Thursday, March 31, 2011

WIP Wednesday

This is the disgusted edition.  In so much I'm so disgusted, I realized it's WIPW at 11:45pm, I'm exhuasted and disgusted.

First the knitting.  I'm halfway finished with the first sleeve.  May or may not have it finished by Friday.  Another inch and I'll do one repeat of the snowflake pattern then seed stitch border.  I don't know will have to try it on.

The sock is progressing.  Tried to get a close-up but even my camera isn't cooperating.  After four bright yellow pictures without flash I just gave up

Dammit will be making a visit to the hospital tomorrow morning.  Tons of crap going on and I'm just too disgusted and exhausted to post about it.  Will update after Dammit's visit tomorrow.  Maybe that will put the both of us in a better mood.

Things aren't going well on the new floor.  Just called up there, and he had an episode of not breathing after I left.  Nobody bothered to call me.  When I came back from going home from lunch, as I was walking up the hall, he was screaming help.  He had taken the trach mask off and was trying to pull off his trach.  He thought someone was strangling him he said.  Then I find that someone,  we don't know who after the nurse spent an hour calling around, pulled his chest tube.  Never told the nurses.  We don't which Dr. did it.  I was told this morning that the ct-scan they did yesterday, showed he still had a small pneumo (hole).

I'm beyond pissed off.  Trying to get to talk to a Dr. in the past few days is like pulling teeth. They keep sending me the DUMB resident.  Sunday night, as an example, obviously not have read the chart he comes to ask me questions.  "So, he's paralyzed since he can't walk?"  That's just one of the many assumptive and stupid questions he asked.  Everything he says, starts with "so". I'm hoping it's a language barrier and not that he's really that stupid.  I'm beginning to think whatever country he's from their village is missing their idiot.

  I have tons paperwork and red tape for the long term care insurance.  Have to apply for SSD and SSI as part of that red tape, which comes with it's own red tape.  It's part of the process I have to go through to be his caregiver, that I would have to go through even if I wasn't, to pay for the skilled nursing facility he will have to go through next.

Sorry, I'm just pissed off, frustrated, exhausted and many other negative moods.  Thank goodness for what small escape I'm getting from a spare few minutes here and there on FB.

Sunday, March 27, 2011

Someone Had A Special Visitor

I went on a very important, special bunny mission.

What a riot.  I took Nippit up to the ICU this morning.  No pictures of the visit as I tell him, he has more lines running than AT&T.  Nobody would want their picture taken like that.

Saturday, I mentioned to his nurse that when he got to rehab, I hoped to bring Nippit up to see him.  She said why wait, I could bring her up to the ICU and got the paperwork.  I wish I would have known sooner.

It did wonders for his mood, though he was a bit overwhelmed with emotion at first.  Nippit did very well as a therapy bunny.  She sat very still on the bed next to hand and I helped him to pet her. She cheered up all the nurses as well.  Even Dr. M came in to visit with Nippit. A great boost to the spirits all around.  I'm still laughing to myself at the thought of bringing a bunny to the ICU.

Update:  Thursday, the thoracic surgeon removed Tuesday's chest tube and put in a full size, quite painful chest tube.  They watching it over the next few days to decide if he will need the surgery.

It's taking some time for him to get used to the talking valve, it makes him feel short of breath at first.  He's doing better starting Friday when we had a patient respiratory tech work with him to figure out the problem.  He's still a bit hard to understand as he whispers and loses his voice.

This afternoon they transfered him to the floor a telemetry unit.  He's in a private room twice the size of his ICU room, with a couch.  The view sucks, it's of a building.  I told him he should feel like a rock star with that room.

Though I know that Dr. M wouldn't have transfered him unless she was absolutely sure he is stable enough, I can't help but feel a bit apprehensive.  She said, if it wasn't for the pneumo (hole) and the chest tube, he would be headed to a rehab hospital now.  After almost 45 days, the ICU was beginning to feel like home.  Now there is a whole floor and team of people for me to get used to.

I just called up to the hospital to check on him before I go to bed.  My nightly ritual.  The nurse was in his room with a cordless phone and had him talking to me.  Wow!!!!

Guess who he requested to come up to visit?  I must be a lunatic, because I'm going to try it in the next couple days, depending on how things go with the chest tube situation.

Yes, it's me Dammit headed on a bunny mission to wreak havoc on a hospital unit.

God help us all.

Wednesday, March 23, 2011

WIP Wednesday

Wow, who knew?  What is it week five headed into week six?  I'm exhausted, is an understatement.

I couldn't find my size 3 double pointed for several days for the sleeves.  I'm using three size three's and one size two.  It should all work out in the wash as they say.  Depending on how my time is at the hospital will figure how fast I finish.

While I was intermitently looking for my double pointed needles, I pulled out my oldest son's socks to work.  These were the ones that made my shoulder and elbow hurt.  My legs ache too much to notice if my shoulder hurts, right now.  All the bedside standing.

Plain vanilla socks, top down on two circs from a sock blank that I dyed awhile back.

Tuesday, I received a care package from Nurse Nikki.  It was right on time for a cheer up.  Tuesday sucked. The residents pulled the second chest tube as I was leaving for lunch.  When I got back the attending had to put it back in emergently. They were considering putting him back on the vent.  They are talking that he might need to have his lung stapled.  You know that rare thing that Dr. M told me last week, could happen but is rare.  Dr. R won't even say, don't worry it's rare, because at this point rare in almost a given to happen.

Butterscotch and Bootsie knew immediately there was something in there for cats.   After a bit of a slap match they decided to share.

There was also a little something for birds and bunnies.  Fleece Artist yarn that is just perfect for these socks I've been wanting to make for 3 years.  I'll use the shawl pin for my little buttonless sweaters.

You may be surprised, but I've never made a sock from the toe up or short rows.  Amazingly, under all this duress I was able to figure it out.  The way I'm going, they should be finished by the time cold weather reaches Tucson again.  They'll last forever, with as few cold days we have compared to up north.

Today, he had dialysis, a speech eval, his trach tube changed so he could use the speech valve.  He hates the valve, says it feels funny.  We had a float nurse from the lung and heart transplant unit and she was just amazing.  I loved her.  She called and arranged for PT to come when I came back from lunch, to get him in the chair and show me what exercises to do.  Speech is supposed to come by every day and work on his swallowing.

Busy days and I come home exhausted.  I haven't slept well for a few nights.  Not my fault, I do go to bed on time.  I've been waking up with awful nightmares or leg cramps.  Ever since my early teens I've had periods of sleep paralysis.  Those are the worst nightmares.  Haven't had one in a few years.  The other night I dreamt it was me alone in the ICU and they gave me the paralysis meds and no pain meds and were torturing me.  D had to work and couldn't get time off.  My mom wouldn't fly down.  So I was up there all alone.  Yuck.  The worst thing is when I have those attacks I need to sit up with the lights on for awhile or it will just happen when I fall asleep again.

All that's left to worry about is the internet/phone bill.  A couple of you have requested I e-mail you my address.  Which I will do later today.  I could live without the phone and internet sort of.  I have a cell phone but it doesn't work in the apartment.  So I would worry about the hospital trying to reach me.  I think I have enough to buy a months worth of food for the pets.  Hopefully, next month the state will start paying me to be his caregiver and he will be recuperating at home.  I know I could do it if they can get him to the point of standing to a walker with one assist.  Then I will have to figure out how to get him a recliner chair, inexpensively from one of the many used furniture places.

Keeping the faith, one day at a time every thing will work out.  He better be home by the end of April as that is my birthday.

Butterscotch says,  Thank you, Nurse Nikki for the package.  Especially, this toy.

Ps.  Excuse any typos, too tired to proof read.

Monday, March 21, 2011

Who's Up For Some Great News?

Friday's moon over the hospital.

One month ago Friday, his kidneys shut down.  This past Friday, we got him out of bed and into the cadillac chair. The new attending said they needed to treat him like a chronic vent patient and he might not come off the vent for anther month.  One month ago Saturday, was that awful night.  This Saturday, they had the vent pressure control turned off and on cpap mode. He tolerated it for 6 hours.  One month ago Sunday, they didn't think he was going make it through the day.  This Sunday, they had him off the vent and on a mask to trach, for 9 hrs.  He did so well, he didn't want to go back on the vent for bedtime.  They promised to put him back on the mask at 5am.

He's pretty much off the vent!!!!  The nurse said he was going to try to get an order for a talking valve for his trach for when he's on just the mask to trach.  D's eyes lit up at the thought of that. You know I'm going to be pushing for that in the morning. (Which is when you'll be reading this.)  I wanted to do back flips and cart wheels down the hall.  With my luck, I would fall and break something, on me.

Just a short update.  My brain has been fried.  Other stuff going on.  I've been zoning out with Cafe World on FB just get my mind to stop thinking for awhile.

The other thing that's in the works, is the social worker put in an application for the state to pay me to be his caregiver.  It takes like thirty days to go through.  I'm worried about how to pay the phone/internet bill this month.  A church begrudgingly paid the electric bill.  They weren't as friendly as the chapter in Oro Valley a year and half ago.  The manager told me not to worry about the rent while D is sick.  That we didn't need that worry.

Short and great news post.  I'm just going through a giant fibro-flare.  I was so exhausted Saturday, D even told me to go home early.  I must have looked like hell,  usually he wants me to stay longer when it's for me to go.

Saturday's moon over our complex.

Wednesday, March 16, 2011

WIP Wednesday

It's hard to believe five Wednesdays, a whole month since I called the ambulance.  I was able to finish the body of the sweater by this evening and am starting on the sleeves.

You've seen lots of bathroom pictures, but how many have you seen taken in an ICU bathroom?  Atleast, I'm not yet homeless knitter taking pictures in a gas station bathroom.  That would really suck.

Details:  merino/angora/silk that I dyed and spun to a three ply light fingering weight.  The sweater is top down, that I'm making up as I go along, because that's how I roll.

From the rear pose.

Other side rear.  I wonder if I can get a modeling job and be my own photographer for more pay?

It comes just to the bottom of my bottom pre-blocking.  The sleeves will be short because this is the desert.

Hopefully should be finished and blocked by next Friday.

This is little Meanie.  I named him/her myself.  Because I've been away so much I haven't had time for this one like I did the previous babies.  He has his Mommy's sunny disposition and yells at me when I come near the cage.  I came home last night to find him out of the nest.  I picked him up and he bit me.  I kissed his beak and he bit my lip.  He looks a lot like our sweet little Herbie,  only the evil twin version.  Herbie still lets me pet him.

I need this in an actual button to pin on my purse, a t-shirt, magnet and coffee cup.

If your my FB friend you saw this with a message that his lung collapsed on Tuesday morning and they were putting in a chest-tube.  It's a good thing I packed a lunch because I stayed the day and was up there for  12 hours.

They placed a perma-cath for dialysis that afternoon.  The renal dr.'s think he'll be having dialysis for quite awhile longer.  They make their decision about life long renal failure after three months from the day they stopped functioning.

This morning, I got a call before I even left the house.  The first chest-tube clotted off and his lung re-colapsed.  The dr. needed to put a second bigger one in the space above the first.  I gave permission, hung up and had myself a good screaming, cussing fit, because I was home and could do that.  Poor guy has two tubes in his side.

I'm told there a third larger size they could go up to if necessary.  The size of a garden hose. I told them if they call me tomorrow before I leave and say his lung collapsed yet again, I won't hang up the phone before I start on a cussing tantrum.  Very rare, they would have to use that.  Yeah, everything that has happened has been very rare so far.  Telling me very rare, isn't comforting.

The attending wants him off the damn vent now.  That's how she put it in rounds.  She read everyone the riot act, including nurses and techs.  You can turn his O2 up if he needs it, but don't leave it up just to leave it up.  I love this attending, fiesty little lady much like me.  Tomorrow (today when you read this) is her last day.  Then another takes over for a week and she said she comes back for a week and he better not still be on the vent when she gets back.  I begged her not to go.

That's all I'm able to type tonight.  Pretty damn exhausted doesn't begin to explain it.  Excuse any missing words or typos.  Just too damn tired to proof read.

How many of you are old enough to remember this one?  It was posted on FB Ultimate 70's Fan Page tonight.  I love this song and so do my birds, they are singing along.

Monday, March 14, 2011

Color Me Gobsmacked

Butterscotch, I wonder when Pop is coming back.

I had a few titles for this but I forgot them, I'm so excited.  But I'll get to that later.  I didn't post yesterday, because frankly I'm tired.  Bootsie is having a hard time.  She ripped the toilet paper to shreds in the few hours I was away Saturday.  I told D, I'm going to pack her in her carrier and bring her up there.

Saturday was dialysis.  Dialysis days are always hard.  Some crap happened with a tech and a nurse but I don't feel like talking about it.  He had a good run and that's all that counts.

The state lab tests came back officially negative for all strains of Hantavirus.  All the tests they did for everything under the sun came back negative.  The attending said, sometimes it happens that someone gets a virus that everyone else has, but this one person's body has a violent auto-immune response and attacks itself.  I said, that's scarier than Hantavirus.   So color me gobsmacked.

When I came back Saturday afternoon, he had the tv on, watching it and was in cheerful spirits.  Since he's been alert he hasn't had much interest in anything.  That made me feel better.  The nurse said while I was gone he told her he wanted to go home.  She told him he had to work at moving his arms and legs so he could come home.  He can move both arms up off the pillow a few inches, now. First thing he showed me when I came in.  We've had her for three days in a row.  She's a real sweetheart.  But now she needs time off, the nurses only work three days a week.

Today, was great and bad.  I'll vent about the bad first.  Please note I'm venting, that no techs or nurses were harmed today.  They are lucky it was Sunday and the nurse manager wasn't on.  If I call up in the morning and today (Sunday) nurse has him, I'm calling the nurse manager tuit de suite.

She is really young, so I don't know if she's a recent grad, but she was argumentative with every thing I suggested.  She took off the leg squeeze things that prevent clots (don't know the technical name) because she said, he wanted them off.  However, when I said he didn't like to be positioned in the high turns they were putting him in, she argued with me he had to be in that position for something that was more convenient for them (let's leave it at that.)  So, then I said, he has to be in an uncomfortable position for hours because of ......  She said, Oh he'll adjust.

I don't know what she did during his oral care, but he flinched and winced and now he won't let anyone near his mouth.  Two things pissed me off the most, well three.  First, they boosted him up so high in bed the tops of his shoulders were above the mattress edge and they left his head hanging.  Well, not hanging, because he was visibly struggling to hold his head up, while the nurse was messing around with something else on the bed and the tech was putting a pillowcase on.  The tech argued with me about leaving his head like that, uncomfortable and struggling.  I couldn't get around to the head of the bed to hold it for him.  The tech finally puts a pillow behind his head.  I suggest that it's only going to fall off like it always does.

Though, uneasy, I went home for a few hours to get things done.  Mostly, just close my eyes and vegetate.  Three and half hours later, I come back.  He's in the same position, they're supposed to turn him every two.  The bottom sheet out from under him, skin against the mattress cover,  the pillow on the floor and him sound asleep with his glasses off.

After fifteen minutes, the nurse comes in and I ask if he's been in that same position the whole time.  No, no, we turned him twice.  Bullshit, BULLSHIT!!!  (didn't say it out loud)  She goes up, whips his head up and shoves the pillow under, abruptly waking him out of a sound sleep.  After arguing with me about him needing his glasses to see, she gets the tech to turn him.  Um, if they had turned him twice while I was away, why does he need turned again, so soon?  Just saying.

They get him settled.  All of a sudden she's concerned about the noise he's making in his throat that I asked her about that morning and she waved me off.  The respiratory tech, (the one I was upset with a couple weekends ago) comes in.  Checks for a cuff leak in the trach, puts in too much air and hurts him.  So then she immediately removes all the air and freaks him right out.  Put's more air back in.  Then tries to suction him.

He was so upset, he yelled at her over the trach.  He freaking talked, full voice over the damn trach.  I freaked out.  He's telling her to stop, go away, eyes bulged out.  She tells me the cuff leak is positional, meaning the position he is in and that they had him in the same position for hours while I was gone.

She leaves.  Then the nurse walks right in and grabs the tube, she's going to suction him.  He yells, stop, go away.  She freaks out.  He talked.  (I giggle to myself.)  Leave me alone, he says.  So then she says, well, I'll turn off the tv, shut the blinds and turn off all the lights.  I'm thinking, you're freaking going to punish him because he wants to be left alone.  She leaves. Another tech had to come in and reflate the cuff because he wasn't letting the other two touch him.

The night nurse turned on his fentynal drip on low so he could sleep as he was having trach pain.  The day nurse left the drip on higher than nights, so he slept all day.  The attending asked me about why he was so sleepy today compared to the past two days, he's been alert.  So I told her.  She said she was going to check about that. He has a bruise on his right heel that wasn't there yesterday.  The attending said it looks like his foot was caught between the mattress and the bed frame.

Anyhow, the great news.  His O2 is down to 40% on the vent.  He should be off the nitrous oxide by morning.  His sats are between 95 and 98.  After that they will try taking him off the vent for an hour at a time to see how he does.

After he fell back to sleep, I went for a much needed cigarette relief to keep from chewing a few people a new one.  I stayed polite the whole time.  A bloody miracle.  Anyway, I get downstairs, light my cigarette and it hits me.  He got angry and stood up for himself.  He's back!!  HE'S BACK!!!!!  He does NOT suffer fools easily. He has no patience for hospitals.  If some of them think they can just flip him around like a sack of potatoes, they've got another thing coming.  I know he's going to be working hard to come home, now.

Because he slept the whole time I was up there, I have only a few more rows of lace then the seed stitch border.  I think I'll do a repeat of the lace on the bottom of the sleeve then the border.  It's going to be short sleeved.

Anyway, did I happen to mention my grumpy guy is BACK!!!!

P.s.  I'm copy writing the name "color me gobsmacked"  for a future colorway I might dye.

Friday, March 11, 2011

Things Are Looking Up

It's spring in the desert. The mountain laurel is blooming.

A pretty decent day.  New attending started today.  Any surprise there?  I liked her on the spot.  She understood my concerns.

His ventilator settings are turned down to half the pressure it was and he's doing well with them.  He's still on the nitrous oxide.  No dialysis today, but definitely tomorrow, which is probably today when you'll be reading this.  They don't do dialysis on Sundays, except for emergencies.  The dr. said he thinks in two weeks they'll know if he'll need continued dialysis or not.

Peaceful day with him.  The nurse manager came and talked to me for awhile to see if I'm satisfied with the new nurses.  She totally understands my feelings.  Such a sweet person.

I'm ass-u-me-ing the infectious control already did the tests for parakeet viruses right in the beginning days when they asked me about pets in the home.  All tests came back negative except for the Hantavirus.  Also, from what I read from that page, it's bacterial and treated with antibiotics.  They gave him a TON of antibiotics from day one.

I'm not going to cause ways about the Fellow Dr. O unless he makes me feel verbally threatened again.  I figure just wait and he'll be rotating off.  New residents and Fellows seem to be coming on every day.  Just bide my time.  Save the waves for the big things.

Physical therapy came to do an evaluation while I was home doing paperwork.  I would have really like to have been there to ask questions.  I know surprising, me have questions.  I would like to know what I can do to help him regain arm and hand strength.  I'm doing passive range of motion on his arms and making him squeeze my hands.  I think he'll feel better once he can move his arms himself.

The sweater might be finished soon.  Just a couple more inches of lace, then the edging and the sleeves to go. Here's hoping for a peaceful weekend for all of us.

I've only heard bit and pieces about Japan.  My thoughts go out to them.

Thursday, March 10, 2011

And So It Goes

First of all, I have the best blog friends.  It really warmed my cold, dark heart to read all your comments last night as I headed off to bed.  Just a short update to keep it all straight in my head.

It's been a busy two days.  Every day is busy, but my schedule was thrown off.  Last night, was fairly quiet while I was up there.  A couldn't pick me up until 9:30 so when I got home, I just had a can of ravioli and went to bed.

Today, something came up and she couldn't get me until 4pm and we went to the grocery store.  On the way back, I asked if it would be possible to pick up later that night at the hospital.  That I was going to put my groceries away, grab a bite to eat and catch the bus back up.  She insisted on coming back and picking me up in an hour so I wouldn't have to take the bus.  She's been such a blessing carting me back and forth for the past three weeks.  I tried to give her some yarn, but she said only if she could buy it from me.  *heavy sigh*

His sedation has been turned off.  He's becoming very alert.  Trying to mouth words, except often I'm terrible at reading lips.  He gets frustrated, I get  exasperated.

Dialysis again today.  I made sure he was as comfortable as possible before I would let them start.  He had a pretty good run until Dr. O came in and started messing with his vent settings and that's when the dialysis machine clotted off and she had to stop.  She and I both blamed Dr. O for messing around.

Rudee, you are correct in your summary of Dr. O.  His new thing now, is because the test for the common strain of Hantavirus came back negative, he's blaming my parakeets.   Said, I have a TON of parakeets.  Compared to the lady I bought the cage from last fall, I just have a family.  The infectious control was trying to blame my parakeets in the beginning.  Ok, you super sleuths who have been reading about Hantavirus.  This is the information I found out about viruses caused from parakeets.  Also, I'm the one that cleans the cages.  He picked up a baby bird a few times to take it out of the box.  We also have a ton of pigeons around here, as the old lady on the end unit feeds the flying rats.  What's your opinions?

I'll end there.  More I could write but it's late and my nightmares are calling me.  Yes, I'm getting sleep, eight hours of nightmares a night.

Wednesday, March 09, 2011

WIP Wednesday

It seems so long ago, those three weeks since he went into the hospital.  I had no clue back then the roller coaster ride that would follow.  For those that are here for the knitting, I will post my sweater progress first.

A recap:  This is being knit with three ply light fingering weight that I dyed and spun.  The fiber is merino/angora/silk dyed sky blue/light turquoise,  medium blue and lavender.  The lavender parts look more pink up close.  I fractal spun the yarn, trying to go a blue opal look.

The pattern is one I'm making up myself as I go along.  The stockinette stitching is five inches from under to waistline where the ribbing portion begins.  It ends right at the start of my hips right now.  The lace section is currently six inches.  I'm thinking to make the lace section anywhere between ten and twelve inches.  Then I will make a border of one and half inches seed stitch.

I'm spinning on the BFL/silk for about ten to fifteen minutes a day for sanities sake.  Not that I have a sane cell in my body. We can pretend.

For more works in progress, click the button below.

Ok, now onto to my very slow WIP, getting D well and out of ICU.  I'm wishing for an uneventful day, soon. You can choose to read the following, not read or skim.  I'm mostly writing things to keep track of and if D wants to read it sometime after he's well.  I do tell him that my online friends are wishing him well, praying and sending positive thoughts.

Another new nurse today.  I'm sure she's probably good at what she does and today was just a very bad day.  She said she was having a bad morning when I went in.  She was very disorganized at what she was doing and rushing around.  The dialysis nurse was there all set up and waiting for the nurse to finish up. When I went to say good morning to D, she came up to give him medicine in his NG tube and sprayed me, him, the wall, and all the equipment with senna.  Sticky stuff.  I just laughed it off and said it happens to everyone at some point.

Afterward, she said she was going to be in the next room with her other patient and she would be awhile as she hadn't spent much time in there.  I really wished she would have made sure D was in a comfortable position before dialysis was started. He was crooked in the bed.  He can't move at all for 4 or 5 hours after it starts.  The cath they put in last week is starting to crap out.  The renal dr. doesn't want to put in a new one because he thinks that D will only need a couple more treatments and that his kidney's are getting better.

After about 30 minutes, D became really uncomfortable, bp going up and complained of trouble breathing.  He was making a grunting, gurgling noise in his throat.  I stood outside the other door and asked to speak to her (this morning's nurse).  She came out, I told her the situation. She said, "I'll be there in a little bit.  Actually, I haven't spent much time with this patient.  It will be a little while."  She took off down the hall.

I sat with D for another 5 or 10 minutes.  His bp, heart rate and respirations climbing.  I'm trying to sooth him. Then I went up to the desk and requested if the charge nurse was busy.  The charge nurse is the one he had as yesterday's nurse.  She was with a patient but they would send her in when she finished.  I took a quick stroll around the unit to see if I could find someone available.  The other nurses help each other all the time.  Everyone was busy in the rooms.  I sat for another 5 or 10 minutes, then he went into distress.  Alarms going off on everything.

The dialysis nurse couldn't do anything to help as she was just there to run the machine.  I pushed the call light and told her if someone came in before I came back to tell them what was going on.  Then I went back to the desk and the nurse manager was there.  She smiled and began to approach me.  I just grabbed her arm, said, I need you to come with me now.  Then explained the situation as walked back to his room.  She got the troops in action.  Went in the other room and spoke to his nurse for awhile.  Then assigned a new nurse to D whose other patient didn't require as much care.  Things were somewhat settled down.

He has a small pneumothorax on his left lung.  His required vent settings of positive pressure are making it hard for the hole to close.  They monitoring it with daily chest x-rays and trying to decrease the positive pressure of the vent.  However, the decrease in pressure is making it harder for him to breath.  He's still very critical and holding his own, the attending said.

Right after I talked to the current attending, Dr. O (Overbearing) comes in the room to tell me about the vent. I nodded yes, and said ok, fine.  He steps closer and repeats the same thing again only louder.  I think, what am I stupid, I heard you the first time, now go away.  So I nodded yes, and said ok, fine louder.  He steps closer and starts to repeat it yet again for a third time, louder still.  That's when his voice became a loud buzzing in my ears and I felt like I was going blow.  I just looked at him from under my eyebrows and put my hand half-way up in a stop motion.  He was smart enough to stop and go away.  I took a deep breath and thought of how Dammit looks at the cats to warn them just before he's ready to pounce.  I think I had a similar expression and chuckled to myself.

I'm home to do some necessary paperwork that was interrupted yesterday.  Still trying to keep all my balls in the air.  Hopefully this evening will be quieter when I head back up very shortly.

I'm going to try to read some of your blogs tonight.  Don't know how many I will get to, as I have a headache starting.  Any day now, will be that week where I can't be held responsible for what my evil self will say, if you know what I mean.  Lord them and me.

Thank you stopping by whether you read or skimmed.  Your comments are still a big help every day.

(gratuitous cute kitty photo)

Mom needs to clean this junk off my bed.  She's really slacking around here. 

Tuesday, March 08, 2011

Ups and Downs and Ups Again

The view from his window that he can't see, it's behind his head.

I tried to start off my morning in a positive attitude.  Even put on a dress he bought me a couple years ago, and I had yet to wear it.

Today, I went from high to low.  They had him all set to go to surgery and the surgeon came up and cancelled saying he wasn't ready for a trach today.   He talked to the respiratory therapist and I guess they are going to try again in two days. His blood gasses were too low and his oxygen requirement too high. They brought the nitrous oxide back in.

In the meantime, he's become quite alert and his cognitive thinking increases each day.  Last night, I was trying to think of something to talk about.  Then I remember how sedated he was when the Christmas pudding arrived.  So, I told him it had finally came in.  He rolled his eyes.  Then I said, that was a very slow boat from England.  He nodded yes, and rolled his eyes again.

The nurse told him about the trach in a manner, I would have rather she hadn't.  It was, "I'm readjusting this because you are having a trach put in."  His anxiety went through the roof.  I was trying to calm him down, and of course, everyone from all the teams wants to talk to me out in the hall.  He was de-satting when the surgeon came up.  It was all too much and I just wanted to scream.  I still want to scream, but everyone would come running in the complex.

When they did rounds, there was mention of a small pneumothorax on his left lung.  I was pretty sure I knew what it was but didn't want to sound stupid.  So I Googled it and it was what I thought I remembered, so I will have to remember to ask tomorrow.

Dialysis didn't start off so well last night, but they were able after 5 hours to get a good run.  They are holding dialysis today to see how he does.

The more with it he becomes, the less patience he's having with being in bed and the whole process.  It's exhausting trying to help him find a comfortable position.  After 4 hours this morning, I was just worn right out. He wanted to see the pictures of the animals, but when I showed them to him, he became agitated.

Here's a cute bunny for you.

So, I ended there this afternoon and was uploading pictures, proof reading when my cell phone rang.  It was my neighbor J. He and Miss Di were up at the hospital.  The Dr. was just starting the trach procedure and the nurse said she tried calling the house but there wasn't an answer.  They said they would get a hold of me.  So they raced back and we all went back up to wait.  Miss Di had class so they had to leave before they could see him.  She said something told her to go up today.

The nurse said the surgeon appeared just as she received the new lab results from the added nitrous oxide.  He was calm and his oxygen requirement was lower.  The surgeon said, Let's go, and they did.  Right then and there.

He looks so much better without all that tubing in his mouth.  Is in much brighter spirits too, it seems.  He can actually give a small smile without trying to curl the corners of his mouth around the tubing.  We'll see how he feels tomorrow after the lidocaine wears off  on the incision.  They say a trach is more comfortable.  I just don't know,  tubes in my mouth or my throat cut.  I'll take their word for it.

Some of the nurses who had him in the beginning stopped in to see him and tell him how great he looks.  Of course, I doubt he remembers them, but he smiled and nodded.  His day nurse said she was going to get someone to help turn him.  She came back with the nurse he had on that awful Saturday.  That nurse's eyes lit up when she saw him so alert with his glasses on.  She said, I was asked to help turn a patient but I wasn't told who.

Tonight he has my favorite night nurse.  I gave her a hug when I saw her.  His day nurse and I started talking about how some nurses work better with some families than others.  I told her how I did a happy dance at a 8am when I called up and he had this one nurse three days in row last week.  She agreed that nurse was just great.  His nurse today was new, and she was great as well.  Anyway, I said, there is no way do I ever happy dance at 8am until now.  D nodded emphatically.   He now sees me after two cups of coffee, I'm still not approachable between the alarm going off and that first cup. I'll have to practice my before coffee cheerful before he comes home.

To answer a suggestion.  He isn't able to write yet.  He can lift his head and shoulders up a few inches by pushing on his elbows. Just today he can lift his hands up about an inch for a few seconds.  He's finally just getting a good grip today.  It yesterday, I was thinking I've had newborns hold my fingers with a tighter grip. He's unable to lift his legs but can rock them back and forth.  When we were positioning him today, I said, something's still not right, those legs are rocking.  The PCT (CNA back home) said, yep, that's how I know something's wrong.

Thank you Rudee for the compliments on my spinning and knitting.  I wish you and Amy could come down to visit, I would love to teach you both.  If I were a millionaire, I would open a dude ranch fiber retreat.

I've already looked into teaching knitting, spinning and crochet.  All the fiber stores have their people. Micheal's crafts is big joke.  I applied to them when we first arrived.  I believe January 2010 post explains what a joke that place is.  I'll find something somewhere, I hope.

Well, the night nurse and I are going to play with the phones now and try to figure out what is going on that I'm not receiving calls from the hospital.

ETA:  I was trying to remember what Miss Di and I were joking about while we were waiting.  I was telling her how Infectious Control is still asking if he's been to India in the last month.  I said, I wish we could afford a trip to India. Not that we would go there.  More likely the south of France, the UK and the Netherlands.

She say's, "Are you kidding me.  Tell them you can barely afford a trip to the grocery store."

We burst out laughing.  Good friends can make you laugh in times of stress.

Monday, March 07, 2011

It's A Fine Line

The French lady across the way has been watering my plants for me.  The petunias mostly died in the hard freeze we had.  Love that deep purple of my pansies.

Actually, I had another title planned, but I forgot to bring my camera for the proper pictures.  Tomorrow.

Not much knitting accomplished yesterday.  D wanted me to just hold his hand, so that's what I did. The window in his room has a wonderful view of the mountains, but it is behind his head.  So, I turned my chair towards him and watched the sunset on the mountains.

His nurse yesterday was great.  We made a pretty good team trying to keep D comfortable, figuring out the right yes/no questions.  That's all I ask for is a nurse I can work with.  Not one that runs in and cranks up the propofol the minute he gets antsy.  When I called up at 8am this morning and found out we had her again, I did a happy dance in the middle of the living room.  Totally freaked out the cats.

My favorite receptionist was back this morning.  She asked me for an update on his progress over the weekend.  I just love her.  She makes me smile for real every morning when she is there. (some sort of miracle worker.)  Then when I said a cheerful good morning to D, he raised the corners of his mouth in attempt to smile.  Only imagine what he is thinking.  First time in nine years she's saying good morning with a smile instead of the usual grunt and frown.

During rounds the attending said, it would take 3 or 4 days for the ENT team to make an assessment, then maybe later this week or next week for the trach.  Imagine my surprise when the nurse said she got an order to hold his tube feed.  Then the chief of the ENT came to talk to me and had me sign the papers.  If they can manage it with the OR schedule they will do the trach today.  Definitely, sometime early tomorrow.

 This should make it easier for D move around, I'm told.  Which is good as he is much more alert and wanting to sit way up high in bed.  He's tall with a longer in the torso than most people.  Anything made for short people like me, makes his back hurt.  A random nurse, came in while I was trying to make him comfortable and knew just how to arrange the bed so he's sitting right up, and helped me reposition him.  I wanted to take her name down.  If only I were a billionaire and could go to the hospital and say in exchange for this rather large donation, we want these nurses.  Not that some others don't have his best interest at heart, it's just some work better with us than others.  Nothing personal.

He's making twice as much urine today.  So his kidneys are trying to regain function.  His potassium and other blood levels are still high, so they will do dialysis today.  I'm sitting here laughing at that.  What other circumstance would anyone blog about their SO's urine output.  I don't know, the thought of it, sends me into a fit of giggles.

I'm bringing both the laptop and camera with me this evening.  He wants to see pictures of the fur/feather kids.  The nurse said, I could just leave my laptop there, that it would be safe.  Yeah, it's not like I can replace it and don't want to take that big of chance.  She said patients families bring in all kinds of electronics into the rooms.  They spend night, some practically move right into the room.  Imagine that.  My back and sanity wouldn't let me do the move right in thing.

  Almost 30 years ago, I went through a similar situation with my late ex-mil and only immediate family could visit 2 at a time for 10 minutes every hour.  Otherwise, we had to sit way down the hall in the waiting room.  They wouldn't get you if something happened, you just walked in for the next visit and the shock.  I remember when fil had a cerebral hemmorage, they didn't come tell her, just popped him on life support and she was shocked when she went in for her 10 minute visit.

Making more bird videos, so I can show D.  Have some paperwork to do. Thanks for stopping by,  see you tomorrow. Still trying to catch up or keep up on you between all the busy.  Pray that his trach operation goes smoothly.

Sunday, March 06, 2011

Leveling Off

I really couldn't come up with a title.  I'm in an angry/frustrated phase of this.  Just angry and frustrated with the whole situation.  I guess acceptance comes next.  He's leveling off on his progress.  He's still progressing just not enough to pop off the ventilator any time soon, as the Dr. put it.  We shall see tomorrow when they are going to decide to put in the trach.

New nurse today.  I like her, which helps.  He's more alert for longer periods of time, with more periods of frustration.  I'm getting better at finding the right yes/no questions to ask.  I can only imagine his frustration with being unable to communicate.

Nothing has really happened in the last 24hrs worth the energy of typing.  I ran into a lady (almost quite literally) that told a friend she was there to rule out viral meningitis.  She was wearing a face mask, but still I was six inches away from her when she said that.  I moved away very quickly.  Went upstairs and asked the nurse about it. This was yesterday afternoon.  His nurse kept saying, "I bet you could have just shit yourself."  I was just worried about carrying back to D.

I have just a few more days, then I'll need to start seriously looking for a job.  Was really hoping he would be off the vent and out of ICU by now.  It's going to be really hard.

The cats are venting their stress, peeing inappropriately.  I put my clean black skorts on the bed, took a shower and when I went to put them on, wet on the backside.  I yelled at them about not needing unnecessary nonsense.

Got a fair amount of knitting accomplished.  It's back to where it was before I ripped it out.  Maybe it will be finished this week.  Then to decide what to work on next.

Yesterday, I took some time to spin for about 30 minutes. The BFL/silk natural color, I was working on in January.  About 2 or more ozs left to spin.  Then I will work on the merino/silk my friend from Phoenix brought me.   I needed a bit of me and spinning time.

I tried to get a picture of the baby bird for you.  It's two weeks old yesterday.  Mama would not leave the nest so I could get a better picture.  She and baby hollered at me something fierce for lifting that lid.  I noticed there is another full size egg in there, plus two that look too tiny to be hatchable.  This baby looks to be mostly white with a little black/grey.  We'll see in a week when the real feathers come in.

That's all for today. Thank you for stopping by.

Saturday, March 05, 2011

Happy Birthday Nippit

Happy Birthday, Miss Nippit.  She is two years old today.  I posted three on FB, but I sat and thought about it, she's two.  We got her in May 2009 before we moved down here in October.  My mind is in a fog, I swear.  She's upset that I don't have time to bake her a carrot cake for her birthday and that her Pop hasn't been here for weeks.  I did finally open the package Suzy sent and found some fruitcake in there.  So tonight, we will celebrate with a little bite of fruit cake.  Just a little bite each.  I will save the rest for when D gets home.

My neighbor Miss Di came over and helped me clean up a really bad case of gunky butt that Nippit had. (Probably TMI) It's a chronic problem, no matter how much I try to regulate her diet.  Then Miss Di snuggled her for a long time and groomed her fluffs she's been trying to shed.  It was good sized pile and I saved it to mix with some merino for spinning.  I forgot last night that today was her birthday.  She probably would have gotten an even longer snuggle time.

Last night went fairly smoothly.  The day nurse turned his sedation way down to get his bp back up and we had a bit of a frustration issue.  Fairly calm other than that.  Dialysis came just before I left and they were able to take another 4 liters off.  He's still fairly bloated.  They are coming tonight because they won't/don't come on Sundays.

New attending showed up today.  He didn't seem to want me around during rounds, but you know I don't care.  He'll be gone soon and another will take his place.  They were discussing that the trach might be hard to do because of the type of ventilation he is on, bi-level.

The resident said, "He's becoming ventilator dependent....."

So I asked for clarification, "Are you saying this is a permanent condition?"

The attending said to me, "What we are saying is, if he wasn't on a ventilator in his current condition he would need to be.  It's medical jargon. That's what happens when you listen in on rounds, you will hear medical jargon you don't understand."  Harumph.

He had a yet another new nurse that he hasn't had before.  He looked better when I came in the room.  Though his glasses were off and his eyes were open.  I'm thinking about taping a note on his monitor that he needs his glasses to see!!!

She was ok.  One of the perky, cool kids.  It's just because I'm a cranky, old school broad that I would have a complaint.  The other nurses kept coming over to her station to gossip and they were what D and I would consider kinda loud.  One would laugh out loud and wake him up.

Things are so different on ICU's now.  One patient, has a ton of family.  They bring this small child, about 3 or 4 right into their room.  When they walk by with the small child she is pretty loud talking or a scream.  They have cowgirl boots on her and she sounds like a horse clomping down the hall.  What ever happened to the days when they kept ICU's really quiet?

I thought the way the morning was going today would be really uneventful and I could post about Nippit, a short update, my knitting progress.  D had other plans. Seriously.

As I was leaving for lunch, I told him I going to home to eat and check on the pets and that I would be back in a few hours.  He nodded yes.  Everything fine.  When I walked around the bed to get my purse, he suddenly began shaking his head back and forth, the motion pulled his vent tube off of his et tube.  His nurse was at lunch.  I re-connected the tubes and put on the call light. When nobody showed up right away, I went out in the hall and shouted for help.

I didn't want to just leave him, he was still quite agitated and I didn't want it to pop off again.  The nurse who came in, reminded me of a younger version of me.  When I told her what happened she asked if I had put the tube back on. Yes.  She said, that was the right thing to do.  Um yes, I used to be a nurse and did at home ventilator care.  I just don't want to leave and the thing pop off again.

Just then he blew out really hard and popped the suction tube off.  We got that reconnected.  She turned up both his meds to settle him down so we could figure out the problem.  It was what I thought it was and we repositioned him more comfortably.  The anal nurse was working charge and she came to the door.  Told me next time to just sneak out and not say anything to him.  Yeah, whatever (fill in the blank) that wasn't the problem.  The first nurse said she would stay with him til his regular nurse came back in five minutes.  I asked him if was alright for me to leave and he nodded yes.

Whew, give me a heart attack and a stroke and I'll just be in the bed next door.

I really think his condition yesterday was mostly the day nurse, reason being she had been for two hours at that point.  She had been in to increase his sedation to lower his bp, that was why the sedation rate was so high. Also, when she repositioned him later, she had his head hanging back over the top of the mattress. I had to say, "Hey, his head is hanging backward over top of the mattress.  Doesn't that look awfully uncomfortable?"

I've asked him if he wanted me to read these past couple days and he shakes his head no.  So I'm getting a lot of progress made on the sweater.  Will post a picture tomorrow.  At this rate, I might have an fo on Friday.

I'm going to go clean cages and do some dishes.  Pray for an uneventful 24 hrs for me.

Friday, March 04, 2011

TUSAL March and You Pick It

Feels like a year has gone by since the last New Moon for my TUSAL post.

Copying Cookie, pick your title:

1. I did NOT ask to ride this roller coaster

2. I should have packed a clue-by-four today

3. Can we check out and possibly resume this on Monday

4. Birds- Natures little prozac.

First I'll get the TUSAL out of the way.  This is my spaghetti sauce jar that I purposely made spaghetti just for the jar.  I think there is more thread this month from working on my Dahlias in the beginning of February.  It seems like a year ago, so I can't remember for sure.

The other night, my neighbor almost fell off her couch when I was telling her about all the clueless people I run into all day, mainly on and around the elevator. I said, I need to pack a clue-by-four to hit some people. She'd never heard that before.  Need to come hang out on Ravelry, it's where all the cool kids go.

New nurse last night.  Didn't care for her, didn't have the energy to deal.  Went home and prayed for the best.  Slept through the night with constant nightmares.  Attempted murder on the alarm clock at 7am.

Stupid thing said to me last night, the anal night nurse told me to "have a good one" as I was leaving for the night.  Yeah, I'll get right on that.  (my snark factory is working over-time)

Walked on the unit, stopped at the desk long enough to say a cheery, "Good morning, and thank you."  I have them fooled into thinking I'm a cheery morning person.  Sponsored by Folgers and the fact that I can be good actress at times.  I deserve a Golden Globe for pulling that one off.  I have also found that the more people you have believing you are a reasonable, sweet little lady, the more seriously they take you when you have to pull off the mask and show your true evil self.

(que the Theme From Jaws:)

Then I walked into his room.  He was all turned funny in the bed and exposed for the world to see.  Looked like someone had just picked him and flung him onto the bed like a rag doll.  Sedation medication way high, him out cold and his glasses off and found by me on the med cart.  I covered him up and go out into the hall and stand in front of his door with my arms crossed.  His nurse comes out of her other patient's room, looks at me and says, "His a-line crapped out.  Nothing else has changed since you called an hour ago.  I'll talk to you later."

I went back into the room fuming.  You know these past two weeks, I've had some personality clashes with a few nurses, but the care wasn't lacking so that I was ready to go to the nurse manager and request a new nurse.  The palliative care team came up to his room door and was talking so I went out and vented my concerns to them.  Besides figuring out the proper sedation, pain and anxiety control, they are also my liaisons when I'm about to blow up.  If you have ever read my post, Eleven Years Ago, you remember how little patience I have for what I consider low quality care.

While I was speaking with them, his nurse went into his room.  We all walk in, so they can do their liaison thing.  She has his radio by his head turned way up, dancing to Michael Jackson, while messing with his a-line.    Not cool.  That might look good on Grey's Anatomy, but so not cool in real life.  Especially, when the patient's family is ME. His sedation was turned down, I put his glasses on and we went on from there.

Because I'm a grown-up, she was able to gain some of my confidence as the morning progressed.  It took a lot of energy on my part.  D always tells me, "It's hard to be the few grown-ups in a world full of really big children."

During rounds, the Dr. went into the room and talked to me about the possibility of a trach.  He's not progressing as fast as they need him to. Good thing, Rudee warned me last week, or that would have thrown me for a loop. They are going to see how he does over the weekend and discuss it on Monday.  I'm counting the days on my fingers, and guess what happens on Monday?  Yes, a new attending should probably be coming on.

D was pretty alert during that conversation.  I asked him if he understood any of what was said.  He shook his head, no.  I said, "I love you and I'm doing the best I can to make the best decisions for you."  He nodded his head, yes.  Which brought tears of relief.  Yesterday, he would only respond to the nurses questions.  I was afraid he was angry with me for letting them stick all those tubes in him.  Which I feel would be a reasonable response waking up after two weeks to all that.

The resident dr. from Renal didn't want to do dialysis today.  He wanted to skip a day and see how he does.  The attending for ICU said, he wants it done every day, that D is still pretty water logged and he believes the x-rays are showing a build up of fluid in his lungs.  He wants to get him to a dry state.  I agreed with ICU dr. and told him so.  We do not need renal dropping the ball yet again and fouling the everything up causing him setbacks.  If they drop the ball again,  I might pick it up and whip it right at their heads.  (sorry, my evil side showing)

That's the past 24 hrs.  Woke up feeling like something the cats beat up over night.  Right now, I have the energy to take on the world.  Right now, that is.  Who knows in another hour or so.

As promised, The Parakeets.  I can hear them all the way into the parking lot when they are really chirping, that's with the door and windows shut. They are usually very quiet when I walk up to the door, then they hear it open and they get all excited with really loud chirps, jumping from perch to perch. It always makes me smile at their greeting.

They chose not to be very active for the camera yesterday.  But I will get them yet.

Thank you keeping up with me through all this. Pray that he gets a good nurse tonight.  I don't want to have a reason to take my sweet little lady mask off.

Thursday, March 03, 2011

A Little Bit Better, A Little Bit Quieter

Last night was quiet.  Thank goodness.  Our favorite song came on his bedside radio shortly after I sat down.

Not mushy, types. But we both think this is the greatest love song ever written. Of course, I sat there and boo hooed.  Wish I would stop doing that.

He was asleep, but when he woke up, I read Standing in the Rainbow (Ballantine Reader's Circle), one of my books.  Not something he would read, but it's a nice story.  I think someone half sedated should listen to a nice story, not monsters and aliens.  Love, love this book.

Since his potassium and sodium levels are in the high normal after all that dialysis and his O2 sat was 99 on 80% they decided to start the weaning process again.  He's at between 93-95 on 65% now.  The Dr. wants to do some changes to the vent today to see how bad his lungs really are.

They can't tell because he's still so water logged.  They took off 2 liters on Tuesday, 3 liters on Wednesday which is quite a lot when you look at it.  His hands still look like over stuffed sausages.  He has 3+ edema in ankles.  88lbs/44kilos is quite a bit of water weight. The Dr. said they would know more about his lungs if they can ever get him to a dry state.

This morning he was pretty alert compared to the past several days.  The day nurse put his glasses on him.  He's able to focus and see me now.  Also able to answer simple questions like if he is in pain or not.  He nods for no and blinks once for yes.  I read to him for a couple hours this morning and his bp and heartrate started raising.  The nurse came in and asked him if he was in pain and he blinked yes.  I asked him if he wanted me to stop reading and he just stared at me.  No blink or small shake.  A said on the way home that maybe that one question was all the energy he had to answer.  I thought when the nurse asked him if was in pain and said yes, he meant yes, please shut that pain up over there.

I tried to catch up on blogs last night, but only got through 3 or 4 and I was just too tired. Went to bed and hour and a half early, then attempted to kill the alarm clock this morning.

I took a short video of the birds this afternoon.  The file was too big for flickr by 5mb and is going to take 2 hrs to upload to Youtube.  Something for you to look forward to.

I'll try to catch up with all of you when I can.  This afternoon I making a date with my spinning wheel for about 30 minutes.  I haven't spun for a few weeks and I really miss it.

Thanks for stopping by.

Wednesday, March 02, 2011

WIP Wednesday

Wow, it feels like a year has gone by since last WIPW.  I know the rest of you are like what, it was just yesterday.  Amazingly enough, I did make some progress on my sweater.  I'm putting the knitting progress first, for anyone just here for the knitting.

This sweater makes my breasts look like flat blobs.  I thought of ripping back and putting bust darts in, but screw it.

I can't remember if it was last Thursday or Friday he had the bronchoscope and while that was going on, I ripped the sweater back.  It was really therapeutic.  This is the time, I was sitting out here angry at that anal nurse, Rip.  This is time I was so frightened when they took him down to Cat-scan, Rip.  This is the time I was angry at that nurse again, Rip.  And so on.

I'm glad I raised the breast line.  The past few days I haven't been able to read to him with so much going on. When things get quiet, I sit there, knit and just let him rest and heal.  Any stimuli right now raises his blood pressure too much. Depending on how the week goes, I should have it almost finished by next week.

How many years can one person age in a week?

My biggest WIP at the moment:

To let you know, I'm eating more now than before D got sick.  Not junk food.  I have a sandwich in the afternoon and something cooked at night.  I've never eaten breakfast since I was a kid.  I have a couple Trisquits for breakfast.  I'm sleeping between 7 and 8 hours a night.  Believe me, I can't afford to miss a meal or an hours sleep, other wise I would just fall down.  Last night was cheap box mac & cheese (I used real butter and half &half with added real cheese. That counts, right?) a can of stewed tomatoes and the last two pieces of Banquet chicken.  The chicken was mostly for the cats, I hate thighs, but did eat a bit.  My grandmother used to make box mac & cheese with stewed tomatoes when I was kid and I needed some Grandma comfort food.  Tonight, I think I'll make chicken and rice. (another Grandma like comfort dish, which will have leftovers)

This morning I woke up an emotional wreck.  I woke up ten minutes before the alarm and burst into tears that I could have slept another 10 minutes.  Then I broke down at the thought of going up there yet another day.  Just make it stop.  After I made coffee, I thought about that anal nurse coming back today.  Broke into tears, no, no don't let him have her, I just can't deal with her today.  Called up to the hospital to see how he did over night.  Found his day nurse is someone he hasn't had, but she's been in the room helping out and always comes in to check on how I'm doing.  I hung up and wailed again, out of relief.

I opened a message, how are you doing?  Waaaaah. Then I started crying about the fact I was crying.  This isn't PMS, this is my one good week.  Betty gave me a hard time and I sat in the middle of floor and cried about that.  Up at the hospital, I started crying about going into the room and seeing him like that, yet again.  The palliative care nurse came in and I broke down again.  I got it together after talking to her and his nurse.

I'm just that emotionally and mentally spent.  It's not like I can just take a day off.  If I didn't go up there for a day, then I worry about what was going on.

I'm holding off judgement on the new attending as he's just getting his bearings.  He's seems like he is going to be more conservative about when he will take off the vent.  He said the O2 has to be way lower than 55%.  His metabolism has to be balanced (renal dropping the ball for a couple days).  He has to be alert and a couple other minor things.  He said about 2 weeks and then he said maybe a week.  In a week, a new attending will be on service. They have, I think, 6 of them.

His dialysis didn't go very well last night, they only were able to take 2 liters off.  I think the nurse kept him well sedated and that makes his bp go down and it doesn't go well.  They came back first thing this morning to try again.  The day nurse took my advice on little things I've observed over several days and we were able to keep his bp up enough without it going to high or too low.  I hope he has her again.

The anal aggressive nurse was there.  She smiled at me when I walked past the desk.  I thought go ahead, smile and wave just don't talk to me.  I can't deal with you today. I didn't mention this before. That Sunday, when they thought he wasn't going to make it through the day, she inserted herself into his personal business where she didn't have any business inserting herself.  We really locked horns and she was trying to bully me.  She said, if he dies in the next 30 minutes, you could face problems a year or two from now.  To which I said, then I will deal with it then.  Then I said,  If he lives when he comes out of this and you make me do what you are trying to bully me into doing, he will come here and punch you right in the face.  He doesn't hit women, but he will make the exception for this.  That's when she begrudgingly backed off.  I found out she called the social worker afterward, who refused to get involved in that matter.

When she did get close, she just commented that she like my knitting and went about her business.

I'm a little better than I was this morning.  I will probably put anything important that happens this evening in tomorrow's post.

Thanks for stopping by and commenting.  I know you all would come bring me food and other stuff if you were closer.  Thank you for the kind thoughts.

Tuesday, March 01, 2011

The Frustration Keeps Rolling In

I'm writing this in two parts today, just to make my life easier.  First of all, quiet night, thank you.  Busy morning.  First of all, new renal Dr. came on service today and decided not to go by the previous Dr.  Sent the dialysis person down to try to get the line old working.  Which didn't work.  Sometime this afternoon, they are putting in a new line, in an emergent situation, because his bun and creatinine levels are going too high.  His lung x-ray is worse because he's building fluid, a ton of fluid.  He's 88 lbs more of fluid than when he came in.

He's making some urine on his own.  Depending on who you talk to as to whether it's a good thing or an indifferent thing.  Some say it's good, others say, dialysis patients sometimes make urine but not enough to take off the poisons.

The dr.s sneaked around me to do rounds on him today.  So, I didn't get to listen in, his nurse missed it to, they were so sneaky about it.  This is why I feel they were being sneaky.  Normally, always, they have done rounds right in front of his room and I go out and stand in the hallway, listen and ask any questions based on what I hear.  Today, they rounded on him while they were standing at the room next door.  I didn't want to break patient privacy so I stayed in the room.  When I thought they were going to do him next, I came out to be told, they had already rounded on him.

If this is how they are going to keep the fellow Dr. Overbearing out of my radar, it's not good.  It's just pissing me off more.  Makes me feel like I'm being punished for speaking up and not tolerating bad behavior.  I requested that he not address me personally.  I realize he's part of the team and would speaking during rounds, I don't have a problem with that.  Just don't address me personally.  Send another messenger.  We'll see if this continues.  Doesn't help a new attending is coming on tomorrow, with this other drama playing out.  I hope this new fellow Dr. O, goes away soon.  I'm amused by the fact that his real last name starts with O, for overbearing.

The palliative team came down and spoke with me today.  Just as NurseNikki said, they were distressed at the conversation I had with Dr. O.  They most certainly help with comfort care in other areas than hospice and end of life stuff.  Wonderful caring ladies the NP and the Dr.  They listened to my concerns and are assessing his file and will make recommendations from there.  Which is good, because the Propofol they are using lowers his blood pressure to the point they can't do dialysis.  When they lower the drug, he becomes agitated.

I've been wondering why I'm just so exhausted all the time.  It's no wonder.  So much information to process in so many areas, renal team, pulmonary team,infectious control drs,  at one short point cardiology, and palliative care.  Then asking questions and decisions to make, input to give.  Hour by hour it's a new onslaught.  Watching the monitors.  I've gotten so I can pick up on changes to his vital signs, the different stimuli that will make it go up or down.  I feel like I'm connected to him through that tv screen.  Also, I'm a bit of an empath.  I don't tell them that, otherwise they'll really think I'm a nutcase.  It's helped with my nursing career in the past and I have an uncanny ability to communicate with people who cannot speak.

That was just my morning.  It's just a brief overview, you can only imagine what it was really like.  My ride is going to be here in an hour.  I think I'm going to knit, watch some tv and decompress.  Yet another day of saying to hell with housework.  I wish these cats would get something done around here while I'm gone.  Lazy little beasties.  I know the busy bunnies would, but they are easily distracted.  Oooo shiny.

Act 2:  I got up there just a little after four pm and his bed was missing.  Not surprised, but wondering what they did for consent as they hadn't called me.  Someone half erased a couple numbers of my cell number on the board, and for some reason they kept saying they can't reach me at home.  It's correct number on file.  Either someone doesn't know how to dial correctly, or there is something with the hospital that only they can't reach me.  So, two dr.s signed off.  This happens quite frequently and makes me wonder why I'm MPOA.

This probably won't come up.  But it also makes me wonder if they should want to do something I don't agree with, if they'll just have two dr.s sign off and over ride me.  Like I said, I don't think it will come up in this situation, it just makes me wonder.

He has a new renal catheter in the right side of his neck, his jugular vein.  Everybody on the count of two.  Grimace, ooooh, ouch, eeeew.  Yeah, it's necessary but I just can't imagine.  He still has the femoral one in waiting for the renal guy to come down and take it out.

Palliative care ordered his oxycodone and ativan to be doubled, so they could lessen his drip meds.  Namely the sedation.  This gets frustrating when you read further.  Trying to figure out how word this so it doesn't get confusing.  I guess I should start with observations made over the weekend and work forward.

As I said before, when they lighten the sedation his blood pressure goes way up. It does come down some if they give him a bolus of the pain med.  When they turn the sedation up his blood pressure goes way down as that is a side effect of the propofol.  The weekend nurse made a sideways comment of, "We can't keep controlling his blood pressure with propofol."  I didn't say anything, just stored it away.

He's had a different nurse the past two days, that won't be on tomorrow. She's a good nurse.  But I have observed, she's been watching and controlling his blood pressure with the propofol.  When his bp goes up, she turns up the sedative rather trying a bolus or turning his pain med up a bit.  When his bp gets too low she turns it back down. Last night she said to me, when she started ten years ago, they just kept everyone very sedated until the day to remove the vent and she never heard of any ICU psychosis.

When the order came to double the other meds, she just gave them to him but didn't turn the propofol down.  Thirty minutes before dialysis is to show up, his pressure is too low for them to attempt it.  He NEEDS the dialysis.  They were making good progress with the vent weaning until the renal people started fiddle farting around about getting him proper dialysis.  The vent weaning has been on hold and he is up to 80% oxygen.

She turns it down some, and we move him around in bed so his bp is up to where the dialysis people won't refuse.  They are late coming, by about an hour.  So she turns the propofol back up a bit, to lower his bp. *head desk*  I made sure to move his hands around, stroke his forward, and talk to him when they showed up so his bp would go back up.

I'm not giving up hope, but man they're killing me by inches.  It's gone past frustrating into maddening.

I need someone to volunteer to come cook for me.  Not because I don't have food, but because I'm so tired of trying to figure out what I want to eat then cook it, when I come home so late and tired.  Hell, you don't even have to come over and cook.  Just bring me a plate of whatever your having. D did most of the cooking and I was glad for whatever he handed me.  It drove him crazy that I didn't have opinion about what he made most of the time.  When he gets home and able to cook again, I'm going to be excited about everything he makes, whether I have an opinion or not.  Liver and onions.  Yum, yum.  Mashed potatoes and gravy. Yes, yummy.  (Wait, I shouldn't put that in print.  I HATE mashed potatoes. He'll suspect something then.)  Please don't send me any plates of mashed potatoes.

Not much reading for him the past couple days.  So many interruptions and things going on, that when it's quiet I just let him rest.  Some knitting has been accomplished for WIPW tomorrow's post.  It's finally up to 80F and sunny here, all week.

I'll stop rambling now.  Thank you for stopping by and sticking with me.