Icky

[glatt]

I'm pleased that she has improved so much!

This part jumped out at me.

Originally Posted by wolf

she says she can't chew meat. She chews fine. Stale bagel is a lot harder to chew than teensy pieces of chicken, which she hides in her cheek and spits out, so I know she can chew fine. And she was chewing ice. So it's not the chewing. Or the swallowing.

It sounds a lot like my son. He's 9. He will chew a bite of meat for what seems like a good 5 minutes and still not swallow it because it just doesn't feel like it's ready to be swallowed yet. I wonder if it's some sort of depletion of meat dissolving enzymes in the saliva. He treats meat like chewing gum, the little freak.

[monster]

Thor did that too. Only he'd also keep shovelling more in until there was so much in his mouth there was no way he could swallow......

twit.

[wolf]

Today crazynurse managed some minced chicken salad for lunch, although she did need the crusts cut off her bread (I think that's personal preference rather than difficulty, it's squishy bread), and a pretty decent dinner, based on current standards, cottage cheese, some canned pears, linguini and mashed carrots, and green lime jello. And yes, at one point I did say, "Rainman, come on, eat your green lime jello."

She get some vicarious enjoyment out of what I eat in the hospital cafeteria, which last night was a tasty and varied salad. Tonight, since I can't eat something good for me two days in a row, I had a bacon cheesburger with fries and a chocolate pudding parfait. Hospital chocolate pudding rocks.

I also helped her with some bed exercises (stop that right now) and encouraged her use of the Spirometer. And dimed her out to the respiratory therapist for something naughty she did. According to her sister they are looking to transfer her out to skilled nursing at some point in the near future. I hope that the sister takes better control of the situation this time around.

[TheMercenary]

Punch her. See what happens.

[wolf]

I have the cold from hell and can't go visit until I'm clear of it.

Don't need to add to her infection control nightmare, after all.

I have a runny nose, sore throat, and gooey cough, all of which has responded fairly well to MucinexDM. Love that stuff.

[wolf]

Yesterday was supposed to be crazynurse's day of discharge to skilled nursing (this is the current polite term for "warehouse for old people") for rehab.

Notice the supposed to ...

I got an email from crazynurse's sister ...

Seems that PT came into crazynurse's room. The PT worker had NOT read her chart or ever met crazynurse.

The following conversation is a complete dramitization intended to enhance the absurdity of what happened

"Come on, Mrs. crazynurse, you're going down to PT, you've been there before."

"No, I've been flat on my back in this bed for the last thirty days. I haven't been down to PT at all."

"Sure you have. You just don't remember. You're old and you've been sick, and your memory obviously sucks. Can you tell me who the president is?"

With the assistance of two other idiots, the PT worker hauls crazynurse to her feet (which she can't feel) for the first time in thirty days.

crazynurse already has a REALLY LOW blood pressure.

When you suddenly stand someone up, stuff happens, including something called orthostatic hypotension. You've done this yourself by accident ... you know that headrush you get when you stand up too fast sometimes? That's your blood pressure bottoming out and oxygenated blood isn't making it into your brain.

Well ... when your blood pressure is ALREADY low, guess what happens ...

Crazynurse passed out.

And stopped breathing.

So they called a code.

And intubated her.

And got her up off the floor and back into her bed.

And put her on a vent and transferred her back to the ICU.

So, I get over there, arriving just after her family. Apparently she came to once on the vent. And tried to pull out the tube. So we know she's pretty much herself in there. They restrained her and knocked her out.

What she didn't have was a stroke ... once they knocked her out they scooted her down to CT, and her head didn't show any changes or abnormalities.

She has a lot of gunk in her lungs. Her left lung is completely opaque on the xray, and her right lung is filled up about halfway. So she's not moving air the way she should be.

Nurse comes in, says she's lightening the sedation because the doctors need to talk to her. They deemed her intact enough for informed consent, you see.

They give her a sharpie and a clipboard to write on for her end of the conversation.

First thing she writes? "AM I ALIVE?"

So, cluster of doctors is trying to explain what they want to do (which is to insert a tube directly into her lung to suck the gunk out and improve her breathing).

This is, however, not what the doctor says. I really think that foreign doctors should be required to take a course in communicating effectively in basic English. No alterations are made to the following conversation for dramatic purposes, it's absurd enough all on it's own

doctorgarble says ...

"crazynurse, you have tube in your mouth to breathe, we could put tube through your throat (and points at base of his neck). We want to put tube in chest to pull fluid from lung."

At this point crazynurse starts shaking her head back and forth, and her eyes are wide and scared-looking.

"but crazynurse, you need this"

Further conversation is fruitless.

We were told to be quiet and not interfere.

Yeah, like I'm able to do that.

So I raised my hand and did an "excuse me" cough.

"What we have here is a failure to communicate."

(I love saying that)

"Doctor, you scared the Hell out of her. She thinks you're trying to trach her."

"I didn't say that."

"No, you didn't use that word, but the way you started that's what she thinks you want."

crazynurse started pointing at me and giving a thumbs up ...

"See, that's why she's scared and keeps saying no. Crazynurse, they aren't going to trach you. They just want to shove a chest tube in you to suck out the crap in your lungs. Is that okay?"

Rapid nodding ensues.

"there's your consent."

Another doc comes in, checks her settings, orders a blood test and announces that if the results are good, they'll pull the vent and let her breathe on her own. He shut off the vent, but let it continue to supply oxygen, but only on her demand ... when she actually triggered the breaths herself, it wasn't pushing air into her.

About 45 minutes later, she was extubated.

First thing she says?

"wolf, you saved my life again. How did you know what I was scared about?"

"I could hear you thinking."

And that is why I am not in the mountains with my girlfriends this weekend.

[Sundae]

Thank FSM for you, Wolf.

I wonder when hospital staff started thinking about patients as units, as opposed to people? I'm not blaming individuals, just the whole healthcare culture, regardless of who foots the bill.

The care team trying to decide on Grandad's future placed most weight on the opinion of nurses on the ward. Mum of course demanded to be involved and certain things were brought to light. The nurses had no idea Grandad had been delusional (thinking he was on a film set, or that his long dead friend had been to visit, or that he was going to be able to drive home). Because he wasn't screaming and moaning and he said please and thank you.

They also didn't realise he is officially classed as visually impaired, because every time they spoke to him they were already at his bedside and he could work out that what he was seeing was probably a face. They assumed he could see perfectly well.

Thank goodness for people who can intercede, who listen and who realise that things cannot be taken at face value when it comes to health.

And for people like you who care enough to be there.

[BigV]

A Golden Hello Kitty for you wolf, and a standing ovation. way to fucking go. srsly.

...

It is widely acknowledged that you are a gifted storyteller but that's not why even *I* could tell that a tracheotomy was what was being communicated, ffs. Of course, you're an empathetic listener too, but how could anyone miss it, like dr garble??? Anyhow, good job, really. I know what it feels like to be able to "hear her thinking".

My Mom had a stroke in 1997. She's lived in an outstanding assisted living facility since 2001. As a result of her stroke, her mobility is severely restricted, but worse, she has aphasia. Her language center was the center of the bullseye and her speech is limited to one "word": "genna".

This word can be said with lots of inflection, emotion, emphasis. It can be sung or whispered. Her receptive language is pretty impaired too, I've see her answer the question "are you a man?" with a clear affirmative nod. Riiight. I've known men, and Mom, you're no man. She just has a hard time understanding a lot of times. But I've spent a lot of time with her, I have her best interests at heart, and (this is important) she trusts me.

Lots of times I've translated her not-strictly-English expressions into words the doctor/waitress/driver/daughter could understand. Lots. Grateful, relieved nodding follows. Mom's physical disability is a big problem in her day to day life, but she's got a lot of that settled. Her failure to communicate is cruel though. I'm glad you helped your friend, wolf. I hope you know how much that means to her. I do, and I thank you.

[classicman]

You ARE teh awesome, Wolf.

[SamIam]

You go, Wolf!

[Griff]

Well played. You should be working in some sort of patient advocacy organization.

[BigV]

she is working in some sort of patient advocacy organization.

what she *should* be doing is collecting a regular paycheck for this work.

[bluecuracao]

Look, wolf. I admire what you are doing for crazynurse, seriously...but is there any possibility of getting her to eat healthier?

The meals you've described that she consumes chills me. She's got to eat better if she's really going to improve. I am sure you already know that. I may be way out of line here, but I am just going to be the one to bring it up.

I can only imagine how hard it would be to convince someone who's been eating crap for so long to switch her eating habits. It was difficult enough to keep my mother on a strict diet while she was recovering from cancer, and she is an organic farmer.

Feel free to let loose on me, I don't mind.

[wolf]

Trust me, I've tried to get her to eat. Good, bad, or indifferent food.

Really the only thing she's getting that's doing her any good are cans of "Nepro," which is a specialty form of Ensure for renal patients.

She nibbled on a bit of pot roast the other night and said she was going to heave.

I think that a lot of this is psychological, but I can't break through it.

And I can't just pick her up a meal from Wendy's which she WOULD eat because of the dietary restrictions.

There has actually been a lot going on over the last week that I didn't get to post about ...

The "Palliative Care Team" got involved with her. There are a lot of vague definitions of that term on the internet. As near as I can figure out, Palliative Care means "we don't think you're going to make it, but we'll keep treating you until we get you and your family comfortable with the idea of hospice."

Crazynurse told them that she "didn't want to live this way," meaning ... just a big lump in a bed, not able to walk or do things for herself. They were on this like sharks on blood in the water.

What crazynurse is is just plain depressed. Her saying that is very akin to a suicidal person assembling means for an overdose. She has a complete tunnel vision regarding her status and ability to recover that is as hard as hell to break through. Her not eating isn't helping her ability to think, either.

Finally, during the official meeting, it seemed to dawn on her what she was being offered, and told them there was no way that she could make a decision about ending her life. So ... they're working on transferring her out to a skilled nursing facility for rehab. The facility under consideration will be very convenient for her sister and mother, and pretty awful for her younger daughter and I, because it's in Cherry Hill, New Jersey.

I do not like New Jersey, and especially do not like driving to it. I may look into NJTransit as an option.

[jimhelm]

I'll give you a ride. meet you at the Valley Forge Turnpike entrance at 8 am... drop you off around 10:30 or 11pm?