Monday, February 28, 2011

I Had A Bad Day

We had a few bumps in the road last night and today.  I almost punched a Dr.  That song was playing on the radio by his bed as I left tonight, it was fitting.

It's what the nurse (me) ordered.  My coffee, cherry brandy, knitting and the dvd remote.

Last night just as I was falling asleep I had a major panic attack wake me up.  My head was telling me something is wrong, danger.  Then the dr. saying, hopefully he doesn't throw a clot, came to mind.  I had just hung up with his nurse 30 minutes earlier.  So I told, my brain to shut up and went to my happy place, an English countryside, noted the time and finally fell back to sleep.   Sometimes, I have those attacks and something really is happening (which is scary) then other times, nothing that I know of had gone wrong.

This morning when I called up to the ICU, as I always do at 8am, after I know they finished shift change.  The day nurse told me they had a blip with his heart, like that Saturday night, only they were able to get him back into normal sinus rhythm with just medication and didn't have to shock him.  Then they had to turn his O2 back up to 100% because he was acidic.  I asked her what time that had all occurred.  Same time I had the panic attack.  My mother said, it's because we are that close.

When I came in, the renal team had a hard time with his femoral line. It's not working right.  His blood pressure went low and they were only able to take less than a liter of fluid off.  They were hoping for three liters like on Saturday. Right after they left, his blood pressure went right back up.  Tomorrow, they will put in a new renal line in a better spot.  One of the ones they put in for people on long term dialysis.  Not that they think it will be long term, it will just be more comfortable for him in the recovery process.

Tired doesn't begin to explain how I feel.  I'm getting pretty punchy now.  There's no getting on my last nerve, because I don't have any left.  Just some frayed wires hanging every which way.  I had mentioned that I requested a palliative consult to get a new perspective on managing his pain and anxiety.  Well, it's a new group, just a couple weeks old.  They are only handling hospice patients.  How was I to flipping know that? (My temper is coming back up at the re-telling.)

So this new Dr. was in on today.  I found out he is one of the Fellows.  I guess the chain of command is Attending, then a few Fellows, then residents, on down the line.  Well, he came up to me this afternoon and started telling me that palliative care was only for hospice, end life care.  He wasn't shouting, but talking really loud, very over bearing, wouldn't let me explain myself, kept talking over me,  every time I stepped backward, he stepped forward.  Just on and on and on.  Insinuating it seemed like I was requesting end of life care.  We will manage his medications, he said.  That fight or flight response really kicked in and I knew I was about to hit him.  So I put my hands up, in a back off stance and turned away from him.  I was so upset I was shaking, which is never a good sign.

My children will tell you, if Mom is shaking with tears in her eyes, it's because she's trying to control the urge to do some serious physical harm.  Lucky for him, he walked away and I went downstairs and smoked a whole cigarette.  (Yeah, quitting went out the window with this mess.  I'll try again later.)  I came back up and calmly told the day nurse who witnessed the scene that I don't ever want to be addressed by that Dr. again.  It will all end in tears if he speaks to me, mine and his.  She calmed me down and gave me a hug.  The dialysis nurse had witnessed it to and wasn't real happy with the way he spoke to me.

Later, they made sure I got to speak with the attending.  Apparently he realized he really messed up, because she said he told her he thinks it would be a good idea to stay out of my radar for awhile.  Yeah, that would probably be the best idea he had all day.  The attending said, he gets too excited and can be overbearing when trying to communicate and apparently this has happened once before.  Then she said, however, I'm still pissed.  It's a good thing he realized his mistake.  Otherwise, I would have to hope that one of you notices I've come up missing for a couple days,calls the Pima County Jail and posts my bail.

She (the attending) told me, she hates this because it's so traumatic on the patients and their families, tomorrow is her last day and she's going off service.  The next Dr. doctor she said is very nice and really likes him, so try not to be scared.  She really wished they could follow their patients through to the end.  I said, I realize they need some time off, like everyone does, but this is really crap.  I just got to know and trust this Dr. and she's going away. *cry, tears*

On a lighter note.  There is this funny thing playing out up there.  To get on the unit, you have to push a button which rings a bell, then the receptionist pushes another button which makes the door open.  There is a window beside the door.  A short hallway of about 20 feet on the other side then the big main desk.  The day receptionist is a greying redhead, like me, maybe ten years older.  Every time, just as I get about 3 feet to the desk before I turn to go down the other hall, I always look at whoever is sitting there, and say thank you.  She's getting a kick out of it, and always says your welcome.  So, she started the other day, when she notices I'm getting close to the door to leave the unit, she pushes the button and the door comes open.  The first time, it surprised me, when door opened by itself.  I turned around and looked, then shouted (not really loud) thank you,  she shouted, your welcome.  Now, we have a game going.  After two weeks, I'm starting feel like the unit's mascot.

This is a picture of me, looking at a picture of my oldest son's new lip piercings on FB tonight.   He likes my reaction.

I'm going to finish my coffee and brandy.  Do some knitting and put Led Zeppelin dvd in for Dammit.  Then I will head to bed.  Bootise is being bad.  She took all the junk flyers and scattered them around the living room, mainly under the bird cages.  She pounces them and the noise sends the birds into a frenzy.  

Thanks for reading and commenting.  Things have to calm down soon, at some point, right?


by Teresa said...

Hi Denise, sorry about that overbearing doctor. They forget they're working for us and start to think they're superhumans.

I got a call from my middle son - he saw a neurosurgeon and has a tumor in his brain. He'll likely need surgery.

I'm pretty shook up about it.

Still thinking of you. Teresa

nursenikkiknits said...

So sorry to hear you had a bad day. As a pediatric oncology nurse, I can tell you I know a lot of people who work in paliative care who would be very distressed at that fellow's portrayal of their role.
I continue everyday to wish for peace and positive progress for you and D. Hang in there.

Susie said...

Look, see, you are Superwoman, because not only are you doing all that Superwoman stuff but also you didn't strangle that palliative care man. I shall remember how palliative care can only be for end-of-life patients next time I take an Ibuprofen.

Keep smoking! Do anything that makes it bearable! You're doing so great.

Daniele said...

Thank goodness you walked away from that doctor. To be that overbearing and rude to a patient's caregiver is just unacceptable.

As a fellow smoker, I can relate - and - piercings eh?? :D I think that would have been my face too!!

melbatoast68 said...

OHHH!!! I know you're fully capable of doing this, but I'll be more than happy to take care of the rude man! I can't stand when that kind of thing happens! As a reformed smoker, I would be having a drink, a smoke right about now and would be plotting the poor fellows demise. Hang tough babe! You're doing great! Waves and waves of love and support coming your way!

Julie said...

{{big hug}} hang in there sweetie

Cookie said...

I'm so sorry you had to deal with that doctor. Hopefully, today will be a better day.


Rudee said...

How frustrating all of this must be for you. In the Detroit area, palliative care has taken off like gangbusters. As I've told you before, not every palliative care specialist is an end of life doctor, but many have a dual practice and moonlight for hospice. They are experts in symptom management. I'm so sorry you're unable to avail yourself to this type of practice. In my experience, palliation care specialists are the kindest human beings. I agree wholeheartedly with nursenikki--the palliative care community would be appalled at the Fellow's behavior (and lack of knowledge).

Yes, it's frightening to have a new doctor again, but look at the possibility that he or she will bring with them a different perspective which may be what D needs right now. Like your half full glass of brandy, perhaps what that doc will bring is hope. Try to keep your mind open.

Hang in there, Denise. My thoughts and prayers are with you.

Sue said...

((((((Big hugs))))))) (You should hve kicked the dr in the balls, that would possibly have cured him of talking to families like they are idiots.

Wanderingcatstudio said...

How you are handling this is absolutely amazing! Stay strong and take care of yourself - your D. is going to be so proud of you when he gets better and reads all this.

Carol said...

oooh, I hate overbearing medical types. I had a run in with a dr's receptionist last friday. patient had cellulitis. Current antibiotic done, infection went wild overnight. Nurse saw it. called me. I called dr. receptionist snottily told me "we'll get to it when we get to it". niiiiiice......

streams of high test coming over. set up the bucket brigade to carry it in!