Making a Little Headway

Thursday morning, I could hear the cardio in the hall talking with the NP. They were arguing about something. He was being condescending to her. So it wasn’t just me; he was that way with everyone. He has the air of a surgeon, the cockiness for sure. The wound was the hot-button issue for us. The surgery fellow had come early before I’d arrived. Their plan was that there was no plan, and just blew things off. We’d just have to wait for the wound to do its thing and maybe heal. It was probably a good thing I wasn’t there for that conversation; my patience is running thin dealing with the baby doctors. I would have asked for the real deal to swing by after I heard that from the training fellow.

Amanda had a horrible night with the wound continually leaking out of the haphazardly placed ostomy bag. We pushed to get the bag off and the wound vac back on. It was a struggle to get it to happen, and when the nurse was trying to get the bag off and a regular bandage on, Amanda just broke down in tears, frustrated about the issue not being resolved. It was also hindering our PT. I’d planned to get her up when PT came by, but we were still waiting for the dressing to be changed. The problem was that the ostomy bag’s adhesive isn’t meant to come off easily, especially in the location of the groin. They had to soak it for a while with warm towels and use adhesive remover to get it off. The cardio was just a pain with his over-explanation of things in a condescending tone, too. Amanda was done with the whole ordeal and asked ‘Can we ask for a new attending,’ referring to when we swapped out nurses in the ICU! 

The NP finally came as the ostomy bag came off, after Amanda’s pleading to get the wound vac back on. She had been miserable, and it showed. I’m sure the nurse conveyed Amanda’s distress. With the wound vac back on, things, including Amanda, calmed down. Finally, I was able to get her up for a walk in the calm after the storm. In typical fashion, PT and OT showed up not long after our walk. So they did chair exercises instead. One that surprised me and showed how weak Amanda had become was when she held a towel out straight in front of her and raised her hands above her head. She couldn’t go all the way up, and it wiped her out. She could only do a few. I also realized I was hindering her by helping her up so easily, and I needed to make her work more for it and get her legs to engage. What we really need is more PT, not from me, but from professionals. 

On Wednesday, I was headed home early, around five, after Amanda left for dialysis. I had a plan to get some food, sit around the apartment in my underwear, and go to bed early! I was stuck in stop-and-go traffic just as I got off the interstate; traffic frustrates me to no end. I had seen Brett earlier in the day; he was headed for a job interview right after work. Just graduating from college not long ago, and after making his first student loan payment, he needed a big boy job, and wanted out of the restaurant business. I had texted him right before the interview, saying I was praying for the interview. On my way to the apartment, he texted with the good news that he got the job. He asked what I was doing while I was stuck in traffic. He was at a brewery near Music Row, where his girlfriend was working, having pizza, and celebrating. He asked me to join if I wanted; the traffic was lighter going back to town, so I took him up on the offer and made a U-turn. 

Just the two of us sat around talking about the new job and his aspirations, Julia popping by every once in a while. We moseyed a few doors down after a bit to a live music spot that features singer-songwriters. I’d seen Brett play there while back. It wasn’t too busy, so Julia was cut early and came to join us after. I didn’t stay too long and left the young lovebirds to their night, but it was nice to spend some time with them both. Usually, I would have just gone home to be a loner, passing on the offer to join, but here I have craved being around people and new friends. I’m not one to go out much at home, nor do I “hang out with the guys” much. Amanda and I usually do everything together. Though I’m with her the majority of every day here, I still don’t have her back yet. Not after the ICU, it took a part of her that I hope will return to me soon.

On Thursday, Amanda wanted a burger, and I knew just the place! I took off to Hopdoddy to get her a plan Jane cheeseburger with pickles. I sat at the bar. The place was hopping, the manager was making drinks for a new bartender, and Jackson was running around like a chicken with his head cut off. I just put my order in online, sitting at the bar unnoticed with nearly every seat filled. Amanda ate the majority of the meat and a good many fries. She’s not back to eating like she usually does, but much improved.

I was listening to a devotion on the way in this Friday. One line stood out to me; the title was ‘Planted in Exile,’ and the scripture was from the book of Jeremiah. I don’t feel we are there, but I suppose, in a sense, we are, being in a foreign land, one of white cowboy boots and dime-store cowboys, away from all those we know and are comfortable with. The line that stood out mentioned that in exile, God is not punishing you, but preparing you. I don’t know what we’re being prepared for, but by now I feel overly prepared! 

The team had heard from the fellow that there was no plan. Which meant their plan was back to discharge. I expressed my disdain for the fellow’s opinion during rounds. I wanted to see the full-grown doctor and not the baby, and they knew it. We talked, and they understood why we wanted to see the attending. I did say that if it’s going to get in the way of the discharge, then we’d hold off. With the holiday weekend, Tuesday was the planned discharge day. The cardio called Amanda’s surgeon; he was scrubbing in for a surgery and would come see us later in the day. But within 20 minutes, he was in our room with a plan for the wound, rather than waiting and seeing. They’ll do a surgery on the area to see if they can find the leak and stop it, and have a plastic surgeon come in and do a muscle flap over the area to help with absorption. This surgeon is not like many others and doesn’t have a god complex like so many do. He was very nice and stayed to answer any questions we had. A drastic turn of events from discharge plans to another surgery, but at least we have a real plan to fix things. It’ll likely push our discharge by a week, but hopefully we’ll leave without a wound vac. The surgery will most likely be on Tuesday. 

We made a walk after the news, the longest walk for her since the knee surgery. Just typing that, I can’t believe she had to have knee surgery. We could have never dreamed all of the complications we’ve faced. She was taken back to dialysis at noon. It was supposed to be on the third shift to help with PT. I prefer that shift because I get to go home a little earlier. The earlier shift today got into our PT. She’s always a little too tired to do much after dialysis, especially when they pull a lot.

I ran to the apartment to have lunch and wash some of Amanda’s binkies. I grabbed some lunch from a to-go only soul food place I’ve had my eyes on for a bit. I got all sides, I’m back to being mostly plant based, well, vegetarian for now, still eating dairy and eggs. This place had the best greens and mac and cheese I’ve had here. The butter beans reminded me of my mother the instant they first touched my tongue, they tasted exactly like hers. The cornbread is not so much, though. I grew up with non-sweet cornbread made with little to no flour, very mealy, salty, and crispy from the hot cast-iron it was placed in. Other than the cornbread, I was thoroughly impressed and will be back.

I had plans after lunch: to get the blankets in the dryer, head into town to run a few errands, and then go to Hop to chat and work on this post. I did none of that. After I ate and got everything in the dryer, I sat back in my recliner, put my feet up, and fell asleep for a while, waking up only a few minutes before Amanda texted that she’d be done with dialysis in 10 minutes. I quickly got up and headed back to the hospital. At least I got the binkies in the dryer and was able to take them back to the hospital. As I got back, I dropped the blankets off and grabbed some soup. Amanda didn’t have lunch before she left for dialysis, and she wanted something light so she could still eat dinner. 

During dialysis, they pulled 3 liters, the most yet. She was doing well and ate her lunch quickly. Not up for a walk, but I had her at least stand up at the sink to wash her face, brush her teeth, and so on. She was feeling fine, then she had a run of PVCs, not unusual for her, but then she started feeling bad. Asking what her heart rate was on the monitor, I noticed high 140s hopping in the 150s a bit. She looked uncomfortable. I went to get the nurse after she didn’t answer the call light. After calling the team, they got labs and an EKG. The room filled with nurses, I was unbothered, still working on this post. I feel like the old vet that is unfazed by random gunshots or fireworks; I’m hardened from my time in CVICU.

I’d already asked the nurse if they’d administer Amio in step down, the antiarrhythmic medication, she had been on a few times in the ICU. She said they did, but her rhythm was normal, just high, so she wasn’t sure what they’d do. The NP came by after the crowd had disbursed and told us the rhythm was A-fib. She said they likely start her on the Amio, but they were going to check with the cardiologist. Meanwhile, Amanda was feeling like crap, but it had calmed a bit. The rate began to subside, and they held off on the rhythm medication.

The labs came back good, but they still ran a bag of magnesium and some potassium pills and liquid. By this time, Amanda was super nauseous and told them she wouldn’t be able to get a huge horse-sized potassium pill down. Her rate finally calmed down, and she began to feel better, but not much. I left after she was feeling better. She hadn’t taken her big haul of meds by the time I left because the nurse was waiting for some meds to arrive and give her nausea meds time to kick in. They pushed her to take the liquid potassium first, which was the first mistake. She felt nauseous and vomited a little while trying to take the liquid potassium, she always does those kinds last. That kept her from taking the other meds, and she only got down one other of top importance for rejection, but was unable to get anything else down. 

There was no definitive answer as to why she had the high rate and A-fib. I suspect it was the amount they pulled during dialysis. I was telling the nurse the same, and she concurred, saying she wouldn’t disagree with that. The nurse had looked at the dialysis notes and said they didn’t use albumin this time. That’s when it really made sense, the combination of extra blood pressure medication and the albumin has been the trick for dialysis, and I’m not sure why they didn’t do this time. I had mentioned the dialysis as the culprit when the NP was in, but she was the type who didn’t want to hear from me, a man, at all. Probably thinking I’m overbearing, speaking up for Amanda while she was feeling bad. She’s not the first I’ve dealt with like that, nor the last. I dealt with a tag team of them in the ICU, head butting galore, too. With those, once they realize I won’t be pushed around, they’ll usually back off, as the tag team did in the ICU. Sorry, but the assertive feminist attitude don’t scare. It doesn’t matter whether man or  woman; neither scare me away from advocating for Amanda as I see fit; I’ll dig in and bulldog, no matter who!