The First Rule

When things are going good, you shouldn't talk about things going good.  Muuhahahahha.  Insert evil, over tired, confused laugh here.  Sunday we were all having a Star Wars marathon with lime sriracha butter popcorn. We already did our Costco run and I vetoed laundry.  Tra le la and the patient is all I can't get my arm to stop tingling.  So we move him to the chair, give him a few minutes, and then off to the ER we go because it is still there.  They take him straight to the CT scan (so that was a really nice response).  They don't see anything specific on the scan but do believe he is having an ischemic stroke.  A small one that doesn't really seem to effect much.  He had one moment of confusion where I was thinking oh snap but everything else seemed normal.  His blood pressure was higher but that was also a lot of stress and bustle.  Anyways, based on risk (aneurysms, age, history) they decided not to give him the clot buster medicine.  I support that decision.  Because of his history, age, condition, they have decided to keep him for a day or three for observation.  They are doing carotid artery ultra sounds, CT scans of back for pinched nerve, EKGs, and an MRI.  He is also not having as much success as we would like without the catheter.  They are doing straight cath every 8 hours.  I see this procedure being in my future.  He is probably borderline UTI.  Lots of waiting.  A tad bit of discouragement, but the patient is in such a better state than the last time he visited the hospital.  The Drs are all speaking positively about it and I think it helps the patient to feel encouraged.  He does not seem to be anxious.  Just settled in and is patiently waiting for discharge.  I was really hoping not to have to add anything to the worry list, but if we must we must. 

The most discouraging moment of my day shall be described next.  The patient's wife and I left the hospital around 1:00 AM.  Around 4:30 AM, Hunter was downstairs getting ready for work.  The patient's wife was looking for the patient.  The patient's wife had forgotten that he was at the hospital.  Hunter had to remind her. This really gets me in the gut and heart. I also know that stress, lack of sleep, and missed medicines can really mess up the patient's wife's memory and that the patient's wife was half way asleep at 4:30.  Anyways...just gonna leave this right here and try not to think about it.  Maybe I am reading too much into this.

I worked 7 minutes today, ate a large #2 meal from McDonalds (ate every fry, I did), and took Kate to soccer practice.  Side note..I love how excited Wyatt is about Star Wars.  We got the Golden Books and he really loves the characters and story line. 

A Positive Post

Who wants to know what has been going on around here?? (me, me, I do, I do). 

First off, can we get a huge hallelujah, praise God!  The elderly patient I am caring for has made huge steps.  There is walking (with a walker).  There is voluntarily asking to get up and be a part of the home (dinners, staying in the kitchen, not hiding in front of Fox News in the bedroom, maybe even laughing or making an occasional joke).  There are steps towards getting into wheelchair on own.  The last stool sample tested negative for c. diff.  And our biggest progress, the catheter, that has been in for 6 months, is out.  I really could not have ever planned or even hoped that things would be going this well so obviously, this is not because of me but because of HE.  The feeding tube may be coming out soon and at that point, he could be tube free?  I just can't even imagine.  The care check list is going to be toned down to give medicine, provide insulin, and eat.  I am not sure I am expressing this clearly enough but seriously this is AMAZING progress for 1.5 months.

Also, selfishly, my life feels good.  I am sleeping all night.  I am back to running and weight lifting.  I am currently going through the "getting back into shape" starvation phase.  Every time I get back into working out, I get back into EATING as a full time job.  I can leave the house and things will be fine.  I am so happy.  Aside from the fact that Hunter is gone 12 hours a day Monday through Friday.  Why can't jobs be closer, and companies stick to a true eight hours, or reward employees with early Fridays.

The kids made some progress in soccer today.  For Kate, she actually stepped onto the field and kicked the ball around.  Wyatt got some kicks too.  He is still lacking in confidence which means he has a tough time being a go getter and playing aggressively.  Watching kids play soccer is such an interesting science personality experiment.  The crying.  The smiles.  The excitement.  The pride.  The annoying parents.  The bribery.  The hitting.  The heat.   Please, please let the heat go away.  2-3 year olds should not be playing in 90 degree weather.  Ha ha.  The 4 and 5 year olds have a tough time too.  The kids say can I please go get a drink of water and I slap them on the back and say "no you need to be tough for 2 more minutes" and they do. 

Speaking of being tough, I am training my nephew for his first 5K.  I decided to sign Wyatt up too.  We are doing a kids 5K training plan.  3 times a week for 4 more weeks and then we have the big race.  Kate is going to be so ticked she isnt in the race.  The finishers medal is a Bat medal so really it doesn't get much better than this for his first 5K.  I hope he enjoys it.  I am surprised at how well these guys are doing.  Today we did  6 times of run 4 minutes, walk 1 minute and they mostly did it.  I do lots of explaining about digging deep and using your brain to tell your body that they aren't tired.  We also do lots of guess what animal I am thinking of.   Some I Spy too.  Running when tired is such a mental game.  I can't wait to see these boys fly when its cooler and running is a joy.  I hope its a joy.  It should be a joy.  We human beans are meant to be runners (when we are young and the joints work at least).  I hope this is a big confidence booster and persistence teacher for the nephew.  Lots of hope.  I am going to try for 7 or maybe 8 miles tomorrow for myself.  The miles are slowly going up and the pace is slowly getting faster.  Who knew that pneumonia would totally knock me back.  Why does it take a month to lose what the body achieved in a year!??!  Not fair.  I am signed up for a 10 mile race in a few weeks so I can't back off.  Last weekend was the first time I didn't have to walk on my long run day and my pace wasn't discouraging me. 

So there it is.  One positive post.  Tune in next week for the usual dose of negativity and sarcasm. 

Blowouts

To any parent that has ever complained about "the blowout" diaper change for their baby / kid, I would like to introduce you to the "adult blowout".  People who have handled an adult diaper blowout are elite, special, brave, strong, and know how to use 72 wipes to get the job done.  Sometimes the adult blowout can take up to 43 minutes to manage.  So parents of baby blowouts that have complained, HANG YOUR HEAD IN SHAME.  Think of the people handling adult diaper blowouts and move on.  These also require anywhere form 4 to 6 gloves. 

You see, my elderly patient, aka iCant, has been on the antibiotics for many many months.  He has also endured some stays in Long Term Acute Care and Skilled Nursing / Rehab facilities.  He has picked up a few shiny antibiotic resistant bacteria along the way and killed all the good bacteria in his body along the way.  I won't even pretend to understand all these things.  MRSA, C. difficile, these might be our friends to stay.  The patient visited his infectious disease doctor yesterday.  This Dr is prescribing something new and shiny and expensive and probably took the office many hours to negotiate with insurance.  This one does not even have to be administered by IV.  Hip hip hoooray.  So after gathering yet another stool sample yesterday, I drove by the specialty pharmacy, that I literally waited on hold on the phone for over 120 non continuous minutes yesterday.  They had half of the order ready.  Next half to be picked up after another 120 minute hold.  So we are 24 hours in.  Will we see some changes?  Probably.  Will this fix the problem for good?  Probably not.  Until then, life moves on.  Side note..I saw an ad for adult cloth diapers.  I literally laughed out loud.  I love how browsers take your browsing history (like best adult diapers) and use that to manipulate your ads. 

Well I have 33 minutes until I go pick up my kids from preschool.  Yesterday, Wyatt got his folder sent home with a bad note.  3 warnings for not listening, being disruptive during circle time, and throwing toys.  This does not sound like my angel.  Maybe he is recovering from birthday, soccer practice, staying up too late for 4 - 5 days in a row. OR maybe this is what 5 is going to be like!?   Probably there is a bad influence in his class and he is giving into peer pressure.  TBD.  Today is also Hunter's birthday, so I am going to really dig deep and try to be pleasant (instead of totally done with all humans and caretaking) when he arrives home from work.  I am also going to make a dessert (as soon as my butter can go from frozen to cold).  He is a dessert man and I hate desserts and baking and making desserts.  I am going to go with this one... Chocolate Butterscotch Caramel Bars because there appears to be less dishes needed for this dessert. Also I bought some T Bones that I will serve with some sides that will magically appear and cook themselves and clean their own dishes tonight so that I can be a happy healthy loving wife like from the 1960s or whenever that happened.  Perhaps, I should stick to casseroles then instead of steaks.

Foley Catheter

Tonight I got to witness my very first Foley Catheter swap out.  I finally got to see the mythical balloon.  They always make you leave the room for this in the hospital, but with home health care I was like I wanna see and they say cooo'.  It did not give me the heebies at all so perhaps I missed my calling.  Are the personality types for software engineers and nurses at all similar?  Probably not.  I think you have to be a people person to be a nurse.  ZOMG they put up with so much.  Although I think the physical therapists receive much more of the abuse. 

Ok sir, now you are going to sit up and move to the edge of the bed.  Can you help me?  I need help.  Im already worn out.  You wore me out.  I can't.  We are done.  And the therapist just goes is this how today is going?  I aint gonna argue with you lets just get it done.  We can work on getting up out of the bed for the whole hour if we need to.  Then they start distracting by talking about something trivial and an hour later he walked through the whole house with his walker and my jaw drops. 

Days when we don't have a nurse or a therapist come to visit are so monotonous.  I will just be honest and say I struggle with chatting and being positive.  It is like I spend all my energy on care of patient and I can't spend any energy on speaking to patient like a normal human or just dropping in to say hi.  It's terrible of me!  The patient really perks up for strangers that come to visit because they genuinely want to chat or have practiced at being chatty or haven't had to care for this particular patient all day.   We hired an angel named Oscar.  He comes 12 hours a week.  He is 65 I think, and is excellent excellent.  I never want him to leave.  He drives 45 minutes on a good traffic day to come visit us.  He really helps to perk the patient up.  Helps with baths.  Trimmed his toenails that are outrageous.  Watches movies with him.  Helped me take him to a Dr appointment one day, so I didn't even have to sweat.  A dr visit requires like 8 patient transfers and I need to work on building up some more muscle because I am worn out at the end.  I am not one of those people that thinks of kind things to do for others like make cookies, or write a note, or pick up starbucks but I need to find a way to express my gratitude towards Oscar and all these therapists and nurses because I would not be surviving without them.  Maybe they can see it in my eyes when they walk in.  Wow....she really needs us! ;) 

Anyways, Hunter got to go have some cervezas with his coworkers which he totally deserves but I had to survive bedtime alone after patient care and it was hard-uh because both kids wanted me to lay by them.  I am going to treat myself to an early bedtime. Can't stop, won't stop. 

Caregiving and Taking

To protect the innocent, lets say I have accepted an elderly gentleman  into my home to take care of them. Maybe their name is Frank.  Or Benny.  Wait, I just thought of their bloggy name to protect the innocent.  Their name shall be iCant.  You see, iCant is really much stronger than he thinks he is but he has been shipped around to various hospitals and institution type places for half a year and has lost the ability for his brain to function and do things for himself.  iCant stood up all by himself about 3 times today.  Well done.

I just tucked iCant into bed for the night (after changing the 3rd or 4th diaper today).  I gave iCant a call button (just like a real hospital) because I HATE having to have my phone set to ring.  Silence forever and ever.  I just layed down in bed to peruse the inter web and celebrate the fact that my kids start preschool tomorrow and I hear ding dong.  iCant had to call me to ask if I gave him his long acting insulin.  Of course, I did because I am the BNE (Best Nurse Ever) and I have a check list and if you know me I am a PCF (Professional Checklist Follower).  The check list clearly shows a check mark in the long acting insulin box.  iCant can't see anymore though and iCant has a lovely lady friend that has started to lose her memory some...perhaps her short term memory...I am not quite sure.  Anyways, we got that settled for now.

I would like to state that being a caregiver is hard. Really hard.   I never knew?!?!  All these people that take sickly into their house it becomes their whole life.  I just blocked that out my whole life. But I mean I guess $80k a year in a place where they just treat you "just ok" and you will suffer from infections your whole life is not a better alternative at this point in life.

The diaper changes aren't hard.  I mean at first they are, then you get some skills.  And holy cows it is hard to find the right diapers at the stores.  Amazon or nothing now. The daily tasks are under control.  Maybe 45 minutes of medical care in the AM and 45 minutes of medical care in the PM.  It is just the ongoing help.  Turn them every 2 hours, clean the dentures, reach this, change the clothes, give the food.  It is like having a newborn that you can't lift that can argue with you about how they can't.

And now, the reason I am writing this post, to confess my guilt.  One nurse told me I can let iCant sleep all night without turning him every 2 hours.  Our assigned nurse told me I must turn him every 2 hours or his pressure sores will get worse.  All night.  She was like you don't have to make a big deal.  Just shift him.  Raise or lower the bed.  Umm ok lady. I am not one of those go right back to sleep people and if I show up down there I am going to get a request of needs/wants. Well, 2 nights ago I turned off my alarm and I slept and it was wonderful and his sores didn't immediately show up and I will never turn that alarm on again until a pressure sore reappears.  iCant's lady friend is helping out with this...I don't want to take all of the credit for the care. She is doing great for someone with memory problems.  Fo Realz.  Anyways, now that I got that off my chest, I am going to sleep until I hear ding-dong.  Perhaps my next post will be more positive.  iCant is able to do more every day.  Maybe we can give iCant a kinder name next week....like John, or Rick, or MaybeProbablyICouldTry?