Funeral Services

Funeral services for Timothy L. Klamert, 71 of Anacoco, Lousisiana will be Sunday, March 29th with visitation being between 10 a.m. and 2 p.m. at the Hixson Funeral Home located at 208 South Fifth Street in Leesville, Louisiana (337-239-2633). A graveside burial will be held the same day at 3 p.m. at the Holly Grove Methodist Church Cemetery located at 801 Holly Grove Rd in Anacoco, Louisiana.

Wednesday, March 25th

Post by Sandy Klamert
Timothy is gone from here and now in his heavenly mansion with Jesus.
We learned yeterday he had liver cancer and it had spread as well as a lot of internal bleeding. We had a very hard day which I would describe as shock and awe because we NEVER saw that coming.

He passed peacefully at 12:20 a.m. this morning with us by his side.
Please continue to pray for our family as we move forward in the difficult days ahead.

The funeral will be held at Hixson funeral home in Leesville, LA but no details yet on date and time. will post when we get it set up.
Thank you for your prayer support and love.
Sandy

Tuesday March 24th 9:20 a.m.

Just got off phone with doctors. He is going on a ventilator as his lungs are filling with fluid. He has a tumor in his liver and they have to do an emergency procedure to go down his throat with a scope to find out where his internal bleeding is coming from. We have to get there quick to sign consents so please understand we are very devastated and not really up to answering to many questions at the moment but we are so thankful for each and everyone of you and are blessed to have so many wonderful friends and family
Love
Sandy Klamert

Tuesday March 24th 1:45 a.m.

Post updated by Sandy Klamert

We had to make the decision yesterday afternoon to go ahead and have the CAT scan done with i.v. contrast so they could find out what is causing his liver to shut down. The risks are great for permanent kidney failure however we felt we had to do it or risk complete liver failure. We will not know if there will be any side effects/kidney damage for 24 hours or so from this scan.

We are still awaiting those results from the CT scan but should have them sometime tues morning once we get up to the hospital. We got a call about 11 p.m. from his nurse telling us that after a series of events they have determined he is bleeding internally most likely from his bowel tract somewhere. They had to start a blood transfusion and that is all we know for now.

When we left last night around 9 p.m. he was finally resting comfortable after a long day of intense pain that meds were not seeming to touch. He did seem to gain a little more awareness in the afternoon after they swithced his pain med from Morphine to Phentonyl. This one is supposedly also less traumatic for the liver.

We are very concerned he may not pull through this and he is declining daily. PLEASE pray for a miracle and that he would recover. We still find ourselves in shock and awe mode of how we exactly got here when he was pretty healthy just a few weeks ago and planning to come and attend the opening Astros baseball game series with Scott.

We have family beginning to come in. Scott's youngest sister, Kristen from Louisiana and his aunt, Kathy from California.

The next few days will tell a lot and the decisions ahead will be many. They have talked of doing a procedure called endoscopy to look down his throat with a scope to determine the bowel issues. They also today will let us know if this CAT scan showed what they need to know about the liver blood flow in and out and what treatment will be required. If this did not give them what they wanted to know the next step would most likely be a biopsy. All of these are risky procedures given all the medical problems he is currently enduring. We are finding ourselves having to constantly ask does the potential benefit outweigh the potential risk and that is just not a fun place to be.

Monday, March 23 11:00 AM

Update by Sandy Klamert;

TIm is not doing well today. He is very swollen and his blood pressure is very low and has been very unstable. Because of this, they are not able to remove any additional fluids off his body only add fluids. He will remain on dialysis and now runs risk of being on it permanently.

He now has an ng (nasogastric) feeding tube for nutrients. He is disoriented so they have had to tie his hands down to keep him from pulling on the tube except when we are in there and can watch him.

He is in pain but they are scarce on administering pain meds because of his blood pressure instability.

Please pray for Scott and I as there are some difficult decisions ahead. His liver is now enlarged and shows further damage. He is most likely going to need further tests on that maybe going ahead with dye test even though his kidney is failed. They would have to remove the dye immediately thru dialysis but there are risks with everything given the myriad of problems he is dealing with.

We are not sure what is going on with his liver and neither are the doctors. He has normal liver labs in March 2008 and with all the abdomen CT's he had in Jan 2009 there was no mention of liver deterioration so we are really wondering how we got here and so are they.

They feel the kidney failure is secondary to whatever else is going on. They ran a bunch of cultures today trying to rule out any infection source because his white blood cell count is continuing to climb.

We are in a hard place today but we are continuing to pray and seek the Lord every step and His guidance, peace and mercy.

Today is a hard day as we are going to the funeral service of a very dear friend whose life was cut short by a brain aneurysm over spring break. She was 41 years old and leaves behind a 10 year old and a 6 year old. Please also pray for the Daly family and the days ahead.

Sunday, March 22nd Update

I went to bed last night with a scratchy throat and now I have no voice, wonderful! What's funny is I didn't know that I didn't have a voice until I tried to call my cousin Tina in Milwaukee to give her an update and I couldn't hardly speak. Sitting in the ICU room today I really didn't do much talking because dad was pretty much sleeping all day. Dad slept so much he really didn't greet his first visitors so well. Linda, my mother in love, came by today and when dad opened his eyes he thought it was Sandy, my wife. Linda was flattered and dad was embarrassed. Then when Beverly, my sister in law, came in he immediately said, "hey Bev how are you". That was pretty much it and he slept the rest of the time. He is really saying some off the wall stuff as if he's a little delirious or maybe it was just the morphine they gave him. You THINK?!

The nurse said she was actually able to decrease dads med today, the one that helps keep his blood pressure up. PRAISE GOD, that's a step in the right direction. The doctor said that the dialysis would wipe him out and he was right, it did. I asked how long dad would be on the dialysis machine and he said he'd probably be on it through the middle of this next week. He said they'd then take him off of it and see how his kidney (remember he was born with just one) holds up on it's own.

The nurse tried her best to get dad to eat something today. I think she was successful with apple juice and tea, or was that yesterday? The days are beginning to run together. Before I left they brought his dinner, MEATLOAF and MASHED POTATOES! Anyone that knows my dad, knows that this is his favorite meal. He actually took a bite and didn't care for it. I've already told him that he needs to try to start eating otherwise, yes THE TUBE! He said he didn't want that and I said well start eating. Real sympathetic I know, but a month is a long time without food. The boys gotta eat ("gotta", that's redneck for "got to")!

Prayer needs: Good reports tomorrow, an increase in appetite (for dad), kidney to strengthen, and me NOT to get sick.

Taking a Break!

We took some good advice and got out of the hospital for a while! The hospital asks ICU visitors to leave the room from 6pm to 8pm for shift change and report. We took the opportunity (no kids) to go down on Kirby to Amazon Grill. We had grilled fish tacos and it was really good! It was grilled fish on two corn tortillas with shredded cabbage and salsa on the side. They also had an awesome cilantro sauce, yummy! It was nice to sit outside, get some fresh air and watch the busy world pass us by.

Hey, what happened to your kids?

If you're wondering what we've done with the kids, they're in GOOD hands! They had fun playing with their friends Justin and Natalie yesterday and even spent the night (THANKS BAUTISTAS!) because mom and dad didn't get home and in bed until 2 am this morning. Janie dropped the boys off this morning at 9:30 am. At 9:35 am they were swept away by Gary & Barbara Hill (BEAUTIFUL PEOPLE) to the Parker's lake house at Livington (I'm jealous!). Now they are riding around the lake with Uncle Cliff and Aunt Karen and being loved on by Pammy and Lara. I'm sure right about now they are lovin' life as evident in the picture that Karen sent to us. We are blessed to know such wonderful people! (Pictured left to right is Caden, Pammy, and Caleb)

Saturday, March 21st 4:00 PM

Dad is now undergoing temporary dialysis to rid his body of built up toxins. To me his color looks better and his swelling seems to have gone down a very little. The liver doctor just came by and advised us that there is no blockage by vascular as he can tell by ultrasound but the liver does show abnormalities in respect to tissue. Still not sure why. Did say from previous scan in Dec there had been some deterioration... again, not sure why. He said once he is more stable, if labs do not improve showing liver improvement then they will biopsy thru the jugular catheter in his neck. He said if they found a blocked duct then they could do a procedure called ERCP but he is not stable enough to do all that just yet.

[ERCP] stands for endoscopic retrograde cholangiopancreatography. As hard as this is to say, the actual exam is fairly simple. A dye is injected into the bile and pancreatic ducts using a flexible, video endoscope. Then x-rays are taken to outline the bile ducts and pancreas. The liver produces bile, which flows through the ducts, passes or fills the gallbladder and then enters the intestine (duodenum) just beyond the stomach. The pancreas, which is six to eight inches long, sits behind the stomach. This organ secretes digestive enzymes that flow into the intestine through the same opening as the bile. Both bile and enzymes
are needed to digest food.

Now his blood pressure is 113/55 and it is bouncing around within a 10 pt radius on both ends. He seems to be a little confused from being in the bed so long, however with dad you never know, he might just be playing. He spirits seem to be good but he has his moments like when I came in this morning and gave him a hug, he didn't want to let go but hey that's fine with me =)

Friday, March 20th

Today is a very different day. It is like we left one world to go into a completely new one. We are not sure if it is faulty lab equipment in Louisiana or if he truly took a turn for the worse in the ambulance in transport here. It is amazing the difference in the resources and the level of care we are so blessed to have here in Houston.

He now has a team of physicians caring for him and all are communicating and staying on top of his condition literally hour by hour.

There are 4 doctors caring for him (Cardiologist, Kidney specialist, Liver specialist and a G.I. which is intestinal doctor.)

Today we learned his kidney function is not normal. In fact it is back to the original admitting level back 5 days ago and he is in renal failure. His urine is very dark again and the output is down. He is toxic because his body has not been able to process the toxins our bodies produce. They put in a large catheter tube in his groin to begin dialysis. This could have stemmed from the dehydration and the fact that he only has one kidney (by birth) and it was already in limited function.

Secondly, he has tissue damage to his liver but they do not know the extent just yet. They are not sure if possibly a vessel is blocked to the liver. The best test to evaluate this is a CAT scan with I.V. contrast however he cannot have it because of his renal failure. The contrast is processed through the kidneys. They are doing a CAT scan now (11p.m.) with just oral contrast to further evalate. They do not feel this is related to the kidney function.

Thirdly, he has a small leak from the graph that was put in back in January for his aneurysm. They do not feel it is significant but they are waiting on heart ultrasound results to further evaluate.

Fourthly, he is jaundiced today and his blood pressure is still bottoming out and very unstable. In fact his potassium is too high and tonight before they could take him for his CT scan, they have had to pump him with insulin and glucose to bring it down to a level where he could at least go for the test. Apparently at the level it was, he was at risk for his heart stopping. He did just come back from that with no problems!!

He still has fluid on his legs ,is in pain and weak but he is in the right place now and we are thankful for the team here at St.Lukes. They are on top of it and doing a great job. They are even addressing the fact that there has been no nutritional supplements provided for him and he hasn't eaten in almost 3 weeks other than small nibbles here and there.

He is on a host of medications that can be dangerous to the vessels over time so they did place a central line into his jugular today in his neck. In spite of all the tubes coming out of everywhere, his spirits are up at times. He still is joking with the nurse now and then.

I will not lie, there are times he is depressed as well so please keep him and us in your prayers!

Thurs March 19th

On Wed evening, we were told he was improving and his labs were beginning to look better and moving towards normal. They told us he could go to a regular room and would most likely be there a week to 10 days. We arrived at Byrd today with intentions to push the decision to move him to Houston now that he was "more stable". We really felt he needed his team of physicians there to evaluate him and that we needed another set of eyes to see him. We still were not getting answers as to how we got here with liver damage and kidney failure.

Timothy did not want to transfer a couple of days earlier when we had suggested it because he was so sick and in so much pain. We talked to him today and said he needed to be in one of the best medical centers in the world to find out how we got here and what the extent of the long term damage would be. He finally agreed. The transfer began after much facilitating on our part. This took the whole day on Thursday.

He arrived at St. Lukes Hospital CCU at 9 p.m. this evening.

Sun, March 15th thru Wed March 18th

He spent four days in the ICU at Byrd Regional Hospital and the first few days were the same. He had dark urine, abnormal kidney function (dangerously high) and abnormal liver labs. He was also severely dehydrated. The CT there had shown liver damage and fluid in his abdomen. His blood pressure was very irratic and unstable in that it would stay low and occassionally fall in normal range but never was consistent. He was nauseas and by day 4 he was vomiting in the night and the next day. He still had not eaten much of anything nor was drinking fluids. They basically kept filling him full of fluids however he could not excrete them as fast as they were going in. By day 4, he was retaining a lot of fluid and was swollen on his legs, ankles, arms, abdomen and face. We were concerned but were told by the staff that they would get him into a regular room and have some physical therapy started to help his body absorp the fluid. When we asked what has made his kidney and liver fail, we were told the trauma from the fall and then him not eating or drinking causing dehydration made the kidney start and then the liver followed. They also told us he had to start eating so his liver could begin to repair itself. Most of this later we found out was pure rubbish!

How It All Started

On January 6, 2009 dad had an AAA which is an Abdominal Aeortic Aneurysm repair. Basically they installed 4 stints and repaired the aneurysm. Dad was in the hospital for about a week and then went home.

Approximately 3 weeks ago today 3/20 dad had an accidental fall at the house. He was getting up from a chair and his slippers slipped out from underneath him. This caused him to fall frontwards on his abdomen and chest area. Dad was in pain but thought it would go away. He was in a lot of pain and nauseas during that time but thought he would get better. He did not eat much or drink much during that time. Almost 2 weeks went by when the pain and shortness of breath got so bad he got Josh (grandson), who is living with him to take to the emergency room at 2 a.m. Dad explained what had happened and that he had abdominal pain, shortness of breath, and dark urine. He also told them as always that he was born with only one kidney. At the hospital they only took a chest xray, an abdominal xray, and rib xray. They then sent dad home with pain medicine and a flowair inhaler as if he had respiratory problem. Had they ran some lab work on him they would have discovered that his kidney and liver counts were abnormal. That is small town medical care for you.

On Saturday afternoon, just 36 hours after being discharged from the 1st ER visit, my nephew called and said he was worried about Dad and something was wrong. I knew nothing of any of the events of the last two weeks until this moment. When talking to dad, I first thought he had a stroke because he was not making much sense and was struggling to breathe. Then I got my wife on the phone with us on speaker and after a series of questions, we realized he was having some kidney failure symptoms, dehydrated and something major going on besides general muscle soreness from a 2 week old fall. We had him go back to the E.R. but this time Sandy (my wife) called up there and talked with the head ER nurse and gave some specifics on what we wanted evaluated.

About 2:30 A.M. We got word that he was being admitted to ICU for kidney failure and that his liver was showing abnormally high levels indicating damage and possible failure. We packed our bags and headed to Leesville, LA.