoclinic.com/health/tracheostomy/MY00261

Occupational therapy has also started working with Dad by making him splints for his arms and legs to prevent foot drop and contractures (shortening of muscles because they are not being used). We want to make sure that he is able to walk on the beach again this summer! He wears a splint on alternating arms and alternating legs for 4 hours at a time each day. Again, thank you for your continued thoughts and prayers. I told Dad that once he is feeling a little better, I am sure that there are many people that would like to come visit. Until then, please keep sending your emails and I will continue to read them to him. He is on a little less sedation and occasionally we see little responses to things like him squeezing his eyes when we are talking to him. I know I was reading him an email from a friend from his old office the other day and he definitely had a few eye squeezes in there. :) I know Dad appreciates all the kind thoughts and well wishes. I can't wait for him to be able to read them all on his blog again.