Posts by Timothy Newman3

God!
Was taken off the ventilator last night—waking up occasionally now, but everything seems fine so far 👍
Just taking it one day at a time.
Hi everyone!

Hi there!

It’s been a while since I’ve had anything to ask here.
I was wondering if anyone has firsthand experience regarding brain tumor surgery—specifically targeting the hippocampus—and what the typical recovery or waking process looks like.
To give some context, this involves a close friend of my daughter; she’s 36 and just underwent surgery at Mayo Clinic today. They mentioned she’s still sleeping and isn't breathing on her own yet—she's currently on a ventilator. The nurse told us to check back later tonight if the doctor is available.
Is it standard procedure to have a patient on a ventilator following brain surgery? And generally speaking, how long does it usually take for them to wake up? 🤔

I’d really appreciate any insight if someone has a moment to reply—we’re all feeling pretty anxious over here. We’re just hoping everything is within the normal range; the most important thing right now is that she's stable.

Scott Allen10, thanks for the explanations—as I mentioned earlier, listing the IBM meds from the discharge papers, I didn't highlight that his cataract surgery back in June went perfectly, followed by a quick laser touch-up about 20 days later. They were incredibly thorough with the prep work—the anesthesiologists even requested extra tests and had a direct consultation with the ophthalmologist. Honestly, the surgery was long overdue; he could barely see his own fingers unless they were a foot away from his face. We practically had to shadow him everywhere—"watch the stairs," "mind the curb," "careful, there are five steps here"—you name it. He couldn't go anywhere without help, and since the rest of us have to head out for work, he was essentially stuck at home being nearly blind. It was also a logistical nightmare managing his medication and making sure lunch was left in the exact right spot—we really needed to get this surgery done ASAP for his recovery. Now, he isn't just seeing again—he’s actually busy with little DIY repairs around the house 🙂—and when the weather is nice, we can take strolls for 2-1.9 miles miles without any trouble at all. Most recently, his stress test clocked in at 7 minutes, and the cardiologist says everything looks solid—both the ECG and the ultrasound showed an EF of 65%!! What specifically should we be looking out for at the dentist? That part is really important to me. Thanks, and I'm hoping everything stays smooth leading up to the scintigraphy. Best!

Scott Allen10 said:🙂.....

I certainly remember—and I'm genuinely glad to hear this story has such a happy ending. Please, don't feel like you have to thank me; honestly. It’s just nice that we could clarify a few things and offer a little help along the way. But really, this is just a small thing compared to the ocean of nightmares you're currently navigating toward safe harbor—so please know that you, and any family facing something similar, have my full respect.
I wish your father all the best—please pass along my regards to your sister and mother as well.

Regarding the ischemia... if I'm going by gut feeling—and let's be honest, my gut isn't always reliable—I’d say it’s just a byproduct of this current hospital stay, basically all the drama that's been unfolding lately. On a slightly dark note—if you can call it that—if someone actually had the luxury of choosing where to experience an insult or ischemia, the frontal region would be the smartest pick. It might not be the most glamorous option, but compared to any other location, the risks involved are generally much lower. Just a little perspective, I guess.

Best of luck!🙂

It’s been a while—time flies! I have a few questions to toss out there. First off, I wanted to say a huge thank you for all the info shared here, and especially for being such an incredible support system during that whole mess with my spouse about a year ago. Truly appreciated.
In short—he was discharged to go home on February 29th.
IBM
Ischemic dilated cardiomyopathy. Status post inferior-posterior STEMI.
Had three PCI procedures—LAD and Cx—this morning. I'm hanging in there.
Post-pneumonia complications—bilateral pneumonia, pulmonary edema leading to ARDS, and Stage II cardiogenic shock.
Morning update—post-cardiorespiratory resuscitation. All seems steady so far.
Severe mitral regurgitation—essentially when the heart's mitral valve doesn't close properly, letting blood leak backward—is quite a significant diagnosis. It’s definitely something that requires careful management and a steady plan from your cardiology team.
Type 2 diabetes—it’s quite the diagnosis to process. It really forces you to rethink your relationship with food and daily habits—all at once. Still, staying proactive is everything!
It looks like there might have been a typo in your message—it's a bit hard to make sense of that string of characters. If you were trying to ask something about cataracts or perhaps a specific medical concern, please feel free to clarify. I’m happy to help once I know what you need!

Back in June, things were being prepped for a cataract surgery—just routine stuff—but during the ECG, they caught an arrhythmia. I didn't even feel a thing, honestly! But the doctors took it seriously and kept me in the hospital right then and there. My discharge papers noted that I was admitted due to VT detected on the ECG. Following that, they ran an echocardiogram, a Holter monitor, and a stress test—which all pointed toward needing more invasive work. They decided on a coronary angiogram, where they performed balloon angioplasty and placed stents for stenoses in the OM1 and LAD after checking them with the FDA. They also successfully tackled stenosis in the CX and LAD via balloon angioplasty and stenting, with the OM1 confirmed by the FDA as well.
He’s finally been taken off his meds—Advil, Aspirin, Prilosec, Carvedilol, Lasix, Spironolactone, Zestril, and Trigard.
It would be a bit much to list everything from my three discharge summaries—honestly, I'd probably lose you in the details—but the gist is that my EF is sitting at 54%, and my left atrium is dilated at 52mm. I did an exercise stress test that lasted about 6.5 minutes; no rhythm issues popped up, but they did catch some 1mm horizontal ST-segment depression in V3 and V5. So, yeah—the ischemia test came back positive. Now for the follow-up—Dr. House wants me to go back in for another stress test, a Holter, and an echo. I’ll be knocking those three out this coming Monday and Tuesday—fingers crossed it goes smoothly—and then I have the myocardial perfusion imaging scheduled for next month.
So, this is all pretty new territory for me—I’m still wrapping my head around the terminology. I just received the instructions for the upcoming procedure, which involve pausing beta blockers, calcium channel blockers, and long-acting nitrates for a day or two beforehand. Since the cardiologist is supposed to make the final call on how to adjust those medications, I wanted to double-check: am I right in assuming I need to consult with my cardiologist before making any changes?
I was wondering—what exactly is VT? My sister's doing a stress test, and her technician specifically flagged it as something to watch out for. Also, since cold and flu season is officially upon us, how risky are fever reducers regarding this condition? Lastly, is there anything specific we should tell the dentist to avoid when they’re administering injections?
Apologies for drifting away from the thread—I feel like I’ve stepped right into my family doctor's waiting room lately.😉Feel free to move my post if it's in the wrong spot—I'm happy to let you decide. Thanks in advance, and sending a huge thank you to everyone who has been standing by us through this! Warm wishes to all.

Speaking from my own experience, if you don't have supplemental insurance this year, the biggest hit you'll take is roughly $1000 for a single hospital stay—regardless of what they actually do or how many tests and surgeries are performed.
That’s the ceiling.
However, if you get discharged after just one day and then end up back in the hospital—whether it's for the same issue or something else entirely—that counts as a second stay. That could easily cost you another $3,000, or perhaps a bit less if the stay was shorter or involved fewer procedures (like a quick 2-3 day stint with some imaging, for instance).☕
p.s. You can download the PDF for the standard treatment fee schedule right here

We've taken one small step forward, so now we're just hoping the process of weaning him off the ventilator starts looking up—the attending doctor mentioned that's the main goal before the cardiac surgeons schedule the surgery. It looks like they’ll be running a brain CT before the procedure, too—since he's been heavily sedated up until this point, any attempt to reduce the sedation has led to major restlessness, which in turn causes his oxygen levels to drop and triggers arrhythmias. I was wondering if anyone here has experience regarding potential brain damage in these kinds of situations? Thanks.

It feels a bit like I'm writing a diary—please ignore me if I'm oversharing, it just helps me process things a little easier.
Today, the doctor on duty—the same one who was there during the heart attack at JLL—requested and received approval from Prof. Duplančić to run another ultrasound. According to the doctor, this afternoon's scan was incredibly thorough and detailed. Based on those results, the Professor recommended moving forward with a coronary angiogram; according to the ultrasound, the heart looks slightly better than it did in the previous scan (which was done just a few hours after the attack). Currently, everything is stable, but we've essentially reached the limit of what can be achieved via ventilator and medication alone—we can't push any further without more info. Because of that, the decision was made to proceed with the angiogram, and I completely agree with their call. She hasn't told me yet if it will happen tomorrow, the day after, or on Monday—mostly because they need to coordinate with Dr. Junio, whom she recommends as the absolute best specialist in Miami. We'll know once they touch base with him. I realize how uncertain and risky this all feels, but I also know we can't stay in this limbo forever—so we’re holding onto hope and trying to stay positive.
Thank you all so much for your kind words; I really hope to be back with some good news soon.

A tracheotomy was performed—current status follows—though I'm assuming the oxygen concentration is at 70% because of the procedure? I haven't been able to reach the cardiac surgeon directly; I only received word (via his staff) that my husband's condition remains extremely critical. He isn't in any position to undergo surgery right now. His heart has been stabilized through medication, which needs to continue until his overall condition improves and he can breathe on his own—only then can they consider a coronary angiography or anything else. Emergency surgery was only an option immediately following the heart attack; too much time has passed now, so we just have to wait. Phew—it feels like every single day is lasting a month.

urbanscout50 said:Hey there!
Your husband is currently in critical condition—he’s really fighting for his life right now. The standard protocol here would involve stabilizing his hemodynamics first, then focusing on respiratory recovery to get him off the ventilator. Once he's stable, the plan is to move him over to Cardiology for a coronary angiogram and follow-up ultrasounds. From there, the cardiology and cardiothoracic surgical teams will hold a consultation to make a final call on whether surgery is necessary.
Given your husband's current condition, an anesthesiologist and a cardiologist really need to sit down and assess whether he can handle a coronary angiography right now—which, let’s be honest, is a risky procedure with its own set of potential complications—and if following that up with stenting or even full surgery is feasible. Usually, cardiac surgeons won't even consider operating without first seeing the results from an angiography to get a clear picture of the coronary arteries; plus, they tend to be very cautious about stepping in with patients this critical, since the mortality risk is incredibly high.
Based on that, you should try to talk to the anesthesiologists on duty at JLL—and don't be afraid to push for a direct conversation with the cardiologist overseeing his care. You need them to be clear and give you a definitive answer regarding the next steps and the treatment plan for your husband. While the anesthesiologists will certainly do everything in their power to stabilize him given how critical his condition is right now, at the end of the day, the cardiologists are the ones managing the heart.
Good luck!
Anyway—

Scott Allen10 said:The workflow at JLL is pretty straightforward—the attending physician handles all patients during their shift, then hands off to the next doctor the following day. Honestly, that’s the most logical way to manage care. It seems totally irrational to claim a single doctor is "managing" a critically ill patient when, in reality, nobody even checks on them once that doctor heads home or the weekend hits—though I know that happens in plenty of departments. By the way, which specific unit is the patient in? If they are performing percutaneous dilatational tracheotomies (PDT) in the ICU, that's a bit unusual to me—usually, ENT surgeons handle those via traditional methods in the OR, and PDT is generally much gentler. On the other hand, since they're on SIMV and a ventilator, they are definitely in the ICU. Ventilation modes really depend on the preferences of whichever doctor is on duty—but SIMV, being a volume-controlled mode that allows for spontaneous breaths, isn't necessarily the most lung-friendly option. Using BiPAP (pressure control) or combining CPAP with ASB helps prevent those high pressures that can actually damage the lungs... but hey, maybe I'm splitting hairs here. The numbers mentioned are definitely trending in the right direction, though. You should try to find out exactly how much of the work the patient is doing themselves—specifically looking at their spontaneous minute ventilation and tidal volume (or SpontMV and SpontTV if they're using Dräger Evita ventilators). If those numbers show the patient is contributing a significant percentage, that's a great sign. In my experience, things usually start looking up once the tracheotomy is done. Fingers crossed everything goes smoothly.

Regarding those doctors... the referral has been sent, so we'll just have to see if they actually show up—though, honestly, I wouldn't hold my breath—it feels like he isn't going to offer much insight. You should really try to dig deeper and ask if bypass surgery is even being considered—or if it was discussed previously—and somehow find a way to get a second opinion from a cardiac surgeon. These specialists—cardiologists, surgeons, internists—all tend to stay in their own lanes and avoid stepping on each other's toes. I get how those professional circles work, but if you insist on getting some clarity, at least you can tell yourself you did everything humanly possible. Good luck.

First off, thanks to you both for all the advice and explanations

He was seen by the cardiologist—Dr. Vujicic—today, and the anesthesiologist on duty mentioned that based on her orders, we’re sticking with the current therapy for now—still no interventions planned. While glancing at his cardiology report sitting on the bedside table (I was trying to be discreet—they don't allow reading charts!), I caught a few key phrases: "patient in post-cardiogenic shock state" and "recommend continuation of current therapy." Honestly, the whole report might have just been three sentences, and I struggled to make out the handwriting, especially since I was just peeking. What we were most terrified of was that mention of cardiogenic shock—we'd read about it online and the symptoms matched him perfectly, but nobody had actually used that term with us until now. Also, the doctor on duty told us today that the lung imaging hasn't shown much improvement since two days before that last heart attack. I did notice it's the first day he isn't hooked up to a defibrillator, and they've moved him into a semi-upright position for the first time since the infarct. He's currently on 60% oxygen with saturation levels between 91-92%. I signed the consent forms for a tracheostomy; they said it should happen tomorrow or the day after in the OR as part of the ICU protocol, performed by the top ENT team. Regarding the CMV and SIMV settings—he was on CMV today (60% oxygen), whereas yesterday he was on SIMV at 50%, and the doctor mentioned he's contributing about 1.5 liters of his own breath (I'd love some clarification on whether that's a good or bad sign). I didn't catch the specific ventilator model. I'm also trying to coordinate a meeting via phone with one of the cardiologists/cardiac surgeons and Dr. Karanovic. Haven't managed it yet, but I'm hoping to pull it off by Thursday.

Coming back to the cardiogenic shock—does anyone here have experience with this, or know what the typical next steps in treatment look like? And is it true what I read online regarding the mortality rate being around 80%?

Thanks so much

So, despite planning to see the cardiologist today—nothing happened. The explanation? A referral was sent over this morning, so he should be in tomorrow. This is the same specialist who handled the ultrasound after my husband's second heart attack—I think they mentioned Junio, though I'm not entirely sure if he’s strictly cardiology or cardiac surgery. Regardless, I’m going to try to track him down on his ward tomorrow once he arrives, just so I can hear his take personally (if that's even possible). They told me they won't make a call on the tracheotomy until after he weighs in—they've already written a referral for ENT (which makes me wonder, do specialists from other departments only show up when there's a specific referral?). Honestly, the updates I get every day at 1:00 PM are incredibly sparse—mostly just repetitive scripts. For instance, today, the doctor on duty—who is only the second one I've seen since my husband was admitted—basically just repeated yesterday's notes. I think I only saw Dr. Karanovic once back when my husband was at Furlong, and it seems like he might be on vacation right now. On top of all that, I still can't wrap my head around how the system works at JLL. People keep asking me which specific doctor is in charge of him, but there isn't one—it’s just whoever is on the rotation schedule. Based on what I heard today, it looks like it will just be the cardiologist giving his opinion tomorrow, rather than a full medical team as I was told yesterday.
Today he's on 50% oxygen and hitting a saturation of 97 (on SIMV). During those first few days, while he was on full ventilator support with 100% oxygen, he could barely break an 80 saturation level—so, looking at it that way, there is definitely progress, I hope...

Thanks for the reply—and yeah, you caught the timeline perfectly. It was only the 28th after that dramatic second heart attack when things really came to light. According to the Neurologist on duty that day, the first one was incredibly intense and hit a huge portion of his heart. They’ve now determined the heart disease is "long-standing," meaning there are older scars present. Up until that point, he had been treated for what they called "severe bilateral pneumonia." I know he underwent two or three bronchoscopies and two chest X-rays before then. As for other labs, he was admitted with a white blood cell count of 36; after a couple of days, it dropped to 27, and then just a day or two before the second infarct, it was down to 10. We haven't been given much detail regarding all the tests performed—all we were told once the infarct happened was that the initial issue was "atypical" and unfortunately wasn't recognized, which led to significant damage following the second attack. The transfer from Furlong was explained to me as a necessity due to overcrowding at JLL—they claimed he was stable enough to move then—but I later found out through others that he was actually moved because the cardio unit at the Cross is superior. No one even mentioned a surgeon to me, other than saying that stenting isn't an option right now due to his current condition. As the doctor mentioned today, a cardiologist should be reviewing his ultrasound and the rest of the team's findings tomorrow—basically, they need to huddle to figure out how to break this vicious cycle. I realize this is a forum, and I know I should stick strictly to what the doctors say, but I can't help constantly worrying about potential oversights or the worst-case scenario. I just want to find the best possible path forward—to at least know what questions to ask to see if certain solutions are actually viable for him. Right now, I feel lost; I don't even know what to ask for or demand. I am painfully aware that there was a massive oversight here—to put it mildly. From that very first night when he started feeling ill, my heart sank, but when the doctor tells you it's just pneumonia, you don't question it. I can't tell you how many times I've thought, "Lord, should I have just taken him to church instead?" Please forgive me—this is just a bit of anger and fear talking; normally, I'm quite composed. I'm waiting for tomorrow's meeting, but I'm terrified of it at the same time.

So, my Neurologist told me today that his clinical picture is looking a tiny bit better—but he still can't breathe on his own without the ventilator to keep his oxygen levels up. There's this constant edema forming, which makes everything so much harder since a large part of his heart was damaged by an infarct. We’re essentially stuck in this vicious cycle between the heart and the lungs right now. They'll probably have to perform a tracheotomy tomorrow (I think I spelled that right?) because he's been intubated for quite a while already. Tomorrow, the cardiologist and the rest of the medical team are meeting to decide on the next steps. If anyone out there has any advice or knows anything about dealing with a similar situation before they ask me to sign off on the procedure, please let me know...

Hi everyone!
I’m feeling pretty desperate and am looking for any information, advice, or explanations you might have... I haven't dealt much with heart issues personally, so I'm trying to learn as much as possible online.
Basically, my husband (50 years old, smoker) started having vomiting and stomach pains on the evening of December 19th. He thought it was just something he ate and didn't want to go to the doctor—he spent the whole night like that. The next day, the vomiting subsided, but he started coughing and having trouble breathing. After another night at home with worsening breathing and a fever of 100.4, we thought it was probably just a virus. It wasn't until the next day that I finally convinced him it was serious, because his breathing was so rapid and shallow. On the 21st, we finally made it to the pulmonary ward with a referral from our family doctor. The doctor immediately put him on an IV and oxygen. They ran blood tests and performed a chest X-ray—it turns out he had severe bilateral pneumonia, very low blood oxygen levels, extremely low blood pressure, and his face was a bluish-gray color. They asked if he had any history of heart disease or chronic conditions. He’s never really seen a doctor, so I told them I honestly didn't know, other than that he hasn't had diabetes, though his blood pressure has always been high during the rare times we checked it. Otherwise, he's in great physical shape; he walks about 3.1 miles miles almost every day and has for nearly 30 years. He was admitted to the pulmonary ward and moved to the ICU that evening, where he was put on oxygen, medication to support his blood pressure, antibiotics, and corticosteroids, because the inflammation looked so sudden it resembled poisoning. The following afternoon, things took a turn for the worse, and he was transferred to the anesthesia unit at JLL, where he was placed on a ventilator and sedated. They told us if he survives the next 2–3 days, there might be hope. He's still on the same therapy; they explained they have to maintain his blood pressure to help his lungs. Over the next few days, he seemed to improve slightly, so on the 26th, they moved him to a hospital with a better cardiac department. He managed to get off the ventilator and stabilize his own blood pressure, so they didn't need to assist him anymore. Then, on the morning of the 28th, while on the ventilator, he suffered a massive myocardial infarction—it was huge and affected a large part of his heart. They resuscitated him at least four times between 8:00 and 12:00. An echocardiogram revealed that his heart already has scarring from previous infarcts, and that what happened on the 21st—when he was vomiting—was actually a heart attack occurring in a location that presented as stomach pain. He was started on cardiac medication along with everything else, but his lung condition worsened; he developed pulmonary edema. He needs stents, but his lungs just aren't improving. As of today, no one has given us an optimistic prognosis—in fact, they haven't given us any at all, though we can see some progress via the monitors. While he was initially on 100% oxygen with saturation barely reaching 82–83%, they've gradually lowered it; today he's on 60% oxygen and hitting a saturation of 96. There were also issues with urination after the last infarct, and his arms and legs were swollen, but that has subsided now, and they said his kidney function stabilized yesterday. When they reduce his sedation, he becomes very restless, which causes his vitals to drop. Two days ago, the doctor tried to have him breathe without the ventilator; he managed for about an hour, but as soon as he became more alert, he developed an arrhythmia and his saturation dropped, so they had to reconnect him. I'm wondering how long it's possible to be on a ventilator before further complications arise, whether this state could lead to brain damage, or dependency (since they say he requires high doses of sedation and is getting 40mg of morphine). Do you know of similar severe cases and what the survival chances are? Can the lungs heal given the state of his heart? The doctors say the lungs are the main issue, but fluid keeps returning to them because his heart is too weak. I'm interested in anything you can tell me.
Sorry for the long post.