Britney had another great night. She was off sedation and most pain medication last night to see if she would wake up more. She had her eyes wide open for a long time and looked at us for what seemed like forever. She blinked her eyes when we asked her to multiple times. She didn't seem scared like I thought she would. She calmed down very easily when me and Casey held her hands. She was awake for a few hours then slept most of the night only waking up when she got repositioned and had a very peaceful night. She had a fever this morning (The ECMO had controlled her temperature before this) and was started on another antibiotic. Over all she is doing great considering all she has been through. Now she is scheduled for a tracheotomy on Friday. They are keeping her very comfortable and more sedated today. I don't mind posting her updates cause then I don't tell so many people the same thing so it's a lot less time intensive to keep this up. each post only takes a few minutes. And we are sleeping pretty well. Have a good day.
John

Britney's off ECMO (Bypass)

The heart surgeon just talked to me and Casey. Britney did great and was just fine when they took her off ECMO!!! Her woulds are all closed and she is doing well on the ventilator. She will get a tracheotomy in a few days. Then they can start to cut down on the sedation medications and wake her up more. She will be in the Cardiac ICU in a few minutes. Thank you all for your extra prayers today.
John

Just got word everything is going well and she will come to the Cardiac ICU. Not sure how much longer.
John

Britney just went to the OR

Britney just went into the OR about 15 minutes ago. The transport from the room went ok. We don't know the time table but will put up a post when she is out. If they have any problems they will just put her back on ECMO. We'll let everyone know soon.
John

Family blog site

We just got a request to make our family blog site Britney has been doing for a few years public so I just opened it up. Here is the link. http://www.winklersite.blogspot.com/

Photo of the Day

Jonas and Vera love to "cook" i.e. make a mess. They got a hold of Britney's old cullinary school uniforms and had a blast a few months ago.

I just spoke with Britney's cardiac surgeon. They are planning on getting her off ECMO this afternoon. She has tolerated the weaning well. They just cleaned out her lungs again with a bronschoscope to get her ready to be only on the ventilator. Say extra prayers for her today.
John

Just a few hours ago I was standing by Britney's side holding her hand and asked her to open her eyes. She has been very sleepy with a lot of sedation and pain medicine. She opened her eyes half way and moved her eyes to look at my face. They nurse asked her to close her eyes as tight as she could if she could hear us and she did. We asked her to do it again if she could hear us and she did. About 20 minutes later I was on the other side of her holding her other hand and asked her to open her eyes and look at me. She opened her eyes and looked where I had been 20 minutes before. I said I'm over here and she looked at me for about 30 seconds. They have been giving her more sedation and pain medicine because she has been more aware this evening. She had a very relaxing 2 days. Tomorrow will be a big day for her. Have a good night everyone.
John

Image of the Day,
Here is Anna,
She looks a lot like her mom. She has been a little angel to look at in the middle of the night. She started laughing and cooing last week. Have a great day everyone.
John

Britney had a good day. They continue to wean her from ECMO. They lungs are taking more of the oxygenating on by using the ventilator more, and her heart is doing most of the work now. As she continues to show that her heart and lungs are able to take over she may go to the OR tomorrow to get off ECMO. It will not be today. Her body continues to fight her ventilator pneumonia and is doing well with it. The dialysis is also going well. Her kidneys are still making good urine also. Her vascular surgeon said she might not lose any toes only a few toenails which may grow back completely. She was biting her breathing tube alot this morning and had to get a bite block in. She has been moving a lot today and continues to blink. She has been looking around a little. She has had a lot more pain medicine and sedation these last few days also and has been more sleepy. Thank you all for following the blog so closely. We went to church today and had so many people ask about her. Jonas and Vera got to play and be with their kid classes. It was a good break and rejuvinating to be at church. We love you all.
John

For all of you who have not heard the story of how Britney got sick here is a condensed version. 1 1/2 weeks ago Britney had a sudden onset Toxic Shock Syndrome that came from a infection of her uterus by Strep A. She had sudden onset belly pain. She made it through an appendectomy and a hysterectomy (this saved her life). Last Saturday night she was being transferred to the University Medical Center in Tucson to possibly put an assist device in her heart to help her heart and lungs recover from the sepsis. On the way there her heart stopped multiple times. Luckily a heart surgeon transferred Britney herself and saved her through CPR and placing Britney on a type of heart and lung bypass called ECMO. She had another stable night.
John

Britney's blood type is A+. I asked the hospital staff about donating to britney. They said it takes a week to process. It is better just to donate locally wherever you are to replenish the local blood bank. I know there are many people who go through a lot of blood in every city. For those of you in Tucson they had a blood drive at UMC cafeteria but it was closed today. Sorry for those of you who came by. Try calling the local blood bank and asking for their hours. That is the best way to make sure you don't miss them. I just figured out how to read posts and respond (Britney set up our other blogs). It is a good way to keep in touch. Sorry I didn't get back to all of you sooner. Please if you have any questions or ideas of what you can do to help just post them and I or one of our family will email you back. Have a good night everyone.
John

Britney moved her eyes.

Hi Everyone,
Britney had a great peaceful day. No ECMO removal. Maybee tomorrow or Monday. Her aunt and uncle Debbie and Gordon came just for the morning to say hi. When Debbie and Jana (Britney's mom) were holding both of her hands and I was standing right by them she looked at each one of them and stared at their faces. Then she had a few tears roll down her cheek. She had a lot of pain responses today with repositioning so they increased her pain medication and gave her some sedation so she slept peacefully most of the day. She is in there trying to wake up. Have a great night everyone.
John

Sorry I didn't get a post up last night. I didn't have internet access. We moved out of the sleep room at the hospital so another family from out of town could use it last night. Britney had a great day yesterday. It was a very great day. She had a trial off the ECMO so they could get a echocardiogram. Her heart did wonderful, even better when the ECMO was off briefly yesterday. There is talk of taking her off it completely today or tomorrow. The other big thing that happened yesterday is she developed a ventilator pneumonia in her left lung. She was already empirically covered with the antibiotics she was on. They also put a scope into her lungs and washed a ton of it out and got samples for cultures. Yesterday she also started dialysis. This is a very common thing in ECMO and from what I have been told the kidney's usually return to their normal function. She has moved both sides of her body, and has turned her head. We have seen tears come up in her eyes quickly while talking to her. One of the night nurses last night said that he saw her follow his face with her eyes which is huge improvement. The Neurologist said her CT scan looks amazing. No areas of lack of blood flow he can see. This is not sensitive enough to see smaller brain damage. According to the EEG there was some damage to the cortex of her brain diffusely but he said that it will be a long time before we know her long term function and he is hopeful much will continue to return. She is young and healthy. She was placed on ECMO as fast as possible and her brain was cooled immediately after starting the ECMO. Thank you all for waiting so patiently for this update.

Today she needs many prayers to help her fight this pneumonia, and if they take her off ECMO in the operating room today. Thank you all for your love and support.

For people helping in Tucson.
I am setting up a online calender in a gmail account so people can know what kind of help we have from day to day and so we can sign people up who want to bring food or play with the kids. I tried to copy and paste the calender into the blog last night but it didn't work so we may have to have one or two people sign people up to help and have links to the PDF calender file daily on the blog. Have a great weekend.
John

Thanks From Casey (Britney's Dad)

My outlook on life and the things that matter most have been forever altered. There are no words to describe a father's feelings when word arrives that your daughter is very sick, followed up with word that she is worsening and we may be loosing her. The 2 hour flight from Denver to Tucson was the longest flight I ever have taken. Britney's condition and outlook was not good upon my arrival. Britney was still fighting and We had some hope. Day by day Britney has improved in small ways (huge ways to us). The outpouring of support has been staggering and very appreciated. We have been contacted by family and friends from coast to coast and from Texas to British Columbia. I cannot begin to express my gratitude to everyone for their love and generosity. I will Thank each of you in a more personal way as soon as I can. I want my Fire Department Family to know how much your support has and will help us get through this together. Since it's impossible for me to call 300 people right now, I hope this Thank you will suffice for the moment. Believe me it is small but sincere. Our prayers along with yours have been answered daily. Please keep them up. If anyone wants to help at a personal level, please donate blood in Britney's name. She has used much and will need much more. Last night our youngest daughter, Arielle, called from Galveston TX and talked to Britney over the phone. Britney's eyes welled up more than I've seen yet. She can hear us I am certain and we relay your messages and love to her directly. Last night Britney fully opened her eyes, turned and looked at the attending nurse with a look of (who are you and what are you doing to me?) Thanks to everyone for now. Love Casey Foster

You Make All The Difference

What can I say... but thank you everyone for fasting and praying for Britney & for our family. The fasting, the prayers, the meals, the beds, the rides, the contributions... it makes all of the difference! It has helped me personally so much to get through each day! Please continue the fasting and prayers! Britney still needs them!! I take comfort to know that she is in the Lord's hands, I don't have to worry... he will take care of her in what ever way is his will!
Jana

6/25/09 Update

Britney had a great night and day. Sorry I didn't get this out earlier. I had a lot of calls to see when I would post this. She has so many amazing friends, family, and people she has not met doing everything they can to support her. A sincere thank you.
Today Britney turned her head to the right and moved her left toe. She continues to cough, blink. She opened her eyes all the way today. The neurology resident and attending doctors stopped by today. Her cranial nerves are completely intact. They said her coma at this point could be due to her severe infection, some due to the lack of oxygen during CPR. It will be difficult to tell and is too early for people who have had hypothermia (cooling the brain). We are very hopeful and have a very peaceful feeling.

Kids update
They are doing great today. Kurt Demminghoff (one of my teachers) and his wife Amy took me, Jonas and Vera to the Desert Museum today. They loved it. Jonas especially loves Gila Monsters. It was very nice to get out and get our minds off of everything. Thank you for a great day.
We slept at home last night and feel much better.

I am going to my orientation day tomorrow. We have so much family here to help out that want me to and I know Britney would want me to also. I am very excited to learn and help other people. My program is amazing. If Britney wakes up they will let me take a family medical leave.
Thank you to so many people that offered to pick up a shift for me. I think we are ok for now.

I'll post another post after orientation and Britney's sister may post one before then.
John

Anna Recognizes Mommy

I held Britney's hand and talked to her for a few minutes before lunch today. Right away, she swallowed and then blinked a few times during my short visit! This was the first I had seen a response from her myself! Mom and I brought Anna in with us. She was squirmy and distracted by all the machines in the room at first. Then she noticed Britney in the bed, stopped wiggling, and just stared intensely at Britney's face. Suddenly, her eyes lit up and she got an enormous smile on her face. I think she recognized her mommy!
MacKenzie

6/24/09 Update

Britney has been responding more and more. She was blinking her eyes throughout the night, and has swallowed several times today. John and Mom spend a lot of time talking to her this morning. Mom spend a good ten minutes talking to her, and saw tears well up in the corners of her eyes. The vascular surgeon has asked the family to talk to Britney a lot, because she will remember some of it and it may help her wake up. We and the medical staff talk to her about everything. They kids love to read her stories and talk to her. I put on her favorite movie, pride and prejudice for her today also.

The vascular surgeon is very very pleased with her feet. The left foot will be fine and the right foot may only lose a couple of toes.

We also just want to provide her with as much emotion comfort as we can. Yesterday afternoon, they calmed Britney down with more sedation because she continued breathing against the ventilator. Her heart is working so well, they may need to decrease her blood pressure to make her heart take a rest and allow the ECMO to do the work.

Vera Update
She took a 3 hour nap yesterday, then was able to go swimming with the Jones family and her dad. Vera slept here at the hospital all night, so she could be close to her mommy. She read her stories until 10pm and then watched her barbie movie. She feels much better this morning.

Thank you for all of your incredible support. We love all of you.

Just one more quick update. I just talked to the infectious disease team and they said if her OB had not given her the right antibiotic by chance (she is penicillin allergic) she would not be here today to continue fighting. There are many series of events like this that have kept Britney fighting.

Love you all,
John

A Sincere Thank You

We are overwhelmed with gratitude by all of your prayers, your support, and all the hands being offered to lighten our burden. Our family would sincerely like to thank everyone who is offering up their homes, giving rides from the airport, delivering meals, donating funds, bringing toys for the kids, sending words of love and encouragement...our list goes on. Your generosity is making this whole experience much easier on our family and bringing us a lot of much needed comfort. Thank you again!

Sincerely,
Our whole family

Britney Swallowed

Just a quick update. When I told Britney I loved her about and hour ago she swallowed. A tear rolled down her eye. It could have been coincidence because they have been giving her eye drops. The fluid is coming off her face and she is looking much more like herself.

Photo of the Day

Photo of the Day.
Here is Vera. She is having a hard time today. Please say a prayer for her. She has been reading her mom stories.

6/23/09 Update

6/23/09
Britney had a great night last night. She had a chest wash out which is common for any one with their chest open. Clotting is common if there is not constant drainage from chest tubes. After the clots were removed and a pnemuothorax (air in the chest cavity compressing the lung) was drained with a chest tube her heart began pumping above the ECMO which is an amazing sign. The blood flow to her feet hands and face improved greatly. Her left foot has normal color now and the right foot is looking much better also. She had a pain response during the surgery and blinked her eyes 20x. She was very stable overnight. They continue to give her blood because the heparin from the ECMO is causing some small bleeding from all of her surgical sites but this is controllable.

I have been a blood donor for 4 years since going to medical school. It is an incredible way to give back. So many people ask what they can do. Give blood locally where ever you are.

Kids update
Jonas is doing much better today. One of the childlife specialists helped him get his feelings out over a game of air hockey, and his friend Isaac who moved to Phoenix last year from Milwaukee was able to come down and suprise him. Today Vera is sad and acting out but we are getting through it. She thought that since mommy looked more like herself last night she would be awake and was angry she wasn't.

Thank you everyone for your love and prayers. We have incredible family and friends. The Emergency Medicine program here has quickly become our family and along with people from our church have taken us in and we will love them forever.
I'll post another update later today and a story of what happened for all of the people I have not been able to explain how she got sick and the series of miracles that has kept her alive and with the chance of recovery.
John