Welcome to the patient updates. This is the easiest and quickest way to update
the
For many of you if it is your first time here, this will be your first knowledge
*******************
Second operation, the most important one started about 1 pm. It lasted about 5
There may be more minor procedures tomorrow. I was under the impression, she
This is the quickest way I can maintain updates. Just come to this page. I have
to
patient's condition. If you have questions or comments you may send them to
patient@paybest.com. I will not be naming the patient for privacy reasons. I will
refer to her as "P".
of the event.
September 30, 2022
P was halfway through heavy-duty antibiotic treatment for H.Pylori stomach
bacterial
infection. She was doing very well after 1st week of a two week program. Able to eat
more challenging foods. At 11am she had an abrupt neck and head trauma, was confused,
not
able to speak with strength or clarity. She was taken by ambulance to first hospital.
CT scan revealed blood in the brain from possible burst aneurysm. This proved to be
the case after very quick second CT scan with dye to map the blood vessels.
P had to be transferred immediately to a hospital with greater expertise in brain
trauma. Again, her critical condition made them move fast through Emergency checkin
and she was to be quickly operated on.
Operation removed blood and water from brain through hole in skull. This protected
her from losing mind and body functions. It was ruled not a stroke, but condition had
similar risks.
*****************************************
Saturday October 1st.
I visited P in ICU. Only family is allowed.
Doctor said it could take 2 weeks or more for a recovery.
P was sedated, and did not indicate awareness of anyone.
I spoke with her in case she could hear me. Her BP has been forced down more than 100
points to protect her from a repeat bursting. This made her skin very cold.
She is normally very warm.
hours. They succeeded in maneuvering a "coil" into the aneurysm which will now block
and seal the site. A second much smaller aneurysm was found. It is less dangerous
and not normally treated due to its size.
will be awakened. I will be there to see evaluation of any impact on her
abilities.
Because the event was like a stroke, anything is possible.
assist her sister who is house-bound with weakness and dementia.
Sunday October 2, 11 am
I visited P in ICU. She was still sedated. She was restless, slightly agitated. She
did not acknowledge anyone. I left suggestion that when events clear, she be re-tested
for
stomach infection to make sure it is gone completely. The male nurse made a note of
my concern. I repeated that to a team doctor who arrived soon after and gave me a long
update on the subject. The concern is not as simple as I thought. Re-testing is
done
in 4 months. Blood tests are not trusted. There may be other causes for them
to look for.
I did not know before I came in that P still has a tube into her skull draining
fluids. I thought that was finished and it had been removed. It has not.
I asked about other procedures yesterday's doctor referred to. The team doctor knew
of no procedures, and said perhaps he was speaking about ongoing testing.
I was under the impression recovery time was 2 weeks. I was
informed that could refer to time in ICU, which was declared to be 10 days. But
long
term recovery was referred to as 3 months and more. This surprised me as it changes
all the
equations in terms of her employment, day-to-day management, and caring for her sister.
Thank you for the contacts and offers of assistance. I prefer to manage things
myself.
I am mostly concerned about when she wakes up, if she knows what is happening, if she
attempts to remove any tubes (from skull, stomach, or lungs -- those are the main
ones). There are also feeding tubes. I also want to know what faculties she may have
lost or be having trouble with.
Recovery will be long and difficult. If patient reaches the point of recovering in
hospital, being alert, I will more than welcome visitors to distract her from the
long recovery. But it will be the patient's choice, entirely.
I visited for a second time. She is still unconscious. This is on purpose,
by sedatives, to keep her blood pressure down.
I asked about the tubes. There is one from her lungs filling a bag with fluid.
I did not know this was a problem. They originally told me it
was for oxygen.
There is a tube from her skull. The bag is half full with pink liquid. I knew
they are still draining the area, but it is disturbing to know this. I was not
expecting it to be so much.
The male nurse mentioned to me that eventually a social worker would visit. This
is
standard procedure. After recovery, they want to know what kind of environment
she will return to.
P will be fasting from 12am (Midnight) until about 12pm (Noon) and will be having a
Friday October 7, 2am & 11am
2am: I phoned nurse. Patient asleep, still fever, BP 155/over ?
11am: Agitated. Congested. Medication through atomizer. Fever. Thirsty. Headache.
Clear vision and awareness of people. Speech is 2 times stronger by volume. Speech 4 times
more distinct. I am no longer required to "translate." I detect no sign
of dementia or loss of any faculties. Only her standing and mobility have yet to
be tested. X-ray (for lungs) coming soon.
I stayed an hour until she settled.
Friday October 7, 7pm
Rough day. Nothing good to report. Lung congestion, fever, bouts
of chills. Thirsty. Headache. Confusion. Speech declined. They tied her hands to bed.
I remained many hours. Staff distracted by other patients. Tomorrow I have to attend
to her sister. If the fever breaks tonight, it could ease off.
I agreed to a special study that would make her special; she would get a
random measure of antibiotics, (correction-->) "7 days or 14 days". I chose that so she would
get more attention. I declined to allow her personal data to be shared.
I will not be answering calls tonight.
Saturday October 8th, 9am & 4 pm *Fluctuating*
9am: === I was at ICU for about 2 hours. It was a workout. I try not to interfere, but
assisted as required when there was much to do and only Nurse Marianne by herself.
Fever is down. Congestion is up. Lungs had to be suctioned deeply twice. I had to hold
P's head repeatedly to calm her. She had to be steadied when she was needled again
to receive anti-clotting medication.
The great needs continue to be "cold cold water" (prohibited), "very mild coffee" (prohibited).
She is no longer being tied to the bed, despite ongoing thrashing and squirming. I had to
massage her arms, feet, and head relax her. Mostly, I had to speak
at close range to let her know how many people are praying and rooting for her. It
helped considerably to settle P.
I left paper work to be filled out by the lead team Doctor when convenient.
I then travelled to her sister to drop off her paper work, and purchase food and supplies.
4pm: === After lunch and a rest, I returned to P. She was asleep. I did not approach.
I was given updated positive data. Another nurse researcher came. I answered all
questions
about P's recent antibiotic treatment, the fact that her prior treatment was for an
entirely different infection in the stomach, and had nothing to do with the lungs.
I left P sleeping, after visiting just 10 minutes. I did not need to get close
to her as she would likely wake up if she heard my voice.
I feel very confident that P is back on the path to improvement,
as long as the congestion clears and the infection disappears. I think her mental
state has a lot to do with it. Thank you for your support. She knows she has
a large audience, and must get better soon so as not to disappoint you.
Sunday October 9th, 10am *Progress*
10am: Temperature eased down to 37.5C. P was alert, relaxed, but uncomfortable.
P had been given water to drink by mouth. The amount is being carefully monitored.
P was not impressed by the progress. "Oh, yeah, water. Thanks for the water."
I was impressed by the fact that I could clearly understand what she said. She added that
what she really would like was "a coffee, with two milk and two sugar." She liked
saying that. She would also be happy with a cold coconut juice, pineapple juice,
apple juice, and about six others. She liked saying those words.
It reminded me of a late 1960s cartoon in an American magazine in which a man was
crawling desperately through a desert, with long beard, and suffering look, holding out
his arm to an invisible saviour, saying, "Booze, broads, water!" P's preferences
had also moved water into last place.
P was not struggling or thrashing, but she still had to have her wrists tied
to the handrails. She could still remove the finger pulse clip, making the reading turn
into a question mark. She knew it was necessary, so she swapped fingers, and
would install it onto an alternate finger, then her pulse would pop back onto the
screen. Being a troublemaker gave her something to do. I gave her a small religious
pamphlet, so she was able to transfer her attention to that for half an hour.
I discovered by accident an hour into the visit, that the lung and mouth suction
apparatus had been folded away and the container empty. She still had congestion
but was able to clear it herself. She had no idea that this was a major improvement.
The only thing I was not happy with was the continued flow of red liquid from
her skull. Nurses were too busy to comment on this and tell me if it was natural, so
I suspect the ruptured aneurysm is slow to heal because it is an internal injury.
I promised for my next visit to read to her. That immediately made her feel sleepy.
3:30 pm ==>I arrived. P not there. Having CT scan. I left and returned in 1 hour.
She was resting, sleepy. Temperature still about 37.5. No congestion. Still having
her skull drained. Quite reddish. Only spoke a few words. I remained for 1 1/2
hours. I spoke little; she said nothing understandable. I propped her head with a
blanket under the pillow, and watched the monitor numbers; they were all lower.
I left about 6 pm. Nurse Marianne was still carefully monitoring her water
intake as it tended to cause choking and make her sleepy. I anticipate tomorrow's
visits will show improvements in everything. That will be Day 10. They first told
me it would take 10-14 days.
Monday October 10th 12pm *Thanksgiving, Indeed*
12pm ====> (Nurse, Cam, "Camellia" )BP 130/65, Temp 37.2, Feeding Tube is gone.
They gave her apple juice. She is demanding coffee and Tylenol for her headache. I will
bring a thermos of what she likes and get permission. She is to have lunch in about one hour.
She was asked the date. She said November 1822. Close enough. I may have to remove the
Ipad she was given to play with as it hasn't been invented yet. The skull drainage
continues.
3PM
An IV needle broke in P's right hand, with some blood. It took twenty minutes to extract,
clean-up, and install a replacement onto the back of the left hand.
I setup P's Android Ipad, including activating the Hospital Network so that P could
occupy and fatigue herself with some games that needed to be online. It is an insecure
network, but she only plays games, no personal activities. After this, she enjoyed much
cold apple juice.
P was again asked the date. This time it was October 2023. Getting closer.
A pamphlet on SAH - subarachnoidal hemorrhage , P's exact condition, describes,
everything, definition, symptoms, treatment, prognosis, it could be long-term up to
6 months depending on P's individual damage, disabilities, recovery.
P ate only a small portion of the lunch. After her hand IV was restored, her BP
was higher, so Cam advised against any of the coffee in a thermostat I had brought in.
In view of the risk of repeat problems, this is a wise precaution.
Tuesday October 11th 9:30am *Coffee*
9:30am ===> The patient had breakfast, finally had coffee. She now thinks it is
November 13th. She is enjoying herself too much, playing with her tablet, so some
occupational therapists came saying they were going to have her sit up
in the bed and sit on the edge. That's probably because ICU beds are high profile
real estate, and the patient will probably be moved out to a hospital ward by Friday,
the 14th day after the aneurysm. I have added links at the top and bottom of this page
to the Hospital Pamphlet that explains her subarachnoidhemorrhage.
4:00 pm ===> In the morning, after I left, the therapists gave her socks, sat her on the bed,
and made her stand. She is still connected to the brain drainage, gets congestion, and has noticeable
short term memory loss. She keeps fiddling with the tubes, like my brother did,
the machine readings go off. They are making the move to free up her bed.
I think she will be in a hospital ward before this weekend.
There are still considerable challenges, and dangers. I will be very busy in the next few
days.
Wednesday October 12th Steady Improvements
I visited Patient twice, morning breakfast time, late afternoon supper time.
Patient sat in a chair by the bed most of the day. She ate pureed food, didn't
like it at all, but was happy with the soup and my guarantee that it had nutrition.
I gave her my coffee from a flask, specially made for her, which she enjoyed greatly.
She gets stronger, her blood pressure reached levels I haven't seen for ten years,
109/43 was the lowest. She doesn't like all the IV needles and tape stuck to her.
I expect she is about 48 hours away from being transferred to the "inpatient" ward, away from
the security doors of ICU and sharing a room with others.
When that happens, she will probably be walked much, and my time may be more intense.
Her sense of reality has challenges. She knows the day and date, but she couldn't
manage her phone well. I am needed to supervise considerably.
I had to perform much maintenance chores for her sister, secretarial chores for
the pair of them, and start preparations for home safety equipment.
The skull drainage is ongoing, is not unusual, but the risk factor for a stroke
remains high. I met a lady whose husband is in the same ICU; she had
allowed him to go home too early, his aneurysm burst again in the same artery and
he had to start all over again. I must be vigilant. The patient is
like a child, careless, starts to wrap up her tube cords, making them pinch and shut
off the supply line, so I have to constantly get her to stop. Her attempt to use the
cell phone was a disaster, so I must continue to forbid her. I just hope it is temporary,
or I'll be a candidate for a straight jacket. I got two of them now, stereophonic
troublemakers.
Thursday October 13, 2022 Notes Preceding Visit
special test. I can't remember what it is or what is the focus, possibly a dye test
throughout the body.
I brought up the topic of the "Study" that P was chosen for. It involved giving her
either 7 days or 14 days of antibiotics randomly chosen. This is because
her temperature is the lowest yet, at 36.0 C, and she has no fever, therefore no
infection. The nurse (Joel) replied that this had been discussed by Doctors and it is likely
they will deny the study. She should not have medicine for a non-existent condition.
I am pleased to know that they are alert to everything, and that it should be cancelled.
Thursday continued 1pm
The skull tube is out. That doesn't mean no blood in the brain fluids. She was thirsty
for coffee, and a special treat I brought, but not allowed. Nothing for her headache.
She's drawn the short straw. Nurse's name I can't understand. She can't be
found when needed. I call her L---. The doctor came with his equipment
for her transesophagalscope. He explained in detail the procedure to P and myself.
P nodded. She doesn't understand a word of it. Except the part he emphasized for her to
remember. When she is told to swallow, she must SWALLOW. I informed him she has no
problem swallowing big pills. This big pill has eyes. Doctor kept looking for L---, but she
was off somewhere. I signed papers, the nurse reappeared, along with 7 more team members,
mostly watchers, I assume. They are going to scope her heart. I moved aside but was
kicked out.
I tried over the next 2 hours to see her, but she was still having her heart inspected.
Finally I got in. It was successful. She was deeply asleep. She was sawing down a
big tree. They told me to go have a nap. Come back later. I'll visit about dinner time.
I had left her coffee there earlier. It will remain hot if L--- doesn't misplace the
thermos.
I got called repeatedly by her sister. I updated her and agreed to fetch medical supplies
for her tomorrow. I haven't worked for 17 years. Now I am working. 12 hours a day 7 days a week.
I'm not getting a tuppence. The two Rogers reading this will know what that is.
Thursday continued 7pm
I misjudged the nurse, she was excellent. As soon as they brought volunteers in to
assist with time consuming chores like answering the doors, all the trained workers could
return to
doing what they were supposed to. I will call her T---- now as she is Totally
Professional.
I said the skull tube is out. Yes. But there is an IV style connection. It is measuring
her
skull pressure. In the beginning that number was bouncing around 20. When I left tonight
it
was -2 after being mostly 0 throughout the day. This is good. There are no results from
the
heart scan. That will take 2 days. So she will remain in ICU longer. I know what they
were
looking for. They should have asked me. Her high BP at the onset is not caused by
arterial
plaque or heart defects, by my estimate. We do not eat garbage. I expect the numbers to
be
better than normal. Her high BP was caused by workplace mismanagement. All they have to
do
is hire a good firing squad and they can clean up the workplace in a flash, then the real
workers
won't be grumbling.
When I returned in the evening, I waited ten minutes for P to awaken. Her temperature was
up to 38.7 (1.7 higher than last reading yesterday). It later went down to 38.2. Even
she complained of a fever.
She had chills, but only a light sheet was provided, intentionally. She is shaking off
the
results of the knock-out drops. You would need knock out drops too, if someone
was
planning to shove a camera down your throat with a tight fit at the back.
I brought her coffee. She drank the old and the new. She started feeding on the pureed
chicken and
some unidentifiable soup, a lot like cultural Lugow. She had one of the Nutella on bread
squares that I had made.
She even tried the pureed broccoli and mashed potato that she had turned her nose up at
yesterday.
I just mixed them together. She was given heavier doses of meds for her headache. Then
she
wanted to lie back again, and is starting to sleep.
I personally would never have been able to tolerate someone shoving a camera down my
throat.
Sixty years ago, the doctors were unable to get a simple tube down my throat to draw out
the congestion from Viral Pneumonia that can often kill seniors and children. But I had a
good reason. In 1952, at age 4, somebody thought my tour of a shed had ended in me
drinking
some coal oil from a 7-up bottle. It was a misconception. I am not as stupid as I look.
But they
rushed me to hospital to pump my stomach. I have no recollection of the event, but nobody
gets near
the back of my throat. I'll bet it was a memorable lesson for Nurse Three-Fingers and Dr.
Four-Fingers, that they'll never forget. So they told me. (with just a bit of
elaboration.)
Friday October 14th
9:30am: and 7pm
She frowns until she gets her coffee. Very moody until the new nurse
demanded a smile. Then she was laughing. After fourteen days in a prison-like ward,
I wonder what I would be like. Her nurse's name is hard to remember, until
I exchange the first 3 letters and the next 3 letters with what they look like. So I
refer to her as Fish-Love. Now I can remember. I hope I don't forget, as she
looks like a Cossack and I'm sure she could whack me big time. She's very helpful. Thanks
Fish-Love.
The patient has good numbers. Her biggest threat is herself. She's like a kid in a China shop.
Just keeps touching her skull tube. It's detached and not draining, but is used to
measure the
pressure. I gave her back her recharged tablet to keep her fingers active.
They promised a CT scan today, but by supper time nothing. Maybe tonight or tomorrow.
Whenever she strains at something (she grabs the coffee thermos
when I 'm not looking, and tries to open it with a big grimace), it startles me.
"Don't touch that." She has no strength, but so far her numbers have held safely.
Sometimes the warning light flashes 'yellow alert' and starts beeping. She pulls the
plugs out
when she wriggles around. I can re-attach most of them now, otherwise the Cossack
will come out of her cave to see what's up. I prefer to manage simple things myself.
I am most concerned about her mind. She has short-term memory only. She can summarize
her experience
but she cannot evaluate or express herself knowingly. I can talk about her to a doctor or
nurse, and she is unaware that I am talking about her. All of her actions are very sweet,
like a cat that starts ripping things apart when you're not looking. The new patient
through
the glass window to her right must be very serious, as his wife and sister were there crying. So, all
of a sudden
P was clutching the religious pamphlet, eyes squeezed shut, intensely praying for him,
whoever he might be.
She is very aware of things, but only within a certain framework. She doesn't want to be
here
but she never asks when she is getting out. Then she says things like, where's my purse?
I'm going to get us
Popeye's chicken tonight. I have to tell her that we are not going to be doing that, and
that her dinner
will be coming soon.
I hope to get the heart scope results tomorrow, and possibly the CT scan results if they
take her tonight
The more real data that comes out, and is matched up with her good numbers, the sooner she will be
transferred to a Neurosurgery ward.
Saturday October 15th *Still There*
10:30am:
Patient had the CT scan the Doctors promised late last evening. Results are unknown
from the CT scan and the heart scoping two days ago. All monitored numbers look good
and normal.She should be sitting up, but seems to have lost some ground. I need a
Doctor's update to find out what's going on, and what we are waiting for. She is acting
devilish. Her wrist itches where the new left arm IV needle was set, and is protected from
her picking at it by gauze bandages. When reprimanded, she denies doing anything,
then laughs and mutters sly comments. She has no recall of yesterday's phone calls
that I forced her to make to test her short term memory. It was as if they had never
happened. The constant headache is resolved for the most part with a cold face cloth
on the forehead. The nurse keeps asking if she wants a Tylenol instead. I say 'no',
as I don't want her drugged up when it is not necessary. I know the human body
gets stressed over the long time by having to filter out drugs. I want her to have
vitamins, not pills. When she is up and exercising, her low BP will start to move
around and the headache and weakness will vanish magically. No more pills, please.
I want her to be functioning, not just another dependent who can barely get out of bed.
I will return later.
7:30pm *Mysteries*
I arrived about 5:30pm. P had already had some of her dinner. She welcomed my coffee.
The nurse reported how bad she had been. Trying to climb out of the bed to visit the
Ladies washroom. I don't blame her.
Now she's tied down, but she can still reach for the coffee cup and other treats I am
bringing (Nutella on a croissant cut into small pieces).
Nurse said she ate so well at breakfast, she didn't eat much at lunch.
Now the bad things. The floor is in Covid-19 alert. It has an infection. Restrictions
are in place. ICU is clear, though.
She will be having another CT scan. She is being monitored for encephalitis, probably
because of her symptoms.
As you know encephalitis is an infection that inflames the brain and can make it swell.
It can kill you easily.
It would be caused by mosquitoes, other bugs, anything external that might cause an
infection or a virus.
I forgot to ask, but I'm sure they already tested her for Covid-19. The patients are well
isolated from one another by giant windows.
It could account for her headaches, occasional fever, memory loss, erratic behaviour, so
far no hallucinations.
I personally don't think she has it. There is no reason, so they are doing the CT scan to
study for more definite identification markers.
I asked for a specific person to visit and she was allowed. She survived her own similar
trauma
earlier this year. Her experience and her profession gives me much important information.
I won't be asking anyone else.
I was supposed to visit the patient's sister for the maintenance task, but the patient
takes priority.
It's not bad now, but it could get a lot worse during the winter, if the patient cannot be
released home.
Everything otherwise looks good. I am optimistic. Time will tell what the CT scans
reveal.
One other indirect mystery. Or am I going a little crazy. I planned a specific dinner for myself tonight.
By some odd coincidence, when I opened the utensil drawer, the potato peeler I was looking
for
jumped out onto the floor. So maybe some guardian spirit is thinking he's helping me
somehow.
Or it was just somehow caught at the edge, and got itself dislodged. I will put the idea
aside, but if anything else decides to become active, I will certainly consider having a
good
shot of whiskey, which won't mix well with my BP medication, so probably not.
Sunday October 16 9:30 am
They gave her another CT scan this morning. Had to drug her to make her lie still. She is sleeping.
I left after 5 minutes. I had to do chores for her sister.
12:30pm
She is still sleeping. She did not have breakfast. I tried to give her lunch and
coffee, but she is sleeping. Her numbers are good.
(BP, temp, pressure, respiration). I tried to get her to eat. She mumbled unknown things.
She didn't 't even know I was there. I have to go home and accept delivery
of cooked food from friends. Special cultural dishes for the sisters and myself.
7:00pm
I arrived after 5pm. She was awake, quiet, tied up to the bed and not resisting. I
finally met
Kelly, the new nurse. She informed me the tests for encephalitis were negative. (I
told you so.)
He normal symptoms she's had for decades, gave them that impression, but have nothing to
do with the aneurysm.
Her last critical connection has been removed. She is no longer measured for skull
pressure.
All that remains is a gauze bandage over the stitches where they drilled into her head.
I was able to feed her like an infant, spooning some kind fish, with potatoes and carrot
mash. Whatever
I gave her, she ate. She even had some fruity slush just because I said I wanted
her to have vitamin C.
Because all critical connections no longer exist (just BP, pulse, and a few more) she is
good to go
to the inpatient ward. They didn't tell me that. But I know she will not be monitored
by a hookup in the ward.
How safe they think she is from the Covid ward outbreak, may be holding it up. I don't know why
they're calling it
an outbreak. Nobody is running around screaming out in the hall. It's pretty quiet.
She's entitled
to semi-private, so at most one other person in the room. Then I want to see her
sitting
up in a chair for her meals, and being walked about. I don't see any of that in the halls
for other patients,
so it's hard to know what comes next.
I tested her myself with photos I printed of family and friends, and she did very well on
the recognition, and on the naming of the subjects. Her short term memory is another
story.
Patient still thinks it's November, and she just randomly choose a date, but she gets the year
correct.
I have invented a puzzle for her that I will bring tomorrow. It will be 4 to 16 squares
of images
with two of each. It was called Concentration. When you pick a square you try to match
it with its mate by location.
If her short term memory is bad, then she won't remember the locations and she'll never
finish it.
I'm not waiting for these doctors to fix her memory. I'll do it myself.
That other thing I mentioned yesterday about the potato peeler jumping out of the drawer.
I decided to dig up
my old trail camera, set it up in the bedroom, and see what the infra-red might capture
with the lights off.
I got a five-second video of sparkles rushing about. I know it's not bugs
or dust.
I don't know what to think. I will conclude that it is a manifestation of your prayers.
Monday October 17, 2022 *Monitored*
11:30 update. First, I am sorry I cannot arrange for special videoconferencing across
the ocean.
I am exhausted. The patient is not well. Read the updates. There is no time to
entertain people specially.
They are watching her. All tubes are gone. They are concerned about bleeding
in the aneurysm site. New nurse Emily gives special medications to treat the wound site.
The patient still thinks it's November and tries to get out of bed to visit washroom. Nurses must
watch her all the time. She's fast. The scoping of the heart showed no problems. CT
scans are clear.
2:30pm
I missed her lunch, attended for a few hours, helped her finish a rice pudding she had
overlooked.
They have her sitting in a chair for eating and circulation. Her automatic blood pressure
cuff makes her itchy.
I took care of her headache with coffee and a damp cloth, I scratched her itchy parts with exfoliator
glove and cream for dryness.
I brushed the knots out of her hair. She is sad not to be able to walk about, but that
should come soon.
5:00 pm
The walking came sooner than I thought. While I was away, they walked her to the end of a corridor.
I didn't think they did that in ICU because staff is all over the place doing important things.
There is no room for athletes. But they did. Probably with one of the primitive aluminum
walkers for support. I forgot to ask if they used one of those or just pointed her in a
direction and held her arms for support.
She had not had her supper before I came, so I was allowed to feed her. She was as hungry as
a bear, but the food was bland. She has put in a request with me to bring my special
pancakes, with yogurt,
a piece of crisp bacon and coffee. She battled with the BP cuff, which they replaced, and
she didn't like that one either.
It kept squeezing her, which is what it's supposed to do, but she took it personally.
Just before 7pm
she settled down and fell asleep. It was probably the medication. That is their solution
for everything.
Nurses don't always reveal to me ('the family') things I need to know. I usually only
hear those things
when I hear them chatting. So, I overhead during one of their chats, that the patient is
waiting for a bed to 'open up' in the wards. That's very important, and they didn't tell me.
It means she has been approved to move on. It also means that whoever moves out from the ward
should move in the morning. That's always been standard at hospitals. However I was told
that it could happen any time. But I find it hard to believe they would wake you up at 2am.
"Good news! Somebody kicked the bucket. Now you get to sleep in their bed for the rest
of the night. If you see anything strange, it's just your imagination."
Tuesday October 18th A New Day
Note Update
Regarding some recent mysteries. When difficult things happen, your senses are
heightened.
I tested the potato peeler. It can easily get stuck at the front of the drawer, then be
thrown out when caught in other utensils. Conclusion. It means nothing. It was an illusion.
Testing the trail camera, caught more things moving. But they were all out of focus, and
happened after I moved by. They were dust particles, caught in the light and swirled around
by an air current. Conclusion. It means nothing. Another illusion.
But thanks for all your prayers anyway, they have been most helpful, I am certain.
9:30 am
I got there late. The patient was mostly asleep. The new nurse reported that the night
nurse had given her Benadryl
for her itchiness, and this was what was keeping her asleep, causing her to miss breakfast
and not receive the morning medication.
Otherwise the patient is fine. I had to leave to do chores. I hope to return for her
lunch and help her to eat that.
1:30 pm
I visited midday. She was still sleepy. She only ate a little bit. I decided to let her
rest and left after 20 minutes.
5:30 pm
They wouldn't let me visit long. They fed her to get the pills down. I fed her some,
gave her coffee.
They were not around much. Fortunately, I stopped her from leaping out of bed to go to
the washroom. She's not allowed.
I explained in detail all her hookups. I creamed her arms for the itchiness, gave her
a brown rice balm cream
for her headache, rubbed on her forehead, which came from the mother of a godchild.
The outside hallways are getting more and more signs about the Covid outbreak. Only I can
visit her.
I have to keep her spirits up, as nobody else knows how to do that. Thank you all for
not bugging me excessively.
I am at a loss to understand where my executive secretary has vanished. Oh, wait. I just
remembered.
I don't have an executive secretary to manage all the requests and the silly nonsense I
have to go through.
I will just be ignoring you anyway. The patient's health and welfare is still at much
risk.
The two occupational therapists who came that afternoon tried to drag the sleeping patient
up to her feet for a walk.
They failed. I could have told them to leave her alone. They'll come back and try again
tomorrow. It is important for them to succeed.
Otherwise, she could be there a long time. I can take care of her at home, and cook
better stuff than the
green, orange, brown, grey, white stuff that they bring her.
Wednesday October 19th **TRANSFERRED**
8:30 am
The old attendant said, unhappily, "You're early?" I could have told them how to adjust
their door monitoring system
to reduce visitor disturbances. But I did not. I also did not explain that I had to make
sure that the night shift
was not drugging P to settle her down. Fortunately that did not happen this time.
So they were
ultimately able to walk her as she needed to be walked. It was most fortunate, because
it was time for her to move up.
I did not stay long, just gave her coffee, then had to rush out to re-supply her sister.
I went home for a sleep so I would be fresh.
I let them manage the situation and walk her as much as they liked. Which they did
and the benefit showed at my next visit.
4:30 pm
I assisted her with her dinner that came about 5pm. The nurse told me she
would be transferred
when dinner was over. She felt better and looked her normal self. I packaged all her
things into the
clear possession bag and left it on her bed. She was ready go to the "inpatient" ward. Not far
to go.
The next time I return I will have to contend with the Guardians of the Inpatient Ward,
who quite frankly
have not done a particularly good job, as they are still in Covid-19 high alert outbreak.
So when they try to make it difficult to see her, I will be prepared to be declared
"an essential visitor."
I will happily give them a few lessons. I just have to say, "Show me your portable isopropyl
spray,
and I'll show you mine." My gloves prevent me from touching outside surfaces, and the spray
sterilizes the gloves.
Thursday October 20 **MASQUERADE**
8:00 am
I visited my clinic. Got my flu shot in right shoulder.
8:30 am
I visited the Pharmacy. Got Moderna Covid-19 booster in the left shoulder.
It had to be done, even though it won't be actively protecting me for 2 weeks.
9:15 am
I visited the hospital, checked in with the INPATIENT front office, was easily
given the patient's room number.
They knew I was aware of the signs of the Covid-19 outbreak and the "Lockdown". But I am
"essential" to the survival of the patient. You can say that again.
When I looked at the room and the bed, I thought "Who the hell is that?" Didn't look like
the patient, but someone who'd been on a pub-crawl all night.
The idiots had drugged her up, probably to shut her up about her headache and
itchiness. She had some appliances installed incorrectly.
The moron who was masquerading as a nurse, kept glaring at me. "We don't allow visitors.
We are under lockdown."
I assured her I was "essential". When the moron departed, the attendant at another bed,
was quite friendly, and realistically accepted my presence.
The two other patients must have been on the same pub-crawl, and a new one that came
shortly after, all the same.
The patient who had been in such great health at 5:30 pm the evening before, was almost
unrecognizable.
I was left alone, so I put on blue sterile gloves I brought myself, I adjusted her
appliances, so now she looked human,
I threw out their brown swill that pretended to be coffee and which she found bitter,
and replaced it with my light coffee made with honey, and she loved it. She started to
look human again.
The OT's were on the case. I like them. They will be walking her very soon. The sooner
the better.
After I organized her possessions, having cleaned everything with my isopropyl alcohol
that I am protecting her with,
I decided against leaving her any electronics, until I am sure the morons have left her
alone to resume recovery.
I treated her headache with "brown rice curry balm" which the mother of her god-daughter
had given me. Wonderful. No drugs.
Just intelligence is all that's required. I left fairly quickly as the OT's were walking
her down the hall,
one on each arm and an attendant with a wheel chair right behind. This is what's needed,
not morons with drugs.
If I'm lucky the nurse will fall down an elevator shaft while I'm away, and the world will
be a much better place.
5:30pm
She was sitting up in bed. Had eaten. I gave her the good coffee. Her same nurse was
there but less hostile.
She let me know I needed more cream for the itchiness. She has two neighbours now. The
opposite one was
gone, after looking very horrible and being quite unconscious. Maybe back in ICU.
I am only telling you this so you know she is in a perilous situation. The other two at
her sides, separated by space and curtain rails are still unconscious and probably alive,
but it's hard to tell.
The patient is alert, grinning impishly, and saying silly things to the attendants. I
expect she is gaining converts.
Her health is almost restored to what it was yesterday. I can't get full information, as
the patient can't remember much
and she is just being nursed. The one at the front let me in when I put on my pathetic
face, and promised not to stay long.
After all, I am not the risky one. I never had Covid, never will, and we never had an
epidemic at our home.
They cannot say the same.
Basically, her body is healing. It will go faster now. The exercise is the key. Her
mind is questionable.
She kept repeating the same meaningless question, which I kept correcting, and each time
she said, "Oh, I see," and then she said it again.
I hope she has not turned into her sister. I expect her to come out of that before they
send her to Rehab, but I don't know.
I can't visit her as often or as long because of the Epidemic.
Friday October 21
9:00am - 10:30 am
Patient is recovering slowly and normally. I was allowed to stay
1 1/2 hours while she had breakfast.
5:45pm - 7:30 pm
I was helping the patient with her dinner, when it was announced
that an ambulance would be
there in 20 minutes to transfer her to a standard hospital. I organized her things and accompanied
the transport.
She is now alone in a room because she is in isolation. It's a precaution because she
came from a pandemic ward.
The nurse is delightful, helpful, professional, and I don't have to beg to be allowed in.
As long as I wear the
yellow gown, the blue gloves, and the mask, I will be there as much as possible to help
her. Because she is a risk
for trying to leap out of bed, they have motion alerts all over the place. I trained her
to use the red button to request
assistance, and she is totally alone, with only the nurse who comes in every so often.
It is imperative that she be walked frequently until she can walk by herself and come home
as soon as possible.
I must take care of her sister's supplies tomorrow, but will spend as much time with her as I
can, as the staff has their hands full
with other patients. I can help the overloaded staff with her healing, so that her release
home will occur so much faster.
I am sorry I cannot give everybody phone calls, and texts, and everything else. That is
the purpose of these updates.
If I don't do it this way, then I will become unable to help anyone.
Saturday October 22
8:30am
The patient is more comfortable. I arrived to feed her; the staff is happy for the help.
As it is the weekend, there won't be any walking being done. I cannot be here in the
afternoon.
5:30pm
Nurse reported that OT visited her. She cannot stand by herself. I have asked her
to exercise
her arms and legs in preparation for the work she will get on the weekdays. She wants
that also and started exercising right away.
Her comprehension is not good. I played word games and she had trouble guessing the
opposite of words.
It is like having a stroke. It will take longer to improve her comprehension, I think.
I don't know what to expect.
I fed her, she plays her tablet games, I watch her and see her having thinking problems.
But it makes her sleepy.
She has few other problems. So the first step is to walk. The second is to understand.
It has been less than a month
so I should feel fortunate that she had progessed this well so quickly.
Sunday October 23
9:00 am
Waited until patient awoke. Had cooked her a special breakfast of pancakes and bacon, but
she did not eat much.
She ate a little bit of everything, including hospital-made breakfast. At least she had
her juice and coffee and yogurt.
12:45 pm
Brief visit only. Patient reported that the staff had walked her. I asked how many
and she said, "only" three. I said, "How many did you want?"
That was the right number, one to hold each side and one to follow with a wheelchair.
She reported that the staff
said it would get better quickly and she would get stronger soon enough.
5:30 pm
She was sleepy. Didn't want to eat anything. It was about half an hour before I
discovered that she had no more hookups.
The catheter was gone, so she was flying solo. But, it was her understanding that
she would be able to leap
out of bed to go to the washroom. No. Not quite. I said, just press the red button
for some help.
Soon after, she pressed it. Unlike the old days, when nobody comes for a long time, a voice
speaks from the wall.
I said something brilliant, like, "It's an intercom." So the patient, still holding the
button, starts talking into the button.
So, after an impression of Lou Diamond Philips singing, "La Bamba," I explain what she
wants, the voice says, somebody will come.
Eventually, somebody came. What I really need, is somewhere that I can get instant
updates.
Otherwise it's like you people, not knowing what's going on, until you read this
at your own speed.
I hate learning things by accident. Anyway, she learns she won't be leaving the bed
any time too soon.
I will try to see the team of doctors tomorrow to see what they have in mind. I know
the sutures have to be
removed on October 30th. That's one month, to the day, when everything happened. What
a way to spend thirty days.
Monday October 24
9:15 am
Patient does not want to wake up. Finally did. Does not want to eat. She ate a little.
I'm trying to find someone to explain this.
Looks like it's my job to heal her.
12:15 pm
Patient still sleepy. Not hungry. I buzzed for assistance. People slow to come.
I broke out my special blend of coffee. Got her attention. Opened my toast and
Nutella. Now she's waking up.
Their food is unexciting. Once I got her taste buds moving, she even ate their food.
She had cold apple juice.
Big 'Ahhhh!' response. She's starting to eat now. She loved the cold tangerine wedges.
Ate more. Drank cold milk.
Now she's eating and drinking, and talking. She's still on antibiotics for potential
encephalitis.
But they never found anything; they're playing it safe.
I'm going to have to spoil her every time I come. The hospital food is as about exciting
as Joe Biden.
I'm telling her it's against the hospital policy to use the button as a microphone.
Especially don't sing
1960s songs into it. The Gen-Z hospital staff get all confused, and feel inadequate.
We'll pretend they know what music is.
Now, she's showing signs of life. When I get here for supper, I may become more
aggressive and try to get a nurse
to help me to get her to her feet. Once she's standing, not necessarily walking, we'll get the blood
rushing to her feet, and out of her head. I hate to think the hospital is full of
questionable professionals
who need to be told what to do. I'll try not to get thrown out.
6:30 pm
Not much happened. The patient is still getting too much rest, doesn't like the food,
it's not home made.
Patient was helped to stand and walk sometime during the afternoon. It did not impress
her. Let's hope it become more frequent.
I did not get thrown out. So far.
Tuesday October 25
8:40 am
We are waiting for the 10 days to be up on the isolation, then she can recover more.
She really wanted to
stand up, so I called the nurse, we gave it a try and she was able to go around a little
bit using the hospital walker
with the nurse and I each standing close to the sides. It was worth it to see the progress.
I had forgotten her coffee in the wrong knapsack, had to go home and get it, and when I returned
somebody or something
had gobbled up all the Nutella toast I had made. The patient is the prime suspect.
4:00 pm
They sat her up in a chair where she stayed most of the afternoon. She
at sitting at the chair.
She is beginning to move around more easily.
Wednesday October 26
9:00 am
Patient is progressing well. Ate her breakfast. I am busy today.
7:00 pm
What a day. Due to inflation, I chose the wrong food, without reading the label, and my
food sensitivity sent my BP reeling.
I fixed that. Then this evening, when I visited the patient, I find her lunch tray outside
her room, untouched.
Her supper tray is with her, so far untouched as she is fast asleep. I know the staff has
been very busy and there are personnel shortages.
But I would like her not to miss a meal, just because I can't be there to watch over her.
Everything worked out in the end.
However, just to give you an idea of future challenges: I phoned some of her friends so
she could chat a bit, relax, and she'll sleep better tonight.
We get off the phone to Mrs. X. Along comes the nurse, has forgotten her scheduled
antibiotic, and sets that up.
She also gives the patient a big cup with a tiny bit of liquid, and says the patient must
drink her potassium.
I give the patient the big cup with a big straw, with a little bit of orange-coloured
potassium. She gives it
back to me and says, "Give this to Mrs. X. She would like this."
Now, rather than doing what I normally do, and try to explain the physical impossibility of
sending the potassium over the
phone line, I say. "She's busy now. She wants you to have it." I say that firmly.
The patient gives in and tackles the tiny amount of liquid, and after about six
tries, she finally finishes it.
I hope this isn't going to be how it is from now on.
Thursday October 27
8:30 am
The patient slept well. I had made her pancakes, toast with Nutella, a piece of bacon.
I helped her eat. The hospital food
made an interesting conversation piece. That's about it.
The OT was planning to get her up and walk her about in her room. She's not allowed
in the hall because of isolation.
I had to leave abruptly and help her sister get food and supplies.
12:30 pm
I arrived late for lunch. The OT had walked her up and down her room a dozen times.
I got to ask the nurse about her antibiotics. The nurse said she had tested positive
for something. I suggested, endocrinitis, as that's what another nurse said.
Two hours later the nurse came back to apologize. She was not positive for any bacteria. That
was another patient.
Apparently all those people lying around in beds look very similar.
I stayed briefly, rushed home, and slept for 2 hours.
5:.00 pm
The patient was sitting up in bed. Her dinner looked good, she offered it to me. I am
not allowed to eat her dinner.
She didn't want it. She was happy with the special coffee I brought.
I had a chance to test her comprehension. Apparently, 7 plus 5 equals 8. Also, the
opposite of "sun" as in "sunshine" is shadow. That was her first guess. She then came up
with second possible answer.
She said the opposite of "sun" was "lizard". For those of you familiar with some alien
theorists, her answer is profound.
Otherwise, she is trying to be funny, because she is tired of my questions.
I tried to leave for 2 hours, but she got restless. The OT's want her to move to
a distant Rehab for longer treatment.
That is going to be a problem. I can't get there three or even two times a day if it
is too far.
11:05pm
I phoned the Social Worker's answering machine. I do not want the patient sent to a distant
Rehab where I am unable to visit more
than once per day. She is under extreme stress from this ongoing imprisonment in a
hospital bed.
I will speak with them tomorrow. I simply registered my disapproval of their estimate of
the best path for the patient.
I did not elaborate on my opinion of her treatment which is declining on a daily basis.
Friday October 28
6:00 am
Went very early to drop off 2 thermoses of coffee. Patient was awake. Then rushed home
to prepare to escort
sister of patient to a major medical evaluation.
6:00 pm
Was out all day. Finally able to take coffee and some food to patient, and check her
progress today.
Patient was sitting in chair. They had walked her back and forth many times. Someone
had given her
the coffee I left for her breakfast and lunch meals I had missed. I was told the doctor
would be in soon
to answer my questions, and clear up some confusion about why she was still getting
antibiotics by IV.
Eventually Doctor came (Dr. Lui) explained that patient had contracted a dangerous
bacteria back in ICU of other hospital.
The bacteria can attack the heart. That's the real reason she had been forced to swallow
a camera and have her heart scoped.
Even though there was no heart problem, the patient is to receive ongoing antibacterial
by IV until November 17 - that's a long time.
Because the Rehab nearby cannot accommodate IV patients, she may be sent to a farther
Rehab location. I vetoed one location
as being too far away, preventing me from visiting multiple times. I approved of a
second location
as it is near enough to allow me to visit the patient two to three times daily.
The patient, as a result, will not be going home any time too soon. The antibacterial
program will have to be maintained.
This makes it more important that I visit frequently as the long-term stress event is
becoming hard to endure for the patient.
Saturday October 29
8:30 am
Patient was awake early. Had not slept well. I gave her fresh coffee and favorite
snacks but she wasn't interested.
Patient ate little. I promised to return in the afternoon and walk her around.
12:30 pm
Patient was sleepy. I woke her up. Made sure she ate some lunch. Fresh coffee and
snacks.
She was eager to walk. I put the rollator by the bed. She was able to stand up and walk
by herself.
We made quite a spectacle of ourselves, breaking all the rules, walking in the hallway
when they are in 'pandemic mode'
which, of course, is a lie. I discovered that when the nurse said the whole floor was in
isolation.
And I said, "Then I guess there is only one person per room." And the nurse said, "Oh,
no, some rooms have two people."
I said nothing, but I'm thinking. "Well, then the floor is not in isolation or you
wouldn't have two people in a room."
I said, "Back straight. Head up. Look where you're going. Don't run into things."
She curved her back. Kept her head down. Didn't look where she was going. Ran into
everything and everybody.
In other words, everything she criticized her sister for in walking wrong she did herself.
The nurses were quite pleased by her performance. Of course, they didn't have to do
anything.
She wanted to try the stairs structure. But they said the OT would introduce her to that.
I will return in the evening to make sure she eats well, and is ready to sleep this time.
I want to make her perform so well, that they will realize, she should be moving to the
next level, and that
she doesn't need to occupy a bed, just to take antibiotic. I can give that to her at
home myself in pill form.
And I can exercise her and monitor her vitals myself when she does any stairs, mainly the
blood presssure.
7:00 pm
Supper time visit. Nurses had provided her earlier with hot water and towels so she could
sponge herself.
She still can't go to the shower herself. After supper we just talked. I'll be trying
to record a movie
which I'll convert to a file and bring her tomorrow evening, so she has something to
relax her and help her sleep.
The nurses are getting used to her being active and I know their reports will help to
move her along
to the next phase of this process.
Sunday October 30
9 am
I brought her coffee and Nutella on toast. She ate and drank some hospital offerings and
all that I brought her.
She kept telling the nurse
she had not seen me in 3 days. She doesn't remember my visits.
She asked me if I had talked to my brother last night. My family visits her at night
in her dreams. I don't remind her they all died years ago. I'm just glad it's my relatives
and not hers who are getting the credits.
I have started recording movies to notebook computer. TV to camera, camera to
movie-maker,
then a large file to the notebook. Soon she can have something to do other than
staring at nothing.
They give her pills I don't think she needs. She doesn't need her liver
filtration system exercised.
She needs her cardiovascular system exercised. I will return at lunch time and see if she
will walk,
like yesterday, or farther. When they send her to Rehab, I want her as ready to leave
as fast as she came.
1 pm
The patient did not want to eat, did not walk. Had only her coffee.
6 pm
Patient was still not hungry, and had no desire to walk. We'll try again tomorrow.
Monday October 31
9:00 am
Patient and I were of the same mind. She needs to get active, walking, getting
out of this pampered environment.
I spent an exhausting hour, getting her cleaned. After a break and lunch we both
want her to start walking.
12:00 pm
The patient lost her enthusiasm. She can't sleep. She won't eat. She won't walk.
I left a message at nurse's station to talk to doctor. To phone me when available.
4:00 pm
The doctor phoned. He thanked me for reminding them that her sutures were to come out
yesterday. They had forgotten.
He said her IV antibiotic was to continue until November 19th. That's not what he told me
the day before.
He had said November 17th. I knew the date, because that is the day of her appointment
at the first hospital for a review of her situation.
But I did not argue. I said I want her out as quickly as possible. He said, they will
try to move her on
to the Rehab ASAP, and then she may come home to be in my care and have her IV given at
home.
Maybe they will train me or have a nurse visit. One way or another, the hospital has
ceased to be a healthy place for her.
5:15 pm
She is sitting up, looking normal. She will not eat. She will not exercise. She will
not sleep.
She is not normal. I must step up the pressure to get her home. I can do all that is
necessary
for her to return to normal. I phoned a friend who knows her well to have her speak with
the patient.
She tried to get her to eat with a technique, but it didn't work.
I will have someone special come and visit her in person in a few days, if they have not
transferred her to Rehab soon.
Tuesday November 01
8:45 am
Patient was moved to a 4-person ward. Must be a good sign. I got trapped in the
ward by a general Fire Alarm.
They shut the doors and elevators cannot be used. Other ward residents called me "Doctor"
and advised I get a parachute.
Based on how the patient is talking, I'm certain it is the loonie ward. They must think I
belong here.
The patient keeps complaining about the terrible hotel service. I just agree with
whatever she says.
Logic no longer applies to this universe. Now I have to go visit her sister, get her supplies,
and experience more lunacy.
5:00 pm
Visited for her supper. She was more relaxed. She is still a prisoner of the Ampicillin
antibiotic.
Otherwise, she doesn't need to be stuck in a hospital bed.
Wednesday November 02
8:00 am 12 pm 7 pm
Patient is healthy enough to walk, gain strength, even took some practice stairs. The
problem is that
she keeps saying, "Why am I still here?" And I give her the same answer, "Because when
you were in ICU,
somehow you got infected with such a serious bacteria that you must continue to have IV
antibiotic
until November 19th."
If a bed opens up at a specific Rehab, patient will go there. The doctor also promised
that she will have
the chance to have her antibiotic IV at home. How that is managed is uncertain. We are
waiting for something
to happen. The patient's legs have trimmed because she is not eating properly because of
ongoing confusion
about why she is still here. I will talk to her case doctor again, about both these problems.
Thursday November 03
8:15am
The patient does not want to eat. The medications probably cause that. She is losing weight. Leg
muscles are shrinking.
The nurse suggested a nutrition supplement like Ensure or Glucerna. Otherwise
she just drinks the coffee.
12:15 pm
I arrive at the room just as the nurse is exiting, saying the patient is going to be given
a shower. I said I'll come back at supper time. I left without seeing patient.
4:00 pm
The patient has discovered the hospital phone by her bed. She phones me and orders 5
chicken wraps from Tim Horton's and bring a "bunch" of drinks: she'll pay me when I get
there. I said, "I have your purse, you don't have any money. Give the phone to the
nurse." The nurse gets the phone, and says don't worry about that.
I said, "You got that right. I am not delivering chicken wraps for the room, they can
eat the usual hospital mush at 5 p.m." [Your tax dollars at work.]
7 pm
She ate everything. She walked. She made everybody laugh. I'm exhausted. She's
sleeping.
Friday November 04
8:15 am
She didn't want to eat breakfast. I trimmed her nails. She can walk short distances
without a rollator/walker.
12:15 pm & 5:30 pm
Patient was showered, walked, did the walking without the rollator. But she hates being
imprisoned here.
Saturday November 05
5:00 am
Was called in by patient and by nurse due to unresolved shoulder pain. I brought
non-medicinal solutions, topical ointment, electrostimulus (Dr. Ho), and gel ice pack.
They also gave her a strong pain killer. I left her falling asleep about 6:00 am.
I left word at nurse's station to have the primary doctor phone me. I want to get her
out of here
preferably this weekend. The hospital is not good for the patient's health. I can do a
better job at home
and still measure her blood pressure, her temperature for fever, and administer the
required antibiotic in pill form.
9:30 am
Short visit to check on patient. Reminded nurse I am waiting for the doctor's call.
I have to run out and get supplies for patient's sister. Then I'll be back again.
1:30pm
After fetching supplies for the patient's sister, I returned to patient, spoke with her
nurse. They promise to send request to Doctor in charge of patient to contact me. I need
someone who can approve her releiase. I can manage her BP readings, temp readings, and
giving her antibiotic in pill form.
I know they want to play it safe and continue antibiotic for another 2 weeks, but the
patient is not doing well
shut in like this. She is healthy enough to be home. I will return this evening for
her dinner, and bring a movie for her to watch on a computer. It must be by earphone
because there are
too many others in the ward and we must not disturb them.
Monday November 07
Sunday November 06 was routine and tiring.
Monday November 07
Today a doctor and attendants will evaluate the patient to see if she still needs to be
in hospital.
Her IV is still required until November 19th, but it can be given at home.
Tuesday November 08
9:00 pm
This is the 40th day since it began on September 30. The patient is now home.
Despite the discharge from the hospital, the situation is far from easy. A ton of
drug bags were delivered about 4pm, and at 6pm a nurse arrived to connect everything
to two black bags that contain 2 pumps, each with a separate kind of antibiotic. One
activates every 12 hours, and the other activates every 4 hours. The tangle of plastic
tubing makes it difficult to manage, and at the same time have the patient visit the
bathroom, and in future days, to have any kind of shower.
Since support for the sister of the patient must be maintained, the patient wants to
visit by taxi, and sit with her sister, while I fetch groceries and supplies
for the sister. As it turns out, this is an extremely good idea. The patient has proven
to be highly impulsive, with few rational skills whatsoever. Four brief chores caused the patient
to be left completely alone for short times, first to fetch lunch, then an early supper meal
and finally two separate visits for supplies at a pharmacy, each time resulting in an
unexpected
near disaster.
The first time, for lunch, upon my return I found the patient gone from bed, not in the
the bathroom and not anywhere initially visible. She had attempted to leave the bed,
had stepped badly onto a small platform designed to raise her up to bed height, but had
broken the platform and wound up fallen to the bedroom floor. No injury, but it was a
shock to find her gone.
The second visit to a food supplier was even more unexpected, since upon returning with the
meal, I found the patient
at the top of the stairway, crying as is if something had happened. It was
reminiscent of the September 30th
aneurysm that had started it all, when she had called out for help from the top of the
stairway.
It turned out to be a frightening event, but without any danger, because the patient had
merely become disoriented
and had tried to leave the bed and find help. (Note, when the patient had arrived back
from the hospital,
she was so disoriented and incapable of remembering the home she had lived in for 20
years, that she had
no idea how to go from the lobby to the elevator, what the elevator was, how it was
designed to take her
to the correct floor, nor did she have any sense of direction, and constantly turned
in the wrong direction.)
By the time the 3rd event occured, the patient was tied up to the antibiotic pumps,
and once again, when she was
left alone, she decided to leave the bed on her own, looking for the bathroom, and had
nearly stretched her pump tubes
to the danger point, where it threatened to pull on the needle in her arms. Despite being
given instructions to "Stay put",
the patient shows no indication that she understands exactly what is happening, and she
did it again.
This is why the hospital constantly had her monitored by machines that when they detected
her leaving the bed,
would set off an unholy set of audible alarms so the nurses would come rushing in and
get the patient back to a safe place.
No such alarms exist at home and everywhere is dangerous, because of the limited length of
the pump tubing
and because there is no barrier at the top of the stairs.
There are 11 more days of this, with supplies to be delivered every 2 days and a nurse
to visit daily to hook everything up to the pumps. How the patient will manage offsite visits
to her sister is unknown.
Putting on a shirt will not be easy since the tubing has to run through
armholes in the shirt, and
you are not allowed to casually unhook the tubing. Showering will be next to
impossible
as the pumps and tubes have to remain clear of the water. The final challenge will be
a November 17th visit to a hospital for the first of a number
of medical appointments
as the patient will be hooked up, and the units not very easily unhooked (as this involves
injecting a neutral liquid
into each pump nodule in order to prevent air or other contaminants going into the
patient's artery at the entry points.)
And as the patient is erratic and impulsive, she will not be able to manage any special
procedure like a CT scan.
Think of taking a cat to a vet and knowing how much the cat hates the vet and has
unlimited capability
of coming up with an unexpected solution to every distressing function that the vet wants
to perform on the cat.
All of this ends on November 19th, when the pumps and rigging can be removed permanently.
Until then, no visitors will be allowed.
Friday November 11
It is an ongoing trial. The antibiotic motor packs have cabling that interferes with
everything. I have asked our local seamstress to convert a nightie into one with a
convertible sleeve, with buttons, so the cable can be run easily to the outside and later
can be easily changed.
The antibiotics have destroyed the patient's hunger, which has destroyed her strength.
The visit by the Physiotherapist
today may be a short one. The patient cannot recover strength without food, and all
cabled up.
The nurse visits daily to repair the damaged cabling hookup. If it becomes a big problem,
the patient will
have to return to Emergency for damage control.
I have cancelled her sister's needs. Her Community Care Manager will have to manage the
sister's food and supplies.
The patient cannot be left alone as she constantly makes bad decisions, damages her
cabling, and risks falling.
8 more days to go before the antibiotic program is concluded, and hopefully the patient
will be able to eat and recover.
Saturday November 12
11:00 am
By trial-and-error, the ability to manage an unmanageable situation is showing promise.
The patient has a nightie that makes the IV apparatus less cumbersome and therefore less
dangerous.
The visit by the physiotherapist yesterday was useful. She had many good suggestions.
The patient
will be exercised to increase her strength. But we are still fighting a lack of hunger
that destroys her energy.
7 more days to go before the IV antibiotic program ends. I then have to book an
appointment at
the hospital to have the picc line removed. That's the hookup lines that have been attached
to the patient
by a needle in an artery.
I don't know when or if her energy will return and how or if I will be able to get her to
a hospital to have the procedure
performed. The nurse who installs the new antibiotic bags every day, does not provide
that service.
Somewhere down the line, it may be necessary to rent a stair lift and engage overseas
relatives to come here
or engage contract workers to serve the patient. But as that involves activating the
power of attorney
and having to deal with lawyers, it is not a pleasant prospect. If you have ever dealt
with banks and their lawyers
as I have, you will soon learn how much they hate to yield any money even, and especially,
if it is not their money
but the money of the patient. I would prefer to deal with braying jackasses and things
that crawl about the sewers
than to have to deal with bankers and their lawyers.
Monday November 14
2:00 pm
At the start (Sep 30) the patient weighed 128 lbs. Today she weighs 100 lbs. She
has lost
21.875% of her body weight in 45 days. She is starting to look like a concentration camp
survivor.
She is so weak, she can hardly stand up. There are five more days to go of the double set
of antibiotic medications
that now run through her constantly. I have assured her that when the treatment ends, she
will gain weight
again and return to normal. That's actually just a guess. Six days after the treatment
ends, she will be
visiting the Infectious Disease Clinic of a downtown hospital for a follow-up. I finally
discovered the full
name of the infection: Enterococcus Faecalis Bacteremia. It is resistent to many
stronger treatments.
A study of the disease from January 1992 until December 1995, had a 59% survival rate. All had
longer hospitalization.
It is known as a nosocomial pathogen. This means that the patient does not have it on
admission to the hospital,
but acquires it within 48 hours of being admitted.
From the study: "Often, nosocomial infections are caused by multidrug-resistant pathogens
acquired
via invasive procedures, excessive or improper antibiotic use." This suggests it was
acquired
on the night of September 30, when the surgeons drilled through the skull to insert a
syphon into the brain fluid
to release pressure caused by the addition of the hemorrhaging blood from the burst
artery. It also explains
the importance of why the hospital would not operate until the spouse or POA of the patient had
signed the
Permission To Operate papers releasing the hospital from liability.
If all this had occured in the United States, the costs would have approached or exceeded
$100,000. Because it happened
in Ontario, cost to the patient is zero. The patient's benefit package paid none of the
hospital bed bills,
but her coverage under the husband's company benefits extend into retirement, covered
all of the hospital costs.
What remains important, but unknown, is what will happen when the antibiotic treatment
ends on November 19th.
The Infectious Disease Clinic must show no more bacteria. There must be no more
antibiotic treatment
in which case the patient should recover her hunger, re-gain weight, be able to manage
normal physical activites, including stairs.
There is the additional problem of seeing what happens to the patient's mental abilities.
She currently has little
sense of time or space. When getting up to go somewhere, she behaves like an IRoomba
vacuuming robot by
entering unknown doorways and proceeding to bump up against closets, and being unable to
identify furniture and
facilities in the room. She doesn't know what an elevator is, or how it relates to levels
that it goes to.
The patient never truly knows what the date is. She memorizes what she has been told.
Then when asked, she takes
up to fifteen seconds to repeat what she has been told. But she has no true idea of the
time of day,
or the season of the year. She constantly asks about having "breakfast" or "dinner"
after the meal has
already taken place. If she is promised that something will occur within an hour an a
half, she will think
that five or ten minutes is long enough to wait. A set of questions to truly evaluate her
lack of ability to understand
where she is, or how to travel somewhere, or what time is it, have yet to be given to her
to determine the precise
misunderstanding of reality, because the physical impact on her body and survival are more
important at this time.
The full impact of the hemorrhage has yet to be evaluated. The majority of this work
will be done by the spouse.
Friday November 18
The last Ampicillin and Keftriaxone antibiotic bags were installed by the visiting nurse
at 9:30 am. Tomorrow morning, they will be removed, and directions given for returning
the pumps and managing the patient records.
The patient is down to 97 pounds and is losing weight at almost one pound per day.
When the antibiotic exits her system, she must regain her hunger and start nourishing and
refueling again. If this does not happen very quickly, and if she continues to lose
weight, strength, and energy, then she may have to return to a hospital. She continues to
be at great risk for a fall. Unlike the hospital environment, the patient must get out of
bed to go to the bathroom. She does not go anywhere else and otherwise remains in bed.
There is no time or facility to manage "visitors". Contacts continue to leave phone and
text messages. It's okay to do that, and the messages are played for the patient, but
she is too weak to engage in any communication.
As a brief summary of what happened. It all started on September 30th when the aneurysm
burst and blood contacted and interfered with the brain. The event was made more critical
when the operation on the evening of September 30th caused someone to expose the patient
to Enterococcus Faecalis Bacteremia (infection occured between hospital admission and 48
hours, suggesting
that medical error caused the exposure to the infection, mostly likely when a hole was
drilled
in the skull to release pressure from the fluid building up in the skull). The bacteria is
extreme
and deadly, often fatal to patients. The decision was made to treat the patient with
heavy duty antiobiotics.
These antibiotics then became a threat themselves ("the cure can be worse that
the disease.")
They are so stressful to the patient's system, that using them is as dangerous to the
long-term
health of the patient, as any attacking organism.
Fortunately, by being at home, the patient can be watched individually and intensively
around the clock.
But in this environment, the risk of falls now becomes another threat to the patient.
Sunday November 20
Yesterday, the antibiotics were stopped. The pump tubes were detached. The patient
slept a great deal.
The patient was weak. Both times the patient was resting comfortably, and I had to go out
to get
supplies, the patient decided to get up by herself. Each time she fell. Both falls were
minor, no injuries
but she was very scared by her weakness. Each time I found her on the bed, where she had
been able to return to.
I have started to give the patient more feedings than normal. I simply bring her food
and she now assumes
it is time for a meal, and she will eat one or two mouthfuls. Otherwise, she doesn't care
about food. And she has
no idea what time of day it is.
I expect this to clear and the patient to grow stronger.
Today, I weighed the patient. She was still 97 pounds.
I then encouraged her to walk around the floor
using the rollator. She happily went up and down the hallway
and into various rooms, and repeated the exercise four times.
I gave her a reward, a spoonful of yogurt, a small coffee, and she assumed it was a meal.
Two hours later, the patient got out of bed by herself, and walked back and forth up the
hallway without assistance,
then returned to bed by herself.
If this continues, I'm going to have her try the stairs.
Tuesday November 22
The attachments for the infusion pumps that sent two separate antibiotics through
the patient's arteries
needed to come out. The visiting Paramed nurse said she could not do it, and I would have
to book at the hospital.
The hospital said, you don't book for it, you either go to your family doctor or visit the
hospital Emergency.
Even though the patient was weak, we went to the family/clinic doctor early. They said
they don't remove
picc lines. We had some other business to attend to at the same location, then headed for
the hospital Emergency.
You wait in line. You get called to check-in, then triage, then registration, then a
nurse comes
and gets you.
It turns out the picc line is not a needle held in place with butterfly tabs.
It is a 3 foot narrow plastic tube that goes in far enough to reach the heart.
The nurse makes sure it is not damaged. Then you wait half an hour. Then you go home.
The picc line is gone for good. The patient can now walk and wash without tubes and bags
going wherever she goes.
The patient lost another pound to 96 pounds. Twice today, she announced that she was HUNGRY.
She didn't eat much each time. But she wanted more meals. It means the antibiotic is
releasing control over her.
Friday November 25
I took patient on outing by mobility scooter yesterday. She couldn't learn. She
could only go forward,
while I walked beside controlling direction and speed, but she wouldn't release the drive bar
to stop when I told her to. Fortunately we didn't hit anyone, though we did panic them,
and nicked doors
and ran over a few curbs into red lights. The patient completed accounting tasks
and had her
Covid-19 booster shot. Ten minutes after having the shot, she couldn't remember having
it.
Today the patient must go to Infectious Disease appointment to confirm what I already
suspect. The
enterococcus bacteria that she contracted from the September 30 operation is gone. Her
low temperature
reading suggests that. But they have to play doctor at the hospital and grow a few vegetable
cultures
from her blood to prove it to themselves.
I must get her back home very fast. She weighs 96 pounds and is weak and shaky. I am eager
to ask
the doctor if this is normal after a long antibiotic treatment, and what is our best option to
recover weight.
I plan on trying a liquid diet of energy supplements, smoothies, soup, since she doesn't like
solids.
The patient was too weak to go to the Infectious Disease Appointment. Spoke with doctor
who realized she had
been through a lot in the last two months. I gave him her recent temperatures. He agrees
that the infection
is gone and there is no more need to visit the hospital. He agreed I should concentrate on
restoring her energy.
The physiotherapist called to touch base. I set up an appointment with her next week. I
hope I can
get the patient on her way to recovery, before the physiotherapist visits.
I bought a vegetarian Energy supplement to add to milk, as well as a carton of Boost. The
patient had her first
of many. Though I warned her, she must also consume solid foods. Then she promptly fell
asleep. The doctor
had suggested her body is in recovering state, and it will take time.
Tuesday November 29
5pm
Progress is minimal. Disappointing. A few days ago patient appears to have
gained 2 pounds up to 98 pounds.
No change today. She continues to have extra "meals" of milk and protein energy drink.
She has fallen a few times. Last time was on a mattress, but couldn't get up. Had to
lie there for half an hour
until I returned from set of chores. Today she ate all of her breakfast, rejecting
nothing. It wasn't big
but surprisingly ate all the portions given to her and said she was forcing herself.
Patient continues to get very confused. When she stumbled into a bedroom and pulled a
TV away from a wall,
almost knocking it over, I asked what she was looking for. She said, "My toothbrush."
I need more time to teach her how to find things. We could make a game out of it, except
she is so weak she
can't play little children games, and remains in bed most of the time, so is more of an
invalid.
I just hope one morning, everything turns around, otherwise I blame the antibiotic for
being even more destructive
than the burst aneurysm.
Don't make any plans for her or for us. We won't be going anywhere soon. And when the
snow comes heavily
it will make it that much harder and slower to do shopping trips, leaving her alone more
frequently and more often.
Thursday December 1
Patient gained 2 pounds, is back up to 100 pounds. That could still be just food volume added
to the body
but without true weight gain. If the protein drink continues to increase 'weight', muscle
may be increasing.
Patient continues to not be hungry, and not want to finish what's put before her. She remains
perilously weak, shaky, unstable, unbalanced, prone to falls.
The physiotherapist visited with simple daily procedures to increase strength. Together,
we devised a system to
safely practise stair climbing on a simulated step.
Sunday December 4
Patient's weight remains stuck at 100 pounds. I have added peanuts and potato chips
to diet
No luck. If she is not hungry, she will not eat more. If she does not gain weight and
energy soon,
it could be difficult to get her to appointments for MRI and medical follow-ups if the
weather turns bad.
The flashes of hunger spells she had a few weeks ago, have not happened again. I continue
to hunt for answers.
SAH - SUBARACHNOIDHEMORRHAGE - The Patient's
Trauma