The Hartford Letters

7/15/2005–1/11/2006 - Striken with necrotizing pancreatitis while vacationing over a thousand miles from home, Lea Vaughn spent 180 days in Hartford (Connecticut) Hospital. When she had recovered enough that she could be transferred to a major hospital nearer her home, friends and family, no surgeon could be found that would accept her due to the severity of her continuing health problems. After her release and return to her home, Larry continued providing updates for those who wanted to continue keeping current on her progress, and posted them on www.godswoodshed.com. You are invited to visit the website, and sign up for automatic notification of Updates posted there.

7/15/2005 – While returning home from vacation in Maine, our friend, Joe, who was driving to our planned overnight destination in Connecticut, suffered chest pains and was admitted to Mid-State Medical Center, Meriden CT.

7/16/2005, Day 1 – Lea enters the Emergency Room of Mid-State Medical Center in Meriden, CT with severe abdominal pains. Ten hours of tests in the Emergency Room before being admitted to the floor with Pancreatitis. She is given a morphine pump to control her pain. She talks to both sons by cell phone from her hospital bed.

7/17/2005, Day 2 – Pain is still severe. The doctor believes the pancreatitis was brought on by an extremely high cholesterol level. Moved to ICU. She continues to push the morphine pump button, gets a dose of pain killer, and then fades back to sleep.

7/18/2005, Day 3 – She is diagnosed with pneumonia in addition to pancreatitis. Unable to breathe sufficiently on her own, they have placed her on a respirator. She is unconscious. Plasma Phoresis was started to remove fat from the blood. Doctors recommend calling the sons. She is expected to survive no more than 72 hours.

7/19/2005, Day 4 –Her kidneys fail. Son, Lance, arrives from Texas moments before LifeStar helicopter crew airlifted her to Hartford Hospital. Lance and Larry drive to Hartford from Meriden in Lance’s rental car.

7/20/2005, Day 5 – Son, Link, arrives in Hartford from Hawaii. Four of Lea’s five brothers and her sister arrive, along with two nieces and a nephew, from Ohio, Indiana and Missouri. She is being given massive amounts of intravenous fluids in an attempt to defuse any foreign bodies in the bloodstream.

7/21/2005, Day 6 – She has been unconscious since 7/17. She continues to receive large amounts of fluids. She is on dialysis, and now has a catheter in place.

7/22/2005, Day 7 - Moved to 9th floor ICU. The fluid in her body was increasing to the point it was pooling on the exterior of her skin at her joints. Dr Orlando Kirton and Dr John Mah perform 3-hour surgery on Lea’s abdomen, removing part of the pancreas. She has 15% chance of survival.

7/23/2005, Day 8 – 7/23/2005 – No change today. Condition remained stable. She is in a drug induced coma. Her abdomen remains open, packed with wet dressings.

7/24/2005, Day 9 – Has a dedicated nurse 24 hours a day. Receiving 18 fluids by IV, is on dialysis and breathing assistance. In coma. Larry writes his first Lea Update for friends and family.

7/25/2005, Day 10 – Dr. John Mah, Lea’s surgeon, said that he and the staff remain optimistic for her eventual, complete recovery, but that it is going to take many months to get there.

7/26/2005, Day 11 – Two more medication drips were added today. Steroids to stabilize her, and Sudafed to stop her runny nose . . . 20 medications in all!

7/27/2005, Day 12 –Urine and other blood poisons are being removed via dialysis. Temperature spikes at 102 degrees. Prognosis for survival is still at 15%.

7/28/2005, Day 13 – Pressure cuffs added to inflate/deflate on shins, to keep blood circulating in the lower legs. Small blisters appear all over her body.

7/29/2005, Day 14 – Sedation is reduced to allow the nurse to validate that Lea could respond to commands by blinking her eyes. Develops nose bleed.
7/30/2005, Day 15 – She has been running a temperature ever since the last surgery. It was about 101-102 initially, but dropped to about 99 degrees by this morning. Her next (5th) surgery is scheduled for Sunday.

7/31/2005, Day 16 – Today’s surgery has been cancelled, to allow her more restorative time. The next surgery will probably be tomorrow.

8/01/2005, Day 17 – The surgery today was conducted in her ICU room, rather than in the Operating Room. Dr. Ivy said that he believes he sees some improvement, although there is still swelling present in the wound.

8/02/2005, Day 18 –She is being weaned back off ventilator support , to help her lungs take over more of the work. Kidneys start working again!

8/03/2005, Day 19 – Lea underwent her eighth surgery, in which surgeons removed dead tissue from her pancreas again today, and found some “sludge” (blood leakage) in her abdominal cavity. They will be taking her to the operating room Friday so they can get a better look at things.

8/04/2005, Day 20 – Fluctuating blood pressure following yesterday’s surgery; kidneys reduced their output by 50% from the previous day’s volume.

8/05/2005, Day 21 – More dead pancreas tissue found during today’s surgery at a time when Dr Mah expected her to be healing. Disappointing development. Her respirator was replaced with a tracheotomy today.

8/06/2005, Day 22 – Lea went from critical to very critical, and almost terminal, hours after her surgery today. Dr Mah says odds are against her survival.

8/07/2005, Day 23 – Dr. Kirton and Dr. Mah are “cautiously optimistic that she has better than a fifty per cent chance of survival” after today’s surgery.

8/08/2005, Day 24 – Hope for recovery continues to improve as her systems appear to be holding steady today after Sunday’s surgery.

8/09/2005, Day 25 – According to Dr. Orlando Kirton, Chief Surgeon, Lea is much farther along than most people are at this time, simply because of her inner strength and desire to heal.

8/10/2005, Day 26 – Respiratory therapist came in and put Lea on reduced ventilator support for 4 hours to let her practice doing some breathing on her own.

8/11/2005, Day 27 – Fluid build up continues in her tissues; diuretic scheduled for tomorrow. She had surgery #12 this afternoon.

8/12/2005, Day 28 – Could not breathe on her own at all today. It was decided that her lung muscles were probably sore from the exercise last night, and that she would have to wait a couple of days to do some more exercising.

8/13/2005, Day 29 – Lea spent five hours on ventilator assist this morning, in which she initiates a breath and the ventilator helps her finish it. Her lungs continue to improve.

8/14/2005, Day 30 – Critical condition; stomach pump, ventilator, circulation pumps on her legs, medications hanging all around feeding into her veins.

8/15/2005, Day 31 – Lea’s cardiac system suddenly shut down. Code blue! Nick, her nurse, administered epinephrine. Entire medical team quickly assembles to stabilize her. I observed the entire procedure from behind Dr Bill Marshall, who was at her bedside with the team.

8/16/2005, Day 32 – Lea seemed to just give up, and her heart rate dropped to nil again today, just about 23 hours after she did it the first time. In this case, however, the nurse was in the room watching her when the event took place, and stabilization was much quicker.

8/17/2005, Day 33 – Lea suffered acute decompression of the lungs early this morning. She is sicker, suffering system sepsis. She is heavily sedated to eliminate the possibility that she is feeling any pain. Placed on Roto-Bed to clear fluid from the lungs. This bed is called “the bed of death” by the nursing staff. It is often the last resort, and doesn’t always work.

8/18/2005, Day 34 – Doctor Mah told me that they were pulling out the big guns in a last ditch effort to turn Lea around. Ultrasounds. Bronchial suction. P.I.C.C. line. SWAN. Blood clot filter. Wonder drug, Xigris. Odds of survival are 30%. Continuation of treatment on the Roto-Bed.

8/19/2005, Day 35 – Still on Roto-Bed. Paralyzing chemicals reduced and sedatives increased to relieve pain.

8/20/2005, Day 36 – The only change planned for tonight is the introduction of some plain water into her stomach to see if her intestines are able to absorb it. It’s now over 30 days since she last used her stomach and digestive system. Still on Roto-Bed bed, unconcious.

8/21/2005, Day 37 – Lea’s four-week long low-grade fever finally broke. Chances of survival slightly improved.

8/22/2005, Day 38 – Recovery looks likely! The staff feels she has all of her mental capacity, and will be able to return to a normal life after completing physical rehabilitation.

8/23/2005, Day 39 – Still on rotating bed. SWAN removed. Dr. Kirton says, “She is doing a spectacular job” of overcoming her medical problems.

8/24/2005, Day 40 – Breathing is improved. Lungs are clearing. She may be able to move back to a regular bed if the improvement continues.

8/25/2005, Day 41 – Removed from Roto-Bed and returned to regular hospital bed with a massaging air mattress.

8/26/2005, Day 42 – Fluid reduction is making her features recognizable again. Padded stockings used to protect skin breakdown on legs.

8/27/2005, Day 43 – Sedatives reduced slightly. She now opens her eyes and grimaces as soon as you touch her. Makes horrible, painful expressions when being moved, but no noise.

8/28/2005, Day 44 – Intravenous ports in her arm replaced today, a unit of blood, and albumen infused periodically to keep her blood pressure up.

8/29/2005, Day 45 – Her lungs are continuing to produce small quantities of thick fluid, and she seems to be able to tolerate the every-other-day dressing changes better, reacting with shorter term temperature spikes.

8/30/2005, Day 46 – Lea continues to struggle tonight, as she is being required to take on more of the chore of breathing for herself.

8/31/2005, Day 47 – CATSCAN scheduled to see why she is having such a difficult time breathing.

9/1/2005, Day 48 – Nearly 2 liters of fluid drained from chest cavity behind the left lung. Breathing greatly improved.

9/2/2005, Day 49 – Lea continued to struggle today, trying to breathe a little more on her own, and had to stop to rest occasionally, by being put back on full ventilator support for a resting period.

9/3/2005, Day 50 – She is slowly being brought up off her pain meds and sedatives a little each day. She mouthed some words in her sleep today.

9/4/2005, Day 51 – Blood pressure spikes alarmingly high twice in ten hour period. High temperature.

9/5/2005, Day 52 – SHE’S IN THERE!! She opened her eyes several times today, mouthed silent words, even turned her eyes to the side when requested, and smiled when son, Link, mentioned our granddaughters’ names!

9/6/2005, Day 53 – Dr. Mah has determined the wound should not be closed up, but, rather, allowed to heal itself from the inside out. He wasn’t comfortable doing the planned closing once he examined her abdominal area durng the surgery today.

9/7/2005, Day 54 – Dr. Mah states that he thinks that Lea is almost ready to turn the corner toward recovery.

9/8/2005, Day 55 – She is working to regain control of her lungs, breaking a sweat each time the ventilator support is reduced.

9/9/2005, Day 56 – Pulmonary relapse requiring increased sedation. She has not responded to commands for the last two or three days,

9/10/2005, Day 57 – Lea is gotten out of bed and into a cardiac chair for the first time. She is completely unconscious, and doesn’t know she’s being moved.

9/11/2005, Day 58 – She worked five hours breathing on her own, and then placed back on the ventilator for rest.

9/12/2005, Day 59 – Dressing changed at mid-day (25th surgical procedure). Fourteen hours of breathing on her own, with ventilator backup support.

9/13/2005, Day 60 – Twelve hours of breathing on her own today. She started running a low-grade temperature mid-afternoon, and given rest.

9/14/2005, Day 61 – Opened her eyes wide when Amy told her that she was going to be rolled over, and she quickly started mouthing words of protest.

9/15/2005, Day 62 – Able to breathe 18 hours without ventilator support before tiring too much to go on.

9/16/2005, Day 63 – She was transported downstairs during the afternoon for a chest & abdomen CATSCAN to determine the source of breathing problems.

9/17/2005, Day 64 – CATSCAN indicated small pockets of fluid around the pancreas, called pseudocysts. May clear up on their own in time.

9/18/2005, Day 65 – The amount of support she gets while in rest mode on the ventilator was reduced today. She continues to slowly progress.

9/19/2005, Day 66 – Ultrasound showed negligible fluid around the lungs; bronchoscopy showed very little fluid inside the lungs; CATSCAN was clear.

9/20/2005, Day 67 – High temperature peaks at 102.3 degrees. Unknown infection or cause.

9/21/2005, Day 68 – High temperature. Delirium and panic.

9/22/2005, Day 69 – Fever of over 101 degrees. CATSCAN negative. Psychocysts seem to have reduced in size.

9/23/2005, Day 70 – Lea kept alternating from high blood pressure to low blood pressure, delusion, Detoxification Tremors, and adjustments to medications.

9/24/2005, Day 71 – Lea was awake for about six hours this morning, talking to persons unknown in a constant stream of delirious conversations. Brain scan scheduled for today. She stares at the ceiling as though focusing on something there.

9/25/2005, Day 72 – Staff psychiatrist reports no stroke or seizures involved with detoxification tremors Lea is exhibiting.

9/26/2005, Day 73 – Nearly 1000 CCs fluid removed from left chest cavity to relieve pressure on the lung. Fever, delirium and body tremors continue.

9/27/2005, Day 74 – She is still delusional, still shuttering with withdrawal symptoms, still on the ventilator.

9/28/2005, Day 75 – Returned to working on the ventilator today, made eye contact with several of us, actually focused on us, and smiled at several people as they came in to say, “Hello.” (Praise God!) She puckered up when I arrived!

9/29/2005, Day 76 – Third attempt at getting weaned off ventilator support begins.

9/30/2005, Day 77 – Lea consciously emerged from the coma, and began communicating.

10/01/2005, Day 78 – Lea attempts to communicate by mouthing words. Looks at us, but arms and hands still paralyzed.

10/02/2005, Day 79 – Frustration with trying to communicate sets in. She gets visibly upset, needs tranquilizer. Starting to move hands.

10/03/2005, Day80 – Tremors decreasing in intensity; frustration with inability to communicate increases. Requests crackers. (Request denied).

10/04/2005, Day 81 – Scribbles illegible notes on clipboard held in front of her in attempt to coomunicate to us what she wants.

10/05/2005, Day 82 – First physical therapy session today. She seemed to tolerate it well.

10/06/2005, Day 83 – She is able to get her hands onto her abdomen. Depression sets in as she realizes size of stomach wound.

10/07/2005, Day 84 – Psychological paralysis sets in. No longer able to move limbs on her own.

10/08/2005, Day 85 – Short term memory returns. She remembered the bathrobe I have been giving her every day.

10/09/2005, Day 86 – Lea completed her third consecutive 16-hour day of breathing on her own, with eight hours of overnight rest.

10/10/2005, Day 87 – Maria helps Lea sit up on side of her bed for first time. She has to be supported the entire time.

10/11/2005, Day 88 – Eyes badly inflamed, bloodshot and photosensitive. Unknown cause, but suspect something sprayed in air while her eyes were open..

10/12/2005, Day 89 – Endoscopy. Ulcer in stomach lining caulterized.

10/13/2005, Day 90 – Passy-Muir valve installed in the tracheostomy tube. First speech. First swallow test. Ice chips. Sleep schedule posted.

10/14/2005, Day 91 – Lea makes her first phone calls with Passy-Muir valve in place.

10/15/2005, Day 92 – Pureed meals allowed. Low fat diet. Thickened liquids, only, due to danger of liquid slipping into the lungs.

10/16/2005, Day 93 – Nurse, Chris Watkins, takes Lea on her first wheelchair trip out of doors! Sunlight, wind and sun! Grey squirrels!

10/17/2005, Day 94 –Trouble breathing again; experienced a panic attack that sent her blood pressure sky high.

10/18/2005, Day 95 – Second field trip outside the hospital. She requests a pedicure, a manicure, a haircut and a massage!

10/19/2005, Day 96 – Tilt table used to begin reversal of drop foot syndrome. Lea attends family conference call in wheelchair. Speaks a few words.

10/20/2005, Day 97 – Skin graft over her wound completed. Last day of ventilator support.

10/21/2005, Day 98 – Completed 24 hours off ventilator.

10/22/2005, Day 99 – Completed 48 hours off the ventilator. Ventilator removed from room.

10/23/2005, Day 100 – Lea does her own voice mail update on the ICU system.

10/24/2005, Day 101 – Moved to the ICU Step Down Unit on 9th floor.

10/25/2005, Day 102 – Anxiety levels high. Blood pressure high. Didn’t eat again today.

10/26/2005, Day 103 – 100th day in Hartford Hospital. Smaller tracheostomy installed. First trip out of the Step Down unit for dinner in the family lounge.

10/27/2005, Day 104 – Staples removed from abdominal skin graft.

10/28/2005, Day 105 – Physical Therapists help Lea stand up for first time since July. Tube in nose to pump stomach removed.

10/29/2005, Day 106 – Dr Chuckwumah reports skin graft on the incision site is advancing better than expected.

10/30/2005, Day 107 – Medications being administered as tablets, rather than intravenous fluids.

10/31/2005, Day 108 – Lea took a big step forward when she was able to eat a meal without assistance.

11/1/2005, Day 109 – Large amount of pancreatic fluid voluntarily drains from the abdominal wound area. Planned departure for Indiana on Thursday postponed.

11/2/2005, Day 110 – Endoscopic ultrasound performed to determine whether source of yesterday’s fluid leakage could be located. Unsuccessful.

11/3/2005, Day 111 – Drain inserted into her right side, near the back, to drain fluid from the pancreatic cavity, which connects to the volunteer drain hole in her abdomen. Endoscopic procedure performed to possibly place stent in pancreas to small intestine. Unsuccessful.

11/4/2005, Day 112 – Preliminary plans made for return to Indiana later this week.

11/5/2005, Day 113 – (#4 size) smaller metal tracheostomy installed to replace the temporary plastic model installed for the endoscopic procedures.

11/6/2005, Day 114 – Fever, nausea, P.I.C.C. line change.

11/7/2005, Day 115 – A change in the nausea medication she is receiving seemed to make her feel better. Fever persists.

11/8/2005, Day 116 – Continued nausea. Temperature now under control. Transfer to Indiana delayed again until next week.

11/9/2005, Day 117 – Larry took Lea on wheelchair trip to the family lounge, pulling along the required IV tower.

11/10/2005, Day 118 – Wheelchair trip to the front lobby. Made a small purchase of a few items at a vendor’s display.

11/11/2005, Day 119 – Wheelchair trip to the gift shop. Didn’t see anything she had to have.

11/12/2005, Day 120 – Lea given a Prayer Shawl from a church in nearby Hebron, Connecticut.

11/13/2005, Day 121 – Wheelchair trip to the hospital’s chapel. Later, watched a bit of a rented movie, then was ready to get some rest.

11/14/2005, Day 122 – Wheelchair trip to 11th floor ICU which was empty during renovations. She liked the quiet.

11/15/2005, Day 123 – Wheelchair trip to cafeteria; chocolate hazelnut frozen yogurt and diet Stewart’s root beer. Dr Mah removed tracheostomy. Transfer to Riverview Hospital, back home, cancelled due to lack of adequate surgical services. Dr Miller has not located a surgeon at who would take Lea as a patient.

11/16/2005, Day 124 – Dr Mah scheduled CT Scan to determine why Lea is not able to eat, and she continues to vomit her intake of liquid. Notifies us that we should plan to be here in Hartford through end of the year. Lea is moved from Step Down unit 3 to private room 928 on the same floor.

11/17/2005, Day 125 – “Trapeze” exercise frame ordered to be placed on her bed so she can start trying some strengthening exercises.

11/18/2005, Day 126 – Lea is back on nothing to eat or drink for at least one more week. EKG leads removed.

11/19/2005, Day 127 – Developed a light cough that continued to increase in frequency during the day. By noon she was coughing up thick phlegm, and by evening was coughing frequently, and deeply, bringing up thick yellow matter from her lungs.

11/20/2005, Day 128 – She has a deep chest cold. Her temperature by nine o’clock this morning climbed to 102.5 degrees. Slept biggest part of the afternoon.

11/21/2005, Day 129 – Currently on a water-only diet, to attempt to stop drainage of pancreatic fluid through the abdomen.

11/22/2005, Day 130 – She discovered that she is able to roll over on her side enough to reach the controls that raise and lower the head of her bed. It keeps her busy. She also discovered that she has a clock on the wall at the foot of her bed, and is trcking her medication times.

11/23/2005, Day 131 – Lea gets haircut and styling in her room. Son, Link, and granddaughters arrive from Hawaii.

11/24/2005, Day 132 – Thanksgiving Day. Lea’s brother, Jim, Ruth and their grandson, Josh, arrived mid-afternoon for a surprise visit.

11/25/2005, Day 133 – Link and the granddaughters continued to entertain Lea and son, Lance, and finance’, Kristin, arrived from Texas this evening to complete the holiday gathering. It didn’t seem to be such a chore for her to get out of bed into the wheelchair to go do family events today.

11/26/2005, Day 134 – Another spectacular day with our children and grandchildren! We had nice “outings” for Lea, which involved getting out of bed and moving around. We went to the cafeteria for lunch, and then went to the family lounge after dark for a nice quiet dinner with Lance and Kristin.

11/27/2005, Day 135 – Lea felt pretty well all day, ate a couple of times without getting nauseous, and was able to visit quite extensively.

11/28/2005, Day 136 – Endoscopic study of her stomach and duodenum, to see if the cause of her vomiting could be located. Stricture in duodenum identified.

11/29/2005, Day 137 – Physical therapist takes Lea on first trip to the shower in wheelchair. Instructs Larry on procedures and techniques to help Lea.

11/30/2005, Day 138 – First trip to PT gym to look it over. We may get transferred to the wing where the gym is so she can access it regularly.

12/04/2005 – Updates reduced to weekly. No vomiting since early this week, and her nausea has been greatly reduced. Drain in side removed.

12/11/2005 – Queasiness continues. Pancreatic fluid continues to drain from abdomen. Heart monitor eliminated. Saline drip eliminated.

12/18/2005 – Fistula may be closing up, indicating that the body may be ready to deal with the pancreatic fluids. She walked!! She walked into the ICU!! Lea spent well over an hour arranging fresh flowers into two large vases. Then slept.

12/25/2005 – Wonderful Christmas Day in the hospital. CT scan ordered to see what is going on in her abdomen that is causing her to feel full all the time. Dr Mah tells her she needs to be out of bed more than she is in it. Lab reports came back with nearly normal results. Walked to family lounge from her room, using only the hand rail mounted to the wall for support.

01/01/2006 - Lea stood up by the side of the bed, held out her hand to shake hands, and greeted Chief Surgeon, “Dr Kirton, It sure is nice to see you again!” Her medical issues seem to continue to improve.

01/11/2006 – Discharged from Hartford Hospital, flown commercial airline back to Indiana to begin recovery.

To read further updates on Lea’s recovery, go to Gods Woodshed, Lea and Larry’s “life and times” website. The above collection of Lea Updates, the collection known as The Hartford Letters, and all content is property of Vaughn Consulting Group, LLC. All rights reserved.