So many things happened yesterday that my head is still spinning. Or is it spinning because it is so stuffed up? These allergies are really kicking my butt. After all the rain, everything has bloomed/blossomed (except for my little rosebush) and breathing is getting difficult. I almost hate to cough at the hospital, or use my rescue inhaler, out of fear they'll cart me off to the pink bus in the parking lot for COVID 19 testing!
The cats were finished and we were back in the car by 8:17 and I was on the road an hour later. Gas was 1.38 at the other end of town, where I happened to be on my journeys yesterday morning so I filled up and then went to Hardees to grab some breakfast for the road. I got to the hospital a about 10:30.
When I turned the corner into the unit, it was a flurry of activity. Dr. Threlkeld was sitting at a work station and he just said "He's awake and talking this morning" and then 2 steps later I ran smack dab into Dr. Edwards! We said good morning and then I danced around Dr. Morris in front of Bill's door and was finally in the room!
He was laying all scrunched up with his gown half off so I knew something was going on, or had gone on. I asked him how he felt and he said OK but they were being mean to him! His nurse Ella came in then and explained what had been going on.
Apparently there was something going on with his PICC line. I don't know if it was the line itself, or the swelling in his arm that was causing concern, but an ultrasound was done and there are 2 little blood clots in his upper left arm. So they pulled the PICC. They tried to get one in the right arm, that was now supposed to be blood clot free, but they kept hitting an obstruction of some sort, even though it was ultra sound guided. They tried all three veins with no luck, so they believe there is another clot in that arm as well. They managed to get a single INT in at his elbow. Dr. Edwards ordered a heparin drip to try to dissolve the clots but said that it could make his lovely yellow urine pink again. And sure enough, within 30 minutes, there it was. So, the heparin drip was stopped. He also said that if the PEG was going to be replaced, he would prefer it be done while he was in ICU (are they thinking of moving him again?) where he could be monitored more closely.
The swelling in his left arm had gone down, and continued to go down all day, but now his right arm was really swollen. His feet were not swollen, but his knees are. And his scrotum has started to swell again, so he's retaining fluid again from somewhere.
Dr. Henderson is the pulmonologist on call this week and he said Bill sounded a little congested and he suctioned him. He got out some good gunk the first time, and it was all white, which is good, no infection. The second time he got very little out, but Bill was breathing easier. He was still talking and interacting with everyone who came in.
Dr. French from GI didn't think moving the PEG tube would do any good. He thought that any new site would also not heal. There wasn't too much drainage yesterday, but Ella said that there was a lot overnight. His skin does look a lot better than it did and it's not quite as sore to the touch for him. There's still a lot of air escaping around it, but it looked a lot better yesterday.
His potassium was too high so they gave him the Kexalate to make him poop a lot. I guess that's the fastest way to do it. Dr. Edwards also changed his formula back to the Nepro from Glucerna. The Glucerna raises his potassium, the Nepro depletes it some, on top of the lasix, but it's easier to hang a bag of potassium than give him diahrrea to get rid of it. Dr. Edwards also wanted him to have some Albumin and a bag of fluids. It seems odd to give fluids to someone who is swelling like he is, but I guess he knows what he's doing, even if I didn't think so to begin with.
Time out for more coffee. OK, back to yesterday.
Dr. Edwards also wanted him in the chair, not in chair position, but in the chair. So they got a new sling, I don't know what happened to the other one but it was gone, and got him moved. He looked very uncomfortable. He's been in bed so long, and his favorite position is to have his head laying almost on his left shoulder, that he's having a hard time holding his head up. I have one of the pillows that goes around your neck so we used that to see if that helped, but it didn't help much. They didn't recline the chair any, so he mainly stared at his lap for an hour. They wanted two hours if possible, but another bowel movement stopped that. Dr. Muir came by at that time and said that his neck muscles were just weak from being in bed so much that it was hard to hold a heavy head up again. He said that his blood numbers were all stable and his kidney numbers were still fluctuating but all in all they were stable.
When they were getting ready to move him to the chair, Ella noticed that his right arm looked really angry above the IV site and Bill said it hurt. So she took a picture of it and sent it to Dr. Edwards. He said to just watch it for 30 minutes and to remove the blood pressure cuff to see if that was the cause. But, when she checked it again, it looked worse and she was afraid that it had blown. It would still draw, and she could still flush it, but she just didn't like the way it looked. So, we're down to the last resort of having to do a central line which is placed by a pulmomologist either in the upper chest or neck. They were going to call whoever was on call for the lung group as I was getting ready to leave. They got a blank consent form and partially completed the procedure part without the doctors name so that I could sign it before I left. They moved him back to the bed and they got everything disinfected since there was stool everywhere. They had also had to rearrange the room to get the chair closer to the vent but they were putting most things back to where they were supposed to be. They left the IV pole on the other side of the bed so maybe that's the side the central line will be on.
Bill said he would try to behave in the night and I didn't get any calls, so he must have at least been stable. I hope he slept! And he may have because I think they lightly sedate for a central line. I'm not quite sure on that.
The cats were fine when I got home, not much itching, but also not much interaction with me. They neither one came into the bedroom last night to sleep. I did hear Cat wandering and meowing about 3 and then again when she saw the bedroom light come on. They've eaten lightly and she's asleep on top of my yarn storage bins. I don't know where Mouse is. The back door is closed so he can't be socializing. I'm going to wait until I get home tonight to give them (try to give them) their prednisone. Since they aren't eating a lot I can't just put it in their food. So that shoudl be fun.
I think I covered everything again. Like I said, it was a busy day. And, I'm going a little later this morning to make sure the caffeine and Aleve have kicked in for my headache. It's almost gone and the sinus drainage has lessened. When I get to the hospital, I can take some allergy medicine, which reminds me I need to fill my little Tylenot bottle again. Better do that as soon as I'm done with this.
It was extremely windy yesterday and it felt like I was driving a billboard at times, especially going across the Mississippi river bridge. It was a 2 hands on the wheel drive both directions. And since it was a cross wind, it didn't do a thing for my gas mileage!
That's it. Happy Sunday!
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