Day 7

The Great Pretender

Today was the 2nd time someone assumed that I was a nurse. I thought that was pretty funny.  I think my basic understanding of some medical terminology (thanks to reading, research and helping my husband study for his boards in the past helped) gave others the impression that I was a healthcare professional. Well, I probably would’ve gone this route if I wasn’t such an emotional person. It’s hard for me to see people sick and suffering. 

Passing the Test

Yesterday we were disappointed and worried about our dad not being able to swallow correctly. He was aspirating food and so he was placed on NPO status again. This morning they had him drink some barium and did a fluoroscopy (live Xray).  With small swallows of diced up/pureed food and thickened liquids he is able to swallow fine and the food settles into his stomach. With large gulps, the food heads to his lungs. So, the speech therapist has advised us to have him eat sitting up and rest sitting up for at least 30 minutes after. Also, she told us to take out time feeding him because we don’t want to worsen his condition or when he does heal from pneumonia, we do not want to spark another episode. 

The rest of the day, Dad remained lethargic. Josie was having a hard time keeping him awake to eat. He could only eat a few bites at a time. So, we were still worried about him getting enough nutrients. His potassium levels were low and he was just very weak. Throughout the night she continued to feed him when she could and the doctor informed us that she planned on sending him home in a couple of days to recover since she felt he would do better at home. Her goal was to get him swallowing correctly and gain some strength.

Day 8

The doctor gave some encouraging news yesterday that our dad could possibly go home this weekend. Pending his tests and a call to the medical supply company to deliver a hospital bed, oxygen tanks and compressor he would be ready to go. Josie said she could tell that he was getting better because he was starting to get cranky and complain about everything. But he had a hard time coughing the rest of the night and ended up keeping Josie awake.

Day 5 

I’m losing track of time. But Day 5 was Tuesday. Ok,let’s see. So, I came in with my other  sister to relieve my hubby so he could go to his meeting. We got  there around 8:30 in the morning after I dropped the little one off at daycare. My dad looked alot better but he was still coughing up very thick phlegm. He was on a regimen of antibiotics, breathing treatments, oxygen and an IV line feeding him. 

Hungry But Can’t Eat

The first thing my dad asked was for some coke, chocolate and buffalo wings! Poor thing was famished but because of his pneumonia he was placed on NPO, which means “nothing by mouth”. According to the next doctor (the original doctor I guess put his duties off to her), the food that my dad was eating the days prior wasn’t going down to his stomach. He started to cough up some. When he was first admitted, he showed no signs of pneumonia, but apparently the food had gotten into his lungs and caused it. So, he was placed on and IV line for nutrients. 

Doing Their Job or Not doing their Job

When you’re the patient’s family, your perspective on the care of your loved one is going to be different than the healthcare provider giving it, obviously. My sister and I are very protective over our parents, maybe sometimes overprotective. I would say that Josie is even more of a “mother hen”. When she wants something, she wants it done right. I know that the healthcare field can be very stressful, after all, my husband has been working in it for the past 8 years. I know that they mean well, and I know that they can be short staffed. But it seems that if you aren’t an advocate for your parent, everything is slow to get done if it all. What I didn’t like, and what Josie didn’t especially like (since she’s been there since last week), is that nobody seemed to read the charts to find out my dad’s prior medical history. It seemed for the first few days, that each nurse that came into see him didn’t know what the other nurse had done before. Well, it’s gotten a little better but yesterday, my dad started physical therapy and it was a disaster. 

If it weren’t for the fact that I was there, Josie was there and our other sister was there, she wouldn’t have known that my dad had a compressed fracture in his lower back. This was something that his primary care doctor knows and it’s written his charts. He also has osteoarthritis in both knees and of course, he was just diagnosed with Congestive Heart Failure. Well, the PT basically hurt him in this session. She wanted him to sit up but in doing so, (he’s already weak mind you from not eating and the CHF), he hurt his side and felt pain on his lower rib cage. She wanted to try some knee exercises on him but basically wanted him to extend his knee while lying down  and tried to make him press down on her hand. He couldn’t do it. Well, hello! I just told her that he had osteoarthritis. She said it shouldn’t hurt, well it did! So Josie was angry, I was annoyed and our poor dad was in pain the rest of the day, really bad pain! They were going to give him a mild dose of morphine but because of his pulmonary problems, Josie didn’t want that, so they gave him liquid Tylenol and propped him up on some pillows. I agreed. 

Still Can’t Swallow

Because my dad was aspirating food and liquid, the doctor ordered speech therapy so they could test his muscles and swallowing. On Day 4, he failed the test so again, he was placed on NPO. On Day 5, they gave him some apple sauce and water to see if he could swallow that ok. It looked like he was swallowing ok and he said that he could feel the food go down. Bad news, there was still some going into his lungs, so again he was placed back on the IV. I felt so bad to have to tell him again that he had to wait until today, Day 6, to try to eat again. 

He kept asking again, “when can I eat?”. We had to eat our food out in the family lounge because we didn’t want him to have to see us eat. 

Day 6

Josie told me this morning that he slept ok the rest of the evening. They continued with his breathing treatments, and she helped him cough up his phlegm and massaged and comforted him. 

A Breaking Point

Josie is probably the most dedicated person I know. She’ll probably kill me for writing all of this, but it’s ok. I feel better airing my feelings out to people who can relate to our situation. Sometimes I think though that she’s so selfless that she forgets about herself ALOT. Sometimes, I don’t make things easy on her because I’m not good at stress. I freak out, get testy, emotional and start being irrational. I try to work on it, but after years of being this way it’s hard to break the habit! but I swear I’m trying! Anyway, we got into a little argument this morning. I think it was just the stress and I made her think that I didn’t understand her plight or appreciate everything that she’s doing for the sake of our dad. Sometimes people forget that she’s been through alot in her life, me included.  She lost my brother-in-law at 37. That’s only 4 years older than what I am now. She also lost him in the hospital after battling pneumonia. Seeing my dad get poked and prodded just brought back all of those terrible memories for her. She also lost her best friend Laurie 2 years later from pancreatic cancer. Laurie died in her arms. She doesn’t want my dad to go through any more tests but knows that he has to.

I was stupid and selfish earlier and I apologized for my behavior. As much as I know that I’m stressed out and worried about our dad, I can’t even begin to imagine the pain that she’s going through. So, I did encourage her to go home. I was willing to stay again tonight, but it was agreed that the hospital is no place for a little toddler to be. So, we picked up my other sister again to help her out tonight. Josie’s going to go home for a few hours and come back to the hospital. Well, we made up. She’s like my mom and I’m like the unruly kid still. But she knows I love her and I’ll do anything for her. 

Tests, Tests, and more Tests

Part of the reason why she was so upset was earlier before I got there with the baby, she said that my dad exclaimed, “why are you guys killing me?”. Of course, hearing him say that upset her. They have to keep changing the IV line on him because he keeps tugging on it. Then, the doc said they had to take him off whatever nutrients that they were giving him on IV because they were worried that it would complicate things with the pneumonia. Great–now how was my dad going to get nutrients? Well, they have him on some kind of sugar water solution. Still, it’s upsetting. They said that if he failed the test again, they might have to put a food tube down his throat. They also talked about the possibility of his swallowing problems being permanent and that he would have to permanently eat his food through a tube in his stomach. As you can imagine, this is just something that cannot be. He has to pass. It dawned on me as she was telling me this, that my dad’s top denture wasn’t in his mouth when they were giving him the swallowing test. I’m not a dentist, so I’m just making assumptions. I asked my sister to ask someone if it would make a difference. She told me later this afternoon that the nurse agreed and wrote it on the charts for tomorrow to see if they can test his swallowing with his dentures in. Also, they will be doing another Xray to watch him swallow and to see how much of it is going into his lungs and how much of it is going into his stomach.

Today, however, they did another chest Xray to check the pneumonia and still no change. So, they will continue with the antiobiotics and they also started him on this breathing treatment that pumps his face and pulses air through to his lungs to thin out the phlegm.  

more tomorrow……another exhausting emotional day. I still have to check on our caregiver and my mom. My poor mom is looking for my dad. Even with dementia, she still knows what’s going on. We’re working on getting him back to her soon!

Yes, we still haven’t taken Dad home.  It’s making us all anxious. He has been improving but he’s had a couple of set backs with a pneumonia diagnosis from the doctor the other day. It’s been on and off. On Sunday, Dad was asleep for most of the day. He was incoherent much of the time he was awake. His breathing was a little labored and he was coughing up very thick and yellow phlegm. So, my brother ended up staying another night because he was concerned about him. Dad had another Xray taken and another! The last one revealed his pneumonia so he was automatically placed on antibiotics. 

Needing to help and Physically Drained

Josie pretty much stayed up all night watching him and helping him cough out the mucus. But I had to make her leave last night because the long hospital stay started to affect her emotionally and physically. I feel bad because there’s not much I can do to help because I have a little toddler to take care of. My husband works varied hours at various hospitals covering shifts as a floating Ultrasound Technologist. So, depending on him for most of the parental babysitting duties is close to nill. My friends have offered but I don’t want to disrupt their work or responsibilities so I just look to them if there are no other options. However, last night I was able to get my other sister (who was with Josie for the first few days) to take a day off and then come back and help me with the little one last night. My plan was to stay the night at the hospital so that Josie could go home. But lo and behold, my husband decides to take it upon himself and relieve me of my overnight duty. He happened to be off today, so he tells me he’d take over the duties so that our little girl wouldn’t be disrupted in her routine. (She had school this morning- actually, I think it was an excuse for him not to take her because the first and only time he took her to school, she cried )

An All Nighter and a Hero Husband

I was prepared though. I had my Chargers cooler bag packed with some drinks, a peanut butter and jelly sandwich, a box of lunchables, breakfast donuts and some KFC……all junk food to fit the emotional situation.  I also had  my laptop, and Ferris Beuller’s Day Off ready to watch! I was ready for an all-nighter. But no, he took over. Actually, he did a great job since he’s already in the health field he was well adapted to the environment, helping the nurses with my dad and calming my dad. I knew that I was up to the task but he insisted that I go home to our baby. My husband is awesome. Before we were married, he went above and beyond what a son-in-law normally does. He stayed with my dad in the hospital when he had his stroke. I couldn’t have asked for a more caring and dedicated spouse. 

A great nurse and not so great nurses

Things haven’t necessarily run smoothly on the end of the staff. My sister is very vigilant with our dad’s treatment. I am too, but she’s very tough. It’s disappointing that she has had to be that way because as the patient’s family we shouldn’t have to deal with all the little nuances and intricacies of procedures and paperwork. Our role should be as supportive children being by our dad’s side and providing support to him. But, Josie had to almost take the reigns and direct the care of our father because noone seemed to have their act together. We can count at least 3 separate occasions when we were told to fill out the medical and drug history for our father. It seemed that nobody bothered to input that information into the computer the first time or misplaced the paperwork. Nobody knew what test results were or about our dad’s prior medical history. You’d think that nobody bothered to check his charts. The doctor as I had mentioned in my previous post, was very dismissive towards her and didn’t provide us with enough information to go on. She had to bring up possible treatment scenarios to him based on my research only to be told it wasn’t necessary, and then implemented anyway later in the day. Anyway, let’s just say that there has been a lot of disorganization in the ranks AND some inter-office/nurse station drama with each nurse pointing fingers at the other one.

There was one nurse though that is one of the most spirited people I have ever met in my life. She’s a traveller nurse from Miami and a native Jamaican lady. I’ve never seen so much light shine from someone who works in a stressful field. She had us balled up in laughter with her personal stories of patients and in her life. She’s spunky, out-spoken and incredibly funny and was very helpful to us. It would seem that after nursing for years, one would get burned out, dispirited and bitter. My husband tells me of the nurses he’s seen at work that fit that description. Yet, here was this lady that wasn’t necessarily popular with all of the staff but seemed to be dedicated to her patients and enjoyed life! Great lady and even if I never see her again, it’s one of those deals where you run into people in your life and they somehow impact your view and philosophies in profound ways.

Slow Improvement

My husband gave me good news when I woke up in the morning. My dad actually slept for more than 30 minutes and he was breathing smoothly. It was good to hear that the antibiotics and the breathing treatment were doing their job.