Just a quick update- Paul seems to be doing a little better. He is eating more (actually has an appetite) and sleeping less during the day. His nurse says he needed to catch up on sleep after all he was through, so we hope that now he can gain more strength and energy each day. This improvement helps Barb too as she cares for him- its hard to know how much to let him sleep and rest, and how much to "push" to keep him from backtracking in strength, etc. We are thankful for every sign of improvement. God keeps answering prayers, giving us our "daily bread". So please keep praying. With love- all us VH's

Just a quick note- we saw Paul yesterday. He's doing well but very tired, sleeps alot. Needs encouragement to cough or to walk any further than the bathroom. Barb is trying to be wife and nurse which is hard to mesh the two. Paul's done with 3 antibiotics now so we hope his appetite will improve. Now that he's rested for a few days it'll be time to start eating and walking more- which he's not too keen on at this point. Please keep praying for both Paul and Barb. There are still tough days ahead. And FYI- its Barb's birthday today. She's 40 plus a few years. :)

Paul is home safe and sound! He is very glad to be home, doing well. He gets around quite well and seemed in good spirits. Time to heal and get stronger. Amazingly he says his chest doesn't hurt much- hard to believe considering his sternum was open for days.

So thank you once again for your prayers and keep sending them up. We all appreciate you checking in. These updates will be less frequent now that we're at this point- not as much to report thankfully. So enjoy your summer everyone!

Wow, things are happening fast all of a sudden! Paul is going home tomorrow! He still has pneumonia, but he'll go home on antibiotics, try to get lots of rest, and use his little incentive spirometer every 2 hours to get good deep breaths. He'll eventually go to outpatient cardiac rehab in Muskegon, maybe in a month or so.

So we have a major answer to prayer! Now we need prayer for increased strength and healing. Paul's confusion is much, not completely, resolved. He's very tired from the lack of sleep during the difficult days of last week. So hopefully time at home and good sleep will help his mind and body.

Because of the pneumonia and need for rest visitors will need to be very limited at first. If you are dropping something off (meals,etc) we ask that you please call first and keep your visits short. Seeing people and hearing your words of encouragement will be a blessing to both Paul and Barb. So "thank you" in advance. We hope it won't be long before Paul is ready to talk your arm off! And then go for walks along the boardwalk... and then...who knows! We're thinking positive here. :)

Thank you for your constant prayers. And thank you to God most of all for answering them in a wonderful way!

Quick update- Paul was moved out of CCU yesterday! That's a big move in the right direction. His confusion is improving too, but still quite depressed. Todd's heading up tonight with my list of questions-we'll see what more we can find out.

Not much to report- things are a little better. Paul's been able to go outside some more, seems a little better, but still requires 1:1 observation (someone has to watch him at all times) to keep him from leaving. Haven't heard anything about a possible discharge date- don't even know what criteria needs to be met. So, we'll wait and see. Just keep praying please. Thank you and blessings to you all.

When we arrived at the hospital tonight Paul was sitting in a chair- could hardly believe our eyes. And it was his 3rd time in the chair today. He had wanted to go back to bed earlier but the nurse said "not yet". They want to build his strength, plus its good for his lungs to sit upright. So I think they're going to push him- he kinda rolls his eyes when we talk about it. :) He's taking ice chips and tomorrow they might check his swallowing (? an actual swallow study or just someone from PT or OT I don't know) but then he might be able to start a liquid diet and get rid of his feeding tube in his nose. Still not much of a voice- so we get the last word for a few more days. :) Not anymore fluid off the past 2 days- still giving IV Bumex for that. By the time we left he was back in bed and very tired. We hope each day there will be a new achievement or one less tube in foreign places.
Thank you again to all our prayer warriors. You help give Paul and Barb (and the rest of us)strength for each new day.

Barb just called- good news to report! Paul is off the vent! They extubated him around noon and he's holding his own. He feels a little panicky or so at times, especially when they do respiratory treatments to bring up the "gunk", and he's weak but else its going well. He has no voice yet- a little whisper. Labs (liver and kidneys) are improving a little, pneumonia is improving per Dr. Boeve, and he feels Paul has some other blockages but won't need more bypass at this point (something that was mentioned the first day)Yea! Paul winked at Barb and tried whispering to her which helped her spirits, but he also seems to be thinking and contemplating it all.

So more prayers are being answered everyday. Thank you so very much. And please keep praying for: Paul's morale/spirits, able to stay off the vent, labs to keep improving. Another concern for Paul is that he is selfemployed- no vacation or sick pay while he's hospitalized and recovering. So please pray for them in this area also. God hears all our prayers and he is able to work this out too. So good night, we'll "talk" soon.

Some news to report- when we walked in tonight Paul looked at us, recognized us, nodded his head appropriately, and was mouthing words at times even. Very good to see. He falls asleep quickly- he's still getting IV sedation although they've turned it down, but we also wonder how overwhelmed he might be feeling as he hears little bits of what has happened. He was calm/ restful which is good to see also. The agitation/restlessness is tough to watch when that happens.

The ventilator settings are lower than before- so he's needing the vent less. He's lost 8.5 kilos of fluid in the past 2 days- very good. He looks a lot better as a result. But the reason the fluid is leaving is not because of improved kidneys- its more meds.

They won't try to remove the vent until more fluid is off (isn't that what they said last time?). But since they've tried it once, it sounds like they'll be more cautious the next time. Our questions are about the kidneys, the liver, the pneumonia. Barb hasn't spoken with the surgeon in a few days, but sounds like he'll be around all day tomorrow. So we hope to have some answers.

"One day at a time". We can't make it go any faster. So we'll take the signs of progress when we get them. Just knowing he's alert is a huge thing for the family. Its a big relief. So thank you again for your prayers. Please pray for Paul as he takes in the enormity of his current and future health issues. Please pray he will be able to "rise above" to become stronger and stay positive. How he handles all this will make a huge difference in his recovery. Some peole become "cardiac cripples" not daring to do anything while others go on to live full and vibrant lives. We pray the second choice will be Paul. Thank you dear ones!

I have a couple days to update on- 2 evenings ago Paul was very restless and it continued much of the night it sounds like. He was also diagnosed with pneumonia- quite common for someone on a ventilator for any length of time, but not good news for someone in Paul's situation.

Then surprisingly considering the pneumonia, they extubated him yesterday (took the tube out of his throat and lungs) so he'd be off the vent and breathing on his own. But he had a hard time breathing and was "frightened" per his nurse, so they re-intubated him, put him back on the vent, and started the diprivan for sedation again. Teresa said he nodded appropriately to questions about watching tv while he was off the vent- wanted tv on, did not want to watch tennis, but did want fishing on. :) That does sound like Paul. So that was probably the only bright spot in the past day or two.

So, I don't know what the plan is for today. Hope they let him rest from his rather traumatic day yesterday. Getting intubated is not fun. Please pray for his lungs to heal so he get get off the vent for good, and that he may be relaxed and calm when he's not sedated.And pray for strength for Barb- she has to be very tired from being there every day (she doesn't fully admit to how much- she's been a "trooper" per Todd). She does go home every night, but then she does a little laundry, runs a couple errands, and then goes up as soon as she can. Thank you to her church family- you have been a source of strength and peace to her. Also to friends and family who call or visit at the hospital. It lifts her and breaks up her day a little. We appreciate all your concern and prayers. Love to all, Jacki

We have some relief! Yesterday Paul opened his eyes! He was restless, pulling at the restraints, pushing off the footboard of the bed (which actually is good for muscles and circulation)and opening his eyes. Its usually not focused, but Todd really thinks dad looked at him with some recognition before we left. And the nurse told Teresa that he had followed some commands earlier. We are much relieved- still have some waiting to do, but its much better than our fears were on Tuesday. Todd loved seeing his dad's eyes open- first time in over a week. They are giving pain meds- he grimaces alot. But I think some of that is he's a little ticked at being tied down with tubes in his throat. :) He acted like he would rip those restraints right off the bedrail if he could and I have no doubt the tubes would be next. So keep praying for his mental status, and the fluid to come off , and get him off the vent. Then he can start some sort of rehab. That will be wonderful. Also, pray for Paul's reaction once he does wake. He has alot to take in and absorb of this whole story. We hope he sees the chance he's been given- not just the work he has to do and the bills that need to be paid. God kept him alive for a reason- what will that be? Thanks for sharing all this with us. Hope you are having a good summer with family and friends. The lesson for all of us is to not take life or eachother for granted- it could all be over in a heartbeat-literally.

We saw Paul last night- his room was much less cluttered! No swan cath, no artline, one less chest tube, no ditropan IV, no primacor IV. So that was all good. Also he's tolerating the tube feedings well, urine doing well with assist from medication. The concern is that the IV continuous sedation was gone for 24 hours and he's not awake. The doctor tried to arouse him- shaking his shoulders, pressing on his sternum (which was just put back together on Friday) but did not wake. The fear is a stroke could have happened. But he seems to be able to move his extremities, can grimace, etc. And we know he was on the IV for days and his kidneys aren't perfect, so how long could it take for all of the ditropan to get out of his system? Plus they give him pain meds too yet. So we'll see tonight when we go if there is a change. So please pray that he wakes soon and has no deficits. We are "concerned but not worried" might be the best way to say it. Al else is stable. Thank you for your prayers!

Not much new to report- just talked to his nurse. Things are still about the same. On the vent, not responding, vital signs are stable, has gotten some fluid off. We're heading up tonight and will update if there's anything to report. Thanks for checking in.

Today was a mixed day. The good is that they were able to remove the balloon pump- Paul's heart doesn't need it at this point, and its one less piece of equipment in his room. ABG's are good yet (good oxygenation), and not much drainage from his chest tubes. The not so good is that they had him on a Bumex drip last night and part of today to help his urine output increase, but too much fluid came off and his blood pressure went too low, so stopped the Bumex and gave Albumin and blood. Urine output is ok now.

Also tried to let him wake a little but he became restless, so had to restart the Diprivan to sedate more. And now blood pressure is better too.

Tried to start tube feedings last night but was not tolerated (did not digest which increases chances of vomiting and getting it in his lungs even tho he's on the vent). So tonight they are starting TPN- an IV nutrition.

Tomorrow they hope to try to work on weaning from the vent, but he needs to be able to wake without getting restless. So we pray for weaning tomorrow and good blood pressure control. All things considered, Paul is doing very well. There have been no major setbacks, no sign of infection. We are so very thankful! Thank you for checking in.

This afternoon Paul went back to surgery to close his chest. All went well again. He's back in his room in CCU. Some things are improving- kidney labs are improved and urine output is much better (minimum 75cc/hour- had been 30/hr yesterday) which is good because he has an extra 30 pounds of fluid in him (he looks very puffy now) and they won't be able to wean him from the ventilator till some of that fluid comes off. So it might be 2-3 days before they try. The balloon pump might come out tomorrow- its still in place but not really being used which is good news.He has only 3 IV medications running- one to decrease blood pressure,(yesterday they were working to raise his BP as it was too low), one to sedate, one to help with heart pumping. We can't talk to him tonight b/c it raises his blood pressure too much.

Prayer concerns:kidneys are ok now but still a potential problem, patch stay holding, blood pressure low enough to help his heart and high enough for brain and kidneys, Barb to get her rest.

We are hopeful but cautious. The doctors and nurses aren't making any promises at this point. But they are surprised at his progress. God has answered so many prayers already! Thank you for your prayers, phone calls, and encouragement!

Tuesday afternoon Paul was admitted to Mercy in Muskegon with a heart attack(MI). He had a heart cath and stent placed in his right coronary artery to stop the MI, but alot of damage had already been done in that area of the heart as well as other areas. Also a complication of the MI (MI's plural?)was a hole in his septum or inner wall of the heart and needed immediate surgery. The doctors first gave him a 25-50% chance of surviving, then said "I doubt he will survive OR and will likely need to go to Ann Arbor for a transplant if he does survive." His kidneys weren't working well (damage from lack of blood flow during the MI) and his heart was not pumping well at all. (EF 20% for you medical people).But thanks to many prayers and a very skilled surgeon the only complication was an area of bleeding that needed additional work. They got Paul off the heart lung bypass machine twice, did not need to place and LVAD to assist in pumping, and the patch was holding after the additional OR. In CCU he was on the ventilator to breathe, had tubes into his heart and lungs to drain, and intra aortic balloon pump to assist/rest his heart, and tempory pacemaker, plus NUMEROUS IV's to do all sorts of things.

At 7pm on Wed. he was still critical but stable. They were able to turn down the ventilator and some IV's. Bleeding was an issue at times but better, kidneys still working but a concern.There has been no talk of needing a transplant.

Today (Thursday) was a stable day, talking about closing his chest tomorrow (its still open, but covered with dressings, so they get to his heart quickly if he bleeds too much)which is a good sign.He's still sedated- starts fighting the equipment if he wakes a little which is very common.

We have received excellent care at every point- from cath lab and cardiologist to OR and surgeon to all RN's (of course the RN's! We all do our best!) :)

As we've said before, thank you for all the prayers. Its why Paul is alive when the surgeons didn't think he would be, its why Barb was able to sleep finally last night, and its why we have any peace at all right now. Please pray for the patch to hold, for his kidneys to heal, and for full brain function when he wakes (his blood pressure has been intentionally low for the past 2 days). Thank you!