85 Hours and Counting

It has now been four days at Howard County General Hospital. The first day was mostly spent in the emergency room. The second day was punctuated by refining the pain management with a lot of sedative induced sleep time. On the third day Faina was comfortable, awake most of the day, up, walking around, and always straddling that border between comfort and pain. Today Faina was up a good part of the day. We took one walk covering the fourth floor from end to end and a second, shorter walk.

This whole exercise has been driven by the need for pain management. While the nurses are completely clear in their understanding of this as the first order of business they are often stymied in their efforts. While in the emergency room, the nurse had to wait for the doctor's ok to give a pain killer. It took three one-hour cycles before he finally made the four mg dose a standing order. This was a case of be involved and be present or delegate where delegating is really not an option. After being admitted to the hospital and given a PCA (patient controlled analgesia) pump, there were two times where the pharmacy did not have the dilaudid ready before the pump's supply ran out. In one instance it was on its way to the room and in the other, the nurse hustled downstairs to get the syringe the moment it was ready, cuttting out the delivery man/middle man from the process. One other nurse said she orders the next syringe early and keeps it in her pocket, at the ready. All of today, the pain was under control.

At one stage there was concern that Faina could have a blood clot, so she was sent to radiology for a CT scan. A later concern led to an order for an X-ray, but Faina refused to go along with that. Three times Faina was offered a flu shot. After the third refusal, and a question asked along the lines of: do you get a bonus for giving flu shots. The nurse said, "As a matter of fact, we do." She added that she could check a box that said "Patient refused" and the question would not be asked again.

There were a number of visitors today. Mom, Dad, Margo, and Jamie. Also our wonderful neighbors, Amy, Linda, and David. They are constant reminders of the wisdom of selling the Wolf Creek house and moving a few miles southwest to Fulton. Given the hit to the price of real estate, we are underwater on our mortgage, but taking residence in this community, is worth every shekel.

Among the last of the visitors was Dr. Knight. He has been covering for Dr. Koutrelakos, who is on vacation this week. He saw the CT scan results and his concern is fluid build up. He thought it could either be retaining water since the hospital has Faina hooked up to many constant flowing IV solutions. He said there is also the possibility of ascites. He suggested a PT scan as soon as possible and an appointment with the well rested Dr. K. without haste.

The last visitor was Dr. Matsunaga, the pain management specialist. Dr. M. was pleased with the situation and said that Faina could be discharged tomorrow. She would get a take home PCA pump and Hopkins Healthcare would keep her supplied. While we were hoping for a speedy discharge process, the nurses disabused us of such fanciful thoughts, and described a timetable that is likely to bring us close to sunset.

86 hours and counting.