Christmas Day, Wednesday, December 25, 2013

It has been a long time since our last blog. For those of you still following Pat's adventure, here is the latest update.

We last came home from the hospital on 12/14. Pat was weak, and had some annoying 'side effects' of hospitalization, but has been working to get better. The week of the 16 - 22 was good, as Pat was home and working on getting stronger. And thanks to kind friends from Park Church and those we know from around town, life was a little easier and a little less hectic! So many, many thanks for your visits and meal drop-offs and the cards and well-wishes that keep coming.

We met a milestone on December 17. Before Pat went into surgery on September 25, she gave me her wedding ring to keep safe. I wore it on a ribbon until I could finally put it back on her finger on Tuesday 12/17.

Pat had a visit to the Radiology department on Christmas Eve. They did some stuff, and replaced two drains with one single one that seems to be working pretty well this time. Also, to Pat's great relief, she did not have to be admitted to the hospital after having a procedure done (as has happened in the past). We came home, by way of a few French fries, by 11 AM. A nap and a snack and Pat was up and ready to go.

On Christmas Eve the Trowbridge family did what it has done for the past 15 years: we put luminaries along Cambridge Street. It has become a tradition for us, but we did not know how much of a tradition it was for others along our block. Pat stayed inside with the littlest grandgirl (Evvie) while Brian and David and the two older girls (Sylvia and Veda) went down the street with me, putting luminaries on each driveway. At the end of the street a family was waiting for us, saying that they looked forward to our visits each year. Sylvia and Veda burst into a rendition of 'Rudolph the Red-Nose Reindeer' which brought smiles all around. Sometimes we don't realize how much the things we do bring joy to others.

Included in this blog are, finally, some pictures. Pat is home, and here is a picture of her and her mother, who has spent so much time with us and has been soooo helpful over the past months (along with Pat's sister-in-law Suanne), and there are pictures of grandgirls Sylvia, in a hat, and Veda, and Evvie with Valerie. There is also a picture of the luminaries at night. What can't be shown in pictures is the love and graciousness that so many people have shown to us over the past months.

We'll get Patty back into action as soon as we can. I promise.

Happy Holidays,
Greg

Saturday December 14 2013

To Pat's blog followers -

It has been a long time since the last post, so here is the update. Pat came home from the continuing care facility on December 5 (yea!) and was doing well at home, though quite a bit weak. She really liked being home, to be sure! Her mom was here, and we had real food made the way she liked it.

On Monday 12/9 we went to the hospital to have some relatively routine things done to her drains. However, Pat was quite weak that day and not feeling well and they sent her over to the ED (Emergency Department) and they checked her hemoglobin and it was quite low. This led to a few more days in the hospital and, after a few procedures and people doing things to my Sweetie, she is feeling much better. As of today, she is still in the hospital but feeling good and ready to come home again, this time for a while, I hope. She should be home today or Sunday (12/15) and her mom and I are finally getting around to putting up some holiday lights and things to surprise Pat when she comes home.

And speaking of things we can finally do: back in September Pat gave me her wedding ring to keep while she was in surgery. I kept it on a ribbon around my neck until, finally, I could put it back on her finger this week. It was cool.

That's the brief update from us, and we are wishing everyone Happy Holidays!

Greg

December 4, 8 AM

To all Pat's blog followers-

Good news! Pat is doing great. Lots of things are happening. She has been granted independence in the facility (she can go around without having PT or a nurse or her husband assisting her). She is still using the walker, but is going farther and farther without taking breaks.

Speaking of farther - I was able to take Pat to her doctor appointment yesterday (Tuesday, 12/3). This was the first time since 9/23 that Pat has ridden in a car instead of in an ambucab. She got a little tired but did well, and the news from the doctor is encouraging. Pat's drains were rearranged on Monday, and seem to be working better, and so her skin is getting better. So, after the doctor's visit, Pat said, "let's go to Culver's," and so we went through the drive-thru at Culver's and Pat ordered crispy French fries and a well-done burger. You should have seen the smile on her face as she ate the fries. I think this was the true milestone.

She also worked with occupational therapy and can get in and out of bed, so we probably won't need to get a hospital bed at home. Pat is so looking forward to being in her own house and, though she is really a 'people person,' and likes to socialize, she has really had enough of nurses and staff and beeping things and pills in the middle of the night, and wants to be home with some silence and Blue Bloods on our home TV.

So stay tuned for the arrival home!

Greg

Friday, November 29

Hello, blog followers! I am sitting with Pat this morning. Though I worked at the hospital on Thanksgiving, but was able to get some turkey dinner and have it with my Sweetie Thursday night. Today she is up and going to physical therapy and reading her own mail (I have been reading her your cards and letters, but today Pat has taken control and is opening them and reading them herself! She is right now enjoying a big stack of letters from the kids at Palmer school.

More later!

Tuesday, November 26, 10 PM

To all of Pat's followers:

I have just come from Pat's room at the Spectrum Health facility, and it is time for an update. First, and of great importance: after work, I brought my iPad with me to Pat's room. We got a chance to watch the Big Bang TV show together. It was cool. 'nuff said.

 Pat is feeling much better. More and more I see that smile for which she is so famous. Pat is doing more in physical therapy, and has gone up several steps, which is one of her milestones. It was quite a workout today, and she was very tired, but very accomplished. She doesn't always think she is making progress, but I see her doing more every day. Now that she is feeling better, the hardest thing is having to be apart while I go to work. Her mom spends a LOT of time with her, and helps Pat with activities, and provides encouragement, and is doing a lot at home to get the house ready for when Pat is discharged to home.

Pat is off oxygen, and we are gradually working to decrease the number of tubes she has to drag around when she does PT and OT. We are close to losing the wound drain, and then, who knows?

I (Greg) got to have a visit with the grandgirls. David and I, and Sylvia, Veda and Evvie went to see the dinosaurs at the Grand Rapids Public Museum. The dinosaurs moved and roared and the girls thought it was great fun. The Museum is a really nice place to visit.

Pat got a surprise visit from a couple of friends. Here are Kim and Paula, bearing gift to banish boredom and bringing some friendly banter into a busy day.

Once again, it is hard to emphasize enough how much your cards and comments mean to Pat. I read them to her and she loves knowing about what is happening at Church, and Palmer school, and at all the places our friends and family go. It really seems to encourage her that all this will get better!

Stay warm, and have a happy Thanksgiving. I will be sharing a bite with my Sweetie that day. And looking forward to the day she is back in her own home, and to when she will be back in action!

Greg

Friday, November 22

I'm updating the blog, belatedly, from Pat's bedside using my iPad, so beware of typos! So is Vi. I just read Pat your cards and letters and it brought big smiles to her face. She is happy to hear about the progress of Night of Giving, and what's going on at Park Church and and the Miss Fits!

A more detailed blog will be coming soon!

Greg

Sunday, November 17 11:45 PM

The wind sure is blowing! We hope everyone is okay and still has power.

Today Pat had a procedure to drain some fluid in her tummy. All went well, no problems. Pat is still uncomfortable, and so her mom and I will be working to find what works well for her to eat and drink. It might just take a day or two for everything to settle down.

She is in the acute care hospital setting now which means close observation but also more pokes and vital signs being done through the night. It's a trade-off. But Pat got something for discomfort tonight and I think she will get some sleep.

Pat's mom, Vi, has been as wonderful as a mom can be. She is Pat's guardian and protector, and always checking with the nurses to make sure everything is going okay. She is at Pat's bedside a lot, especially this weekend when I had to work. I have no mother-in-law jokes because mine is a real gem.

Also wonderful are the comments we get from everyone. Pat loves keeping up on what is going on 'out there.' I know a lot of you sent Halloween cards to Pat at the NIH. She was transferred out of the NIH before the cards arrived, so - surprise!- a few days ago we got a HUGE bundle of Halloween cards. I read every one to Pat and that sure got some smiles! Even though it was past Halloween, Pat thought the cards were great!

So, keep the sweet lady in your thoughts and prayers. You are all kind and gracious people, and I can tell by the messages you send to Pat. Thanks.

Greg

Saturday, November 16 2013

Hi, Pat's followers! Time for a much needed update. Well, E and Froggie have been doing a bit of traveling. For a few days Pat has been feeling a bit under the weather and has been getting tired more easily. She did not like this one bit, as she was trying to do as much physical therapy as possible and it was getting harder and harder. The PA (physician's assistant) at the Continuing Care facility saw that Pat wasn't feeling well (as did I, for a couple of days or more) and so she was sent to Butterworth. She is now at Butterworth, a bit uncomfortable, and waiting for the doctors to fix some things, which is scheduled for tomorrow, the 17th. This won't be major surgery, but just some stuff to help resolve some problems.

Everywhere Pat goes, the nurses like her and the aides like her and all the staff likes her smile. Even in the midst of problems, Pat touches people's lives and makes them better. As for me, I'm working full time, but the distance from where I work at the Children's Hospital and Pat's room at Butterworth, well, it's just a short walk down a couple of hallways. So if she has to be here, I'm glad I'm here too.

I'll post updates soon. Thanks for your comments because Pat loves to hear them! And thank you for your prayers and thoughts.

Greg

Hello, Pat's Blog Followers!

And apologies for the delay in an update. It's so nice to have Pat back in GR that I have spent a lot of time at her bedside. Well, it's time to update the blog!

Pat is doing better and better. She still needs some oxygen and she still has to take a break from time to time, but she has come a long way, to be sure. Every day, when physical therapy and occupational therapy come by, Pat asks for more. She does her exercises, and her activities, and physical therapy. We are getting closer every day.

Tonight, Pat and I had fun. We had dinner together, and we ordered birthday presents for grandgirls, and we watched Dancing With the Stars. What could be better?

Thanks for the blogs. As always, I read them to her with delight. Here is a pic of Pat giving her physical therapist a workout.

Greg

November 6
8 AM

Hi, Lily Pad followers! I'm getting ready to head to the Continuing Care facility to see Pat. That's a really nice thing to say, that I can get up and go visit her, and be there in twelve minutes instead of twelve hours! Since it is not far from the hospital (where I work), I will be able to see Pat, take her cards, read your blog comments to her, and do her laundry quite easily.

It's a busier place; instead of a private room, Pat has a roommate, and potentially two (each room could hold four people, but they seem to max out at three). The nurses are busy, but in general seem quite friendly and helpful. There seems to be an inability, though, to break free of something that beeps all night long. Though Pat has no monitors or IVs to make noise, there is a thing in the ceiling of the hall that beeps once a second whenever anyone has pushed their call button. Since someone is always pushing their call button, the thing beeps continuously. Such is life. I have grown more sensitive to these things in regards to my patients at the hospital.

Physical and occupational therapy is much more involved than at the NIH. Pat, as always, wants to do as much as she can, and she is doing more every day. Her ability to stand and transfer move is much better. She is a bit discouraged, but I see how much improvement she has made, and it's a lot. We are still working on getting the diet right and the meds right and get off oxygen. It's one small step at a time, but it's a step forward!

So, off I go! Thanks again for your comments. Sara, Pat loves hearing about the NOG progress, and her heart is always with the kids at Palmer. She knows the people from Park Church are keeping her in their prayers, and thanks to Rev. Todd and all the staff. I bring the Congregationalist to her and it cheers her up. Pat always smiles at messages from Ria, her sister across the sea. Deanna, we had a suggestion, based on what we have seen: rather than having Rob go hunting, just park a bunch of cars around, have a party, and in the morning go collect all the deer that have run into them. Kim, eventually Pat will be walking the aisles of Once Upon a Child, so don't despair. And thanks to Leslie, and sister Suz and everyone who keeps Pat in their thoughts, whether you blog or not.

More updates soon!

November 4
11:30 PM

SHE'S BAAAAACCKK!

As of tonight, Princess Pat and Froggie are back in Grand Rapids. Every day a little closer to being well. Pat is happy to be here, as are Greg, Brian, E and everyone else! Pat is still a little uncomfortable, and still has some healing to do, but is so glad to here. She was flown back from the NIH, and of course the story must include delays, bumps, and an ambulance with a flat tire. Such is the stuff of the legend of Froggie and E.

The focus now is on exercise and rehabilitation. Pat is actually much stronger and much more stable with her walker than when I left her a week ago in Bethesda. With the acute medical problems much better, she can work on her physical therapy and strength and balance. But I was amazed to see how much progress she has made.

For the time being, Pat is working on adjusting and will still have a lot of doctor stuff to do; we'll let everyone know when she is up for visitors but she still loves the blog readings.

 

Pat was happy to see Brian, and he was delighted to hug his mom after six weeks absence. And, as you can tell, Froggie (on Brian's shoulder) and E (on Pat's) are so glad to be back together again.

 

 

So, again, thanks for your comments. I will be reading them to Pat, once again in person, and I get to see her every day (as it worked out, I had Monday off and was at the facility when Pat arrived from the airport).

 

Yeah!

 

Greg

Sunday, November 3
7:30 PM

Yes, blog followers, it's true. Our little Froggie is coming home on Monday. Not actually home, she will be coming to the Spectrum Health rehab facility on Fuller. Through the hard work, kindness, and graciousness of staff at both the NIH and here in GR, she is being flown back to Grand Rapids late Monday.

Pat sounded so good when I talked to her today. She is walking farther and sitting up longer and really feels ready for doing more and more. The way she is going, I think she will be flying in a week.

Many major kudos to everyone for their encouragement and thoughtfulness. The journey isn't over, but we can see the road ahead and it looks pretty good.

I'll blog a 'Froggie Arrival' update tomorrow. Enjoy your extra hour of sleep, everyone!

Greg

November 11

Thanks, blog followers. Pat is having her ups and downs but, primarily, the plan is for her to be coming home to Grand Rapids next week. Medical problems are stable and we're looking for some serious rehabilitation. I already have a healthy respect for physical and occupational therapy and speech therapy, but now even more I appreciate their skills and abilities. With what little time they have had at the NIH, they have helped Pat progress to better walking, better eating, and better telling her husband what to do at home (I love it).

We are planning to have her at the Spectrum Health rehabilitation facility on Fuller Street tis coming week. She still has some work to do, but now her sweetie (that's me) can see her every day for help and encouragement. If I know my Patricia, she will fly the plane herself to get back if necessary.

Here's a picture of Pat celebrating Halloween with the nurses. We'll all be glad to have her home!

Greg

October 31
Happy Halloween!

3 PM

Hello to all Blog followers. In my conversations with Pat yesterday and today. We had the longest conversation ever. Pat is doing well, off oxygen, and walking farther. She's eating regularly and I can hear a hint of a smile in her voice. Estimates for coming back to GR are for early next week

Today she said some kids would be coming by her room doing trick or treat, and she was looking forward to that because she has always had fun at Halloween. Speaking of which, I've been given orders to get out the ol' orange and black stuff and put it out on the porch. I'll be thinking of Pat as I hand out the goodies.

Suanne took some pictures of Pat when she got out into the sun room. I hope they brighten your day.

Greg

Monday, October 28
Live from Grand Rapids

Hi, Pat's followers! I've made it home to GR. Pat is still at the NIH with her mom and Suanne. She is doing much better and is gaining strength every day. Willie (the physical therapist) can really encourage Pat to get up and move, so she does.

Plans may be to come home some time within a week, but it depends on how she is doing medically. In any event, it will be nice when she gets home. When I spoke to her today she sounded a bit tired, but overall more energetic than I thinks she has been since surgery. I like it.

I will be talking to her every day, and I'll try to put a note on the blog whenever I can. Thank you all for your comments!

Greg

Sunday, October 27 9 am

Hi again from Pat's room!

Pat has a huge window in her room and she can look out and see all the fall colors on a beautiful autumn day here in Bethesda. It is even more beautiful because Pat's smile is shining right back out the window. She continues to improve, still needing oxygen, but breathing easier. We have been through breakfast and the morning doctor parade and so now there are a few minutes down time.

Last night when dinner came we put the iPad on the tray table and Pat ate while we watched a couple of Big Bang Theory episodes. It was dinner and a movie. It was cool.

There are still some things that need to improve before Pat can come home, but we haven't had any major setbacks so we are heading in the right direction.

I'm heading back to GR today. I don't want to leave, like always, but this time it's easier than last time. The blogs may get less frequent, but I'll try to avoid a long gap like last time!

Pat says 'hi' and thanks for the blog comments. She also says the food is yummy. Best bananas in town.

Greg

Saturday, October 26

Hello, all followers of Pat's blog!

I was so happy to walk into Pat's room this morning and see her sitting up and smiling. Sitting up and smiling is a lot of work, but you all know Pat. She was doing it. And when Physical Therapy came by (in the form of Willie, a physical therapist Pat really likes and would do anything for) she put forth her best efforts. She walked and joked and rolled her wheelchair. She is a real trooper.

Today Pat said the three words I most wanted to hear: "I am hungry." She is eating better, and it seems as if she is sleeping better, and this leads to a more comfortable Patricia.

I have to head back to GR on Sunday, 10/27, but fortunately (and there is no way I can be happier about this) her sister Suanne will be heading back down to Bethesda. Pat's mom, Vi, is still here, and she stayed the night in Pat's room last night (10/25). When some of the nurses went in checking Pat's vital signs, her mom was there, something very reassuring to Pat. I think Vi is really wonderful.

We're not exactly sure when Pat will be coming back to Grand Rapids, but I hope it will be within the next couple of weeks. But, also, I want her to be okay. And the docs want to make sure when she comes home (to physical rehabilitation) she will be doing okay.

I love my Patricia. She is a gem. And thanks to all of you for your comments. As I have said, I read them word for word to her. And she loves hearing them.

When I am home, I promise to update the blog whenever I talk to my wonderful lady.

Greg

Friday, October 25

I'm blogging from Pat's room, and Vi is here as well. Pat says 'hi' to everyone. She appreciates all the work everyone is putting in on all of the projects, and keep her informed on Second Best sale. Also, thanks much for all the comments!

Today had its ups and downs but is ending on an up note, though everyone is wearing yellow. The yellow is paper disposable gowns that we have to wear. Pat had a 'surveillance' culture, which everyone gets who has been in the hospital for more than a week. They swab various body parts to look for 'bad bacteria,' (our own E is a good bacterium) and one of the cultures is growing a bacteria, we just don't know what the bug is, if it is a bad one or one we can just ignore. So, until we know, we wear yellow gowns.

Pat is getting an upgraded diet. She can have a little more fat, which makes for a much more palatable meal. Angel food cake today!

So we keep on working and walking and trying to get things better. The docs have been very quick to respond to problems and the nurses are doing a good job, too.

Now Pat is on unit 3 Northwest Room 1648, but otherwise the address is unchanged. Thanks for your blogs, everyone!

Greg

Thursday, October 24, 9:45 PM

A busy day for Pat. She was visited by PT (physical therapy) and OT (occupational therapy) and SLP (speech and language pathology) as well as multiple doctors, nurses and other staff. She walked out into the hallway, she sat for a long time, and she ate more than ever before. And, by the end of the day, Pat was transferred to the regular floor. I hope she stays there.

I left her bedside about 8 PM after seeing her be comfortable for the night. It is quite a transition. Pat is determined to not go back to ICU. She uses her breathing stuff, she sits, she walks, she talks - sounds like a doll. Well, she is my doll and I think she is the bravest woman in the world.

The doctors don't give a definite time for transfer back to Grand Rapids, but it will be a 'few days' yet (that's doctor talk for 'we don't know', trust me).

Pat overcame a number of hurdles today. She was a bit scared to eat for fear of choking. The SLP person came by and made Pat take BIG bites of food instead of LITTLE bites of food. Surprisingly, it went much better. Pat overcame her fear (like she always does) and now is eating better.

When I asked Pat if she would like to hear the blog comments tonight, her eyes lit up and she smiled and was all set for some fun. She really does take comfort and encouragement from all your blogs. She likes the Palmer and Park updates (thanks Sara and Deb) and family updates (from Deanna, her side, and Sue, my side, and Dawn, every night I'm here I watch another Doctor Who-I'm actually growing to like Matt Smith) and the kind thoughts of Kim and Ria and Leslie and everyone whose name I haven't included for the sole reason that I have a Y chromosome. Your replies and comments make Patricia happy. And that is good. Thanks to you all.

Greg

Thursday, October 24
7:30 am

I'm getting ready to head back to the NIH from the hotel. Pat is still in ICU, but yesterday (Wed) she walked several steps and is better and better at transferring herself. She loves to have PT and OT come by.

The respiratory setback that put her back in the ICU seems to have gotten better, and yesterday afternoon Pat went from her bipap device (helpful but quite inconvenient) to regular nasal prongs for her oxygen. She is still having some trouble eating, but we are coming up with ways to work on that. The sun is coming up and the weather looks clear, so I'm hoping that is how the day is going to go.

Pat likely may be here through our second-favorite holiday, Halloween. Each year she sits at our kitchen table at home and hands out goodies to the neighborhood kids, and she loves it. So, if anyone has a Happy Halloween greeting, feel free to mail it to

Pat Trowbridge, Inpatient, ICU
NIH Building 10
10 Center Drive
Bethesda   MD   20892

Thanks!
Greg

Tuesday, October 23

Hi, Pat's friends (of whom, I know, there are many)!

We have spent the day together, and Patricia started the day with fatigue and respiratory distress, but through the work of the staff and most importantly herself, Pat has improved. She still has a lot of fluid in her lungs, but less than anticipated, and after spending a lot of the day upright (tiring, but worthwhile) she is gradually better. Pat is getting stronger now, and able to do much more for herself and is able to take a little more food with each meal.

This just might work.

I have said it before and I will say it again, Pat so much loves your comments. They make her smile and when she smiles she gets ready to do more, more steps on the road home.

Thanks.

Greg

Monday, October 21

If anyone is still checking the blog, E has an update.

When I left the NIH last Tuesday Pat was out of the ICU, gradually improving, starting to eat some, and working with physical therapy. Unfortunately over the past weekend she began to have some more problems breathing an ran a fever, and is back in the ICU. She did not have to go back on the ventilator, but is getting some oxygen assistance (bipap) and is back on the antibiotics they discontinued. She's able to eat, but it bothers her stomach some when she does.

Once again through schedule adjustments graciously made by my co-workers, I was able to come back down to the NIH and arrived early today. Though Pat was quite tired, she was able to participate in physical therapy and has kept up some of her strength.

I hope the doctors can work to get some of the fluid off so she can breathe easier. The surgical team has consulted the ICU staff and pulmonology, so they are working on the problem.

I'll keep doing updates as long as I'm here.

Greg & E

October 14, late

Hello to all followers of Pat and Froggie. Unfortunately, E has to head back home, leaving Froggie behind at the NIH for a while. But she is slowly getting better, though still weak. And, most graciously and helpfully, Mother Vi and sister Suanne are staying behind to help, watch and report. She is able to take more by mouth, and is trying to pick things to eat that food services will send. And she is gradually more comfortable and working hard to gain strength.

Blogs may be a bit irregular from this point on, but E will work to update all the essentials.

Thanks to all, and for your comments, that Pat loves to hear.

Greg

Sunday, October 13

I'm updating the blog from Pat's room. She is now on 3W, transferred out of ICU yesterday. The night nurses took good care of her (tonight she has a nurse named 'Princess' - thought you would like that, Kim) and the docs are allowing her some actual food, but Pat is being careful not to overload the system too much at once. Not much happens on a Sunday here, so it is quiet, which is good and not so good. Good because, well, it's quiet. We sure don't miss beep, beep, beep. But we do miss physical therapy and nutrition not being here. Also, tomorrow is Columbus Day, so many Federal agencies and services are closed (a microscopic bit of humor, there)

Pat is awake right now (7:30 PM) and on the phone, giving Brian instructions on how to pay bills. We did NOT expect to be here even half this long. I have to head back to GR on Tuesday to do stuff at home, but Vi and Suanne will stay for a while - not sure how long yet.

Take care, everyone. Suanne is putting up the good wishes paper chain links in the room. Pat has been really excited to get to them

For stimulation and eye-hand coordination, Pat and I played catch with E and Froggie today. Fun for all! Pat says (this is a direct quote) 'thanks for your messages. Keep 'em coming.' Me too.

Happy Columbus Day,

Greg

Saturday, October 12

Thanks to the generous gift of time from my friends and fellow physicians at Helen DeVos Children's Hospital, I am able to stay some more days with my Honey. Thanks to Brett and Mike and Martina especially, and to Dan and Becky and Jeri and Bob and James and Leslie and Julie and Jodi and Hilary and Amanda and everybody.

Progress - slow, but progress. It is now the three day weekend (Columbus Day, Monday the 14th, is a Federal holiday, and the staff is trying to figure out what that means in the perspective of the shutdown). It is quiet on the NIH campus. Not even deer are wandering the streets. The patient population is down and lots of things are closed. Fortunately I have family, and a sweetie who is getting better.

Pat got hot tea today. It was delicious, she says. They have expanded her diet to sundry clear liquids, and a nutritional beverage called 'Ensure Clear.' If it was me in the same position, a useful nutritional beverage would be called 'Chardonnay.' But, alas, none available on the NIH campus. But the doctors are encouraged. They are anticipating moving Pat to a regular floor this weekend. She is getting a little cranky, now, which I take as a good sign as she is 'more interactive with her environment,' i.e., she is giving me orders. I love it.

Thanks to all Pat's followers!
More updates tomorrow.

Greg

October 11, evening

An interesting day. When I arrived on the unit (Pat is still in ICU, not because she is that critical but because meds and things take a lot of time) they were whisking Pat away to radiology so, of course, I went there too. She had an ultrasound to look for blood clots and there were some small ones in the usual places, like where she had her big IVs in. The doctors are debating what to do, and ponder and consult other doctors ... just like I would do on the pediatric unit. There are a couple of really great fellows (not guys, they're girls, but they are doing additional training after their 5 year surgery residency) who take the time and patients to explain things to me and Vi and Suanne. It helps.

Pat also had a swallowing study, where she had to drink some disgusting stuff to test her swallow and how things are working. The swallow study was OKAY and the rest of the stuff was okay and so they are letting Pat have a few sips of clear liquids now. You should have seen her face with her first real sip of water. Big time smile. The smile I love to see.

She is spending more time up in the chair position and tolerating it better. So we work on strength and movement and being awake during the day and sleeping better at night, and it is good. Pat is smiling more, and protesting more and questioning her doctors more, all of which I like! We have a ways to go, but we're going.

Thank you all for you comments. I love to see Pat smile when I read them to her.

Greg

October 10

Ah, another day, another test...

Actually, the test was yesterday. A CAT scan showed some things, but her tummy is looking better. No abscesses. Things are looking up. Tomorrow (10/11) the 'pod,' as Pat calls the group of doctors that come by, are going to do another contrast study. If this goes okay, they might let Pat start some oral intake. She's looking forward to that, let me tell you.

She is kind of sleepy today, so the nurses and physical therapists are pushing her a bit, which is good. She did some more weight bearing today, also good.

So things are moving along. Fewer lines, fewer beeps, less pain, makes a happier Pat!

Greg

October 9

Pat says 'hi' to everyone following her on the blog. So, hi!

She is a little tired but she has big smiles for everybody, especially for Suanne who brings the brush. Pat loves having her hair brushed. And we are going to get some of the dry shampoo to clean her hair, too.

Pat did some standing at the bedside and more weight bearing and moving this morning. She had her dressing changed and everything looks good. She's had more meds discontinued. She is still NPO (nothing to eat or drink) and she gets intravenous nutrition, but the surgeons think things are getting better. It is possible she will go from ICU to the (I almost typed 'peds floor') general floor tomorrow (10/10).

Pat is doing her incentive spirometer (she calls it her 'barometer') and a curved device that vibrates when she breathes out. It looks vaguely obscene, but it helps to clear her lungs and she works at it pretty well every 1 - 2 hours.

She did get her triple lumen IJ out today. This is a large intravenous line that goes into the right side of her neck and it had lots of plastic spaghetti hanging from it and was cumbersome when she was trying to move. It was valuable when she needed it, but now she doesn't, so it's gone, which makes life a bit easier and it's just one more step on the path to home.

Thanks for everyone's comments! She loves to hear them, and I read them word for word. I love to see her smile and laugh. Laughing makes her tummy a little bit sore, but helps her pulmonary mechanics. When she smiles, everybody smiles.

So thanks to relatives on both sides of our family, and to our friend Ria in the Netherlands, and friends from Park Church and at Curves and Miss Fit.

Greg

October 8 2013

Hello to all followers of the adventures of Pat and Froggie

As you can tell from the intro, today, Tuesday, is looking up. As noted, Pat, Vi and Suanne stayed up

late last night watching "Dancing With the Stars." Pat stayed awake throughout the show and then had a pretty good night's sleep. Today Pat has put for the supreme effort and has participated in physical therapy, other activities, and stayed awake most of the day. I think she will sleep well tonight and start getting stronger every day.

At last she was able to sit up for a long time and Suanne did her hair which absolutely delighted Pat. She's thinking of getting her hair cut very short so it is easy to care for. There is apparently a service in the NIH that does this, hair care for inpatient ladies (and gorgeous women like my Sweetie, too), but, wait for it, the service isn't available because of the Government shutdown.

This morning (10/8) we had a most interesting experience. We (Vi, Suanne and I) were in Pat's room when an armed policeman (yeah, that means wearing a gun) put his head into the room and asked if this was the Trowbridge family. After a few puzzled looks we said yes, and he took Suanne and Vi in tow. They didn't come back for a while so I just assumed they had been hauled off to the pokey by the popo.

Vi and Suanne had done a simple and trusting thing. Considering that everyone at the NIH Clinical Center is already checked and has a badge, they left their ordinary, flowered and cheerful bags beside the chairs in the common area near the ICU when they came in to see Pat. Some 'good' soul saw the bags, called security, and security called the NIH Campus Police, who brought in bomb-sniffing dogs (all true) and dumped the bags out and examined the contents (benign lady stuff inside) and, after talking with Vi and Suanne, all was well. I think that Violet DeMeester hardly meets anyone's definition of a threatening individual. Here is a picture of Vi and Pat and me and Suanne, who is hard to see because she is in the background behind me.

So, we are looking at improvement. It might be slow, but we are expecting improvement. Tonight Pat seemed to be ready to rest, to sleep, and be fresh for tomorrow.

I listened to music for the first time in two weeks. It was good.

Greg

October 7

Hi, Pat's followers! Pat had some tests this morning, but overall the results were optimistic. Pat is ready to move and when the physical therapist came and made her exercise, she did all he told her and asked for more.

There are some things that may take a while to get better, but as of now we don't know how long Pat will be here. But she is smiling, and tonight she sat up for an hour and watched 'Dancing With the Stars," with her mom and sister (they are sisters-in-law, but as close as sisters) Suanne. When I went into her room to kiss her good night, Pat was sleeping comfortably, and smiling. More tomorrow.

Greg

October 6, Late

Hi, blog followers!

Pat continues to improve. Slowly, but definitely. And she is definitely tired of the ICU. There are a couple of tests tomorrow (Monday, 10/7) that will help determine how things will go over the next few weeks. Pat's labs and numbers are good, per the surgical staff. And the nurses have been good at trying to minimize the numbers and kinds of beeps on the monitors. I think she has been getting better at getting some sleep.

Last night I read Pat your blog comments and you should have seen her smile. Everyone's comments (especially about rattlesnake hunting) got very big smiles.

Pat's mom, Vi, and sister-in-law (though they are essentially sisters, in my book) are staying around to help pat get through the day (and they help me as well).

It's a short blog, but thanks so much for your comments (letters to Pat).

Greg

Saturday, October 5

Greetings to all Pat's blog followers. Pat remains off the vent, breathing on her own and just on nasal cannula at 2 liters. This is good. So far, no signs of infection. and Pat's numbers are gradually improving. She is smiling at times, and working hard to get better, doing some of her own stretches and physical therapy. Not yet walking, but that will come with time. She is also getting more of her lines out, including both art lines and all her peripheral IVs (she still has central lines).

Now ...

Go to bed tonight. Set your alarm clock to go off every 5 - 8 minutes. Have the AC or heat go on 10 to 15 times an hour. Invite the neighborhood over for a 24 hour pizza party in your living room. And when you just fall asleep, make sure one of people from the party comes into your room to fluff your bed (which is lumpy and isn't yours) and, about once an hour, to poke you in the finger or arm. That's a good day in the ICU. Pat is kind of getting tired of that routine.

But ...

As of this moment she is sleeping, and everyone is working to get her better (except the monitors, which beep at everything including passing motorists).

The shutdown continues to be a curse, but also a little bit of a blessing in some ways. The original plan was for me to have to leave the Safra lodge for a few days because of other scheduled patients and families. Not a disaster, but an inconvenience because I like to stay in Pat's room late, and the lodge is very convenient for that. But because some patients were cancelled due to the shut down, I can stay more days. That's good for me and Pat.

Pat's mom and Suanne are here, and they've been working hard too, to keep Pat comfortable and distracted a little. Valerie brought videos of the grandgirls on her iPhone and showed them to Pat. You should have seen the smile that got.

So we are planning on a bit of a stay yet. We'll keep you posted and, as always, thanks for your comments!

Greg
The good news is she can tell us how she feels, and what position she likes better

October 4

IT'S OUT!

Hello to all Pat's followers. At 9 am today the team removed Pat's ET tube. Which is good; if they hadn't, Pat was two shakes away from pulling it out herself. She's tired but happy to have it out. She has a lot to say, but we're taking it slow. The surgeons are happy with how everything is going so far. For my hospitalist followers HDVCH: all cx neg, CMP and ABGs good, starting TPN (finally!), NM scan of biliary tract 10/7, less output from JP drains.

We're encouraged and happy. Over the next 24 hours she'll get more of her lines out, and start to walk (Pat has been laying in bed doing exercises in preparation). Family is here and we're able to make sure Pat has company whenever she needs it. Now she needs some decent sleep. She is really not hurting very much at all.

Thanks for your comments!

Greg

Thursday, October 3, 10 AM

Whew! Pat came through the second surgery very well. It was shorter than the first, not so much fluid resuscitation required, and overall she seems to be more comfortable than yesterday, even considering that, as of this moment, she is 10 hours post-op. The problem was fixed, per the surgeon, and he seems pretty optimistic, and though she has a little extra hardware (couple of drains) that may be in for a while, the recovery from this surgery should go much better (as the recovery from the last one wasn't going anywhere at all, any recovery is better, by definition).

Pat is awake, tired, smiles at times, wants us to talk to her (she's still on the vent) and after the PT/OT crew came by, she is doing exercises and making us help her with range of motion, which we do gladly.

She already is much stronger than she was yesterday, pre-op. Her numbers (the ones I can see, anyway, on the monitor) look good, she has a triple-lumen IJ CVL this time which means easier blood draws and IV and med management without five (yes, count them, five) separate IVs in her arms.

She is bound and determined to get off the vent within the next 24 - 48 hours and, by golly, I think she'll do it. Vi and Suanne are here and are just fantastic to have around. Despite being sleep-deprived themselves, they are on the job, talking to Pat, reassuring her, keeping Pat's spirits up, and keeping me from going completely crazy. The docs have been good, the Physiatrist (who plans rehabilitation) was a pleasant, friendly guy who knows some of the docs I know in Grand Rapids, the surgery fellows focused and attentive but also good at keeping us informed despite being sleep-deprived themselves; the ID (infectious disease) team, well, hmm, they acted like ID docs, and the nurses are all doing a great job and are good at picking up subtle cues from Pat that she needs something. The respiratory therapist re-secured her ET tube which is now much more comfortable and as a bonus put Pat's hair up in a knot which is much nicer. Even the social workers are proactive in helping our stay go well. All in all, I am much less frantic than last light, and Pat looks so much better.

E and Froggie are feeling better too. They are perched on the back of a chair, keeping a watchful eye on Patricia.

I am cautiously optimistic. I love her very much. More soon.

Greg

Late, October 2

Hello to all Pat's followers.

My sweetie has been a brave girl. Unfortunately, there were some complications of surgery done a week ago, and Pat had to go back to the OR at 8:30 pm (10/2) and is still there as of 11:30 when I write this blog. I've been told to expect a long surgery. This time, I have backup while I wait, and Pat's mother Vi and her sister-in-law Suanne are here with me.

Pat has been aware of all of this. She is such a trooper and a strong lady, but, as you can imagine, two big surgeries in one week takes a toll on the body. But they are going to do some things to make sure she gets nutrition now and, well, we will see how things go.

Keep on sending those comments and words of encouragement. I will read them to Pat as soon as I can.

Greg

Here is the blog for whichever day of the week this is, October 1

Happy Government Shutdown Day

Pat is still in the ICU, and still getting some vent support, but we are inching closer to our goal. Pat has generally been doing well, but had a fever today and had to go for a CT scan. That was a bit of an adventure. The staff lets me help, and I went to CT with Pat to whisper words of encouragement in her ear. The nurses, as noted have been attentive and perceptive, and have done their best to keep her comfortable. She's had a good response to medications.

As mentioned, her mother and her sister-in-law are here, which gives Pat a lot of comfort. She likes to have us talk to her, and her mom and Suanne can talk to her more than I can, at least without lapsing into a discussion of Starling's principles of physiologic hydrodynamics and renal handling of sodium. They are also good for a hug, when I need one (a lot). I'm grateful for their presence.

I'm back in the Safra Lodge, it's 11 pm. It's an absolutely wonderful place, a short walk from the Clinical Center (where Pat is). It is very difficult to get onto the NIH campus after 10 PM, but I can walk to and from the CC and the Lodge anytime, so I can stay late with Pat. One of the NIH social workers, on her own, got me set up for a room in the Lodge. I love social workers.

The Clinical Center patient care areas still function as usual, but the Government shutdown has affect us, somewhat. Some parts of the Clinical Center have shut down, including some of the research areas, and the au bon pain café where I usually get coffee. I use the DC Metro to travel, as it's easier than trying to find parking and it's kind of fun. Plus, usually, I can get back onto the NIH campus pretty easily, using the visitor entrance. But today, 10/1, the visitor entrance was closed, so I had to walk about a half mile to go to the alternate entrance, and walk back to the CC. I don't mind walking, but when my Sweetie needs me, I want to be there fast. We are hoping for a swift resolution of the situation.

Thanks for your comments! This morning (10/1) I was trying to understand what Pat was trying to say around her ET tube. With a little work I figured out that she was saying 'For heaven's sake, read the blog posts to me!' She loves them, and thank you for each and every one.

Keep your fingers crossed.

Greg

Good gravy.
The post I just wrote labeled for September 29 is actually written on September 30 at 11 PM. Sheesh. I have to put a calendar up. I'll write more, if the Government doesn't collapse at 12:01 AM tomorrow, Oct 1. Greg

Post for the actual day of September 29

Hi, all followers of E and Froggie's adventures (and Pat, too). Just to keep our days straight, this post is being written at 11 pm on September 30 (just before the Government shutdown? I haven't seen the news yet!)

It's been and up and down day, ending on up. Pat had an irregular heart rhythm starting Saturday morning, and today the cardiologist fixed that. Now she is back in a regular rhythm :-) . She had some trouble with her oxygen level and a little breathing trouble and she is still getting vent assistance :-(  . But buy the end of the evening, when I left at about 10:45, she was getting better again :-) . Everybody out there in Lily Pad Land clap your hands so we can get Pat breathing on her own soon!

It's been a bit of work for Pat, and so her Mom and sister-in-law Suanne drove down from GR (on a moment's notice!) and Pat was so glad to see them. After all, there is just so long you can listen to your husband whisper sweet nothings into your ear and all the machine make beeps and swooshing noises in your other ear.

The nurses remain great, the fellows great (they're surgeons already, doing additional special training), the ICU attendings are great, the cardiologist was a really nice guy. Overall, a pretty great team.

And you who read the blog, send comments and prayers, and keep Pat in your heart are the greatest. When I read her comments, her blood pressure comes down and her pulse settles down and she really smiles. So thanks a bushel full, from me.

Greg

Blog for September 29 (though a bit late)

This is actually written on September 30 am, just before I go to the Clinical Center to see my Sweetie. Sunday was a fairly quiet day, with mostly some meds and correction of electrolytes and stuff like that. Pat still gets some support from her vent, but now that other things are improving, each day we hope she can get the tube out. I have E and Froggie at the head of her bed watching over her.

Pat isn't having much pain or discomfort, just a lot of frustration that she can't talk. He brain is still all Pat all the time, and she is able to express her joy when I read your blogs to her, and dismay when we can't understand what she is trying to tell us. When she tries to talk, it makes her heart rate go up, then the doctors get worried, so they tell her 'to relax' (yeah, tell Pat to relax and not talk), and that makes her more frustrated ... You get the picture. Still, lots of things are going well, and she had a temp which mostly seems gone now.

And I can't emphasize enough how much Pat enjoys your blogs. More tonight.

Greg

Blog for Saturday, September 28

Hello to all Pat's friends who read the blog and send comments. As I noted, I read all the comments to Pat the way you write them, and it is such a pleasure to see her smile as I read them because she loves to hear them. Pat still has a tube in today, and is still on the vent, but is more awake and getting stronger and things are definitely trending in a positive direction. Labs look good, body functions are looking good and, to me, Pat is the most beautiful woman in the world, though she will look just a shade better when all these lines and things are out.

The nurse she had yesterday and today was really sharp. Late last night she got a longer bed for Pat, a bed that has built in rotation so it will roll her from side to side. It's great for her comfort, but I keep having to go from one side of the bed to the other to talk to her. We're also figuring out what makes her the most comfortable.

As I have mentioned, this place is not quite like an actual hospital. I saw that in detail today (Saturday) as I walked from the Safra Family Lodge (a place that I have come to appreciate immensely, as it is a short walk from the Clinical Center, as opposed to a Metro ride away). Though the patient care units still have staffing, the main part of the Clinical Center just totally closes. No coffee, snacks, people, nothing!

So thanks for your kind words and greeting!

Greg

Hello, all Pat's friends and followers!

Here is an update at 11 pm 9/27. Pat is still in ICU and still getting some support from her friend, Mister Ventilator. But, she is awake and lets me know, through smiles and nods or shakes of her head, how she feels. Overall, physiologically, she is stable, and improving a bit. She still has a little way to go, but I think she is more comfortable today. We (Froggie and E and I) remind the staff from time to time that yes, surgery can be uncomfortable, and pain medicines will be really nice. The nurses in the ICU are actually quite nice and take good care of Pat; my job is to help them be aware of what she needs. It is, to be sure, difficult to balance the role of being physician and husband at the same time. I will be, first and foremost, Pat's husband and advocate when she can't. She is a most wonderful lady, and when she can be her own advocate again, well ... watch out.

The doctors (surgical, medical) are being cautious and careful in their decision making. It means Pat will be getting some support tonight (9/27) and we will see how she does on Saturday. Hopefully, Pat will be able to get her tube out, but it depends on how she is doing. I want Pat to be off the vent, but I know the docs are being cautious and, having been on both sides of the issue, I will trust their judgement, especially because I agree.

The greater lights (highest up on the totem) are largely aloof or non-existent. The fellows, despite being surgeons, are actually a nice and caring bunch, which I measure by how happy they appear when Pat is improving. There are a couple that are really good doctors with a nice bedside manner (how did they become surgeons, exactly?) and I am pleased to see them when they round, which they do several times a day, along with some of the medical support staff.

Pat likes me to read to her, and I am reading a story by Sue Grafton (I love the Kindle, thanks David and Brian and Valerie). It is good for both of us when I read to her. I love to see her smile, so I do everything to make her smile. But I don't like to see her laugh as that makes her incision hurt! We'll work on laughing later, just like we'll work on walking around, coughing, swearing at whatever (my job), and so on.

I want to let everyone know that I take the iPad to Pat's bedside and I read all of your messages to her word for word. She loves hearing them. I know, when the tube comes out, Pat will have lots of things to say. I'll pass those comments along in future blogs!

Greg (or as they know me at the NIH - Pat's Husband)

September 27

Thanks to all Pat's well-wishers! And thanks for your comments.

Pat is still in surgical ICU and will still be getting some breathing assistance tonight so she can rest and get pain meds. The doctors have been following her closely to make sure she does well. E and Froggie are in her room to keep her company.

I'll post more tomorrow, after Pat get's a chance to tell the staff what she is really thinking about being in the hospital.

Greg

11:55 PM 9/25

Hi to everyone following our blog, from Greg & E. Pat had kind of a long day. She was in the OR for about 10 hours, for various reasons, fortunately none of them being for complications or unstable vital signs, just a lot of stuff to do. But she is now in the ICU, sleeping comfortably, and stable. If I know my little Froggie, she will be up soon doing everything she can to get outta here and go home.

So thanks to everyone. All comments will get read to Pat verbatim.

Greg

Tuesday, September 24

It's been a busy day for E and Froggie! Seeing doctors, signing papers, going places throughout the NIH, trying to fix problems. One problem is that the bed has been very cranky. The foot of the bed goes up; the head of the bed doesn't. If you like sleeping upside-down, this place is for you. E tried hard to make the bed work properly but, alas, it remained uncooperative. The doctors, and the nurses, have fortunately been much more cooperative than the beds. They have said lots of things that Froggie and her friend Pat like to hear.

E and his friend Greg went to their last day of the conference, learning about biomarkers and estimation of renal function in adults, children, and E coli. Ask Greg to tell you about it sometime, when you are having trouble falling asleep.

Froggie is in good spirits, and though not looking forward to surgery, feels she has a good handle on what is coming. The nurses have been very nice and helpful, and the doctors have been quite good at explaining what is going to happen. She has done her preps and blood tests and E thinks she is the bravest lady there is.

Froggie and E sign permits.

More to come.

Greg

To all followers of E and Froggie:

Everyone is all checked into the Clinical Center at the NIH. Blood has been drawn; CAT scans have been performed. Tuesday 9/24 will be a day of preparation.

E and Froggie have been very busy. They closely examined a fish tank in the Radiology Department at the NIH, as you can see. And they helped their friend Pat select dinner items from the menu. So far, the NIH inpatient units seem to be not quite run like an actual hospital, but things do get done, after a fashion.

E's friend Greg is learning lots at his conference. And, the weather is beautiful.

More later!

E and Froggie are always ready to travel!

It's Sunday night and everyone has had a busy but a fun day. First of all, it wasn't raining and the sun was out and it was a beautiful day. E's friend Greg went to medical conference most of the day, and learned lots about pharmacokinetics and the use of dried blood spots for analysis of drug data. It was interesting, in a medical sort of way.

Froggie's friend Pat had a relaxing day, and was able to do a few things for herself before she has to check into the NIH for tests on Monday. E and Froggie checked into the hotel and checked out the DC Metro lines, just to make sure they were getting to the right place. Then they went out to dinner (at the Woodmont Grill) and had a quiet little dinner together.

Monday starts the process of tests for Pat, to get ready for surgery later in the week. It is possible that Greg might get a place to stay in the 'Lodge' on the NIH campus, close to the clinical center. It's like a children's inn, only for adults. The nicest thing is it is just a very short walk from the clinical center, which means Greg gets to stay closer to Pat for longer.

Pat's in good spirits, and already planning on what to do on the way back to GR. Keep that thought.

Thanks to all our well-wishers and thanks for all the little things to send us on our way. We'll keep you posted.

E & Greg

Saturday night:

Well, E and Froggie have arrived in Bethesda. The trip was nice and without incident except for driving in 12 hours of constant heavy rain. Still, they are all tucked in and ready to get down to the business of making sure Froggie is okay (after having a nice little dinner out together, that is). Sunday is a day of rest. E goes to a conference about medical stuff (pharmacodynamics and the use of blood spots in research) but he will always be back in time to tuck Froggie in for a good night's sleep.

E and Froggie's friends, Pat and Greg, say thanks for the messages and thoughts and prayers from everyone. We'll keep you posted.

On The Way

E and Froggie are on the way to the NIH. Thanks to the help of some co-workers at E's workplace (thanks Jeri, Becky, Jodi and Hilary), the couple was able to get an early start. They are grateful for all the well wishes and cards and calls and comments to the lily pad (blog), goodies from friends to get them going. Rain and lightning and more rain accompanied them on their start, as they seemed to be following a big rain cloud eastward through Ohio. More adventures await as they complete their trip on Saturday. E drove well thanks to lots of coffee, and Froggie took a well-deserved break.

They have received lots of well-wishes from friends and family and will keep everyone up to date on the blog site.

E

Froggie and E have a lot of friends and family wishing them well. They will be heading out to the Great Kingdom of the NIH in the near future. E is amazed at how much packing there is to do, even for a (hopefully!) relatively short stay. A lot of friends have said they want to follow us on our BlogSpot, and we're grateful for those who have commented already! You may want to know that E will be the principle blog author, but Froggie has lots of input and is the focus of the blog (because E has really special feelings for Froggie!). From time to time, E and Froggie's good friends, Greg and Pat, may also add a comment or two. More to come!

This is Froggie and E. They're going to the Great Kingdom of the NIH together. There, Froggie will get better and E will try to not cause any trouble.

Pat's feeling okay and generally prepared for the trip though there are still a few things to do. Most of all we're hoping the NIH doesn't let us know of some heretofore unknown Federal holiday that might chuck a wrench in the works. So far, so good. We'll use the blog to keep everybody informed of our progress, probably on a daily or near-daily basis. We know a lot of people are thinking of us. - Greg

Welcome to our new blog! Follow the adventures of Pat the Frog as she goes through her transformation to Princess Pat and comes home! We plan to keep everyone updated.

As you know, we are preparing for an adventure to the NIH this fall. Things are slowly coming together as planned. So far no unexpected delays or problems.

This is where to look for updates. We'll post here again in a few days for more information. We appreciate everyone's interest and concern!

Greg (Prince Charming, so to speak) & Pat (the Frog)