The Waiting is the hardest part (cont'd)

We were back in purgatory. Dad had survived the surgery but the verdict was still out on whether he was going to live. We saw him that night, hooked up to a dozen machines, breathing on a ventilator, he looked awful. But of course everyone looks awful when they come out of surgery. They sent us home. He's going to sleep all night, they said nothing is going to happen until the next day. They hadn't even closed him up, they told us, just put a bandage over the wound just in case they need to go back in. The next day the gave him a "sedation vacation" brought him out of sedation to see if they could get a response. We took a shot at it as well. Standing on either side we tried to get dad to move his fingers. He could. We asked him to squeeze our hands. He couldn't. I told him we were going to go back to the waiting room, but we would be back to check on him, O.K.? He nodded. He Nodded. Or did he. Did his head merely twitch and I wanted it to be a nod so I thought it was a nod? I didn't know. We went back to the waiting room. We talked to another family who were currently in purgatory. Their father was also getting a VAD and he was in surgery. We knew how they felt. We tried to comfort them, to share our experience, but our words felt hollow. We knew surviving the surgery was just the beginning. An hour later the VAD coordinator poked her head in. Its all about the peeing, she said, he's gotta pee and she was thinking about stamping on his bladder she joked. They were watching she said, more news to come. About an hour later, we went back in the ICU. We were there as the nurse was recording the urine out put. One inside the room, one outside. Through the glass the one on the outside mouths -- what's the urine. The nurse on the inside signals a 4, a reduction from the hour before when it had been 5. But then he signals a zero. 40cc's. That was some pee. The nurse explained they had given him liquid, figuring maybe he was just dry. And so it seemed. They had also given him some medicine to prime the kidney. It seemed to work. But could he continue to urinate without the medicine. When we came back an hour later the answer appeared to be yes. He was now up to 70cc's and they had taken him off all kidney medicine. He seemed to be doing it all on his own. meanwhile, the nurse had gotten him to squeeze both hands and also seen him nod his head. Perhaps it wasn't wishful thinking after all. By the end of the day they took him back in the O.R. They were at least going to wash out his incision. Maybe, they said, they were going to sew him up if it looked O.K. and maybe, just maybe, they were going to remove the RVAD or at least "play" with it. I signed a release the gave permission for all the above. We went back to the waiting room. An hour later they brought him back and we talked to the surgeon. He looked good, the surgeon said. He had decided to sew up dad's chest closing the wound. The RVAD stayed in, we would still wait for that. Dad would sleep now. Tomorrow they would take him off all sedation and let him wake up. And perhaps they would be able to remove the breathing tube. For now they told us, go home. Everything looked stable, they'd call if anything happened. We decided to go catch a movie and try to take our minds off what was going on. We ate some dinner and settled in to watch an action movie. I had no service in the theater so I was relieved when I got out to see I had no messages. No news was good news and we headed back to the hotel. Moments after arriving at the hotel my phone rang. Dad had started bleeding and had reached the threshold where they need to do something, about 1 liter. They wanted my permission to return to the operating room, open him up again and try to find the source of the bleeding. It could be a major organ, and they would try to repair it, but that would be a bad thing. I asked them to call me when they had finished. It was ten o'clock. My phone range at 1 am. The stupid thing froze while I tried to answer it. I quickly called the number back, but the doctor was clearly leaving me a voice mail. I waited for the voicemail to come through. Everything was all right she said. They had stopped the bleeding. I called her right away. She said nothing was big or vital, just some small cuts that she easily fixed. The next morning the surgeon speculated on what had happened. What we understood is that a couple of blood vessels or capillaries that perhaps had not been used in a long time due to the decreased blood flow, now suddenly had blood and they had started bleeding. Perhaps they had degenerated. At any rate, such a thing in a normal person would heal itself, but they were being extra careful with him. But the bleeding had been staunched. We had reached our benchmarks for the first day. We had kidney function, neurological function and had addressed bleeding. Now they would start the process of waking him up.