Update on Timna from P337 Monday 11/30/09

Timna Update Monday 11/30/2009 11:00-ish am Eastern I approached Timna's room this morning and was struck by the vision of gowns and gloves enhanced by restricted entry signs. Timna is now in contact isolation. As Timna starts her 31st day in the hospital she has been presented with the one month anniversary gift of a mutated strain of Pseudomonas aeruginosa. Gram Negative! From: http://en.wikipedia.org/wiki/Gram-negative_bacteria One of the several unique characteristics of Gram-negative bacteria is the structure of the outer membrane. The outer leaflet of the membrane comprises a complex lipopolysaccharide whose lipid portion acts as an endotoxin. If endotoxin enters the circulatory system it causes a toxic reaction with the sufferer having a high temperature and respiration rate and a low blood pressure. This may lead to endotoxic shock, which may be fatal. The drug chosen to combat this bacterium is MICROMEDIX Colistimethate Sodium. This appears to be the 500lb bomb of bacterial warfare. Just one of it's side effects is renal impairment. That means that Timna's already impaired kidneys will be impaired further by this bombshell. The doctors will talk to me later about the full situation. I feel empty. An emotionallly empty husk. This will change, of that I'm quite sure. Again, please pray. And from TWITTER: p337 As Timna starts her 31st day in the hospital she has been presented with the one month anniversary gift of a mutated strain of Pseudomonas p337 Pseudomonas aeruginosa. Gram Negative! The drug chosen to combat this bacterium is MICROMEDIX The untreated bug will kill her. p337 The treatment might kill her. p337 She's in isolation

Timna /P337 update 11/29/09 SUNDAY.

Timna Update Sunday 11/29/2009 Noon-ish Eastern The nurse put it succinctly when I asked how Timna was doing this morning, "Not so good." Timna's fever started coming back yesterday evening but was only in the 101f range. Last night it came back hard with the added complication of her blood pressure dropping as low as 64/39. They've medicated her for her blood pressure and brought it back up. Now 118/60. She's been given Tylenol for her fever and Dr. Gordon (Infectious care) has reviewed all her cultures and antibiotics. He has called for left leg wounds to be debride (surgical removal of foreign material and dead tissue from a wound in order to prevent infection and promote healing). ICU dance: One step forward, two steps back, two steps forward, one step back. Kiss your partner, dosey doe, tear out your heart and give it a throw. Our friend Brian asked some good questions that he suggested I answer for all. •Is she still on dialysis? Yes - Every two to three days as she is able. •Is she off the ventilator (entirely or partially)? No. She has been too weak with the lung infection for them to resume weaning. •Receiving IV antibiotics? Yes, a whole battery of bacterial killing drugs. •Have some of the infections cleared up? Yes, but other opportunistic bacteria have taken advantage of her weakened state. •Still receiving sedation? No. Since the trach she has been sedation free except for surgery. It's hard when every brainstorm results in a power failure. - Lee Peterman

Timna Update from P337 Saturday 11/28/09

Timna Update Saturday 11/28/2009 8:45-ish am Eastern Just a quick update. Timna has been watching the dog show all morning on Animal Planet. Her choice! No Fever. Wide awake. Talking a little with a lot of effort. She has found out how to force air past her tracheostomy tube to make sounds. So what if it upsets the respiratory specialist. She'll nod affirmative and shake her head for negative as well. It's early and the doctors haven't done rounds yet. Today I'm accepting each and every miracle of strength and healing with joy. Timna is still so sick, Please pray for more. No more setbacks, Timna. That's an order!

Timna Update Friday 11/27/09 from @P337

Timna Update Thursday 11/26/2009 5:15-ish pm Eastern WHEN IS ENOUGH, ENOUGH! Respiratory culture results: ... NUMEROUS PSEUDOMONAS AERUGINOSA SEE F43309 FOR MIC ....oh Timna......... Sealed room aerosal treatments have begun. I can't write more now. Pray. Should have read: Timna Update Friday 11/27/2009 5:15-ish pm Eastern It must have been you readers that read it wrong. Thank you all for praying. From Twitter: Friday night around 8pm Eastern: p337 Thank you all and @RealChevyyGirl & @WisSmokeFan . I'm feeling a little better now. Timna awoke for a few seconds before I left her room. p337 Leaving Hospital. Maybe I'll tweetle dum and tweetle dee a little later as TWEETLE LEE ? Hmmm... Maybe not.

Friday 11/27/09 Update from @P337 and Timna

Timna Update Friday 11/27/2009 10:15-ish am Eastern No hymn this morning. Still have an underlying joy but any hymn this morning would be in a minor key. "Man of sorrows"? (Nice that that hymn ends in joyous exaltation. Don't believe me? Google 'man of sorrows lyrics'.) Timna's fever came back yesterday evening with a vengeance. She's had the cooling blanket on all night yet her temperature is still up at 39.6c 103.3f. I passed Dr. Gordon (Infectious care) in the corridor but he hasn't been to see her yet. Timna pulled at her trach tube again, according to the respiratory specialist. They reinserted it before I arrived this morning. When I saw the nurse I asked her to restrain her again since her arm tried to pull at it again while I was sitting there. (I don't know why the restraints were removed. The trach tube being pulled and reinserted must aggravate her as well as being dangerous.) Pray that Timna's fever goes away along with the cause of it.

Thanksgiving Message from P337 and Timna

Timna Update Thursday 11/26/2009 11:15-ish am Eastern I woke up this morning with an old hymn running through my brain. I didn't mind. The lines, " Angels, descending, bring from above echoes of mercy, whispers of love." and "Watching and waiting, looking above, filled with His goodness, lost in His love." struck me with happiness as I arose. I don't think I've ever had that happen to me to such an extent before. The full lyrics: Blessed assurance, Jesus is mine! Oh, what a foretaste of glory divine! Heir of salvation, purchase of God, Born of His Spirit, washed in His blood. Refrain: This is my story, this is my song, Praising my Savior all the day long; This is my story, this is my song, Praising my Savior all the day long. Perfect submission, perfect delight, Visions of rapture now burst on my sight; Angels, descending, bring from above Echoes of mercy, whispers of love. Perfect submission, all is at rest, I in my Savior am happy and blest, Watching and waiting, looking above, Filled with His goodness, lost in His love. When I got to the hospital I found Timna with the bed in a sitting position and her watching bits of the parades between dozing bouts. The nurse said she was doing great this morning. They can't use the feeding tube for a Thanksgiving dinner since they have to wait 24 hours. She'll have to go hungry on Thanksgiving but there's so much to be thankful for. She is moving her arms a little more purposeful this morning though there are still some spastic motions. They don't have her tethered and hope she will be able to control herself. I pray for blessings on each and every one of you on this Thanksgiving day. It's hard when every brainstorm results in a power failure. - Lee Peterman

Post Surgery Update on Timna Wednesday 11/25/09

Timna Update Wednesday 11/25/2009 10:30-ish pm Eastern Timna's surgery went well according to the doctor. He decided after reviewing Timna's vitals to make the surgery as short as possible for her. That meant that instead of a laproscopic feeding tube insertion he made a small incision and inserted the tube manually. The surgery took about an hour but didn't start until after 8:00pm. Timna was still out of it when I left the hospital but her fever was gone! They said she would be out for a couple of hours but did clench her jaw when the nurse tried to get her temperature. Even asleep she has a strong will. Thanks to all for praying for her... and me.

Timna Update from @P337 Wednesday 11/25/09

Timna Update Wednesday 11/25/2009 11:00-ish am Eastern Timna is feverish again. Her temperature is 39.C 103.F. They are running cultures on everything to try to find if there is an 'untargeted' bacterial culprit. Timna is getting stronger despite her fever. Her arm and hand motions are spasmodic at times. She did manage to non-purposely grasp her trachea tube and was gasping for breath as her arm did it's own thing pulling the tube out. I was frantically trying to unwind her fingers as I called for the nurses. It only came part of the way out and respiratory was able to reset it. Her blood oxygen only dropped into the low 90's. Her arms are gently restrained now. I was able to ask her in different ways about the arm motions and she confirmed each time that she was not trying to move her arms. The nurse will make the doctor aware of this today. Timna's surgery was moved from last night to this morning. I am sitting in the surgical waiting room now. Please continue to hold Timna up in prayer before the Lord. Timna Update Wednesday 11/25/2009 1:00-ish pm Eastern After waiting a while in the surgical waiting room and not seeing Timna's surgical number go up on the status board I asked what was going on. Timna's surgery had been bumped back to 6:30 this evening by a critical surgery. I am not upset about that because if Timna's surgery was critical I would want hers to bump a non-critical one. Waiting and finding out she had already been taken back upstairs without notifying me... I'm a little upset about that. Timna is sleeping deeply -- all that travel. Gurney lag. The cooling blanket has brought her temperature down slightly but her fever probably is what has her out like a light. Please raise your hands in prayer because we all know, 'many hands make light work'.

Update from Lee and Timna Tuesday 11/24/09

Timna Update Tuesday 11/24/2009 11:30-ish am Eastern

I didn't send an update yesterday. Stop looking for it.

Timna was feverish yesterday morning and I was despondent. She would open her eyes briefly then go back to fever world.

She got dialysis yesterday.

She also got a PICC line (peripherally inserted central catheter) and they removed the central line (central venous catheter).

Yesterday afternoon her fever broke and timna became very aware and responsive. My brother was here (MI) from St. Louis and she responded very well to his stories of her nephew and niece as well as looked closely at the pictures he had on his Blackberry.

This morning I found out that Timna (awake and aware) had pulled out her feeding tube during the night... twice. I'd probably never tolerate an 'up my nose with a rubber hose' feeding tube. The feeding directly into her stomach seemed to agravate her pancreas anyway.

She will go down later today for a surgical placement of a feeding tube directly into her small bowel below her duadenum.

Weaning off the respirator continues but intermitantly since she tires and starts breathing rapidly.

She keeps pulling on her breathing tubes but not out... yet.

I am pleased (today) with the slow progress even though setbacks wrench my soul.

She just fell asleep. She needs a bit of sleep right now.

Again, thank you all.

It's hard when every brainstorm results in a power failure.

- Lee Peterman

Timna Update from @P337 Sunday 11/22/09

Timna Update Sunday 11/22/2009 10:30-ish am Eastern Timna has given me a new understanding of the term "Bedside Baptist". Actually I am at the foot of her bed since medical equipment still takes the dominant role in her daily life. She is awake at times but for only moments as fever again ravages her body and mind. I got a damp washcloth for her forehead and asked them if she could have a fan since the room is hot with the equipment and bed generating heat. The respirator is still only supporting her for 10 breathes a minute. Her actual breathing rate is between 16 and 22 breathes a minute. The reason they are trying so aggressively to wean her from the respirator is that respirator patients have a 3% per day chance of developing pneumonia. Timna has been on the respirator for about 20 days now meaning she now is more likely than not to add pneumonia to her complications. Whether you are in a pew or chair, bedside or trackside, on a green or in a sand trap, as you pray for your family, race car driver or golf shot, please remember to pray for my precious Timna. Thank you all. It's hard when every brainstorm results in a power failure. - Lee Peterman

Nascar Fantasy Crash League Rules Refresher

The Nascar Fantasy Crash League was concieved during a chat at the GSNAP.Com chat hosted by NascarByCooter during a crash filled race that was wreaking havoc on everyone's Fantasy Nascar contests.

The rules will be short and simple, we want this to be fun, and require Minumum involvement.

To best enjoy our version, you should be logged in to the NASCAR chats at GSNAP. You can get a free gsnap membership anytime by registering at http://gsnap.com . Then starting about an hour before every Sprint Cup Cars race, go back to GSNAP and follow the link to the Nascar Chat.

It's free, simple, and we have a lot of fun chatting, sometimes we even chat about the actual race. LOL.

Official Rules:
1.)Before each Nascar Sprint Cup Race post your picks by email to NascarFantasyCrashLeague

@gmail.com We will then post them on the chat site for you. If you cannot email them, make sure to post them yourself at chat before Green Flag.

If all else fails Tweet them to @WisSmokeFan.

The Picks: Pick One Driver who you think will crash first (crashes defined later) (50 pts) Note:if this driver crashes LATER it's still worth 10 pts.
Pick Five other drivers who you think may crash during the course of the race.(10 pts each crash)
Pick One driver who you believe will finish in 43rd place. (25 Bonus Pts)

2.) Keep track of your own points on the honor system. But, post them as they happen for the fun of it.

3.)PENALTIES: If any of your drivers finishes in the top 5 you lose 5 points each.

That's it. It's easy and fun. Now here's some FAQ:

WHAT CONSTITUTES A POINTS EARNING CRASH? Obviously a crash that brings out a yellow flag counts, but in some cases, a crash that does not cause yellow to come out will also earn points. Simply smacking a wall does not count (or we couldn't play at Darlington), nor does bumping another car, if neither of them crashes or spins. However, if a car spins out (either alone or because of contact) and keeps it on the track, or makes it directly to pit road without bringing out a yellow, that DOES count. If one car spins another, or causes a crash, but is mostly undamaged and continues racing, that car DOES NOT count.

WHAT IF MY CHOICE FOR FIRST CRASHER, CRASHES LATER, BUT NOT FIRST? That will count as a 10 point crash. Basically you have 6 drivers who's crashes are worth 10 points. And ONE of them is worth 50 pts if that particular driver crashes first. The Choice for last place is ONLY worth CRASH points if they are also a Crasher pick.

WHAT IF THE FIRST CRASH INVOLVES MULTIPLE CARS? If your driver is involved in the first crash and it's a multi-car crash, that counts regardless of where their particular crash occurred.

WHAT DO I WIN IF I FINISH WITH THE MOST POINTS? Pretty much bragging rights, BUT I may occasionally come up with a prize or gift certificate that I will mail to the winner. It's possible that other players may occasionally donate a prize just for the fun of it too. Note: For the CHASE races, we will keep cumilative score for a Grand Champion.

WHAT ABOUT THE CAMPING WORLD TRUCKS OR NATIONWIDE SERIES? The official contest is only for the Sprint Cup races, but they may be playing for fun during the other races. The GSNAP chat is active during all three races.

WHAT IF THERE IS A DISPUTE ABOUT A CRASH? A simple vote of whoever is on the chat and wants to vote will decide things not covered above. Simple majority of voters is all that is needed to decide.

That's it. Now get a GSNAP account (if you don't have one) and have some fun.

Doug Kimpel
WisconsinSmokeFan on GSNAP
WisSmokeFan on Twitter

@P337 and Timna Update Saturday 11/21/09

Timna Update Saturday 11/21/2009 Noon-ish Eastern I was looking forward to seeing my sweet girl this morning. I expected her to be maybe a little stronger but I tried to not have any false expectations. Instead Timna is still aware but feverish. 38.5c 101.3f . I read some more get well cards and e-mails to Timna but broke down when I was reading a card from my sister. No, no. That's a good thing. I needed to cry. The nurse shared some comfort with me as she handed me the tissue box. A new one. They must buy them by the truckload here. The saying on the card from my sister: "There's a saying that God never gives us more burdens than we can bear... "And if that's true, Then God must think you're very, very strong because this hasn't been an easy time for you. "I wish there was a way I could shelter you from pain and unhappiness, because if there was, I would. "But all I can really do is be here for you and keep you in my prayers. "You are a child of God. "He made you. "He loves you and will not forsake you... "That I know for sure. "So hang on, keep your faith, and know that you are loved... "Because believe me, you most certainly are! "Linda Lee Elrod" *wipe computer keys dry* Thank you, Wanda. On a good note her liver enzymes must be deemed acceptable enough to tolerate a little Tylenol which the nurse gave her around 10:00am. I don't know yet what could be causing the fever again. At least not specifically. I don't know if they have a clue. Will Timna be strong enough to transfer before thanksgiving? I doubt it. I'll probably be eating a turkey sandwich in ICU 7 while Timna gets some more of that cranberry colored antibiotic. I know there is just a ton of support out there. This hospital must be getting overwhelmed with all the God's Love deliveries requested. They just poured a new concrete heliport. Must have been because angels wore the old one out. Please, help wear out the new one. It's hard when every brainstorm results in a power failure. - Lee Peterman

Friday Update From Lee and Timna

Timna Update Friday 11/20/2009 11:15-ish am Eastern

Timna is getting dialysis. She's tired or drugged or both. I haven't spoken with the ICU doctors yet this morning but Dr. Margolis (Kidney guy) said her creatinine levels continue to drop. That's a good thing. Now at 3.1.

Timna doesn't seem to be aware for more than a few seconds at a time. Nothing seems critical right now but her being out so much concerns me.

More later.

Timna Update Friday 11/20/2009 10:45-ish pm Eastern

Today was a bit of a shocker. The hospital discharge specialist met with me and told me that she was preparing the groundwork to get Timna discharged until she was well enough to have her foot surgery. She then started asking if there was family in the area that could care for her. Was our house a ranch house, etc.

I just about hit the roof!

To the best of my knowledge Timna is looking at at least 6 weeks of needing intensive or tightly regulated care.

It turned out that the discharge specialist and the ICU doctor had miscommunicated. The doctor is looking to transfer Timna to a specialty care hospital in about a week where she can start getting physical therapy along with intensive care. Huron Valley Sinai Hospital does not have the staff nor facilities for that.

Relieved with a new understanding I again spoke with the discharge specialist who will handle the insurance arrangements, etc.

Timna and I watched another movie which she slept through parts of. The doctor had asked me to try to help them adjust her to a normal day night routine. Some afternoon activity helped but she's not going to adjust all at once.

I'm tired. Good Night.

P337 and Timna update Thursday 11/19/09

Timna Update Thursday 11/19/2009 12:15-ish pm Eastern

I haven't had time to read all the email replies yet but I wanted to get a quick update out to match the news I just Twittered.

Timna is breathing

on her own for a while

through the machine

without assist!

A

MAJOR

MILESTONE!!!

Timna Update Thursday 11/19/2009 3:15-ish pm Eastern Timna has been resting so far this afternoon. She will start receiving some food directly into her stomach for the first time in a while. The program now is to regain her strength and get her ready for foot surgery. Her hemoglobin is staying up which is an indication that the bleeding has stopped. Still a long row to hoe but God has a tractor. It's hard when every brainstorm results in a power failure. - Lee Peterman

P337 & Timna Update Wednesday 11/18/09

Timna Update Wednesday 11/18/2009 11:15-ish am Eastern TImna's color has vastly improved just since yesterday. A visible indication that her liver enzymes are improving and that her hemoglobin is staying up. They are doing blood tests more frequently since there are still small amounts of blood in her stomach fluid. This could be because her blood pressure has raised above where they want it (now at 171/59). The nurse said she was already getting something to lower it. Timna is raising her arms more and squeezing harder. Attentive and her face is expressive. There is still a communication lag where she seems to have to think about what muscles to move to nod or shake her head. After a less than a half hour of my attention and her responding she tired to a point I knew she had better rest which she is doing fitfully right now. The doctors have not finished their rounds yet but yesterday she never got dialysis and I found out that her schedule has been changed to every other day. Yesterday's dialysis canceled and today's dialysis scheduled for late morning. The emergency room has a patient that required immediate dialysis so Timna will get hers right after that. The respiratory specialist said she is triggering most of her own breathing but the machine is assisting her to take full breathes and a minimum of 16 breaths a minute. When the raising of arms and slight squeezing are garnishes of success to her condition it's easy to see that she is still a very very sick girl. I'm gladdened and saddened as I type while looking at her face. Out of immediate danger but oh so far to go. Timna Update Wednesday 11/18/2009 5:15-ish pm Eastern Timna and I just finished watching a movie together while she was getting dialysis. A silly romantic comedy called "Confessions of a Shopaholic" or something like that. She enjoyed it. Now she's sleeping as dialysis finishes. Timna is scheduled to go down to surgery in an hour or so to have her dialysis portal changed to something more permanent. Dr. Margolis (kidney guy) said that her creatinine levels had held at the same level between dialysis treatments which shows that her kidneys are functioning at a low level. Timna's face is much more animated today as I had mentioned earlier but she tires quickly which I understand completely. Her strength will come back. I'll do an update later after her surgery. Many thanks to my sister, Wanda for sending a picture taken in August that you see above left. Timna Update Wednesday 11/18/2009 9:00-ish pm Eastern Timna's surgery went well. Dr. Armstrong just told me there were no problems at all. She is on her way back to ICU for recovery. I'll head up there in a few minutes. Thank you all for being such great prayer partners.

P337 and Timna Update Tuesday 11/17/09

Timna Update Tuesday 11/17/2009 Noon-ish Eastern To varying degrees Timna is still in what the ICU doctors term 'multi-organ failure' which includes her lungs, liver, kidneys, gall bladder, and pancreas. The recent blood cultures have come back negative for active infection. This means they they couldn't detect anything. She is still on multiple antibiotics because the 'undetectable' could still be present. There is still some blood in the suction tube from her stomach. Not bright red or in the quantity as before. They are closely monitoring that. Her enzyme levels for various organs have improved slightly showing that there is a degree of healing. Timna smiled twice last night. I slept. As I told her Aunt Doloris, Timna looks to be much more comfortable this morning with no tubes running through her mouth. She's still very weak. It'll be a day by day battle for her and her care providers. Please keep praying for her, the medical team, her parents, her brother and his family and myself.

P337 and Timna update. Monday Evening 11/16/09

Timna Update Monday 11/16/2009 2:45-ish pm Eastern

Timna is bleeding again.

She is receiving more units of whole blood. They have decided to proceed with the dialysis with some adjustments to compensate for the blood loss. The general surgeon will be up as soon as he is out of surgery.

The decision to go to a surgical solution rather than or after doing another endoscopic procedure is yet to be made.

The liver may be causing the stomach bleeding.

Please pray, please pray, please pray! This is so hard.

Timna Update Monday 11/16/2009 4:30-ish pm EasternT

Timna has urgent surgery scheduled for 8:00 this evening. They'll do the trach while they have her in surgery for the bleeding.

Timna Update Monday 11/16/2009 10:00-ish pm Eastern

Timna had such a successful surgery she didn't need it.

The surgeon did do the trach but before he cut he checked the stomach suction tube and saw that the blood coming out was not fresh red. Instead it was brown coagulate in fluid.

He called in the endoscopy team. When they got there they found that the bleeder had clotted. The surgeon was satisfied that it would hold as long as the pressure was not allowed to rise (portal hypertension for those who want to know) which can be controlled in ICU.

Praise God.

And thank you all once again.

Afternoon, Monday 11/16/09 Timna & P337 update.

Timna Update Monday 11/16/2009 9:45-ish am Eastern So far this morning Timna has not shown any signs of continued bleeding. She has been removed from any blood pressure elevating drugs. Current BP is 113/42. Pulse at 113. Dr. Margolis (Kidney guy) has not been in yet to confirm that the dialysis should be cancelled. Timna is again running a fever which they are controlling with the cooling blanket only. Her current temperature is 38.2c 100.76f. The infectous care team will be in shortly. I don't know whether to laugh or cry but Timna just now developed the hiccups! I'm going to ask if anything can be done for that. Enough for now. Please continue in prayer. Added 3:09 eastern time 11/16/09 from twitter: p337 Timna is bleeding internally again. Please pray! p337 Damn!

Monday 11/16/09 Update on Timna and P337

Hello all;

Lee's dad here. Lee arrived home from the hospital a short while ago, only to be called back for approvals for possible procedures. As you likely know, they found a couple of bleeding ulcers in Timna's stomach today. They thought they had the bleeding stopped. However, her blood pressure is dropping, and they have decided more action is necessary at once. Please pray for guidance for those caring for Timna, and for Lee. You all, as Lee's "prayer warriors" have been a significant help to him, and we believe we can offer praise and thanksgiving to God for His proving to us that "the effectual fervent prayer of a righteous man availeth much" !

Many Thanks !!

Allen

Timna Update Monday 11/16/2009 12:30-ish am Eastern Timna is out of danger. They found that one of the ulcers they had taken care of earlier had started bleeding again. A followup exam is scheduled for tomorrow morning (strike that) this morning. She's getting more blood (I hope she doesn't break the bank). Now they are giving her a coagulating agent. Dialysis is out for tomorrow. This problem has taken it's place on the priority list. Can't do dialysis which requires an anticoagulant and a good blood pressure. I'll go home again and get an hour or two of sleep, get cleaned up and get back for the morning examinations. Please keep praying. Thank you.

Phoenix Results 11/15/09

While Phoenix only had two yellow flag crashes, they involved nearly 2o cars. So crash points were abundant.

The winner of the week was Allyson who had an 80 point day. GennaGirl, WisSmokeFan and BecBeat555 all had 65 pts. Champion Points leader RealChevyygirl had 40 pts, Shell came in with 30, TwentyFour had 20, P337 had 10 and Renee4Jr ended up with negative 10 pts after penalties for 2 of her picks finishing in the top 5.

Championship Standings:

Allyson: 355 Pts 3 tie breakers

RealChevyyGirl: 325 pts 1 tie breaker

BecBeat555 320 pts 3 tie breakers

Shell: 310 pts 3 tie breakers

GennaGirl 295 pts. 2 tie breakers

TwentyFour 230 pts 2 tie breakers

P337 230 pts. 1 tie breaker

Renee4Jr: 185 pts.

WisSmokeFan 150 pts.

Smokestoy12ts 10 pts.

Uplifting Update on P337 and Timna.

Lee and Timna still have a long way to go, but things seem to be moving in the right direction. Keep them in your thoughts and prayers. Thanks for caring. I know that Lee is using our support as a crutch to keep from collapsing. Let's keep being a source of strength for him.

Timna Update Sunday 11/15/2009 10:45-ish pm Eastern Timna has been carrying on a yes/no conversation with me! She had me turn the music down. Told me that her arm was hurting. She tried to squeeze my finger but could only move a finger a little bit. She grimaced and I asked her if that hurt to squeeze and she said yes. Unfortunately she is bleeding into her stomach and needs endoscopy to assess and maybe take care of the problem... More sedative. They will do this shortly after 11:00. They will try to get neurology up to make a quick neurological study before they sedate her again. She's gagging a little now and then. What a trooper. If I had five or six tubes down my throat I'd be gagging constantly. I asked for the nurse to look it up and found out that Timna did test flu negative on the 31st of October. So it was a sepsis fever and only coincidence that I got sick at the same time. If we had known... Please continue in prayer for my sweet girl. UPDATE: Timna Update Sunday 11/15/2009 noon-ish Eastern Timna is done with the procedure. They found two ulcers. One was bleeding. They injected, cauterized and clipped. She will continue to be followed by the gastro team to make sure she heals properly and new ulcers don't form. The ulcers are new, due to the stress and the medications, etc. the Motrin and Heprin certainly didn't help but again, it's a balancing act. She's sleeping off the sedative. Thank you all again.

Texas Motor Speedway Race 11/08/09

Texas proved to be a much more interesting race than previously thought with the early crash of Jimmie Johnson. Crash points were spread pretty thin, but it served to tighten up the Championship Crash Chase a lot.

This weeks winner was:

Genna Girl with 45 points. She also won the weekly prize of a $10 Buffets Inc. gift card.

Shell236, BecBeat555 and Renee4Jr had 30 pts.

RealChevyygirl, Allyson13, l had 20 pts.

P337 had 10 pts.

TwentyFour and WisSmokeFan had ZERO pts.

Championship Points Chase:

RealChevyygirl: 285 pts and 1 tie breaker

Shell236: 280 pts and 3 tie breakers

Allyson13: 275 pts and 2 tie breakers

BecBeat555: 255 pts and 3 tie breakers

GennaGirl: 230 pts and 2 tie breakers.

P337: 220 pts and 1 tie breaker

TwentyFour: 210 pts and 2 tie breakers.

Renee4Jr: 195 pts.

WisSmokeFan: 85 pts.

SmokesToy14TS: 10 pts.

P337 and Timna Update Saturday Evening 11/14/09

Timna Update Saturday 11/14/2009 1:30-ish pm Eastern

Some random notes and thoughts:

Slight fever but expected.

Timna is slightly more aware today. Not necessarily responsive.

I put Timna's glasses on since she's opening her eyes a lot and looking around. She will turn her head and look at me when I talk.

I pray Timna is passively accepting the situation and not screaming in silence. It hurts so much to see her like this. I'm so tired of it.

Dialysis has not started yet.

Timna's CAT scan did not show any brain abnormalities, pockets of infection nor abdominal abnormalities. Again, that faith in radiology issue.

Timna is getting her bath. I'm going to try to nap in the lounge.

So many of you are praying.

I'm amazed at the response.

Thank you.

It's hard when every brainstorm results in a power failure.

Timna Update Saturday 11/14/2009 6:15-ish pm Eastern Timna has finished dialysis for today. I'm not sure when the next one is scheduled. I went in and she didn't even look sleepy. She looked at me and her eyes followed me around the room. She has a long road ahead of her still. She is still not strong enough for surgery. As a minimum, the necrotic tissue on her right foot needs to be removed. My dad is taking me out for supper shortly. If Timna is not able to breathe on her own by Monday they will want to do a tracheotomy for the respirator and run a line directly to her stomach through her side for feeding. Please continue to pray. Pray for her strength to return. Pray for healing. Thank you all.

Lee Peterman

P337 and Timna Update Saturday 11/14.09

Timna Update Friday 11/13/2009 8:45-ish pm Eastern

Timna's temperature is 37.6c, 99.7f, without any further cooling or fever reducer which is the lowest it's been in almost two weeks. An answer to prayer. She was given some Fentanyl for pain assessed by her having a higher blood pressure than normal and her elevated heart rate. Her blood pressure (now 186/59) and heart rate (now 80) responded soon after receiving the Fentanyl.

Still awaiting results from the CAT scan and for dialysis information.

My father is waiting with me.

Maybe more later. If not, Good night and once more: Thank you all!

P337 and Timna Update Friday 11/13/09

Today there's been a bit of a setback for Timna. Let's renew our prayers and see if we can get Lee and Timna through this. Thanks for your support- Doug.

Timna Update Friday 11/13/2009 10:45ish am Eastern

I didn't send an update out yesterday because I was using my laptop to play music for Timna and her condition was relatively unchanged. She did get another dialysis treatment in the evening. When I got home it was just too late.

Please pray for Timna even more this morning. When I came in she was covered with a chilled water blanket and appeared paler than yesterday. She had an 'event' during the night with temperature spike as high as 40.4c and tachycardia. They scheduled an ultrasound because they say her liver numbers were a bit off and her eyes appeared slightly jaundiced. They mentioned a possibility of meningitis. The ultrasound is taking place as I type.

Please pray.

Timna Update Friday 11/13/2009 5:15ish pm Eastern Timna's temperature has been reduced by a fever reducer and the cooling blanket to a balmy 38.2c, 100.76f, as they prepare her and all of the accompanying monitors and IV machines to go down for a CAT scan. This time they will use contrasting dye to reveal details of her organs and blood vessels. The ultra sound revealed fluid around the gall bladder and liver, a slight amount of thickened fluid inside her gall bladder but no narrowing nor obstructions of the ducts for her gall bladder, pancreas or liver. While down for the CAT scan they will again scan her head to monitor any changes from the previous scan. If safe enough they will again scan her legs but with dye this time. Timna will be getting dialysis tonight or tomorrow to remove the dye from her system. A neurology expert has been asked to look at her because it has been more than 36 hours since she has had any sedative and she is not responding except in reflex manners. There has been a change in her antibiotics and no further studies are scheduled of her spinal fluid because the antibiotics she is now on will target any infection there. There is no sign of viral meningitis. I'll try to update more later. Thank you all, family, friends, NASCAR fans and others, for praying so fervently. It's hard when every brainstorm results in a power failure. - Lee Peterman

Wednesday 11/11/09 Lee and Timna Update.

mna Update Wednesday 11/11/2009 7:45ish pm Eastern

Timna has not received any sedative since 7:00 am because the doctors want her to wake up again. I'm sitting here while some John Michael Talbot music plays on her CD player. She and I have always liked his music. I have had to relax her when she bites the breathing tube and fights the respirator as she has moments of awareness. Our God Reigns is now playing. How reassuring. Even the nurse is humming along.

Her second dialysis treatment was this morning and removing more of the toxins is allowing her body to fight the infection better. I hate seeing her here with the breathing tubes that I know are aggravating her throat. But, I know it is necessary.

They will be kicking me out (gently) soon for the shift change although some nurses let me stay.

I have been encouraged today seeing her respond more to me. She did try to talk once (probably to scold me) but she went back to sleep from the effort. Her temperature has been holding around 38c. (I'll let you do the math.)

This has taken a while to write because I have been. getting up to calm her a bit more. I don't know if they will be able to hold off on any sedative through the night. It's a balancing act. Let her arouse naturally yet keep her from going into a rapid shallow breathing pattern that does her no good. She is still getting Tylenol and Motrin but they are holding off giving her any more Fentanyl unless she shows signs of distress through the night.

Please pray for continued healing of her kidneys. Right now her urine output is down but I'm told to expect that with dialysis. Very early tomorrow morning they will be taking more blood samples to check how the dialysis is doing among other things.

I'm doing better today since I was able to sleep fairly well last night.

Thank you all for praying for both Timna and me.

Tuesdays Updates on Lee and Timna with some GOOD NEWS!!

Timna Update Tuesday 11/10/2009 7:30ish am Eastern

The procedure is underway to place the dialysis catheter in Timna's jugular vein. Timna's primary care doctor reviewed the recent developments with me and assured me that holding off with the surgery and getting Timna on dialysis ASAP was the correct decision. Her creatinine levels and BUN numbers had continued to trend upwards through the weekend. Creatinine nearing 6.

I am continuing to depend on the Lord for guidance and her healing. Please pray in concert with me as Timna starts the dialysis treatments.

-- Lee

Timna Update Tuesday 11/10/2009 Noonish Eastern

It's been two hours since everything was cleared for dialysis and they still haven't sent a unit up. I'm getting impatient. The sooner Timna can get rid of the toxins the sooner she can start healing. I guess I'm back to the anger side of grief. This has been one heck of an emotional Yo-yo I've been on. Glad so many of you have been supportive. I sincerely thank you all and please keep praying.

New note! The dialysis unit just arrived. But so did her new bed. (The old bed was not inflating properly.) So, they'll change the bed, and then finally get her started on dialysis. I'm going to get some lunch because I'll only be in the way here.

It's hard when every brainstorm results in a power failure.

- Lee Peterman

Timna Hallelujah Update Tuesday 11/10/2009 6:30ish Eastern

During Timna's dialysis, earlier, I was talking to the tech. and my voice triggered a response in Timna. She started fighting the respirator but quickly quieted when I calmed her. She opened her eyes and looked at me. Her eyes followed my hand as I brushed some hair from her forehead. I gave her some calming words and told her to go back to sleep; which she did. Twice more during the late afternoon she awoke and did the same thing.

Timna's pulse had been mostly between 100 and 112 before the dialysis and after it dropped to the 80 - 93 range. Somewhere towards 60 is normal. Timna's blood will be evaluated tomorrow morning to see how much dialysis to give her tomorrow.

This going in the right direction but she is still a very sick girl.

Please keep praying.

My love to all.

Lee

Updated Update on P337 and Timna

Timna Update Monday 11/09/2009 7:00ish pm Eastern

I found out that Timna's blood pressure is not being artificially elevated. She's holding her own. Pump it, Honey, pump it! Not too high.

From Wikipedia:
Dialysis may be used for very sick patients who have suddenly but temporarily, lost their kidney function (acute renal failure). When healthy, the kidneys maintain the body's internal equilibrium of water and minerals (sodium, potassium, chloride, calcium, phosphorus, magnesium, sulfate). Those acidic metabolism end products that the body cannot get rid of via respiration are also excreted through the kidneys. The kidneys also function as a part of the endocrine system producing erythropoietin and 1,25-dihydroxycholecalciferol (calcitriol). Dialysis is an imperfect treatment to replace kidney function because it does not correct the endocrine functions of the kidney. Dialysis treatments replace some of these functions through diffusion (waste removal) and ultrafiltration (fluid removal).

2:00pm EST. Still waiting for the Nephrologist (Kidney guy).

3:00pm The surgeon will place the catheter for dialysis when he gets out of surgery around 4:00pm.

6:30pm The surgeon came up and told me that he would place the catheter at 7:00 tomorrow morning because of a longer than usual surgery. He felt that he was too tired to rush into another procedure when doing it in the morning would not delay the dialysis.

Thank you Debbie for bringing me dinner.

Here's a link to a web site that Dr. Humphry recommended.
http://www.uptodate.com/patients/index.html

Please continue praying... And thank you all.

It's hard when every brainstorm results in a power failure.
- Lee Peterman

Sunday 11/08 & Monday 11/09 Update on Lee and Timna

Date: Sunday, November 8, 2009, 7:17 PM

Timna was about the same this morning except her temp had dropped below 103f. Not much below. She had very slight Kidney improvement. Timna's temp didn't stay down. Around noon it was back up to 39.6c 103.3f. Her pulse has been rapid with occasional missed beats throughout the day. Now down slightly at 110. This afternoon she began fighting the respirator more so they have given her a mild sedative. this evening she received more of that ativan fentanyl cocktail to help her stop fighting the ventilator which though set at 22 she has been pushing the breath rate above 30 for most of the day. Some close friends and family came by today and the nurse wanted to deny visiting because visitors seem to excite Timna's breath rate further. I intervened for short visits. The hospital already has a two at a time if 18 or older policy in place due to the propensity of influenza at this time. Thank you all for praying. Please continue to do so. Update Monday 11/09

Doctors are making their rounds right now. Group of white coats at Timna's door.

9:02 Eastern

Dr. Sethi (This weeks head ICU resident) gave me some very encouraging news. Timna is now strong enough for dialysis! Hallelujah. 9:20 EST

Dialysis will be scheduled with the kidney specialist. I'm not sure how soon that will be since they will have to give her a larger blood portal first.

Blood Pressure 145/55. (I don't know if they are still giving her something to raise it or if it's on her own. Forgot to ask.)

They are still keeping her mildly sedated.

Her Temperature has fallen below 103f again.

Please keep her in your prayers.

It's hard when every brainstorm results in a power failure.

- Lee Peterman

Talladega Nov. 1 2009 Statistics

While we thought Talledega would be a bonanza of points, it turned out to be quite a quiet race. There was no weekly winner as: GennaGirl, TwentyFour, P337, BecBeat555 & Allyson all had 30 pts, RealChevyygirl had 25 pts. Shell and WisSmokeFan has 20 points and Renee received 5 points are a few penalties when some of her crashers finished in the top 5.

Championship Points:

RealChevyygirl: 265 Pts and 1 tie breaker

Allyson: 255 pts and 2 tie breakers

Shell: 250 pts and 3 tie breakers

BecBeat555: 225 pts and 3 tie breakers

TwentyFour: 210 pts and 2 tie breakers

P337:210 pts and 1 tie breaker

GennaGirl: 185 pts and 1 tie breaker

Renee4Jr: 165 pts.

WisSmokeFan: 85 pts.

SmokesToy14TS: 10 pts.

Saturday 11/07/09 Update on Lee and Timna Peterman

Timna Update Saturday 11/07/2009 12:30ish pm Eastern I have lost the rest of my faith in radiologists. Yesterday evening the surgeon looked at their report and her foot and said things were good and there was no need to operate. I raised her foot and showed him the bottom of her toe where it was pussing out. He looked at the actual CAT scan images on computer and said the images show necrotic tissue inside the toe. Now it's just a question of when the toe is removed. This morning Timna responded to stimulus by trying to cough during lung suction and by moving her eyes. I met with the infectious care Dr. and with the surgeon this morning. We've decided that the toe surgery need in relation to her strength is not immediate (Monday). The surgeon will meet with the podiatrist, ICU cardiologist and the kidney specialist tomorrow and re-evaluate. Timna's urine output has decreased slightly. Her blood pressure is back in the normal range. Her temp is hovering around 103f. Some of you have been asking about my test. The test results from my small bowel series will be available next week. Anything critical would have been revealed to me right away... back to my faith in radiologists issue. I have been getting a lot of support from God, family, friends and on line friends. Without that my emotions would be like Jello dropped on Daytona Speedway in July. THANKS TO ALL! It's hard when every brainstorm results in a power failure.- Lee Peterman

@P337 and Timna Update Friday 11/06/09

Timna Update Friday 11/06/2009 10:30ish am Eastern Currently there is not much new to report. There is concern about localized infection in Timna's left leg. The infectious care doctor and the surgeon he called in are looking in to the matter. It turns out that Timna's current infection is not MRSA but an antibiotic responsive staph bacterium. The MRSA information given to me was precautionary due to her history of MRSA. This was very poorly explained by the aid giving me the information. There is still the possibility of a MRSA recurrence but the cultures are all negative at this point. Timna has not received sedatives for 24 hours now but she is still unresponsive to voice and pain. This is to be expected for now due to sedative buildup and the current blood chemistry. The intensive care physicians periodically check her ability to maintain regular unassisted breathing. She's still not there yet. Blood sugar is being controlled. Temperature is up indicating current infectious activity. Please continue in prayer. Thank you all! Lee Timna Update Friday 11/06/2009 2:30ish pm Eastern I just got some good news! THey feel TImna is strong enough to be wheeled down for a CAT scan of her legs to check for pockets of infection. While she is down there they will scan her head to check for anything outside of normalcy. (Good thing they aren't checking my head.) It's hard when every brainstorm results in a power failure. - Lee Peterman

Update from Lee and Timna Thursday 11/5/09

Timna Update Wednesday 11/04/2009 10:30ish pm Eastern

I'm home.

Another complication in Timna's condition: Compartment syndrome.

Never heard of it? Neither had I.

The podiatrist was called in to look at the ulcer on her right big toe. He suggests that removal of the toe would be the best option since she had already had a bone of that toe removed and has had a series of blisters turning to ulcers on the remaining toe after that. While he was there I told him about her injuring her left foot in the fall she had while she was sick. He left but came back laterr because something about the left foot was bothering him. He had the nurse remove the bandages and looked at the swelling and the blisters which he lanced and sent the fluid out for culture. What he really suspects is compartment syndrome ( CS http://en.wikipedia.org/wiki/Compartment_syndrome ). This would explain the extreme pain Timna felt even with the weight of a sheet on the leg. CS is, from what I gather, more associated with athletes.

I believe she will have some tests concerning the possibility of CS tomorrow. I have my own test tomorrow which was postponed from last week: a small bowell series. I'll be in radiology which is about 20 feet away from where Timna is, just one floor down. My brother will be with her and able to contact me if my consent is needed for anything.

Now to study for my test.

Update on Timna, from Lee (P337) WEDNESDAY 11/04/09

Timna Update Wednesday 11/04/2009 5:30ish pm Eastern

Things were a little rough for Timna this morning after a feeding tube was inserted. Her gag reflex kicked in with the additional volume of tubes in her throat. Hourly injectable sedation had to give way to a morphine drip which complicated things by lowering her finally stable blood pressure. Medications brought that back up but, from what I gather, put additional demands on the healing kidneys.

Her blood acidity has moderated.

Her lymphedema has been exacerbated by more fluids going in than are coming out which causes blistering and rupturing of same on her feet and legs as well as sites traumatized by blood drawing, etc.

The sepsis ( http://en.wikipedia.org/wiki/Sepsis ) turns out to be MRSA ( http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus ) which caused, or along with, the DKA ( http://en.wikipedia.org/wiki/DKA ) took her down.

Did all this start out with a virus? I wonder. Since Timna and I were both sick at the same time we just naturally assumed some form of influenza. Maybe it was and her being weakened by the flu created an opportunity for the MRSA. Or, Maybe me being sick with the flue was merely coincidental to her suffering from the sepsis.

From the first referenced Wikipedia entry:

• Sepsis is usually treated in the intensive care unit with intravenous fluids and antibiotics. If fluid replacement is insufficient to maintain blood pressure, specific vasopressor drugs can be used. Artificial ventilation and dialysis may be needed to support the function of the lungs and kidneys, respectively. To guide therapy, a central venous catheter and an arterial catheter may be placed. Sepsis patients require preventive measures for deep vein thrombosis, stress ulcers and pressure ulcers, unless other conditions prevent this. Some patients might benefit from tight control of blood sugar levels with insulin (targetingstress hyperglycemia), low-dose corticosteroids or activated drotrecogin alfa (recombinant protein C).
  

That one paragraph pretty much defines Timna's current state.

They started feeding her some yummy looking grayish tan... not sure what to call it in a G rated communication. Brand name Oxepa. (I don't want to know from what part, if any, of the ox it came from.) As expected it raised her blood sugar levels so they are going to increase her insulin to compensate.

Her blood pressure is currently 103/38 so the medication is working to bring that back up.

The morphine (which she still refuses to share) is allowing her to rest comfortably without gagging and fighting the respirator. They are taking steps to prevent yeast, etc., infections on other parts of her body such as behind her knees and between her toes where moisture could collect and provide an environ for yeast, etc.

With her creatinine levels dropping slowly any decision concerning dialysis is able to be postponed. But that option is not being ruled out, just with her blood pressure on the low side and her general weakened state it is best to avoid dialysis.

Please keep Timna in your prayers.

Thank you.

It's hard when every brainstorm results in a power failure.

- Lee Peterman

Updates from Lee (P337) about Timna

I will continue to post updates and writings from Lee on this Blog. Please come back often to stay in the loop. Our prayers are still needed more than ever. I am afraid Lee is very exhausted and devastated, and we need to help him keep his spirits up for both his own and Timna's sake.

Here are recent posts and updates:

Update Monday 11/02/2009 10:30pm Eastern:

Timna was moved out of ICU to a regular room and she is no longer on an insulin drip.

Her kidneys are putting out urine but her creatinine level is still high (4.1). Her BUN/Creatinine ratio is still whacked out (must be a medical term because that's what the doctor said).

Her Mother and Father visited today. Later she did not remember that.

I have had some support from my father and some of Timna's and my friends.

Timna ate a little three times today but had to be spoon fed. Her leg pain is being controlled with morphine.

She still recreates reality regularly in several interesting versions. She finds talking difficult most times but seems able to say, "Lee, stop it. That's not what I meant," with good clarity.

She may be sent to dialysis to get rid of the toxins which are playing havoc with her system but hopes are that she won't have to.

Nothing can be done for her lymphedema right now which is a further complication.

Family, church family, friends, Twitter friends, my father's Facebook friends and unknown folks from many avenues have let me know they are praying...

That means a lot.

Thank you all.

It's hard when every brainstorm results in a power failure.

- Lee Peterman

TWITTER update: 11/3/09 11pm Eastern.

p337 Timna has been moved back to ICU. @WisSmokeFan Too much lung fluid and the TV in her new room didn't work. Please keep praying... yea, pray.

Twitter update: 11/3/09 3 Eastern

p337 To all & @WisSmokeFan She's sedated on respirator. They wouldn't sedate me though. Thanks for all the prayers.

Timna Update Tuesday 11/03/2009 3:ish pm Eastern

I'm sitting in the darkened room with Timna who is sedation resting.

She is on a respirator and just received her 4 hour albuteral inhalation. Some wheezing according to the respiratory specialist but not real tight right now.

I'm just going to try to put some scattered thoughts together and send this out.

Acidotic was a term tossed at me. I'll have to look that up later.

Her breath rate had gone up over 30 and was labored before they got her on the respirator.

They have to do a balancing act with the fluids they are giving her due to an enlarged heart, etc. She's still a little on the dehydrated side.

I had optimistically left her clothing and stuff with her since Saturday. I finally took them to the car. She won't be using anything for a while... I'll keep them in the car though.

I had such high hopes when she ate a bit three times yesterday and seemed more lucid at times. I was devastated to find an army of white coats in her room this morning when I arrived. At this point "holding up" for me means that I am able to occasionally get my legs under me and walk around without a storm of emotions.

The RN just plugged another unit of blood into the filling station. Are there this many tubes and lines for a NASA launch?

The Doppler ultrasound blood flow specialist was kind enough to pray with me and supply me with a new tissue box, I don't know her name so I'll just nicknamed her "Sonica".

Timna's parents came up but weren't able to stay in the room very long due to tests, meds and such. A close friend of Timna's came up and stayed on doctor watch while I went to eat.

It's pretty quiet now with an occaisional check by the ICU resident or his assistant. The staff here have all been professional yet very kind. Should I tip when I get the bill?

P337's Wife needs our prayer.

Hello Nascar Chatters and Fantasy Crash League players. Our own Lee Peterman (P337) is going through some very trying times right now. On top of his painful orthpaedic problems his wife is in the ICU with some very serious concerns. They both could use our prayers right now. As you know, everyone who has ever chatted with Lee becomes an instant fan of his wonderful wit, and his great friendly attitude. Let's make sure we send all our prayers and wishes to him.

Send your best wishes to @p337 on Twitter.

Here is a copy of the email he just sent about his wife Timna's situation:

Timna, still in ICU, is resting, but not comfortably. Her sugar is under control. The infection has entered her bloodstream and she is receiving IV antibiotics for that. Her kidneys are demonstrating some function by putting out some urine. Her foot ulcer is being cared for. She is still not 100% aware of the full situation but she has chewed me out twice which shows she is gaining strength and frustration with the situation. Visits are not requested at this time. Please continue in prayer.

Thank you,

Lee

It's hard when every brainstorm results in a power failure.

- Lee Peterman