September 30, 20009

Tonight many of Gene's family and friends gathered at the funeral home to share in the beginning of this celebration of his life.

One of the defining times of Gene's life was certainly the time he spent in the military during World War II. He left high school at the end of his junior year and volunteered for the army. He was trained and in place in time to participate in the landing at Utah Beach during the Invasion of Normandy. His job there was a longshoreman unloading troops, tanks, jeeps, and supplies onto the beach under heavy fire. As soon as the opportunity arose, he transferred as a replacement into the 17th Airborne and was assigned duty as a member of an anti-tank artillery unit. He participated in the Battle of the Bulge and campaigns across Northern Europe and in the Rhineland, and crossed the Rhine in a glider in Operation Varsity.

It was only in his later years that Gene really began to talk and write about his memories of that time. After he moved to Chattanooga, he participated in the Veterans History Project where he had the opportunity to talk about some of his experiences. The family hopes that those who are interested will take the time to visit Gene's personal narrative at the Veteran's History Project.

Of course Gene was much more than his time and experiences in the military, but in some way even to the end the metaphor of brave and courageous soldier suited him.

September 29, 2009

Several years ago Gene took his family "down the Stepping Rock" to the farm where he lived with his parents and grandparents until he was about 10 years old. The house was no longer there, but the old barn still stood. That barn burned in 2006, and when Gene heard the news he composed a poem called The Barn.


THE OLD BARN

The old barn stood the test of time
For a hundred years or more
It stood on the farm where I was born
And welcomed all with open door

Built from the finest chestnut trees
Of wood that would not decay
It withstood the ravages of strongest storms
It laughed at the sun’s fierce midday rays

It provided shelter for man and beast
From the cold and wind and rain
It was old in 25 when I was born
I played in its loft amidst the hay and grain

Slowly the tenants left the farm
But the barn kept a watchful eye
Its sturdy beams unyielding to time
Offering comfort to whoever came by

The old barn burned a few days ago
Its time on earth well spent
Imprinting a lesson upon my heart
Be strong, be friendly, be helpful, as God meant

I will miss the old barn!


By Eugene W. Howard
July 20, 2006

September 28, 2009

Eugene W. Howard

Eugene Wright Howard “Gene” passed away on September 27, 2009 in Chattanooga, Tennessee.  He was born on January 22, 1925 at Ano, Kentucky, to Ola Dean Wright and Lawrence Hulbert Howard.  In 1935 his family moved to Harlan, Kentucky, where he attended Harlan City Schools.  In his teenage years, Gene was a paper carrier for the Harlan Daily Enterprise and worked for the Boston Store in Harlan to help support the family after his father died. On June 3^rd, 1943, Gene left high school and volunteered for the U.S. Army.  He served with distinction in the European Theater beginning in Normandy at Utah Beach on D-Day where he was a longshoreman loading troops and supplies under fire onto the beach. He described it as endless tanks, jeeps, men, and supplies. After the invasion, he was attached to an engineering company responsible for making roads to the front.  When the opportunity arose, he volunteered as a replacement to the 17^th Airborne where he was assigned to the 155^th Anti-Aircraft Artillery.  His anti-tank gun squad, under Sergeant Pete Peirgiovanni, saw action at the Battle of the Bulge, Northern Europe, and the Rhineland.  His squad dropped across the Rhine in a glider during Operation Varsity. Gene spoke of spending an entire year sleeping outside during the coldest European winter on record.

After being discharged from the U.S. Army, Gene returned to Harlan to finish high school. That spring, on April 12, 1946, he married his sweetheart, Emily Caroline VanSant. After finishing high school, he enrolled at Berea College, in Berea, Kentucky.  Gene graduated from Berea in 1950 with a Bachelor of Science in Agriculture.  For 10 years Gene worked for the University of Kentucky Extension Service as a county agent in West Liberty in Morgan County, Hyden in Leslie County, and Stanton in Powell County.  In 1957 he returned to the University of Kentucky to pursue graduate studies.  In 1960 he began his career with Kentucky Utilities and worked for them for 33 years. He worked in farm management and ended his career as a District Manager in Middlesboro, Kentucky. In 2003, Gene and Emily relocated to Chattanooga for their retirement where he quickly became involved in church, community, and civic affairs.

Gene was a Trustee of the Appalachian Regional Healthcare for 16 years, appointed a Kentucky Colonel by the Governor, selected as “State Friend of Extension” by Epsilon Sigma Phi, listed in the Who’s Who – Men of Achievement 1990, listed in Personalities of America in 1991, and honored as a Distinguished Alumnus of the University of Kentucky in 1993.  He was a Master Gardener and active in Kiwanis.

Gene made a profession of faith at age 15 at the Harlan Baptist Church and was an active member of the Presbyterian Church all his adult life.  He served the church as a Deacon, an Elder, the Moderator of the Transylvania Presbytery, Delegate of the Synod, Delegate to the General Assembly, and was a faithful member of the Gideons. Upon their move to Chattanooga, Gene and Emily became members of First Cumberland Presbyterian Church.

Gene leaves to cherish his memory -

His beloved wife of 63 years, Emily Caroline VanSant

His children - Russell Howard and wife Tina Hart, Lynn Howard and husband Alan Richelson, Steve Howard and wife Pat Lambdin

His adoring grandchildren and great grandchildren - Elizabeth Howard Brashars, her husband Josh, and their son Elijah; Greg Howard; Shelley Richelson Stein, her husband Louis, and their son Max; Daniel Richelson; Liga Richelson; Valdis Richelson; Lauren Howard McSwain, her husband Ryan, and their daughter Madison Claire; Sarah Howard Fetz and her husband Ryan; Meredith Howard; and Patrick Howard.  

He is also survived by four sisters -  Muriel Howard, Irene Holbrook, Doris Leach, and Mary McKenzie

He will also be remembered fondly by many beloved nieces, nephews, and other relatives and a host of friends.

Funeral services will be held on Thursday, October 1, 2009, at 11 A.M. at First Cumberland Presbyterian Church, in Chattanooga, with Dr. Gary Carver officiating.  Gene’s grandchildren will serve as pallbearers; the Gideons and Auxiliary will serve as honorary pallbearers.  The family will receive friends on Wednesday from 5 P.M. to 8 P.M. at the Chattanooga Funeral Home, East Chapel and on Thursday from 9:30 A.M., to 11 A.M. at First Cumberland Presbyterian Church prior to the funeral service.  Interment will be in Chattanooga National Cemetery with full military honors. 

In lieu of flowers donations may be made to the Komen Breast Cancer Foundation, P.O. Box 11288, Chattanooga, TN 37401.

September 27, 2009

Gene passed away peacefully at 12:35 this morning.

Funeral services are planned for Thursday morning at 11:00 at the First Cumberland Presbyterian Church here in Chattanooga. There will be a visitation at the Chattanooga East Funeral Home, 404 South Moore Road, East Ridge, TN 37412 (423) 698-2541 on Wednesday evening from 5pm til 8pm. There will also be a visitation before the funeral service on Thursday morning at First Cumberland Presbyterian Church, 1505 N. Moore Road, Chattanooga, TN 37411 beginning at 9:30 AM.


In going through Gene's recent notepads, we found a poem in progress:

To my friends and loved ones left on earth
I bid a fond farewell
God in his infinite wisdom
Has called this soldier home.

The Gates of Heaven were open wide
No enemy, the scout reports
The welcome came from the almighty
Well Done, Good and Faithful Servant.

September 26, 6:00 PM

Gene continues to be in a coma. His temperature has been up and down. As the family left Kindred this afternoon it was about 101. His oxygen support has been moved from 80 to 60 percent. His blood glucose this morning registered as low as 5 when they began to give him glucose. They got it stabilized at 80, but this afternoon it dipped down to 15. They again administered glucose. His blood PH indicates that his kidneys are beginning to have difficulty functioning. And his blood gases continue to show that his lungs are having difficulty exchanging the oxygen and CO2.

This afternoon the family had a meeting with Hospice. They could take over Dad's care while he is still at Kindred. At this time, the family has decided that Hospice can be called in at a later time if needed. Dr. Deversa shared that he could and would provide palliative care for Gene. He is also on the floor every day, whereas a Hospice physician would only be there in the case of events. Emily feels very strongly that Dr. Deversa has developed a relationship with her and Dad and that he is the very best doctor right now to oversee his care. Dr. Deversa has shared with the family that although he wouldn't predict an hour or day that he believes Dad's body is shutting down and that his time is drawing near.

This afternoon, Steve's girls and the two husbands all came up/over to Chattanooga to see PaPa. They are gathering at the house to order up some supper and such before heading back in their own directions later this evening. Russ is here, as are Steve and Pat. Alan and Liga and Valdis are joining them for dinner. Lynn made a quick, brief visit to the house to see everyone, but did not stay.

Prayer Requests
Please pray for Gene to have peace.
Pray for the family to know peace at each step of the decision making process.

September 26, 2009, 10:00 AM

When Emily and Steve arrived early this morning they found a crash cart in the room with Gene.  When Emily and Steve arrived early this morning, they found a crash cart in the room and understood that he had a significant heart rate drop.  Emily, Russ, Steve, and Alan met with the staff of Kindred this morning to review Gene's living will.

The decision has been made according to Gene's wishes that no resuscitation efforts will be made.  He will continue to receive the care that he now has, and every effort will be made to prevent him from having pain.

Hospice has been called, but as of now there is not a schedule for when they will be able to meet with the family. 

This blog will be updated as new information is available.

September 25, 2009

Russ and Steve drove up to Chattanooga today to be here for a meeting with Gene's attending physician, Dr. Deversa.  Pat was already here as she had come up last night and spent the night with Emily and Alan joined them all for the meeting.  Lynn's doctor as well as Dr. Deversa have made Kindred off limits for her at this time.

The term desaturate from yesterday's blog brought lots of questions.  The amount of oxygen saturation in the blood is supposed to be between 88 and 100.  When it goes below that it is an indicator that the lungs are not exchanging oxygen efficiently.  Gene desaturates sometimes when he is moved to the side.  This is not a big move generally, just putting a wedge under his shoulder or torso to reposition him.

Dr. Deversa explained that Gene probably has acute respiratory distress syndrome.  He also says that Gene is now in a coma, and that his lung tissue has probably become scarred from all his infections, and this prevents oxygen from passing through the lung tissue and making the exchange. They also believe that he has pneumonia, although that hasn't yet been confirmed by an x-ray. Every time they have to raise his oxygen level, that also causes damage to the lungs.  It brings about a short term benefit, but over the long term it's not good. As of tonight Gene's ventilator settings have been raised and now are at 35 pressure and 60 oxygen.

Emily is staying at the hospital tonight. That's pretty hard on her physically, so Russ is going to relieve her at about 2:30 this morning.

At this point obviously the discussion about him being moved to another facility has been tabled. 

Prayer Requests
Please pray for Gene's spirit to be calm and at peace and for the family to have peace in the days to come. 

September 24, 2009

Gene is not doing well today.

Last night when they were bathing him, he desaturated.  And he has been unresponsive since then.  Today they ran his blood gases and found his CO2 levels were too high.  This means that his body is not exchanging oxygen and CO2 as it should. 

They have set his ventilator on a higher setting. 
Pat has come up from Atlanta to stay with Emily.

Pray for Gene.   Pray for Emily. 

August 23, 2009

Emily reports that Gene has had a restful day.  This evening his vital signs are good and his pressure remains at 20 with oxygen support is 35.  Emily wanted to spend the night, but decided that since she was comfortable with the staff that she would come home and just call them later this evening.  It is very uncomfortable for her to sleep in the recliner they've provided - her back always suffers. 

Joyce was here today and she and Emily made a second visit to Standifer Place, the only nursing home facility in this area which has the capacity for handling patients who are on a ventilator.  It is not an acute care facility like Kindred is, but they have recently added vent weaning as one of their medical services. The other option would be for Gene to come home and be cared for at home.

The family has some very difficult decisions to make and appreciate your prayers for guidance to do the right thing at each step along the way.

September 22, 2009

This morning Emily went early to Kindred in order to meet Dr. Brice who is Gene's wound care physician.  He took care of the wound and told Emily that he's very pleased with the progress and thought that it is on it's way to healing.  The tissue is all now the pink healthy granulation tissue that one sees in a healing wound. It will take months to completely heal, but for now the expectation is that he is on the road to recovery from the wound.

The news about the ventilator is not so positive.  It seems that they are finding it very difficult to lower his pressure very much without him quickly desaturating.  He also desaturates when he has very much physical exertion - especially when he is turned on his left side.  And of course turning is so critical to making sure that he doesn't spend too much time in one spot for the purposes of pressure wounds. Tonight his pressure was set at 20 and his supplemental oxygen is at 35%. He seemed comfortable at these levels.

Gene also has another infection in his PIC line as well as a urinary tract infection. He has seemed to have a good day in spite of these infections although he seems very tired and is mostly resting.

This afternoon Kindred had what they called a family meeting.  This is an opportunity for the family and it's advocates to meet with the care givers and hear what they have to say about the patient's progress and to ask questions.  Emily, Lynn, Alan, Steve, Joyce, and Dr. Carver, Emily and Gene's minister, were at the meeting.   Unfortunately none of the physicians were in attendance.  Dr. DeVersa gets a pass on that because it was his day off and he has attended these meetings before, (and because the meeting was scheduled for Lynn's benefit because of treatment schedules)  but all in all the family was disappointed that the other physicians were not in attendance.   The bottom line for the meeting was to let the family know that Gene is no longer considered to be in need for acute care, which is the level of care offered by Kindred and to ask that we begin to consider what care plan we would like to implement in the fairly near future.  There was no strict timeline at this point.  There is much to consider.


Prayer Requests
Please pray that Gene and his family have the  strength and courage for the next steps and peace about the decisions.

September 21, 2009

Emily ended up coming home last night.  Dad was resting well, and she knew all the staff that was on the night shift and was comfortable with each of them.  She also feels very comfortable with some of the staff.  And she knows if she wakes in the night and wants to call and check on how he's doing that she can do that. She rests so much better in her bed than in the recliner they have in the room.  Last night they didn't even have a pillow she could use. Her back does so much better when she sleeps in her own bed! It was a good decision for her to choose to come home. Again this evening, she knew all the staff that was on duty and felt comfortable enough after the shift change to come home for the night.  She did stay quite late tonight!

There was lots of rain in Chattanooga again today and the water in the drainage canal at Emily and Gene's got up over the bank again.  It came into the yard up to the flower beds, but nothing like the other night when the dumpster was lodged up against the bridge stopping up the water flow.  Today there was news that a man in Chattanooga drowned in a storm drain similar to the one that flows through Mom and Dad's neighborhood. Perhaps people just don't understand the power of water!  Mom certainly does!  When the water was up this morning, she was watching like a hawk, and calling to check in with neighbors - she even called the city to let them know the water was about to breach the bridge again!

Gene is still running a temperature today.  His fever is at 100.4.  But his ventilator pressure remains at 20 and his oxygen at 35. He is resting very comfortably at this ventilator setting, his oxygen saturation is at 100%, and his heart rate seems to have stabalized in the 70's.

The medications that Gene would normally take orally are ground up, dissolved in water, and given to him through the feeding tube. So tonight when his nurse started to give him his medications, his feeding tube was stopped up, but she was persistent and worked with it and got it going.  The first thing she tried was some coffee!  Dad has been wanting a cup of coffee -- of course he didn't get the tasting part. When that didn't fix the problem, she got it fixed by using a second course of action - some of Mom's petroleum jelly.

Dr. Carver came this afternoon, after a week of being gone for a well-deserved vacation. Dad recognized that he was there and tried to focus on him for a bit, but he's tired and spent most of his time with his eyes closed seeming to rest. It is still very frustrating for both Emily and Gene that it is sometimes so difficult to understand what he is trying to say.  Sometimes she can understand him and but often is unable to and because she is so devoted to taking care of him and advocating for his needs, she can hardly stand it that she doesn't know what he wants.

Tomorrow the staff is having a family meeting.  They do a meeting like this about one time a month.  They invite members of the patient's family to come to a meeting that has a respresentative from each of the specialty areas.  Each of them speaks and lets the family know how he is doing and offers the family an opportunity to ask questions.  We'll be able to report on his progress from every angle next blog.

Thinking after visit to Uncle Gene

Ann, Gene's niece,  wrote this after her visit in August.  She had intended to send it as a comment, but when she sent it recently it seemed much more appropriate as it's own post.


August 9, 2009  Flight from Nashville to Denver

Ann VanSant

            I am very grateful for being able to see Uncle Gene. Sue and Ken picked me up in Nashville and we all went together to Chattanooga. (While we were there, we also met the Rudolphs’ granddaughter and visited with Margery and her grandson—it felt a little like a return to Mt. Victory.)

            Uncle Gene’s face was clean shaven but his white/gray beard was still visible below the chin line.  His face is thin but even with the tracheotomy (and the neck brace that he had on on Friday night when we got there)—creating all that busy-ness about his head and neck—he is still Uncle Gene.  He is very tired, but he is still really present.  I am touched by how much he is still himself even in these circumstances.  He speaks with his lips but also almost with a whisper.  It’s not hard to understand what he is saying.  I told him Friday night when we first went for a visit that I would tell him “Uncle Gene” stories the next visit, stories that would make him smile.  And he smiled at that, smiled in a way that was completely Uncle Gene.

            At one point when Aunt Emily was massaging his hands, she touched the tracheotomy tube structure, and he said, “Be careful.”  She asked him then if he needed to have  suctioning to clear his airways and then got a nurse to do it.  She is calmly, consistently vigilant for him.  She is, I think, talented at being both gentle and insistent.  And he is alert to the fragility of his life because his body is giving him so little cooperation right now.

            This visit lets me better picture him as I read Lynn’s remarkable blog.  I know the angle of his bed and where the window is and where the gloving, masking, and gowning take place before a visit. I can imagine Joyce and Frances and Bob visiting him, and Russell, and Steve, and Lynn. I can imagine the family’s lifting the babies up outside his window so he could see them.  And I can imagine little Elijah bringing him the brightness of a little boy’s life.

            We spent the night at Aunt Emily’s and had her wonderful corn and the tomatoes. And Lynn came over and Lynn and Alan for breakfast.  We had lots of talking time.  In the evening Emily showed us a sort of yearbook of Grandma’s college. There was a strange story, a mystery, very veiled, as part of the history of the freshman class. Sue found the details in an old newspaper online.  And we talked about family stories, about Mt. Victory & Hyden, Russell and Lynn and Steve and our childhood days, and about how important Uncle Gene was to us.  He used to worry my brain over and over by asking, “How do you know you’re you and not Nancy Sue?” It was too much for my small mind, and Uncle Gene would half laugh/half chuckle. (As I told Uncle Gene, I later knew that the answer was “Because God knows,” but I didn’t know it then.) For Sue and me, Uncle Gene is part of the framework of things.  I slept in the Uncle Gene room at their house and dreamed about him.

            I told him on Saturday that Hannah was sorry not to have been able to come.  And he said, “Tell Hannah I love her.”  That is a gift for me to take back to Hannah.  He means a lot to her.  He was so important to me and now he is so important to her.  I am grateful that Hannah and I could see him twice in short succession last summer, listening to him tell his own Uncle Gene stories.

Love, Ann

September 20, 2009

Gene has been somewhat better today.  He is still very tired and not having much interaction.  His temperature has gone up and down but he seems much more comfortable.  His ventilator settings have been moved down a bit.  He is now on 20 pressure and 35 oxygen and seems very comfortable. 

Emily is planning to spend the night with him at Kindred because he is still running some temperature.  It is not comfortable for her there, and she is especially uncomfortable being away from the house after the flood the other night.  We've had quite a bit of rainfall this afternoon and early evening, and the "creek" is up like it often gets during big rainfall.  But it was a bit more intimidating because of the experience the other night while she was away.  She's hear several stories from neighbors about how bad it really got!  One neighbor told her there was two feet of water running down the street in front of the house in addition to the rise from the creek.  Her house would have had water on three sides!  Another neighbor told her that a car tried to come across the bridge where the dumpster had lodged.  He kept trying to motion the driver away, but the driver didn't pay attention.  He didn't make it and the car ended up not even on the bridge but on the creek bank partially submerged in the water.  The police had to come and help rescue the car and the driver.

Anyway, it was a hard decision for Emily to decide to go spend the night with Gene rather than stay home and watch over their "place", but that was the decision. She reported in that his left leg is still a little swollen but that she thinks her massaging over the last couple of days may have helped it go down some.

Prayer Requests
Please pray for Gene to gain strength in his body and his respiration.  Pray for Emily to have the strength to continue caring and advocating for Gene and for her to have peace with her decisions.

September 19, 2009

Betsy was still here this morning - she spent the night with Emily and they went together to visit Gene this morning.  They found him to be much more alert.  His temperature was down and he was much more responsive.

Emily went out for lunch today after coming back from spending the morning with Gene.  Lynn, Alan, Liga, and Valdis and Emily went to enjoy lunch at the Longhorn Restaurant.  It was a nice, pleasant time and good for everyone to be together.

Lynn had planned to go visit Gene later in the afternoon, but developed a fever and did not.  Steve and Pat are here in town and will spend time with him in the morning before returning to Atlanta.

It's good that Gene seems to have rebounded some from his downturn this week.

Prayer Request
Please pray for Gene to continue to gain strength.  Pray for Emily to find a balance between caring for Gene, and caring for herself. 

September18, 20009

Gene is running a temperature tonight and is very tired.  He is sleeping most of the time.  He will open his eyes when visitors come in or when the caregivers speak to him, but he can't focus for more than a few seconds.  He closes his eyes and seems to be sleeping.

Emily and Betsy have spent lots of time with him today.  Emily arrived fairly early this morning and waited for Betsy.  After lunch they returned for a good bit of time this afternoon.  Emily worked on giving him a manicure.  She is so attentive to his feet and hands. Actually to providing for him or advocating for the things that she can't provide.  She is feeling somewhat discouraged right now - her tiredness and her back probably contribute to that. 

They have been running cultures on Gene's blood, sputum, and urine.  So far the blood culture is showing nothing, and the urine is showing nothing.  The sputum did come back with something and several recommended antibiotics - it doesn't appear to be resistant to antibiotics.  He should start on something tonight or tomorrow.

During the afternoon the alarm on his heart monitor kept sounding.  They have it hooked up to a monitor at the nurses station now, and they are keeping an eye on it, but the rate varied dramatically from low 70's to 100 teens.  The nurse seemed to think that it might have to do with his temperature.  Right now they have put him on some medicine, and seem to think that it's not terribly alarming.

Prayer requests
Please pray for Gene to regain his strength, for his fever to return to normal, and his respiration to grow stronger.  Pray for Emily to have peace.

September 17, 2009

Gene has been tired and running a temperature today.  His pressure is still at 24 and his oxygen is at 40.  For the first time he complained of pain.  Emily asked him if he was having any pain, and he said yes.  It seemed as though he was saying his buttocks hurt.  He had just been turned.  At any rate Emily requested some pain medication for him. 

This evening he was running a temperature  - about 100.4.  All his life his temperature has been a little lower than the 98.7 that is normal for most, so the 100.4 is a bit of a high temp.  They've given him Tylenol for the fever.  He had a difficult time focusing on anything today

Emily has been very conflicted about spending the night with him.  She only has a recliner to sleep on when she stays and  her back is really bothering her. It's very wearing on her to have her back hurt so much.  She also feels like she really needs to be with Dad at night when he is running a temperature.  She finally decided to go back to the hospital for awhile tonight, but not to stay.  She says she will call the nurse tonight before she goes to bed to check on him. 

Last night she spent the night at the hospital and was very uncomfortable. She came home about 4:00 AM.  In the night, we had a great big storm.  The concrete drainage ditch overflowed and came way up into the yard - all the way up over the garden and to the corner of the storage house.  It seems that an industrial size dumpster somehow floated down the ditch and lodged at the little bridge that goes from the Avenue to the Circle and blocked up the water flow!  Alan had the brilliant idea to go look at the name of the company on the dumpster and give them a call. (That was after a call to the city help line got a less than enthusiastic response).  Apparently they had lost several and came right away.  They assessed the situation and brought in the equipment they needed and got it carried away.  So if it rains tonight, perhaps the water will be flowing more freely and not be up in the yard.  So this morning, she stayed home until that was all taken care of.

Prayer Requests
Please pray for Gene to have healing and for his respiration to improve.  Pray for Emily's back to show improvement and for her to have peace about her decisions.

August 16, 2009

Gene has been experiencing atrial fibrillation  yesterday and today.  They did an EKG and found him to have a good strong heart rhythm.  They changed out the leads on the monitor (one had come loose and was stuck to his gown instead of his chest), and that seemed to keep it from going quite so high, but it did keep on alarming. They have started him on some medication to get it in check.  Emily has decided to spend the night at Kindred again tonight. She's stayed for several nights, and she sleeps in a recliner when she is there.  It's causing her to have some level of increased back pain.

Gene's temperature is now near normal and he said today that he rested well last night and felt better.  He was alert, but kept his eyes closed and rested most of the time.

They have increased both his oxygen and pressure to give him support and let his heart not have to work so hard.  His pressure is at 24 and his oxygen is at 40.

Prayer Requests
Please pray for Gene to have strength and courage.  Pray for Emily to find the balance she needs between caring for Gene and nurturing herself.

September 15, 2009

Emily spent the night with Gene last night, because he was feverish and not feeling well.  She came home early this morning, and was back to be with him by mid-morning. She makes it her business to know exactly what's going on with him, to talk with him about what's going on in the family, to have his out of town children and grandchildren talk on the phone to him, and always, always advocate for his needs.

Granddaughter Elizabeth called this morning, and Emily put the phone over for PaPa to hear her.  She spoke to him and Elijah also talked to him.  He told PaPa "OK" and "wuv you PaPa" and Yah Yah - his pronunciation of his name! We are excited about having them here to visit in a few weeks.  It's always such a lift to Gene's spirits when someone visits or calls him.

Gene's temperature during the day was 101.  He was comfortable and although his heart rate was a bit high, it did not seem to be of concern. He was responsive to his caregivers, but was tired and resting most of the day.

This evening Emily saw Dr. Deversa, and he said that some of the cultures had come back and they all looked fine.  They had looked at his sputum, his urine, and his blood.  Since they didn't find anything, they took more samples this morning and are doing some more cultures.


Prayer Request
Please pray for Gene to grow stronger, and for him to overcome his infection.  Pray for Emily to have the strength to continue to balance all the demands in her life and to have peace. Pray for all of his caregivers.

September 14, 2009

Gene has an infection and is running a fever. Last night, it came back down to nearly normal, but today it has been back up to 102.4 or so. That is not done orally, but under the arm, so is probably 103.4. He has been put on Vancomycin.  Emily reported that Dr. Deversa has ordered a sputum specimen. 

This morning, he was alert and watched part of a dog show that Mom found on TV.  This afternoon, he was tired and had his eyes closed a lot of the time, but when anyone interacted with him, he would wake and make eye contact and be very responsive.  He said he felt better.

Emily is considering spending the night with him this evening.  She really wants to assure that his needs are being met and has said that when he is so sick, she feels very uncomfortable leaving him alone.  It also sometimes depends on who will have night duty and how confident she feels about their care.  Sometimes if it's a person who hasn't had him before, she wants to be on hand to observe and make an opinion.  She is an amazing advocate for him.  She is an example and inspiration to anyone who is around her.

Prayer Requests
Please pray for Gene to have strength and healing.  Pray for Emily to have the strength to continue her caregiving and advocacy for Gene.

September 13, 2009

Gene has been sick today. Emily spent the night with him last night; she said that he was interested in a television show that she'd found. After the television, he was a bit restless but settled down later and had a restful night.

This morning when she left to come home his temperature was 100.4. This afternoon it was down a bit, and this evening it was close to his normal temperature, at 97.9. His pressure is up to about 24 and his oxygen is up as well, so that he doesn't struggle with his breathing while he is still so sick.

Emily went to Kindred planning to spend the night tonight. When she got there she knew most of the staff that would be on duty with Gene tonight and felt comfortable coming back home for the evening. She'll probably call the nurse right before she goes to sleep. Last night when she spent the night she got a crick in her back, so it's probably a good decision that she planned to spend the night in her own bed.

Dr. Deversa came by this evening while Emily was visiting Gene and she felt good about their interaction. She told him again that she wanted them to do everything they can to get Gene off the ventilator. He assured her that they would work very hard.

Prayer Requests
Please pray for Gene's respiration to improve, for his body to grow stronger, and for him to be able to conquer his infection. Pray for Emily to stay strong.

September 12, 2009

Gene has not been feeling well today. He is running a temperature, and is feelinlg lethargic. He was working so hard on his breathing that they have increased his pressure to make it less tiresome for him. He has developed some bruises on his arms that seem not to be related to his PIC lines, Emily has not been able to find out what has caused them.

Emily visited him this morning, late this afternoon, and is planning to spend the night in his room tonight. She is very concerned about his lethargy and his infection. She insisted today that they nurses help her elevate him more and she kept him in a more elevated position for about forty minutes. There is a delicate line - it is better for his breathing for him to be more elevated, but it is better for the pressure wound healing for him to be lying down.

Prayer Requests
Please pray for Gene to have strength, for his respiration to improve, for his body to fend off the infection, and for him to have courage. Pray for Emily to have the strength and courage to do the things she needs to do.

September 11, 2009

This morning Emily and Joyce visited Gene.  Emily is so attentive about making sure that his needs are met.  He washes his face, puts lotion on his hands and feet, and checks him over good to make sure there isn't something that needs the attention of a staff member.

Last night Joyce had the weather channel on for Gene and there was a piece about the weather causing the shuttle landing to be postponed and Gene was interested in it.  So this morning while they were there they found the shuttle landing on TV - Gene was interested in it and watched some of it.

This afternoon, he was running a bit of temp and looked flushed but his other vitals were good.  He was also seemed tired.

This evening, Gene seemed a bit weary.  His temperature had gone down by about a degree and was at 98.7 which is just a tad high for him.

Gene was a bit weary tonight when Joyce and Emily visited. He seemed to be working a bit harder to breath this afternoon and evening.  His settings are pressure 18 and oxygen 40. Last night they increased his pressure just a bit to help him breathe easier, but it is back down tonight.

Prayer Requests

Please pray for Gene's respiration to grow stronger, and for his body to heal.  Pray for Emily to continue to find the balance she needs to nourish herself so that she can stay strong for Gene.  

September 10, 2009

Gene seemed to have a good day today. He was alert and awake most of the time he had visitors.  Even though he kept his eyes closed, he was quick to open them when he was stimulated.  Emily noticed a bit of swelling in one of his ankles and called attention to it.  She had them make a note of it for the doctor to look at tomorrow and put cool compresses on it for awhile today.  His vital signs have been good all day and his oxygen saturation has stayed at 100%!

Joyce has come down to give Emily some support and will spend the night.  They went this evening to visit at the shift change and Joyce turned on the Titan vs. Steelers football game.  Gene got interested in it and watched a bit of it.   What a great idea that was!

For most of the day his pressure has been set at 16 and the supplemental oxygen at 30.  He was comfortable until this evening when the respiratory nurse raised his oxygen a bit because he was working pretty hard.  Danny and Felicia are the staff on duty tonight.  Emily has lots of confidence in them. She particularly likes Danny and seems to think that he gets good response from Gene.

Emily went to lunch at church today.  Another step at doing things that nurture her so that she has the strength to keep on with the task of  being with and advocating for Gene. They had people take home the flower centerpieces, and she took one to the nurses station. 

Prayer Requests
Please pray for Gene's respiration to improve, for his pressure sore to continue healing, and his spirit to remain strong.  Pray for Emily to find the balance she is striving for and for her to continue to have strength.

September 9, 2009

Emily visited with Gene this morning for a couple of hours and found him looking rested and comfortable.  His Physical Therapist came and worked on his range of motion.  Emily is learning to do those exercises with him and is doing them some when the therapist is not there.  She read letters and cards to him and he especially enjoyed the one that Elijah made for him.  Emily put it up in the room where she hopes he can see it.  A

This afternoon, he was more alert in short spells, but he napped between these times.  He was resting well and Emily raised his bed some.  She reports that since he had the blood transfusion, he has perked up and his fever has gone down some.  When Emily returned at the shift change, she found staff on duty that she knows and is very comfortable with. She finds them very capable and compassionate, and is able to rest better knowing that they will call her if anything happens.  She says that they tell her to call anytime in the night if she wakes and wants to know how he's doing.  This gives her reassurance and helps her to rest better.

They have moved the PIC line from the site where the infection had started and it's now on his left side. He's still on an antibiotic, and his pressure support has stayed at 20 and his supplemental oxygen at 40.  

Prayer Requests
Please pray for Gene to stay strong and be at peace.  Pray for his respiration to improve and his pressure wound to continue to heal.  Pray for Emily to find the nurturing she needs to stay a strong advocate and be at peace. 

September 8, 2009

Gene has been resting most of the day, but has been aware. Emily went to her PEO book club this morning and seemed to enjoy it. She was not particularly fond of the book, but she enjoyed being with her "PEO sisters" in one of her regular activities. Since she was not going to be with Gene in the morning, she made arrangements for Bruce to go be with him. Bruce has been such a wonderful support for Gene and Emily. He's truly a renaissance man, there's not much, if anything, he can't do! And one of the things he's doing, in addition to visiting with Gene regularly, is giving him gentle massage.

Emily was at Kindred this afternoon and again in the evening. Dr. Brice had been to see Gene and indicated that the pressure wound was looking very good. Gene was very aware tonight, but was tired and kept his eyes closed most of the time. At one point, he pursed his lips as though to give Emily a kiss.

Prayer Requests
Pray for Gene to gain respiratory stength and for his body to heal. Pray for Emily to continue to have strength and to find her way through the next steps as she supports Gene and keeps the home fires lit.

September 7, 2009

Gene was alert this morning. He had a little fever last night and they discovered that his infection could be traced to his PIC line. They started giving him an antibiotic. They also discovered that his blood counts were low as well, so this afternoon he got two units of blood.

Dr. McGill indicated that it is very common for a PIC line or a tracheotomy to become infected.

When Emily was there this afternoon she spent some time taking care of his fingernails and toenails. She also washed his face and his feet. She is very attentive to his needs and to advocating for him with the caregivers.

Emily is planning to go her PEO book club tomorrow. She joined PEO when she first moved to Chattanooga, and it's been a really good group for her to be involved with. Her sister Frances has been involved with the group for many years, and her sister Joyce is now involved with a chapter in Knoxville as well.

Prayer Requests
Please pray for Gene to have healing and strength to face the hurdles ahead. Pray for both Emily and Gene to have peace.

September 6, 2009

Emily visited with Gene this morning before she went to church and found him much more alert than he's been for the last couple of days. Dr. Carver has been called to pastor their church, and as an elder, she wanted to be there. It's good that she's feeling the need to be back in that community. It is a very powerful ministry to see Dr. Carver's faithful visitations with Gene.

This evening when she visited, Gene was tired, and less responsive. His temperature was down to 99. He is on two antibiotics. His pressure setting is on 20 and his oxygen at 50. Steve and Frances and Joyce all called and spoke with Gene on the speaker phone.

Emily makes it a point to go visit Dad at shift change or after so that she can touch base with the staff that will be working the night shift. She knows the staff that is taking care of him tonight and is comfortable that they are competent and attentive.

Prayer Requests
Pray for Gene to gain respiratory strength and to have healing. Pray for Emily to have strength to continue to care for Gene and to take care of her own needs as well.

September 5, 2009

Gene has had a difficult day today, and he has fever tonight. He has been largely unresponsive to Emily and other visitors.

Emily is planning to go to church tomorrow, and has said that she feels very conflicted about not staying with him tonight even though she knows the staff that are on duty tonight and thinks they are all competent and attentive. She plans to get up early and go spend some time with him before she goes. She needs the support of family and friends to know that her efforts to provide for Gene's needs through her visits, her attention, and her advocacy are of the highest level one could imagine. She also needs continued encouragement to take care of her own needs, such as attending church and participating in other activities which bring her strength.

Prayer Requests
Please pray for Gene to have an easy night and day on Sunday. Pray for his respiration to grow stronger, for his body to heal, and for him to have peace. Pray for Emily to be at peace.

September 4, 2009

Gene had a very difficult day today. When Emily visited him this morning, she found him fairly unresponsive and his breathing was pretty rapid and shallow. Bruce had been there before she arrived to do a massage and found him unresponsive as well. Emily had the respiratory team as well as the nurses check him out. They found his vitals fine, but with a slight temperature. They checked out his blood gases and found them to be in the normal range as well. He responded more to the medical personnel than he did to Emily. Alan went to the hospital early this afternoon and found Gene's condition to be very similar to the times after previous debridement treatments.

Perhaps as a response to Emily's advocacy, the respiratory team raised his pressure. Since this afternoon he's been at pressure 20 and oxygen 40. This evening Emily found him much less distressed and more comfortable at those settings. When she left the hospital this evening she felt that the staff on duty was very competent and would be very attentive to him.

Prayer Requests
Please pray for Gene's respiration to grow stronger, and for him to make continued progress in his healing. Pray for Emily to continue to be a strong advocate and for her to have peace.

September 3, 2009

Gene had a minor debridement procedure done today and seemed to do very well with it. There was a piece of bone that needed some attention, and just some minor tissue involvement. Dr. Brice was very pleased with the progress of the wound. Gene did not have the dramatic downturn that he has had with past procedures; Emily actually found him more alert in the afternoon after the procedure than he had been in the morning.

Steve was here for a visit with Gene; Pat wanted to come, but this was her sister Deb's first day home from the hospital and it was important for her to be there to help get her settled in. Steve was actually there to observe the debriding procedure and has a good idea at this point of what Gene is facing in that healing process. Steve gave an update of all the kids and Madison and Gene seemed to be responsive.

Emily was there again in the evening and found Gene to be comfortable. He is on pressure 10 and oxygen 50. They put his oxygen on 100 during the debriding procedure and he did not desaturate either during the procedure or after!

Emily has seemed more tired in the last few days than she has since this all began in May. She had a routine doctor appointment today that seemed to go well. Some time ago, Gene gave their primary care physician, Dr. Cannon, a set of Airborne Wings. Today, Dr. Cannon gave the wings back to Mom and asked her to take them to Dad and tell him that she wanted him to bring them back to her when he was better.


Prayer Requests
Please continue to pray for Gene's respiration to grow stronger, for his pressure wound to heal, and for him to have peace. Pray for Emily to find the well of strength she needs to continue to advocate for Gene, to fill her own needs, and to keep her home going.

September 2, 2009

Gene had a pretty good day today. Emily was with him this morning and again this evening. She makes sure that she goes in the evening at shift change time to give positive reinforcement to the day shift people and to let the evening shift be aware of her presence and to advocate for Dad's needs as she has assessed them during her time with him during the day. Tonight she was very pleased with the staff that would be caring for him during the night. She has a phone number that rings directly with the nurse that has him and they always tell her that she can call any time if she has any questions or just needs to check on Gene.

Tonight the respiratory nurse told Emily that they would be trying again when Gene was a bit stronger to wean him from the vent. He is still loosing oxygen saturation when he's turned on his side. Today, he was on pressure 10 and supplemental support 50.

Tomorrow morning, Dr Brice will do a small debriding procedure. Emily has a doctor's appointment very early tomorrow.

Prayer Requests
Pray that Gene has an easy debriding procedure tomorrow and the Emily's doctor's appointment goes well. Pray that Gene's respiration continues to grow stronger. Remember to pray for Pat's sister Debbie.

September 1, 2009

Gene was comfortable today and fairly alert. Emily was there in the morning, then went to her church meeting mid day then back to the hospital for a short visit, and then back again in the evening. Dr. Brice was there this morning to examine the pressure wound. He says there are two small places that will need some additional debriding. When they turned Gene all the way on his side to examine the wound and change the dressing he did fine, but afterwards, he desaturated. His pressure stayed on 10 today and his oxygen for a time was up to 50. When Emily expressed concern that Gene seems to take a long time to recover from the debriding procedures, Dr. Brice indicated that there should not be a connection between the two.

Emily seemed to enjoy her Church Women's Group today. She indicated that many people asked about how Gene was doing, but she also had an opportunity to just be in the group doing their normal activities.

Steve is planning to come up for a visit sometime tomorrow. It will be good for Gene to have an opportunity to see him for a bit. Emily noted that many of Gene's men visitors are able to bring out a level of interaction from him that he doesn't always exhibit with her. She is always very grateful for their visits.

Prayer Requests
Please pray for Gene's respiration to grow stronger and for both Emily and Gene to have peace and comfort.