Pneumonia Scare

Waring - post contains slightly graphic pictures.

J.R. started feeling sick on November 29th 2016. He had a fever, body aches, and the beginning of a cough.  He called in sick to work and spent the whole day in bed trying to get feeling better.  It seemed to help because he was able to go to work for the rest of the week, although he still felt really sick.

That Friday (Dec 2) he stayed up late playing video games with his best friend. That next morning, his cold came back with a vengeance! He was so miserably sick and he had the worst body aches.
It was our nieces three-year birthday party that afternoon and he stayed home so that he wouldn't get anyone else sick. (And so that he could try to get some more rest.) Later that evening we decide to go to our local Urgent Care walk-in clinic. After waiting for 45 minutes, the doctor looked him over and came to the conclusion that J.R. had a really bad virus. He said, “Go home, get lots of rest. Drink lots of water.”

Following the doctor’s orders, J.R. stayed in bed the rest of Saturday and all of Sunday. On Monday he still wasn't feeling any better. He called into work that Monday and Tuesday. By Wednesday, he decided that he was feeling well enough to go back to work. So he worked Wednesday and Thursday.
He still felt horrible, but he seemed to be doing better.  Looking back, I should have seen the signs and had him go to another doctor. I should have realized how sick he was because even after taking Ibuprofen, he was still running a low-grade fever. The biggest red-flag was on Thursday when the Raiders were playing. The first quarter wasn't even over when J.R. turned off the T.V. and said he was going to bed because he didn't feel well. He never misses a game, even when the team isn't doing their best. 

Friday December 9th (10 days after he first started feeling sick)  J.R. went to work and then came home two hours later. He told me, “Something is seriously wrong. I feel like I’m dying.”
Thinking that he just had a “man cold” and that he was exaggerating the pain I asked him, “What’s wrong exactly?” He told me he had a ton of pain in his chest and that he felt like he had separated some ribs on his right side, probably from coughing.

I don’t know if you remember, but J.R. was in the hospitallast year on Christmas Eve because he had internal stomach bleeding. We had just made the final payment on that hospital bill the week before. So going to the hospital for a cold and some separated ribs wasn't something I wanted to do.

I told him, “Separated ribs aren't going to kill you. How about we take you in to see another doctor?”  
He agreed.

This time, I called and made a same day appointment with a family practitioner at a doctor’s office 30 minutes away from our home. 

Now it’s Friday afternoon in December, and everyone wants to go home- including the doctor. She comes in, looks over J.R. and declares he has pneumonia. She prescribes him an anti-biotic and a cough suppressant. She gets up to leave the room, when as a last minute thought, she turns around to tell us that she wants to have an x-ray done on J.R.’s ribs, but that she won’t review the x-ray until Wednesday.

We went down stairs to the x-ray technician, where she did a standing x-ray of J.R.’s chest. Then she points to the table and says, “Ok, now we’re going to get one with you lying down.”  J.R. sits on the edge of the table and tells us that he’s not sure he can even lie down because he’s in so much pain. I grab his shoulder and tell him that I’ll help him lean back slowly. But as soon as his shoulder blades touch the table his face went bright red and he sat back up, gasping. “I can’t breathe.”  I thought maybe he was hyperventilating from the pain he was experiencing, and tried to comfort him. In the back of my mind though, I was worried something might be seriously wrong. I know separated ribs hurt, but they don’t hurt that much!

 The x-ray tec told us to sit tight, and that she would develop the standing x-ray before we did anything else. She went to a back room and within a few minutes I could hear her talking on the phone. Alarmed she said, “You have to look at his x-ray right now. He can’t go home. He can’t even finish the exam.” After a few minutes she stepped out of the back room and with a polite smile on her face told us that the doctor wanted to see us upstairs again. 

We got back to the doctor's exam room, and before the doctor even came in, we saw the x-ray image on her computer screen. I don’t know how to read x-rays, but I knew what I saw wasn't good.

The doctor came in and told us that we needed to immediately go to the hospital. She said that J.R. had a severe case of pneumonia and then she said, “Do not take this lightly; young people still die from pneumonia. I need you to promise me that you will go to the hospital.”

So, within 20 minutes we found ourselves sitting in the ER. Luckily, I had the picture of the x-ray on my phone, because the doctor didn't seem to believe that someone with the oxygen saturation level J.R. had needed to be in the hospital. But then within a half hour, he couldn't keep his oxygen level high enough and they put him on oxygen. 

They wanted to give him an IV, but the nurse had a hard time finding J.R.’s veins. So she called in a tattooed nurse (who I guess was the best at sticking people with needles) and asked him to start the IV. Even he couldn't do it at first. He had to use a mini ultrasound machine to find J.R.’s vein.  They took another x-ray while J.R. was sitting up in bed. They tried to get him to lie down again but he physically couldn't do it, because all the fluid in his lungs would shift and it literally felt like he was suffocating.

Shortly after that they admitted J.R. into the Medicine/Oncology Unit. (Which all the nurses referred to as 3 West because of it’s location.) They continued to pump J.R. full of antibiotics and gave him some pain medication so that he’d hopefully be comfortable enough to sleep.

That evening, my uncle David and my cousin Kyle came to give J.R. a blessing (which is a powerful prayer). They blessed J.R. that Heavenly Father would help his body to heal, that he could find peace during this time, and that the doctors and nurses would be able to perform their jobs to the best of their ability.

Kyle, my cousin, is actually a nurse at the hospital we were at, but he had the next week off because he was going on vacation to Disneyland. We had sent him the picture of J.R.’s x-ray earlier in the day and he had been really worried about him. Now that he was with him in person, he was even more concerned. Kyle didn't tell anyone, but he had seen a few patients with the same symptoms as J.R. come into the hospital and not make it out alive.

The next day, (Dec 10th) they took more x-rays to see how the antibiotics were helping with the pneumonia- and J.R. wasn't improving. He seemed almost worse than before. His pain had increased and he was having a very difficult time keeping his oxygen levels were they needed to be. 

Later that afternoon the doctor came in a said that they were worried J.R. might have a blood clot in his right lung, or that the lung may be leaking the pneumonia fluid into his chest cavity. The only way they would be able to determine how to properly treat him was to find out exactly what was wrong, and this meant he needed to do a CAT scan. And obviously that means he would need to lie down on his back. The doctor told J.R. that he would feel like he was suffocating, but that the medical team would monitor his oxygen and they would make sure he was alright. So they drugged him up on pain medication and gave him anti-anxiety medication. (Because when your body thinks it’s suffocating, its natural reaction is to panic.) By doing those things J.R. was able to lie down long enough for them to get the scan. 

Fifteen minutes after the scan, a surgeon was standing in our little hospital room telling us that he was going to operate on J.R. at 7:00am the next morning. The surgeon said the reason J.R. wasn't feeling any better was because his right lung had developed a hole "about the size of a pinky finger" and that fluid had started filling up the area in-between the lung and the lining of the chest cavity. His problem was compounded because of his severe pneumonia.

He said that without doing surgery, the doctors could pump J.R. full of antibiotics for weeks, and it would eventually clear out the infection inside of the lungs, but it wouldn't touch the infection that was now outside of the lungs, in the in-between area. It would continue to fester there and cause pain and discomfort. He told J.R. that if they had done the CAT scan on Friday, when we first got to the hospital, that he would have operated on him today.

This was when I realized how serious J.R.'s illness was and that there was a possibility he might not have made it had we waited any longer to get into the hospital.

The next morning (Sunday the 11th) my mom got to the hospital at 6:30am. She said another prayer with us and then a few minutes later a nurse from the OR was there to take him to surgery. The nurse wheeled his bed into an elevator, down a long hallway, and through a set of doors as my mom and I followed behind them.

The OR prep-room was large and cold, and mostly empty because it was Sunday. Navy blue curtains, with a silver flower design, hung though out the room to creating semi–private areas for the patients who were preparing for surgery.  

A few nurses came to check his vitals, the IVs, and to prepare him for surgery.  They gave him a surgical cap and asked that he take off his diabetic medical id tag. They also wanted to make sure his wedding ring was off, but J.R.’s fingers had swollen while he’d been in the hospital and he had a difficult time removing it. This must be a common problem because a nurse started working at it and said that if she couldn't get it off now, they would get it off when they put him under the anesthesia. Luckily, that didn't have to happen, and she was able to hand it to me a few minutes later.

I'm so glad that my mom was there because fear started creeping into my heart as I held his cell phone in one hand and his wedding ring in another and watched the nurses wheel him off to surgery.

When Mom and I walked out into the waiting room, J.R.'s sister Julene and her husband Chris were already there. His surgery started at 7 am and it wouldn't be done until 11 am, so we had a lot of time to wait. About a half hour later, J.R.'s mom and dad came with breakfast. Because it was Sunday, we were the only family in the waiting room which was nice. "It's a Wonderful Life" played on the waiting room T.V. and we all tried to have patience while we waited.

Finally the surgeon came out into the waiting room and said that everything had gone well. He told us that their original plan was to try and do the surgery thoracoscopiclly, through three small incisions, but once they did the first small incision, they realized that it would not be as effective and decided to cut a seven inch incision instead. The incision was on his side towards the back. The surgeon said that J.R. was now in the Intensive Care Unit for his post-surgery monitoring and that we would be able to see him in about an hour.

About an hour later, a nurse came out of the ICU and said that J.R. was starting to wake up and that one person could come back to see him. As the nurse walked me back to his room, she said that he had a breathing machine and a breathing tube. She said not to be alarmed, but that they had to restrain his hands to the hospital bed, because he had seemed a little agitated as he was walking up and they didn't want him to pull the tube out himself. She also said that he would not be able to talk until they removed the tube.  

J.R. was still having a difficult time waking up from the anesthesia, but he had opened his eyes when I first held his hand.  

The nurse was typing on the computer in J.R.'s room, with her back turned towards us when J.R.'s eyes flew open and he had a terrified look. His face started turning a bright red color, and he started making a weird choking sound as he tried to move his hands.  I grabbed his hand tighter and said, "Something's wrong!" to the nurse. 

The nurse turned around, "Oh he just needs to cough." She moved a smaller tube up into his main breathing tube and started to suction out a bunch of gunk. After getting that cleared out, J.R. relaxed again and fell back asleep. 

I was terrified though, I've never seen J.R. look so scared before. He had literally been choking. I stood there holding his hand, trying to calm my nerves when the nurse said, 

"You know, its probably going to be awhile before he fully wakes up, you could go get some lunch if you wanted." 

I didn't know how the ICU functioned so I asked her, "Oh, so are you going to stay in this room with him the whole time?" 

"Well no, I have one another patient I have to care for as well." 

This was when I felt the tears start to well up in my eyes. "I think I just stay here." I told her, trying to hold them back.  All I could see was J.R.'s face as he was choking and I didn't want him to be alone if that happened again. 

The nurse could see that I was having a hard time, so she gave me a small sideways hug and said "You guys seem too young to be dealing with something like this. I'm so sorry." 

"Thank you." I told her. "Thanks for taking care of him." 

I tried to stay in his room as much as possible while he had the breathing tube in, but only three visitors were supposed to be in the ICU at a time, and I wanted to make sure that everyone else had a turn to see him. 

His other sister Kristen and her husband Michael drove almost two hours from Logan to be there when he came out of surgery. I was with them in J.R.'s room when the nurses said that his breathing was strong enough that he didn't need the breathing machine anymore and that they would be removing his tube. The nurses asked us to step out of the room and then they they pulled a small curtain across the bed. From where we were standing though, we could still see them remove it (if we wanted to watch). I didn't want to watch, because I knew it would make me uncomfortable. But our brother in-law watched the whole thing. 

J.R. says he doesn't remember much from this day. (He remembers seeing everyone's faces, but he doesn't remember what they talked about or if he said anything to them.) But he does remember the nurses pulling the breathing tube out. He said it was horrible and that when they pulled it out, wet stuff splashed across his face. ha! 

Even though J.R. just had major surgery, the nurses wanted him to get up and stand every four hours. The hospital bed would fold it's self up into a chair position and then J.R. was able to stand up from it. Which I thought was pretty amazing because I don't think he would have been able to "roll" out of bed. During the surgery, they had inserted three "draining tubes" in between J.R.'s ribs so that all the infection would be able to drain out of his chest cavity over the next few days. 

This is what the incision and his draining tubes looked like the first two days: 

This was also the first time since we'd been in the hospital that J.R. was able to get some really good sleep. He said that he already felt like he could breath much better.

The day after surgery J.R. was able to get up and walk a lap around the ICU. While on the walk his nurse told us, "After this, you guys deserve to go on a nice vacation. Like Hawaii." 

Laughing I told her, "We probably spent enough money, we could have gone to Hawaii." 

She smiled, "Yeah. Probably twice." 

Luckily though, J.R. was in the ICU about 24 hours when they said he had made enough improvement to be moved to the Progressive Care Unit. 

J.R. hated sleeping on the bed, because he said it put pressure on his draining tubes, so he spent the majority of his time in the recliner. Also, coughing was the worst for him. Can you imagine having tubes smashed in-between your ribs and then having to cough? I teased him that if he was worried about having separated ribs before, that he definitely had them now. 

Tuesday December 13th, they did another X-ray of J.R.'s lungs so see how things were coming along. I know these aren't greatest pictures, but you can tell that some progress was being made. 

This was also the day they decided to pull out J.R.'s draining tubes. I thought that they would put him back under anesthesia to pull them out - but nope! The nurse pulled them out right in our little hospital room and J.R. felt the whole thing.

This is what they looked like right before they were removed. (Just so you have a reference of how big the tubes are, each one is about the same diameter as a dime.) The little black "strings" are sutures that they stitched into J.R.'s skin to hold the tubes in place.

The nurse cut the sutures and then told J.R. to take a deep breath and to exhale on the count of three. I held J.R.'s hand and she counted down and then she grabbed all three tubes and pulled them out at the same time. Immediately afterwards, she slapped a big piece of gauze on the holes and then taped the gauze down. I thought for sure they would want to stitch up the holes, but they just left that gauze on for about 24 hours and then pulled it off.  

(The first picture is what they looked like on Thursday December 15th and then the following picture is 11 days later on Monday December 26th. He's still really swollen in the first picture, and the second picture shows his incision and the bruises as they start healing.)

Thursday December 15th - after six nights and seven days in the hospital - they let J.R. go home!  

The doctor still wanted his antibiotics administered through an IV, so they gave him a PICC line and they set us up with Home Health Care through CNS. He also still needed to be on oxygen, so one of the hospital social workers helped us to get in contact with a company who would deliver a home oxygen system to our house.

Since J.R,'s been home, he has continued to make improvements. He's still really sick, but he's getting stronger everyday. 

He sent me this text on Dec 21st while I was at work: 

His Physical Therapist, Matt Warner, has said that he's starting to look better and better, and that he might be discharged from Home Health in the next week. 

We are so grateful for everyone who has helped us during this time, we have been shown so much kindness and love.

We are grateful for all the doctors, nurses, and staff at St. Marks Hospital for their knowledge and care. We are grateful for our home health nurses and physical therapist. We are grateful for our wonderful neighbors and our ward family, and for our immediate family members and our close friends. My mom came and helped us set up our Christmas tree and then helped us pack J.R.'s oxygen tank around on Christmas Eve. Many of you have visited us at the hospital or our home. You've brought us food, shoveled snow from our driveway, and prayed for us. We are so grateful for the love that you've shown to show to us, and we know that your prayers have helped J.R. to heal as quickly as he has. This has been a difficult year, but we hope to come out of this stronger and better than we were before.    

When we start to feel discouraged, I try to remember a conference talk given by Elder Richard G Scott who said, 

"When you face adversity, you can be led to ask many questions. Some serve a useful purpose; others do not. To ask, Why does this have to happen to me? Why do I have to suffer this, now? What have I done to cause this? will lead you into blind alleys. It really does no good to ask questions that reflect opposition to the will of God. Rather ask, What am I to do? What am I to learn from this experience? What am I to change? Whom am I to help? How can I remember my many blessings in times of trial? Willing sacrifice of deeply held personal desires in favor of the will of God is very hard to do. Yet, when you pray with real conviction, “Please let me know Thy will” and “May Thy will be done,” you are in the strongest position to receive the maximum help from your loving Father. "

As of right now, I honestly can't say that I know exactly what lesson J.R. and I were supposed to learn from all of this. But we do know that Heavenly Father has an individual plan for all our our lives, and that He is there for us through all the sunny days and through all the dark nights.

Thank you to our family and friends for always being there for us too.

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