2:33am
Yesterday was… a lot.
One of the reasons why it’s hard to get anything done when you’re in the hospital (even as an observer/helper) is that the patient’s got a revolving door of people coming in to check on him from about 4am forward. And Nathaniel is, as the doctors all love to remind me, a complicated patient.
So they check his blood sugar like six times a day, and almost every one is followed by a shot of insulin. They pull blood cultures from two different sites once a day. They pull blood for other tests at least once a day. The ICU team does rounds up to three times a day. The transplant team stops by at least once a day. Nephrology/renal/kidneys (they keep introducing themselves differently) shows up at least once a day. Pulmonology rounds once, and the respiratory therapy techs come by three times a day for nebulizers and percussion. Physical therapy is coming around at least a couple times of week and working Nathaniel’s liver-wasted muscles. Infectious disease has started showing up now that Nathaniel’s culturing a yeast infection in his blood.
And we owe that little yeast infection a lot, I think. If that little asshole had died during surgery, when all the patients are treated with an antifungal to prevent this scenario, then we wouldn’t have discovered that Nathaniel’s also having heart issues. So I guess we’re glad it was resistant to the meds?
The cardiologists believe that Nathaniel has broken heart syndrome , which usually strikes when someone has gone through a physically or emotionally stressful event. I want to stress here that *I* didn’t break his heart. His liver did. But generally the syndrome reverses itself over the course of about three months. So this is a bump in the road and not much more than that. Add cardiology on the list and more tests and more imaging.
Meanwhile the yeast infection is being treated with more powerful antifungals, thus all the blood tests.
Because yeast loves plastic, they had to pull Nathaniel’s central line, which means he’s not on dialysis right now. His body still isn’t producing enough urine to compensate for the extra fluids he’s still carrying around from the surgery, so he’ll be going back on dialysis in the morning. I’m not sure where the new line for the dialysis machine will go — someone mentioned the groin earlier — but i’m hoping it will be less of a stressor than having a bunch of tubes coming out of his neck did.
Near the end of the day I drove home and swapped out clothing and refilled medication bottles so I could come back for the weekend. I took some time to get some chores done that have been bothering me and I got a shower. So I’m clean and mostly warm and while the chores took longer than expected at least I got back here OK in the rain and the fog.
Since it is almost 3am I’m going to stop here and we can pick up with more adventures in the morning. Which is like an hour away now. Yay.
***
4:09pm
I don’t really have a good way to explain what it’s like when someone is having delusions. Sometimes it’s anxiety. We spent a good part of the morning discussing how he was worried about… well, everything. And not at the level of “I’m worried about the shenanigans the president is getting into” or “I’m worried about the impacts of global warming” more like “I’m worried that because I moved this cup from location A to location B an unknown assailant is going to drain our bank accounts.”
Imagine if you lived in a very small house with only one door and one window. Imagine if every person you saw through the door looked like a relative, but none of them would come in to say hello. Imagine if your window had been replaced with a one-way mirror and there were a dozen people in masks and gowns watching you through it. You’d be pretty upset! And that’s the problem with hallucinations and delusions — they feel exactly the same as real things at the time.
Plus they come and go. Sometimes the conversation is almost coherent. Sometimes it definitely is not. Sometimes he’ll string a set of words together like “I have to health tree purple bean” and I’m just like “I have no idea what you said, try again.” Other times he’ll sound absolutely with it, except for the part where the television is going to explode if the nurse opens a specific drawer in a cabinet.
Obviously, we’re not working in a vacuum of mental health care for all this, and the staff is both understanding and effective at implementing changes. There are medications for delusions and hallucinations. There are medications for anxiety. There are counseling sessions with psychologists that help to build skills during the times that the delusions aren’t coming. And all of those have helped, both Nathaniel and I, when things aren’t running the way we expect.
It’s still hard.
I could use a few days for both of us that weren’t hard.