Water, Water

Thanks to Jesse Judah's day nurse who noticed how much fluid Judah was retaining Dr. Forman et al ordered dialysis. 3 liters of fluid were remove. I am sure Judah is feeling more comfortable. His blood pressure was fairly stable but his o2 is very high at 90. Cindy,his night nurse is going to slowly reduce the o2 to a better level if possible. I will spend the night.

The air outside cooled off, for the first time in a long while, sort of announcing a new season to be. I hope it brings with it a new and better season for Judah.

Good night all.

M

Moving Tubes

Judah tolerated the tube moving procedure fairly well. While the Doctor's intention was just to move it to relieve pressure against the chest wall, it did manage to drain a lot of fluid off Perhaps this will help.

Visitors include, Helen G, and Bob S. CJ and Dalia regaled us with New York stories, and Janet and George flew in from NY, Josh K and Anne not only visited Judah but Josh was doing Mesheberach (Get well) rounds on various people he knows here.

Josh also helped hang a mezzuza sent by Brandy's Mom El. The other night Andrea and Gay also visited,(I forgot to mention it).

Thanks for your blogs.

M

This morning Judah is going to have his chest tube rotated to attempt to pull more fluid off. He has gained two kilos again. Diaylsis has been ordered. His o2 is up to 75 % with a 90% saturation. The goal is to lower his 02 requirements. Perhaps decreasing the fluid around the lung will enable his lungs to work more efficiently. The staff continues to be aggressive in their treatment. We need a series of small miracles to augment the medical treatment. If any one has a miracle or two to spare we will accept all donations.

Pixie, welcomed me home last night. After a good sniff, a back scratch, and foraging into the old laundry, she decided that it was time for bed. As is her habit, she stands by the laundry room door head towards the bedroom, and barks at me. I raise the mattress (she is too old to jump directly on the high bed) she jumps on my bed then on to Seymour's bed, circles the pillows, gets comfortable and lets out a great sigh. Then I can go back to doing what ever it is I was doing.
During the night she came into my bed for a snuggle, since she is not petite I have two choices, get up (usually what happens) or experience her displeasure at being sent back to the other bed.

Oh the life of a dog!

I will write later after the procedures. If you want to contact us directly you can always e mail, to ivorytrust@aol.com. I can't always get to the phone.

M

Market Theory, Legends and Mandel Bread

The Schweitzers were here. Stuart enjoyed the last piece of Stella's mandle bread and Suzanne brought my mom a book of Women Legends featuring a best hits list including Oprah, Mother Theresa and Martha Stuart.

I got an ivy league education on marketplace theory. Stuart talked, I listened. Discussion included a comparison of NYSE, E-bay and the Farmer's Market. It all started when I asked a fundamental question about the stock market: how is the price set? "It must be frustrating, being a layperson," he said. Kidding aside, it was an absolute pleasure to ask a knowledgeable person and receive a knowledgeable answer.

El Gordon sent Judah a mezzuzah. Her rabbi told her to change her mezzuzahs when she had troubles. It might work here.

Judah is resting peacefully. Suzanne and Stuart chatted with him and I'm sure it perked him up. Uh oh...there goes a beep.

Good night everybody, aaw.

ps for those of you who don't know and are afraid to ask, the answer is the "invisible hand."

Pixie Has a Hot Date

Iss is going to spend the night, so I know that she will write a long blog later. Mom finally agreed to go home for a few hours (thank God)! Pixie will be in dog heaven, her bedmate has come home to her at long last.
Judah is managing. His lungs are still not well, and his O2 needs are very high (74% concentration), but he has fought off his fever. Now we are watching his blood pressure very carefully. Iss will fill in the rest.

The Lion of Judah- Heritage Park-COH 

A Month ICU Visit

ICU - 30 days
Post Transplant -June 7, 2005- day 83
O2 65%
Saturation 90 %
Temp 36.9
BP 122/54
heart rate 103
3 antibiotics
2 antifungals
platelets
weight, 80 kilo
amiodarone
pentabarbitol
dilauded
dopamine
saline
dextrose
are all part of the daily routine.

Its easy to forget that Judah is the person, not the sum of the numbers. He is heavily sedated, unable to communicate, the essence of him is muted and not available to us. I want so much to talk to him, and to hear him complain that he did not get enough sleep, tell me his latest dream, discuss everything from baseball scores, to medicine, to his analysis of the political scene, I want to hear his easy short laugh, I want to feel him tap me on the right shoulder while he passes me on the left, I want him well.

The doctors are doing their utmost to help Judah out of this mess. Nurses are unbelievably good and kind. Strength and pride come from watching Alissa and Benji care for their brother. Comfort comes from friends and family. Prayer comes from every where. It takes a village to cure an illness.

5:45 PM

Not much news to report except that Judah has gained 20lbs in a few days. We are waiting for the dialysis to begin. The new regimen is dialysis for two days and day off. It seems the medical staff things its good, but doctor mom doesn't see it that way. I think he did better with daily dialysis.

Alissa and Benji are here, trying to balance work and love. Josh K, David, Lisa K visited today. We walked to the Heritage Garden where a Lion sits in the courtyard surrounded by olive trees, magnolias and conifer trees. At his feet is a bed of marigolds. Very few people come to this spot. I find comfort in looking at the Lion, and ask G-d to make our Lion of Judah strong and well.

M

Preliminary early am report

Lights are up, nurses begin their early morning routine of washing patients, drawing bloods in order to prepare for the day shift. Quiet of the night is over. Alarms beep, and today, there are several children on the floor who began to cry.

Judah spent an uneventful night, his stats remained stable, no change. Thank G-d for another day. When the nurses finish we will sing Modeh Ani to Judah, watch the sun rise and hope for a better day.

Boker Tov, good morning

M

... But Wait, There's more

The Stricks were here (mandle bread), Rina Carmel (in time for dinner al fresco with food provided by Judy and Rachel), and Rona Legman Cosgrove (brownies). Rona had the good sense to come when Judah was looking his best. His color is back and the meds puffed him out a bit so he's less gaunt. His mouth is staying closed on its own. "He has beautiful color," she said, "like a baby."

David Kukoff named names on the Camp Ramah snapshot, Wozzy brought it in. Lisa Gordis, are you there? How about Mr. Nesis? Gary Lainer we know you're here.

Yesterday,I asked Ron Andiman if he had any thoughts and he said, "Thoughts, yes. Words, no."

Judah's Sunday

Judah's condition remains the same. The news could be better and it could be worse. He hasn't made any progress, but he is seemingly level. There are discussions with the doctors about changing Judah's lines. He has several leading into his body and there is the possibility that they are all infected. The procedures are surgical and are potentially lethal, but then again, so are the infections.
In the meantime, Iss noticed that Judah's mouth is closing. This makes him look much healthier and calmer. He seems to be resting.
He's had a full day of visitors. The roster (for those that follow these things):
Mikes Lewis and Kadish, Deb Kadish, David Kukoff, Ziony and Rachel Zevit, Josh Katzan, Dr. Crazy Josh and his wife Talia, Michelle Lewis, Jule Hackner, Helga Weinbach, Hilda and Al, Zehava, Eli, Yotan and Havi. All this and it's only 5:30.
Thankfully, there are no "events" to report. Judah is still here, thank God.

Sunday AM

Judah finished dialysis around midnight. He had a bout of irregular heart rhythm that finally converted to normal rhythm after a while. (two hours). His temp is normal, and respiration stable. His o2 is at 65% with 93 % saturation rate. His peep is 8. Sunday is a break in aphoresis as the tech gets a day off. Everything else will continue. In a few hours the medical staff will round and give me any new details.

Yesterday, brought visits from Bill C. Topics ranged from mundane to lofty. Libby, Audry, Erica and Amihai flew, drove from NYC, San Fran area. Debby D and guys, ( cookies) Mara, Dave Stacey,(cake) Aviva and Leon (strawberries) Felice and Ron, and of course the many e mails, blogs, phone calls help stave off the feelings of sadness. Judah loves company as you all know, and he is told of every comment, call and visitor. We can't wait to have him smile at us, bat those baby blues, and give thumbs up, and "back at you, Ma".

A strong sun is shining through Judah's window signifying another very warm day, filled with sunshine. Let's pray it shines on Judah.


M

Update

Mom will write a formal post a little later, as she will spend the night tonight. In the meantime, Judah is very much the same as before, but his oxygen needs have been higher today. He is receiving dialysis right now which usually helps him breathe a little better.

Making sense out of sensless things

Shabbat morning- I sang(in a tuneless tone deaf manner of speaking) some of the Shabbat morning prayers to Judah. He lays in his bed, immobile, with tubes pushing fluids into his body, with tubes taking fluids out of his body. It reminds me of a passage in the novel Catch 22- the paraphrase is avoid the middle man just put input tubes to out put tubes. In his hand is the stone from Biblical times, in our broken hearts a prayers of all kinds, prayers for refuah shelemah, prayers to give us another day, prayers for the care givers to be strong and vigilant, prayers of thanks giving for all we have had, prayers for every one in this building, prayers for every one who is suffering, prayers for wonderful friends and family. This is truly a spirital palace. As I walk into the modern glass and steel building, I pass thru an arcade of tall magnolia trees whose spires reach into the pale sky. Last night, we made a motzei underneath these giants. We can watch the moon rise and the planets shine brightly. Soft warm air flows over us as we eat a Shabbat meal, some times Hilda's, Rachel's Judy E's. For a moment we forget all the sadness and difficulties. Often we lay down directly on the grass, and just let the moment over take us. No tears, just peace, and once again prayers. Not formal prayers found in Liturgy books, not fancy prose, most often just a "Dear G-d".

As the day continues, Judah is stable. We are grateful for another day.

Shabbat Shalom to all
M

The Overnights

Judah has had a good night. He shows no signs of fever. His signs have been stable throughout the evening. His oxygen needs are still quite high at 60% O2 concentration, but no higher.
His blood pressure is 109/42 and his heart rate is at 100 (normal for him).
More later.

Friday Night

Judah managed well today for the most part. He had a bout of fibrilation earlier today that surprised everyone but was under control in no time. Dr. Forman came around a little later and told us that this kind of fibrilation is unsettling, but it is not the lethal kind that we have been afraid of. He also told us that it is very common to see this kind of thing in the ICU. Also common, but more pernicious is the staph infection that Judah has sprouted out of cultures drawn from his arterial line. The doctors may consider removing and replacing the lines surgically, but for now, they've chosen to let Judah be.
Florenda, his dialysis nurse is with him now and for the next few hours. Our cousin Libby showed up just in time for Shabbos dinner under the magnolia trees. Judy and Hilda made a great meal for us. Only thing missing was Judah, of course.
As for the rock, it's amazing to see a piece of history so close. It is a very loving gift that E. Gordon sent to Judah. Mom and Iss have wrapped Judah's fingers around the velvet pouch that holds it. If there is any magic in this world, I hope it rests quietly under Judah's hands, leaking slowly into his body.

Mom 

Mom's taken up crochet! She bought the basics at Walmart. 

Judah's hand 

Judah holding a velvet purse with stone from King David's steps 

Letter From Tennessee, A Chip Off the Old Block,

August 22 05
Dear Martha and Judah,

The chip is a piece of the steps leading to the ancient city of Hebron mentioned in the Tenach. I will find the verses and the drawings I did of the steps and send this to you. I had 10 chips I was allowed to keep as they were too small for us to repair the steps due to political pressures to finish. This is where King David ruled from for seven years before capturing Jerusalem... I have learned many Jews carry earth, stones, etc from Israel so they are always close to it. I feel since King David was such a powerful king, perhaps his special place will give you xtra stregnth and all the prayers all of us give to you.

...ps do not handle the chip too much as it will crumble. it is 4,000 years old. I am trying to find a glass container to hold it in before it turns to sand.

...If you drink wine, I have pieces of tile taken from the city (later period, some of it Byzantine) from the winery there...

Once again to you and your mother my affection,

E. Gordon
Tennessee
(lightly edited by Alissa)

Ron and Thelma

Thumbelina, photo by Judah,
Ron, respiratory therapist and Thelma, are smiling this morning. Judah's fever stayed down without ice packs, and his oxygenation is at 93% with 59% o2. This is a return to better numbers. Still a long way from recovery but its a small step in the right direction. It seems there is a small competition between the night and day staff as to who will get Judah to have better numbers. It's fine with me as long as Judah keeps going in a positive direction.

I look out his window, its still dark, but the headlights of cars moving along the 605 form a ribbon that ties the sky with the earth. It's still pre dawn, in a few minutes a soft glow will be visable from the window. Life goes on and with it hope.

Much love,
M

Small Steps on Mt. Enormous

It's so important to us to post the good news as it comes, but we also want to make sure that everyone knows that Judah is still far from recovery. His fever seems to have broken right now, and his temperature is normal again, but the doctors are still unimpressed. They know more things than we do, but we know that they are sometimes hardened by their experiences. Judah is fighting some kind of infection, he is suffering from CMV virus and his lungs look like cotton balls on his x-rays. Nonetheless, Judah is hanging in there. His breathing is slightly stronger than before and he is showing remarkable tenacity. Others would not have made it this far. Things turn around quickly here, and they could go left, right, up or down. It seems that Judah has made it through another day, and we will wait to see what the morning brings.
It goes without saying that Judah is supported by countless friends, family and well-wishers. I'm also especially grateful for the dozens of people who give my mom the support that helps her endure. She could not do what she does without the love and friendship from all of you.
It's hard not to celebrate the small steps Judah's body is making in the right direction, but bear in mind how much more there is to overcome.

Busy Afternoon

Morning rounds with Dr. Forman and afternoon rounds with the nephrologist confirmed that no dialysis for today. The concern shifted from extra fluid on the lungs to keeping his blood pressure up. He still has a high fever, and a bronchoscopy was performed to see if his lungs had any overt infection. Specimens are being sent to the lab, not much inflammation was seen. The infectious disease doctor was consulting, and all in all keep praying.

Mazal Tov to Jon and Aneta on their upcoming wedding, its the same day as Cousin Amy and Dvir. Judah has been known to give wedding gifts a little later than Emily Post would dictate. I think that he will be true to form. ( Check is in the mail).
In between all the doctors and procedures, Mara B, with Kosherland game for Judah to play ,Dave and Stacey, Mark and Delia, Jon and Anetta, Sabine, the Chaplain, Al Ashley and Zioni came by. Zehava, Rachel, Judy and Les, Judi, and Mike L have also stopped by yesterday. Cousin Bobbie, Linda, Amy and Dvir are frequent flyers. Helen G. Bob S. shared lunch in the Bistro. Helen S and John S also deserve the pepto bismal award . Of course, all of the bloggers have been welcome visitors.

M

Quick Check In

Judah's lungs seem to be improving a bit. They've lowered his O2 concentration down to 65% and his oxygenation is holding steady at 92 (compared to O2 levels of 85-95% the past few days with oxygenation at only 86-88). This may be as a result of the steroids, or natural healing. His is still suffering a high fever, however, and low blood pressure. Doctors have not come around yet.
A very special thank you to Nancy Leonard- you were right, it beats by far what's available out here.

A new morning

The yellow sunlight is peeping into Judah's room. Thelma, his night nurse kept his blood pressure under control, ( swings from 85/45 to 114/53 and everything in between) his temp cool , and in general kept him comfortable. Blood gases are being drawn now and soon Dr. Forman will round.

I read and reread your comments to Judah, I think it helped stabilize his blood pressure. Getting Judah well is a team effort. The medical team is doing their part and you have been stupendous in your outpouring of love and support for Judah and for all of us. When I started to thank one of doctors for his help he said "the thanks I want is when he gets well".

With much love and appreciation,

M

11:15 pm

Dear All,

Your words of encouragement and love have been relayed to Judah. As of this hour, Judah finished dialysis and as usual it gave him a boost in his oxygenation . He still is running a fever,which despite this high tech age, is being controlled by ice packs. Thelma is back on duty, I will spend the night, Alissa has Pixie patrol and Benji will try to sleep at home. Will write again in the morning.

Good night,
M

More Frank Talk

Sometimes we are reluctant to put down our thoughts and observations on the blog for fear that by writing them, they will become true. We are scared. Judah is teetering on a precipice.
Why we have reason to hope: There is a woman on the floor who was in a similar position as Judah; she suffered from lung fibrosis and inflammation, and she required 100% oxygen for over a week. She had been in the ICU for about 5 weeks. She made a spontaneous recovery. She is not fully healed yet, but she is able to speak and even stay off the respirator for long periods. Her children keep reminding us to hang on.
Judah now has increasing complications. Each one compounds the gravity of his condition. The doctors and nurses at City of Hope (God bless them) continue to afford Judah every treatment available, and they continue on as if Judah will recover, even though some of them think he will not. It's business as usual; Judah will have dialysis, apheresis, change in antibiotics etc.
We are very lucky in that Judah made his wishes explicitly clear as to how to proceed in the case of a dire emergency. Judah not only discussed his wishes with Mom, Issy and me, but with his doctors, his nurses and other care-givers.
Here at COH, they have a policy of meeting with the family members when the situation turns serious. Dr. Forman met with us yesterday and we discussed the different scenarios that may play out, and we confirmed what we knew about Judah's wishes. Judah made it clear to all that he wants all measures taken to preserve and prolong his life. Despite the seeming clarity, shades of nuance still came up that created questions about how to proceed if things turn bad. We are lucky in that Judah made the hard decisions for us. We will continue along even when things seem bleakest. We will give Judah every opportunity possible to make a recovery and turn the tides, even in the face of advice to the contrary. Judah must have his reasons for making these choices, and I hope to God that they pay off.
Still, we are lucky to have Judah with us for another day. I hope to write this again everyday for many years to come.

6 am report

Judah is being given his morning bathing by his nurse Thelma. During the evening all of his numbers remained the same. We are grateful that they did not get any worse. He is still in a very difficult position and we continue to pray.

Your words of encouragement, hope, and love keep us strong. We relay them to Judah, and I am sure it helps him as well.

With much love,
M

What We Know:

This is a frank update of what we know.
Judah is continuing to worsen. Specifically, his lungs are requiring greater and greater amounts of oxygen, and his blood is receiving less and less of it. Dr. Forman has provided us with a picture of different scenarios that may play out in the next day or so. We understand that there is still room for a reversal; that Judah may make spontaneous improvements. We are now informed, however, of what may occur if Judah does not make any progress.
In Judah's favor, dialysis is continuing in order to possibly allow Judah to oxygenate better. After several hours, however, his oxygenation is not improving. Since his steroids have been reduced over the past week, Dr. Forman is going to provide another megadose overnight so that we may see if any improvement occurs.
We are facing another crisis, with fewer and fewer options. We want everyone to remain optimistic, but realistic. Judah may be facing the worst. Our hands are tied and time is the only thing that can reveal what fate lies ahead for him and us all.

Judah's really having a rough time. There have been some fundamental changes in his condition over the past few days which are causing serious concern. He has having a hard time keeping his oxygenation levels normal despite very high levels of O2 concentration. As Mom mentioned, there have been two chest tubes inserted in an effort to draw off fluids and air. His CT scan was not encouraging either. He is enduring a fever as well as consistent acidosis.
These are the bad signs. There are some hopeful signs as well, but they seem slighltly less impressive in the face of so much adversity. We are remaining hopeful that things could change in a positive direction just as quickly as they changed in a southward way.
In the meantime, some Good Samaritan has come to play the harp (of all things!) for the patients in the middle of the ICU. I bet some of the lightly sedated patients think they are approaching the Pearly Gates to the serenades of the cherubim.
Will know more after our meeting with Judah's doctors later today.

39 and a day

Judah reached his 39th Birthday, yesterday, and today we begin the march to his 4oth. I am sure he will take up all the offers to Las Vegas, trips to Westport and parties to celebrate all the summer birthdays, including the Birthday of Judy Sherman his birthday mate.

Yesterday was eventful from a social perspective. Josh and Dave came to visit Judah, Eileen negotiated the blood donor system, John and Helen braved the 134. Benji began a new semester at school. Alissa beat Dave at Gin Rummy.

Yesterday was eventful from a medical perspective too. Judah had another chest tube placed in his left lung. The earlier tube did not address the fluid and air accumulating higher up. Dr. Horac called in a Thoracic Surgeon to do the procedure. ( Done at bedside). The tube seems to give some relief but Judah's o2 requirement is still very high. Josie, his night nurse has just given him a bath, reducing his fever, and has drawn all the bloods. The results will be available to Dr. Forman et al when they round in the morning.

Breakfast at six in Duarte means IHOP . Let me describe the location, its off of Mountain Ave, properly named as the mountains are immediately north of the area. Walmart is on the northside of the street. To the east is Ross for Less, and Home Depot. Early morning breakfast club includes truckers either having just made deliveries or about to begin a days work. A few strange souls like myself a little bleary eyed, and a few of those very peculiar people who actually are cheerful at six am. The wait staff is usually young and like to listen to loud music and watch some oversized tvs whose sound volume is just below my hearing, but loud enough to create a continuous buzz of noise. Early morning silence is not on the menu. But, they do have a senior citizen's menu and I like that!


M

Judah at 39

When Judah and I were little, we used to celebrate our birthdays together at my grandparents' house in Westport, New York. Although we are 3 years apart, our birthdays were only 8 days apart. The annual county fair was always held around this time of year, and we'd beg to go for as many days as our parents could tolerate unsafe rides, toothless carnies and demolition derbies. Judah was an exceptionally graceful kid. He was very tall, thin, handsome and he could run as fast as jackrabbit. There were other kids around for the summer in Westport, and Judah was always the first to make friends with them. I used to think that if I wore the same style sneakers as him (Keds NBAs), I could run as fast as him. Never mind that I was always three inches shorter than him and 30 pounds "healthier."
His birthdays back then were usually uncomfortably hot days. Mom would show up with a cake that had some particular theme acted out on top by small plastic figurines and sugar lump landscapes. One year it was cowboys and Indians, another year it was a baseball game. No matter what cake he got, I was jealous and wished it for myself. If, just one week earlier, I had an elaborate cake of dinosaurs and cavemen, I'd wish I had his racing cars and astronauts. He was just cooler. Sportier. His life seemed easier.
There reached a time when I got cooler, sportier and taller. He was always gracious about losing the height wars with me, but he seemed to be bitter about the hair issue. Still, he always kept an older brother's pride in me. Judah is so much my rock. He is my dictionary. My encyclopedia. My doctor, my lawyer, my rabbi, my friend. My brother.
It's overwhelming to now be the one who watches over him, helplessly, as he fights some internal battle just to stay alive.
Alissa and I were much closer in age, and Judah felt left out. He confided in me that he longed for the intimate bond that similar aged siblings seem to share. It was an imagined condition. During Judah's long illness, we've spent infinite hours just sitting with each other. Sometimes talking, sometimes not. We've become close again, narrowing the three year gap between us.
Now, the staff who do not yet know us often ask me who is older. I take gentle umbrage.
I can't say that Judah looks great today. He is gaunt and immobile. His nurse tells me that he has had a fever during the night. His oxygen concentration is high again, now at 50%. Still, it's our privilege to celebrate his birthday today. For me, it's my 36th time with him. He has all of what it means to be loved surrounding him, lifting up the battle axes inside of him and plowing through whatever is hurting him. Let's hope for a more wonderful year than the past one.

Judah's Small Setback and How Eating a Brisket Sandwich Can Speed His Recovery

Judah had a complication today. His doctor noticed an air pocket in Judah's left lung (his problem lung from before all this mishugas) on Judah's daily x-ray. He inserted a chest tube into Judah's lung to drain air and fluid. The procedure seemed to go well, and Judah is now receiving dialysis. This setback is forcing Judah to rely on higher oxygen concentration which is now set at 55%. We're hoping that he will get back to lower oxygen levels soon. The pocket of fluid from the other day is also draining, but at a lower volume than the first time it was tapped.
It feels like Judah has too many holes in him already. It's hard to allow even one more, but the doctors are doing what they can to keep Judah stable enough to begin progressing.
As with virtually everything else that has been put in, put on or put through Judah, this too is supposed to be reversible when Judah is weaned off the ventilator. I had dreams last night that Judah was talking and laughing about this whole thing. It is a friendly reminder of what we have to look forward to, hopefully someday soon.
Thank you to everyone who is considering or has considered donating blood in honor of Judah's birthday. There are many stringent rules that prevent many of us from giving, and it is also a deeply personal choice to give. It seems to me that for the rest of us, there are many other ways to celebrate Judah's birthday. Take a walk. Look at some flowers. Eat something delicious. Think of Judah and maybe all of these sensual experiences will somehow awaken in Judah a memory of the things he liked most. If there's one thing that could bring about a speedy recovery, it's the promise of a good meal.

Sunday AM

Quick update: Alissa who spent the night reports that Judah had a quiet night, all vital signs were stable. Thanks to Josie his night nurse, and looking forward to more of the same today. Will post again later today. Have a great day. M

Judah's Good Deed

Judah did real good last night. He let me sleep peacefully.
Additionally, he slept peacefully. His lungs seem to be improving alot. As Mom mentioned a few days ago, Dr. Horack let us sit in on his bronchoscopy. The fear was that we were going to find signs of infection, excess fluid and possibly blood. The catacombs, however, were stone dry, pink and yellow, and infection free. The X-rays continue to show signs of congestion (for lack of a better word). Nonetheless, his lung functions seem to improve as they've been able to bring the oxygen concentration down to 35% for prolonged periods- including last night!
Dr. Horack also showed Mom and me Judah's x-rays. While trying to explain some technical issue, he brought up on the computer a CT scan of Judah from May. We were scrolling through Judah's body in a 3 dimensional cross section. Dr. Horack showed us where the signs of congestion and fluid build-up in Judah's lung x-ray corresponded to Judah's CT scan. On the CT scan, he showed us, there is a very clear area under the left lung that is holding fluid. Mom, remembering what Dr. Les Stricke had told her several days prior, wondered why a needle wasn't put to the lung to drain the fluid. Dr. Horack suddenly had an idea! Why not put a needle to the lung and see if they could drain the fluid?
Mere hours later, as Mom reported, almost an entire liter of motor oil brown fluid was drawn out of the lower part of his left lung. Maybe an honorary M.D. is on the horizon?
Judah's blood-work is a big concern/interest now. Thank God, I say. I'd much rather the doctors move on from worrying about his lungs to his blood. One crisis may be moving out of the way, making room for the next. Eventually, the next will be quashed, and so on and so on. The only way out of this is through this.
Since it is Saturday, I don't expect much insight from Judah's doctors. Many of them are taking a well deserved break.
For those of you who will come to visit Hadj, you will find him looking surprisingly less scary. the removal of the face-mask makes him look more normal. He is very thin, though. Speaking of thin: Thank you Hilda for dinner last night. Mom and I are holding on to whatever weight Judah lost in the hopes of returning it to him shortly.

Shabbat Shalom

Shabbat is entering the environs of the City of Hope, Judah is resting after a day of dialysis, blood exchanges, xrays, blood draws and encouraging words from his medical team. The Shabbat mantra is small steps, steady steps, all leading toward a refuah shelma, (Complete recovery).

Shabbat Shalom,

M

City of Hope Address

ZZ requested City of Hope address:
1500 E Duarte Road
Duarte, CA 91010
www.cityofhope.org
626 256 4673 (hope) General number
626 301 8386 Blood Donor Center

e mail address: Personal address, www.ivorytrust@aol.com


Currently Judah is in the ICU, but any mail addressed to him does find its way to his room.

Judah has required daily infusions of blood and platelets. If you are coming for a visit and can donate blood or platelets it would help replenish the supplies that have been used. The City of Hope has its own blood bank and is not part of any other collection agency. Call 626 301 8820 to set up an appointment. If you do want to donate blood/platelets and are out of town, it still would be a Mitzvah (Good Deed) to donate to another blood bank.



General blood /platelet information:
Blood can only be stored for 28 days, platelets a bit longer.
Blood donations usually take an hour, platelet donations apx 2 and half hours.

To qualify as a donor:
Be over 17 years of age
Weigh at least 110 pounds (not my problem)
Be in general good health
Not taking antibiotics
No history of cancers (except basal cell)
No risk of hepatitis exposure
No risk of HIV exposure
Have not spent more than three months in United Kingdom from 1980 -1996
Have not spent more than five years in Europe since 1980

The telephone intake person will ask additional medical questions to determine eligibility. At this point in my life and I assume most of my friends we all have had something that disqualifies us. So, in advance, The White's say, once again, Thank You for being there and supporting Judah on this unbelievable journey.

This would be a wonderful birthday gift for Judah.

You can go to the City of Hope web site for more details www.cityofhope.org

Seven AM Friday

An early morning report: Good Morning East Coast and early morning commuters,

Sunrise over the 605 freeway was beautiful. Light is pouring into Judah's room and directly on his face. This is the first time in many days, that he looks more rested and less stressed. His o2 has remained over 90% all night. He did require platelets again. But none of his alarms went off, no great shifts in numbers on all his monitors. Lourdes, his night nurse and Ron the RT, kept up with all his meds and needs allowing me to sleep. I would wake up just enough to see them attending to Judah and then close my eyes again. Its amazing how one can sleep inches away from people working.

After the Doctors come in I will write more.

apheresis 

Long Day

A Long Day for Judah Oxygen sat at 93%. wow. The day began with chest x ray, next a broncoscopy followed by a review of his chest x-rays which showed a plural effusion that has been stable and around for a long time. Dr. Horac, (pulmonologist) ordered an ultrasound which pinpointed the site of the fluid and did a needle aspiration of almost a litre of fluid. Dr. Wong ordered apheresis of Judah's blood as he has developed antibodies against the new red blood cells. This is a two hour procedure in which his blood is circulated thru a machine which removes the broken and damaged red cells. When this was finished, the infectious disease doctor examined him. Next came the endrochrinologists (3) the cardiologist, Rabbi Krause the Chaplain, Barb, Dr. Forman's assistant, the respiratory therapists. The only specialty that did not examine him was ob/gyn. Now he is undergoing dialysis which will end at 11 p.m. In between all this he received platelets and his usual dosages of steroids, pain medicine, antibiotics, and other medicines that I can't spell or pronounce. I will spend the night, Alissa is on Pixie duty, and Benji is getting a nights rest. Wishing you all a good evening,

Alissa Bringing Dinner 

Judah's World 

Bronchoscopy

Judah's doctors invited us to watch the bronchoscope. Truly an amazing experience. A fiber optic scope is placed down the wind pipe into the branches of the lungs. You can see the walls of the lungs, the little air passage ways. Its better than biology 101. Judah's lungs are clear of any blood or infection. However, he does seem to have fluid at the base of the left lung. Later today an ultra sound will be done. This will help determine if the fluid can be aspirated by a needle. The game plan is still for more dialysis, some blood work, antibiotics, steroids, antifungal meds, pain meds, and if he can, get rest in between.


Judah is still heavily sedated and non responsive. This is good as his sleep is pain free. The staff is wonderful.

Will write when we have more details.

For all of those who pray, keep on praying,

Love,

M

Morning

Judah's nurse, Meiling gave me the rundown on Judah just as soon as I woke up this morning, so the details are a little hazy. She used more abbreviations than there are letters in the alphabet. It sounded like she was spelling the team roster of the Polish National Hockey Team. Still, I did manage to understand that Judah has a fever this morning. He was covered up nicely at night with a cap and sheets, and Meiling said that when she removed all of that stuff his temperature came down. She drew cultures anyway.
Judah also had a bout of low blood pressure overnight. The doctors ordered more fluids for him and that solved the problem.
Perhaps for his comfort, or perhaps for other reasons, I awoke to find that his oxygen concentration had been raised slightly during the night. I will understand more when either Mom or one of the other doctors come in.

For the Nite Owls

Not to start blog wars but, jeez, Mom, couldn't you find a more flattering picture of me? Well, at least you got me in my most recognizable position: horizontal.
Judah is sleeping well. His nursing team of Jay in the daytime and Meiling at night has been a great combo. He looks more comfortable now than he's been in a while.
There are still questions to be answered about his transplant and his blood cells. Dr. Forman will begin to investigate in depth starting tomorrow.
His numbers are the same as they've been in previous posts. As people of my generation may recall Gary Gnu saying, "No gnus is good gnus."

Cat Naps 

Night has come to the hospital. Things get quiet, all the bustle of the day disappears into silent empty halls. The nursing staff has begun to settle the patients in, meds are ordered, housekeeping emptied the waste bins, and another rythem is felt in the building. Some families choose to sleep over, and if there is more than one person, they camp out discretely in the meditation rooms, conference rooms and the lobby.

Benji and I rotate sleeping in Judah's room. To night I will go home an Benji will remain. Judah is stable, but we still are concerned about leaving him with out one of us here. Soon Benji will return to school and Alissa will help out with hospital duty. I do hope that Judah will be well enough to be left in the care of the nurses.

He tolerated the trach fairly well. The doctors increased his pain medicine and they assure me he feels no pain. Slowly they will decrease his pain meds. Gwen, his dialysis nurse is completing his dialysis around 11:pm, his room will be silent, with only the huh huh of Judah's breathing.

The rythem of a restorative sleep will wash over him and hopefully all the other patients.

Good Night All.

A Hole New, Judah

We've gotten Judah settled again. When I walked in after the surgery, Dr. Ahmad was in Judah's room loudly yelling at him to "WAKE UP." This from a man who terrifies the nurses when he simply whispers. Despite Dr. Ahmad's commands, Judah remains deeply asleep. He has subsequently been given additional pain medication in case he feels discomfort from the recent procedure.
The mustache that Judah has grown since intubation has a distinctive D'Artangnan flavor to it. He would look handsome if his mouth wasn't stuck open in "The ICU 'O'"
Mom bought Judah a new knit cap to wear that looks like it was left over from a 1979 macrame party. Very earthy.
Hilda and Al Ashley stopped by with more Pico Kosher Deli sandwiches. Even though the fresh brisket sandwich was delicious, there's something to be said about letting it sit out for 24 hours.
Will post more when news arrives.

Trach done

Judah is back in his room, surgery completed. His doctors said he tolerated the twenty minute procedure well. We can now see his face. During the last 18 days he managed to grow a goatee and a mustache. I guess this is the hottest look in intubation!.

Blood pressure 109/57, oxygen sat 89, peep 8 40 % rate.

All of your prayers are working!

Love

M

waiting

Just thought I'd keep you in the loop. OR was to have come by 8:15 its now 8:30 and no OR. that is typical as one can't rush or predict OR schedules closely. I will write when Judah comes back into the room.

Thanks for your prayers and good wishes. I have just played several versions of the Mesheberach prayer for Judah. Craig Taubman, Debbie Friedman, and my own off key, not accurate version. All choruses are welcome.

Love
M

For Early Birds

Judah is having a good night. His Respiration Therapist has managed to keep his oxygen levels low and his saturation high. He looks good as we are getting ready to send him in for surgery this morning. His nurse, Meiling has given him all sorts of platelets, and medicines in preperation for the procedure and they seem to do him good.

Judah WILL have his tracheostomy performed tomorrow morning. Doctors and others all insist that this will be more beneficial to Judah. Nobody likes the idea of a hole in their neck, but if it affords him greater comfort...(For more info on the procedure, here's a link: http://www.nlm.nih.gov/medlineplus/ency/article/002955.htm

For those out there who are tech savvy, here's the run down on Judah's numbers:
His PEEP is down to 8 which is great considering that last week it was at 15. His pulse ox is staying around 92% with an Oxygen concentration of 41% (in the evenings he seems to do better with a 45% concentration). Last night his nurse Thelma woke me up to tell me that his blood gasses looked good. His numbers are in line which is a good improvement over before.
I wish I had more news to report, but that is about all. Judah's color seems strong, and he gurgles a little bit when we talk to him. I like to think that he is trying to answer us back.
I cannot state enough how proud we are of Mom for the recognition HUC is giving her by bestowing upon her an honorary Ph.D. We've known for years that her contributions to the community have enhanced many lives, and enriched the culture of Angelinos of many faiths and backgrounds. Many people don't realize that Mom already holds two Masters Degrees, and we will be thrilled to clutter our walls with this capstone(?). In this short life, nothing is to be taken for granted. Not our lives, not our friendships, not our achievements.
Mom will be back here very early in the morning to usher Judah in and out of surgery. She will post his status just as soon as she is able to.
Thanks to everyone who has made these past few weeks bearable. Even in this darkness there have been ample hours of sunlight.

Pixie enjoying a summer day 

Pixilated

Judah is having is dialysis a bit early today. Dr. Ahmad stills wants to keep the fluid off to give his lungs a chance to rest. So far it has been a help. As Benji says, we keep looking for very small improvements, and are reminded of the math game given to children. It goes like this: Would you like $365 today, or a penny a day doubling every day for 365 days?. We will take the slow and steady road. His oxygenation is good with a lowered o2 push for him. His peep also has been lowered a point. Kidney functions are stable, heart is good( Be le Ayin Harah). I keep wondering what Judah is going to say when he wakes up. If it was like last time, he could not believe the day and time. He kept checking his watch and the calendar. Today is day 17 in the ICU. No one is suggesting a time table for his recovery. As my father says " We are patient".

Pixie greeted me like an old lover greets his returning love. After the initial warm greeting, and scratching in special spots, she stayed by my side and barked at the bedroom door. It was time for sleep. Once on the bed, ( she needs help getting on to the bed) she circled, plopped down, let out a great sigh, and slept through the night.

This morning as I left for the hospital, she looked at me, put her ears back, head down and tail lowered as if to say, "That's it you are leaving again?"

I tried to explain, but to no avail. She even refused a cookie. (She like the rest of the White household as a strong sense of pride and knows a bribe when she sees it.) I hope that when I return tonight she won't be too out of sorts.

Will keep you posted as details arise.

M

PS. The fish is going to be renamed Pixie, the third or as they say Tre.

Pixie enjoying summer 

Dr. Mom

It's official. Mom will receive an honorary doctorate from Hebrew Union College (HUC). We got the notice last night. Mom almost tossed it out with the junk mail. The ceremony is scheduled for May 2006.

Congratulations mom. We're very proud of you.

It's funny how Judah seems to be improving so much to me, but his doctors are not as sanguine. Every notch that the ventilator moves down, or every percentage that his hematocrit moves up fills me with exuberance; a feeling that each day is bringing us closer to getting Judah up and around. The doctors, however, see signs and omens that remain invisible to praying classes. Dr. Forman, at least, remains optimistic. Judah's regular team of interventionists have been away for the past few days, so perhaps they will come in today and give Judah a gold star on his chart for impressive progress.
We have been lucky to have Thelma as Judah's night nurse for the past five days, and today we have Jay back in action after five days off.
Since Judah's recovery is in the slow lane, the doctors are considering a tracheostomy for him. This is a hole that is placed in the windpipe for ventilation, allowing the respiration tubes to bypass the mouth alltogether.


The hole heals up quickly after recovery, and the doctors say it is more comfortable for patients who are going to be on the ventilator for prolonged periods.
We'll let you know what the doctors say after they've come in today.

In the meantime, I heard that the endocrinologist team was very pleased with Judah's endocrinology.
Also in the meantime, Mom went home to Forrester Drive last night for the first time in forever, and Pixie has been stuck to her side ever since.

Monday Morning Update

Dr. Forman was in as was Barb his assistant, and Dr. Ahmad called in. The consensus is Judah is holding at this level, and perhaps a tad bit better. Its a very cautious statement, but it keeps the flame of hope going. It is fifteen days since the intubation. The doctors are beginning to talk about removing the tube and doing a trachetomy. This may be a little bit more comfortable for Judah. He still will be sedated to avoid any undue stress to his system. The surgeons will come up to evaluate him and schedule the procedure during the week.

Judah has required platelets again so far today he has not needed additional blood. He will get dialysed later this afternoon.

The nursing staff continues to amaze me with their dedication, love and knowledge. The medical staff is intense, interested and committed. Together they are a formidable team helping Judah and all the patients here.

Early this morning I took a walk around the grounds and started to giggle. Its full summer, all the flower beds that were so meticulously planted in neat rows, small plants in front, tall ones in back, round bushes surrounded by spiked tall trees have been disrupted. Raising their heads in defiant comeback are the summer weeds. The definition of a weed is any plant that you don't want in your garden. Interspersed among curly leafed plants are willowy shoots with long seed heads waving in the wind sending new seeds for next year. No heavy cultivation for them. They erupt deep into the planting beds making it almost impossible to eradicate.

Those of you who know Judah, are aware that he is cheering this maverick on. Hence the giggle. Just like Judah, strong, defiant, and with a great sense of whimsy. Go Weed, Go

Judah

Judah, thank God, is doing well. By well I mean he's stable and his breathing seems to be slightly improved. We still haven't seen his doctors yet, but when we do, we'll let you know what they think.

Its 9:45 and Thelma, Judah's nurse is back. She is working five days straight and will have some time off for a class reunion. She is very attentive to Judah, making sure he is comfortable, clean and all his medicines are delivered on time.

Judah had dialysis again today, and seems to have tolerated it fairly well. His blood pressure is stable and his oxygen requirement settings were lowered. Small steps, but giant leaps at the same time. Tomorrow Dr. Forman returns and will let you know if there are new strategies or shifts in treatment.

We talk to him all the time and relate all the blog entries to him. I do believe that he hears us. Benji has the TV on to American Dad ,one of Judah's favorite programs, Mike L came for a visit but did not discuss the fantasy league baseball details for fear of upsetting Judah. Alissa fills him in with details of Pixie adventures and misadventures. Hoping to bring Pix to City of Hope for a visit with Mom Alissa tried to get her into the car. Poor Pixie associates car rides with trips to the vet. She sat down, put her paw over the leash and refused to go.

If Judah continues to stay stable I will go home to get reaquainted with Pixie, Forrester Drive, and Cheviot Hills.

Visitors today and yesterday included Morely and Joyce, with love from Nina, Helga and Elia, Hilda and Al, Judy, Les and Daniel E., and Gaby K, Janet K, Bobbi, Larry, the Bride and Groom to be Amy and Dvir, Steve and Lisa, Andrea and the best whitefish salad and plums on the Westside. Our neighbors Ruth and Jeffrey, who recited a misha berach . Eva, one of the nurses said, we need a social secretary! ( Andrea brought a good Jewish rye bread that Eva, who hails from Europe and misses good bread, greatly appreciated).

Will check in the morning, Night all.

M

Really Now, Stop it Somemore

Thanks for all of those wonderful birthday greetings. As we all know, however, wishes (no matter how wonderful) don't fill coffers. So, checks may be made out to...
Iss and I are grateful to have so many well wishers. The only gift that matters this year is Judah's wellbeing. He is going to turn 39 on Monday, August 22. When he is well again, we will celebrate all of our birthdays (including Mom's) together. So, get those birthday cards ready for Judah, and make the checks payable to...

Birthday(s)

"That is the sound you have been waiting for Mother", is what the Doctor said, when he delivered Benjamin Gideoni White into this world. Today is his Birthday. All birthdays are special, this one and Alissa's a few weeks ago bring this message home.

We take so much for granted in our daily lives, especially the bonds of family and friendship. If we have learned anything from this journey it is the grace and power of love.

Join me in wishing Benji A Happy Birthday, and Alissa a belated Happy Birthday.

Martha

Judah seems to be steady. His numbers are all good right now, including his oxygen saturation levels. It's encouraging that when he is suctioned, no fluid comes up. His breathing seems to be improving every day and people who have come to visit have all said that Judah looks better than they had expected.
Yesterday brought a welcome visit from the Hackners, Zoe Nemetz (who dragged her parents along, again), Mr. and Mrs. Hearn, and the ever present Ashleys - who have become such regulars that Judah's doctors now tell them how he's doing.
Mom should be along soon, and Iss a little later. I'm trying to get Mom to go back to the house this evening for the first time in almost 3 weeks. I don't know if Pixie has ever been away from her for this long.
More later.

Shavuah Tov

Just a short update on Judah. It's Saturday evening and the beginning of a new week. We pray for a week of healing and well being. Today Judah tolerated his dialysis well. His nurse, Thelma, will not allow a repeat of the events of last night. Alissa is here with me now, and Benji will be here soon. A discussion of who will do Pixie duty, hospital stay or hotel rest will take place.

Tomorrow is Benji's birthday. Alissa celebrated her birthday a few weeks ago. All the kids are Leos. Leo's are creative, strong willed, and interesting people. Makes for great conversations.

Shavuah Tov, Have a great week.

Judah Demands Shabbos

There's no tricking Judah. True to Friday night form, Judah had an "episode" last night. Right before our eyes, his heart rate zoomed up to 160 and his blood pressure fell accordingly.
Here's what happened: I didn't want Judah to know that it was Friday night because he often falls ill, so I didn't want to sing kiddush to him (which is what we usually do). Mom started to sing Shalom Aleichem to him (which is what we usually do), but I shushed her, lest he realize it's Friday and then fall into some trouble.
Around 11 pm, his heart took off like a flock of pigeons. For about an hour, his poor nurse Thelma tried to get hold of whichever doctor she could. In the meantime, we sat on pins and needles, helpless and unsure as to what was happening. Mom still wanted to sing Shalom Aleichem to him, but once again I stopped her, telling her that the song is not a magical amulet. Dr. Ahmad came to the rescue and ordered a pint of this and a litre of that. Still, nothing was happening to Judah's heart until - and I SWEAR THIS IS TRUE - Mom started singing Shalom Aleichem to him after all. His heart recovered immediately. A bit cowed, I made kiddush for him. Since then he has been spending this shabbos resting comfortably (which is what he usually does).

Friday/Monday

Statistics show that Judah doesn't do well on Friday nights and Saturday mornings. He also doesn't do well when his oncologist Dr. Forman is away, or sick. Superstitious I am not, but the math shows us that tonight is a double witching hour because Dr. Forman has been gone since yesterday, and it is Friday night. The solution? We tell Judah that it is Monday and I stand by his bed and pretend to be Dr. Forman for a few minutes. Hopefully this will trick Judah into having a good night.
In the meantime, he is being dialyzed. His numbers are fine and we are waiting for more good news. There are some specifics that I won't go into now that may become complications but things are being headed off at the pass by the very pro-active doctors.
I'm including my favorite Judah/flower shot. When my father was alive, he saw genitalia in every flower. As Dad used to say, the apple doesn't fall far from the tree.

Steady Mate, Steady

Issi reported and the nurses confirmed that Judah had a restful night. I slept 7 hours straight, felt refreshed.
A flock of green parrots took up residency in the palm trees around the hotel. They greet each other with loud cries and then proceed to announce the presence of any human who tries to reach their cars parked below the trees. Dive bombing is a specialty, with training given to all. I think they provide certification and CEU credits. I also believe they are being hosted by the local car wash association.

Ryan, Judah's nurse today, after discussing all the numbers, BP 131/78 o2 saturation at 88% heart rate 90, noticed the photos on the screen saver. Nature photography is a specialty of Judah's. An outstanding feature of the City of Hope is the magnificent rose garden, (thanks to Ruth Zeigler) the Koi pond and Japanese Gardens ( also a major donor) and the great lawn in front. Patients, their families and staff all find refuge and comfort from the beauty of living, growing, blooming plants. Judah loves to prowl the walks with his camera(s) in tow.

I hope you enjoy his photos.



Shabbat Shalom to all

Media Cental

Judah has had an uneventful day and early evening so far. Dialysis gives him some relief by removing fluid thereby allowing his lungs to "dry out". Blog central is also media central. Eli and Yotan recorded Zimiros, Josh K graced a CD with his guitar virtuouso, Rebecca A, and Sarah S created drawings worthy of framing. Judah has a lot of thank you's to write. To those of you still waiting for his Bar Mitzvah thank you's please be advised , the check is in the mail.

Alissa will spend the night, I will go to the Hotel, and Benji has Pixie Patrol.

Good night all.

Nothing New

Judah is getting dialysis again right now. His numbers look fine (for him), and he looks the same as always. The nurses were finally able to get a hydration cream for his eyes. No one knows why it took so long, but it did. Now his eyes look greasy, but they say that it will keep the insides of his eyes nice and moist. He looks the way a hung over Vegas showgirl might, after she has tried to wipe away her mascara with tons of vaseline and cold cream.
Les Eber came by and took me out for a bit, Mom is having some kind of work related meeting nearby. Issy plans on spending the night tonight. No news is good news.

Dawn Again

Judah had a peaceful night. The oxygen concentration was down to 40-45% and his saturation remained stable. Mom showed up super early this morning (5:30 am) surprising his nurse and me. Poor Judes was getting a "bath" when Mom walked in.
Mornings and evenings in Duarte are really pretty nice. In the morning, there is still some residual heat from the day before that hints at the warmth the new day will bring. In the evenings, the wind is blowing a warm dry breath over us all. Green shrubs, plants, trees and flowers seem to have no problem growing tall and full out here. The city of Duarte is not particularly beautiful but the land sure is. City of Hope has loads of cotton-tail bunnies that come out when the light is dim. The wind, the rabbits, the crickets all conspire to create a dreamlike sense of peace and safety.
Stick around to see what the new day brings.

Re: Shakti Gawain

I had bought Judah a pile of relaxation and meditation tapes at the Bodhi Tree. Didn't know the first thing about any of it, so grabbed a mixed bag including Shakti Gawain's Creative Visualization. When I brought them to Judah he gave me the sign of the cross like I was the devil. The package was banned from the room. So... I of course started listending to them on the hour plus drive to and from the hospital. In the Shakti tape she talks about being bathed in a warm yellow light. I used the image to make a collage-card for Judah. In it he is standing on the brick wall in front of our house. Benji' s head is at his feet. He looks like a giant. The background is a yellow shape reaching out in all directions.

The collage was acceptable, even though the CD was not. I didn't know Shakti was MOT. -AAW

Judah Tonight

Judah is resting seemingly comfortable now, after what Mom called a "beautiful day" for him. He gave quite a scare tonight, however, as his blood pressure and heart rate made a sudden and rapid rise. Mom was having a tea downstairs when Judah's nurse, Dana phoned her to let her know. By the time she got upstairs, his bloodpressure had risen to over 250 over something.
Fortunately, our friend Judy Sherman (a nursing professor - I use the term charitably) was here to oversee everything and comfort mom. By the time I arrived, Judah had been given some medications to bring his numbers back in line. Although it was scary, it was temporary and now it's over.
Hopefully Mom will go get some sleep while I guard the Hadj. Interesting tidbit: Our family nickname for Judah is Haduj. The more astute readers will notice that Haduj is Judah spelled backwards. Apparently Judah used to suffer a form of dyslexia (also known as "devil-writing") that caused him to learn to spell his name backwards. Haduj is pronounced HAH-dooj. Hadj for short.
Special thank yous to Joe Saracheck (will be put to particular use tonight), Eric and Eileen Strom, and the nursing staff at COH, particularly Dana and Jay who have been tending to Judah with such great care and attention.
General thank yous to everyone else who have shown so much love and support for my brother and my mom. We're lucky to have you.

11:57 am

Thanks for all the energy waves coming toward Judah. I am sure he felt them. Knowing Judah and his love for sleep, he probably groused at having his nap time interrupted. But in the long run I am sure he will thank every one.
God Bless you all.

Martha, Alissa, Benji

P.S.

Its now 2.25, Judah was sleeping with his eyes shut tight. He is under heavy sedation to keep him from moving about and basically is unresponsive. A few minutes ago, I was talking to him and describing the meditation. He slowly raised is left eyelid a tad. I know that he heard me and it is his way to say "back at you, Mom".

"Back at you, Everyone", especially Eli (of many last names) for proposing the idea, and Rachel for teaching us how to Meditate.

If you were able to join in this meditation please blog on and let us know.

6:45 City of Hope

Judah spent a quiet night. Tina, his night nurse, said his o2 remained stable and all his vital signs are holding. We are thankful for small miracles. Alissa spent the night with him and is now in search of a cup of coffee. All food services open at 7 am.

The doctors start to round any time after seven and at 11.50 we will join with Eli et al for a visualization of Judah in good health. Amen v Amen.

Atomic Clock?

For those of you who missed the suggestion by Eli Zevit (I know his real name is Al Sheikh or something, but really, Eli, who married who?), Eli is organizing a synchronized minute or two of prayer/thought/reflection on Judah's behalf. He encourages everyone to stop and spend 60 seconds focused on getting Judah better at 11:50am PACIFIC TIME. If you care to read his suggestion, it is under the blog posting called "Early Morning Preliminary Report."
In order to synch everyone's watch, I've posted a link to the national atomic clock. It should be on the bottom right of the blog. All the way down. Keep scrolling. Further. Further. There. Check your watches, make adjustments and thank you in advance. All of you.
Judah is holding steady (we hope). The Infectious Disease guy didn't see anything of interest, but he'll be around some more. We still haven't seen Judah's pulmonologist, so we don't know what's really going on. In the meantime, we are babysitting our worries and eating cookies to soothe our anxieties away.

It's increasingly difficult to write new posts, mostly because we've already posted so many varying scenarios of Judah's condition. Today, it is slightly worse than yesterday. Some things are stable and some things are improved, but there has been some difficulty in getting Judah's blood to saturate with oxygen lately.
For those who are true laypeople, the basic rule is this: The ventilator has two settings which are key for Judah right now. One is called PEEP, and the other is the O2 CONC. % (the amount of oxygen mixed into the air that is being pumped into him). We need to lower both settings, yet keep Judah's saturation levels up. Each time one of the settings is lowered, his saturation levels drop. Yesterday his O2 level was down to 45% (good) while his PEEP was 12 (horrible for normal people, but lower than Judah's usual of 15). Last night, his O2 had to be raised to 65% just to get his saturation to a tolerable level.
Right now he is having dialysis. This always seems to lower his heart rate and raise his saturation levels (as it is doing right now). He also seems to be developing an unaccounted for fever, so Infectious Diseases has been called in to take a look at him.
So, things continue to be compicated, tough and scary. Mom is encouraging us to keep our spirits high and hopeful.

Quiet Night

Judah spent the night pretty much the way he spent most of the day. His numbers are steady and he is in a deep sleep. Will post more once the doctors come round.

Evening in Duarte,

Night falls silently in Duarte. Tall trees reach into the multihued sky. A crescent moon rises accompanied by the planets. Its 9.27 pm. the shift has changed. Jay, who has been his nurse for the last three days, went off shift at 8 pm. He has helped Judah through some rough spots. Evening means a bath, review of medicines, discussion with Benji as to which one of us will stay and who will go to Hotel. Alissa is still on grandpa duty. Abe is leaving in the morning for the North Country- the adirondack mountains- where he has a home. He drew "a Plant of Loving Hearts" on the bulletin board.

As I sit in front of the keyboard and blog central, I think of the last few days. Judah's medical condition is serious, lots of consultations with his medical team, reading lab reports, and hanging on .01 % changes in lab values, lots of consults with Les Strick , Murray Epstein, Ralph Carmel, Les Eber, lots of love from all the bloggers, and lots of good food. Judy E. set the stage, Stella's cookies have helped lift the spirits (although Grandpa requested rum balls, 200% proof) Hilda's chicken, Rachel's Morrocan fish balls, Andrea's pita sandwhiches, and Gay's kebabs have set the standard for "hospital food" to soaring heights. Too bad the patients and their families have to make do with the daily offerings of The Bistro downstairs which specializes in Cream of Turkey soup. Daily. Dave and Stacie and Lisa K stocked the hotel room as well.

I hear the steady HUH HUH HUH of the ventilator and I am brought back to reality. Laurie Gross the artist created pocket blessing from hand woven cloth. One of the blessings reads
"every breath is healing".

Good Night

SYNCHRONIZE WATCHES

For those who wish to participate in Eli's coordinated prayer/meditation/thinking of Judah session, search all the way near the bottom of the blog on the right hand side for a link to the United States Official Time Website. Synchronize your watches and clocks people. And never have an excuse to be late again!

Early Morning Preliminary Report

Dawn is breaking over Duarte, or more accurately over the 605 freeway which is the view from Judah's room in the ICU. In a few more minutes the sun will flood his room. Judah loves the light . When the medical staff comes in to do rounds we have to lower the shades because they can't see the digital print out on all the machines. As soon as they leave the shades go up and room once again is bathed in sunlight.

Judah had a quiet night. His nurse Thelma, was attentive making sure all the iv's did not beep, chirp, scream or sing. She just told me her prayer for all her patient, "Please, Lord, let all these medicines work and restore them back to health". I told her of our daily prayer " to heal the sick in body and spirit and to give strenght to those who take care of the sick" . Our prayers acknowledge all the nurses, aids, therapists, doctors, health care workers, friends and family.

Boker Tov, Good Morning to all,

Martha

Small World

Here's a picture of the actual beast that is dialyzing Judah. It looks like some old fashioned piece of machinery from a 1950's science fiction movie. What's really funny is when you look behind the machine, the tubes and bottles look like some really smart 12 year old put it together in the back of his dad's garage.













We were having a chat with Judah's nephrologist, Dr. Bashir Ahmad when my mom mentioned her friend Dr. Murray Epstein (also a nephrologist, and by some accounts, The Nephrologist, as he's written some of the textbooks used to teach other nephrologists!). It turns out that Dr. Ahmad's teacher was one of Murray's students. After playing a few rounds of do-you-know-him? and do-you-know-her? It turns out that my mom and the doctor know quite a few people in common. Not bad considering that she's a tough yeshiva girl from the wrong side of the tracks in Flatbush, and he's a Kashmiri Indian physician running the kidney department at the City of Hope in beautiful downtown Duarte.
Now for the numbers: Blood pressure good, respiration solid, pulse good. Judah actually looks a little better now than he has before.
We were visited today by Dr. Sam and Judy Smith, and a beautiful lunch was brought by my mom's friend Andrea.

Grandpa, My Hero

Last night there was a uninvited four legged guest of the rodent variety here in the computer room. Pixie sniffed it out. I screamed my best B Horror film scream and ran upstairs. Pixies followed. (She never goes upstairs without Mom.) "Grandpa, grandpa, GRAN PAAAAH" (remember he's deaf) "There's a rat down stairs." "Oh ho ho." he chuckled. "Well you better get down there and do something about it." He was in the process of undressing and had so far taken out the hearing aid, and hung up his pants.

When he realized what I meant he headed downstairs, pantless. "Grand pa, you'd better put some pants on." (our house is a fish bowl and all the lights were still on). He waved it off and headed down stairs one stiff hip at a time."have you got a baseball bat or something?" he asked. I imagined him slugging it out with the little rodent, leaving schmear marks on the walls. In a minute I could hear him and Pixie banging away in the den., "Where is it Pix? Where is it?" He found his walking stick and was banging around trying to out the little rat. "Where is it Pix? Come on you bark all the time, and now not a peep out of you."

A few minutes later he returned, and presumable the rat was gone. I was still upstairs. "Grandpa, you're my hero." "Eh, what'd you say?" "You are my HEE- ROH." Vowel sounds bouncing off the stairwell into his massive and vacant ear drums.

"Mosquito?"

By this time I was crying. Petrified. (I know it's just a mouse/rat, but they scare me.) "Are you nervous honey?" Do you want to sleep upstairs? You can have my room." I declined, sniffled and went back downstairs.

First Light

At 5am one of Judah's IV alarms went off. Nothing unusual. They are in constant need of attention. He usually has six or so medicines and fluids dripping into him at once. One of his nurses refers to the hanging IV bags as Christmas tree ornaments.
His signs on his machines look reasonably better than yesterday. His pulse rate is slightly higher than last night's but it is lower than it had been. His oxygen levels were reduced overnight to under 50% and his saturation levels are holding steady at around 93.
The only thing that concerns me is that his chest doesn't seem to be rising and falling quite as much as I remember it usually does. His nurse doesn't see a change. I'm hoping that a) I'm imagining it, and b) perhaps the volume or pressure from the ventilator has been lowered.
Other than that, the ship HMS Judah is being patched up and bilged, and slowly being towed back to port.

Saturday Night

Judah is being dialyzed right now. There is a washer/dryer sized machine in his room that is hooked up to an in and out blood line in his thigh. The blood comes out of him through one end and is processed by the machine, and reintroduced back into his body. The whole process will take about 4 hours.
In the meantime, his pulse has come down by about 12 points, his oxygenation level is about 99% and his blood pressure is 127/66. Hopefully the dialysis will give him some relief.
More news in the morning.

More Reasons to Hope

There's so much information to process. The endocrinologists always come in threes. They sit outside the room, glancing in occasionally and they argue and discuss like Talmudic scholars until they all break out in smiles and agreement. Next thing we know, they are gone and Jay, Judah's nurse, is adding 10 cc's more of this to 2 litres less of that.
Dr. Les Stricke and Stella came again today. Stella brought more homemade cookies for Judah (and by Judah, I mean Benji). Dr. Stricke reviewed Judah's chart and again gave us reason to keep up our hope. There is no denying that Judah is in a difficult position, but there are still possibilities of recovery. There may be some difficult-to-endure procedures ahead, but, as Dr. Stricke says, Good stories of recovery come from difficult situations.
Meanwhile, the nursing has been great, the doctoring has been compassionate and the food has been free flowing. The mood is still somber but maybe now we will give ourselves permission to lighten up.

Think Positive

Here are some photos of Judah from before his intubation. At the time, we had no idea that these would be pictures of the "Good Old Days." Judah was so annoyed with being in the hospital. All he would talk about was going home. Still, we had some fun. Here's Judah mugging for the camera, arguing with his nurse, listening to his Ipod, and chatting on the phone. In between, Iss, Mom and I managed to have a few laughs too.










Self portrait, Judah two weeks ago









Wired Man






Judah and Benji




















Checking on Baseball Stats





It was only a week ago that Judah was put on the respirator. Although things looked glum at the time, Les Stricke helped us breathe new hope into his/our outlook. Dani Hackner, a childhood friend of Judah's and also a pulmonologist at Cedars gave my mom even more help and advice. We are lucky to augment our great doctors here at COH with some of the best doctors in the world who happen to be our longtime friends.
Thank you to everyone for your continued love and support. Everything from everyone has been enormously helpful. I believe that your good wishes are keeping Judah and all of us hopeful. Miracles aren't expected, but they are always welcome.

Judah is Struggling

Judah is having a difficult time. It started yesterday in the early evening. His nurse was washing him when he coughed up a good deal of blood into his respiration tube. Since then he has been having increased difficulty breathing. His ventilator is using a higher mix of oxygen (not a good thing) and Judah is struggling to keep his pulse ox up.
He has been collecting fluid in his abdomen and they are continuing to suction it out. His sedative has been increased by 1/3. Mom spent the night at the hospital, and this morning he is not looking well. As much as each day has greeted us so far with numbers and stats that seemed hopeful and promising, today we are met with details that are frightening and painful.
Judah's doctors have not been to see him yet, but we are putting in an early call to his pulmonologist, Dr. Dunst. Most of his other regulars are away for the weekend.
We will post more as we know more.

Judah has been poked, prodded, and pinched by every variety of nurse and doctor today. Appropos of Shabbos, it reminds me of an old joke:
Mrs. Schwartz went to the butcher and asked to see a whole plucked chicken before she bought it. The butcher obligingly handed it over and she sniffed it everywhere, lifting up its wings, its polkas, its underside. "Ugh!" she said. "You expect me to buy such a bird?"
"Tell me Mrs. Schwartz," he said smiling broadly, "would you pass such an inspection?"
Things are still looking stable which is good news. I get excited but the nurses remind me that he is still in critical condition. Hilda and Al brought a lunch for Mom and Iss today, and Rachel made a shabbat dinner for us. It's a real treat to make another Kiddush with Judah.
Look below and to the right for a new link to a yiddish dictionary.
Best to all.

First Report Revised (slightly)

Judah slept well. I overheard the nurse an the RT talking this morning, and Judah's oxygen levels were lowered on the ventilator last night and he did well. She tried to suction his lungs and found nothing in there to suck up. His blood sugar is well under control, with the lowest overnight reading he's had in months. His blood gasses were relatively good compared to previous ones. His creatinine levels (indicators of kidney function) are still slightly elevated but are lower than they were yesterday. There is still an issue with his fluid retention that will have to be addressed by his nephrologist. Will give official report when the doctors see him.

The Numbers Game

Mom and I have this thing worked out. Around 9 pm I run out to Studio City for 10 o' clock yoga. I go home, shower, change etc. and come back here around 1 am. Mom is usually dozing by Judah's bed. I whisper for her to wake up, but she doesn't hear so great. Then I gently tap her and she startles. She looks at me with rabbit red eyes and takes a while to get up. I push her out of the hospital and back to the hotel. Hopefully, she sleeps until 6 am. Then she comes right back here by 7. Then she has a full day of Judah, nurses, doctors(!), Grandpa, us kids, friends and relatives and visitors. Usually, I disappear again at around 11 am and head out for a quick nap. How she manages is beyond me.
Thank God Iss came back. She also splits her time in mysterious ways, managing to spend all day with Judah, taking care of Grandpa, the house, Pixie and Mom.
Ooh, some woman is having a horrible pain fit right now. She's screaming.
Andyhoo, Judah is doing the same. I see the lack of regress as progress. Oh, the poor woman is crying out again.
Let's keep encouraging Mom to write more blogs.
As for the Brisket Sandwich That Wouldn't Die - it may have some life left in it yet. I think I may be feeling some movement.

Coping Strategy

Hello from Mom Arbis,

Judah is resting, the night shift has settled in, all his medicines are on board, his visitors have left, and I have a few minutes to write to you.

Many people ask how are we managing, and I would like to give you an insight to the White household's psyche.

Creative people have the most interesting coping strategies. Benji took over for Judah in the nap department. Grandpa enjoys the visits from all the Judah's female friends. Alissa has become the family card shark. She beat Grandpa in Gin Rummy. And I am enjoying my new hobby as Mom Arbis.

Love to all,
Martha

Judah's Stats and Visitors and a Brisket Sandwich That Wouldn't Die

Judah is still continuing to stabilize. There are some minor setbacks, but they are mostly things that can be treated. His blood pressure remains strong and steady, his arterial blood gases (ABGs) have been slightly better each day. His nurse, Jay, tells me that Judah's CO2 levels (carbon dioxide) are really good now - just a tick out of normal range. He attributes that to an adjustment in Judah's respirator setting. They've increased the respiration rate (RR) from 32 to 34. His fluid output from his lungs seems to be diminishing and there doesn't seem to be much if any bleeding today. His gastric bleeding has also subsided. All of these are fairly positive. His kidneys, however, continue to confound. His nephrologist is considering putting Judah through temporary dialysis to help take some of the pressure off of his kidneys and to ensure that Judah's blood is properly cleansed. The dialysis machine is ugly, I'm told, but the treatment is tolerable and temporary.
Yesterday, Hilda and Al Ashley were kind enough to bring out some food for us from Pico Kosher deli. I didn't have a chance to eat the brisket sandwich that they brought for me until this afternoon, more than 24 hours after they bought it. I know it's risky to eat something that hasn't been refrigerated, but I couldn't help myself. It was delicious, and I haven't had to go to the bathroom yet. For you non-believers out there, trust me, Kosher food has You-Know-Who on its side.
Many visitor have been with us today, including Judah's old friend Cindy Chau, Zioni, Danielle and Les Eber. Alissa brought her psychic friend Richard "I Knew This Would Happen" Shave, and Grandpa. Richard, oddly enough, predicted Alissa's return from New York to the exact day. Weird.
When Judah recovers, I've been thinking that it would be great to create a book of this blog to give him, complete with everybody's comments. It would be a great idea to be able to publish the blog as a book, with entries on one side and comments on the other.
People ask us how we are doing. We are doing fine. We have a wonderful group of friends and family who keep us afloat. They/You enable us to keep Judah afloat. Who ever knew that my chronic unemployment would come in handy? My mother, my sister and I have been fortunate enough to spend most of our time with Judah, and with each other. It makes the unbearable bearable, and the intolerable tolerable.

The View from Home

Pixie hasn't seen mom in over a week. How do you explain to a dog? For a while, Merri would ask every day, "Is Judah coming home this week? Tomorrow? I want to prepare the room." or "Judah, he's coming today? I want to make it the room." Merri loves Martha's garden as much if not more than Mom. She spends a good deal of time out there gathering flowers for any one of her many decorative arrangements around the house. Hilda comes by too, for roses and other cuttings. Mom grew some fabulous tomato plants this year. She's missing the week where they all turn red. We have more than Merri can make salsa with, if anyone wants some, please help yourselves.

I had considered photographing all the budding fruits in the yard and making an accordian book for Judah.

Grandpa could never figure out how to use our toaster (it requires three buttons for toast). He took matters into his own hands yesterday at Walmarts (mom took him) and bought a two slice toaster with a single lever. He's eating toast and jam very contently in the kitchen.

The phone still rings here starting around 7:30am. It's usually mom with a morning report.

Last night I took grandpaws to the Mexican on the corner. He had his first fajita. after cleaning his plate he said, "I'm a better a cook." When the waitress asked if he liked his meal, he said, "No, not at all." Of course charming and she laughed and we bought mom fish tacos to go.

Back at the house, grandpa anticipated a strawberry yogurt all the way home. When we got here he found strawberries and a large container of non fat yogurt. He snapped and cursed. "G-d dammit, what the hell am I going to do with that?" Haven't seen that in a while. And then, "Sorry Issy, I'm uptight." I found him some mango sorbet and diet tea biscuits which hit the spot. He even shared the leftovers with Pixie. Before going to bed he kissed me on my forehead and said, "I hope tomorrow's a better day."

Six and a Half Bells

Judah slept well. His nurse, Cindy, is amazing. Really great. she is very calm and thorough and smart. She will return tomorrow night.
Judah's blood sugar has been brought under control to the lowest level I can recall in a long time. His blood pressure has been stable and good. They are drawing blood gasses now. I'm not sure exactly how blood gasses work, but they seem to give the staff a good idea of how Judah's respiration is.
Mom will be here shortly and the doctors will start coming (hopefully) in the next hour or two.
Cindy showed me how to read some of the numbers on Judah's respirator. They have set him up to breathe at 30 breaths per minute. Judah has this funky habit of always taking one or two additional breaths per minute on his own. I asked if this is a good sign, and Cindy gave me an answer that was basically part yes, but part no. Perhaps because it was 4 in the morning, I don't have a clear recollection of what it all means.
The sun has broken over the entire valley here. With the orange comes the hustle and bustle of the changing shifts. It is a hopeful feeling, knowing that another day brings with it another day of possibilities.

Nightly Report

Judah has quite a little bit going on tonight. His night nurse, Cindy, just gave me the rundown:
His respiration seems to be little changed from earlier. His blood pressure is stable and good. He was given some blood earlier today and he is retaining a good deal of fluid. They will treat him with a diuretic and draw some fluid off of him. He has an entire team of doctors who see him daily. Dr. Forman, a hemotologist is the lead, Dr. Ven is the cardiologist, Dr. Ahmad is the nephrologist, Dr. Dunst is the pulmonologist, and Dr. Al-Sayed is his endocrinologist. In addition, there are the on-call doctors and others who drop in from time to time.
I sent mom off to the hotel to sleep and I'll take the night shift while Iss has the Grandpa/Pixie shift. We'll all reconvene here in the morning.

Joshua

Some of you will remember a few nights ago when I met the pastor who was singing in the middle of the night. He was tending to a young boy named Joshua who is right next door to Judah. Joshua, only 13, passed away this morning.
I clearly misunderstood the pastor about the boy being abandoned. His entire family was with him, plus a cadre of ministers, friends and caregivers. Early this morning he came close to dying but he was successfully resuscitated. When I asked Pastor Johnson how he was doing, the pastor told me that he was in God's hands. I told him that I had put out an internet request for prayers on Joshua's behalf and he was truly grateful.
This morning, before all of this happened, my mother and I walked past Joshua's room. His young brother was asleep sitting in a chair with his head laying upon Joshua's lap. My mother whispered to me, asking me to bring some of Stella Stricke's cookies over to the brother. I said I would, but I didn't want to wake him. Then, thank God, Mom left for an hour to run some errands. I wouldn't have wanted her to see and hear what happened when Joshua passed away. A dozen people wailed at once. A nurse came by and closed Judah's door, but we could still hear and feel the cries.
It is an indisputable tragedy to see someone so young, so loved, die this way. It had a palpable impact on the entire floor. The nurses and doctors walked around somber faced. Judah's nurse disappeared for a while, asking another nurse to cover. "When I come home to my husband at night, sometimes I say 'I just need a hug,'" she told me.
When my mom returned, I told her what had happened. She immediately reached out to the family and offered to help in any way she can. She offered her professional contacts to the pastor on behalf of the family, and she has been busy make phone calls ever since. It's truly amazing how the same cultural and religious divisions which separate us all outside of here disappear as soon as you enter the City of Hope. My God becomes Our God. My Prayers become Our Shared Hope. Your Sadness becomes Our Understanding.
Although Joshua has left us, perhaps it is not too late to say a prayer of gratitude and hope for his family, and for his spirit. We are all always such a short distance away from the chasm that is infinitely deep, from which there is no returning.
Seeing and hearing the grief of Joshua's family today has made me intractably grateful for Judah's life. As bad as things are, today, we are the lucky ones.

Dr. Sandoval's Take

Dr. Sandoval is covering for Dr. Dunst, Judah's pulmonologist. She says that Judah's condition is stable compared to yesterday. Overnight, they tried a different setting on his respirator but Judah did not tolerate it well enought to warrant the change. He is back to the same settings that he was at yesterday. His lung fluids appear to be as expected, and his stomach continues to bleed, although this is a side effect of the transplant that is often seen here. His fluid output remains good and his fluid retention seems to be diminishing slightly. Although we all are praying for some signs of improvement, we must also remember that signs of stablility are very good news. The doctors have warned us that Judah may suffer setbacks, but that they too can reverse on a dime. Once he is stable, the hope is that he will start to heal. Today, right now, Judah is stable. Will keep posting as news is available.

Wednesday

It's great that Mom is trying out the blogger for the first time. Last night she sent everyone home and she slept over with Judah. She says she had a good sleep and that Judah did too. His respiratory therapist (RT) told my mom that Judah was breathing more on his own than before and she took that as a very strong sign of recovery. Dr. Forman, however, saw some different signs that seem to balance out Judah's condition. There is an issue evolving about Judah's carbon dioxide output that we will continue to watch. Like many things here, one step forward is challenged by one step backward.
Judah's nurse just suctioned him and drew up a fair amount of fluid and blood, two things we are hoping to see less and less of. She told me that his hemoglobin is slightly better than yesterday, and his blood pressure is certainly much more normal. His fluid output is strong and he looks okay.
Mom took a series of photographs this morning:

Jeremy Fine's "silk" flowers











The Blogging Office








The Chair that turns into a Bed