Saturday, May 31, 2014

Mr. Sprocket in the ICU - Prayers Needed

Mr. Sprocket in the ICU, 5/30/14


Note: Read each day from the bottom up. Sprocket
UPDATE 6/7 8:20 PM
I'm heading home for the night.
UPDATE 6/7 8:00 PM
(Ol) brought Mr. Sprocket partially out of sedation to tell him where he was and to check his cognitive function. He partially opened his eyes and was able to tell I am here. He's slightly anxious. She's giving him some medication.  He has a temperature. Now he just got repositioned again. He gets move at least twice a shift.

UPDATE 6/7 7:30 PM
Day nurse (Ir) has left. She lets me know that Mr. Sprocket's nurse for tonight is (Ol). Mr. Sprocket has two IV ports in his left arm and one in his right. I forgot to mention that he no longer has the pressure cuffs on his legs. Mr. Sprocket's new nurse introduced herself to me. It's interesting that every time a nurse goes to interact with Mr. Sprocket, or a therapist interacts with the equipment, they put gloves on. One time use. Then they are thrown away. Afterh they take the gloves off, each and every time they wipe their hands with the hand sanitizer dispenser that's on the wall by the sink.

P.S. (Ol) said that it's no uncomon and it's called "ventilator acquired pneumonia."

UPDATE 6/7 7:00 PM
It's the start of the shift change. Visitors are not supposed to be allowed in ICU during the change. Mr. Sprocket's nurse tonight (as all of them have before) is letting me stay with him for the next hour. She just let me know that during the change she "..has to close the door while she does the report." This is something that I didn't notice the other nurses do. (Ir) has a beautiful accent. It could be a Russian accent, I'm not sure.

A respiratory therapist has come in to listen to Mr. Sprocket's lungs. She's wearing a mask. At first I thought she might be a doctor because she has a stethoscope to listen to his lungs with. Even though Mr. Sprocket is sedated, every nurse and therapist speaks to Mr. Sprocket, telling him what they are going to do.

UPDATE 6/7 6:00 PM
I came down to the cafeteria to get a little bit to eat, a pick me up. Normally I would bring my lunch or dinner. I've been trying to eat two decent sized meals a day, and then when I come home from the hospital, some fruit, that is categorized as "beneficial" for my Type O body (pineapple, mango or banana). I had a bodywork client this morning, consequently lunch was a little earlier than usual. And I had to do some item shopping for when Mr. Sprocket gets back to the Telemetry unit. Since I ate lunch so early, my second meal didn't last me very long and I didn't bring dinner.

For those of you who don't know, Mr. Sprocket is the cook in our house. It's a dangerous situation when I get near a stove. I've burned and ruined perfectly good pans just trying to boil water.

Right before Mr. Sprocket's heart attack, he had made a huge batch of his special turkey meatloaf. When I say huge, I mean huge. Six glass loaf pans and one extra large, flat, glass casserole type dish.  It's one of my most favorite meals that he cooks. Ground turkey, Japanese yams, white onion, anise bulb and a special chili powder from India.  He cooks up all the vegetables one at a time then mixes them in with the turkey. He then bakes the loafs in the oven until the sides of the glass pan are black and a real bitch to get clean.  After the loafs are done, we slice them up and freeze them into servings. It's real manna from heaven, it is so good! I've sort of watched him make it for several years but I would never attempt it myself. He always does something a little different every time with the spices.

In the cafeteria, along with what I bring for lunch, I sometimes get a small leaf salad. The only non-compliant addition to the salad I've been eating is honey mustard dressing. Tonight, I wanted a little more than that and took a chance on the chicken and rice soup.  I should have passed. I can taste the corn starch thickener (anything made from corn is bad for us) and the black pepper (also a food we need to avoid).  I'll have to take some Type O Deflect when I get home.

Many of my dear FB friends keep telling me to "take care of you," so I thought I would share what I've been doing. I make sure to get in at least a mile walk in the morning. I also try to get in an hour of sewing a day. I didn't get my hour of sewing today, so I'm going to give myself 2 hours tomorrow. I water my potted garden in the morning and try to spend time in it. I also make sure I wash my dishes before the end of each day and don't let my laundry pile up. That's my morning. When I come home from the hospital, I make sure to try to watch some mindless TV. (Million Dollar Listing, New York qualifies as mindless. Never ceases to amaze me how much people will spend on an apartment in the Upper West Side.)  And, I make sure to spend some play and love time with the fur kids, Jumpy and Scout.

I am fortunate that I have a wonderful neighbor who has been taking care of the kitties in the evening; girlfriends and family who call once a day as well as all the great support on FB and Google+. Thank you all.

UPDATE 6/7 5:15 PM
One of Mr. Sprocket's previous nurses (S), stopped at his nurse station, looked through the window, saw me and smiled. She came in to chat. She said that (M), Mr. Sprocket's first night nurse will be on tonight and she will have her stop by. (M) was on something I think (S) called "emergency runs," where they are tasked to go pick up a patient from Telemetry who is in trouble and needs to come back to the ICU.  I believe (S) said that (M) was on the run that picked up Mr. Sprocket from Telemetry, and (M) remembered him.

(S) confirmed that pneumonia can be a complication of being on a vent for so long. She looked at the meds he was on and saw he was on a diuretic. Having the extra fluid would put a strain on his heart and his heart is already strained. I brought her up to date with what Cardiologist #2 said about the newer echo, and Mr. Sprocket's heart not being as sick as they originally thought in the ER. She said "Well that's good."

I asked (S) how Mr. Sprocket was when (M) went to get him from Telemetry. (S) said that (M) said that he was having trouble breathing and that he was scared.

UPDATE 6/7 3:35 PM
The respiratory therapist just came in to check the fancy breathing machine. When Mr. Sprocket came back to ICU last night, he was on 100% oxygen. Since then, they have been able to lower it to 40%. She tried 30% but Mr. Sprocket didn't do too well on that.

When he was on the Telemetry ward, it was very interesting. He had a gadget that was attached to his sensors, that was put into the big pocket on his gown. Like the size of say, oh, a portable CD player but thicker and not as wide. That machine, uses either bluetooth or WIFI to send all his vitals data up to monitors at the front nurses station. No one would have to come into his room to monitor his blood pressure, heart rate, oxygen, etc.

In the ICU, the nurse has a desk right outside his room with a computer and see through window into his room. She can see the big monitor above his bed that displays his vitals via the window.

UPDATE 6/7 3:25 PM
I just arrived at the hospital. Mr. Sprocket is now in room 2222. I met Mr. Sprocket's day nurse (Ir), who brought me up to date on how he's doing. He is intubated on 40% oxygen. He is on a medication to keep his blood pressure up and the Diprivan (propofol) to keep him sedated. I think she said something about the propofol does have an affect on the bloop pressure, but I'm not sure.  He has a feeding tube with the gray goopy stuff, that's mostly soy.

He has wrist restraints on him. She already brought him out of sedation earlier today and said he had good responses neurologically. He has lower right lobe pneumonia, so I'm sure he is on antibiotics for that and he's also on a diuretic to try to get rid of the extra fluid from the pneumonia. (Ir) said he is peeing quite a bit from the diuretics, which is good. She drew blood to send off several cultures but those won't be back for (a while?). If the results look good, they may try to get him off the vent on Monday.

His nurse just came in to tell me she's giving him an injection, a blood thinner, to prevent clots.

I checked his closet for his things. They got everything out of the other room (cell phone, cord & charger, special modified sippy cup, other water bottles and small boxed juices) except the electric toothbrush. I just asked his nurse about that and she said she would check on it.

Ah. She had the electric toothbrush. I'll take that home. I'm doing some pages reading (65)  for my friend Matthew (the book is going to be grrreattt!), but after that, I'll be here, if anyone wants to chat on Facebook or Google+.

JUNE 7, 2013 1:45 AM - Steps Back
I just got a call from the hospital. Mr. Sprocket is back in the ICU. He wasn't breathing too well. His blood pressure went way up as well as his heart rate. The oxygen he was pulling in was in the 40's when it should be in the 90's. They just reintubated and sedated him again. He's back on Diprivan (Propofol).

Before I left the hospital, I got a little bit more of the story, of what may have happened with his night nurse on the evening of 6/5. He is still a bit mixed up about what happened when. They brought him a dinner tray, and he was able to eat a little food. He did eat all the jello. Mr. Sprocket said he had abdominal cramps and diarrhea all night. His nurse had to change his pad many times. He thinks he had too much sugar, causing the diarrhea, and that's what the nurse was upset about. I'm guessing all that liquid nutrition he got through the nose tube didn't set well with his intestines. He may not know the real reason the nurse was upset.

They also wouldn't give him the specific type of sleeping pill he wanted. (He usually takes a small anti-histamine pill, Benadryl, to make him sleepy.) They only offered him other meds which he didn't want to take.

He had just come off of the intubation. He told me his throat was real sore, and that he still had some pain or difficulty swallowing. I never saw a straw in any of his water cups when I arrived at the hospital the morning of 6/6.

He said didn't sleep at all that night. When they did the procedure yesterday am to take out his femoral vein IV, he had to lie flat for many hours afterwards. He wasn't able to take a sip of water lying flat, because of his throat soreness.  That's why he was so urgent about needing his sippy cup. He was feeling real dehydrated. He wasn't able to explain all that to me on the phone.

My husband is eccentric and drives me a little nuts at times, but he has some very good qualities, too. When he is on a job, he always calls me to check in on me and let me know how the job is going. He always calls when he was finishing a job to let me know that he's on his way home.

I cannot recall the last time he was truly angry with me. He may not understand why I did something and ask why I did something, however, he rarely ever criticizes me. He truly wants to understand my thought process because he can't understand it. He will often criticize a product, something he bought, that he feels is not made well and ends up modifying it to his satisfaction, but rarely me. (He wanted to modify a microwave once and took it all apart.) I am the one who needs to learn from him to be less critical.  He will always see the positive in someone or an event, verses coming to a negative conclusion.

From helping him on a few projects, I've had the opportunity to meet some of his clients. They always make a point to tell me how highly Mr. Sprocket speaks of me. Mr. Sprocket is a sweet-natured person and has a tender, gentle soul. 
UPDATE 6/6 6:15 PM
To be fair, part of the problem with him being a PITA right now is, he did not get any sleep last night.  He wasn't able to get a sleeping pill last night. 

He also says there was a bit of hospital drama that happened last night. His night nurse got so upset  that his nurse was going to quit. Might have something to do with the fact he ate a lot of fruit, had indigestion pain, and couldn't sleep. My sympathies are with the night nurse.

UPDATE 6/6 6:00 PM
Mr. Sprocket is in his new room 2324 North Tower.

With the assistance of a walker, his nurse (T) from ICU and his new nurse (Ca), Mr. Sprocket was able to walk from the gurney in the hallway, to the bathroom in his new room. He is still on 4 liters of oxygen (I think per hour, but I'm not positive.), and he's supposed to be on that even when he goes to the bathroom. 

He's quite uncomfortable, because there is a lot of residual swelling in his groin area. It's uncomfortable for his to sit up all the way. This is from the arterial line (Impella) that was in his right leg and the IV line that was in his femoral vein. Once that inflammation goes down, he will feel worlds better, I'm sure.

Mr. Sprocket walking from the bathroom to his new bed with the help of his physical therapist.

UPDATE 6/6 4:00 PM 
(T) has found a gurney and Mr. Sprocket will be transferred in a few minutes. 

UPDATE 6/6 3:20 PM
The hospital approved a sleeping pill for him, but they would not approve for him to take his Blood Type specific probiotic.  I gave nurse (T) a bottle of it and he called the pharmacy for approval.

The hospital policy is, because what's in Dr. D'Adamo's formula is not the same as the Culturelle® formula, they stock in their pharmacy they won't approve it. The second issue is, it's a open bottle.  Mr. Sprocket accepted that at first, then later he gets all riled up because he thinks he has an answer. He tells me that I need to go print out all the ingredients of the other blood type probiotics, so we can show them the differences.  I ask him, how am I going to do that without a printer. He says, "Good question."  Then he says, "Oh, they have WIFI here, just connect to one of their printers."  I tell him I'm not going to chase that tail for him.

So he calls in his nurse, and asks him if we show him the documentation on D'Adamo's probiotic, if that would do anything. Bless his heart, Mr. Sprocket's nurse (T) is quite patient. He says that the pharmacist has gone home, but they can ask him tomorrow.

UPDATE 6.6 3:05 PM
A bed has been found in the Telemetry Unit. It's just a matter of getting him cleaned up and moved.

UPDATE 6/6 3:00 PM
Mr. Sprocket just told his nurse (T), that there are studies that show hand sanitizers are not effective and they can possibly do worse damage. One of Mr. Sprocket's pet peeves, is hand sanitizers. He has about another 1/2 hour before he can sit up again.  He's resting after having his meal. He ate just a few bite of everything, but he said, "The food is wonderful." He kept trying to tell me that jello had protein in it, so he didn't want the salmon. He wanted to compliment the cook, and thought the woman delivering the trays was the cook. As soon as I can get a photo off my phone, I'll post his lunch.

UPDATE 6/6 1:30 PM
Twenty phone calls before I even got to the hospital this morning. He was demanding I stop going to all my other important stops and bring him a sippy cup right away. He was thirsty. 

At Target, the two different sippy cups and the sports cap water bottle I got were not good enough. The water came out too fast. 

He had the other femoral artery line taken out today, and what he didn't tell me was that he had to be lying flat for many hours after that procedure. 

Luckily, I brought a thin-walled water bottle from home. Lying in bed, he took a ball point pen and punched a hole in the cap of that water bottle.  He now tells me that what he should have asked for was a baby bottle. I told him I wasn't going to give him one. He now says he knows what he has to do to invent a better one. He'll get a utility patent he says.

He has to lie flat for another two hours. Nurse (T) came in just now and said that after 3 PM, he can sit up. There are orders that he will be going to Telemetry. They are just waiting for a bed to turn up. It could be tonight, it could be tomorrow.

JUNE 6, 2014 10:30 AM
The big mistake was leaving my husband his cell phone last night. The calls started at 8:15 am this morning. Mr. Sprocket was telling me to: "Go to Target right away and get a sports bottle," or a sippy type cup, a new scratching brush, and all the things to bring from the house. Oh, and "Call me from Target." so he can tell me the right type of sippy cup to get.

He also tells me I deleted all is contacts from his cell phone (did not happen). Then he tells me that (BV's) air conditioner is not working and I have to go over to this (BV's) house "right away and turn her air conditioner on. It's just like ours on the roof. You know now to do it," he says.  This was the client Mr. Sprocket was going over to after he dropped me off at the train station, last Friday morning.  I think he listened to his old messages, and listened to (BV's) service call again.

So I call and ask (BV) if they spoke to my husband. "No." I explained to (BV) what happened and (BV) replies, "Don't worry about it. Just get him well."

I've now received my sixth call of the morning. "Are you coming? I really need my sippy cup."
UPDATE 6/5 8:15 PM
I'm heading home. Thank you everyone for your kind words, thoughts and prayers. And thank you all, for donating so generously.  If Mr. Sprocket does get in a new room tomorrow, it will be the next chapter.

UPDATE 6/5 /7:15 PM
Now he's telling me that I have to give him his phone, so he can make a phone call. He has to call his friend, so he can "talk shop." I tell him that he's not coherent. He can call tomorrow when he's more coherent. He tells me, "Betsy, stop trying to control me."  Mr. Sprocket is almost back to his old self.

P.S. I told him if he wants his phone, to get out of bed and come get it.

UPDATE 6/5 6:45 PM
Mr. Sprocket's cardiologist #2 stopped by to give him an update. He's doing pretty good for as sick as he was. Dr. #2 said the motor control in his hands will come back.  The results of the echo cardiogram were pretty good. The right side of the heart is fine. That was the big worry. The left side hasn't come fully back, but will in time with the heart medications he will be on. The echo cardiogram also showed that the hypertropic cardiomyopathy isn't as bad as they thought with the first echo done in the ER. Sometimes, in those situations there's fluid or it's blurry, and they don't get as good an image.

Tomorrow, they will take out the last arterial line. They will also move him to a new unit tomorrow to get him sitting up and hopefully standing. This is telemetry, where they will monitor his heart. That may take a few more days.

Mr. Sprocket's dinner tray arrived. He didn't like me feeding him and he at first ate with his fingers. He's now trying to eat with a fork with his left hand. He is surprised at how good the food is here. Mr. Sprocket asks me, "So this is one of the premiere hospitals?" I nod my head yes. He smiled and laughed and was thanking the grocery store he had stopped at.  He also told me that he had no pain when he dropped me off at the train station. He was fine until he came out the grocery store bathroom.  He tells me that his stomach "shrunk." He can't eat more than a few bites at a time. He's still suffering from indigestion pain at the moment, but this will pass. He also told me that he "knows" he's seen his doctor before on TV; ABC, CBS, CNN. He told me to look him up. (Eye roll.)  He also keeps thinking he's going to have a bowel movement, and that he's certain he's had one, but (T) tells him nothing is there. That's the magic bedpan for you.

P.S. Now I remember what Dr. #2 called it when I asked about the hypertropic cardiopmyopathy. He said what they saw with the first echo could be "artifact." The good news is, his heart has improved from when he came into the ER.

UPDATE 6/5 5:30 PM
Having a heart attack hasn't changed Mr. Sprocket's general nature. He thinks that he will be able to have his cell phone in the ICU. He demanded that I plug it in so it's "fully charged." He was adamant about that. He was quite confused earlier. He told me he dreamed he died and that his friend, Kent, would have to put in an air conditioner for the Bakery. He thought that the air conditioner was ordered, and it should have been delivered to the house by now. Since I told him nothing was delivered, he thought it was stolen. He's confused about a warranty part for the Bakery that he ordered before the heart attack. That item is supposed to be "drop shipped" to our house. He's confused. After patiently explaining that nothing has been delivered to the house, he realized that the warranty part will take some time to get here. He's slowly remembering things and putting them together.

He still has some painful indigestion but he may have that for some time until his digestive system wakes up and is functioning okay again. 

UPDATE 6/5 3:30 PM
Mr. Sprocket has a memory that he thinks he punched out a nurse. This might have been the first time they woke him up to do the breathing test, where he almost pulled his breathing tube out. He was asking everyone to find out who the person was, so he could apologize.

JUNE 5 2014 UPDATE 6/5 3 PM -Progress
I didn't get to the hospital until almost 2 PM today. My friend KR offered to take me to lunch and I grabbed at the offer.

When I got here, Mr. Sprocket was off the breathing tube. Right after I arrived he started demanding his cell phone and his glasses. I didn't bring his glasses. He was demanding I go to the lost and found and see if I could find a pair that would work. He can't work the phone without his glasses.

He was worried about the service messages he may have received, and something about an air conditioner that he ordered. (He didn't order an air conditioner from the time he dropped me off until the time he got to the hospital.)  Apparently, he thought he had ordered an exchange on his cell phone, and he kept saying the "air conditioner" was $700.00. He wouldn't stop about the glasses. He was demanding I leave the hospital and go to the drug store to get him a pair.

He had pulled out his nose feeding tube earlier, but he was so hungry now he was asking that it be put back in. He was so hungry. They said that couldn't happen until he had the swallow test. He was telling me to go get him some granola bars. The nurses said no, absolutely not.

He has oxygen tubes in his nose and he's very weak. He can't understand why he is so weak.

He told me, he thought that the house got foreclosed on and the truck was towed. He thought that I left him and went to live with family. He said he was so happy to see me. He's cognitively confused a bit, but that should clear up.

The speech therapist came by and fed him some apple juice and pudding.  She wanted him to eat a graham cracker.  He asked me if it was okay this one time, for the test. I said okay. He did okay, so she ordered a meal tray. He will be on a liquid diet for a while; not solid foods.  The speech therapist was impressed with how well he is doing having been intubated for seven days.

Right after that, the respiratory therapist came by to give him some breathing medicine. He has to breathe it in for about 10 minutes. This is a bronchial dilater, since he has fluid in his lungs.

Mr. Sprocket asked for a pen and paper again, but he could not write. He told me that, his handedness changed. He now believed he could write with his left hand again. (When he was four, they forced him to be right handed.) I put the pen in his left hand and he couldn't write with that hand either.  He was surprised, then laughed. So much for that. He did remember me being here yesterday and our inability to communicate. He told me that what he was trying to get me to do yesterday, was put the pen in his left hand, because he thought his handedness had changed.  Like I said, he doesn't understand why he is so weak. I had to explain to him this is normal

Our dear neighbor, is so kind, she is going to bring his glasses.  He wanted to know what everyone is saying on the blog.  Mr. Sprocket wanted to thank everyone for all the donations. He's quite surprised.  He said, X's and O's. Amazing, amazing, amazing. I'm just shocked." I haven't even sent out my thank you's to everyone yet. Mr. Sprocket is thanking everyone first.

He said that for his first meal, apple juice and wheat crackers, "Bad idea. I'm suffering for it." (He has a little indigestion from the first thing he's eaten.)

Now he's telling me more things I "must do" right this minute; call this person, call that person. I told him, all these things can be done later. Our neighbor just came by with his glasses. He wants to tell her his story.

Here is what he remembers of being at the grocery store. He went into the bathroom. When he came out felt weak and saw a bench outside the store. He thought, that looks like a great place to lie down. He says there must have been cameras, because the manager came out to see if he was okay. Mr. Sprocket said he wasn't feeling well. They must have called 911 for him. He thinks the paramedics were wrong about him having diarrhea, because he doesn't remember that at all.

He had a conversation with his nurse about "magic bedpans" where, you go to the bathroom and it magically disappears.  He's weak, his movements are slow, but we are hopeful that in time he will regain his strength. I almost forgot. Mr. Sprocket's nurse is the wonderful, handsome (T) again.

P.S. Special thanks to legendary detective, Rick Jackson, who asked one of his friends who works as a nurse here, to stop in and check on Mr. Sprocket. She was so nice.
UPDATE 6/4 7:00 PM - Tomorrow is Another Day
I left the hospital a little after 5 pm. Cardiologist Dr. #2 did not come back to the room to tell me the results of the echo cardiogram. (MA) told me that there wasn't a report in his chart. I don't know if that means the doctor didn't file it in yet, after viewing it, or that meant that the Dr. didn't write up 'his' notes about the echo.  When the technician was done, she told me that her report would be online in five minutes. Or, she told me that she told the doctor her report would be online in five minutes. I can't remember. I'm holding out hope that there was nothing negative to tell me about it. I decided to go home early because Mr. Sprocket was sedated again and I was quite tired. I was starting to yawn.

It wasn't until I got all the way home that I realized why I was so tired. I had forgotten to have a green tea this morning and I didn't go to the cafeteria for lunch. I just ate my lunch in Mr. Sprocket's room. Usually when I go to the cafeteria, I get hot water for another green tea. The other thing I didn't realize was, I didn't drink any water at the hospital. I had brought a large bottle of water but I totally forgot it. I was too busy focused on the breathing test and trying to communicate with the great communicator.

Hoping tomorrow, day seven, is a better day for Mr. Sprocket and the breathing machine.

UPDATE 6/4 3:30 PM
They just set the breathing machine back to the earlier settings and started his Diprivan (propofol) again, so he can rest/sleep for a bit. He's just not ready to come off the breathing machine yet. Earlier, he kept telling me he wanted to write and I'd give him a pen and pad, but he couldn't write. He tried, but all he could make were some lines.

I did get one command right, he wanted to sit up more, with his right leg bent so he could have the pen and pad against his leg. bBut the nurses can't have him sitting up too much because that could cause a clot in the left leg that has the IV in the femoral artery. He can't be bent at the waist too much. When I would ask him if he knew what happened, he nods his head.  He knows I'm there and he would understand me, but I'm not understanding his hand signals. I'd ask questions, but I wasn't asking the right ones most of the time. He is back to resting now.  That breathing test I'm sure, was pretty exhausting.

P.S. I tried doing an alphabet chart with him. He was having none of that. Kept shaking his head very forcefully back and forth. He wanted a pen and paper.

UPDATE 6/4 3:00 PM 
Mr. Sprocket is still doing the breathing test. It started at 2:00 pm. He has been awake and trying to communicate with me.  He's supposed to be resting and concentrating on taking big deep breaths, but he's not concentrating on that. I'm not always understanding what he wants, and it seems like he's frustrated that he can't communicate. I get the sense that he's not comfortable in the bed. He nods when I ask if he's in pain, but every body part I point to, even asking about the tube, he shakes his head no.  I think the breathing test will be for two hours again.  They are taking blood gasses now.

At least he's stopped struggling against the wrist straps. The nurse just told me that he's not doing well with the breathing test. He's breathing too fast, struggling.  But they have to do this every day, to build up his lungs. This is how he improves.  So, maybe tomorrow he will be better.

UPDATE 6/4 1:45 PM
The respiratory doctor stopped by and they are going to do that test, soon.

UPDATE 6/4 1:15 PM 
Mr. Sprocket is getting the echo cardiogram at the moment.  Then the doctor will be by to look at it and tell me the good or bad news.

UPDATE 6/4 12:30 PM -Off Topic: Criminal Trials & Sewing
A few moments ago, a dear friend, Lonce LaMon of reminded me that a year ago today, Kelly Soo Park was found not guilty in the murder of 21 year old Juliana Redding.

If you get bored reading about Mr. Sprocket's trials and tribulations, there are many cases and trials that T&T has covered over the past seven years. You can find T&T's coverage of those cases on the right side of the blog.

Park's DNA was found around Juliana's neck, on the front of her shirt, on her cell phone, on a door knob and on a gas stove knob in the kitchen.

Additionally, tomorrow, June 5th, is the 5th year anniversary of the arrest of Stephanie Lazarus for the murder of Sherri Rae Rasmussen. My friend Matthew McGough is deep into writing a book about the Lazarus case.

Although I've got quite a bit on my plate right now, I'm still working on getting my Market Bag Madness Sale, 2014, up on my Sewing Blog soon. There will be great discounts offered for a short period of time, so keep checking for the notice.

JUNE 4, 2014 UPDATE 6/4 12 NOON Steps Forward, a Few Steps Back
 I just got to the hospital about 15 minutes ago. I got to speak to his second cardiologist, who I saw in the hallway.  His first cardiologist (who saved his life in the Cath Lab) is on rounds and will be by shortly. So will the respiratory doctor, too. Mr. Sprocket is sedated at the moment.

Cardiologist doctor #2 said that, regarding the breathing test yesterday, Mr. Sprocket failed that after 2 hours. This is not unusual for what he has been through. His lungs need to be able to build back up the strength, the muscles to do what they need to do. It may take a few more days, or even longer for him to build up the ability to breathe on his own again.

The big concern is the right side of his heart. They will be doing an echo cardiogram today.  If the right side of the heart is in bad shape, it won't matter if his lungs work or not. Dr. #2 said the EF is not as important. It's good that he's off the BP medication and the heparin and for now, he's holding his own, and that's good.

Dr. #2 ordered some some heart medicines that his new day nurse gave him right after I arrived. She is very nice. She made a point to introduce herself and shake my hand. I made sure to let her know that when she does the breathing test. I missed understanding her name because it's unusual. I'll have to ask her again.

Since they are concerned about blood clots they are going to order compression socks for him.

The oxygen that he's on is 40%. The room oxygen is only 30%. Dr. #2 said it's quite a sophisticated machine. It can detect when he needs, or should be taking a breath if he hasn't and will force the air in. I believe that's what he said.

I'll have another update after Mr. Sprocket does the breathing test. Just as I typed that, a Dr. P stopped by, a general practitioner. He told me that Mr. Sprocket gets an X-ray of his chest every morning to see how the fluid build-up in his lungs is. It's a delicate balance between trying to keep the fluid down with medications, because those medications can drop his blood pressure. He said that the respiratory doctor is just two doors down and will be by shortly.

His nurse (MA) just came back. She explains her name (it means 'ship') and that she is Japanese. She has the compression stocking machine and explains it. The dual leg device is wrapped around his lower legs and cords are plugged in.

All the nurses comment on how tall Mr. Sprocket is. They are surprised when I tell him he's not 6 feet, but five feet, eleven inches. Some of you have asked how old Mr. Sprocket is. He turned 57 at the end of March. He shares a birthday with Vincent Van Gogh, another creative person who also marched to his own drummer.
UPDATE 6/3 9:30 PM I left the hospital a little after 8:00 pm. I'm home now. My dear friend JG stopped by the hospital about 6 pm, to keep me company and talk about the steps ahead.  I shared with her the stories of the last time Mr. Sprocket was in the hospital for a life threatening illness. He had a kidney stone and then discovered he had bacteremia, a staph infection. He was there for a week. Every time he got a meal delivered, he was calling down to the kitchen, complaining about it. And he had to have his sleeping bag with him.

Mr. Sprocket's night nurse tonight is (L). (V) said that Mr. Sprocket's condition is still considered critical (he could make a turn for the worse at any time), but stable. The nurses who were taking care of him when he was on the Impella, I could tell have had additional, advanced training.

After the pain medication at 5:00 pm, he settled down and didn't move around at all in his bed. Tomorrow morning sometime he will have the breathing test. From what I understand, they bring him out of sedation and try to have him breathe completely on his own without the assistance of the machine. If he does well with that, he may get the tube taken out.

The tricky part is keeping him calm while he's coming awake and not freaking out about the tube. As we know from the Conrad Murray case, Diprivan (propofol) suppresses breathing. He must be completely off the medication before they can take out the tube. If he's struggling around, being difficult, there is a possibility that his vocal cords could be damaged trying to take out the tube. When the respiratory doctor came by in the afternoon, he said to me that they have to be careful. They have to do this process slowly. They don't want to have to put him back on the heart machines (Impella) again.

UPDATE 6/3 5:00 PM (V) gave Mr. Sprocket a pain medication a little bit ago in the hopes that will make him not be so uncomfortable those short times he's a bit lucid.

UPDATE 6/3 4:30 PM The nurses just adjusted him in his bed. They alternate every 4-5 hours or so, a wedge under his body to try to prevent bed sores. Every time they move him, he struggles against his restraints and shakes his head a lot. (V) can tell he's not comfortable because his blood pressure is going up. She's trying to adjust him again, It might be that he doesn't like the wedge, so they are going to try a pillow.

UPDATE 6/3 4:00 PM Tomorrow morning, Mr. Sprocket will have the breathing test again, to see how well he can breathe on his own. It's a delicate balance with the level of Diprivan (propofol) to see how well he can do, and not freak out.  Part of the problem could easily be that he is disoriented from being on the Diprivan for so long, or the antibiotics they had been giving him are also disorienting. That could be why he's anxious/agitated when he's coming out of the Diprivan. He is not on as much Diprivan as he was when he had the Impella. He's on a little more than what he had this morning.

If he can get through this hurdle, and the breathing test is good, the tube will come out. After that, the next tests will be what his EF (ejection fraction) is like, some heart monitoring and then it will be how is he doing standing/walking.

UPDATE: 6/3 2:45 PM The respiratory doctor came by. They are going to sedate him more and take the breathing tube out tomorrow, possibly in the morning. He is too anxious, (shaking his head vigorously, etc.) with the tube in, and being difficult, so they think it's best to wait until tomorrow morning to take it out.

UPDATE 6/3 2:30 PM I didn't notice it earlier, but the nurses put restraints on his wrists because he was struggling so much to take out the breathing tube.  He can move his arms some, but not enough to grab the tubes. 

UPDATE 6/3 1:45 PM Mr. Sprocket is on a heart medication, dobutamine, an antibiotic, the breathing machine and the Diprivan (propofol). They stopped the heparin when the Impella came out.

UPDATE 6/3 1:00 PM There is quite a bit of space now in Mr. Sprocket's room. There are way less bags hung from poles, and the nurse doesn't have to be in his room almost 24/7.  Yesterday, when I was talking with (M) about the layout of the critical care unit, she told me that normally, Mr. Sprocket would have been in a surgical ICU room. However, that unit is shut down because they are not very busy at the moment. This unit is not a specific cardiac unit. There are other types of critical care patients besides heart patients.

The "breathing exercise" is where I think they take him off the machine and he breathes on his own.

A few minutes ago, Mr. Sprocket came out of his sedation. He heard my voice and nodded his head that he could hear me. He didn't want me to leave his side. He keeps fighting to take the tube out of his throat.  The nurse told me that when she asked him to seqeeze her hands earlier, he was so strong, he clamped down on both her hands and almost broke her fingers.  He kept trying to talk to me. I had to keep telling him that he has to have patience and that the tube can't come out. 

JUNE 3, 2014 UPDATE 6/3 12 NOON I just arrived at the hospital. Mr. Sprocket's day nurse is a lovely, tall woman named (V).

Mr. Sprocket came off the Impella by 7:30 AM!  He no longer has blood pressure medications. He is still receiving heart medications. He is on the breathing machine and sedated.  He did a 2 hour breathing exercise from 9:15 am to 11:15 am, and now the breathing machine is back assisting him.  When (V) tried to take him out of sedation, he became very agitated, tried to take the breathing tube out. (V) said he is very strong so she had to sedate him again.  He is not in as deep of a sedation as before. She said he might open his eyes. I tried talking to him but he did not answer any commands to squeeze my hand.
UPDATE 6/2 8:00 PM Just as I was getting ready to get up out of my chair and leave Mr. Sprocket's room, (E) told me that she just turned off all his blood pressure medications and he is holding his own.  If he continues to hold his own, he won't need them.  If things change, then she will start the medications again. (E) confirmed that this means there is some function in the right side of his heart. If he does well throughout the night and is able to get off the Impella tomorrow, then that will mean that the right side of his heart is functioning and doesn't need any assist.

UPDATE 6/2 7:30 PM A new, attractive night nurse is here. She is getting briefed on his condition right now. (S) says Mr. Sprocket has a really good nurse tonight. Her name is (E).  (S) says she's very thorough. (E) looks like she might be Filipino.

UPDATE 6/2 6:00 PM At 4:15 the Impella was set to 2. He seemed to tolerate it okay. They are putting him back to 3 overnight. At 6:00 am tomorrow they will put him back to 2. If he still does well, then they will try to take the Impella out tomorrow. 

The next test to the recovery of the right side of the heart will be to get him off the medications. If he reacts negatively to weaning off the medications, that would mean that the right side of the heart is not healing as well. However, (M) did say that he is not on a high dose of the medications. They are more of a low dose.

The last thing to come out will be the breathing tube. They want to make sure he gets as much respiratory/oxygen support as possibleHe will be brought off the Diprivan (propofol) before the breathing tube comes out because Diprivan supresses the breathing.

Mr. Sprocket is quite swollen at the moment. Normally, his feet and legs are quite skinny. (M) tells me what's happening is he is "third spacing," meaning his fluid is moving into other tissues. This is understandable/normal at the moment. It's similar to when pregnant women get puffy. He needs the fluids at the moment. Once he's off the meds and fluids, it will reverse itself.

UPDATE 6/2 3:50 PM One of Mr. Sprocket's cardiologists stopped by and explained to me what was going on and what Mr. Sprocket is dealing with.  The situation is not as good as what many of us had hoped. His condition is more serious than I previously thought.

Because Mr. Sprocket had the older blocked artery on the right side of the heart, basically, an older heart attack, that makes this heart attack all the more problematic to treat. It means that, in addition to the left, there is damage to the right side of the heart and it's a big problem if the right side of the heart cannot pump blood to the left side. Ideally, the cardiologist would have wanted an Impella that inserted into the right side of the heart, but those devices are only in research hospitals in testing/trials at this point and not approved for general patients yet.

The cardiologist said that because he did not have a good reaction to the first stepping down of the Impella from level 5 to 3, he is trying a different, slower approach. Hopefully, this slower approach will give the right side of the heart time to heal. If they are able to wean Mr. Sprocket off the Impella, the next step would then be the respirator/breathing tube and then the medications.

One of the things complicating his case, totally independent of the heart attack, is the fact that Mr. Sprocket has a heart condition called Hypertrophic Cardiomyopathy. The heart muscle becomes like, stiff. Here's a little bit more information on this disease from the Mayo Clinic.  We did not know that Mr. Sprocket had this heart condition. So that's a complication.

If Mr. Sprocket is unable to be weaned off the Impella, then the next step would be surgical implantation of a right, and/or left, ventricular assistant device.  However, that would have to happen in a different hospital facility, like UCLA or Cedars, that's part of a bigger program.  They do not do that here. Those devices would, hopefully, be temporary, until his heart could recover.  If his heart is not able to recover, then the last option on Mr. Sprocket's journey would be a heart transplant.

(M) Told me about an hour ago that at 2 pm, Mr. Sprocket was stepped down on the Impella to 3.  The cardiologist also added a heart medication to kind of give his heart a little "kick" to help get it going on it's own.  As of now, he is still doing okay with the Impella on level 3. So, I am holding onto that hope.

A few minutes ago, a second chaplain stopped by, Beverly. She is normally assigned to this section of the hospital and didn't know that Phil had stopped by earlier. Phil usually covers the ER, and other areas. Mr. Sprocket is the one who is more 'religious' than I am. He reads his Bible on a very regular basis, along with his favorite author, John Bunyan.

So with the new medication to give his heart a kick, there are now seven IV monitors, the respiratory machine, the Impella, the feeding tube/nutrients and the catheter, along with all the sodium chloride bags (I see five at the moment) to keep the lines clear, as well as another line that is not attached to an IV monitor.

I almost forgot to mention that another nurse stopped by, who is in charge of nursing for many of the units, Cath Lab being one of them. She is a friend of one of my friends who is a nurse. Thank you so much JG, for having her stop by. 

Please forgive me if I don't answer messages right away, but please - keep those messages, texts, emails and phone calls (for those of you who have my number) coming. I'm still mostly overwhelmed with the update from the cardiologist and I so appreciate everyone taking the initiative and checking in.

JUNE 2, 2014 UPDATE 6/2 12:30 PM Mr. Sprocket's cardiologist did come by this morning, but I missed him. I didn't get to the hospital until 10 AM. Mr. Sprocket has a new day nurse, a lovely woman named (S), and another pretty nurse (M) who is learning the Impella. (S) has been with the hospital 14 years but this is the first time she's had a patient with the Impella.

The nurses tell me that they are going to try to wean back the Impella level sometime today. They are giving him more fluids before they do that. His blood pressure is better than it was the day before, so that's a small step. He's still on two BP meds, but the doctor won't cut those back any more until he's off the Impella.  He's still on the heparin via the machine and the IV; his oxygen through the breathing tube is 40%, just like last night. His urine output is still good. So not much has changed.

He got a bag of platelets yesterday, but his platelets are still low at 52. They should be anywhere from 150 to 400.

There are bags of medicine and fluids hanging everywhere in Mr. Sprocket's room. There are at least six "IV pumps" controlling medications. One for the Diprovan (propofol), two for the BP meds, one for the extra heparin. I'm not sure what the others are for. There are also many bags of sodium chloride hanging. I've been told that these are to keep the "lines clear."  There is also a respiratory therapist that comes by at least twice a day to check that machine. Mr. Sprocket is still in critical condition. He is still sedated, still on a breathing tube.

There are 28 beds here in the Critical Care Unit. There are an additional 10 beds on the ICU unit that are ICU "surgical rooms." (S) tells me that they've only had the Impella at this hospital for about a year.

Oh. (M) just told me they weaned the Impella back to level 4 at 10 AM today.  When (T) tried to lower the Impella to level 3 (I think on Saturday) his BP bottomed out. So, the doctors are going slow with Mr. Sprocket in trying to wean him off the device.  (As of 11:45 am, he's doing okay at the lower level. His output and numbers are holding steady.)

Phil the chaplain just stopped by and introduced himself. He gave me a bit more information about what he saw of Mr. Sprocket in the ER.  He was screaming and hollering out in pain, "Oh my God! Oh my God" My abdomen hurts." The cardiologist gave him some morphine and was trying to interview him. Mr. Sprocket tried to give Phil my email address but he wasn't able to. They did the EKG's. Mr. Sprocket was taken to the Cath Lab and the cardiologist explained to him what they wanted to do and Mr. Sprocket was able to sign the consent for the procedure.  After the Cath Lab, Phil and (T) went through Mr. Sprocket's phone and were able to call me.

After Phil, the dietitian stopped by. I had some concerns about the formula they were giving him.  Last night, I had talked to his night nurse (TR) about the amount of corn and corn syrup in the formula. It's not really about diet at this point; it's about getting nutrition into him so he doesn't lose too much weight. But still, there are some things that I wouldn't want Mr. Sprocket to have in this fragile state.

(TR) agreed with me and said she would put in for a dietitian to stop by.  We went through her thick book and found a formula that had the least amount of corn in it; it's more soy based, and has more protein. Soy is not great for Type O's, but it's a better alternative than giving him the lectin in corn, and corn byproducts (corn syrup).  It was documented as early as 1981 that the corn lectin (zea mays), is resistant to an autoclave.

Food lectins were discovered in 1888. Lectins are carbohydrate-binding proteins, macromolecules that are highly specific for sugar moieties. They are often called "nature's glue" because they can bind things together. Our blood type, (A, B. O, AB) is expressed as sugars. William Boyd discovered in 1945 that lectins are blood type specific, meaning, they can agglutinate the blood of one person, and not another.

Depending on how Mr. Sprocket does today, the doctor may decide to lower the Impella level again. I'll try to give an update later this evening.
UPDATE 6/1 8:30 PM (TR) tells me that tomorrow will be the big push to try to wean him off the Impella and other medications. The cardiologists will probably see him early in the morning and assess how to proceed. (TR's) job tonight is to just keep all his numbers stable and prepared to be weaned off the Impella. Since he is getting nutrition, (this is basically to wake up the digestive system) his body is on a slight foot down slant to help the sphincters (stomach, etc.).  Once they are able to take the Impella out, then the breathing tube comes out and they can wake him up. His breathing tube is only on 40%.

UPDATE 6/1 7:30 PM The shift change is going on now. Shift change takes an hour. Mr. Sprocket's night nurse tonight is a pretty brunette, (TR). (T) is going over all of Mr. Sprocket's IV's/ meds/ devices with (TR) now.  (T) tells me that his blood pressure is real stable. He is still on two PB meds but it is a very low dose.  He thinks tomorrow they will try to wean him off of those more, and try again to wean him down lower on the Impella. Both (T) and (TR) said his color is good, meaning his blood vessels are getting good "perfusion."

Here is an image of the Impella computer/display/controls at the foot of Mr. Sprocket's ICU bed.  There is a table in front of it so the nurse can sit and monitor it.


UPDATE 6/1 4:00 PM The ENT doctor just came by to check on the suture he put in his soft palate to stop the bleeding. The ENT checked the suture and said, "The suture line is fine; no fresh blood in there. I'm happy. ... For you or me it would be a scratch but for him because of the heparin ... It's a big deal. My easy case of the day."

UPDATE 6/1 3:00 PM I arrived at the hospital about an hour ago. Mr. Sprocket's awesome day nurse (T), told me that Mr. Sprocket's numbers a good. He has been able to cut back on the amount of his his blood pressure medication. His liver numbers came down and look good. His kidney numbers look good. He also had two more pints of blood this morning.

When the Impella device was first implanted Friday morning, it was set at the highest number, 9. That same evening, they were able to set it down to number 5. (T) tried to set the Impella down to number 3, but he didn't do well with that so it was set back up.  He might also be having some trouble with the heparin because his platelets are low. A hematologist came to see him and they are going to give him platelets. Mr. Sprocket is also getting nutrition through the nose down the throat tube.

After I arrived, I asked (T) if he could bring him slightly out of sedation so he could know that I was here. It took a little longer. Mr. Sprocket was moving his legs and reaching up with his left hand to try to take the breathing tube out.  He did not wake up enough to let us know by squeezing our hands if he heard us or understood us or not. He did move his legs when (T) asked him to try to wiggle his toes. Since his legs were moving too much, (T) quickly sedated him again.

If he moves his legs too much there is a risk of dislodging or causing a disturbance with the Impella or the IV in the other femoral artery. The fact that he has so much movement in his arms and legs is a positive sign that his neurological function is good.

The big "wait and see" is his "EF" aka as "ejection fraction." That measures how well his heart is able to push the blood out. Right now, the Impella device is doing most of the work so his heart can rest.

I just found out that Mr. Sprocket was brought into the ER at 8:21 AM on Friday. Less than an hour after he dropped me off at the train station. I don't think he wanted to tell me how poorly he must have been feeling.

JUNE 1, 2014 UPDATE 6/1 7:00 AM I did not get a call from Mr. Sprocket's nurse last night so that's a good sign. I'll let everyone know when I get to the hospital today. Sprocket.
UPDATE: 5/31 8:00 PM Day nurse (T) said it would be up to (A), the new night nurse if he thought Mr. Sprocket was doing well enough to be brought partially out of sedation. It's not likely though because of the new nurse tells me 1, he wants to make sure he has gone over all the medications that everything is hung right and 2, the stitch the ENT just put in, patients tend to want to cough when they wake up a bit. (A) also tells me that he's been a nurse for 27 years. Mr. Sprocket is getting exceptional nursing care here!

So on that note, I'm heading home. I'll probably call for an update if I wake up in the middle of the night.

UPDATE 5/31 7:05 PM The ENT put a stitch in a small tear in the soft palate and that should correct the back of the throat bleed. Mr. Sprocket is on the second pint of blood now. He has a new nurse for this shift, an older, slender man.

MAY 31, 2014 Story Starts Here
You never know what life has waiting for you, around the next corner.

Yesterday morning, Mr. Sprocket was going to have the car all day to make sales calls.  After a slow recovery from another painful, 5ml kidney stone last month, (It took 12 days to pass!) he needed to get back to the business of creating new business. He was going to stop by a client's home to check on their home AC system, and then solicit around the North Hollywood area.

He dropped me off at the Red Line train station around 7:30 am so I could attend a hearing in the Cameron Brown case.  Before I got out of the car he asked me, "Do you have your laptop? Do you have your phone?"  It was then that I realized that I forgot to put my phone in my bag.  Oh well. I'd just have to get along without it.  I would have Internet service down at the courthouse, so I wasn't too worried. Before he left he did tell me that he needed to use the restroom. I suggested he stop in at a grocery store to use a bathroom. Those are 'usually' better than a gas station.

After the hearing was over, I sent him a text message via email that I was leaving the courthouse.  When I came out from underground at the other end of the Red Line tunnel he wasn't waiting for me. I called him from a pay phone and left a message. He didn't pick up. I didn't think anything about that, because he would not have recognized the number and thought it was spam. After a couple bus rides, I got home around 12:30pm.

There was a message on my cell phone when I got home, but it wasn't from Mr. Sprocket. A man named Phil told me that Mr. Sprocket was at Providence St. Joseph's Hospital in Burbank. He had been admitted and he had a "procedure." He asked me to call him. I immediately went into a panic. What had happened?

I called Phil. He told me that Mr. Sprocket had gone into a grocery store to use the bathroom. When he came out, either the employees or a customer saw that he looked poorly and called 911.  LA County FD Paramedics arrived and brought him to St. Joe's. He was complaining of abdominal pain and had diarrhea.  Phil said that in the ER, Mr. Sprocket told him that they couldn't call me because I forgot my phone. Mr. Sprocket tried to give Phil my email address but he wasn't making any sense to Phil. Phil got Mr. Sprocket's phone, found the number for "WIFE" and left the message. Phil told me he thought my husband would be alright, but he was asking me to come to the hospital. He said that after the 'procedure' Mr. Sprocket was already taken to the ICU.

I was in a panic. What had happened?  I called family, and then I called Phil back. I didn't even know who Phil was. He told me he was the chaplain. That put me into a worse panic, but Phil, in a calm voice, asked me not to freak out on him. I told Phil he needed to try to find out where the car was. Please find out what grocery store Mr. Sprocket stopped at.  Fifteen minutes later, Phil called back.  It's at the Vallarta, on either Lankershim or Laurel Canyon.  I was at a loss because I know there isn't a Vallarta on either of those streets.  So, hoping that the name of the chain was right, I went to their online website. I started calling Vallarta stores in the area I knew Mr. Sprocket was making sales calls in.

I lucked out on the second store I called. After my inquiry about a man taken away in an ambulance, a manager replied, "Yes, your car is here, third spot from the front door. The paramedics locked it up for you."

The next chore was trying to find someone who was home in the afternoon that could take me to the grocery store. Both of my close neighbors were not home, and calling two girlfriends got me their voice messages.  Then I called Matthew.

Matthew has been a wonderful friend and mentor to me. He has been writing non-stop on his Lazarus book, and I try not to bug him to much.  Matthew dropped everything he was working on, drove over the hill, picked me up, and took me to the grocery store. He then led the way to the hospital and went with me to the ICU. While I was falling apart, Matthew was calm, collected and asked specific questions.

In the ICU, I got to speak to Mr. Sprocket's nurse and the floor supervisor nurse. Mr. Sprocket was brought to the emergency room. He was complaining of abdominal pain, nothing else. They did two EKGs. On the second one, they found a blockage. Mr. Sprocket was having a heart attack. His blood pressure in the ER was 46. The took him immediately to the "CAT Lab." They inserted a balloon and then a device to help his heart pump. The nurses were under the impression that his heart attack didn't start until he got to the hospital.

When I got to speak to Mr. Sprocket's cardiologist he brought me to a stark reality. "He had a big heart attack," the cardiologist said. Mr. Sprocket's circumflex artery on the left side of the heart was 100% blocked. A stent was installed. Two other arteries slightly further away were partially blocked. One was 70% blocked and that received a stent. The other was 80% blocked but it has some collateral circulation around it and did not need a stent..  On the right side of his heart, there was an artery that was 100% blocked but it was an old injury, meaning it had happened in the past and the heart had been able to circumvent around the blockage.

The cardiologist said they did a balloon pump through a femoral artery and installed an impella  through that artery, too. "An impella?" I asked him. "What is that?" The cardiologist said it was a like an artificial heart. You can see a video at the first link and a YouTube video HERE.  What an amazing, little device. This is cutting edge medicine.  It is connected to a monitor device that tracks the pumping output it provides.

Mr. Sprocket has a breathing tube down his throat combined with a suction tube to clear fluid in his mouth. He also has a tube down his nose to give him medicine, an IV in one femoral artery, the impella in the other, and an IV in his right arm. He has some bleeding from the mouth, that might be from trauma to the back of the throat when they put the breathing tube in.

Mr. Sprocket is on two blood pressure medicines to bring his blood pressure up. He is also on a double dose of heparin to thin his blood. The impella requires heparin delivered as part of the device and he's also getting heparin in an IV.  The cardiologist said that the next 24 to 36 hours will be key. That it is too soon to know the extent of the damage or what's going to happen. He is in critical condition. He has a single nurse dedicated to him, 24/7.

Have you ever thought about what it would be like to lose someone you love? I have. I think about the victim's families, of the cases I've covered. Until you actually experience it, you can't really know the overwhelming feeling of helplessness; the shock; the feeling of being lost, in limbo. 

Mr. Sprocket has been sedated since the CAT Lab. This reduces the stress on his heart and also because of the breathing tube. The sedation drug they are using is Conrad Murray's drug of choice on Michael Jackson, Diprivan aka Propofol. It's a wonderful drug when used in the right setting, with the right equipment to monitor the patient. When this is all over, he won't know or remember a thing.

Mr. Sprocket's nurses have been fantastic. His day nurse is a calm, tall, easy on the eyes handsome man named (T). Friday, I stayed at the hospital until the shift change at 7:00 pm, so I could meet his night nurse. She is a lovely compassionate woman named (M), that (T) told me was the best night nurse on the floor.

Friday night I went home and tried to keep my mind occupied and get some sleep. I knew they would call me if something serious happened. I got about three hours of sleep and woke up around 1:30 am. I called the night nurse (M) at 4am, to get an update.

Mr. Sprocket was still bleeding from the mouth (understandable since he is on blood thinners), so I gave consent in advance in case they need to give him blood in the future. They won't have to call me to get approval; it's done.

His blood pressure was still all over the place so they can't wean him off that medication yet. A short time after I left the hospital, he spiked a fever of 101.3 so they gave him an antibiotic. The nurse did say, that could have been because of all the procedures. He has good urine output and that's a positive. (M) said that if they don't call, that's a good thing.

I was able to get a little bit more sleep before the morning, when I started the round of phone calls to friends, bringing them up to date.

I arrived at the hospital today around 11 am. (T) told me that his blood pressure has stabilized some and they've been able to cut back on those medications a bit. At 8:00 AM  they took Mr. Sprocket partially out of sedation. They told him where he was and that he had a breathing tube so he wouldn't be able to talk. He didn't open his eyes but appeared to understand them. (T) gave him some commands that he was able to follow. He squeezed (T)'s hand.  This is a good sign. They do this to check his neurological function. They only do this about once a shift.

At 5:00 pm today, (T) told me that Mr. Sprocket's blood count is low, probably from the slow bleed at the back of the throat. On his chart, from the admitting physician, there were orders in place if the blood count dropped below a certain point, they were to give two pints of blood. They've already hung the first bag. (T) is going to see if they can get an ENT to look at the throat to see if the bleed is something that could be cauterized and take care of it. (As I was finishing up this entry, the ENT arrived and I was asked to step out of the room. Sprocket)

I'm going to stay by Mr. Sprocket's side for the shift change tonight to see if the evening shift will bring him out of sedation again. I told his day nurse that I wanted to be here if they decided to do that again, so that Mr. Sprocket could hear my voice and know that I'm here for him.

Dear readers, this event is devastating to us and I am reaching out to T&T readers for help. I do not know what the future holds for us. Mr. Sprocket is a one-man shop and is the sole provider for our family. Mr. Sprocket will have a long road to recovery.

T&T readers, please keep Mr. Sprocket in your prayers. I would also like to ask if you have appreciated my five years of in-depth trial coverage, please consider making a donation. In our time of need, any amount you can give would be greatly appreciated. There is a link on the right side of the blog.

Big hugs and THANK YOU to all my Facebook friends who have left messages and said prayers. Thank you so much to my family and dear friends TC, SK, RH, MM&KB, JG&MG for your love and support.  

I will post updates on this entry when I can.

Friday, May 30, 2014

Cameron Brown 3rd Trial: Pretrial 16

 Defendant Cameron Brown and Lauren Sarene Key
Date unknown

May 30, 2014
I’m taking the 8:39 AM train today into downtown Los Angeles. Mr. Sprocket is using the car to make sales calls. I don’t mind taking the train. It’s a shorter walk to court than the budget parking lots downtown. The only downside is if I have to take the train and bus all the way home.

As I was saying goodbye to Mr. Sprocket he asks me, “Do you have your phone?”  Nope. I forgot it, again. It’s at home, plugged into the charger. Once court is over and I take the train back to the valley, I will have to use a pay phone to see if Mr. Sprocket is nearby to pick me up.

This will be the first hearing that I cover with Brown representing himself.

8:27 AM
I’m up on the 9th floor. Patty Brown, the defendant's wife is already here. She gives me a smile and says hello.

A very sharply dressed female attorney arrives. I’m admiring the braided hair band she has on her head. She enters Dept.105 once the bailiff opens the door.

A see a few defense attorney’s who are familiar faces. I don’t know any names I have seen them several times in Dept. 30 or waiting outside courtrooms. One attorney is knocking on the door to Dept. 107.

Judge Ohta’s bailiff comes out of Dept. 108. When he returns he’s carrying a large bottle of water.  He unlocks the door for the attorney who is waiting on Dept. 107 to open.  The attorney comes back out after having dropped out a large envelope.

Before Brown is brought out, the bailiff tells the court that the defendant has motions. Judge Lomeli responds, “Tell him the next time he has motions, he can’t file them on the day he’s ordered.”  The bailiff goes back to the custody area.  When he comes back, Judge Lomeli tells his bailiff, “We can go ahead and bring him out.” One of the bailiff's nods to the court.  Judge Lomili responds, “Thank you.”

Brown is brought out. His hair is cut short but his beard is quite long. He’s carrying a green, canvas looking satchel with two light colored fabric handles.  Brown has filed a request for discovery.  Judge Lomeli asks, “I thought he had all the discovery?”  Brown tells the court that this is a request for any new discovery.

It appears Brown has also filed a motion for a paralegal. Judge Lomeli states he’s not inclined to appoint a paralegal. Brown has a standby counsel and a private investigator. Judge Lomeli goes on to state for the record that he plans on setting the trial for a September date and that there will be no further continuances.  "If Brown states he’s not ready, I’m going to declare him ready," the court states. Judge Lomeli states that the evidence, and all the information is very familiar to both parties. I’ll bring you back in July for status.  Or, the court can bring you back in June for your paralegal request.  Judge Lomeli states he hasn’t read Brown’s motion yet. Once the court has had the opportunity to read it, then Brown can respond/argue.

Brown’s investigator took possession of the discovery in this case. The court proposes to bring Brown back later, in June, and on the (prosecution’s?) end, they will address any new discovery.

DDA Hum tells the court that there was a prior list of discovery that was presented to the prior attorney, Mr. Laub.  Judge Lomeli proposes to bring Brown back on June 27th, that’s a Friday.

Brown objects. Brown states that his motion is an informal request for discovery. “If he [DDA Hum] doesn’t respond within 15 days ...”

I believe the court addresses Mr. Hum, asking if it’s his belief there is any new discovery. Hum replies that he doesn’t believe there is but he will certainly check.

Judge Lomeli rules that he will declare that, June 27, to be zero of 60 at this point. “Mr. Brown, do you agree to this?”

Brown replies, “No I do not agree with that. The reason is that my prior counsel Aron Laub was discussing with you that he had an expert who wasn’t available until November and you agreed with that."

Judge Lomeli replies, “Well, he is no longer your counsel. .. The expert in question, which expert? What expert are you talking about?”

I don’t believe Brown provides a name or even identifies the expert.

I believe Judge Lomeli continues, “But that was because he was counsel on that.”

Brown tells the court that he’s not available (ready?) to go to trial. “My PI told me six months. He hasn’t done anything.”

The court informs Brown, “That’s up to him. You went pro per in April. That would mean you will be going to trial in five months. ... If you don’t agree ..”

If Brown doesn’t agree to the continuance, then legally, he must go to trial in 60 days.  Brown doesn’t appear to understand this.

Judge Lomeli asks Brown what the name of his investigator is. He tells his court clerk to get the investigator. Tell the investigator I want to see him.  The court will determine if the investigator has done “absolutely nothing.”

The court tells Brown that if he doesn’t agree to the June 27th date, then he goes to trial in sixty days. Those are the terms, after the court consults with Mr. Royce.

Brown tells the court, “But I don’t agree with any of those. ... How is Aron Laub able to delay for three years then I have pro per and I have to go right away?”

The court tells the defendant that he is sadly mistaken if he thinks he will get the same amount of time that Aron Laub had.  Brown repeats again, that Aron Laub when he’s not ready there are continuance, but now that he gets the case he has to go to trial. “How come he got special treatment and not me?”

Judge Lomeli tells the defendant that he seems to be implying that this court, because Mr. Laub had continuances grant to him, and that because Brown is pro per, he should be given those same continuances. “That’s not the way it works.”

Brown replies, “I just need some more time. Not three years like him.”  Judge Lomeli states, “Right now it’s a September date. If for some reason, a compelling reason, and you are close to trial on that date, if I need to tweak that date..." The court would move the date.

Brown tells the court, “I’m starting from zero on on this.” The court informs the defendant, “You were granted pro per in April.”  I believe Brown tells the court that his PI is not cooperating with him. That his PI has not done any work on the case and that he needs a new PI to start over.  The court replies that to grant a new PI, he has to talk to him first. He tells Brown that his PI did come over and pick up discovery. There is some discovery that Brown can’t get because it might contain information he is not directly allowed to have. That’s why discovery is going to the PI.  The court also mentions security as a reason.

I believe it’s Mr. Hum who tells the court that it was his understanding that Mr. Laub was going to redact information that the defendant was not allowed to have, or the PI was going to do the redaction. Hum states that he remembers the last time they were here, Mr Brown didn’t want the investigator that Mr. Laub had. Mr. Brown wanted a new investigator. Mr. Laub told the court that the investigator he had was very familiar with the case. Mr. Hum states he doesn’t know what the investigator was given (to give to?) the defendant. Now, all of a sudden, the new PI needs to be replaced.

Judge Lomeli tells Brown that his two options are the June 27th date, or go to trial in 60 days.

Brown tells the court that he didn’t want Laub’s investigator because he had problems working with him before. Now the things that Brown wanted the investigator (Mr. Laub's? His new one?) to do, separate than what Aron discussed, he still hasn’t done any of that.

Judge Lomeli tells Brown that he doesn’t want to hear/know what he discussed with his investigator. The court then adds, Mr. Laub noted (in his exparte communications?) that you had some theories that you had, that are not in any way germane to whether you are ready for trial. He is not going to follow leads, or what ever you want him to do. He has an obligation to prepare you for trial. He is under no obligation to follow (these other requests).

The court again asks if he will agree to the June 27 date. He gives the defendant his choices.

DDA Hum interjects and tells the court that possibly there is a misunderstanding.  He addresses the defendant directly. DDA Hum spends quite a bit of time patiently explaining in simple terms to Brown what accepting the continuance means. At one point, Brown interrupts Hum and Hum snaps back in a firm voice, “Don’t interrupt me. Let me finish. ... If you want more time then you need to waive.”  He adds that waiving means that on June 27, it does not mean that he will go to trial sixty days from that date. He could get a continuance again on that date. Hum continues to go over in minute detail the court process that Brown has experienced ever since the last trial.  Judge Lomeli further explains to the defendant what the hold over to June 27th means. “If you fail to waive, then in order to protect your rights under the constitution, you have to go to trial in 60 days.” 

Brown at some point, admits that he didn’t understand what it meant to waive. He finally understands and does waive time until June 27.

The last thing Brown tells the court is that he needs a doctor’s order. The judge asks why he needs to see the doctor. Brown replies, “I have a growth on the bottom of my foot that needs to be looked at.”  Judge Lomeli looks over at his clerk and asks. “Didn’t we already do that?”  Brown tells the court, “I need to go back. I got medication but it expired and I need to go back.”

DDA Hum then tells the court that he needs the name and number of Brown’s investigator.  Robert Royce (sp?).

Brown asks the court if he can request a certain investigator. “I have someone I like.”  The court tells Brown, “He’s already picked up the boxes and I want to see what he’s done.”   Then Brown tells the court he objects to the 6/27 Friday date.  The court asks Brown, “Why? Do you have some place to go?”  I don’t believe Brown has an answer to that.

Brown is then taken back into custody. After Brown has left, the court clerk tells Judge Lomeli that he has the investigator on the phone. Judge Lomeli gets on the phone with the investigator and tells him that Brown claims that he’s done nothing on the case.

The court tells the investigator that when he meets with his client, to tell him that you’ve have a chance to speak to me [Judge], and you tell him that if he doesn’t provide those things to you then you can’t prepare for the case.  Judge Lomeli also mentions something about, “... these theories that are way out there...” and that the investigator is not required to investigate everything that Brown wants the investigator to do.

Judge Lomeli is still on the phone. A bit later, I hear the court say, “... Right. ... and you say that you don’t have all the discovery? ... Mr. Laub. ... Just a mess.  ... Okay. When you meet with him the court is not inclined to replace you. ... can’t follow up on it. ... Plain and simple.”

I hear more of Judge Lomeli’s statements, to either the investigator or Mr. Hum. He says he (Brown) wants him to explore all these ... all these things that he can’t do. The investigator has met with Brown almost once a week, so the court is not inclined to replace him.

And that’s it for this hearing.

Here is what I’ve taken away from this hearing.  As far as the prosecution is concerned, they handed over all their discover to the defense, via Brown’s prior defense attorney, Mr. Laub.

Mr. Laub was required to hand that discovery over to Brown’s new private investigator. The investigator will give Brown specific discovery he asks for, but he is not allowed to have certain information in his cell with him.

I suspect it’s doubtful that Brown will be allowed to have the 30 plus boxes of trial materials from his first two trials, that his previous defense attorneys turned over to Mr. Laub.

From what the court said today, it’s my impression the court will not be giving Brown any special leeway, or extensive time to prepare his case, unless Brown is able to present reasonable cause for the delay.  It’s my best guess that this case could go to trial some time later this year, as early as September if Judge Lomeli holds to his projected trial date.

I have no idea what it is that Brown is asking his investigator to investigate, regarding theories that are not germane to the case.

Friday, May 23, 2014

Dawn DaLuise Case: Pretrial Hearing 2

Dawn DaLuise in custody March 19, 2014. 
Photo Credit: KTLA Pool Camera

UPDATE 6/23: An earlier version had Judge Dabney's name spelled wrong. I apologize.
May 19, 2014
8:15 AM
I’m on the 8th floor of the Airport Courthouse.  I arrived before 7 AM, missing most of the 405 traffic. Unfortunately, the cafeteria doesn’t open until 7:30 AM so I sat in the lobby to wait.  While I was waiting, I did have a very interesting chat with a woman, a retired minister. She was here for her first experience on jury duty.

My lobby companion lived most of her life in the center of her east coast state. When she and her husband retired, a family member offered them the opportunity to live with them in their home in the south bay area. They jumped at the chance.  They currently live in on the coast and are relatively recent transplants.

I shared with her a little bit about the LA County court system.

8:23 AM

Although there are several people from the general public here, I don’t see a single person from the media. A few people come and try the doors to the two courtrooms on this wing of the hallway.

Just to be sure that nothing’s changed, I check the LA county Sheriff’s inmate locator site again. The date is today and the courtroom is Dept. E.

There is a new sign on Judge Dabney's courtroom door that states no electronic media. It specifically states NO laptops. I'm disappointed.  Wont be able to use my laptop to write.

8:26 AM

I put my phone on silent and try to stretch out my low back.  I was up until 4 AM, helping Mr. Sprocket on a new ductless split system at a bakery.  I slept for maybe an hour before I got up to get ready to come here. I have no idea when I’ll get these notes written up.

8:33 AM
The courtroom opens. People head inside. I debate on whether to get in there to get a good seat, or wait to see if any of DaLuise's family show up.  I close up my laptop and head inside.

Inside, there are signs that indicate no sitting in the first row. I take a seat in the second row, directly behind the defense table. Judge Dabney's courtroom is a mirror image of Department F, next door.  The black female bailiff's desk is to the right. The court clerks desk is along the wall directly beside the curved corner bench.

I believe I forgot to mention in my last notes, that the courtroom ceilings are constructed and a nice, wide arch. Very attractive.

The clerk is at her desk and it is eerily silent in here.  After a while, I start to get a little chilled. I forgot to bring a light sweater. There are several attorneys in the well and three in the lone chairs on the very left side of the gallery.

There is another desk directly beside the clerks desk. Then there is a walkway space to the jail area and the bailiff's desk to the right. There isn't a phone or computer at this desk but there is a file basked and what appears to be an industrial size hole punch or stapler. An attorney stops at the clerks desk to check in. There is a woman seated at the extra desk. She looks like a defense attorney. A Latino woman in the gallery gets up to speak to her.  The woman at the desk replies, "It will be a while."

Another deputy opens the door to the custody area and peeks his head inside Dept. E for a moment they goes back inside the jail area.

8:45 AM
Judge Dabney's court reporter arrives.  On the right side wall next to the gallery there is a large, permanent sign that says "No Food Or Drink In Courtroom."  There are individual fold up seats just like in Dept. F.  Two male attorneys come and go and then enter again.

Just to be safe, I put my phone in 'airplane' mode.

The female bailiff takes a suit of clothes back to the custody area. I start to yawn. I'm hoping I don't fall asleep. I had about a quart of iced tea this morning and a second, hot tea in the cafeteria. I only had sausage and hash hash browns in the cafeteria for breakfast. I was too afraid to have scrambled eggs because I'm still not sure exactly how I got the food poisoning after my last trip here.

A woman enters from the back area, sits in the jury box and is typing on her cell phone. My best guess is that she is a court appointed interpreter.

A defense attorney asks the bailiff if his client could be brought up so that he could speak to him. He is informed he may have to go to another area to see him because they already have some one (back in the private room/cell?).  A minute later he says that's okay, "Where ever."  The bailiff then calls him back to speak to his client.

It's now that I realize there are two ways that defense attorneys can speak to their clients. There is a second door to the custody area in the far back right corner.  It has a sign on it that says "Interview Room - No Cell Phones Allowed." This door does not have a window or one of those special locks on it like the doors behind the bailiff's desk. My guess is, this leads to a room where there is an enclosed "cage" area, much like Dept. 30 downtown, or Dept. 100 at Van Nuys.  I imagine there could be several defendants in this area at once, talking to their attorneys.

I'm guessing that DaLuise's case wont be called early since her family isn't here.

9:03 AM
A female attorney checks in with the bailiff.

9:15 AM
I didn't see him enter, but there now is a slightly balding white haired man sitting in the well seats directly in front of me. Is that defense attorney Pat Harris? I didn't see him check in with the court clerk. It will be a surprise if it is. Pat Harris defended Cameron Brown in his second trial.  Harris was affiliated with Geragos & Geragos for about 15 years or more. Now he has his own practice.  I attended most of Brown's second trial. I became ill right after the defense case started and missed several defense witnesses.

The defense attorney stands and faces the gallery. It is Pat Harris. He's known for defending Susan McDougal and co-authoring a book about it. I address him. "Pat Harris." He looks at me, but he doesn't recognize me. It has been a while. I add, "Betsy Ross, Trials & Tribulations." He smiles. He's surprised to see me. He replies that it's been six years.  I inform him that his former client is now pro per and still in custody.

It's my understanding that Brown earns "good time" credits while in the LA County Sheriff's custody. I believe (but I'm not positive), that he earns 1 day for every two days served in county.  He's been in county custody over 10 years. If Brown got convicted of second degree murder, it's possible he could be eligible for parole after he's sentenced.  It doesn't mean he will get parole, it just means he's eligible.

9:20 AM
Philip Dube, (pronounced Due-bay) DaLuise's public defender is her. I don't see any family. Dube comes out from the jail area carrying some magazines. He hands them to a gentleman in the last row, sitting on the other side of the courtroom. The man is older, gray hair and a beard. I don't believe he was here last time. If he was, I didn't see him. I hear Dube tell him that DaLuise is not allowed to have magazines while in custody.

It's my guess that one of the reasons that magazines are now allowed is because of the staples that could be used to hold them together. I can see the face of the magazine that was on top: People.

Judge Dabney takes the bench. He has mostly black hair, slightly balding with a grayish mustache and small beard. The first case is called. A defendant in an orange jumpsuit is brought out.  While this case is heard, Pat Harris and Dube get up from the well and chat beside the right wall in the gallery. Now I'm wondering how Harris is associated with the case.

I've become fascinated with the unusual lock on the door to the jail area.  It takes a huge, flat key that's on a ring on the bailiff's waist. From where I'm sitting, the key looks like it's three or four times the size of a normal door lock key.

Harris paces back and forth in the well. When the first case is over, Harris addresses the judge. He tells the court, "My is a witness who was ordered here today." Harris' client is Edward Feinstein, who is not in the courtroom. New discovery was provided to the defense late (last night? Friday?) and it's going to be held over.  The judge orders his client back for the next hearing.

That's it for Harris. He takes off.

It appears that Judge Dabney wanted to call the DaLuise case but her counsel can't be found. Someone tells the court that he needed a few more minutes with his client.

Another case is called in the mean time. A defense attorney tells the court that his client changed his mind and decides to take a plea on count 2.  The defendant takes a plea on a charge of assault with a deadly weapon.  He pleads no contest. Judge Dabney makes sure that the defendant understands his rights and that he is giving up his rights by pleading.

9:50 AM
Judge Dabney leaves the bench. Mr. Dube passes an envelope to the gray haired friend of DaLuise. I hear him say, "These are some cards and letters."  I don't think that DaLuise had these cards and letters in her possession and gave them to her attorney. My guess on what happened is, Dube may have been able to share these items with his client in custody, or he returned them to DaLuise's friend because he was unable to share them with her.

The courtroom is back to that eerie pin drop silence.  There are only eight people in the gallery.

10:05 AM
DDA Heather Steggell, who is prosecuting the DaLuise case, returns. I believe Dube is still with his client. My notes are not clear, but I think Judge Dabny is back on the bench and asking if they can do the DaLuise case. He's told that Dube is still with his client. The bailiff gets up to check.

DDA Steggell gets up and goes to the 'Interview Room' to ask Dube if they can call the case. Steggell has a three defendant plea next door.

10:17 AM
Mr. Dube comes out from the interview room.  Judge Dabney and counsel talk about future dates off the record. They want to set the case at zero of 10 on June 23.

Judge Dabney calls the case: SA086704. DaLuise is brought out. I believe she has a waist chain, or is cuffed at the waist somehow. She quickly looks in the gallery and smiles at her friend in the back row.  Dube tells the court, "Friday, I received a large packet [of discovery] from the people and apparently more is to come."  Judge Dabney asks, "What is it?" I believe it's Steggell who answers. "Analysis of computer and phones from the defendant." She continues, "There are other witness phones (and computer?) ..." that still need to be analyzed. She tells the court that the report on the defendant's computer and phones is "pretty substantial. ... There is one witness computer in the process and possibly a second witness."

Judge Dabney rules that he wants everyone back on June 9th. The 9th doesn't work for Dube. Dube offers Friday the 13. Judge Dabney replies, "I'm not superstitious."  DaLuise lets out a little giggle or laugh at the courts comment.  Dabney orders Edward Feinsten, the prosecution's witness to be on call for the 13th and ordered back on the 23. And that's it. As DaLuise is taken back into custody, she turns to the gallery again. Smiling at her friend she lifts her palm up slightly to give him a wave.

After I leave Dept. E, I head up to the 9th floor to see if Judge Deborah Brazil's courtroom is open. I'd like to drop in and say hello. The door is locked so I make my way back home.