Friday, July 31, 2009

Kindred Hospital is going well

Hi everyone,
Britney had a really good night. She was flexing her arms up to her face again and almost pulled off the ventilator tubing multiple times. The people at Kindred are great. The Dr. who took care of her at TMC in the ICU back when she first got sick came to Kindred to take care of her. His group comes there also. He told everyone in his group that he wanted to come take care of her. It totally made my day. He was instrumental in saving her life has been following along on the blog for the past 6 weeks. Thanks Dr. Toiber. Talk to you soon.
John

Thursday, July 30, 2009

Britney is going to the acute rehab hospital in a few hours. We are really excited. She moved so much yesterday she is very tired today. Yesterday also after I posted Britney lifted her head and arms off the pillows and opened her mouth like she was trying to say something but couldn't. Her trach makes all the air go out below her vocal cords so she can't make any noise. When she couldn't get a sound out she started to cry. I talked to her and stroked her hair and she calmed down. This happened about 10X yesterday. She is in there still and coming back to us.

Wednesday, July 29, 2009

More movements

I just got back from the hospital and wanted to give an additional update for the evening. Britney was getting some gases building up in her stomach, so they took her off the feeding tube tonight. She seemed very awake and full of movement most likely due to the discomfort in her stomach. She was far more active than Jessah or I have ever seen! With a lot of effort she managed to move both her hands from down at her sides to up near her face. She was even pivoting one of her wrists quite a bit. I thought I caught her staring at her hands, but wasn't sure if it was on purpose. A minute or two later I asked her to look at the green grip in her hand to see if she'd do it again. She couldn't seem to, so I asked her to follow my hand to try and lead her eyes back to the grip. She did it perfectly! For the next forty five minutes or so, Britney continued moving her hands around a ton and once accidentally disconnected her ventilator tube. She also stared at her hands again, that time without any coaxing. Eventually, her heart rate rose some and she became shakey and tense from exerting herself too much. She kept trying to lift her head off the pillow and was acting like she still had stomach pains. The nurse gave her some pain medication to calm her back down and within a few minutes she was breathing at a good pace and fell asleep. Have a good night everyone!

-Kenzie
Britney just moved both of her legs. She hasn't moved them since she has been off ECMO. There was a CT scan about that time that had showed a possible stroke in the leg territory of her brain, but now she is moving them!!!. Arielle stayed the night at the hospital last night and also saw her move her toes!!!!!!! Arielle read to her a lot yesterday and she looked at her and stayed awake the whole time she was reading to her. She also saw her smile when Arielle was singing to her last night.

Tuesday, July 28, 2009

Britney opened her eyes and looked at Anna when Anna smiled and cooed at her. She had another great day. I met with the people from Kindred hospital and went on a tour today with all the kids and Britney's sisters. It seems like a great place. They have a great staff with a lot of experience in critical care. They have lots of physical and occupational therapy. They said they can take Britney even with the chest tubes in. Britney may go there in the next few days.

Monday, July 27, 2009

Britney's feeding tube got put in today. It went really well. They used a camera in the stomach to shine a light on her abdomen so they could do it in her room. With the camera they saw her whole stomach and the beginning of her small intestine and it didn't have any ulcers. Lots of ICU patients commonly have ulcers from being bed ridden and sick for so long. Me and Jonas spent the day at the hospital. We read to her a lot and she opened her eyes every time we read to her. When her nurse was cleaning Britney's mouth Jonas told her it was ok and told her to open her mouth and she did. She was breathing fast in the afternoon and had to go back on the ventilator for a rest.

Sunday, July 26, 2009

Britney had another really good day. She has been moving and tracking (following people with her eyes) a lot more. She heard Anna crying today and started moving alot. When I brought Anna to her Britney calmed down. I brought Anna to her and Britney calmed down and layed back down. The doctors and nurses are excited about the progress she is making. She is going to get a feeding tube tomorrow that will be put in her stomach from the outside. She has had a naso gastric (nose stomach) feeding tube for almost 3 weeks now, and needs something more permnant that wont irritate her nose. Medically she is doing very very well. One of her chest tubes got taken out today. Her air leak is almost better and she may get off all of her chest tubes in the next few days and not need any more surgery. She has been breathing great on her own during the day and resting on the ventilator at night. She will likely be going to Kindred hospital an acute rehab hospital that is much closer to our house in a few days.

Saturday, July 25, 2009

Vera read Britney a book today and she started moving her arms a lot. Vera was really excited. I told her that she could help wake Britney up if she talked to her and read to her. She has been looking at us a lot more today. She has been doing great without the ventilator during the day and being back on it at night to rest. Vera had a great birthday. We went to a swimming party, and she opened her presents from family in the morning. She put a barbie wig on Anna and Anna liked it.

Friday, July 24, 2009

Britney slept for a lot of the day, but opened her eyes and looked at me when I read to her and when her sister Mckenzie talked to her a lot this afternoon. She had a fever overnight and this morning but was out of it this evening. She will probably go to rehab next week.

Thursday, July 23, 2009

Anna Learns Piano

video
Britney has been breathing on her own for most of the day. She has been really relaxed. I was talking about our kids to one of the RTs and she saw Britney smile. I showed Britney the picture of our family we have in her room and I saw her smile again. She turned her eyes toward the phone when her dad was talking to her on speaker tonight also. When we were talking about her how I asked her to squeeze my hand and I thought she did but wasn't sure she picked her head and arm off the pillow. She put her head down when I told her I believed she could hear me. She didn't squeeze my hand again or close her eyes when I asked her after that. I really don't think it was concindence at all. I'll give you all a update in the morning.
John

Wednesday, July 22, 2009

Breathing on her own all day

Britney was breathing on her own with just oxygen over her trach for 12 and 1/2 hours today. The more she breathes on her own the faster the air leak in her left lung will heal. She did amazing. Her oxygen saturations stayed near 100% all day. She got really tired near the end and got put back on pressure support ventilator for the night to rest. She fell asleep soon after they put her back on it. She was looking the other way when I said hi to her last night. She moved her eyes and looked at me, and I put my ear phones in one of her ears and she moved her eyes all the way to the side where the ear phone was put in. She moved her hands (mostly her left) all day, and has been opening her mouth for the nurses most of the time.

Kids update.
3 of Britney's sisters are here for the next 2 weeks. Mckenzie, Jessah, and Arielle. The kids are having a blast with them. They have been playing with some friends a few days a week. They went swimming today at our pool and had a great time. Vera is turning 3 on Saturday and is really excited. Anna is 15 weeks old and is growing a ton. She is a really easy baby. Vera was too until she could roll then she rolled around the house following Britney everywhere, and pulling things off shelves. We'll see what Anna does. Jonas has been having a harder time the last few days and has need a lot of one on one time. Yesterday he stayed with me at the hospital and played games with me. Tonight he read me a chapter of one of his books.
T

Tuesday, July 21, 2009

Surgery went well

Britney's surgery went well. She was very stable during the surgery. There was a lot of scar tissue around her left lung and a lot of blood clot at the top of the left lung also. When the clot was removed an air leak was found. Dr. Smith made a pleural tent (used the lining of the lung to try and cover up the air leak). It may work. She said that they will see how her lung expands and to a functional scan (ventilation and perfusion) to see what parts of her left lung are exchanging oxygen. She didn't end up having a feeding tube put in today and will get one in the next few days. During surgery they also did a bronchoscopy ( a camera in her lungs) and found the pneumonia is resolved, but took samples of the mucus in her lungs anyway. She's back on the ventilator until they wean her off it again because of the anesthetic and paralytics used for the surgery. Thanks for all your extra thoughts, concern, and prayers today.
John

Monday, July 20, 2009

Surgery Tuesday

Britney is going to have surgery tomorrow to have the scar tissue around her left lung taken off so her left lung can expand more. Right now she is breathing on her own without the ventilator and is doing very well with it. She is doing so well they are talking about getting her to a rehab facility in a week or two. Talk to everyone soon.
John

Sunday, July 19, 2009

Another good day

Hi everyone. I hope you all have had a good weekend. Britney continues to move her arms a lot. She has lifted her elbow off the bed multiple times. She followed me with her eyes when I talked to her. She has been picking up her head off the pillow a lot also. She does these things intermittently throughout the day and has been more sleepy at night. Her responsiveness comes and goes. We have had amazing nurses. Her nurse today told us that she has had many amazing experiences with patients who have been on ECMO who have recovered. Many have taken months to be ready to go to a rehab hospital. She is most likely having her lung surgery on Tuesday to take off the scaring on the outside of her left lung so it can expand more. Kids update: The kids had a great day playing at a friends house. Vera is having a hard time understanding why Britney isn't up talking to her yet if she is still alive. We have to reexplain things everytime we take her to see Britney. She gets really excited about every little movement Britney makes. Anna is growing like crazy. She kept me up half the night last night. I think she hit a growth spurt because she is eating a ton more and waking up more. She had some rice cereal today and gobbled it down. Hopefully she will sleep more tonight. She is staying the night at a friends house so we can get caught up on sleep. I'll post again tomorrow to let you know when the surgery will be.
John

Saturday, July 18, 2009

Britney has had a great day. She has done more and more throughout the day. She was asleep tonight and I had her aunt Jan talk to her on the phone then she opened her eyes a little, held up her head, and L arm off the pillow, turned her head and moved her other arm all the time her aunt talked to her. After she was done Britney went back to sleep. She has picked her head up off the pillow a lot today and her left arm too. She has been following us better with her eyes also. She is still in there trying to wake up all the way. Have a good night.
John
Britney is moving more and more. She has been moving her head in different directions, yawning, moving her hands, and following us more and more with her eyes. I have lots of her family and friends call and talk to her on speaker phone. She has been turning her eyes towards the phone a lot today. Yesterday there was a box dropped down the hallway and her whole body jumped. It happened again when her mom coughed in the room. The nursing staff has been taking amazing care of her. They have been talking to her, moving all of her arms and legs to keep them loose. We have been massaging her hands and feet. Everyone I have talked to says the people they have seen come back from coma's have started doing little movements, and moving eyes more. This happened to my sister in law and to one of Britney's extended family members. I talked to her CT surgeon today and her pneumothorax (air leak) in her right chest is gone. Her pneumonia is healing very well and there is no evidence of clots in her lungs any more. She has a fibrous layer around her left lung that is constricting it. On Monday she will probably have that taken off with a video assisted surgery. She is completely off of dialysis also. Have a great day.
John

Friday, July 17, 2009

More movement

Hi everyone. Britney continues to improve and show us she is still there. She has been opening her mouth for the nurses. She has been tracking (moving her eyes to follow people and objects). She was turned on her side a few days ago and her hand fell off the pillow, she lifted her hand and put it back on the pillow. These episodes don't happen constantly but are increasing in frequency. Her kidney's are almost better and she might not need any more dialysis. Her lungs continue to improve, but she still might need an air leak in her right bronchus (the air pipe in the right lung) patched, and some of the blood clot removed in her left lung. There is a tentative plan to do this Monday. She is still having some fevers. Her doctors think it may be from the fungal UTI she still has because the only antifungal that works against the type of UTI she has doesn't get into the bladder very well. Also she is still fighting her pneumonia. They more blood and urine cultures everythime she gets fevers and so far nothing has grown from her blood cultures. Everytime I lose hope for her to get better I feel an incredible amount of peace that everything will be ok and that she will come back. I wish I could see into the future at least a few weeks or months and see what will happen. It's hard to be patient. Thank you for all of your continuing support, kindness, prayers. Don't lose hope. She continues to get better. I constantly hear stories of impossible situations where people have gotten better and come back to their families and lives. Have a good day.
John

Wednesday, July 15, 2009

Britney had another really good day. Her kidneys are continuing to get better. She had another CT scan of her chest abdomen and pelvis. Her pneumothorax on her right side is almost gone as they have repositioned the chest tube. Her left lung pneumonia is healing much faster than expected. She may or may not need the clot in her left lungs removed to heal completely. Have a good night everyone.
John

Trust Fund

We have had many requests, by people wanting to donate money, to open a trust fund for Britney and her family. Reluctantly John has agreed to open a fund. We don’t want anyone to feel obligated to donate. We have been helped in so many ways and we could never express how grateful we are to everyone who has helped us during this time. We appreciate EVERYTHING that you have done for us.

 

We would like to thank all of you for your thoughtfulness, prayers, help with the kids, words of comfort, offering your homes to us, meals, and rides to and from the airport. We are grateful to those who have made it possible for us to spend time away from our homes and jobs to be with Britney and to care for her kids. Thank you to those who are assisting John to help him keep up with residency. To the doctors who have used their skills and knowledge to make the best decisions for Britney, and the nurses who tirelessly care for her and are willing to answer all of our questions. To those who have already made donations and all who are simply thinking about us and letting us know you are there for us. We could never list all of the ways you have helped. What a difference each of you have made. You have been the hands of the Lord to bless us and help us through this.

 

For those who wish to donate:

The title of the trust fund is “For The Benefit Of Britney.”

You may donate at any Chase bank.

Bring account number #815195532 with you.

Make all donations to John Winkler. (We are unable to put Britney’s name on the account because she cannot be there in person)

Donations can be made using check or cash.

All donations are anonymous.


Sincere Thanks, 

Carlie

Tuesday, July 14, 2009

Britney had another very restful day. She tried breathing on her own with only oxygen this morning and did very well with it but is not ready to be off the CPAP assisted ventilator yet. She continues to move her arms a lot, and to track a little with her eyes. Casey went home today. He was very sad to leave. He has been an amazing friend. We have become very close through these past few weeks. Britney's mom is trying to get on another flight tonight because the other one was canceled. Her aunt made it here this morning after 3 days of flying stand by through about 10 cities. The kids are doing really well being at home on a schedule and playing with other kids. It's amazing how resilient they are. Have a great night.
John

Another good day

Britney moved her arms very purposefully today multiple times. She looked at me when I talked to her tonight after I got off my shift. She has been breathing on her own with a CPAP ventilator for almost 2 days now. Her kidneys are starting to work again on their own. Her left lung is still clearing on it's own. Her heart rate has been very normal for the most part. I had a great 1st shift today, and really fun ultrasound training. Talk to you soon.
John

Sunday, July 12, 2009

No surgery tomorrow doing better

Britney is having a very good day. Her pain is very well controlled with a small amount of pain medicine. She has been awake sometimes looking around. She followed her sister Arielle's finger around with her eyes. She also was switched to a new ventilator that allows her to breath on her own and give breaths as needed. It also has some pressure support like CPAP to keep her airway open. Her left lung is beginning to clear on its own, and they are readjusting the chest tube on the right side to take care of her pneumothorax. Today was such a amazing day for her. Thank you for all of your prayers and thoughts and support.
John

Hospital Photos


These are a couple photos that I took of the kids at the hospital while I was visiting Britney about two weeks ago. I thought everyone might like to see them.

Carlie

Saturday, July 11, 2009

Britney has been much more comfortable since last night when with a lot of help we found a oral surgeon who has hospital privileges. He took out 6 of her teeth, numbed her mouth very well, and took a lot of time cleaning up her mouth and lips. She has been very peaceful since then and has not required much pain medication to stay comfortable. She was calm and peaceful all last night and today. Her eyes have been open and looking around. She looks beautiful. Close to her normal self which is incredible from how in pain and damaged her mouth and teeth looked yesterday. I went to our Intern retreat yesterday on Mt. Lemmon and had an awesome time. I tried to come back last night but we had a giant hail storm right before night fall and I didn't want to drive down it in the dark. I took the kids up there today and they had a blast. Vera has made a great friend. One of the other Interns has a 4 year old daughter and they are almost inseparable when we get together as a class. We still have a lot of peace and hope that everything will be ok. It is incredible the stories people have told me and keep on telling me of family members or friends who were in a similar situation and have made it back to their families. Thanks everyone for your incredible support.
John

Friday, July 10, 2009

Britney had a good night

Britney's pain was controlled the whole night. Her hemoglobin and hematocrit have been stable for 36 hours and she hasn't needed any blood. She has been very peaceful since her pain medication was increased. We pray for her body to heal over the weekend so she can be ready for her surgery monday.

Thursday, July 9, 2009

Britney had a very hard night and day today. Her blood counts dropped a lot last night. They thought it was a GI bleed but the GI doctors didn't think so. Luckily with 3 units of blood overnight she was stable and kept her blood counts stable all night and day. She was taken off all sedation and pain medication all night and morning for the neurologist to come. She was in excruciating pain when she tightened her mouth because of her teeth or when they repositioned her. She looked at me many times. We have seen many movements we have put in our blog that seem very purposeful to us. Neurology came by at 9:00am and told me they are signing off because they do not see any purposeful movements. They have only been by 2-3X in the past week for about 5-10 minutes per visit. I told them what they see is only a snapshot in time. They were very abrupt, and stated her chances without any purposeful movements is very close to zero to come back to us. It was very frustrating. I asked her primary team to keep her comfortable because they didn't need to torture her anymore for the sake of the neurologists. It still took about 4 hours to get her pain under control and to help her fall back asleep. They are trying to track down a dentist who will pull out her teeth since the other one went on vacation and didn't do a thing for her. Britney's best friend in Wisconsin's husband is a oral surgery resident and they offered to have him fly down to help her not suffer so much but he can't do anything without hospital privileges. Neither can his dad who is a oral surgeon in a different state who they also offered to fly out. She will have to suffer with her teeth until they get someone to come here. Today she also had a CT scan to look at her lungs, and the fluid collection behind her right kidney and to see if she was having any bleeding anywhere. The left lung is very infected and has a lot of blood clot keeping her from getting better. A surgery is scheduled Monday to clean out the clots in her lung and help her heal. The time until then they will work on getting her well enough for surgery. She is stable and comfortable since they got her pain under control a few hours ago. The primary team is great and said they will go all out to save her. It is way to early for us to give up on her. My sister in law survived a severe head bleed and was written off for dead many times. We don't want her to continue suffering but want to give her the chance she deserves at the same time. We have felt so much peace and hope. Ever since the night she was placed on ECMO and we thought she was gone I have such a strong thought and feeling come to my mind and heart when I start to loose hope. The story of Lazarus has popped into my mind so many times with such peace. If God wants to take her home to him I pray it will be soon and without suffering but if he wants to give her back to us I know he can. Sorry for such an emotional post. So many of you are so emotionally invested in her and our family. Despite the horrible tragedy this is to all of us we are not our tragedey's. We are filled with a peace that is well beyond us and has kept our family going. What ever the outcome of the next few weeks there will be a great life to live. She will be our angel in this life and the next. Keep praying for her to get better, and to be comfortable. Thank you for all of your love.
Have a great night,
John

Wednesday, July 8, 2009

Britney had a rough day but is doing much better tonight. She had a lot of different arrhythmias today and had to have lots of medication to help her come back into a normal rhythm. She had cardioversion pads on for a lot of the day because her heart rate was fast but never needed to have her heart shocked. Her teeth are very sore. A dentist came yesterday and looked at them. He said she would have to have her three front top teeth pulled. He didn't do it and left on vacation today so the team is trying to find someone to pull them. When we put a movie on for her this afternoon she picked her head off the pillow to look at the TV and stared at the screen for about 1 minute. She was also very awake tonight and looking all around. She looked at me for quite a while but didn't seem to be able to understand me. She is still having fevers also and is being treated for a urinary yeast infection. She had another broncoscope of her left lung today also which got out a lot of mucus. No bacteria has grown from the other two other times they took samples the past two weeks. Tomorrow will be a big day also. They are considering having her go to interventional radiology to drain a fluid collection behind her right kidney to see if it is the source of her fevers. They are also planning on taking her off all of her sedation tomorrow to see how much she wakes up. The last EEG last week showed that she was still in a metabolic coma. That means it could be from infection or her kidneys not working well, or other things. There are many reasons she has to not be fully awake yet. We are still hoping and trying to be patient. Have a good night.
John

Tuesday, July 7, 2009

Britney was opening her eyes more today. She had a CT a few days ago that showed inflammation of her intestines, and a small amount of bleeding or abscess behind one of her kidneys. She is going to have a drain put in under live X-ray later today. Thank you for all of your support. She is still very sick but overall slowly improving. It will be a bumpy road but she is headed in the right direction. Have a good day.
John

Monday, July 6, 2009

Britney had a trial without the ventilator this morning with only CPAP (she is breathing but the CPAP helps keep her airway open). She did it for about an hour!!! She also opened her eyes wide open a few times this morning and was staring at her dad and my mom before my mom went to the airport. It meant a lot to my mom to see before she left. I successfully passed my advanced pediatric life support this morning also so we are having a good day so far. Thank you all for your prayers and love.
John
John and the kids having fun with surgical masks! Jonas said he was being storm shadow (GI Joe)

Sunday, July 5, 2009

Hi everyone,
Britney had a tough day. She has been biting her tongue and lips and had to have a bite block put in. She bit it so hard she broke one of her front teeth. She is still very sleepy. The hardest thing is being patient for her to wake up. We all miss her a lot. The brief moments she opens her eyes and looks at us are wonderful but so small a part of everything we miss about her. The kids are having a great time with their aunt Jessah. My mom is going home tomorrow. She has been incredible to have here. I got through the 1st week of residency (lectures only) and was able to miss my 1st shift in the ED to be with Britney. We have the best intern class in the world. I have to go read a book to Vera now. Have a good night.
John

Saturday, July 4, 2009
















Anna doing karate


At the request of Grandma Foster or grandma LuLu as our kids love to call her here are some more pictures of anna for everyone. I haven't uploaded the latest and greatest pictures from our digital camera so these are a few months old. We will get some more up soon. Britney had a very good day. She has been awake off and on today. Her dialysis is going well. We had an awesome party for all of the new interns to meet the other residents and faculty. Everyone had a great time. It was really good to get out and have fun. The kids had a blast. Hope everyone had a great 4th.
John

Happy 4th of July.
Britney had a very good night. She was looking around a lot last night and and squeezed my hand. Have a great 4th.
John

Friday, July 3, 2009

Trach done went well.

Britney had her tracheotomy done today and it went very well. She woke up quite a bit after surgery and was pretty responsive. She is getting dialysis now. Over the next few days they will wake her up more by decreasing her sedation. This is another huge step for her because she can heal her mouth, and possible mouth words, and be able to get off the ventilator quicker.
Have a great 4th of July tomorrow everyone.
John

Thursday, July 2, 2009

Hi everyone. Britney had a great night. Today she got a dialysis catheter. She didn't start dialysis because her blood pressure was a little low this afternoon. She is doing better now though. She squoze my hand really hard today when she was having her mouth cleaned out. She looks a lot better but has been more sleepy with more pain medicine and sedation. The kids are doing great. I slept at home yesterday and they kept me up until 10:00 playing and laughing. They have been very happy being at home on a schedule. My mom has been amazing with them this past week and a half. Have a good night.
John

Wednesday, July 1, 2009

Britney had a great night and day. She got her central line changed out, and a new air bed so she doesn't get any bed sores. So far she hasn't had any which is pretty amazing. She doesn't like being moved at all and clenches her jaw and hands. She is still pretty sedated otherwise. She still tries to open her eyes whenever we talk to her. I'll post another update tomorrow.
John

Picture of the day

Hi everyone it's Jonas,
Thank you for helping us with our dinner cause our mom is sick and my dad is helping with mommy. Thank you for praying for my mommy. Thank you for watching me and Vera. We miss you.
love Jonas (Jonas told me what to write)