Thursday, February 17, 2011

this infernal medical system


the Nephrologist decided to give him fluid last night via IV. No staff to assist him to urinal. They tried to cath his penis, it blew up, his call button wouldn't work, so he got up out of bed. The bed alarm went off and the nurse came in. He had THREE bed changes last night.

They tried to get the staples out of his back and the didn't have the right tools An MD finally got them out today and hubby said it felt like he had a million bee stings going into his back all at once.

He is having another gout flare up in his left knee and they went ahead and started him on a prednisone burst which will increase his glucose levels. So, he and I were talking, trying to figure out why this is such a problem. I said, have they been giving you allopurinol because I haven't heard them say that. He said, no.

So we got his RN in here and she looked through his chart and he has not had allopurinol or terazosin for at least the last 4 days since he transferred to this unit.

Are they trying to kill the man? No allopurinol? Absolutely why his is having a gout attack. I cannot believe the complete moronic idiots working in this hospital.....which is supposed to be "specialized" care?????

The neprhrologist was in today and he said, "I am going to write an order that if his creatinine goes below 3.0, to pull the dialysis port tomorrow." Great news!

So a nurse comes in and tells me that there's an order to put a perma port in him tomorrow if his creatinine doesn't go below 3.0. It's been 3.3 for the last 2 days. I said, "ABSOLUTELY NOT!!!" No one discussed that with us and it will not happen.

I think I'll be spending the night tonight. I don't want him in a saturated bed again......and I certainly do not want a perma port put in a guy who has not had dialysis in 5 days.

Complete total utter quacks running this joint? ONE MORE and I will get administration involved because this is just a little bit too much as far as I'm concerned. It's just a darn good thing that I got a good night's sleep last night and have the energy to get mad!

So he is sleeping now, left knee all propped up, heating pad under it (that I brought in from home), battling a gout attack that was brought on by the hospital not giving him the medicines he is supposed to have. And yes, they have had his list from day 1.

It is no wonder people die.

I HAVE to get him home. I just have to.

DW - beyond frustrated

Tuesday, February 15, 2011

this amazing journey

So much happens so fast. He was transferred to the LTACF and he loves it there. They removed the fentanyl patch. Today....he was much better. Day 3 with no dialysis. May not need it any more. Kidney function back up to 15%. Great progress.

He has a gout infection going in his left knee. His glucose dropped to 34 today. But they reacted timely and treated appropriately. Nutrition on board. Endocrinology present. He is still quite weak, but he is going to come home ok.

We talked a bit today. He apologized for his behavior the other day. We talked a little about the future. About how to handle this the next time, and with his poor kidney function, we all know there will be a next time. He's just been given a reprieve for now. He had visitors today and I think that did him a world of good.

He is so weak. Can barely lift himself up off the bed. c.diff still going. Hoping they can get that under control soon. He got up and walked to the bathroom today using a walker. Huge progress!

I'm exhausted tonight, going to bed. But it's such a good "tired" feeling! I really believe he's going to make it this time.


Sunday, February 13, 2011

and after all that....

I went in this morning and he was in a fighting, ranting, raging mood!!! Wow! Completely took me by surprise. He point blank lied to the surgeon, who decided to write a discharge home order! The nurses got the order and in 2 minutes, the surgeon was back in the room with 2 nurses, a social worker and a case manager! I guess he told the surgeon that he took a shower yesterday. The nurse said, yes, but his wife was in there trying to hold him up, bath took her over an hour. He was light-headed and had to get right back to bed.

He told the surgeon he had eaten breakfast. He failed to tell him he ate 2 teaspoons of oatmeal, 4 teaspoons of yogurt, and didn't even attempt to drink any of the liquids on his tray.

I think everyone learned something today! That this guy is good at presenting a wonderful image. Mind you, he did not "lie". He did take a shower. He did eat breakfast.

So after an hour, we all agreed that he is going to a long term acute care facility. The doctor said that he will not go until his nutrition iv is done, and that will not be done until he eats and drinks at least half of each item on his tray.

I was beside myself. He cannot get himself up out of bed. He cannot hit a urinal. He can barely get up from a chair if he gets to it. But he had a surgeon convinced that he could go home?????

Then we had another 1 hour discussion about WHERE he was going to go. He didn't want to stay downtown. He wanted to go closer to home. Problem is, his HMO does not have a residential facility that has dialysis on site. We would have to put him in an ambulance, take him to dialysis, ambulance him back to the facility and each step we would have a co-pay for. He argued and argued about each facility and he would not believe me that they did not have dialysis. The he said, well I will go to this place and mentioned the place close to our home that does dialysis. I said, "sweetie, that place does not offer residential care. You need to go somewhere where they can help you get to the point where you can walk, do stairs, take your own shower...." I had done the research, but he did not believe me.

We finally all agreed that he was going to the long term acute care facility in the hospital where he is and everyone left.

He slept. And after an hour, I asked him if he wanted to get up and sit in the chair for a bit. He said yes, so I asked him to call the nurse. He said that he had been getting up by himself all night long and didn't need the nurse. Now tell me, why did I ever buy into that lie? But I did. I actually stood there and made him get up on his own, use the walker, get to the chair. He was literally trembling as he tried to lift himself up off the bed. Sitting in the chair, I asked him if he wanted to eat something else. No, he didn't. I asked him how he was going to get nutrition into him if he didn't eat? He said I ate enough, I ate half a bowl of oatmeal and all my yogurt. I said, No, you ate 2 teaspoons of oatmeal and 4 teaspoons of yogurt. Oh my gosh, he got so mad at me. He stood up in a complete rage and glared at me with pure hatred. I just stood frozen in my spot. I didn't even realize that my sister went out to the desk and got a nurse.

The nurse came in (love her to pieces!) and started doing a number on him for being out of bed without calling. That's when I realized he had point blank lied to me. I left the room and went down to the lounge. She came down a little bit later. She's a good negotiator. She said that he was in a rage because he felt like everyone was treating him like a child. She told him it was because he was acting like one. She basically sent me home for the day. Told me to take his phone and turn mine off. Which I did. She really read him the riot act. Told him that he would not get out of his bed without calling the nurse. She is going to put an alarm on his bed tonight. She told him that he would get up to his chair 3 times a day for meals. That he would eat half of everything on his tray and that she was putting a calorie count in place. She told him that he will walk 3 times a day and sit in his chair for at least 30 minutes each time he is up.

I came home and my sis and I have been watching movies and eating chocolate this afternoon. Just what I needed. It is so sad that I cannot call to see how he is doing. But I understand that he needs this. He needs to find out just how much I am worth to him. And if I walk in there tomorrow and he gets pissy, I am supposed to leave again.

So yesterday was true love. Today is tough love. And I totally understand that they go hand in hand. He cannot say things to me like he did today. He cannot yell at me. He cannot treat me with anything but respect. He has to do that for everyone involved with him. And I understand that his anger is not about me, he is simply directing it towards me. He needs to vent and I hope they get a therapist in there so he has someone to vent to. And I know that he is angry about going to a long term acute care facility. A couple of people have used the term "nursing home".....and he is NOT going to be happy over there. It's not new, modern looking. But literaly, it is the only place in this area that offers on-site dialysis. We just don't have options.

What a day. I'm going back to watching stupid chick flicks so I don't have to think. I need a day off. Tomorrow has to be better. It simply cannot be worse.