Monday, August 19, 2002

Monday, August 19, 2002

Oreta here again.

Gosh. Thank you, all of you for the comments, especially yours, Dr. Stoufflet.

Daniel has weathered the weekend well, with his aphasia getting much better and his pulse and blood pressure responding to the oral and patch medications. He can move around on the bed without it sending his pulse through the roof now. I don't believe I have mentioned it, but he also has a staph infection, so he has been running a low-grade fever. They've been giving him tylenol, which controls the fever but doesn't do much for his continuous headache.

Friday's CT scan was good and they will be running another one today. Today should be a big day. As well as the CT scan they will be putting in a "picc" line. This is a special IV which can stay in longer and which can be used to deliver the intrevenous antibiotics that they want to use on the staph infection. For what it is worth, the doctors seem confident they can lick the staph infection. The plan was to start him on some aspirin today, cautiously. Since he had another mild "cardiac incident" one night last week ("angina" is the word I pried out of the doctor) the cardiac doctors really, really, really want him on some sort of blood thinner. The neurology doctors, of course, have a different opinion.

You know, I could have cheerfully gone the rest of my life without learning the difference between a "C-line", an "A-line" and a "picc-line".

Because they work the nurses in twelve hour shifts and because we've been here for over a week, I'm getting to know the nurses. I can't tell you all their names because they persist in wearing their badges wrong side out. :-) The nurses all have their different styles. Some are in and out of the patients room all the time; some vigiliantly sit at the nurses station staring intently at the monitors. Some are comfortable with patient families; others less so. The older nurses are comfortable asking me to hand them stuff and to do things; the younger nurses not comfortable with that. Some are sticklers for rules; others not. All of them are less hard-nosed about rules then they were the first few days.

Communication continues to be a problem. The doctors come when they can, which is usually when I am away and in Daniel's case there are a lot of doctors. One of my frustrations is that there is no central place or person to ask a question of. This may be a function of being in the neurology/surgical ICU where there are a variety of reasons a patient is there. Daniel's needs are very different from the patient three doors down who had a tonsilectomy a month ago which has started bleeding uncontrollably. (He's doing okay and moved out of ICU three days ago). This is different from the cardiac ICU where there were a variety of problems but they were all cardiac problems. It is possible to get different answers from different doctors -- some are optimists; my favorite is a pessimist. And some come in to talk to me after only a cursory glimpse at his chart. Then after giving me some generic information they go out and go over his chart in depth with the nurse. It would be nice if it were possible to schedule a daily briefing. It doesn't have to be with a doctor; it could be with a "patient advocate", say a nurse practioner, who could review the results of yesterday's tests with me and talk to me about the what to expect. So far I am getting some of my best explanations from my priest (it is very convenient to have a priest who was a med student before deciding to become a priest.) It would have been a great deal of help if someone had turned to me last Saturday and said, "He's going to get worse before he gets better." It's not difficulty in understanding the doctor -- it's difficulty in getting the information. I should not have to ask for the results of his CT scan or blood cultures.

Again, I'm not really dumping on modern medicine, because I know very well what state Daniel would be in even twenty years ago. But my concern is -- if they aren't talking to me, are the doctors talking to each other?

Well, it's time for me to go back to the hospital since visiting hours will be starting again. I've been shuttling between work and the hospital and home -- fortunately they are all 10 - 20 minutes from each other depending on traffic.

I'll post more when I can get back to a computer. Thanks everybody.


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