ICU

I went to see dad yesterday and the trip ended as an ICU trip. He was very lethargic upon me getting there, which really isn't anything new. I tried to show him some pictures I had done lately and he kept falling asleep. I thought that was normal because usually he is tired in the morning and wakes up in the afternoon. So, Coleman and I just sat next to him waiting for him to wake up. He was in his chair.

At about 3 he motioned that he had to go to the bathroom, so I called the nurse in and thought that they should just clean him up and put him back to bed. He had been in chair since 1030. We left the room and when they were done we went back in and he kept saying that he hurt and it was in his chest. I asked him if it was more of a muscle pain hurt and he said more of a heart hurt. He rated it on a 3. Now, he has had a ton of shoulder pain from it subluxating out of the joint and Mr Aspirin only, is now at 10 mg of vicodin with no relief. He said that his shoulder did hurt, but that wasn't what was making him sick. So, I asked him what he wanted to do and he mouthed that they couldnt help him there and that he wanted to go to the hospital.

In the two years since he has been sick, he has NEVER volunteered to go to the hospital. The LPN and respiratory therapist were in there and they both said that for the past few days he has been in a lot of pain and seemed very sick. They had mentioned it to the charge nurse and she didn't do anything about it. So, they told me that they thought he needed to go in and that I should go to talk to her.

I walked out and simply said, "Hey, my dad really is in a lot of pain and is complaining of chest pain. In all the time he has been sick, he has never asked to go to the hospital, so I think this is worth investigating."

So, she came in and he told her he hurt and wanted to go to the hospital and that he generally felt awful. She took his vitals and they were all fine. So, she said she would call the doctor. She left and then came back in and said that the doctor said no because he didnt have a temperature.

I was like, "What does a temperature have to do with it!!" So, she said I could talk to him about it, so of course I said, "Lets go!"

So, we go call him and she tells him I want to talk to him. So I get on the phone and this not word for word, but you can get the point: "Hi, this is Liza, Im Jims daughter how are you?"

"I am fine, it is nice to meet you!" he said.

"Yes it is. Say, I have been with my dad all day and he is pretty lethargic and says he doesnt feel good, has some chest pain, so I think we need to go to the doctor to get checked out." He says, "Well, he doesn't have a temperature."

.......I said, "So, when does a temperature determine whether or not he needs to go to the hospital or not? I thought chest pain was a good indicator?"

He said, "I dont think he has anything that we can't address at the nursing facility."

"Really? I asked. So, what if he needs a chest Xray??"

"We can do that here, but not until tomorrow!"

So, I said, "Look, the last time I checked, my dad is 62 years old and of complete sound mind, so if he wants to go to the hospital, than he should be able to go to the hospital!"

So, he says, "Well GOD DAMNIT!! Why didnt the DAMN nurse TELL me that he wanted to go to the hospital!!???"

I said, "I thought she did and you told her no!! That is why I wanted to talk to you!"

He said, "Well, that is fine, but you need to realize that due to your dads disease process, he is NEVER going to get better, so you need question yourself how aggressively you want to treat him, because it isn't going to do any good!"

I said,"Oh really?? Than why the hell are we here?? We are here for him to wean from the ventilator and if that is not the case, then we can pack him up and take him right back to Des Moines if you think this is a waste of time!!!"

He said, "Well, from his disease process, I would say he isn't going to get better and you need to keep that in the back of your head."

I said, "What disease process are you talking about??"

He yells, "HIS AML!!!!" I said, "What?? He is a post brain aneurysm with invasive Aspergillus!!!" (AML is leukemia)

He goes, "What god damn patient are we talking about here???"

I said, 'Jim Shoning!!!'

He goes, "Ooohhhhhhh......"

So, the douche bag doesn't even have his patients straight!! So, he wanted to send dad up the street to the crap hospital that the staff told me to not let him go to and I refused. I made them take him to Covenant in Waterloo.

He has a pretty significant pneumonia in his left lower lobe. Which, is from aspirating food. They were pulling tons of it out. He was in the ER for about 40 minutes and they had shot him up to ICU. He had a temp of 101, but no temp according to the nursing home.

We met with his doc and she is a FABULOUS lady. We gave him his complete history and she said that a lot of times when patients are paralyzed, their intestines dont push the food through so it comes back up the esophagus. What they can do is put the tube in past his stomach, so it cant come back up. I truly think that is what has been holding him back all this time. After thinking about it also, we think that is why he was so sick at RML all the time. It was the food coming back into his lungs, which we thought was infection from the Aspergillus. Feeding tube food looks a lot like mucous secretions.

The doctor is having him meet with a gastroenterologist, a rehab doctor and a pulmonologist to get a handle on all of this. I think for once we are actually in great hands.

I just talked to Martha too and he is set up for surgery tomorrow for replacement of the tube. Not a big deal. The pulmonologist also poked his head in and asked Martha some questions and assessed dad. She seems really happy with the doctors there.