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May 31st, 2009

The Fight of His Life

As I am writing this, my beloved grandfather - Riley Claude Prestenback - lies in the Critical Care Unit of a local hospital fighting for his life.  Since he was rushed by ambulance to the emergency room last Wednesday, our lives have become a roller coaster of bleak distress and hopeful trepidation.

On Wednesday, May 27th, around 9:30am in the morning, my brother, Johnnie, called to inform me that our Pa-Pa Riley (pronounced "paw-paw", btw) - my mother's father - was en route to Our Lady of the Lake hospital via ambulance.  My stepfather, Tommy, was in the ambulance with him and Mom was in a tearful panic trying to finish up what she was working on so that she could rush to the hospital herself.  Thankfully, my sister - who my brother called just before me - had already left work and was rushing home to pick Mom up and bring her back to Baton Rouge.  None of us wanted her driving as upset as she was.

What we thought was a simply intestinal blockage turned out to be much more.  At some point in the past couple of weeks or so my grandfather's colon had ruptured.  Being his usual stubborn self - and not wanting us to worry - he had kept how bad he was feeling to himself.  Mom only knew that he was "constipated" and bloated.  During the initial surgery Wednesday evening, the doctors removed nearly 50% of his damaged colon.  He was very ill from the toxins, and all of the other waste the body normally eliminates through stool, that had leaked into his abdominal cavity from the rupture.  His very wonderful doctor, Dr. Kleinpeter, also informed us that several nodules were present on his colon and a few other organs.  Biopisies - to date - have showed them all to be benign, but Dr. Kleinpeter is still worried that cancer exists somewhere and is causing all of these problems.

By the end of Wednesday, Pa-Pa Riley was lying in the Critical Care Unit on a ventilator; his stomach "left open" from the earlier surgery so that the surgeons could easily go back in when he was more stable and they had the results of the initial biopsy back.  That night, his future was uncertain.  He has high blood pressure and diabetes, and the damage from his ruptured colon and the surgery had been almost too much for his body.  His blood pressure was in unsafe territory and his heart rate too high.

Just before his surgery, I rushed to the hospital from work to see him.  As we did not know he would need surgery when he first brought in, I hadn't left for the hospital as soon as he got there.  When they called to tell me he was being scheduled for emergency surgery, I feared I would be too late to see him beforehand.  However, as I pulled into the ER parking lot, my sister, Amber, told me on the phone that I still had time.  She met me inside and led me to the small prep room where my mother, my stepfather, Tommy, and my mother's brother, Uncle Keith, stood around a hospital bed that held my normally sprite and healthy grandfather.  He smiled when I rushed into the room and I thanked all the gods I could think of for letting me get there in time to see him.  Since he has not regained full consciousness since that time, I know now - more than ever - how blessed I truly was.  I had about ten minutes with him, wherein I joked around and made him smile and even a share in a few small laughs.  He was weak and in pain and, I know, embarrassed to be "in public" without his teeth in; even if that public was no more than us and the nurses and doctors who swarmed around, taking notes and asking questions.  Mostly, I could tell that he was scared and, though we all put on a brave front for his benefit, we were, too.

Since then, it has been a day to day - and often, hour by hour - vigil.  He is surrounded by kindhearted, competent nurses and astute, compassionate doctors who encourage us to continue talking to him and keep us wholly informed of his changing condition.  They talk to us personally when we come in and call us on the phone every morning or in the event of any sudden difference that occurs in his care or with his vitals.  We've told them all that when he gets better, he'll be busy making his infamous bread pudding for each of them.

When visiting hours arrive, always a couple or more of us are there to be with him.  We hold his hand, talk to him, put on his favorite TV shows (he will be so miffed about missing Days of Our Lives).  We know he can hear us.  In fact, last Thursday afternoon they tuned the television to his soap opera and his heart rake spiked a noticeable bit.

Presently, his condition is as follows:  He runs, off and on, a low-grade fever and his white blood cell count is slightly elevated as his body attempts to fight off the infection that still lingers from the ruptured colon.  A pocket of pus near his liver was removed in an emergency surgery Friday afternoon; one from which we were advised he might not survive as he was rushed into it with a fever of 104 degrees and dropping vitals.  Since then, his fever has been either non-existent or low.  Right now, a low-grade fever - along with the white blood cell count - is a good thing as it means his body is still fighting.  As I mentioned, around 50% of his colon has been removed and more may - as yet - have to come out.  If he survives this ordeal and is able to come home, he will be doing so with a small bag on one side of his body for his small intestine to drain and a colostomy bag on the other.  Being charmingly vain and always conscious of his appearance, we know he will abhor this aspect of what will be his new life.

He is, sadly, in acute renal failure and the doctors have spoken to us of his undergoing dialysis.  Currently, he is too unstable for the procedure, and his kidneys are producing just enough fluid on their own so that emergency dialysis is not yet needed.  Since yesterday, his kidney output has nearly tripled, and so that is good news.  His kidneys were already weakened as a result of his being diabetic, and the extra strain of trying to purge the toxins his colon could not caused the failure.

For the past couple of days his blood pressure has been holding steady.  While it isn't anything to write home about, it is considerably better than it was late last week.  None of his vitals are good enough for him to be labeled "stable"; he is still in critical condition.  While those numbers fluctuate - sometimes dropping enough for alarm - he is holding strong, for the most part, and his body is still fighting.  Not too surprising for anyone that knows the tough, stubborn, old goat we all love so much.

All of your thoughts, prayers, and well-wishes have been so very appreciated and I ask that you, please, continue to keep Pa Riley and the family in your affirmations as he needs all of the help he can get.  So, too, does this weary family; I thank you from the bottom of my heart.

Tomorrow morning I start work at my new job - wish me luck!  I regret that I could not be going into this with a lighter heart and a less burdened mind, but life is rarely such a walk in the park.  However, I intend to be my best, give it my all, and shine as brightly as I can for that is what my grandfather would want.  He was always proud of my accomplishments at my old job, and I want to make him even more proud in this new venture (regardless of his ribbing that "state workers never actually work").

Once more, thank you all; I will keep you posted.

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