What has happened...

What’s happened over the past 30 Days is wonderfully portrayed in Caroline’s Notes. I read the Google news page every morning but on the morning of April 18 it wasn’t making sense. I drove to Havre de Grace to see the Osprey, walk and say the rosary (as I do most every day) and I couldn’t say the Our Father, or Hail Mary. Then I called Caroline. So here the notes are:

Saturday, April 18, 2020:

Joseph calls Caroline—signs of incoherence.

Sunday, April 19, 2020:

Caroline calls Joseph mom, Dolores his sister is there, we talk, there is something wrong. Dolores calls Joseph’s primary doctor. Over the phone, the nurse asks basic questions about date, time, name, etc. Joseph cannot answer. Dolores brings him to St. Joseph’s emergency.

In the evening, Joseph is transferred to University of Maryland for neurosurgery, scheduled for surgery next day. Caroline is contacted by the neurosurgeon in training and told that Joseph needs to have the meningioma removed (tumor located between cranium and brain—pressing on the brain). He asked her if she gave consent because Joseph was then not coherent, and they were not sure that he was understanding everything. Caroline asserted that she wanted the best for her husband, but that the Doctor should first talk to Joseph and explain everything to him and see what Joseph says. The surgery was set for morning of April 20th.

Monday, April 20, 2020:

In the meantime, Joseph had been administered strong dosages of steroids, which kept the swelling down, and he was able to regain his speech and clear awareness. That morning he spoke with neurosurgeon and Joseph chose not to jump into the surgery right away. It was explained to him that while he could put off the surgery for a bit, he should have it as soon as possible. It was also suggested that he fly down to Austin to have his surgery, because after the surgery he would not be able to fly for a while. His surgeon referred him to a surgeon in Austin.

Caroline and Francesca fly to Baltimore.

Tuesday, April 21, 2020:

Caroline and Francesca pick up Joseph from hospital. The day is spent packing, visiting park, and visiting with Joseph's mom and sister and brother in law.

Wednesday, April 22, 2020:

Joseph, Francesca and Caroline fly back to Austin.

Thursday, April 23, 2020: Family together--wonderful times!

Friday, April 24, 2020—Teleconferencing with Dr. Koltz. Joseph likes and trusts Koltz. Direct admission is scheduled for April 28th. Family together-wonderful times!

Saturday, April 25, 2020 –Family together—wonderful times!

Sunday, April 26, 2020—Family together—wonderful times!

Monday, April 27, 2020—Family together—wonderful times!

Tuesday, April 28:

Direct Admission to Ascension Seton Hospital for surgery scheduled for April 30th.

Wednesday, April 29th:

Given the size of the tumor as revealed by latest MRI, the surgeon suggests that the operation be done by his colleague,Dr. Ortega, who has greater and more extensive experience with these kinds of tumors. Joseph agrees. In the evening, he is transferred from Ascension Seton to Dell Seton at University of Texas, downtown Austin.

Thursday, April 30th:

Joseph undergoes angioplasty to embolize vessels that feed blood to the tumor in order to prevent excessive bleeding during the surgery.

Friday, May 1:

Joseph undergoes surgery for removal of tumor. The surgery is successful. The tumor has been completely removed.

Saturday, May 2—At hospital following surgery

Sunday, May 3—At hospital following surgery

Monday, May 4—At hospital following surgery

Note: Family cannot visit because of Covid-19.

Tuesday, May 5:

Caroline picks up Joseph from hospital along with a series of meds.

Wednesday, May 6:

A physical therapist from Home Health Care visits Joseph and Caroline at home to assess needs and assign speech therapist and physical/occupational therapists. Things look good and hopeful. Does not foresee long term care—maybe a couple of weeks at most.

Thursday, May 7:

Joseph and Caroline have the best day they’ve had in years! Joseph’s speech is perfect! We listen to music, watch old movies, a lot of laughter. This was the last day for steroid meds.

Friday, May 8:

Speech therapist visits early in the morning and is amazed by Joseph’s speech ability so quickly after surgery. She tests his swallowing—all good.

As the day goes on, Joseph experiences sharp headaches at closer intervals; his language begins to slur. Caroline assumes that the cessation of steroids might be forcing the brain to access speech on its own, making it more difficult.

Saturday, May 9:

Joseph cannot control flow of saliva and is having difficulties swallowing. The speech is becoming incomprehensible. Ears and head continue hurt. And then, the right side of mouth droops and he cannot feel the food in his mouth on that side—food is falling out.

Caroline calls Doctor Ortega’s office. There is no one there. Caroline is referred to a hotline with physicians available to answer questions about symptoms. Caroline explains the symptoms and is told to bring Joseph immediately to emergency; the doctor on call said that it looked like he was “stroking”.

Caroline brings Joseph to the Dell Seton hospital emergency. He is immediately admitted and undergoes an MRI. Caroline is not allowed to stay. Much later in the day she gets a call from a resident doctor that the MRI reveals bleeding in the brain and that it does not seem to be a stroke. They are waiting for experts to assess further procedures. He is immediately put back on steroids to decrease inflammation.

Sunday, May 10:

Caroline can barely get info from hospital. She gets some info from nurses about general vitals, but no doctor calls. It is mother’s day, the weekend, and the surgeon is in surgery. I later find out that Joseph is put on a saline drip to dispel the edema in the brain and stop leakage. Joseph also continued on high dosages of steroids.

Joseph is upset, calls Francesca and asks her to bring his cell phone to the hospital. Francesca and Jacob bring him his cell phone. Very difficult and challenging times with no visitations under Covid-19, and hectic mother’s day weekend and no known doctor available on site…

Monday, May 11:

Caroline is still waiting to hear official reports from doctors. In the meantime, Joseph asks Emmanuel to bring him his recorder. Emmanuel brings his recorder to the hospital. Finally, toward the end of the day, Joseph's first surgeon in Austin, and who is affiliated with Ascension Seton and is not on the ground at Dell Seton, lets Caroline know that he found out that the bleeding has been stabilized, and vitals continue to be strong. But, there are signs of paranoia and manic behavior that have to do with meds. They begin to taper off from steroids, which they believe resulted in manic behavior and some paranoia. Throughout, Caroline tries to reach out to the doctors via text messages to get more information. They explain to Caroline that stroke symptoms were the result of fluid build-up and pressure on sites of the brain connected to swallowing and speech. Very difficult to get information.

Tuesday, May 12:

Dr. Ortega calls Caroline and reports that all is stabilized, the healing of the wound looks good. The saline drip is stopped. All looks good except that now the blood pressure is spiking, along with manic behavior. One of the resident doctors calls Caroline to tell her that they are keeping Joseph yet another day to make sure that he gets off the steroids appropriately, that his blood pressure stabilizes and that he is able to swallow properly.

Wednesday, May 13:

Joseph is angry and agitated. Too many residents in and out of his room. The nurse practitioner in charge of coordinating across care tells residents to stop visiting. New blood pressure medicine is prescribed.

Thursday, May 14:

Joseph is discharged. Caroline picks up Joseph. Speech is comprehensible. Joseph is strong…some coordination problems given the brain is adjusting post-surgery. Home care continues…

... Me Again:

And is very strong… According to the Doctors, recovery might last 8 weeks. In the meantime my speech and other capability will be up and down and I often won’t be able to communicate. Sometimes it’s turned to ‘word salad’, sometimes dry mouth, sometimes just exhaustion and so many drugs, so far. I want you to think of my writing as a fiction not a fact. A fiction from my heart at this moment, perhaps remembering though the facades of drugs and frustration throughout. But I’d Still like to talk to my friends, often for very good reasons. Caroline, Emmanuel, Francesca and Jacob are very loving and capable of supporting me.

And other thing: I went from 20 years of Depression to live without it in the snap of the fingers. The opposite of Depression is Curiosity.