We went to the admitting to get all set to go the floor, then had to wait for transport to get us even though Amanda was already in her wheelchair. I told them I knew the way, but it was hospital policy to have transport take us. We came up in the service elevators to a room that seemed very familiar, but I wasn’t sure since we didn’t come in from the regular elevators. When we were getting settled, I put my gait belt lock on the door since it wouldn’t stay open. Then I realized it was our hold room, confirmed by the deer photo that peers in the room from the hall just opposite the door. What are the odds we would have the exact same room we had last visit? Same room, but someone stole my recliner, and I was left with only a straight back butt grooved chair that was killing my back.
I saw the charge nurse pass in the hall and said hi. He had a big welcome back for us. Then, after a while, he returned to chat and see how we were doing. The fanfare would continue all evening and thought shift change. It was like I was with a celebrity! We had ten or so nurses and techs stop by and say hi, many exclaiming how we were in the same room. It was funny that they even remembered our old room assignment. At least five of the ones to say hi came in the room to chat with us, many with hugs for Amanda, and one of our favorite nurses even had a hug for me, too. One of the techs who calls Amanda “my friend” came by and said she was just asking about her yesterday. We joked that she jinxed us!
I was a bit worried when our nurse was the same one we had for the horrible discharge last time, but she has been great so far. Amanda heard a nurse in the hall looking for a bedside commode. So, she volunteered ours to get it out of our room. I made a quip about how we’d trade it for a recliner. The trade didn’t work out, but I was persistent and finally got one. I left to get Amanda a refresher, and when I returned, she was talking with a pharmacist. They were arguing about whether or not she needed what medications. Amanda made a smart remark, saying that if that’s what we are here to do, I can do that at home! The pharmacist was insistent that we needed to have the Furoscix. There is no need for it anymore since we are in the hospital. Even if she needed the furosemide at home, we wouldn’t do it via a needle in her belly for 5 hours with the PICC now. Amanda agreed I could bring it in but was ready to bear down. I could tell Amanda was done, so I just said ok. But when the pharmacist left, I told her there was no way I was bringing that in! It seemed there was a miscommunication, and the PA at our clinic visit wasn’t the one who put in the admission orders.
One good thing was that the dopamine order was put in, and they started it pretty early. However, they didn’t start the Bumex drip we’d talked about. We told Dr. Nair what the magic cocktail was and what we needed to do. It didn’t take long before her heart rate jumped up with the dopamine drip. They started on a higher dose than what we settled on last time. If her high rate continues, they will likely lower it like last time. The high heart rate kept her up most of the night. I thought she’d have been kept up by going to the bathroom since the dopamine was already doing its job well by the time I left for the night, but surprisingly, she wasn’t up much for that. Either way, she was down five pounds from her admission weight yesterday evening until this morning’s weight check.
The cardiologist rounding was the one that works at Methodist, too. He is the one I kept missing before because he doctors from afar. We both like him and were glad to hear Dr. Nair say he was on. Having him on board as we transition to Methodist will be good. We thought we might see him last night since he likes to come by late at night, but he never did. He did come by with the rest of the team in the morning, though. He also jokingly confessed that he caused us to return because he saw a lady who reminded him of Amanda and asked about her when he started his rounds this week! We talked about things and got him up to date on our side. He was happy things were moving in the right direction. He also mentioned how we were savvy and knew the daily diuretics game well, maybe even better than them since Amanda knew her body well.
Not long after the team left, they started the Bumex drip too. All that had slowed down with just the dopamine overnight was then amped up, and he has been stopping peeing since! As I write this, she has already voided over 5 liters since I arrived this morning. She mentioned how she was surprised she wasn’t hurting yet with the Bumex. It’s what usually makes her ache all over. It was salad for lunch, so I used up our $7 frequent flyer reward at Salata. Like the Starbucks staff, they had an “it’s been a while since we’ve seen you: for me. It was my turn to see a ton that we knew. On my walk over and back to get lunch, I saw about five doctors I spoke to that we knew.
I left in the afternoon to let Tank out and get some union work done. Amanda had a care package from a friend that included a couple of prizes, Tank. He was excited to hard-core, sniff the bag out, and everything came in. I’m sure he realized there were treats in there and that it came from a house with pups! We went for a couple of walks, and he was excited to get an early dinner. I stayed a couple of hours with him while I finished my bookkeeping before returning to the hospital.
As I got back, Amanda said she may have spoken too soon about the achy pains. She went to take a drink of the refresher I brought, and her jaw was starting to hurt, and then she felt it elsewhere. A few doctors have asked her about the dopamine at home. This got us thinking: Can we just do this at home? So, if there is a next time she gets fluid overloaded, we will be pushing the dopamine at home instead of having to come to the hospital.
Amanda got a call from Brittany, and when she asked how it was going, Amanda told her she was peeing like it was her profession! That about sums up today for sure. For dinner, Amanda wanted burgers; we talked of a few places, but she just wanted a cheapo burger. So I walked to Burger King to get us Impossible burgers. We hadn’t had them in a long time, but they satisfied the burger craving. It’s a few blocks over in the parking lot of the hotel we used to stay at, probably a little over a mile round trip. I joked with Amanda when we realized she’d need to be admitted that she needed to go back in the hospital so I could get my exercise. When I said I was tired from all the walking today and would probably go home early, around 10 or so, she told me well; you said you needed to exercise, so I’m making sure you get plenty! On my way back, I saw a young woman pulling up to stop at a light. Then I realized it was one of my old students from youth ministry! She reconciled me, too, rolling the window down to talk. She was cute, telling her passenger this is my old youth pastor. We chatted quickly before she pulled off. She asked about Amanda and said her best friend had lymphoma, and she was there seeing her. I don’t think I have seen her since she graduated high school; it was good to see her.
Amanda has been feeling a lot better, even with the pain of the Bumex. I could see this afternoon that she just seemed better. She says it literally feels that her heart is working better. And that is precisely what is happening. The dopamine makes her heart work more efficiently by altering the force of the heart’s contractions, strengthening them in her case. It is just working more as it should. Amanda wants to discuss with Dr. Nair whether the doapmine would be feasible at home. I think she may be getting ahead of herself, though. I feel we have a good home regiment now and can maintain and keep the fluid off once we are out. Inotropic therapy, dopamine, and a few other drugs fall in this category and can be used for patients with advanced heart failure to bridge them to transplant. Some of the different drugs can be used around the clock. The caveat is that it will work till it doesn’t; then, you’re up a creek without a paddle. I don’t want us to get into that situation.
It seems we are heading in the right direction now. We both think she will be down over 6 or 7 pounds tomorrow with as much fluid as is coming off. We are shooting for a discharge on Friday. I will make that known to the team tomorrow so we can get them on board. I will also make sure the doctor knows I don’t want to see the next rounding doctor for sure! I know Amanda wants to go home for Easter, and I do, too. We both know that’s not a good idea. It is a blessing we are here in an apartment so close, though. I still feel it was a great move to move here. I’m just hoping I can get back to work, and my biggest complaint is about the long drive and not the fact I have to keep taking off.
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