Surgery at UPMC on Monday

Dad is scheduled for surgery at UPMC Presbyterian on Monday, March 1st, most likely in the afternoon. Assuming that the surgeon finds what is expected, Dad's left forefoot will be amputated. The technical term for the procedure is a transmetatarsal amputation. The surgery is necessary to remove a significant area of dead tissue that resulted from tiny blood clots (a/k/a shower emboli) that were a known risk from the original surgery to repair his aorta.

While I alluded to the problem briefly in an earlier post, I haven't written about it due to the sensitive nature and, frankly, considerable uncertainty about the treatment plan. I preferred not to speculate on such an important point.

Dad and I talked at some length about what was going to happen and why. He understood the situation and is on-board with the surgery option (not that there is an option). Clearly, though, he is depressed and concerned. I can't imagine.

• Dr. Rabih Chaer (pronounced SHAR) the senior vascular specialist who will be doing the surgery, concluded that the amputation is needed due to the significant risk of infection in some areas of damaged but not dead tissue immediately adjacent to the dead tissue.
  
• The right foot sustained the same type of damage, but to a much smaller extent and without the apparent risk of infection. The plan is to let nature take it's course and allow the tissue to slough off on its own.
• Obviously, an amputation is disappointing, to say the least. However, this prognosis is much better than other options that were presented to us.
• One piece of good news is that resolving the problems with Dad's feet should allow his recovery to move at a faster pace. Due to the damage to his feet and the efforts to avoid infection, he has been bed-ridden since the original surgery.
• Also good news is that Dad will be able to walk on his own.
  

Otherwise, Saturday the 27th was a good day (I know, some of you must be thinking, "Other than that Mrs. Lincoln, how did you like the play?").

• He was alert and responsive throughout the day.
• The weaning process was resumed and Dad breathed well on his own and was able to speak clearly (actually staying off the vent until Sunday afternoon).
• His vital signs remain strong and steady.
• The fine people at UMPC ICU are taking good care of him.

Sunday continued to be relatively uneventful. As noted above, Dad was off the ventilator for a total of about 26-27 hours.

• While off the ventilator, he maintained good oxygenation and heart rate. By around noon, he was getting tired and he went back on the vent for an assist that would let him rest.
• He was alert and responsive.
  
• Vital signs and other tests continue to be good.

Please pray for a successful surgical outcome and for Dad to recover quickly. Also, please pray for peace and strength for Dad as he deals with this traumatic event.

Thank you, as always, for your support.