Icky

[wolf]

Today I will be working on cheering up crazynurse, and as a sneaking side effect, making sure that she eats decently.

I am packing up a picnic lunch that we shall most likely eat in her room, although we may be able to access the cafeteria.

I haven't seen the cafeteria, but I am hoping for those unupholstered hard chairs that I need.

Anyway ...

A little bird told me something.

Doctor GapingMoron from the beginning of the story ...

He just lost his privileges at the hospital.

All of them. Can't operate, can't see patients, can't do ER call, NOTHIN'.

It is unknown whether this is directly or indirectly related to crazynurse's predicament.

But it is strongly suspected.

[BigV]

justice prevails!

bon apetit!

[Nirvana]

I am afraid of the health care system. Wolf you deserve the title human(e) being

[monster]

How is crazynurse doing? Is the wound healing?

[wolf]

I haven't managed to be at the nursing home during the right part of a dressing change. When I got there the other night the biofoam was already in place and they were just cutting the hole in the plastic sheeting to attach the suction hose. She has a follow up visit week after next and her sister, who is a registered nurse practitioner (in a field other than psychiatry) is going to be taking a good, long look.

I have been getting calls from crazynurse's family today, all of them ecstatic over doctorgapingmoron's defrocking. Well, not defrocking exactly, that requires intervention by the licensing board, but it is rather like pulling the teeth out of a viper. Just before you cut it's head off.

[Sundae]

Mum fought hard to get Grandad into care, and into the right home.
Her friend's father was in the same home until quite recently, and she went to visit it as well as some others.

It isn't perfect - Grandad has a moaner in the room opposite. I don't know what her precise situation is, but she is always in bed when I visit (her door is kept open) and if she is awake she is either moaning, sobbing or occasionally shrieking. Grandad's hearing is really quite poor, so it doesn't bother him. But it's creepy when you're visiting!

He's outside a lot in this glorious weather. There is a lovely terrace, with plenty of shade and he loves it out there, just dozing. It's been a long while since he's been able to go outside because he was so scared of falls in the last two years - he had a really nasty one just putting his rubbish out and Mum had to call an ambulance for him.

When they take him outside he goes in a wheelchair, although inside he is still able to use his walking frame (but must be accompanied). The staff are lovely, and there are enough of them. The food is good - he's eating better than he has in years, but he still sometimes misses his takeaways, or asks Mum to bring him some supper - cheese & crackers and a piece of cake rather than the full meal they serve.

So some places really do get it right.
But again, this is all down to Mum who refused to let him back home when the hospital wanted to discharge him.

Well done for fighting for your friend Wolf.

I would say her daughters need a kick up the arse, but then I know that mother-daughter relationships can be a hell of a lot more complicated from the inside.
Mum asked me to check her emails the other week and I read something that really surprised me, about how we could get on so well sometimes, and I always made her laugh and she had the closest bond with me of all her children - even if I could be a bitch sometimes and make her cry. I was shocked. I thought I was the one who cried in our relationship. I didn't storm out at Christmas and make it a misery all the way through to New Year! So who knows what people feel when they don't communicate well.

Still that, and threads like this, remind me to be kind to her. Human beings are fragile things and don't work forever.

[wolf]

Thanks, Sundae.

The only place that counts as "outdoors" at Horror Hall (uncomfortably close to it's real name) is the entry porch, which is where residents congregate for smoke time. I'm pretty sure I've admitted at least three of them, but I can't remember their names and I ain't asking.

This week I have initiated Operation: Crazynurse.

I emailed an organization we both belong to, of which crazynurse is a founding member.

Folks are jockeying for position on visits, and coordinating what they're taking. One of the paramedics who works in the jurisdiction of Horror Hall is taking her sandwiches tonight, and a firefighter is going with flowers later this week.

I've also arranged (hopefully) for a phone call from someone she hasn't talked to in several years.

[Pico and ME]

Wolf, you are a good egg.

I hope the best for crazy nurse, but knowing you are in her life means she is a step above, no matter what happens.

[wolf]

crazynurse's healing has been proceeding well, amazingly actually, as far as the wound closure is going.

Until ...

She has developed some kind of infection, has swelling and cellulitis in her left leg, and she has gone crazy. Paranoid, raving, trying to escape crazy, but it's delirium (medically based) rather than my kind of crazy.

She's now at the hospital, and I'll be visiting later today to get an eyeball on things.

The crazy could be coming from the infection (not of her primary wound, incidentally), a low PO2 (pulse ox, measure of how much oxygen is actually getting into her blood), or some cardiac arrhythmias (yes, more than one kind) she's got going on.

Right now she's in dialysis, my plan is to head over there sometime later this afternoon.

[BigV]

wow, that's scary, good luck to crazynurse, and goodluck to you wolf.

[Bullitt]

UTI?

[wolf]

Nope.

Gram negative bacteria in the blood, not a UTI (first thing you test for in a female nursing home patient, incidentally). Tatadoc says that's usually either bowel or gall bladder ... well, crazynurse had her gall bladder out years ago, so it's not that, which leaves bowel, or something else.

My suspicion is that over at the pitfromhell's dialysis center sterile procedure isn't, and the badbug was introduced directly into her system.

Before leaving last night I had to write a list on her whiteboard:

1. No one is trying to kill you.
2. You are safe.
3. You are not melting.
4. You are at Abington Memorial Hospital.
5. No one is making a movie about you. There are no actors here. Those are real doctors and real nurses. Yes, there is a video camera in the corner of a room. It's to monitor your safety.
6. Everybody you know is okay. You need to focus on getting better.

Her BP crashed last night, and they were having trouble stabilizing it, nearly transferred her to ICU, but they managed her medically okay and she's still on Cardiac telemetry.

I was feverishly (ha ha) texting tatadoc ... she had some concerns stuff was being overlooked and called the surgical resident on call and sent her in to take a look at the things she was suspecting.

leaving shortly to check in on her for today.

[classicman]

Good luck Wolf. Keep us posted.

[wolf]

Today, with a majority of her family in attendance, her BP crashed again.

One second she was talking relatively normally, still bizarre stuff about melting and being inside of a prism (she is having visual hallucinations of rainbows, or maybe is seeing halos of some kind and can't find any other way of describing it), next second she was totally incoherent.

Called the nurse, who called the resident. Foreign resident came in and mumbled something, wandered off.

Happened again worse, with loss of consciousness. Called nurse again.

New shift, new nurse, new attitude ...

"Yeah, I'm done with Frick and Frack. I'm cancelling your CT scan and calling the attending to get you transferred to the ICU."

20 minutes later, she was on the ICU.

Nurse to patient ratio is 1:1, sometimes 1:2.

Telemetry equipment is fancier.

She's still melting.

But they're being more aggressive about treating it.

ICU nurse even straight cathed her, to get urine for a culture. Her kidneys are at the point where she doesn't produce but a dribble of urine, but that dribble apparently looked pretty ucky (which is worse than icky), and it's been sent off for a culture. They are culturing everything on her that doesn't move, and a few things that do. They've even cultured the wound vac from the nursing home in case that was the source of the infection. They're also going to be checking out her fistula (entry ports for her dialysis hookup) and that abdominal CT has been rescheduled for 2230 tonight.

The surgical team keeps coming in to look at her leg wound, which they all agree looks like a nicely healing wound, but they've cultured that too, just in case.

[Griff]

Wow, sounds like they're working it. Good luck wolf.