Hopeful but not optimistic

Its been a rough day. The nurse I dealt with tonight was down right rude. She answered one of my questions with "oh my god..." and then complained I was keeping her from actually caring for my father (I told her if it wasn't a good time I would gladly call her back, she demurred). I was infuriated with her and complained to the social worker, not only about the nurse but about the failure of any doctor on the VAD team to call me since I left L.A. Be careful what you wish for.

Dad's surgeon called me a couple hours later. Dad's alertness has improved, but the problems are the liver and the fact that he's still on a ventilator. The ventilator weaning has not gone so well. He can do it for a while but then he gets tired and begins to hyperventilate. So they think they want to do a tracheostomy which is essentially a direct connection to the windpipe. The lets them take the tube out of his mouth but still lets him be on a ventilator. Its a longer term solution, but when its no longer needed its capped and then it heals. Its medically cleaner, but doesn't actually allow him any more communication ability than he has now. The liver has plateaued this makes them nervous. In fact in general the doctor feels like he's plateaued. The doctor said, if he was asked if dad would be better in a week or worse in a week he'd expect worse. The problem seems to be the longer he's in the bed the weaker he gets, so plateauing is actually a form of declining.

The title of this post comes from the doctors words, he said "I'm hopeful but not optimistic." He asked when I was coming out next, and I said Oct 13. He recommended I come out sooner. So I'm changing my flight to next weekend. It will be fewer days in L.A. because I don't have Fall Break to play with, and the flight is early morning, but it does give me two working days there: Friday and Monday to interface with the doctors.