The Rollercoaster Continues

Amanda was stable overnight. Her white count elevated, so they sent blood cultures to check for infection. She finally warmed temperature-wise, almost on the hot side, no more burrito. Her skin was cold, then hot to the touch, and she was sweaty, even when cold. My cousin from Louisiana was here in Nashville and came early this morning to have breakfast with me. We walked to a nearby restaurant and chatted for a while. It was good to see him and have a break. I made it back just in time for rounds; they were in the room next door.

They wanted to back down on the sedation to wake her up and do a neuro check. When they did, she was almost entirely unresponsive. It was kind of scary. They had to stop the sedation and pain meds completely. Then she was writhing in pain when she finally woke up. It took so long to get her back sedated and pain under control. It’s so hard to see that, she was coughing and trying to pull the tube out. The nurse wasn’t really even paying attention to that, and I ended up being the one to cinch her arm restraints down. I stayed by her side, but there’s only so much I can take of her like that. I had to sit down for a while. There is no consoling her when she gets so anxious with a tube down her throat. I had worship music playing in the background. The line of the song For the Good ‘I know You’re working, I know You’re working. I believe, I believe. Good things are coming, good things are coming. I believe, I believe,’ really spoke to me at that moment.

She has been on a lot of antibiotics, broad-spectrum and some specific ones, since the donor was positive for staph. The CRRT machine clotted off after only 12 hours of running. They held the heparin for the cath in the afternoon, so that didn’t help. The nephrology team came by and ordered citrate, another anticoagulant, to go with the dialysis. That required a whole new set of orders and a prime; it was a few hours from the cath, and as they prepped things, the nurse didn’t want to start it because if it were off more than 2 hours for the cath, it had to be started all over again with new everything. I suppose she spoke with someone to keep from starting, or simply decided not to.

Nephrology came in and did an assessment. The dumb intern whom I signed the CRRT consent with spouted something off about phenomena. I quickly questioned the real doctor about it, and she gave me a line. I was quick to say I was in on rounds, and nothing was said about that. I think there were a lot of assumptions in that statement. I’m pretty sure if the team were concerned, they’d have discussed it this morning in rounds. I questioned the PA about it, but she wasn’t concerned. I think assumptions are best left in the hall and not bedside with faimly there.

In the mix of things, I needed to write a letter to my manager to share with the upidy ups. I worked on it instead of this post. I sent it to Brittany for a proof, and she approved with a couple of suggestions then I fired it off. I decided to ask for a week of vacation when my leave is up next week, to keep my insurance through August. Then, to back it up with a 30-day personal leave of absence. Which will get me to mid-August and still have time to go home to get insurance via working. I just kicked the can down the road because I don’t want to deal with the UP can right now. Hoping they will approve my request and continue to work with me.

Kim and Nathan are on the way up. They made it to Austin and had tire issues. I got pictures. It was a good thing he checked it when he did. The good Lord held that tire from blowing out and tearing a fender off. Then the spare didn’t fit! They limped it to a tire shop and got three new tires and a wheel that fit, and were back on the road.

An echo tech from the other day came in again to get a pre-biopsy echo, so they’d know right where to go during the cath. She asked if yesterday was when they intubated her, and I said no, a few days before, mentioning that the days were all running together. It turns out it was yesterday; so much has happened in the last 24 hours! 

Here’s where the rollercoaster kicks back in! Amanda’s O2 levels didn’t look good, so they ran some stat blood gases to check things. By the time the entourage arrived, including the PA, who was questioning a run of SVT rhythm in the 150s. They noticed her blood sugar was 400. The gas came back, and she was acidotic. They ordered multiple stat meds and an X-ray. The room had filled with anywhere from 5 to 8 people, including the doctors. It was a little scary. 

She had been off the CRRT for a while by then, almost 4 hours. I noticed before all of this, she was also very puffy. They were questioning everything. The PA was grilling the nurse. The nurse had turned the insulin drip off because she said she saw an order to discontinue it. The PA hadn’t ordered it, and no one else on the am shift had either. Something didn’t add up. Someone discontinued it, or the nurses misread the order. Either way, someone didn’t do their job right. The insulin had been off for almost 4 hours, as well. The cath team came in, followed by the cardiologist who did her first cath here, the one I was recommended to see for my valve. She quickly realized the chaos and said they should push it. That was swiftly followed by the fact that they weren’t even going to think about the biopsy right then, with the urgency to get things under control.

It was wild for about an hour. When things calmed down and there were five nurses in the room, they needed to clean Amanda. I was still decompressing from the rollercoaster ride. I noticed a male nurse singing along with the worship music for a few songs. As they worked on the lines, and then helped Amanda get cleaned up, she laid there uncovered with multiple nurses around her. I just had to think how this would be mortifying for most; we are both desensitized for all we’ve been through. The one singing wasn’t ashamed to be praising in that moment. The song Somebody Prayed by Crowder played in the background as the nurse sang. There is a line that says, ‘I’ve seen hospital rooms turned into cathedrals.’ In that moment, with a nurse signing over Amanda, that hospital room was a cathedral, all because Somebody prayed. Now I’m crying as I typed that out sitting at a bar in a burger joint!

The CRRT had been off for about six hours by the time it was started back up. Amanda had leveled off, and I needed a break. This rollercoaster of a hospitalization is rough. As I’ve mentioned, I had to beat some friends off coming. These posts are therapeutic for me; if someone were here during the craziness, it would only stress me out. I wasn’t able to hold it together at first like I can now. I’ve developed ways to deal with and cope with the rough rollercoasters like this. Everything we’ve gone through has built me up and refined me to be able to handle what we are facing. I may seem strong, but it’s not me; it’s the experience, the recalling of God’s faithfulness, and everyone’s prayers that get me through. I think I can say that for Amanda as well. We’re no better than any other saint who sits in the pew every Sunday. However, we may be a little more experienced for our age than most! 

I waited for things to calm down before I left. The CRRT was restored, and Amanda was out of it. She needed a pillow and to be covered up. The nurse seemed too busy to notice. I got a clean pillowcase, put her head on it, and covered her with a sheet. I felt comfortable enough to leave since she’d leveled off; I needed a break from that room. The bartender I know had a big date last night. I needed a debrief on it to take my mind off things, I thought! So, I headed out to Hopdoddy for a needed break. Since I’ve been going there so much, add them to the list of sponsorships we need for this site! I called Britt to talk on my walk over, since she’d called me earlier after things got hairy and I didn’t answer. She told me pretty quickly that she was packing a bag. I had to beat her off from coming. This whole thing is a rollercoaster; it’s just up and down and around. By the time she got here Amanda woudl probably be better! This is the craziest hospitalization that we’ve ever had. I think there were ups and downs last go round, but I wasn’t there the entire time like this due to covid. Either way, it wasn’t anything like this.

The bartender I knew wasn’t there; I guess he called in. The date must have been good, now I really need the details! I had taken my Mac to keep busy if there was no one to talk with, so I popped it out and started working on this post. I really would have rather heard about the date or chatted, though. I did see a back of the house guy I met a couple of weeks ago at the open mic, the goofy one. We chatted a bit. He asked if I knew about the bartender’s gig tomorrow night. I did, and as long as Amanda is doing good, I plan to go see him play. He’s told me that it was his biggest gig yet so I wanted to go support him. Nathan and Kim should be here to go too, so I can play the third wheel. I need a break with some of our people.

I called to check on Amanda, and the nurse said things were improving and she was much better than when I left. Still sedated, too, so I felt comfortable staying out a little longer. I had been back and forth if I wanted to eat or not, but that made my mind; burger and fries it was. I finished my burger and got out of there. The five o’clock rush was coming, and it was getting too busy for me.

Amanda was good when I returned. Things are looking a lot better. A new night PA came in, followed by the ICU doc I like, the intubation guy. He spouted his typical line, speaking to the nurses, ‘What can I do to make your life easier?’ I’m sure the nurses like him as much as I do. Seems they think taking her off dialysis for so long may have been the issue. It’s just a combination of things going on, but no one knows why it all went south so quickly. Being more dependent on the CRRT isn’t good, though; it means her kidneys really aren’t working very well. She’s barely had any output, even with the dialysis running. I hope we don’t need kidneys, but that’s a whole other conversation; we knew it was a possibility, though.

She’s the most relaxed I’ve seen her yet. Even sedated before and on the vent, she still had labored breathing. It just looked uncomfortable. They have the sedation on pretty high, but it’s not as potent as the sedation she was on before. They did add a fentanyl drip, so that’s definitely adding to the sedation and comfort level. I’ve been telling them I thought the breathing was from pain. Sedated or not, she was still in pain, and her face was grimacing. Not now, she looks peaceful for the first time. I know they want her to get off the vent but an entire day of peace with dialysis running may be what she needs. Tomorrow the cath is still on the table, though.

I picked up some undershirts that I had delivered to Bev’s yesterday. Ever since my fat guy days, I’ve always worn them, and I try my best not to look like a plumber! All I’ve had to wear were my sleeping ones, and I’ve worn them a few too many times now. The ones I ordered are my regular undershirts. I had one on today, I just felt a little more normal; it’s the little things! I’ll take a baby undershirt win after today! On a too-personal note, Amanda would tell you (I can see her rolling her eye about this, but I needed a laugh), the dialysis machine is connected to the toilet via a long tube. I have used the hospital toilet with everything, dumped countless hats, and recorded the output for the nurses and so on. However, until today I had never peed with a dialysis machine before; when I was a boy we’d have called that sword fighting!