So Close and Yet so Far

I returned to Las Vegas on the Wednesday just after Labor Day.  I went to see Dad and was surprised to see him doing so well.  He was in this incredibly spacious room.  I asked what he had done to secure such spacious accomodations.  The room he had been in when I left the previous Friday was a fraction the size of this room.  The nurse told me it was because Dad needed dialysis and this room was set up specifically for that.  Dr. Ahmed was talking about moving Dad to Harmon Rehab Hospital on Friday.

I changed my plans for returning home until Saturday so that I could follow Dad over to Harmon and be sure he got set up in his room alright.  

I spent most of Friday afternoon with Dad waiting for the orders for him to be moved to be signed.  I had to go over to the State Museum for an exhibit opening.  I told Dad I would be back by 7:00.  I wasn't gone more than 90 minutes.

When I got back, Dr. Holland walked in.  He looked over Dad's chart and his latest blood work-up.  He canceled the move to Harmon.   His reasoning was that Dad's white count was very high, over 20,000 (less than 10,000 is where it should be) and Dr. Holland didn't feel he should be moved until they could find and treat the source of the infection.  I asked him what he thought the source was and he said it was likely Dad's other foot.  That foot was bandaged and Dr. Holland, doning gloves, took the bandage off and we could see that Dad's foot was looking pretty grim.  After replacing the bandage, Dr. Holland said he would call and have the Ortho surgeon come in and take a look.  His prognosis was that Dad would likely lose that foot as well.

I called Jon and told him I wouldn't be home just yet.  I went over to my Mom's and told her the news.  We had all been so hopeful and this deflated our good moods.

We had to wait until Monday for the Ortho surgeon to come take a look.  But Dr. Holland had called it.  Dad was going to have to have surgery to remove his left foot.  Surgery was scheduled for Wednesday, Sept. 13th.

On Wednesday morning, because he was having surgery, Dad was not allowed any food or drink.  Surgery was scheduled for late afternoon, 4:00 pm.  I got there in the afternoon to sit with him until they came to take him downstairs.  The afternoon dragged on.  By 3:00, he was thirsty and hungry and there was no one from the Pre-Op coming to get him.  By 4:00 we were getting concerned.  Our nurse finally called down to the OR to find out what the delay was.  By then, Dad had not had anything to eat or drink for almost 24 hours.  Word came back from the OR that the surgery had been canceled because the surgeon had been called to an Emergency at Sunrise Hospital.  Dad's surgery was rescheduled for tomorrow evening, Thursday, at 6:00 pm.  

Needless to say, I was irritated.  No one had called up to the third floor to tell us that the surgery had been canceled despite them knowing for awhile.  We quickly got Dad some water and ice chips to quench his thirst.  I thanked the nurse for calling.  I went down to the OR/Pre-Op to find out what happened.  They told me that the scheduler from Nevada Orthopedic should have called us.   I then called Nevada Orthopedic to find out why no one had called us.  I was told that the scheduler was gone for the day. 

The next morning my first stop was Nevada Orthopedic.  I wanted to talk to the scheduler myself.  I tried to explain to her that Dad had gone the day without food or liquid, that he had spent the day worrying about the surgery and that the least they could have done was call us and tell us that the surgery had been canceled.   She explained that the Pre-Op people should have called us and told us.  It was the classic Catch-22 so prevalent in healtcare these days.  I was very understanding about the Emergency surgery that had called the surgeon away, I was just upset that they had left Dad worrying for hours when a simple phone call would have let us know.  Dad has been through enough and the worrying about the surgery didn't do him any good.   Rather than apologize for the oversight, the scheduler basically shrugged and said it wasn't her problem.

When I got to the hospital I was glad to hear that they had given Dad a bit of breakfast since his surgery was scheduled for the early evening.  The nurse, Lise, asked how it gone with Nevada Orthopedic's scheduler.  I explained what had happened.  Lise, like the people down in Pre-Op, said the phone call should have come from the scheduler as soon as she was made aware of the need for the surgeon at Sunrise.  She had to rebook any other surgeries and call those people to let them know.  We, more than likely, fell through the cracks, thinking that someone else would handle it.

Dad tried to belie that fact that he was nervous.  Mom and Serena came up to sit with us while we waited again for Pre-op.  This time they showed up on time and took him off to the Operating Room.  We went downstairs to wait.    Less than an hour later the surgeon came in to tell us that everything had gone alright.  He was able to give Dad a "matching pair" of legs.

Once out of recovery, Dad would go back upstairs to his room.  He didn't think Dad would spend too long in recovery.  I waited.  I finally saw them taking Dad back upstairs and followed them in the elevator.  By the time I got up there, Dad was resting.

I told him I loved him and would see him in the morning.   

Posted on Sunday, November 25, 2007 at 3:55PM by Registered CommenterLasVegasLynn | CommentsPost a Comment | PrintPrint

The Struggle to get Better

The next day Dad is awake and alert.  He wants to know when he is getting the prosthetic for his right leg.  I tell him they will probably wait until he can be fitted for both.  He asks how tall do I think he is.  I tell him I think he is 6'1 like always.  He tells me no, he is two feet shorter.  His sense of humor is returning and that is a good sign.

Over the weekend he continues to improve.  Unfortunately, his white count jumps to over 40,000 on Monday.  They give him some heavy duty antibotics to combat it.

I am surprised by the middle of the week when they are talking about sending Dad to Harmon Rehab Hospital.  Dr. Ahmed feels that with his white count coming down, that he can be moved.  We are reminded that it puts him closer to coming home.

Barely a week has passed since his surgery and he has orders to be moved to Harmon on Friday.  I call Jon and tell him I will be home on Saturday.  I want to be sure that Dad gets moved properly.

Medi-Car transportation finally comes to get Dad at 6:30 pm and I follow them across town.  We get to Harmon Rehab and he gets taken to his room.  I explain to the Charge Nurse, the nurse and the respitatory therapist that Dad needs an air bed (it was in Dr. Ahmed's orders) and a suction tube would be good.  I am told that the Wound Therapist will have to evaluate him to see if he needs an air bed.  I am told that Dad will get a medical evaluation as well as a Respitatory evaluation.

I settled back waiting for all of this to happen.  Dad and I are watching television and talking.  Serena and her husband, Rob, come in and wait for us.  By 10:30, no one has come through.  I decide to call it a night and Serena and Rob say they will stay with him awhile longer.  While they are still there, the staff comes in to try and weigh Dad.  Unfortunately the equipment is not working right. 

It is a sign of things to come. 

Posted on Sunday, November 25, 2007 at 4:32PM by Registered CommenterLasVegasLynn | CommentsPost a Comment | PrintPrint

Stop Babying Him

I am at Harmon Rehab the next morning about 11:30.  I have plans to return to Los Angeles after checking in with Dad and making sure everything is okay.

When I get there, he is laying almost on his back.  Knowing that is very uncomfortable for him, I raise his head up and ask him how he is doing.  He says he has bad heartburn.  I ask if they have given him anything for it.  He says the food sucks and they gave him some Maalox earlier but it's not having any effect.  He also is trying to cough up phlegm and says that he still does not have a suction tube.

I go out to the nurse's station to talk with his nurse.  She says they gave him Maalox.  I tell her he is still having bad heartburn and the Maalox isn't helping. 

Is there something else we can give him?  Maybe some Zantac

Well, they have to have the doctor's okay to do that. 

Well, how about calling the doctor and see what he says, I suggest. 

She says she will try to find him. 

Is he in the facility or not?

She's not sure.

While I wait for her to find out, I ask about the suction tube and am told that someone from Respiratory has to evaluate him.

I go back to his room.  A few minutes later, a young woman comes in.  She is the Respiratory Therapist

I explain that he needs a suction tube. 

She asks why. 

I tell her that he is weak and has a hard time coughing up all the phlegm.

My hand to God, she tells me that we have to "stop babying him".  She has worked in many hospitals and she knows that all they do there is baby their patients.  Now that he is here, we have to stop babying him and get him strong enough to be able to go home.  

I tell her that is all good and fine but that he had surgery barely a week ago and is still very weak.  A suction tube would help him cough up phlegm.

Again, I am told to stop babying him.

She says she will do an eval, consult with her Supervisor and let me know what they decide.

Fine, do the eval, I say.  The sooner, the better.

She listens to his chest, his lungs, takes his pulse, asks him to cough.  He does so weakly, complaining of heartburn.

Serena comes in and I explain what has happened.  The Respiratory Therapist leaves but not before telling us that she will be back to let us know what they decide.

I go in search of the nurse to find out if they can give Dad some Zantac.  The nurse says they are still waiting for the Doctor to call back.

Serena offers to go to the near-by 7-11 and get Dad some Zantac.  It seems the fastest solution.

While she is gone the Respiratory Therapist comes back to say she was right.  No suction tube is needed.

I bite my tongue.

She leaves.

About 15 minutes later another Respiratory Therapist comes in.  She performs the same eval as the first one.  Her reaction, however, is very different.  She says that Dad needs to be moved to another wing with oxygen portals on the wall.  She rushes out to the nurse's station to find out if there is a bed available in the right wing.

Serena returns.  We are both concerned by the very quick turn of events.  The second Respiratory Therapist comes back in and says there is a bed and he has to be moved NOW!  Two other nurses come in and they try to move the bed.  The bed won't move.  The wheels are stuck in the immobile position.  Another nurse comes in.  For a few minutes they are more concerned about the bed than Dad.  He is now complaining his chest hurts. ALOT.

While the comedy of errors about getting the bed to move continues, the Doctor shows up.  He listens to Dad's chest and lungs and pronounces Dad in congestive heart failure.  The Paramedics are called.  Serena tells Dad not to worry, the Paramedics are coming and we will be going back to the hospital.  The Charge Nurse scolds my niece, telling her that only the Doctor can make that pronouncement.  Serena tries to explain that she is trying to keep Dad calm.  The Charge Nurse continues to scold her.

The Paramedics show up and get him hooked up to oxygen.  I explain that he had come from Valley Hospital just yesterday and we would like for him to go back there.  They tell us that it is doubtful that he would survive the trip across town.  Desert Springs Hospital is just around the corner.  We are going there.

They get Dad on the gurney and we all fly out the door.  From the car, I call Mom and tell her we are on our way to Desert Springs Hospital and why.  I call Jon and tell him.

All I can hear in my mind is that Respiratory Therapist telling us to "Stop Babying Him".  In less than seventeen hours in this facility, they have managed to undo the last month's progress and Dad, again, is fighting for his life.


Posted on Sunday, November 25, 2007 at 4:46PM by Registered CommenterLasVegasLynn in | CommentsPost a Comment | PrintPrint