SCREW IT I've tried 10 times to put up a post, but the computor elves are really enjoying messing with me. I'm as well as can be expected and I'm deeply grateful for all the support you've all shown me, Talk to ya'll soon.
DELFTS
No, I am not a doctor. Nor am I a nurse. I've never taken even so much as a CPR or first aid course outside the cursory one they teach in high school driver's ed so you can save your passengers after you've screwed up behind the wheel.
Even so, I know that after major surgery you do not send someone home who has not passed a decent bowel movement, who blew out his own catheter in the middle of the night, who cannot even eat because of the nausea and what vomiting does to his split sternum, who sill has bedsores, and who be left alone for hours at a time because he cannot get out of a chair unassisted. It is dangerous, it is irresponsible, and it is bad medicine.
Yet today when I went to take Delfts a bowl of fruit from the cafeteria breakfast bar he told me he thought that they were considering exactly that. Even though he badly wants to be out of this hospital, even he thinks that Monday is entirely soon enough.
I do not know who is pushing this release, but I strongly suspect the insurance company is putting the pressure on the hospital and the surgeon. Yes, it is true that under perfect conditions a patient having the same surgery could reasonably expect to have been home long before today. This, however, was far from a perfect case. Five days of atrial fibrillation did number on him, and the fact that he was in very poor condition prior to the surgery only contributed to the situation we have now. A former health care worker with whom I am friends was astounded that they sent him home from the Congestive Heart Failure unit over the weekend prior to his surgery based on his overall condition and the problems he was having.
And now they want to send him home again.
This is not a good thing. It is, in fact, a very bad idea. I desperately hope that this is more the product of a combination of pain meds affecting Delft's mind, and not a real option that they are considering for him.
In the meantime, he truly enjoys the calls. He has missed you all so very much. Thank you for calling him. I fixed the phone number in the previous post, so it is correct now.
Update: Well, I am much relieved after talking to Delft's nurse. Relieved, but not as relieved as I'd like to be.
It seems that after the successful cardioversion on Tuesday, he was able to keep a sinus rhythm only until Wednesday night. He's been in and out of A-fib and back on the meds for it since then. He has been light-headed and dizzy, so much so that they had to cut his 11am walk back from 150 feet to 75 feet.
Based on all of his indicators, there is no possibility of his being released either today or tomorrow for love or money. He got his conversation with his nurse all mixed up in his drug-addled mind and completely misunderheard what was being explained to him. It is a Very Good Thing™ that he was wrong. He has no business being home alone. Hell, he has no business being at home even with other people as long as his cardiac rhythm isn't regulated.
Delfts is in room 2427 now, a regular room with a phone and everything.
St Vincent Hospital
Attn Pt. Lambertus Meyer
2001 West 86th Street
Indianapolis, IN 46260
Phone: 317-338-0598 or 1-866-338-2345 and ask for extension 80598.
I know he'd love to hear from you.
Update: Sorry about the phone number. It's corrected now. This number will work.
I just left Dad's room, and I'm quite pleased. The cardioversion went perfectly and Dad is all set (assuming no changes tonight) to move to the step-down unit tomorrow. I'll post info then. He's sitting up doing crosswords again. He's awfully frustrated because his brain can't seem to find the right words, but that's an after effect of all the medicine and the major trauma his body has been through. He is joking with the nurses and is threatening to chase them around the bed just as soon as it doesn't hurt to move. Although he looks like a pincushion (his sensitive skin just can't handle the brutality of IVs and BP cuffs), he looks markedly better every time I see him. More later.
Erin
I called on my first break of the day to check on Delfts and spoke to his current nurse for his status and how his night was.
Apparently he rested well, is in relatively good spirits, and is in his chair. He enjoyed the fruit, so I will be picking up more in the cafeteria this afternoon to drop off for him. Lychee fruit? I may actually have a can at home.
The nurse yesterday did as I asked (demanded) and placed a waffle mattress on his bed to lessen the chance of additional or worsening bedsores. The nurse today had already bathed his back, examined the existing sores, and had changed the way that they were being treated. No more tape laid over it. She was using something else that required a little more time to administer but would promote the healing process, not just stop the skin from splitting further.
Oh, you didn't know about the bedsores? Neither did I until yesterday, and I was Not Pleased™ at finding out about them. I discussed them with my submissive during the course of the day, and he made several suggestions based on his experiences both as a CNA and as a clinical engineering technician who has worked on the various beds used in such situations. Based on that information and what I had seen on Delfts' back, I made a decision and made a demand. It was good to see it was taken seriously.
Here's the scoop on his A-fib: The surgeon is not happy with his lack of progress on the meds they have tired for converting his rhythm back to some semblence of a sinus rhythm. As such, they are going to do a "Cardioversion" on him at about noon or whenever the surgeon is finished in surgery and free to do it. It will be done in his room under anesthesia. It won't take long. Hopefully it will be successful. If it is successful, he could be transfered into the step-down unit tomorrow, maybe earlier.
I am hopeful. If he is well enough to be moved to a real room with a phone and visitors, I am certain that it will do much to promote an improved mental outlook, something that has the potential of being of great benefit to him as he heals.
The nurse has been instructed to call me with an update when the cardioversion has been completed. I will post the results. Now it is time to go read what I can find on the proceedure...
Mamamontezz
Update: Okay, I don't feel so bad about this. I can deal with this.
Update: The Cardioversion is over.
He's waking up from the anesthesia.
His heart is in a normal sinus rhythm.
They've taken him off of one of the meds they were using
to regulate the A-fib.
They're watching him to see if it holds.
The nurse is hopeful.
I may have a room and phone number
for you before evening.
Yes, I am an optimist.
Now the battle will be between us, the insurance people, the discharge planners/case managers and the Utilization Review people. They will look at the total stay time and want him out. It will not matter to them that he has not truly had the time he needs to recover because of the complication of A-fib. The normal stay for open-heart is about a week and he's had that, damn the patient, keep those costs down.
My loins are girded. I hope they don't chafe.
I really don't have anything to update about Dad's condition, except to say that because they haven't been able to successfully wean him off of the medication, Dobutrex(sp?), that is strengthening his cardiac function, they're going to do an echocardiogram tomorrow. They're hoping to get a clearer picture of what is going on in there, so they can find a new way to treat him and get him stepped down to the next unit. It looks as if it may be another 1-3 days before that happens.
On a personal note, I want to say thank you to all of you. I've been at the hospital for at least 12 hours every day since Tuesday, not counting dinner away and the exciting trips Beth and I have been taking around the north side of town to find the things that Dad requests and requires (although finding pear juice, music, and a nail brush, has been relatively simple, it seems that the north side of Indy is not the place to go for lychee fruit. I guess I'll have to make a foray into Dad's neck of the woods to an Asian grocer...). It has meant so much to me to check the comments on this site here on the waiting room computer and see the support you're giving, not only to Dad, but to our entire family. Thank you from the bottom of my heart.
As usual, I'll post as info becomes available. Until then assume that Jiffy Pop is progressing nicely and is becoming crankier and more antsy to leave by the minute. Although occasionally annoying, this is improvement, and we're grateful for it.
A quick P.S. to all of you who are nurses: thank you! Dad has had such tremendous care here, and the nurses (with one notable exception) have been so helpful, friendly, and accomodating, and I am in debt to them for the kindness and rule-breaking exceptions they have given to me. You all do great and essential work and I will forever thank you.
Also, a HUGE thank you to Beth. You have got to be the kindest person I've ever met, and I've enjoyed our talks and our outings so much. Thank you thank you thank you for the support you've given my Dad, and for being there all the time for him. You are an angel. I hope you've had a safe trip home; I'll sure miss you and I'll talk to you soon.
Erin
erinm26@hotmail.com
It's just after 8am and no news is good news. Delfts is still in the CVTR, but I fully anticipate they will move him today.
I hope the nurses let him know about the fruit I took up for him yesterday and that he was able to enjoy some of it. I will make sure he's aware of it if I am able to get up there this morning.
As for the rest of you, enjoy your holiday and grill up a brat for me. Updates as they occur. You know the drill.
Mamamontezz
After days of not being able to get in to see Delfts, I took that walk again and got there during one of their restrictive little visiting times. My co-workers covered the phones and would not take "no" for an answer and I thank them profusely.
He looks a lot better than I expected. I don't know exactly what I did expect, but with all that I had been told by the nurses, it wasn't good. His color looks better than it has, his eyes looked clear, and he was feeling well enough to express his righteous indignation, both at me for not being around and at the nursing staff for some incident last night. I've asked one of the administrative people to go talk to him and find out what happened, and she agreed to try to do so today, barring any other issues that might take her attention.
As for his anger at my absence, I'm going to assume that either my messages to him have not been passed along like I asked, or he was drugged enough to not remember them. It doesn't matter, not really. At least he's around to be pissed.
His current nurse is apparently his favorite, and she was pretty encouraging about his being moved to the CVPV unit. It could happen as early as this afternoon if his indicators stay good. They just want to do one more set of readings at noon before they commit to the move. When they do, I will post the room number and phone for all of you.
I know he'll be happy to have a few things of his own around him too. He has a bag packed and sitting on his computer chair with two of his pigs and the little goat that Beth sent him. It will be nice to be able to put them in the truck and bring them up and know he will get them and be able to enjoy them.
Currently his favorite things are not his pigs or his goat or his books or his fruit-cup (long story). They are his daughter Erin and his new and very special friend Beth. They have attended to him, humored him, bucked him up when he needed bucking up, cajoled him into cooperating (if I know him), and been gracious in their kindness. He is a lucky man for having them.
*heavy sigh*
Anyway... As soon as I know more I'll let you know.
Mamamontezz
Update: One of my wonderful co-workers stopped at the grocer on her break and brought back a quart of fresh pineapple chunks for Delfts to help satisfy this fruit fixation he is having. Fruit he can have. Red meat is history, but fruit is do-able. So much so that on the way to take the pineapple to his unit, I stopped off at the cafeteria and picked up most of a pint of fresh strawberries too.
Of course, when I got up there he was sound asleep, upright in the chair, his head bent over like his neck was broken. All I could think was "Why the hell didn't someone wake him enough to get him into his bed before he got that far under?"
Anyway, his fruit is upstair in the unit fridge with his name on it, and the nurse assured me she'd make sure he got some if he asked.
I also asked about this move to the other unit that she had discussed with us in the morning. Weeeellll, as is the case of most things around here, nothing is set in stone except the fact that nothing is set in stone. The highest probability is that he will spend one more night in CVTR before going to the CVPV unit. She does want to do another set of indicators and call them in to the surgical assistant so that a decision can be made soon, but nothing has been decided yet.
Soon... soon...
Mamamontezz
A lot has happened, so I want to share with everyone what the doctors and Dad's fabulous nurse Maria have told me in the last couple of days. While A-Fib is not the most comfortable thing in the world, it is also not dangerous in itself. The only real danger is the risk of stroke with long-term A-Fib, so they're giving dad injections of blood thinner periodically. My maternal grandfather lived with A-Fib for 27 years and had no effects stemming from it. I myself have had episodes of it relating to my heart disorder. It sucks, but don't worry too much about the old bugger :) Dad's surgeon (who is highly respected and brilliant) told me that it is a "nuisance problem" that occurs quite often post-op, and they're treating it pharmaceutically and have every confidence that he'll be back in sinus rhythm soon. This has been very encouraging to me as I was quite worried yesterday morning.
Dad has made great strides since early yesterday. He was in an awful lot of pain yesterday, but everytime we visited (before the nurses fearing the nun's wrath chased us out), he improved a little. I'll admit I was still a little concerned last night, but I am very glad he's still in the recovery unit, because he's receiving outstanding care from the best nurse I've ever encountered (and for a 26 year-old, I've met a good number of them). Maria is a Godsend. She shares info willingly and with a smile and she's treated Dad with both compassion and dignity. Never underestimate the healing power of a good nurse.
Today's visits have been extraordinarily encouraging. Dad is sitting up for a few hours at a time, much more cheerful, listening to music, and even doing crossword puzzles! The respiratory therapist said he might move today, but the surgeon said he would probably move to a progressive care unit early tomorrow. While there have been setbacks like fluid retention and nausea and vomiting, his overall health is greatly improved from yesterday and quite a treat for our family!
As the nuns aren't here right now and the unit has many open beds, the nurses have relaxed visiting hours and are letting us stay back for as long as we want (as long as we're not interfering with his care or rest), so I'm going to have to wrap this up and go see my Popsicle. Thanks for your prayers, keep the cards coming, and watch for updates from either Lila or myself.
Erin
Just got in to work and called the floor. Delfts is still in CVTR, the recovery area where he has been since his surgery on Tuesday. The nurse du jour said at 7:30 that he was still in A-fib and would not be leaving the unit anytime this weekend.
I'll keep an eye on the unit and put up any changes as I hear them... Personally, I hope it's a quiet weekend and that there's nothing to post. Healing is the best thing for him. Maybe the next couple of days will make the difference.
Mamamontezz
Because of issues with visiting hours and a low fever that I have been fighting intermittantly all week, I have still not been able to see Delfts. Resting all day yesterday on my day off and working on getting better seemed to work at least temporarily. I may not be "Medically Trained" and involved in patient care, but I do know enough to reduce the risk of his picking up an infection while he recovers, especially after the report I read last week.
But I did feel a little better, so I decided to put the decision in the hands of the nurses on his unit. I made arrangements for an extended break to allow me the time needed to walk the .25+ mile to his room, then called the nurse to get clearance based on the fevers.
That was when I found out about last night.
Atrial Fibrilation. On a drip to restore sinus rhythm since last night, and as of 9:30 it had not dropped back into sinus. But if you ask the nurse, all she'll say is "He's doing okay."
I'm not happy. I can't talk to him, I can't see him, I can't make it better...
Hopefully I'll know more later. In the meantime, he has no business being in a step-down unit, so hopefully they'll keep him right where he is.
So at this point I'm reading everything I can find on AF and it's implications at this point in his recovery so that I can prepare for whatever is in store for him, good or bad.
Update:
I spoke to the nurse over my lunch and got a little bit more information.
Delfts is awake, aware, and at the moment sitting up in a chair. He is still in A-Fib but the rhythm is steady and acceptably slow at this point. They are doing what essentially a Medical Cardioversion to try to restore the sinus rhythm. Although he has still not achieved it, he is stable.
It's not as bad as it sounded this morning, but it's still worrisome. Based on what I read this morning, Delfts could have been dealing with A-Fib for years and the A-Fib caused all of this instead of the reverse. Regardless of the chicken/egg possibilities of this, there are several treatment options open for consideration. I'll be interested in hearing the concensus that his cardiologist and cv surgeon come to.
Update 2: Just because he is in Cardiac Recovery does not mean he cannot receive cards. The only restriction is that he cannot have anything "Alive" in his room because of the increased risk of developing infection. Cards are fine and are something I think he would appreciate. Especially the ones with nekedness and boobage. He's quite fond of the boobage. Stick some boobage on a Rottie just for fun and send that. Just make sure the boobage is on XX members of humanity. He is a bit picky that way.
Send your cards and letters to:
St Vincent Hospital
Attn: Patient Lambertus Meyer
2001 West 86th Street
Indianapolis, IN 46260
Today was a roller coaster for dear old dad (or Jiffy Pop, as I now call him after seeing him in his metallic pre-op shower cap-esque thing). This morning when Beth and I went in, he was in a lot of pain, and his blood pressure was unstable and going back up to his normal Oh-My-God-He's-Going-To-Stroke level, which made the nurses uneasy. Throughout the day he made improvements, however. He got lots of rest, and with massive pharmaceutical intervention he was able to maintain a manageable pressure. He was also able to get some sleep today, so we sat with him in silence and watched the fascinating film that is the heart monitor. It was nice to see regular blips and encouraging numbers.
By the last visiting hour of the day (and as you read on Lila's post, visiting hours are fairly strictly enforced and few and far between -- I really have to make the most of my four visiting hours a day), Dad was able to manage a smile -especially when his sister was teasing him about a childhood nickname. I was fairly discouraged this morning, but feeling much better as I left tonight, being reminded that recovery is not a linear process, but rather a series of of advances and setbacks that grow increasingly favorable.
Between the third and fourth visiting times today, we went to Target (or Nirvana manifested, as I like to think of it) and Best Buy and bought Dad a small CD player and a CD of Gregorian chants so that he can listen to some music tomorrow and mask the sound of his monitors constantly reminding him that his normal blood pressure is freakishly high to the hospital staff.
All in all, Dad is still doing well, and if all goes well should be in a regular room with a number and a phone by tomorrow night. When that happens I will post his info so that you can wish him well in card or voice form.