Hospital Adventures

A rough night last night left Jeff looking pretty wrecked.  He was disgusted at having to keep his leg straight, unable to get comfortable.  The automatic blood pressure cuff pinched infuriatingly at regular intervals.  The Benedryl he needed for the allergic reaction helped him doze off but it didn’t last.  Ativan (the post-transplant sleep aid I preferred because it gave him a peaceful sleep) did not see him through the night.  His nurse did everything he could to help Jeff including propping him on his side with pillows.  Jeff said, “That lasted about 30 seconds before I couldn’t stand it anymore.”  It seems the night nurse was quite attentive but it was no use.

Shortly after I arrived at St. Mary’s, Nurse Felicia began getting Jeff ready for transport for Part Two of the Rapid Lysis.  His own Stryker bed was put into Drive and propelled itself down the hall.  Before we reached the doors to exit the ICU, the battery petered out and the heavy thing became difficult for the Nurse Felicia and the transport gal to maneuver.  It made for an exciting ride to the Cath Lab, with the bed alternately motoring along and requiring significant pulling and pushing. 

I left Jeff in the lab and went out to the waiting room.  This was a smaller seating area near the larger waiting room where I sat yesterday.  I asked at the desk whether I had been waiting in the wrong area yesterday and maybe that is why they couldn’t find me.  No, they told me.  The staff will check both waiting rooms.  I shrugged and sat – alone - in the smaller area directly outside the lab door.  Eventually I was joined by the family member of another patient who placed a restaurant-style pager on the coffee table.  I looked at it and had to ask whether her family member was in the same lab as Jeff.  She was.  The woman said she was told she could go anywhere in the hospital and they would page her when her mother’s procedure was finished.  We wondered together why they don’t offer a pager to everyone who is waiting.  Or why they didn’t call my cell phone yesterday. 

Part Two of the Rapid Lysis involved using dye again to see whether the overnight treatment with TPA disintegrated the clot enough to suck it out of the vein.  It did!  The clot and the paraphernalia in and attached to his leg were all removed.  What a relief!  The blood thinners caused Jeff to have a bloody nose during the procedure and he had an allergic reaction to the dye they used.  Both are fairly common issues, the latter is known as “Red Man Syndrome.” 

Jeff slept the rest of the morning but woke when Internist Dr. Kravatz visited.  He was so pleased about the success of the procedure that he got our hopes up that Jeff would be discharged “soon.”  He wanted to know if Dr. Porter was in the loop (he is) and we discussed which blood thinner might be the best choice.  My vote was one of the newer ones that do not require their levels to be checked and dosages fussed with.  Dr. Kravatz wanted to make sure that Dr. Porter wasn’t going to recommend at-home injections of blood thinner as is sometimes the case for oncology patients (he did not).  Dr. Kravatz said he’d order many, many blood tests to make sure everything else is okay.  There was discussion about moving Jeff back to Telemetry where he would be able to have a shower!

Dr. Kravatz then picked up Jeff’s blankets and looked at the left leg. 

“Oh,” he said.  “You’re still symptomatic.”

The leg is still swollen and hard and, we later discovered, still cannot support much weight.  That will delay discharge.

Dr. Kravatz left and a phlebotomist came in to draw the blood that would be required for all those tests.  Jeff hadn’t yet eaten very much and was only sipping water so I picked up his water and encouraged him to start drinking.  Because of the blood thinners used during the procedure, the blood draw had to be done from the IV port.  Nurse Felicia helped the phlebotomist because they knew it was going to be difficult.  You might think the blood thinners would make the blood flow well but it was a slow process.  There was much discussion about which color tubes ought to get priority, in case they couldn’t get enough for all ten.  It seemed as if an entire episode of HGTV’s Vacation House for Free played before the ten vials were filled.  Phew!

Jeff snoozed and, I think, I did, too.  Nurse Felecia returned within an hour to announce that Jeff’s blood specimens had hemolyzed and that only one of the vials was usable.  Special permission was granted to stick his arm.  Unfortunately, he still hadn’t been drinking anything.  Another phlebotomist attempted to get nine more vials from him and she became irritated with the difficulty of the task although she eventually succeeded.

Less than an hour later a third phlebotomist came to the room to get one vial only – to check the heparin levels in Jeff’s blood.  I couldn’t believe that the order for ten vials didn’t include a check for heparin levels and I asked the phlebotomist to check with the nurse to make sure another stick was really required.  The same woman came back later and said that she did, indeed, need to take another.  This would be the 20^th vial within a couple of hours.

A social worker confirmed that our insurance plan will cover the newer blood thinner called Xarelto.  He’ll start it tomorrow while he is still on IV heparin.  Then the heparin can be stopped.

Jeff was not allowed out of bed for a period of time following the procedure.  He was highly motivated to use the bathroom but was disappointed to see it was still extremely difficult for him to put any weight on his left leg.  He said, “I’m never going to get out of here.”

Jeff did manage to joke with the nurse who scanned his wristband when switching out an IV bag.  In a whispery voice he said, “I feel like I’m at Home Depot.”

Jeff’s brother, Paul, visited today and my niece, Nurse Becky, stopped after her clinicals.  Jeff and I got to see Rosie via Facetime.  We played “Where’s Rosie’s belly button” and I told her that Grandpop used the potty today.  She did not seem impressed.