Amanda was up before me to get a shower in case they came to get her for the liver biopsy early. It was a good thing she did since they came to get her not long after she was out. After she left, the team came by; I listened intently while they chatted in the hall. The doctor finally said, ” Let’s go in to talk to the husband,” so they came in and went over the plan with me as well. I heard talk of adding metolazone in the hall, but he just told me they are adjusting the diuretics. I had mentioned yesterday that medication used a couple of days in a row would tank her kidneys. He mentioned the Bumex drip but said that if she is peeing with the drip, there shouldn’t be any difference in running multiple boluses a day. I explained previously that the Bumex alone wouldn’t get her dry, and that when they added the dopamine. He replied that the way it works clashes with a beta blocker she is on. He said it wouldn’t work, but she nearly came to a standstill without output when they stopped it. Then, it picked up when they started back, and now, without the dopamine, she only pees when they run the bolus of Bumex, with nothing in between. I don’t know the medicine behind the drugs, but I do know the clinical side for Amanda, and the dopamine with Bumex was the golden ticket to pee pee!
I just really don’t like trial running things just for them to see; we’ve already done that back in Texas. They wanted to get the MRI done and also a PET scan to see about inflammation in the chest. They really want a definitive answer to the pain, but I don’t think it’s that easy. When pain meds are brought up, it always makes me think they don’t feel she needs them if they can’t see a reason for the pain. They always make you feel like you have drug-seeking behavior. Amanda has been on and off pain meds for chronic pain many times, always coming off of them after the issues were fixed. She wouldn’t make a good junkie she hates the way the meds make her feel and ditches them as soon as she can. She is sensitive to chest pain, though, and has always had a high tolerance for pain medication. Even before everything started with her first EP study, the doctor said she used well over the amount of drugs to knock me out, much less Amanda. They’ve always had issues with putting her out under conscious sedation. Even for some pacemakers and ablations, they would put her under general anesthesia because she would squirm too much. The cardiologist did mention he had a long talk with Dr. Nair about Amanda’s case. He agreed with them getting an MRI. He couldn’t shed any light on the pain situation, though.
The pain specialist stopped by while Amanda was gone, too. He was going to leave, then asked me a few questions. He wanted to know about the type of pain. I explained it the best I could. He doesn’t agree with the team in taking her off the meds, saying there is no need to make her miserable. Mentioning that there was a reason that she landed on opioids and that there were likely other things tried. Before he would proceed with taking her off of them, he wanted a valid medical reason and not just a well, we would like that. He said if it were a matter of pain management after transplant, then that would be his department and thus his problem.
Amanda came back pretty tired from the biopsy. They didn’t need to balloon anything. She wasn’t out too much and was pretty aware of what they were doing. It was different for her since they were right in front of her face. She was out of it afterwards and on bedrest for a couple of hours, even though they let her stand to get out of the transport bed. We are used to strict bed rest with groin sites, so it seemed this one was loose bed rest. The nurse started a bag of Mag and gave her some pills. A new one was in there. Amanda is pretty observant with her pills and knows each well, so she recognized the odd one. It was the metolazone, and she quickly told the nurse that if she were on bedrest and took that, she’d need to get up to go to the bathroom. So the nurse said she could hold on taking it.
Later on, her blood pressure was low, and the monitor was beeping; it was set to check every 15 minutes. It was the 80s over the 40s. I ran an extra check, and it only got lower. I continued to watch it go lower. The next scheduled check was in the 76/45. Even for her typical lower BP, that was pretty low. I ran an extra check, and it was up a bit, but not much. I called the nurse and told her of the soft pressures. The tech, or “care partner” as they are called here, came in and ran another check, which was higher; she was impressed I knew how to operate the monitor when I told her I ran a few extra checks. It still dropped a little more later on as Amanda slept. The nurse had come in and said the median BP was still good, so she wasn’t too worried.
Amanda never felt like lunch, but she was up for a refresher, so I grabbed her one from the knock-off StarBs at the cafeteria. I grabbed a late lunch from there for myself as well. While I was gone, the cardiologist came by to see Amanda. He mentioned that they had spoken with me, but wanted to examine her. He went over the same we talked about, then mentioned the pressures from the liver biopsy were normal, so it didn’t indicate cirrhosis.
Once Amanda was up and more lively, her BP came up and leveled off. Our Nashville heart friend came by for a quick visit and to drop off a package that was too big for the local Amazon locker that I had delivered to her house. She couldn’t stay long because she had a car full of kids waiting. What I had shipped to her home was a dresser. A cheap China put-together fabric drawer one to keep our stuff in, we’re moving in! I put it together, trying not to get caught. I’m not sure why I thought it needed to be done incognito, but I didn’t get busted either way. It looks like it belongs here. I joked with Amanda and said that if I didn’t disassemble it to take it out when we left, I would probably get busted by security for stealing hospital furniture!
Amanda will have the MRI in the morning around eight. The nurse came in with a slew of questions from radiology for the MRI. You can’t have any metal in an MRI machine. So all the questions were to check if Amanda had any metal in her body. She has a daith piercing, which she is worried about. It’s the innermost cartilage in her ear and has a heart-shaped hoop in it. She has had it out once for a neck/head MRI ordered by her neurologist a while back. We couldn’t get it back in, and she had to go back to the piercing place for them to put it in. I always have trouble getting her cartilage piercings back in. If we can’t get this one back in, it’ll likely close, as it’ll be a while before we can get to a shop to have them put it in. The nurse had to have around 50 questions that she went through with Amanda. A couple made us chuckle. The first was Do you have an ankle monitor? Also, when the nurse said I’ll just answer this one with a no: Do you have a penile implant? We all three got a good laugh at that one!
We’ve been binge-watching the show House. It’s a show from a while back that we used to watch frequently. It’s about a diagnostician and his team of doctors. Many of the doctors and nurses who come in have noticed and commented about it. I’ve about reached my limit after a few seasons for a while. So, for another boredom buster, I got the Xbox out and hooked it up. We started playing a game we’d gotten into back at the apartment. It was a nice change of pace. The night nurse commented on how we had a nice setup! We’re doing our best to make this place home, since everyone has been talking about how we might be waiting a while.
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