DH started to make a small improvement yesterday, but not much. His enzyme levels got back to normal in his pancreas, but he is still inflamed and in much pain. His oxygen still drops too low, when he's not on it. His BP is high. They did finally, later in the afternoon, let him start having some ice chips and some ice type lemon flavored drink, but apparently that was a mistake because it added to his pain and caused a fever? at least that's what they are telling him now.
The doctor for that day (we actually met her once, when we lived across the street from the hospital. She used to bring her dog to work on the weekends and take him outside on the big yard and sometimes her sweet dog would come over to our yard if dh was outside LOL.) called me about 8:30 last night, but for the most part updated me on everything dh had managed to update me on. She said the oxygen issue was due to the opioids. She said he should have his high BP monitored/treated. I said he doesn't usually have high BP. Later I read online that low oxygen can cause high BP, so it's probably just from that. All cause and effect.
Then the night shift came on and another bad night. He can have the pain med every 4 hours, but it's only lasting him about 2 hours, so he's in pain for almost 2 hours by the time he can have more. The day shift is good about getting it to him at 4 hours or shortly after. He texted me at 1:30 last night just miserable with pain. Said he'd asked 3 times in the last 2 hours. I said what do they say?? He said they say ok and walk out and don't come back. I said push that call button and tell them you need some NOW, that you can't even go 4 hours without pain, let alone over 6. Finally at almost 2 am they gave him some. At 6am he asked for his next dosage. At 7:30 am he texted me that he still didn't have it. What the hell?! He needs 2 doses of pain meds, on time, each night. How hard is that to take care of? Give it to him and the rest of the night he sleeps or waits until the next dose.
Then the day shift nurse arrived and gave it to him right away. Blamed it on shift change. Then blamed the middle of the night on there being only one nurse. I told dh make sure to tell the dr what is going on at night. She'll just look at his chart and think oh good, he's not needing as much pain meds now, when that is not the case.
The doctor last night told me she wouldn't need to do another CT scan, but dh just texted me that they are taking him back for one (that nurse, who's in xray is a friend of ours). He doesn't know why, and the doctor told me last night she had no plans to do another CT scan. This day nurse also thinks his heart is acting strange, might be from electrolytes, so she is telling dr. about it. They are also going to change his pain meds to a half dose every 2 hours to see if that helps even him out a bit on the pain, rather than a roller coaster type thing where he's good for 2 hours, miserable for 2 hours. I said that is great (I actually suggested it to dh yesterday they should try that) except how is that going to work with the night shift? They can't even get it to him every 4 hours (let alone 6) how are they going to be able to do it every 2 hours? and so he'll have a half dose in him and then have to go 6 hours?? I'll probably have to make a call in the middle of the night to complain.
The dr yesterday also did another Covid test, the deep swab type. He had a rapid test the first day, but she wanted to make sure and that one takes 2 days for results. She also told me that while he doesn't need to be transferred to the city hospital now, even if she wanted to they are all full up. She said she had another patient she needed to transfer and every bigger hospital within a couple of hours here is full capacity. I'm finding that hard to believe. Our state has a website for covid cases that is updated daily. It says there are currently 164 people in the hospital due to Covid. Our state has at least 2245 beds. The site that lists how many beds each hospital has only lists the bigger hospitals in the state, doesn't list our little hospital or the small one in the county to the north of us. I get that they can be full, but it's not due to Covid.
They also did a chest xray, I guess because of the low oxygen, but it came back all good.
It seems odd to me that these doctors only seem to work one day, LOL. This hospital has like 7 doctors on staff and each day it's a different one. The doctor I talked to last night said she wouldn't be in today, so it will be another one, but she will be back on Friday. I suppose that first doctor I talked to the first day was the ER doctor, though. Thankfully he's had the same day nurse and she is really good, but I'm sure it will be someone different, if he's still in this weekend.
Maybe this will get him to finally get off drinking so much Mountain Dew, now that he's had to go cold turkey with it.
In other news I am so confused by those 2 luggage rack holders I ordered! Remember the undecipherable email? from the Walmart 3rd party seller. Then I got an email that they were shipping FedEx, with tracking and would be here yesterday. I get a notification yesterday your packages have been delivered. No, they haven't LOL. Nothing out front and FedEx didn't come. I look up the tracking history and it was delivered somewhere in the middle of the state like 3 hours from me, LOL. How do they do that? Like how did they deliver it to somewhere that isn't even the town on the address? Then UPS shows up with 2 big boxes from Amazon. What? I haven't ordered anything lately from Amazon. It's the two luggage racks? Huh? There is this little slip of paper inside one of the boxes with a printed message here is your gift from so and so and a QR code to scan and leave feedback. I'm so confused! But hey, I have them now and they look nice.
I think, (from my nurse manager friend's explanation) that hospitals being "full" might also have to do with the number of staff. Hospitals can't (at least here) operate beyond a nurse:patient ratio. And, the U.S. is still experiencing a huge nursing shortage. Part of THAT is due to the fact that there is an even bigger shortage of qualified nurse educators. These things have a domino effect. As for the doctors on staff--could they covering a region, perhaps? In my former state, we had hospitalists (doctors on the hospital staff who did the rounds) who covered an entire county worth of hospitals. So, if you weren't a scheduled admittance via your doctor of record, say ob/gyn or GP, you wound up under the care of the hospitalist, who had rounds at every hospital in the county, usually one city or town/day. That *might* be the situation you are encountering. Anyway, bottom line, when you are in the hospital, it's the nurses who keep you well. Also, bit of advice, if you want action, best to ask for the nurse manager--he/she has the actual authority over the floor nurses, more so, than the doctor. The nurses report to the nurse manager, not the doctor. I hope he feels better soon. This is scary, and my best thoughts are headed your way.
ReplyDeletethat makes total sense, that's probably what the situation is. If this happens again tonight, I will be calling them myself.
DeleteYes. Call. With my many and varied experience with and in hospitals, I can tell you that nobody should be in a hospital WITHOUT an advocate, even if that advocate is only able to advocate remotely. Call, call, and call some more. Also...another bit of information (which may serve only to irritate you) is that regarding the pain medication, which I learned during one of my c-sections: If a shift dispenses beyond a certain amount of pain medication, the nurse is required to fill out a very in-depth DEA report, something they try to avoid doing, as it detracts from patient care. (Which itself is ironic--how can you help a patient in pain if you don't give them their prescribed pain medication?)So, if a patient asks for pain meds, toward the end of one shift, and they have reached their quota for the shift, they will try to hold the patient off until shift change. Not saying that's what happening, mind you, but it's something to bear in mind. I'm also not excusing it. I think it's a piss poor reason for giving piss poor care. It's 2021. I don't think there is any excuse for a patient to suffer pain.
Deletedh just told me he asked them to call and update me again, so I'm bringing up the night time issue. He is supposed to have a dosage every 4 hours, so they should have given it to him at 11;30, 3:30 and 7:30. He got it twice in 12 1/2 hours.
DeleteIt is unfortunate that he's not getting his meds on time. I doubt its nursing staff sitting around not wanting to take care of him-the staffing crisis is real. With doctors, yes, in small hospitals, they usually do only have 1-2 doctors actually a the hospital as the others tend to work in the clinics and urgent care, and the nursing staff do the bulk of hospital care. Its been like that in our small town hospital forever.
ReplyDeleteI don't doubt that the nurse is busy, but making him wait an extra 2 1/2 hours and have to ask 4 times is ridiculous. I'm sure there is a method to having different doc each day. Like the dr last night started to explain to me they don't know what is causing his pancreatitis, and the doctor the day before already told me all that.
DeleteYes, Sam is right. The staffing crisis is very real, very serious, and very dangerous. Again, just because a hospital has x number of beds, doesn't mean they have the staff to safely care for x number of patients. With COVID, the larger hospitals have pulled nurses from the smaller ones to keep the ratios up to minimum standards. (Hospitals have to have a minimum staff to participate in Medicare.) Beyond that requirement, while some states have minimum nurse staffing regulations, (and if you live where I think you live, yours is not one of them) no state other than California has a law limiting the number of patients a nurse can care for beyond the requirement to be able to participate in Medicare. So who knows how many patients your husband's nurse has--he/she could have 10 patients, all sicker than him, or maybe, just with better advocacy. YOU MUST ADVOCATE. Do not ask them to call you, you call them, even if you have to call the nurse's station 20 minutes before he is due his pain medication to remind them, and then 10 minutes after each scheduled pain medication to see if it has been given, and if it hasn't, every 5 minutes after that until he gets it. 2 1/2 hours late is not just unacceptable, it's inhumane. I certainly hope tonight is better for him. -Meg
DeleteHave you or DH mentioned his MTN Dew addiction & how much he drinks? That alone could kill you. Can't imagine it's good for your health. Maybe they could tell him that so he stops drinking it once discharged? Hope he makes a full recovery - scary time to be in a hosp. with Covid, Esp. if not vaxed.
ReplyDeleteWhen I was talking to the dr. last night she seemed to know about the Mtn Dew as she mentioned his bad headache and I said probably caffeine withdrawal, as he drinks a lot of MtnD and she said, yes he mentioned that and told him he probably is having withdrawals from quitting cold turkey. Hopefully he will stop drinking it or at least cut back. He drinks like 3-4 cans a day, though I'm sure there are people that drink more than that of soda day, too.
DeleteI was going to suggest half doses every two hours as that is what I asked when I needed pain meds for a week. It worked since I did not need to be out of it for two hours and in pain the next two hours. I love Mt Dew but rarely drink it and then only about two ounces. Otherwise, I have heart problems. And, I drink the Diet MT Dew. I pour out the rest. He should be over his addiction by the time he gets out...lol.
ReplyDeleteThat is strange about the luggage racks. Does your dog miss your husband?
I'm hoping the dosage every 2 hours helps better. I can't stand Mtn Dew, too icky sweet LOL. I'm hoping he won't drink it anymore, but doubt it. I think the dog is missing him. He's used to hanging out with him and following him around most of the day.
DeleteSo sorry that your husband is still in pain. I hope they do a better job giving him his pain meds on time today. At least his enzymes have improved. Sending good vibes!
ReplyDeletethe day shift is great, but I had a chat with the day nurse about the night nurse and she's supposed to pass the message to her to keep on top of it.
DeleteI wonder if they would consider giving him a pain pump. I had one after a c-section. It's self-administered, but you can't overdose yourself. When my husband had pancreatitis, it took them hours to get his pain under control.
ReplyDeletea couple friends have suggested that too. It took them days now to get his under control.
DeleteIt is common knowledge that pancreatitis is a symptom of Covid-19. At least, 2 people I knew, had it as their symptoms. I don't know how the docs did not mention this.
ReplyDeletehttps://casereports.bmj.com/content/14/2/e239656
could be why the dr decided to do the 2nd, deep swab test, even though the rapid test was negative. We should have that result today, they said it takes 2 days.
Delete