Jim's Obituary

This will run in both Salt Lake newspapers and the Daily Herald on Saturday and Sunday.

James Baker Meeks

“Jim”

James Baker Meeks, beloved husband, father, grandfather and brother, passed away on Tuesday, April 28, 2009 after a fifteen-month battle with spindle-cell sarcoma, a rare cancer.  He was born October 11, 1956, in Concord, CA, the third child of Arden Earl Meeks and Dixie Ann Baker. 

Jim married his high-school sweetheart, Patricia Jo Godfrey, on August 18, 1978 in the Salt Lake Temple after serving a two-year mission for The Church of Jesus Christ of Latter-day Saints. He served in numerous church callings, especially cherishing his time as Bishop of the BYU 53^rd Ward from 2004 – 2007.

Jim began his career as a proud firefighter/paramedic for the Salt Lake County Fire Department, where he worked for eight years before completing the Physician Assistant program at the University of Utah in 1992.  He also served briefly in the Army Reserve before being released honorably due to a serious injury to his hand.

Jim practiced as a PA from 1992 – 2008, when his illness prevented him from working more. He tirelessly worked for the advancement of his profession, and among other things served as President of the AFPPA from July 1, 2008 to the day he died.  He received many awards and honors, among which were 1990 Utah Public Employee of the Year, Utah Physician Assistant of the Year in 1995, and Distinguished Fellow of the AAPA in 2008.  No matter how busy he was Jim always made time for the greatest love in his life, his wife and family.

His mother, father, stepmother Sherry Carr Meeks, and one sister preceded Jim in death.  He will be greatly missed by his loving wife, Patricia; devoted children, Clint (Jen), Mariah (Enrique), Coleton, Clayton, Makell; adoring grandchildren, Boston and Roman; seven siblings, and all those who knew him.

Services will be Monday, May 4, 2009, 1:00 p.m., Lindon Central Stake Center, 50 E 600 N, Lindon, UT. Friends may call at the same address on Sunday from 6 – 8 p.m. or on Monday at 11 a.m – 12:45 p.m. Flowers may be sent to Goff Mortuary, 8090 S State Street, Midvale, UT, 84047. In lieu of flowers, donations may be sent to ATTN: University of Utah, c/o Dr. Chen/Gouw’s Sarcoma Research, 540 Arapeen Drive, Ste. 250, SLC, UT 84108.

Funeral Information

Thank you so much to everyone who has been posting their comments about Dad here on the blog, as well as those who have called and visited over the last two days. It is so wonderful to hear how much Dad was loved and admired by all those who knew him. The world, and all of us, are a little worse off without him. But, we know he has gone to a better place and look forward to the day when we shall see him again.

The funeral will be held Monday, May 4, 2009 at 1:00 p.m. in the Lindon Central Stake Center, located at 50 East 600 North in Lindon, UT. Two viewings will be held at the same location, the first on Sunday night from 6:00 to 8:00 p.m. The second will be before the funeral on Monday from 11:00 a.m. to 12:45 p.m. The interment will be at the Lindon City Cemetery, located just east of the chapel at 550 North 200 East.

Here is a map of the location:

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It's Over Now

Dad's long battle with cancer is now over.  He passed away at 6:10 a.m. Mountain Time today, April 28, 2009.  He didn't sleep at all Sunday night and had a difficult day yesterday (Monday).  He was very anxious all day and had difficulty breathing, but we thought that it was due to the lack of sleep and that if he just got a good night's rest he would be back on track.  Unfortunately, at about 4:30 a.m. the hospital called my mom and said that we should come up as soon as possible.  She called my other siblings and me and told us to head up as soon as we could.  My mom, Clayton and Makell made it to the hospital in time to say goodbye.  The rest of us (all of Jim's kids, plus several of his siblings, his grandkids, and a nephew) didn't make it in time though.

Things at the hospital didn't go quite as smoothly as we would have liked.  Dad wanted to donate any organs he could, but the only ones they would take were his eyes.  So, we sat around waiting for the harvester to come, but it was taking much longer than they had told us it would.  We called the eye bank and found out that the harvester had gone to Pioneer hospital instead of the Salt Lake Regional Medical Center.  He finally made it, completed his task and then called the mortuary to tell him he was finished and that they could come to pick up Dad's body.  He told us they would only be about half an hour or so.

We waited around, some of us in my Dad's room, the rest of us out in the lobby, but it was again taking much longer than we had expected.  I called the mortuary to see what was going on and they told me that the driver had just arrived and was waiting for security to let him in.  We waited for about another 15 minutes and he still hadn't shown up.  I went out and asked the nurse if she could call security and see what was happening.  When she hung up the phone she had a very odd look on her face and was shaking her head.  She looked at me and said, "They picked up the wrong body."  I just looked at her for a second and then asked, "Really?"  She nodded her head and I just said, "Well, I guess it's just one of those days."  Security called the mortuary and had the driver turn around and come back.  He finally made it up to Dad's room and all of us who were still there then left.  It was about noon.

Mom, Mariah, Enrique, Coleton, Jen and myself went and picked out burial plots at the Lindon City Cemetery this afternoon, and we will be meeting with the mortuary and the bishop tomorrow.  We are tentatively planning the funeral for Monday, May 4, 2009 at 12:00 p.m. with a viewing at 11:00 a.m that day, as well as Sunday night.  I will post more details when the plans are more concrete.

Thank you to everyone who has visited, called, posted comments, and for all the other support we are receiving today.  Dad was a wonderful man who touched so many people's lives, and it means so much to us to hear what he meant to all of you.

Significant Progress

I finally have some really great news to report – Dad is no longer in the hospital! He was moved to the Promise long-term acute care facility yesterday around 3 p.m. Mountain time. He is in room 240, but for the time being Mom has asked that only his children, siblings, and aunts Jill and Nola visit him. If things continue to progress at the rate they have this week though, I'm sure he will feel up to other visitors very soon.

The week started out very poorly, as some of the doctors in the SICU were telling Mom on Monday that Dad's cancer was back in his lungs because they had seen it in his chest x-rays. They also told her that they had done everything they could clinically, but Dad hadn't made any real progress for quite awhile, and probably never would. As you can imagine, this really upset Mom and she asked to speak with Dr.'s Bull (Dad's surgeon) and Chen (Dad's oncologist) to see what they said. It turns out that somehow some of the doctors in the SICU mistakenly thought Dad has carcinoma instead of sarcoma. Dr. Bull said that if that were the case, then they would have been able to see tumors in his lungs because they grow that quickly. But, he said that sarcoma tumors don't grow that quickly and that all they are seeing in the x-rays is scar tissue and normal post-operative things. He reiterated his optimism that Dad will recover sufficiently to resume chemotherapy and return home, just that it will take some time and patience. He also said that with patients like this, they do sometimes hit plateaus, but that is to be expected and he will continue to progress, we just have to give it time.

One thing that we have definitely learned recently is how important it is for a patient to have an advocate who fights for them and is willing to question the doctors opinions when they seem wrong. If Mom hadn't stuck up for Dad and asked to speak to the other doctors, the SICU doctors would probably still be treating him like he had carcinoma tumors in his lungs and would die soon! It's hard to imagine that such huge "misunderstandings" can happen in an age with so much technology and amazing capabilities in the medical field – but they do. Please don't get me wrong, we are extremely grateful for all the work the doctors at the U of U hospital have done over the last six weeks. They saved Dad's life on more than one occasion with their expertise, but they are human too, and are therefore prone to mistakes. That's why it's so important for patients to have an advocate to look out for their best interests.

Thank you to everyone for your continued support throughout this whole ordeal. We hope that this chapter of Dad's struggle will soon be behind him so that he can move on to the next phase.

The Six Week Mark

You read that correctly. As of today, Dad has been in the hospital for six weeks straight, all but a few days of which have been spent in the Surgical Intensive Care Unit. In a way it seems like a lot has happened over the last 42 days, but unfortunately there hasn't been a whole lot of progress in Dad's condition overall. In fact, in my opinion, he is doing worse now than he was just 1 and 1/2 weeks ago. When I saw him on April 7th he was very awake and alert, happy to see me, and had gained quite a bit of strength is his hands and arms. He was even spelling words out using a paper with letters and brief statements typed on it. Things seemed to be going well.

The 9th is when his lungs collapsed again; things have not been well ever since. Both my wife Jen and I went to see him on Sunday the 12th and I was honestly quite shocked at what I saw. He was no longer alert or happy. He didn't even really seem very happy to see us. I could see the utter exhaustion on his face, and he couldn't even really find the strength to mouth anything other than, "Thank you," or, "I love you," and even with those phrases his lips and tongue would quiver for a few seconds before he was able to form them the way he wanted to get his message across. Most of the time we were there he didn't even look at us, he would just stare up at the ceiling. One of his doctors calls it, "The thousand-yard stare." The doctors felt that some of the drugs he had recently been treated with were at least partially to blame for Dad's lack of focus, so they have spent the last week trying to get them all straightened out and get him back to being more like himself.

I went and visited Dad again yesterday (the 19th of April), and things seem to have improved, but only slightly. While Dad would look at me more and noticed things go on in the room, he still had a difficult time communicating and would just sit and stare at me or others for long periods of time. He showed very little emotion and was very tired from the new exercise they started him on. They put Dad on what they call a cardiac chair and strap him in. The chair is kind of a cross between a hospital bed and an arm chair (I'll post a picture as soon as I get one). It's adjustable, and they sit Dad almost straight up and then push him around the halls – hopefully he'll be able to go outside soon. Dad's nurse and respiratory therapist on Saturday were both really pushing hard for the doctors to order the chair for Dad, as they felt it would really lift his spirits and hopefully help get some of the gunk cleaned out of his lungs.

Dad's ventilator settings are still very high, and when they tried to change them a bit today his lungs didn't react well, so the settings had to go right back up. His kidneys are producing about 50 cc's of liquid per hour now (which is good) but they still aren't filtering like they should, so he is still receiving dialysis every other day. He has had pancreatitis the last couple of days, so his feeding tube was shut off. It was turned back on today and he seems to be doing alright with it for now. The cytomegalovirus and several bacterial infections are still being treated, and he is still receiving blood and/or platelets every couple of days.

As you can tell, there hasn't really been a whole lot of change over the past week. One day will be a little up, the next a little down, but it is averaging out to be very little change overall, which is why I haven't posted anything in just over a week. I promise though, that if there are any significant changes, I will definitely post it right away.

One more thing I wanted to share is about the incredibly huge costs of staying in the hospital for so long, especially under such intense care. Mom said she received the bill for the first month of his stay and it amounted to just under $500,000! Thank goodness Dad has good insurance through the university and for yearly out-of-pocket maximums! :-)

Thank you to everyone who posts their wishes of hope and words of encouragement here on the blog, and to all those who pray, send donations, or help and encourage us in many other ways. All the acts of kindness truly mean a great deal to all of us, especially my mom and dad.

See What I Mean?

So, we've had another turn around, but at least this time it is in the direction we like. Dr. Bull, the cardio-thoracic surgeon who performed both lung surgeries on Dad, spoke to my Mom yesterday and his outlook is much more positive than that of the Doctor from Friday. He said that he has been doing this for a long time and deals with patients almost every day. In contrast he said that the SICU doctors are usually on for a week or so and then have a few weeks off, and that everything they say should be taking with a large grain of salt. He told Mom that based on Dad's situation and his will to keep on going, he fully expects that Dad will be able to go to the Huntsman Cancer Hospital soon and begin receiving the experimental chemo and that he'll be able to go home at some point. Dr. Bull said that the SICU doctors sometimes forget that cases like this just take a long time, require some patience, and that there are bound to be setbacks. So, for now, we're all breathing a big sigh of relief.

The procedure they performed on Dad Thursday night is called a bronchoscopy, and Dr. Bull says that Dad has been much improved since that time. They took a scope, went down into Dad's lungs and sucked out a bunch of blood and mucus. The virus for which he is currently receiving treatment is called cytomegalovirus. It is actually a virus which most humans carry and have antibodies to fight, but is serious for those with compromised immune systems like Dad. Another factor which puts him at high risk for being affected is the dialysis. The medicine he is being treated with is called ganciclovir, which has been around since 1980. It works by inhibiting the growth and replication of the virus.

Another piece of good news is that Dad's kidneys suddenly started to work on Friday, enough that they put a catheter in him for the first time in a couple of weeks. They aren't producing enough for him to be taken off of dialysis, but Dr. Bull is encouraged by the fact that they are trying to do their job. Overall, Dad was in a much better mood yesterday and is starting to look better again (Mom says he had big dark circles under his eyes on Thursday and Friday).

Happy Easter to everyone! This Easter is especially meaningful for us as we reflect on the meaning of the Savior's sacrifice and resurrection for our family in light of Dad's condition. Although we want Dad to be around as long as he is up to it and as long as the Lord sees fit, we know that we will be with Dad again in the next life because of Jesus Christ. His gift gives us comfort and hope for the future.

Back to the SICU

It's hard to believe how this whole ordeal lurches back and forth and up and down. I was about to post an entry yesterday afternoon which would have been a very positive one. At that time, Dad was still in the Intermediate Care Unit and his ventilator settings had been turned down in the morning to where he was initiating every breath and the ventilator was just supporting him. They had also discovered why he has to keep receiving blood every day. He has some sort of virus (I haven't been able to get the name yet) which is causing the problem and they have started treating it.

Unfortunately, that is the only good news from what happened yesterday. When the care team took an x-ray of Dad's chest, it looked like there was a bunch of mucus stuck in his lungs. They decided to send him back to the SICU so that he could again receive one-on-one care from a nurse and hopefully prevent it from happening again. In order to get out the mucus that was already down there, the doctors decided to use a scope and clean it out. However, when they got down there, they didn't find any mucus. Instead they found that his lungs were again inflamed, bloody and had deflated – especially the right side. So, they had to turn the ventilator settings way back up in order to inflate the lungs again.

One of the SICU doctors took Mom outside of Dad's room and just told her straight up what was going on. He said that while Dad did come close to dying several times in the first couple of weeks and got better, even though none of them expected him to, things again don't look good. The doctor said that most of the time when individuals have been on a ventilator for so long, with so little progress toward getting off of it, it usually means that they never will. He also mentioned Dad's kidneys again, and how they are basically not functioning at all and that they will continue to have to put him on dialysis every other day. Then he got right to the heart of it and said that there is a good chance he will never get to go home again – in fact they may never be able to get him to the point where he can even go to Promise, the long-term acute care facility. This doesn't mean that Dad is going to die in the next couple of days, but it's definitely not the kind of news we were hoping for.

Mom has asked that only Dad's immediate family (kids, siblings and Aunt Jill) come to visit for the next few days due to this setback. The whole family wants to again thank everyone for your continued love and support. It means more to us than any of you will ever know. I'll post again when there is any significant change.

P.S. I almost forgot, here are a couple of pictures Dad wanted Mom to take and have posted on the blog.

Dad wanted to make sure everyone could see him with his trach. :-)

This is Dad's every-other-day dialysis machine.

Another Week

Greetings to everyone from Akron, OH. Jen and I are here checking out the law school at the University of Akron. My dad has made quite a bit of progress this week. He has been moved to the IMAC, or intermediate care unit, and all of his chest tubes have been removed. In about 7 - 10 days he will need to be moved to a "Long Term Acute Care Facility" where they will continue to wean him off of his ventilator and help him with his physical and occupational therapy.

He is still having difficulties with anxiety and so for the time being he has asked for no visitors except for his wife and children. The doctors are continuing to treat it with medication and we're hoping that it will subside soon. We'll let you know as soon as he is ready to receive other visitors. His hematocrit is still dropping on a regular basis as well, so he has to continue receiving a couple units of blood or platelets every day or two. The doctors still can't figure out what is causing it, but are working diligently to try and do so.

Thank you to Aunt Jill and Enrique for staying with Dad during the days this week. Mom is still too sick to visit, which is really hard for both of them. Thank you to everyone else for your continued support and prayers.

Still Improving

I apologize that I haven't updated this since Thursday night, but it has been a little crazy for me trying to get caught up with everything from spending every night at the hospital last week. I know there are many of you who depend on this blog to stay apprised of what's going on with Dad, so I'll try to keep it more up to date.

Dad has been struggling with sleep since about Tuesday of last week. He usually falls to sleep at around 10 or 11 and sleeps for an hour or two and then wakes up. He then looks over, smiles and mouths, "I think I slept better." I then inform him that it has only been a little bit and he scowls. Part of the problem is that he has had a lot of anxiety and panic attacks that don't allow him to relax.

Last week they gave him a sleeping medicine on Tuesday night called Cyroquil (spelling?) that allowed him to sleep for about four hours. However, Dad wanted to take Ambien so they gave that to him on Wednesday and Thursday. Unfortunately, it didn't help as much as the first drug so my mom was able to talk him into going back to it for Friday night. Unfortunately, it wasn't helping much either. They also started him on Haldol to help with the anxiety and panic attacks, but it seemed to have no effect whatsoever. So yesterday they discontinued the Haldol and started giving him Lesoprin (or something like that, I can't remember the exact name, sorry). They also double his dose of Cyroquil last night, and this morning the nurse told my mom that he slept much better last night and that Dad actually had a smile on his face this morning - something he hasn't had for a few days. So it sounds like the new drugs are starting to help.

Mom has been sick since Sunday with a severe cold, and the nurse on Sunday gave her several hints that she shouldn't come up on Monday, but instead stay home and get feeling better. She is also home today, and hopes to be better by tomorrow so she can start going back up and seeing Dad each day. Since Mom couldn't go yesterday, I went up and spent a few hours with him, and today Dad's aunt Jill is spending the day with him. Even though he is the one who is sick, he still worries about everyone else. He knew that I needed to leave by 5:00 p.m. yesterday to meet with a group for school and he started falling asleep around 4. But, he couldn't sleep because every few minutes he woudl wake up and ask me, "Don't you need to go?" He didn't want me to miss my meeting. So, in order to let him sleep, I decided to leave about 30 minutes early.

Dad's vent settings continue to slowly improve, as he completely controls the breaths now, and his PEEP setting was at 6 yesterday. Unfortunately, his kidneys still arent' really working at all and he will have dialysis today. He hates physical therapy because it is so draining. All day yesterday he kept asking me when they would come because he wanted to get it over with so he could relax. The anticipation was horrible for him. All of the doctors, nurses and other care givers say it will still be a long haul, but that he will definitely get out of there and go home eventually - a big turnaround from where we were a week and 1/2 ago.

Thank you to everyone for all of your support in whatever form it comes: prayers, donations, visits, bringing food to my mom, Clayton and Makell, etc. We truly appreciate everything you do and may God bless all of you for your kindness and generosity.

Thursday Night

My mom said that she felt today was the best day Dad has had since this hospital stay started 2 and 1/2 weeks ago. For example, he currently has no IV drips going – it's absolutely unbelievable. His kidneys also started working on their own a little bit today, which I don't think anyone expected, and he is no longer on 24/7 dialysis. Tomorrow he will be started on standard dialysis, which lasts about 4 - 5 hours per day. The standard dialysis will begin to take a lot more fluid out of his system, which should help his lungs to start working better.

Uncle Derek, thank you for volunteering for Saturday night, I really appreciate it. All the numbers I have for you are disconnected, so I hope you read this :-). Thanks to Enrique as well, he is going to stay tomorrow night. My wife is very excited to have me home for two nights!

Dad still has a long way to go, but things are definitely looking up.

Thursday Morning

Dad has made some great progress today. He is now off all of his heart medications, so the only IV drips he is on now are antibiotics and calcium (due to the fact that the anti-coagulant for the dialysis binds to calcium and clears it out of him). His vitals are much improved with a pulse of about 75 and a blood pressure of 160/65. They were also able to reduce one of the settings on his vent today, which is another good sign.

Early Wednesday morning, Dad's hematocrit was at 19 (which is low) so they gave him two units of blood and the number jumped up to 28, which the nurse Jill said was a big jump, so that was positive as well. Because the hematocrit keeps dropping, the care team is assuming that he is still bleeding somewhere, but they did another CT scan today and couldn't see anything which would be causing the number to drop like that. The resident on tonight, Dr. Millar, said that it is possible the dialysis is causing the problem, so they will just keep monitoring him and see what happens.

The CT scan did reveal that Dad's NG tube (which drains fluid, mostly bile, from the stomach so it doesn't seep up through the esophagus and go into the lungs) was too far down, which may have been the cause for the issues with his pancreas. They pulled it out a little, and we are currently waiting to hear back from the lab to see if the pancreatic enzyme numbers have improved. If they have, then they will be able to start feeding him through his feeding tube again, which I know will make Dad happy.

When Dr. Millar came around tonight he started talking to my Dad about the priesthood blessing he received on Saturday night (the 21st). For those of you who aren't aware of it, we are members of the LDS faith and believe in the anointing of the sick and afflicted as spoken of in James 5:14. So, on Saturday night, when things were bleakest, my brother-in-law Enrique did just that, with the aid of one of the doctors here in the SICU. He was anointed with oil and given a blessing that he would be able to have the strength to make it through the night and the procedure he was going to have the next morning. Dad was also given a blessing by his bishop (local church leader) a little bit later, in which he was told that he would be here long enough to complete his mission.

Anyway, doctor Millar was trying to tell Dad something about the blessing, but Dad started talking about having a care conference for all of the patients that he would lead, so the doctor wasn't able to finish. A few minutes later I went out and asked the doctor what he was going to say. He said that he and the doctor who helped Enrique on Saturday (his first name is Matt) are both LDS as well, but that it is very hard for them to participate in blessings sometimes b/c their education and training sometimes overshadows their faith. He said that the expectation of the doctors on Saturday night was that Dad wouldn't survive until the next morning – medically it looked like he didn't really have a chance. So, it was a somewhat difficult task for Matt to have the faith to participate in a blessing for Dad to get better when he didn't really think that would happen.

Dr. Millar continued to tell me that because he had been asked to help, Matt was happy to, despite his reservations. Then, miraculously, Dad started to improve – against all odds. The medical team hadn't done anything different to help him, he just started to improve on his own. Dr. Millar said that ever since Matt told him the story of what happened that night, Dad's experience has been a source of spiritual strength for him and helped renew his faith in the power of priesthood blessings. I can only say, "Wow!" Dad continues to touch so many people's lives, many of which he doesn't even know about. We're sincerely grateful for the priesthood and the Lord's continued sustaining of Dad and the family.

I also had a frank discussion with Dr. Millar about what we can expect going forward. He said that Dad is still very sick, and actually used the term, "pulmonarily disabled". It will be a minimum of "weeks" before Dad will be able to get off the respirator and breathe on his own – assuming everything continues to improve as it has been over the last few days. Any setbacks could obviously change the time frame. He also said that he has renal failure, and that it is fairly likely that Dad will never regain the full functionality of his kidneys. The doctor also said that Dad is extremely weak, and it will be a long time before he can stand up on his own, or even sit up. When I asked about what kind of quality of life Dad could expect, he said that as long as they can get him off the respirator and home Dad should still expect to have a high quality of life. As far as predicting anything else, Dr. Millar said it was anyone's guess. So, we'll just continue to take each day as it comes and hope for the best.

I noticed that Pam Slade (one of my parents' neighbors) left a comment to the effect that they would like to come see him, but can't. Well, you can! The SICU is open to visitors 24/7, with the exception of shift changes which occur every twelve hours from about 6:30 to 8:30. If you would like to come visit Dad, it would be best to come between 8:30 a.m. and 6:30 p.m b/c that is when he is most likely to be awake. We would only ask that if you are sick with a cold or the flu that you wait until you are better to visit, and that you keep the visits short (5 - 10 minutes), as communicating is difficult and tiring for him. But, I'm sure he would be happy to see any of his friends, family, neighbors, etc.

I have a favor to ask. I have a new nephew who is being blessed in church on Sunday morning, and I would like to attend. If someone would volunteer to stay with Dad on Saturday night, from 8:30 p.m. to 6:30 a.m., I would greatly appreciate it (my wife would also like to have me home at least one night this week :-). It's a pretty easy job, as he sleeps the majority of the night. You would just have to be here to help him when he is awake, with things like more blankets, suctioning out his mouth, listening to his iPod and watching TV. Just post a comment here on the blog, or call or email me if you're interested.

Thanks to everyone for all the help and support. We know Dad wouldn't be doing as well as he is without your collective faith and prayers.

The Fight Goes On

I want to thank my wife Jen for the fantastic job she did on the last post. I was way too tired to write anything at that point, so I really appreciate her help. The doctors were able to turn down the settings on Dad's ventilator ever so slightly today, and he is almost all the way off Milrinone, a medicine used to dilate the blood vessels.

Because Dad hadn't slept for two or three days straight after they stopped sedating him, he has been extremely tired yesterday and today. A few hours ago, he was so exhausted that he started to cry a bit when he was having a hard time telling me something he needed. It is so frustrating for him to not be able to do anything for himself. I asked him if he would like something to help him sleep, and he said yes. The doctor's prescribed him 25 mg of a combination sleeping and anti-anxiety medicine that starts with a "c" (sorry I can't remember the name). When he woke up just a few minutes ago, he said that he feels like he slept better, so it seems to be working.

Dad's pancreas (which produces insulin, among other things) is not working correctly; it is producing too much of a couple of enzymes that aid in digestion. Because feeding him would only cause the pancreas to produce more of the enzymes, they have stopped feeding him through his feeding tube. If the enzyme levels don't go down in the next day or two, then he will have to receive his nourishment through an IV. Hopefully the levels will go down so he can get something in his stomach, as he told me last night that he felt famished.

His biggest request continues to be for water, and the nurses have started to allow him to have four or five swabs (small sponges the size of a die on the end of a stick) worth of water at a time – but he still wants more. His mouth and throat always feel dry, and nothing would make him happier than to take a big swig of water. Unfortunately he can't, because his esophagus is currently pinched closed by his tracheotomy tube, so the water just goes right to his lungs. They try to limit the amount that goes to the lungs to try and prevent infections. Dad's blood pressure and pulse are pretty much normal now, and he only has to receive insulin once or twice a day after he is given steroids (which raise blood sugar).

While he is making progress in the right direction, all of us wish it was at a faster pace (him most of all). Unfortunately, we just have to be patient and let his body heal as fast as it can. When I told him yesterday about the AFPPA scholarship that had been created in his name, he just started shaking his head and mouthed, "Wow!" I could tell he was very touched. Thank you to his fellow PA's who deemed him worthy of such an honor, and to all of those who continue to pray for him and the family. While this is a difficult and trying time for him, we know that Dad can get through it with your support.

What a Weekend!!!

Hi everyone, this is Jen, Jim's daughter-in-law. Clint asked me if I would just give you a quick up date of what has happened since Saturday. I only know basics, so once Clint has rested enough, he'll fill you in on anything I miss.

On Saturday they turned Jim's SICU room into a make shift OR seeing he wasn't stable enough to move. He had a temperature of 104 and they thought that his central lines where the cause of his infection so they were able to successfully move all of the lines to the other side of his body.

Unfortunately this didn't help much and his blood pressure seemed to still struggle. The only thing that seemed to control his blood pressure was to give him more blood. They decided that he was loosing blood somewhere, they just weren't sure where the problem was. They had wanted to do a scan, but seeing he was so unstable they weren't able to move him. The Doctor was very concerned and Jim kept mouthing, "No more medicine!" When he was asked if it was his time to go, he just rolled his eyes and said, "No I have more of a mission."

Patti asked the doctor if it would be a good idea to get the rest of his family up to see him, and he highly recommended it. The doctor wasn't sure if he was going to make it through the night and told us if there was anyone who wanted to see him, they should come now. All of his siblings were able come up to the hospital, except for his sister Mel who is on vacation in the Philippines.

The SICU staff was kind enough to let bigger groups into see Jim, usually they only allow two people in the room at a time. Everyone was able to tell him that they love him and spend a little time with him. The immediate family was able to spend most of the night with him.

Despite Jim's condition Saturday night, I am pleased to tell you that he is still Jim. All night he was still cracking jokes and making funny comments. Even though it's hard at times to read his lips, we definitely know he still has his sense of humor. When Patti came back from the restroom once, he told her to not leave him again and that she should get a cathater put in her so she wouldn't have to leave again.

By 2:00am nothing major had changed, so we tried to get some sleep. All of his children and his spouse stayed the night, along with Melody's son Jordan. We slept (if you call it sleep) in the waiting room, some of us on chairs and other's on the floor. We all wanted to be there in case something happened. Patti stayed by his side all night and when she woke up from a little 30 minute nap, Jim told her not to do that again. He hasn't been able to sleep much since they took him off the sedation meds and he doesn't want to be left alone.

At 5:30 a.m. Jim was stable enough to move to get a CT Scan where they found the source of his bleeding. If I understand right it was in his thoracic cavity. The doctors were afraid to take him into surgery in case he couldn't handle it, but decided that it was better to take the risk then not.

We're so thankful that they did! Dr. Bull cauterized 50 capillaries on his lung which took care of the bleeding. He also took a look at his lungs and is very pleased with how they are healing. He said that usually when people have gone through what Jim has, the lungs are purple and not healthy looking. Jim's were pink and looked very healthy.

As Sunday went on Jim continued to get better and better. His blood pressure is higher than it has been since his last lung surgery, they have turned down the ventilator and he is breathing more on his own, and they have taken him off two of the four heart drugs he has been on (this is very good news because the drugs he has been on are damaging after long time use). By the end of the day they hope that he will be off all four meds.

We are just so happy that this miracle has happened. We know that things still aren't over, but being at the bottom and now working up, is a much needed change. We just hope that he keeps continuing to climb and that we don't see the bottom for a long time.

Thank you, thank you, thank you for everyone who has prayed for Jim and the family. We know that it's because of you that we've all been able to handle this situation. I have to apologize that I'm not as eloquent or as informative a writer as Jim or Clint. Clint spent the night in Jim's room last night so Patti could get some sleep and I offered to give an update so Clint could get some rest. Once he wakes up, and has received more information, I'll have him update you with the latest and correct any of my mistakes.

Thank you again for everything!

A Bad Night

Despite the successful tracheotomy yesterday, and the fact that we were able to communicate with him after a week and a half, Dad is still not doing very well. His blood pressure was very low again last night, even though they are giving him steroids on a regular basis. His white count is up to 29,000 (meaning the infection is getting worse), and he continues to have a GI bleed.

During the procedure yesterday the team only removed and replaced the external parts of two of his three central lines. Since the infection is just getting worse, they have decided to sterilize his room today and completely replace all three of them right there in his room. They will most likely also being doing a scope of his GI system to see if they can find the source of the bleeding. For whatever reason, it just seems like Dad can't have two straight days of improvement.

We continue to hope and pray for the best, and thanks to all of you for doing the same. Here are a few more pictures my mom asked me to post.

Dad and his current setup

The dialysis machine

This machine delivers medicine through the ventilator which helps the right side of Dad's heart pump better

My parents' friends, Richard and Kasey Elkins, flew up from Texas last week. Thank you!

Quick Update

Dad's tracheotomy is complete, and he has been back in his room for about an hour. They keep telling us that we can't come back for a few more minutes because they are getting him settled. We were told that the procedure went well, and they also replaced the three different central lines he has, as they believe one of them is a source of infection. I'll post any other info as it becomes available.

12:21 p.m.: We're back in Dad's room now and he is actually interacting with us! The SICU doctors wanted to see how he would do without the paralytic (although he is still under heavy sedation) and he seems to be doing very well so far. We were able to talk to him and he squeezed our hands three times for "I love you". He kept mouthing the word "water" because his mouth is so dry from having the tube down his throat and his mouth open constantly. Now that his mouth has been swabbed a few times he seems to be happy. When I told him he was in the hospital he also mouthed, "I know." When I said that it was great to interact with him and that we had missed him he cried a little and shook his head. It makes such a huge difference to be able to communicate with him! I'll let you know if anything changes, but things are going very well right now.

Ups and Downs

The marathon and drama continue, unfortunately. Every day there seems to be a few small improvements along with a few small setbacks (or sometimes large ones). The net result is that not much has changed since the last post. His blood pressure and heart rate are fairly stable, most of the time, but every once in awhile his blood pressure falls to 50/30, which is obviously not good. The nurses then give him a quick shot of steroids or other medication and it usually returns to a more stable number shortly thereafter.

There are two big things which have changed. The first is that on Tuesday the doctors discovered that Dad had developed a bleed in his gastrointestinal tract. He was given some blood and platelets and it seems to be under control now. It was a little scary when he passed a blood clot the size of a fist on Wednesday, but their hasn't been anything since then.

The other major development is that Dr. Bull thinks it would be beneficial for Dad to have a tracheotomy, which is when a hole is cut in a person's throat (I apologize for the blunt way of putting that). This will hopefully allow the ventilator pressure to be turned down to a more normal level, and will allow them to more easily remove the tube for short periods of time once Dad is ready to start being weened off of the ventilator. Additionally, I noticed today that his lips have become quite dry – despite the nurses very regularly placing cream on them – even to the point that there was some dried blood on them. Having the tube go through the "trach" will allow his mouth to be closed and moistened more naturally.

In order to get the tracheotomy, Dad will be going to the operating room at 7:00 a.m. tomorrow morning. Please pray for the procedure to go smoothly. Again, thank you to everyone for your prayers, visits, donations, food, and everything else everyone is doing to help our family. We couldn't have made it this far without all of you.

The Marathon

Over the last few days, several of the doctors have been talking to my mom about what is going on with my dad, and how long we should expect his recovery to take. They have been using phrases like, "it's going to take a long time," or "we just try to make small, incremental improvements each day, and somedays there will be set backs." Dr. Bull was talking to my mom about trying to take care of herself, telling her she needs to eat and get plenty of sleep, etc. He said that this process is like a marathon, so she needs to pace herself and make sure she takes care of herself. So, I guess the point I'm trying to make is that Dad is going to be in the SICU for quite some time, and most days there probably won't be much significant change.

Friday there was a bit of a scare when the doctors found a large white mass on the right side of Dad's chest in an x-ray. They weren't sure whether it was fluid or air, but knew they needed to get it out of there by inserting a chest tube on that side. They were thinking of just doing the procedure right there in his room, but Dr. Bull said it would be too dangerous not to know exactly where it needed to go. They decided to do a CAT scan so they could get the tube precisely where it needed to go. It took six people to move Dad, his bed and all of the equipment that had to go with him. They were able to get the scan and insert the tube successfully, and as soon as they did there was a big whooshing sound, so it turned out to be air. However, the doctors have no idea where it came from, as there is no leak in his lung or any other obvious source. But, getting the air out made it easier for the respirator to function correctly and for Dad to breathe, so overall it was a positive development.

Saturday was fairly uneventful, with the doctors continuing to try and slowly wean Dad off of the ventilator and his medicines. Sunday they began to switch his sedation medication from Verced (spelling ?) to Propolol (or something like that, sorry) which is a more mild sedative and will make it easier for him to wake up. The only problem is that changing the medication also caused his blood pressure to go a little crazy and his heart rate to go back up into the high 100-teens, when it had been down around 100 prior to the change. They also took Dad off of the paralytic medication for about an hour-and-a-half yesterday, which he seemed to tolerate very well. After that time he began to fight against the respirator again so they had to restart it. But, my Mom said that during the time he was off it he did raise his eyebrows once while she was talking to him.

Several times over the last few days they have tried to set the dialysis machine to start removing the extra fluid which has been accumulating in Dad's body, but each time they try he doesn't react very well. So, the dialysis is currently only removing the amount of fluids they are putting into him. As a result of the extra fluid, he has a somewhat swollen appearance. Because of the high blood pressure (190/90) after changing the sedative yesterday, they wanted to make sure that Dad hadn't had an aneurism or anything, so they checked his aorta and it was the correct size, so everything looked alright.

As you can see, there hasn't been a whole lot of progress over the last few days, just a little bit here and there. This whole process really is like a marathon and is going to take a long time. As more changes occur or information becomes available we will keep you up to date. Thank you once again to everyone who has been praying and fasting for my Dad and our family, we can't thank you all enough or tell you how much it means to us. Thank you also to my dad's sisters Karyn and DeAnn, and my parents' friends from Texas, Richard & Kasey. They have all been spending quite a bit of time at the hospital with my Mom over the last few days when us kids couldn't be there, we really appreciate it.

Slow and Steady

I apologize to all of you who were anxious for an update Thursday, but I was severely behind on school work from being at the hospital Monday through Wednesday and had to do some catching up. The post tonight comes from an email that my sister Mariah sent me a couple of hours ago. She was at the hospital with my mom most of the day and knew everything that had been going on. Thanks Mariah!

This morning the hospital called and obtained Mom’s permission to put a feeding tube in Dad, and to also put a tube in for dialysis. When we got up to the hospital, we were glad to find out that Dad had a much better night. They had started to give him a new medicine last night directly through his ventilator and it had started to help the right side of his heart pump better. Throughout the day it continued to help, and all of his heart numbers have improved.

Since all the monitors were showing that his numbers had improved slightly, they wanted to confirm it with an echo to see if they should continue on the same course or try a different medicine. Dr. Lou came in and told us that the echo did show some improvement in the heart. The right side looked better than yesterday, but is still dilated; his left side showed that it was getting more of the blood that it needs.

All the doctors told us that the dialysis machine is going to be his best friend for awhile. They started him on Continuous Veno Venous Hemodialysis (CVVHD). There are two types of dialysis and this one is the lesser of the two evils, so to speak. It will run 24/7, and is much gentler on the body vs. the other, which runs 4 to 5 hours at a time and is very harsh on the body – which he couldn't handle right now.

I think that they started the dialysis around 2 p.m. At first they were just taking out the fluids they were putting in to see how his body would handle it, and it did very well. About 5:30 p.m. they started taking out a very minimal amount of excess fluid to see how he handled that, and when mom left at 7 he was still doing well with it. Once they can start getting out more of the fluid, the more his heart and lungs will start to improve. Hence the reason dialysis is going to be his best friend.

They have also been worried about his kidneys, since their function hasn't been normal, so they did an ultrasound on them today. Dr Lou just had the preliminary report, but said that from what he could tell the kidneys look fairly normal. He feels that they haven't been functioning properly due to lack of blood flow, which is caused by the low blood pressure, which is caused by his heart not working correctly, which is caused by the water retention. It is just one big circle.

The kidney specialist team (nephrologists) came to check on Dad. They told us that with Dad’s diagnosis his kidneys have an 85% to 90% chance of fully functioning again, but that first the heart and lungs have to heal, and then the kidneys follow. As of right now, the dialysis machine is doing the total function of his kidneys. With the dialysis they have to use citrate to keep the blood from clotting in the machine. It also has dextrose in it, which has caused Dad’s glucose levels to go up again, but they aren't too worried about it because that is to be expected and have simply increased his insulin to regulate it.

Things on the ventilator are slightly improving. They were able to lower his oxygen to 40%, which is the lowest they put it at while a patient is on a ventilator. There is also a PIP number and a PEEP number which has to be met in order for him to be off the ventilator. It needs to be 5/5 and today when we left they had it at 28/12 vs 36/12 yesterday. Throughout last night and today they were able to lower it in small increments. Dr Lou was happy with this progress, saying that even though he is just making baby steps, at least they are in the right direction. His main goals now are to get the excess fluid off of his lungs, to continue to slowly decrease the numbers on the ventilator, and also get him to a point on it that they will be able to start taking him off sedation and paralysis. They have to make sure that he will be able to be comfortable and relaxed so that his body won't try to fight it again. But they really want to get him awake so that he can start interacting again.

If things keep slowly improving, Dr. Lou also wants to gradually start taking him off some of the 11 medicines that he is getting. All of the doctors say that they are happy with his progress today and that if he continues to improve a little more each day, or at least stays stable for a day or so in between days with improvements, then they will continue to be happy. Dr. Lou said that he isn't walking such a fine line as he was on Tuesday, and he has more leeway to move numbers around (on the ventilator, etc.), which is a good thing. I again asked him his opinion on the probable outcome, and he still wouldn't give a certain answer, just that there will be more waiting and seeing.

Also today, they were able to take out his tube for the spinal block (which was used during the surgery on Monday for pain management). At first his clotting factor (INR) was too high, meaning that his blood was to thin and wouldn't clot, so they had to give him two units of FFP (fresh frozen plasma) to bring it to a normal level. They then took it out, so now he has one less tube. Dad also ended up having three units of blood yesterday to help hydrate the left side of his heart and raise his blood pressure, which together with the new medicine they are giving through the ventilator, helped his blood pressure to be up and his heart rate to be down. They said that although they are happy with his improvement, Dad is still very sick and his situation is still very serious.

Thank you again to everyone who is keeping Dad and the rest of us in their thoughts and prayers. It is making all the difference.

SICU Day 3

Good morning everyone. I want to take this opportunity to thank everyone who visited, called and commented on the blog yesterday, and to all those who kept Dad in their thoughts and prayers and continue to do so today. I also want to especially thank Jordan and Jane Putnam for their hospitality in allowing my mom and I to stay with them overnight. I would also like to thank all of the doctors, nurses, aids and everyone else who have been taking care of my dad over the last year, and the last couple of days. Almost without exception, they have been extremely kind, caring and willing to answer any of our questions and explain everything they are doing to us. It makes such a big difference to be able to at least understand what is wrong, what they are doing to fix the problems, and what all the machines that are plugged into Dad are doing and measuring. Thank you!

Last night around 8:30 p.m. we were told that Dad had spiked a fever of 104ºF, and his white count was at 19,000 (it should be between 4 and 8K) due to the infection in his body. The theory is that he had a latent infection prior to the surgery on Monday, which the body was fighting until all of the stress of the procedure compromised his ability to do so. They are currently treating him with a powerful broad spectrum anti-biotic as well as an anti-fungal, and then as soon as the blood cultures return (hopefully some time today) and they know what the infection is they will start treating it with a more targeted medicine. When we arrived this morning, the nurse informed us that his fever was gone, his white count was at 12,000, and gave us some other good news which I will address below.

One of the main problems Dad has is what is called Adult Respiratory Distress Syndrome, which means both of his lungs basically completely deflated and couldn't function properly. In order to get them back to normal, the doctors put him on a respirator at a very high pressure in order to re-inflate them. Because the pressure is so high, and because the respirator is set to such a high number of respirations per minute, it feels very unnatural to Dad (or anyone) and the body naturally tries to fight it. So, in order for the respirator to do its job, Dad had to be sedated and paralyzed chemically so he wouldn't fight against it anymore. It is very interesting to see the different perspectives all of the doctors and nurses have about what is going on and what to expect. Some are optimists and others are more realistic in their expectations. Basically, we can expect Dad to be under sedation for at least two to three more days, and on the respirator for anywhere from one to three weeks - depending on which estimate is correct. While yesterday the respirator was set to 100% oxygen most of the day, it was turned down to only 50% O2 today, which means it is progressing in the right direction.

Because of all the problems he's been having with his lungs, his blood pressure and heart rate have not been ideal. Yesterday his blood pressure was around 80/50, and his heart rate was up in the 140's most of the day. The SICU team tried several different medicines to normalize them, but unfortunately, Dad's body didn't really react very well to any of them, so they kept hovering around those numbers most of the day. However, during the early morning hours he was started on a new medicine that helps the right side of his heart function better, which has been working quite well and his blood pressure this morning is around 100/60 and he has a heart rate of about 117, both moving in a positive direction.

Last night Dad's blood sugar, potassium and creatinine levels shot up, so they have been treating those with medications as well. At its peak, his blood sugar was at 200, but this morning it is back down to 121, and Stewart (his nurse today) said that anything between 60 and 120 is considered good. The potassium and creatinine levels are still too high, even though he has started having more urine output from his kidneys. He may have to have dialysis to take care of those two levels if they don't turn around on their own soon.

An ultrasound was also performed on Dad's heart this morning, just to make sure everything is functioning properly, and the ultrasound tech seemed to think it was. Although my mom had a bit of a scare when the tech mentioned to the nurse that it didn't look like he had endocarditis or anything like that. Well, all my mom heard was "endocarditis" and I could see the instant panic on her face, because that is what my dad's mom had that eventually took her life. I quickly reassured her that the tech had said he didn't have it, and the color soon returned to her face.

Below are some pictures for your viewing:



Here is a picture of most of the tumors that were removed by Dr. Bull and his team from Dad's left lung on Monday

This is a picture showing his vitals at about 11:00 a.m.

This picture and the next are for a general idea of the setup of machines that surround him right now

As you can see, the "tree" of IV medicines is quite large - a total of 11 different items at the moment

Please Pray

Update: After we gave Dad the blessing, the SICU team came into his room on their morning rounds and told us what is going on. Basically, Dad's lungs aren't working efficiently enough on their own. They're retaining too much carbon dioxide, which is unbalancing his pH levels and making it too acidic. Because his lungs aren't working correctly on their own, he has been put under heavy sedation and paralyzed from the neck down so that the respirator can take care of breathing for him.

His lungs are also retaining too much fluid. In order to offset the fluid, he is being treated with Lasix, but his kidneys aren't functioning properly either so that's complicating matters even more. When I asked one of the doctors if he was optimistic about the outlook, he said that he just can't tell right now. He said that Dad is walking a very fine line right now, and they are just trying to find the balancing point. The next 24 to 48 hours are critical and the doctors will be able to tell a lot more after they have passed.

Original Post: We know that there are many of my dad's family members, friends and colleagues who continuously pray for him and have him in their thoughts. We are asking that you especially do so today, as things aren't going as well as hoped after the surgery. All day yesterday, Dad's heart and breathing rates were much higher than the doctors would have liked them to be, and the trend continues today. In order to better measure what is going on, and to help them get the rates back down where they need to be, the doctors are inserting a catheter into Dad's heart this morning. Mom, Mariah, Enrique and myself are heading up to the hospital and I'll let you know as we learn more. Thanks to everyone for your unbelievable generosity, love and support through this entire ordeal.

Lung Surgery #2

10:45 a.m. – Dr. Bull just came out and said that the surgery is complete. Everything went well, but they had to remove approximately 50% of his left lung in order to get all of the nodules (about 15 of them). The doctor actually said that if his right lung had been whole he would have rather just removed the entire left lobe, but since that wouldn't leave him with enough capacity b/c of what he lost in the last surgery, just cutting out the individual tumors was the best option. We're now just waiting for him to recover enough for us to go see him in the SICU, which will take about an hour and a half. He'll also wake up with a tube down his throat as he isn't awake enough to remove it yet.

9:40 a.m. – The nurse called again and said that it would be at least another hour. She also mentioned that they have already removed several "specimens", and that every thing is still going smoothly.

8:45 a.m. – One of the nurses in the surgery room called and said that it is underway and everything is going well so far.

7:45 a.m. – Hello everyone. Today's surgery started very early. Jim, Patti, Clayton and Makell had to get up at 4 a.m. this morning to make it to the U of U hospital by 6 a.m. Coleton and I (Clint) arrived at about 7 and Mariah just arrived. Jen is working, and Enrique is staying home to take care of Boston and Roman. Dad was taken from his prep room at about 7:30 a.m., basically right on time, and we'll hear from the nurse in the surgery room in about an hour. One positive change from last time is that Dad was able to receive a nerve block, so his pain should be much more manageable this time around.

SURGERY - Date set for next round

Patti and I met with my cardiothoracic surgeon yesterday. He felt that I was doing well and that I looked well. We talked about the next surgery and he decided that Monday, March 9th would be the date he will go after the tumors in my left lung. So that is the plan now, less than two weeks away. I cannot even begin to explain the emotions that come up when I think of going through this again. With God's help, all is possible.

During our conversation with the surgeon yesterday, I learned some things about this first surgery that I did not know. Of course, he tells me that he had this conversation with me while I was in the hospital, but I don't remember any of it, so this was all new to me.

Essentially, I lost about one third (1/3) of my right lung during the operation. The largest tumor, the one he reported was about the size of a baseball, had progressed beyond lung tissue and was invading the area in my chest called the mediastinum. This is the area between the two lungs where the heart, large blood vessels, wind pipe, esophagus (food passage), thymus (a gland), lymph glands and such hang out. The doc reported that the tumor had invaded the thymus gland and the phrenic nerve (goes to the diaphragm) so those were removed as well as the tumor and any lung tissue that appeared to have disease in it. No wonder it hurts to take a deep breath now.

In my last posting, I included a picture of some of the lung tissue that was removed, but I wasn't sure what it was. So, I'll post it again with another one showing the major resections of lung tissue from this first surgery.

















The first picture is the one I posted previously. This is the largest section removed and is the one that was invading the other structures described above and described as being about the size of a base ball. The second image, with two pieces of tissue shows what was removed from the lower lobe of my right lung. Both of these pieces contained tumor. If you click on the images, they will enlarge and you can see the rows of staples along the edge of the tissue where it was cut away from healthy tissue.

We read the pathology reports yesterday and learned that all surgical margins from this operation were clear meaning that the diseased tissue was all contained within what was removed during the surgery. A great blessing.

Thanks so much to everyone for your continued prayers. Your prayers and blessings from God are what keep us going and give us strength to face the next day. God bless you all.

Jim & Patti

I'm Still Alive

Dear friends and family, I am alive. There were a couple of moments when I doubted whether I'd make it or not, the recovery has been better than I had feared, but rougher than I had hoped.

I was discharged from the hospital on Tuesday afternoon. Since arriving home, I have struggled for physical strength and emotional stability. Thanks to my eternal companion, I am finding both.

I have no recall whatsoever of events on Wednesday following the surgery. I was on heavy doses of morphine and ketamine for pain control. Normally, in this type of surgery, the anesthesia and pain teams like to place what they call a thoracic block - about the same thing as an epidural when a women is having a baby - to provide pain control after surgery. This obviously would have been higher up in the spine than that done for having babies. Anyway, my blood platelets were still low enough that the pain team didn't feel comfortable doing it as the risk of complication would be too high. Thus, I ended up being heavily sedated for a couple of days.

I recall very little of Thursday either - I was still under the influence. Patti tells me that I was quite conversant and that I spent a great deal of time promoting the benefits of a career as a PA to a nurse that was thinking about PA school.

I also recall seeing a good freind of mine from my fire department days - 20 years ago - who is now the fire marshal at the hospital. I guess I happened to see him walk past my room so I called him in to visit. I remember the fact that I saw him and we visited, but I have no recall at all about what we talked about. Sorry Dave!

Thursday afternoon, I was transferred from the University of Utah Hospital to the Huntsman Cancer Hospital via ambulance. Clint already mentioned that in his post. My purpose in mentioning it is that I DO remember that. It was uneventful other than somewhat painful to move from bed to gurney and then to another bed.

I have a large incision on my right upper back. It is healing well and isn't too bothersome for the most part. If I bump it or something, I definately know that it is there.

I had two chest tubes hanging out of my side for several days after the surgery. I think it was Sunday that they finally took them out. Now that was an experience. Bandages were removed that had been in place since the surgery. Sutures holding the two tubes in place were cut and the PA from the cardiothoracic surgery team said, "take a big breath and hold it." Out came the tubes with one long pull. I was amazed to see how much of the tubes were actually inside my chest. I'll include some pictures below. The best way I can describe the sensation of having them pulled out would be to compare it to being turned inside out.

After the tubes were out, I seemed to improve a little each day. I was on oral pain meds after the second day from surgery - Friday I guess. My biggest challenges were coughing. That hurts like the dickens and on one occasion while I was letting myself recline gently into my bed and trying to protect my tubes and incision, I coughed really hard and felt something terribly painful in my chest pop. Right along my breast bone on the right side, right at the bottom where ribs attach, I felt like I had been shot. To this day, this spot is the source of most of my pain. It hurts to move, to breathe, to laugh and most of all to cough. I also found that the hospital beds are really hard on my back. I have had the worst back ache since the surgery. That has been my biggest challenge. I just can't seem to find anywhere to get comfortable. Either the front or the back of me just aches intensely.

Yesterday, out of stupidity or something, I skipped a dose of pain medicine. Wow, did I ever pay the price for that choice. It took a couple of scheduled doses of pain medication after that before I got back on top of it. Last night was probably the best night I have had since the surgery and today, for the first time, I am finally starting to feel a little better.

I struggled with oxygen levels at the hospital. As long as I was on oxygen, my levels were fine. Every time we tried to get me off the oxygen, my blood oxygen levels would drop and I'd have to go back on the oxygen. When it came time to send me home, they sent an oxygen bottle with me and told me to stay on it for a week. So now, I am dragging this long tube around behind me that is attached to a machine in the livingroom and blowing oxygen in my nose all the time. I don't mind the oxygen, but the tube over my ears really makes them sore.

Not much else to report at this time. I spend most of my time trying to get comfortable. My digestion has been a little messed up, but that will improve with time I am sure. Here are some pictures.

Here is a picture of part of the lung/tumor resection.













Wednesday in intensive care at the University of Utah Hospital.












Thursday in "Specialty Care" at the Huntsman Cancer Hospital. Some of my family came by for a visit: My brothers Mick and Derek, my sister Melody (from California) and her son Jordan (attending law school at the Univ. of Utah).









Getting ready for chest tube removal. My head is at the left with my right side up in this view. My new incision on my back and the chest tubes hanging down on the right.










A "better view." Incision on the back, chest tubes below. There are sutures holding the tubes in place that had to be cut. The long sutures were placed at the time of surgery and will be used to close the holes once the chest tubes are pulled out.













Here is a picture of the chest tubes once they were taken out of my chest. You can see where the sutures are that were used to hold them in place. These were at the skin level. Everything above the sutures was inside my chest. Oh joy! No wonder it felt so good when they pulled them out.












And finally, here is a picture of Bill Wong, PA-C that removed my chest tubes and also provided post operative care for me. A great guy!

Post Op Day 2

Jim and I are sitting in his room at the Huntsman Cancer Hospital. For anyone who has not seen one of these rooms, they are absolutely amazing. They are more like a nice hotel than a hospital room – except for the tubes, machines, and bed of course. From the hardwood floors, to the more than adequate square footage, to the excellent room service, we couldn't ask for a better place. He was able to move here yesterday, but had to come via a three-minute ambulance ride, even though the U of U hospital and the Huntsman Hospital are right next to each other and connected by a couple of indoor walkways. Apparently it is protocol, just in case something happens during the transport.

I (Clint, Jim's son) am still posting because the pain medication Jim has been on has been really fogging up his brain. He attempted to post something yesterday but couldn't really focus and kept falling asleep as he tried to concentrate. The doctor's have permitted him to stop taking Morphine and Ketamine, and to begin taking Lortab, so hopefully he will be able to start thinking more clearly very soon.

Yesterday Jim's blood sugar was at 179 (it should be between 60 and 100), so he had to receive a shot of insulin to get it back down to normal levels. They just took his level again a few minutes ago and it was 114, low enough that he doesn't have to take more insulin. He still has a chest tube, but the volume is steadily decreasing. Once again, we as a family want to take the opportunity to thank everyone who reads this blog and supports my dad and the family with calls, emails, comments, prayers, donations, and everything else. It is amazing, and truly moving, to see how many people love and care about my dad. We'll keep you updated as his recovery progresses.

He's Out!

The surgery is already complete and everything went well. The surgeon feels that he was able to get all of the tumors, including a piece that was starting to grow into the fat surrounding Jim's heart. It was definitely a good thing that he had the surgery now and not later, or it would have soon taken over the heart. The surgeon also removed the remainder of Jim's thymus (Jen says it is used when humans are young to develop their immune systems).

Jim will soon be taken to the surgery ICU where he will need to stay for at least 24 hours. Once he is coherent, we will be able to go visit him, but the doctor said we would have to give it about an hour and a half.

I will post some pictures of the tumors (and chunks of lung) that were removed a little later, for some reason they aren't uploading right now. The surgeon said that the main tumor was about the size of a baseball.

The "Right" Side

Jim's surgery is just getting underway, even though they took him back over an hour ago. He was in good spirits while in his waiting room, and is anxious to get this behind him. The anesthesiologist came out and told us that he is doing well. He will be breathing on only his left lung throughout the procedure - this is accomplished through a special intubation tube, which actually has two separate tubes. The two tubes allow the surgery team to only inflate the lung they want. All we can do now is wait, and it will probably be a couple of hours before we hear anything. Thank you to everyone who is fasting and praying on his, and our, behalf today.

SURGERY - Here We Go!

OK, we got the final word this afternoon. I am scheduled as the first case for my surgeon, 8:30 a.m. tomorrow morning. I was instructed to be there by 7:00 a.m. to check in at the registration desk. That means that Patti and I and the kids have to leave here about 6:00 a.m. to drive the 45 miles to the hospital. Hey, it's better than having to check in at 6:00 a.m. like we've had to do a couple of times before.

Yesterday (Monday) was pre-op day. I had some blood work done at the cancer hospital in the morning and then met with my oncology team at 10:00 a.m. My white count had improved to the 4.2 level (I needed it to come in above 4) however, my platelets dropped to 75,000 - the minimum acceptable for the surgeon. They were at 86,000 on Friday. The Temodar cancer drug messes with all of these levels for weeks and weeks after taking it. Since I took five courses of it and the effects are cumulative, well, I guess I can't expect anything different.

I also met with the research coordinator for clinical trials and discussed the trial the oncology team is trying to get me qualified for. It is called ARIAD and is investigating the effectiveness of a new drug on sarcoma. Sounds quite interesting to me. I have 13 weeks from the last dose of Temodar to start the program, so I'll have to recover from surgery quickly to get started on it. I think they said that I have until the 27th of March to start. If all goes well, my second surgery should be on the 11th of March, plenty of time.

After the oncologist, I went to the University of Utah hospital for surgical prescreening. I had another EKG, was examened by a PA by the name of "Tatum" who works on the cardiothoracic surgery team and then I was examened by a Fellow from the anesthesiology department. I had an indepth interview with both of them and with a nurse who asked me about everything in my life. It's amazing what stuff you forget until someone asks you.

Finally, they got a urine sample and took 4 tubes of blood for testing. It is most likely that I'll be getting some blood transfused during the operation, so they have all the tests going now so that they will be ready to go for tomorrow.

Patti is still not feeling very well, but is showing some improvement. She plans on being at my side come hell or high water.

Check back here occasionally for updates tomorrow. Thanks for all the prayers and offers of help.

God blees you all.

Jim

SURGERY - testing my heart

During the visit with the cardiothoracic surgeon on Wednesday, we discussed my overall health and current medications. I have a scalp folliculitis (pimples on my scalp) that I have had for years. I take a penicillin tablet every night and that keeps it under control 99% of the time.

Also, I have high cholesterol. I have had that for most of my adult life. Actually, all of my adult life - for as long as I can remember. I haven't always taken very good care of it. In fact, I ignored it for many years. I was always of the opinion that I'd rather die of a massive heart attack than rot away of some other disease. (see what I get?)

About 5-6 years ago, I started taking Crestor for my cholesterol and it has worked exceptionally well. Because of my history of high cholesterol, the surgeon wanted to be sure that my heart function was normal. He ordered testing.

Yesterday, I underwent a chemical stress test of my heart. I was given a drug called "dobutamine" while hooked up to an EKG machine and while an unltrasound technician was taking pictures of my heart. Everything went well and the preliminary report was that everything checked out OK.

I am very glad that the nurse and technicians administering the test warned me about one specific side effect of the drug. While it is designed to make your heart beat faster and stronger - the desired effect, it also creates a VERY STRONG urge to urinate. Had they not warned me about this before the test, I'd have been off the table and headed to the nearest restroom. I have only experienced that same intensity related to the need to urinate when I have had a prostate infection (twice in my life).

I have more testing on Monday (blood) with hope that we can move ahead with the surgery on Wednesday. I'll update things when we have the results.

Jim

SURGERY

Hi to everyone. I am amazed by everyone's kindness and attention. I am often asked when I will again update this blog by family, friends, neighbors and even strangers. Thank you everyone. If by some small measure, someone is inspired or encouraged by what it written here, then this has been worth it.

Patti and I met with the cardiothoracic surgeon yesterday. I had a CT scan in the morning that showed only minimal changes in the existing lung tumors. There were no new lesions and no significant increase in size of any of the others.

The surgeon reviewed the CT images and then discussed his plan. Essentially, next week on the 11th, I'll go in for surgery. This will be at the University of Utah Medical Center in Salt Lake City. The caveat would be that my blood has to have recovered sufficiently by then to allow the surgery. If not, it will be put off until the next week, on the 18th.

He explained that the goal would be to survey the entire lung and remove any suspicious tissue and of course remove the obvious tumors. This would all be done through an incision about 5 inches long on the right side of my chest. I can expect to be in the hospital for 3 to 5 days and then in about a month, return for a repeat performance on the other side. The right side will be done first because that is where the largest tumor is. Check out the CT images posted previously.

It has been five weeks since my last chemotherapy. I am just now starting to feel like I have some strength coming back. Last week was totally exhausting. Each day is a little different. Some days are pretty good and some just aren't. I still have this nasty chemical taste in my mouth that is really annoying, but food is finally getting better and the nausea seems to be easing off some.

God bless you all. We will try to keep you posted on the developments as they unfold. On the day of surgery, I'll ask my son to post updates here to keep everyone posted on how the surgery is going.

Jim

Another Update

Well, not much has changed. We met with my oncology team yesterday at the Huntsman Cancer Institute and discussed the CT and MRI studies done last week. Essentially, the cancer continues to spread or grow. We knew that.

As reported last time, new lesions have been identified in my lower spine and a new one in my cervical spine was identified in this last study. The good news is that these all appear to have responded to the chemotherapy.

The majority of lesions in my lungs seemed to have responded to the chemotherapy quite well as they have either disappeared or shrunk significantly. However, there are 5 lesions that have not and actually appear to be increasing in size. You can see several of these on the CT images of my chest that I posted several weeks ago. It is these lesions that the sarcoma team wants to get rid of. I am scheduled to see a surgeon on the 4th of February.

Chemotherapy has been suspended for now due to my blood being so messed up (see last post). After I recover from surgery, I will be reevaluated and it will be determined at that time if I will resume chemotherapy and what kind.

In the mean time, there isn't much we can do about anything. Patti is quite stressed and the oncologist even commented about how stressed she seemed to be. As we were checking out and scheduling another chest CT for the 4th, she came up to Patti, put her arm around her and told her that for now, there is nothing more we can do until after the surgery. She then said that we should get out of town and forget about it all for as long as we can. That might be fun.

We have had horrible inversions here with severe smog/fog socking us in and very little direct sunlight or clear skies and terribly cold temperatures. Warm and sunny southern California might be just was we need for a couple of days.

Gods blessings to you all!

Jim

Quick Update

Here is a quick update. I got a call this morning from my oncologist's nurse informing me that the oncologist has decided to suspend chemotherapy for now. Each time I have undergone this "new" chemo, my blood has suffered some. My white count drops significantly - thus, I've been getting that Neulasta injection that I described some months ago to try to keep the white count up. Additionally, my platelets have dropped significantly. Platelets are the part of your blood that form clots to keep you from bleeding to death when you get cut.

Back in November when I was hospitalized for infection of my central line, my platelets had dropped to 26,000. A normal person's platelets are supposed to be above 240,000. At that time, I required a transfusion of platelets just so they could pull out the infected central line without fear of me bleeding to death then.

Every time I go for a chemotherapy session, my blood is checked and it usually gets above 100,000 or so allowing me to proceed with the treatments. They prefer it to be above 120,000, but the last couple of times, it has been just above the 100,000 mark. This past Friday, my platelets were only about 58,000 or so.

The Sarcoma Team meets every Monday morning to discuss active cases and they decided that suspension of the chemo was in my best interest for now. I was told to see the cardiothoracic surgeon as soon as possible (my appointment for that is February 4th) to discuss surgery to remove the larger lesions from my lungs.

So, that is about it. We are waiting to see the surgeon on the 4th. I have to admit that I am not disappointed about the suspension of chemotherapy. I am just starting to feel semi-normal after the last round three weeks ago. I was not looking forward to the sickness that comes with each treatment.

On another topic, the topic of faith, I am so thankful for everyone's encouragement and prayers. I am thrilled and deeply humbled to be included in prayers of so many. I received a wonderful e-mail today from a physician colleague of mine that I haven't seen for a year or so informing me that I had been included in his prayers since he had learned of my cancer. What a wonderful blessing it is to be included. I am so appreciative.

A wonderful cousin of mine sent me another wonderfully inspiring message that I'd like to share with you as well. Here is a link that you will have to copy and paste into your browser to connect to. http://www.youtube.com/watch?v=u2AibapAJfE

It is amazing and really exemplifies my feelings about my faith and trust in Christ. Please enjoy.

Jim & Patti Meeks