9:28am
They took Nat downstairs at 6 and it is now almost 9:30. Last time I got text messages the entire time with updates. This time either he isn’t even started yet or they aren’t doing the text messages. I’m trying to keep in mind that it took until 10:30 for him to get sent back up to his room last time and last time there was a clear and obvious problem.
In the meantime let’s talk about the saga of the bathroom leak.
He moved into this room something like Thursday of last week because the liver people wanted all their patients on one floor. Midafternoon of the day he arrived maintenance came in, trying to figure out if there was a leak in the bathroom. Note that there was no water in his bathroom, the leak was in the room downstairs.
Oh! The nurse just popped her head in and said that he’s in recovery and will be up in a little while. Whew!
So every few days since then the maintenance folks have asked to come in, usually 2 to 3 of them, to see if they could identify the leak. The good news is that it doesn’t appear to be N’s toilet or tub, though it might be his sink. The bad news is that there has been a lot of banging on pipes.
I was about to say that it’s really good N isn’t here right now because someone one floor down is either using the wrong size drill bit to remove a screw or they’ve gotten out the saws all to go hunting for the pipe. They’re trying to be quiet about it, only running it for a few seconds at a time but surprise surprise it’s still really loud.
I hope they find the leak soon so we don’t have any more disturbances.
***
10:48am
When the attending says “at some point you and I are going to have a discussion about this but not in a public hallway” someone is going to have their ass handed to them and I’m pretty sure it’s not the attending.
***
3:54pm
Docs came around and said the hope is Nat can have a colonoscopy as early as Thursday to make sure his digestive system isn’t causing the abdominal pain. In the meantime they did find a stricture (tight point) in his bile duct so the stent that was put in should help clear out any lingering infection — which means he’s going back on antibiotics.
Best of all (to me) they put a tube down his nose to give him his colonoscopy prep so that he doesn’t have to taste it and I don’t have to nag him to take it. With eating and drinking being a big effort right now, any way we can help him increases the chances that the colonoscopy will be useful.
***
9:59pm
I suspect that I am a resident’s worst nightmare. I read the test results. I ask what words mean. Today I asked two questions at the end of rounds. One was about whether the stent they put in was or wasn’t going to need to be replaced because GI had said both answers at different times. The second was “so I understand what albumin does now but how low can a human’s albumin get before he, just, y’know, pops.” (Albumin is a protein that keeps fluids in your cells where they belong. No albumin should make all your insides into abdominal fluid.)
And the resident looked at me and I looked at him and the attending said “oh he’s not going to be able to answer that.” And I said “ok” and then looked at the attending who essentially shook his head as if to say “because nobody knows that” and then proceeded to tell us all about studies where they’re testing whether giving liver patients albumin in an outpatient clinic will improve their health.
My other winner this week was “if the hypothalamus tells the pituitary gland to release TSH and the pituitary gland sends TSH to the thyroid, and there is no thyroid, but we’re providing enough synthroid to create stable levels of T3 and T4 then why is the TSH still climbing? Is the hypothalamus on some kind of hallucination or is it the pituitary gland?”
I got told to ask Endo.
Endo was not prepared for the question and essentially ran like hell.