Allen Hospital - After dialysis

Hello friends,
On Wednesday, April 7th.  I spent the day at Iowa City Hospitals.  This was the full day of donor tests, blood workups, psychological interview, physical, ekg, cat scan with contrast, etc.  These tests are to determine if I am physically healthy enough to undergo donor transplant surgery.
Blood work was first and all there looks good.  Clotting potential, cholesterol, sugar, etc. were all acceptable.  Pysch evaluation, donor education were next.  Ekg and chest extra before lunch.  Then a full physical and finished the day with a CT.  That CT with contrast was a rush.

Denise had gone along to support and keep me company.  She was not feeling very well the whole day.  So spent most of the time in the various waiting rooms.  She had a very bad headache, so sat with her head in her hands trying to remain quiet and inactive.  She had been told that her high blood pressure was a strong contributor to these headaches.  Her blood pressure on Dialysis days is usually between 160 and 180.
Since she is usually a Mon, Wed. Fri dialysis patient, she had bumped her Wednesday appointment to Thursday so she could join me in Iowa City on Wednesday.
Wednesday evening when we got home she crashed on the couch and relaxed.  Her dialysis appointment was at 6am on Thursday.  She was up and out of the house before I got up for work Thursday morning.  Around 11:20 Thursday, the Dialysis Center called me.  I was anticipating that she didn't feel well enough to drive home and wanted a ride.  No, the Dialysis Nurse was informing me that they had called an ambulance and were going to transport her to Allen Hospital.  She had become lethargic and her blood pressure was very high.
When I got to the Dialysis center, the ambulance was loading her onto the cart.  She did not react when she saw me.  She was not saying anything and looked very confused. A quick trip to Allen and a visit with admissions office put us in her room at 12:30.  She was acting like a person who was in a very deep sleep and didn't want to wake up.  You had to nudge her and ask her simple questions in order to elicit a response.
The staff advised that she would be getting a chest xray and a cat scan.  Family members were called and notified of the events.  As family started arriving, the nurses took her to x-ray and CT.  After 20 mins or so, she was returned from radiology.  They did not report on the X-Ray, but did say that the CT had revealed something.  They would be moving Denise to ICU-West very shortly.  In ICU they could give Denise medications through her IV.  A neurologist was called in to review the results of the CT.  Her Nephrologist was also consulted with.  After a couple of hours, we spoke with the Neurosurgeon, Dr. Z.  He wanted to do a MRA or CTA, but needed consult with Dr. K the Nephrologist first.  The earlier CT was showing a pool of blood (Hematoma) on the right front quadrant of her brain.  What Dr. Z didn't know was if there was an aneurysm hiding behind the hematoma.  Allen is not equipped to handle aneursyms, so if that was the situation, she would have to be transported to Iowa City Hospitals.  The MRA or CTA should be able to tell us if an aneurysm existed.  Either way, surgery was most likely going to be needed before the end of the day.
Late afternoon on Thursday she was taken for a CTA (Cat Scan to map Arterial vessels.). The CTA indicated that no aneurysm was present.  The most likely cause of the hematoma was a combination of her high blood pressure (218/113) and the blood thinners/anti-coagulants.  Dr. Z explained that occasionally people with high blood pressure will develop inner cranial bleeds.  However, people normally clot and the bleeding naturally stops.  Since Denise was on Cumidin (anti-coagulant), her leak did not clot.  She now had a 5mm thick pool of blood above her right eye, extending back to her ear.  The pool was pushing her brain 7 to 8 mm to the left.  This pressure on her brain is why she was so groggy and was beginning to effect motor skills on the left side of her body.
After a long discussion, surgery at Allen as consented to and scheduled.  We had hoped that Surgery would begin at 6 PM.  Since Denise had been been on 'blood thinners' for so long, they had to 'thicken' (make the blood more capable of clotting) her blood.  It took 9 bags of PPFP to get her INR to 1.3.  They would hang a bag, let it drain, then do a blood test to see if the INR was acceptable.  This went on until 12:30 AM Friday morning. Each bag and test cycle had token 45 to 50 minutes complete.
At 1am they started the Craniotomy. They estimated 1.5 to 2 hours.  Longer was better, it meant that they were finding and cleaning the problem areas.
At 3 am we were notified that Denise was in recovery and the she was doing well.  At 4 they would move her back to ICU.
Dr Z later reported that he felt very positive about the surgery.  He felt he had gotten 95% of the pooled blood.  No obvious ruptures or leaks remained.  He felt that taking her off of the Cumidin and adding the PPFP had actually helped to start the bodies own healing process.  Essentially, all he had to do was the cleanup.  Now we had to wait and see if there would be any long term effects from the inter-cranial pressure.  Motor skills and weakness were the things to check. 
At this point, friends and family started to go home.  All were tired and baths were needed. Later Friday morning after a quick shower and change of clothes I returned to the hospital.  Denise was still disoriented and very groggy.  Friends and family trickled in and out all day.
On Friday they brought in a portable dialysis machine.  They had put a significant amount of fluids on her the evening before.  They wanted to get that fluid back off and transfuse a couple of units of blood as well.  Denise was on the dialysis machine from 1 to 5 pm.  Her blood pressure was still a little higher than we owuld have liked, but the Nurses and Doctors were monitoring it closely.  She was still sedated as she was intubated for oxygen saturation.
Early Friday evening, Amber and Grandma arrived.  We have been moved from ICU-West to ICU, so it took them a bit to find us.
Denise was not much more responsive, so all said their good-byes and called it a night.  Many of us hadn't had consecutive hours of sleep since the ordeal began.  We all went home for much needed rest.
Back to the hospital first thing Saturday morning.  Denise is doing better.  She actually put a couple of full sentences together. They were able to spoon feed her some water and apple juice as part of a swallowing test.  Denise stated that she didn't like the apple juice as it was nasty.    Kim came to visit, Denise recognized and smiled at her.  Denise's blood pressure is still higher than we would like, they are adjusting her medication accordingly.  Dr. Z. reported that he is very pleased with her progress.