Billy's Empyema Thoracis Ordeal
This page is set up for the friends and family of Missy and Bill Ellingham to keep you informed of Billy's progress.
While Missy and Bill kept vigil at Billy's bedside, email and irc access was limited so updates were be posted here.
Now that Billy is home, there are still weeks of convalescence ahead.
Further significant progress reports will be posted as and when they are advised.
Empyema Thoracis is a condition in which pus and fluid from infection collects in the pleural cavity (space around the lungs). Empyema is most commonly caused by the bacteria, Staphylococcus aureus, and is most frequently a complication of pneumonia.
28 Nov - Visited doctor with respiratory difficulties
3 Dec - Billy had to be collected from school and taken to the doctor . The diagnosis was bronchitis. Hopefully the new meds will do the trick with his lung woes. His stamina is kaput. He can hardly finish a sentence without having to take breaths between words.
29 Dec - Billy still not totally well and became feverish
3 Jan - Admitted to North Oaks hospital in Hammond with suspected pneumonia. One of his lungs thought to be full of fluid and infection. They asked if he has a family history of turberculosis.
4 Jan - Following a CT scan of his lungs, it was determined he had a chest cavity full of very thick infection that had collapsed the lung. They inserted a chest tube to drain that out. The first cultures were actually putty-like.
8 Jan - Doctors have determined that a fibrinous pleural rind has formed on the lung, encasing it and preventing it from expanding. Surgical decortication of the rind is necessary to alleviate and allow the lung to re-inflate.
9 Jan - Bill given shore leave and arrives home.
10 Jan - Relocated by ambulance to the CCU (Critical Cardiac Unit) at Ochsner Foundation Hospital in New Orleans. Surgery scheduled for Monday afternoon.
Ochsner Foundation Hospital
1516 Jefferson Hwy
New Orleans, LA 7012111 Jan - Billy had his first bath since going into hospital and was feeling much better after it.
Schooling Provision - Three hours per week of in-home teacher time is being arranged through the "Homebound" program, so that during the time of Billy's convalescence at home a teacher will visit and assist him to keep up with his studies. As soon as the application is processed the time begins to accumulate. If it takes three weeks for him to feel up to school work, he'll have nine hours stored up. This will continue until he is well enough to return to school.
12 Jan - Tests have shown high phosphorous levels. It seems to have to do with him having lost so much weight so fast. the result is he has to limit his protein intake. He's a real meat eater, so that's not making him happy.
13 Jan - Pre-op consultation with Dr Do, who will assist Dr Abbas in the operation.
The procedure, is expected to take 1-2 hours and involves a thoracotomy, a 6 inch incision in the side or back to give the surgeon access to the the lung through the rib cage. Surgical decortication of the fibrinous pleural rind will free the lung and enable it to reinflate.
From pre-op to post-op recovery is expected to be about 5 hours. It is expected that he will return to his room at that time.
14 Jan - Surgery is scheduled for 2:30 pm.
12:15pm - Taken down to pre-op.
4:05pm - Taken into surgery
7:00pm - Billy is out of surgery.The rind was older, thicker and more extensive than anticipated, extending to the chest wall and heart lining. It took longer to work on it. Billy lost a lot of blood but didn't require a transfusion. The incision is larger than the surgeon expected it would be. He was unable to get all of the rind but feels what remains will not cause loss of lung function once Billy heals.
10:00 - Nurses advise that Billy is doing fine and will be returned to the room as soon as the anaesthesia wears off.
11:00pm - Billy is back in his room, groggy but good.
15 Jan - Almost to the minute, 12 hours after he left the room Billy is back and much to the nurse's surprise has already sat, stood and walked to Aunt Missy for a hug. She is so proud of him.
2:00pm - Billy is in a great deal of pain. He's doing well, considering it's not yet 24 hours post-op. He sat up for about 45 minutes in a chair and walked to the end of our hall and back. His oxygen saturation level is at 98 which is good. He has a catheter in and that is uncomfortable. He has two chest tubes now instead of one. He has special wraps on his legs below the knee that inflate and massage at frequent intervals as well as tight support stockings from the knee down, all in an effort to prevent blood clots from forming. Every effort is beig made now to prevent pneumonia. One thing he has to do is cough and cough hard and often. That is very painful to do right now. He's getting breathing treatments to help him cough up any phlegm and to keep his bronchial passages moist so that coughing will be easier. The more he walks and sits up, the faster he'll get over the worst of the pain. Once he no longer needs the epidural pain narcotics, they'll remove the epidural and catheter. After that, the next goal will be to get him to the point where they can remove the chest tubes, and then he can go home. The medical staff say a week, maybe two is the norm.
10:00pm - Billy sat up in the chair for over three hours today, quite a feat with two chest tubes in and an incision that starts in his back and winds around to his chest. He is in much less pain tonight than he was this morning. He walked again this afternoon, too, a good bit farther than he did this morning. Right now there are two concerns. His shoulder was in a difficult position for the three hours of surgery and is now very stiff and he either can't move it or is afraid to move it because of its proximity to the incision and chest tubes and it just hurts. Heat is being applied and that may help. Some physio will start tomorrow to loosen it up. The other concern is that his urine is cloudy. A specimen was sent to the lab but no results, yet. He's awake now, watching wrestling on TV. His voice is much stronger and he's talking more. This morning he resisted talking unless it was absolutely necessary.
16 Jan - Billy attempted to get out of the bed on his right side for the first time, the side of his incision and chest tubes. The stress on the incision caused him pain for hours. The anesthesia doctors increased his medication to help him. Despite the additional pain Billy walked a lap of the ward, twice the distance he walked yesterday, and in less time. He sat up in the chair for a good long while, determined to pass yesterday's sitting time. Dr. Do said that one of the chest tubes isn't draining anything at all, and indicated a possibility of removing that one. They may do that tomorrow.
Billy has tried hard to not use the medicinal pump today, but the new manoeuvre out of bed sabotaged his efforts. Once he no longer needs that pump for the morphine like drug, he can get the epidural out of his spine. Six hours after that, the catheter can be removed.
Bill left to return to the boat today.
Billy was fearful of the new IV line. Others have taken multiple tries every time.
This is Dina. She did it in one stick with no pain.17 Jan - Billy was able to get out of bed on his own today. He awoke hungry too. Radiologist has been and if xray is clear both chest tubes could be removed today.
2:00pm Chest tubes have just been removed. Billy can go home tomorrow
6:00pm - All tubes including catheter and epidural are now removed. Expecting to be discharged in the morning.
18 Jan - 9:45am Discharged by the physicians.
10:30am - Waiting for Uncle Vernon to come and help move 16 days of stuff
1:00pm - Heading home to recover after a 16 days in hospital.
8:00pm - Safe at home, Billy is sore but coping with the pain on oral medication. He's going to have to work hard on the right shoulder mobility, on his inspirometer to strengthen the weakened lung, and on coughing hard (which hurts lots) to prevent pneumonia from setting back in.
19 Jan - Billy has done very well on his first day home. The mobility in the right shoulder has increased a LOT. He's been up and about a good bit of the day. His spirits are high. He got in and out of the shower on his own.
20 Jan - A quiet day at home Billy slept off and on most of the day. He insisted on cooking this evening, He felt so much more himself as he cooked. The incision is healing well and there is only very minimal seepage from the holes in his back where the chest tubes were. It should be only a few more days until the wounds heal enough to go without bandages.
21 Jan - Today brings more range of motion in Billy's shoulder. Uncle Vince came by and did some massage on Billy's shoulder again today and that helped a lot. He played with his Wii a bit, and that made him very happy. He also helped prepare a vegetable beef soup. He is happiest in the kitchen. The wounds look very good and soon the the chest tube wounds will be able to remain open to the air. With temperatures down to the low 20's here, he is confined indoors. Once temps warm up a bit, he will venture outside in small doses.
22 Jan - Today Billy got a taste of fresh air. He took the ride to pick Reggie up from the groomer, then to get the ingredients for stuffed hamburgers which he saw on Food TV last night and insisted he make for dinner. And he did! Delicious burgers stuffed with Monterey Jack cheese.
One of the maneuvers the doctor wanted Billy to be able to do was hold a comb, start at his forehead and comb all the way back to the nape of his neck with his right arm. Today he did it. It hurt and it was cumbersome, but he did it. He has worked very hard to regain mobility.
Using smaller bandages, the area of his skin exposed to tape down by about 90 percent of what it was. The smaller bandages are still effective. Changing the dressing was much less painful today.
On his own, Billy took only one pain pill each dose until late evening, when the stress of the day and its increased activities caught up with him. For that one dose he returned to the prescribed amount . He is well on the road to recovery.23 Jan - Not much physical change today. Billy received a stack of beautiful cards with lovely messages from Youps and an adorable wooden truck with his name on it which sported HUGE lollypops that were actually cookies from Amazing, Bambi, Itsy, Makk and Scottie. A huge thanks is due each one of these StarLink-IRC folk for putting a smile on Billy's face. He also had a visit from Aunt Pat and Uncle Howard who came bearing gifts of soup and goodies and money for a special outing once Billy is ready to go out and about.
25 Jan - Yesterday there was some seepage from one of the chest tube wounds. It caused concern because it was a different color. He didn't have any fever and the wound is not angry, red or swollen. The wound seeped more blood overnight than ever before. It took until late afternoon to get in to see the doctor and he put Billy on an antibiotic. If the wound gets any worse Billy will have to go back to Ochsner Foundation Hospital to be seen by one of the thoracic team . Other than the ugly seepage from the chest tube wound, all is well for Billy.
29 Jan - Nothing new to report. The tube wounds are no worse. The incision is healing well. Billy is scheduled for an X-ray on Friday, then the staples will be removed.
1 Feb - Staples were removed today. All restrictions lifted. Billy is at 85 percent lung capacity and it won't expand more. With exercise he can build endurance up to regain 100 percent function despite less lung capacity.
2 Feb - When the doctor said do whatever you feel you can do, and do lots of it, Billy said he wanted to go to a parade. Here's his wish come true!
12 Feb - The teacher who has been assigned to do his homebound instruction and to be his advocate within the school system is Mrs East. As Billy has been out of school so long, he has a bit of work to do to catch up.
Missy (NOLady) and Bill (gngrbrd) thank you all for your care, support and prayers.
Last Update 3:00am 2 Feb CST