Paul: 2/23 Morning Report

UPDATE:

Paul had another good night!  

BP: his BP is 112/75 and holding on its own - all pressers are off!!  Praise God!

Kidneys:  Creatnine down to 4.5. Still no urine. They will start pulling 50mL/hr. If he tolerates that, they will go up to 100mL/hr.  Praise God!

Liver:  still elevated but improving. 

Lungs:  the pulmonologist hasn't been in yet. We believe he will start dropping the PEEP down and then the oxygen. They kept that stable last night as they worked on the BP. 

Skin: his rashes seem to be improving. I did read he may slough off a lot of skin - even in places where the rash wasn't. Something to watch for. 

Things to watch:

Platelets:  his platelets continue to go down slowly. They are down to 31. They really should be above 150. Please pray that Paul's platelet count increases and he has no active bleeds while they are rising!

Paul:  I still haven't seen his eyes. I have seen him "wake up" and he is very agitated. I would be too with all of these lines, machines, and especially the tubes in his nose & mouth. That said, I know he is in there & he is coming back to us!

Please continue your prayers!  Today, we need platelets to rise, no active bleeds, and Paul to tolerate the dialysis pull to help his kidneys turn back on. 

God is moving mountains and you are all helping!  We cannot thank you enough!!

Paul: 2/22 Evening

UPDATE:  I had to send one additional update tonight. Two things:

1-the nurse came rushing down to the waiting room before the end of shift change to tell us the new room rules because - Paul is waking up!!!  

While we still have a long road, this is great news!  He opened his eyes and was moving around.  That said, he still has lots of healing to do. He needs to rest to let the meds work and help his body get stronger. So, while I cannot wait to look into his handsome eyes, I need to be patient and let him heal. 

That brings me to update #2. 

I passed the intern who was with me the first night we were here. He stopped and said - "your husband - he is a miracle!"  AMEN!  I thanked him for all they did for Paul. And he said - "God needs thanks for that!"  I agreed and said "Yes!  And, you all made sure the medicine was on board so God could do the work."  

PRAISE GOD!!!  

While I know we still have a long road with ups and downs - progress & setbacks - God continues to provide very clear signs that He is here and He is providing!  Hallelujah & AMEN!

Paul: 2/22 - Afternoon

UPDATE:
Today has been a day full of progression.

BP:  Paul is down to 4mcg/minute of one presser & his blood pressure is stable.  They will hope to stop that tonight.  The goal was to get these down today, and we might be off of all BP help - AMEN!  BP is pretty stable at 100/70 and pulse is down to 82.

Kidney:  Creatnine was down to 5.01 this morning from 7.5 at it's high.  Labs are only pulled once per day, so we will need to wait until tomorrow to see what that looks like.  Good news is that once the BP meds are off, they can start pulling off extra fluid via dialysis.  The doctor said he has about 20L of extra fluid now, and they will only pull 1-2L per day.  So, this will take some time - and they cannot start until we are sure his body can handle it.

Lungs:  The have kept him at 50% and the PEEP was down to 8 (from 14).  He was tolerating that well and was maintaining at 97 - AMEN!  The goal is to get the PEEP down to 5 and then start dropping the oxygen help to 30%.

Skin:  The rash on his back is improving which is a true answer to specific prayers.  He had other spots of rash around his body, so those are starting to peel / slough like his back.  They are watching those and taking care of them when they do.

Paul:  He is resting comfortably, and he sometimes makes extra movements to let us know he is in there.  He moves eyebrows and squeezes his eyes shut.  He hasn't opened his eyes since Friday, but I know he is still in there.  He has moved his toes & thumb (for those of you who knew Grandpa Muszik - he definitely gave us the thumb :)).  And, when they were moving him the last time, it seemed like he was trying to use his legs to help.

Kids:  The kids have been doing well while we had a houseful to keep them busy.  This next week will be a true test.  While they are used to me traveling for work, their dad is always with them.  So, knowing that Paul is here, I am worried about them.  Please pray for God to protect their minds & hearts.

Home:  Thank you to everyone for your prayers, support and offers to help.  We are starting to get the house needs figured out.  We will get something out soon, and truly appreciate the offers / willingness to help.

Paul: 2/22 - Morning

9:39am
Jennifer Muszik UPDATE: Paul made more improvements last night. Here are some of the numbers:
BP - He is down to only 2 BP meds and the 2nd one is half of what it was last night. They will pull both of those off together, so the goal today is getting him off those and allowing his body to do this work.
Kidneys - The dialysis has helped the ph in his blood. He is no longer considered acidotic & his creatnine is down to 5.01- Praise God!
Liver - Those numbers, while still not good, are also improving.
Lungs - He is down to 50% oxygen with PEEP still at 14 and blood gases look good. They will start to lower that PEEP today and see if we can get to the goal of 30% with PEEP below 5 in the next few days
Rash - His rash looks like it is getting better. There is still open skin that is weeping, so we need to keep an eye on that both for infections and pressure, but God answered those specific prayers.

New Concerns:
Platelets - his platelets are really low. This is concerning because that is how he would clot if there is an active bleed. While they don't see any active bleeds right now, they are making decisions on what to do about that

Ultrasound Results - there is an abscess in his abdomen with fluid. They would really like to get a CT Scan to see more before making any decisions, but he is not stable enough to get that. And, since the antibiotics seems to be working, they are likely going to wait another day or so to get that done.

Paul is in there. When I was talking with him this morning, he was moving his eyebrows and moving his thumb. I am trying to help him understand that his body still works, but the medicines are slowing his ability to move it. I know he is scared and I continue to try to talk with him through the process. To let him know the next steps, what is happening, and that we are all here - both in person, and all around the world, praying for him.

Please continue to pray! I don't know if I have said this in the past, but Paul is still on life support. Without all of the interventions right now, he would not be here. So, while I talk about the improvements, because that keeps us positive, he is no where near out of the woods yet. This will be a weeks - months process. The good news about that is - just yesterday - we were talking about getting through minutes & hours. We weren't talking about longer term plans and complications because we didn't know we would have that much time. Your prayers are working. Please know how much we all appreciate them. And, we will keep you updated.

Much Love & Many thanks to everyone!!!

Paul: 2/21

8:14am
Jennifer Muszik UPDATE:
He had a good night.

The dialysis is working. They are able to pull the fluids they are giving him. Plus, they were able to take off 1 blood pressure med and his BP is holding strong.

The first creatinine (kidney function) reading after starting dialysis showed improvement - from 7.5 to 6.5. The goal is back around 1.

His oxygen level has increased to 107 so they were able to bring his oxygen percent back down to 80% but still needing lots of help expanding his lungs. Yesterday, it had dropped to 54, so they had to up his oxygen to 100% and increase the pressure to open his lungs.

Our next concern is the rash. The one on his back is starting to slough off. They will switch his bed to make it easier to watch & clean. The two worries with this are infection and the potential fluid loss. This can affect his blood pressure so having the one presser completely off gives us room to add it if needed.

They will wake him up a bit today to ensure he can wake up and then put him back to sleep. I have asked to be in there to see his eyes.

I appreciate the prayers for all of the family. We all did sleep a bit & they kept him alive and some small improvements.

I'll send more when I know. Thank you for continued prayers.

2:22pm

Jennifer Muszik UPDATE: Paul is still resting comfortably. That is my new way of saying sedated. When I spoke to him earlier, he moved his eyebrows and tried to blink. I know he is in there and he can hear me. But, we need him to rest so his body can heal.

Kidneys - dialysis is seeming to work. His creatinine is lowered. His is still a little too acidic, but that is also moving in the right direction. They are also removing all of the fluid they are putting in which is good news. I promised him no pictures so I will not post any. Just know that this is a great thing.

Lungs - he is back down to 65% oxygen. His blood oxygen level was back up to 99%. They will try to get him down to 50% before lowering the PEEP (the pressure to fill his lungs)

Cultures - blood cultures haven't shown anything. Infectious disease doctor says it's because the toxins made by the bacteria were the cause of this - not the bacteria itself. He is going to do another type of test to see if they can find more out.

Liver - still no good news there. But, it doesn't seem to have gotten worse.

Skin - his skin is our next challenge. It is starting to slough off where the rashes were. That causes two potential problems - infection and due to the fluid loss, blood pressure challenges.

Which brings me to the better news for the day. He was on four pressers to keep his BP up. He is completely off of one and down to about half of another. That is good news both for his heart and so that if he needs help, we have room to add if needed.

I'm holding his hand and telling him all about your love prayers & support. Please keep it up! We still need them.

 

5:39pm

Jennifer Muszik UPDATE: Paul is still resting comfortably.

BP: His BP is holding strong and is now only on 2 BP meds. They will start to lower another one slowly to see what he can handle. They are going slow which is good for me.

Lungs: he is down to needing only 60% oxygen with his oxygen level staying around 97. Talked with pulmonology resident and learned a lot about the numbers on the screen. So far, those look good. Goal is to get to 50 to start dropping the PEEP (pressure). It's at 14. They don't like to go above 18, so it's pretty high. Goal there would be down to 5.

Temp: holding at 99.7 without any meds. That is good because they really don't want to add anymore to the liver.

Next Update - they are currently doing an ultrasound of all of his organs. That information will be sent to a radiologist to read and send a report. Will be a while for that to come.

Overall, we have seen some positive steps today. This will be a many week / several month process, but our focus is on getting him better and bringing him home.

 

5:46pm

Jennifer Muszik KIDS: I also had the opportunity to go home & see the kids today. LoraLee - thank you for your guidance & support with this. Noah & Sarah know that daddy is still sick, but he is at the place where people go to try to get better. That the doctors are doing their best and daddy can use their prayers. Noah did ask how long until daddy can come home and I told him I'm not sure. I don't want to promise something I can't guarantee. And, while I 1 Million% believe Paul is coming home with me, I want to be very cautious about making a promise to the kids.

Paulie was a little different story. I talked with him one-on-one to let him know that daddy was really sick and needed lots of prayers. He knows that it will be quite some time before daddy could get better. He also knows that some kids at school might ask him - and just to remember that means their family is praying for daddy.

We will need to work on what our new normal will be for them. And, thank you all for your offer to help / support. I'm not sure what that looks like today, but I know we are going to need it

 

10:54pm

Jennifer Muszik UPDATE: Paul has had a good day today. The goal today was to stay stable. He did better than that.

BP - down to 2 pressers from 4 with a stable BP. They will slowly titrate another one down and help Paul do the work.

Oxygen - vent is down to 55%. PEEP still at 14.

They are moving him to an "air bed" to help give more air to the wound. They will lift his sheet up, pull one bed out & push the new one in place and then lower him down. Because of that, they didn't want to move anything until he is resettles in his new bed.

They will pull more labs soon. Those results and ultrasound results should be here in the morning.

Goal is to get him settled & keep stable (well, critical but stable) through the night. Praying for that.

Thank you all for your prayers! While we are not out of the woods, each day gets us closer to it.

Paul: 2/19-20

February 19th - 10:48pm
Jennifer Muszik He is vented & sedated. His kidneys aren't working and his body is in shock. Please keep praying! We need it!

February 20th - 5:38am
Jennifer Muszik Paul is in multi-organ failure. Trying to keep him stable for the antibiotics to work so that his systems can turn back on. Please continue to pray!

February 20th - 10:49am
Jennifer Muszik Thank you everyone! Please keep them coming. He is running 104.4 fever and they know they need to start dialysis sometime soon. Radiology coming up to place port. Keeping him sedated. He looks more comfortable than before.

February 20th - 11:11am
Jennifer Muszik We are at St Vincent on 86th. Right now, we have lots of family in town both here & with the kids. Thanks so much for all your prayers. God's got this-but the extra encouragement is truly appreciated!

February 20th - 7:10pm
Jennifer Muszik UPDATE: He has gotten better throughout the day. His temp is down and his blood pressure is better (with lots of medicine help). His kidneys are still not working - may start dialysis tomorrow. Port is already placed for that.

They are also worried about his lungs as the next organ to fail.

Please keep praying. While he has improved some, his still has a long road to recovery. And, we are only focused on recovery.
February 20th - 9:40pm
Jennifer Muszik UPDATE: Paul's lungs have started to become impaired. Looks like the starting of Adult Respiratory Distress Syndrome. This was somewhat expected.

They also believe it is time to start dialysis. They will start that tonight.

Please pray that he handles the transition to the dialysis. 
Please pray that his pressure stabilizes and they can pull off some of this fluid. 
Please pray that the lung damage that we see is as minimal as possible. And please pray for his liver. They are seeing signs of failure there which might challenge their ability to keep Paul sedated and calm. Please pray he can stay sedated and calm.

February 20th - 10:47pm

Jennifer Muszik Starting dialysis

February 20th - 11:02pm
Jennifer Muszik Transition to dialysis went well. He will be on a slow, continuous dialysis

Oxygen levels are low - too low. So, they did all they can with the vent and will be starting protocol for Adult Respiratory Distress Syndrome. Will send note when I learn more.

 February 20th - 11:13pm
 Jennifer Muszik Please keep praying. They are working

February 20th - 11:45pm
 Jennifer Muszik Chest X-ray was better than expected. Still not great but better than they thought.
Still not getting great oxygen. Upped vent and waiting 1 hour.
  

Paul - How it all started...

Many have been asking how this all started.  And, since we were so focused on getting through the next second, minute, hour - it was hard to go back and share all of this because we were focused & praying on getting that next second, minute, hour...

Here is what we know:
Late last week - Wednesday - Friday (2/11-13), Paul felt like he might be coming down with something.  He wasn't bad, just a cold or something. 

Saturday (2/14) - Paul played basketball in the morning and came home with significant pain in his back - upper left side.  When he lifted his shirt, it looked like someone slapped him or elbowed him - red & a little swollen. 

That said, he felt good enough to go to dinner that night.

Sunday (2/15) - Toward the end of the evening, Paul started to get the sweats / chills.  He was also starting to get an all-over pain. 

Monday (2/16) - The pain was getting worse.  We saw the doctor at 2pm who diagnosed him with shingles.  They started him on steriods, anti-virals, and pain meds.  They said it would take 2-3 days to truly feel better.

Tuesday - Wednesday (2/17-18) - Paul would have bouts of feeling better & feeling worse.  It was tough for him to sleep - he was still feeling hot flashes / cold chills.  Based on the side effects of all the medicines he was on, we believed that to be the cause.

Thursday (2/19) - Paul said he was feeling better that morning.  I had a meeting away from the home, and this was suppose to be the 48-72 hours where he would feel better from the shingles.  He told me to go to my meeting & he would be fine.  That was 9am.

At 12pm, I received a call / text from both Paul & his mom.  Paul was throwing up, light headed, and a rash had now started in other parts of his body.  I rushed home & called the doctors office on the way.

Upon arriving home, I saw the rash and put Paul in the car and went to the Urgent Care.  On the phone, they said it was likely a reaction to the steroid, but this didn't look like a reaction.  Paul's fingers & toes were cold and blue, his breathing was labored and his heart rate was low.

It was there they called the ambulance, and took him to the ER.

I had the two little ones with me and needed to get Paulie off of the bus, so Paul was sent - alone - to the ER.  He had his phone and was texting me the entire time:
What meds was I on?
BP 66/40
ICU - asked if I want to be intubated if lungs fail

I am so sad he had to deal with this on his own.  He was hearing words that he hasn't heard before.  And, neither of us knew how sick he was.  I never wanted him to ever deal with any of this - especially not alone!

When I got to the ER, they wouldn't let me see him.  They were putting in a central line for antibiotics and a line in each arm.  He was terrified.  We got him up to the ICU and were talking for a short time before shift change - and they don't allow family during shift change. 

Just before they kicked me out, the pulmonologist said he wanted Paul to get a vent.  Paul was scared, but based on the doctor's tone & facial expression, I knew it was the right thing to do.  I told Paul that was what he needed - Praise God for that decision!

Before I left, Paul told me that he was scared and that he would be waiting for me in Heaven...

When I got back with Paul's parents, Paul was in a fight for his life, but we really didn't quite know it yet.  His body was toxic all over, but no one had much to say to us.  So much that I sent his parents home and said I would be here and see them in the morning. 

Just before 2am, the doctors were making some additional changes so I needed to leave the room again.  When they came to get me, they told me it was time to call in the family.  Paul was decompensating fast.  They had done all they could medically - now it was up to Paul's body to fight this. 

At that time, I sent a text & a message on FaceBook for everyone to pray.  What is amazing to me is how many people were up and sending prayers!  And, I had told the rest of our family to stay home because I didn't think it was going to be that bad.  No one listened, and right when I needed strength the most, God provided through family and friends.  We had a priest and a minister in the room with all of us praying for him right when he needed it the most. 

Then - we needed to wait.  We watched numbers and prayed for improvement.  Every minute / hour was important.  We saw small improvements, praised God, and asked for more.  He provided!

Father,

I know you did not give this infection to Paul.  I know this was not part of Your plan.  And, I know You will see us through this.

While we do not know Your plan, I am PRAYING BOLDLY that Your plan is to have Paul and I walking hand in hand out of this hospital together.  Paul will be healthy and home with our family. 

You have moved mountains.  You have parted seas.  You have healed the sick - and have gotten Paul to this point.  He is still so very sick, and I pray for Your healing!

Please be with the doctors.  Help them see what is invisible to others.  Help them to ask the right questions, draw the right labs, and make the right decisions.  Help them to do what is medically necessary to allow Your Great Work to be seen by all.

In Jesus' Name,

AMEN!