The next day I looked at his toes and was very concerned. The tips on a couple of his toes were turning purple. His big toe had turned purple! His toes were cold, his capillary refill was > 3 and I could only feel one pulse on his foot and it was diminished. I could tell that something wasn't right. So I texted my friend BreAwn that is a NP for our vascular doctors. (She used to be a TICU nurse). Originally we were going to have to wait until the end of April for an appointment. So BreAwn called the office and squeezed him in with Dr. M on March 23. On Monday, Mom sent me pictures of Dad's toes. They looked even worse. So I sent the picture to BreAwn. She said that he needed to be seen a lot sooner. Thursday morning, I woke up at 5:30 and couldn't go back to sleep. I just had a feeling that something was wrong with Dad. I ended up getting up and exercising and getting ready for the day. BreAwn texted me at 9:00 and said they were fitting Dad in this afternoon. Dr. M was extremely concerned with Dad's leg. He had NO blood flood in his toes and very limited blood flow to his foot. Only his capillaries were getting blood to his foot. Dad started taking things seriously when Dr. M said "I'm not worried about your toes being amputated. I'm worried about you losing your leg!" He said Dad needed emergent surgery tomorrow (Friday) to restore the blood flow to his leg. (In hind sight, we shouldn't have had his toe nails removed because we didn't know how severe his vascular problem was. But it made us aware of his problem so he didn't lose his leg)
Because of COVID restrictions, we were only supposed to have one visitor but Dr. M said we could have two. Luckily it was before they started getting really strict. Originally Dr. M was hoping to do an angiogram and look at his blood flow and just open things up. But after a couple of hours, things weren't going well. He decided to do a femoral popliteal bypass graft. Luckily my friend BreAwn was in the surgery so she sent us a couple of updates. My stomach sank when she said they needed to do a bypass. Dad stayed in surgery for another six more hours! I was getting so worried. They finally finished up around 11:00. The surgery was very complicated. They harvested the graft and attached it. They went to flush it and there was still not blood flow. So then they had to keep digging for the problem. They finally figured it out that his femoral artery was completely occluded from the TVAR procedure. When they closed it, the device snagged on the inner lining on his femoral artery partially occluding it. With time, clots formed around the partial occlusion and eventually caused a complete closure. Dr. M ended up doing a 4 inch femoral artery graft. Dad is so lucky he didn't lose his leg!
Dad went to my floor (TICU) after his surgery around 11:00. My sweet friends allowed Mom and I to come back despite the no visitors rule. Seeing Dad wake up from surgery was so hard!! He wasn't responding really quickly and his arms and hand were posturing. He was really slow to talk and look completely confused. At first I was worried that Dad had stroked. But luckily he started to wake up and become more appropriately responsive. We ended up staying an hour with him. Before we left, he said "what the hell happened?" That made us laugh! Mom and I finally went home around 12:15.
The next morning, mom stayed home and I went to the hospital. We knew with the COVID restrictions they wouldn't let both of us in. When I got there, I had to talk to the nurse on the phone. They weren't going to let me in. After talking to her for 15 minutes on the phone in the waiting room I said "are you really not going to let me back to see my Dad?" They bent the rule and let me come back. When I walked in my unit, Dad was walked around the unit with the physical therapist. At first they said I could only stay for 15 minutes. They relaxed once I was back there and let me stay a couple of hours. They said to wear my name tag and say that I'm doing education hours if anyone asked. My unit is the best!! They were so sweet to bend the rules for me. Dad looked so much better!!! He was back to talking the nurse's ear off!! (and anyone else that came in the room)
Dad was doing so well that he was transferred to the floor on Saturday. Visitors were not allowed on the floor but they told the floor nurse the situation and she said I could come and get Dad settled. Dad had a great nurse on the floor. Luckily she was relaxed and was so sweet with letting me stay. I stayed with Dad another couple of hours. We planned for Dad to go home the next day. Dad only had his docker pants and I knew that would be uncomfortable. I talked with his nurse and she said I could run to Costco and buy him some sweat pants and then just run them back up to the room. So that's exactly what I did.
The next morning (Sunday), Mom drove to the hospital. She called Dad to tell him she was here. The nurse brought him down to the car. This COVID thing is making things so strange!!!!
Dad did really well at first. But after about 5 days, the scabs on his toes went black and looked really bad. His lower extremity had 3-4+ pitting edema. He got a big seroma on his upper thigh. I texted BreAwn and told her about it. She put him on STRICT bedrest!! She said that it was crucial for him to keep his leg elevated. That was really hard for Dad!! By Monday, March 30, the seroma was the size of a softball and was very painful for him. I texted BreAwn again...she said that they would squeeze Dad in and have someone try to drain it. I took Dad in at 10:30 and Brad, NP drained it. He said that it could take up to a year to drain it. That was discouraging for Dad. But it felt a little better being drained.
On April 20th Dad went to see a wound specialist for his toes because they weren't getting better. The wound doctor was wonderful. He's a vascular doctor so he knew all about Dad's surgery. He said "if anything could have gone wrong, it did with your situation!" He cut off all of the black scabs. That was so painful for Dad. He lined up home health to come in three times a week to do dressing changes. He told Dad that if he wanted any chance of keeping his toes, he needed to keep his foot elevated. "No yard work!!" Dad was really discouraged. He said that Dad was one week away from having the wound get to the bone. They would have had to amputate his toe tips if that would have happened. Luckily Dad's toes responded really well to the dressing changes and improved. After a few weeks, he switched Dad to daily dressing changes that Mom did. After 8 weeks, Dad was finally discharged from the wound specialist. His toes look 100% better. At Dad's vascular follow up appointment, he asked BreAwn why he feels so tired. She said "you got the wind completely knocked out of your sails!" She told Dad that this was a major surgery and that it's normal to feel this way and that it's going to take 6-12 months to fully recover. This has been quite the ordeal. It's hard to see Dad so weak and frail. I hate it! He's always been so strong and energetic. It's been good to rally around him and help him with some yard work.
BreAwn has been a lifesaver through all of this! She's been a tender mercy sent from Heavenly Father. I'm so grateful for the wonderful people I work with and how they've helped me!
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