Done Since 2021-07-04
2021-07-11 09:35 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
mdlbearColleen spent the entire week in the hospital -- WhidbeyHealth Medical Center -- waiting to get a transfer to UW, which has the specialists she is going to need for surgery. As of this morning her condition had worsened to the point where they decided to operate on an emergency basis this morning.
She made it -- she's one tough old lady.
She'll be transferred to UW as soon as she's stable enough for it to be safe to transport her -- tonight or tomorrow, hopefully -- where the specialists can finish fixing her up. Details in State of the FlowerCat Episode 9 probably.
For the sake of continuity, today's part of the log has been moved up. You'll find it under the cut with the rest of this past week. I've also been working on a post about Cordwainer Smith, but it's not finished yet. Life happened.
Notes & links:
0704 Independence Day
* Up 5ish; S=5:31, BP=140/83, P=64, W=200.2;
/ call 6:50 still waiting, but she's been accepted at UW or Harborview, and they've been
called to make sure she's getting what she needs. She's actually producing urine but
it's coming out her rectum. -> Dr. called, mainly asking about anticoagulant; they'll
restart with heparin or ??? while she's there.
@ The Windows 11 rollout: Microsoft’s most-botched announcement ever
% where the hell did this week go?
/ 12:12 call from Colleen. She started out sounding pretty down, but perked up when I
said I would come up to see her.
& 1ish up to see Colleen. She seems to be eating well today
* send email to Dr. Harper's office about her upcoming appointment. The way things are
going it looks like that may be in person rather than by zoom.
& Finished reading "The Boy Who Bought Old Earth" and started "The Store of Heart's
Desire". (been _ages_ since I read that) Writing a post about Cordwainer Smith has
certain occupational hazards.
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/ I've been here about 9 hours; the hospitalist was supposed to have come to talk to us.
(RN)Steve has been helpful, but... He says this kind of thing isn't all that
uncommon, and that UW estimates that beds will open up on Tuesday. It would be better
if she could have had PT at least; she may get a PT evaluation tomorrow.
% my left eye has been itching all day, as usual
% meloxicam 11:35
0705Mo * litter boxen
* up 5:50; S=6:04; exercise, shower
% some hip pain; exercise seemed to help
* put new battery in car remote
* Colleen wants assorted lollypops. Half sweet, half sour. ~ Travel-sized box of
band-aids -> in box of-> * Desitin.
* arrived at Coupeville ~12:45 -> leaving 4:30
% pain seems to be extending down my right leg, on the inside. consistent with sciatica
% meloxicam 6pm with evening drugs; heat
: S made blueberry muffins
0706Tu
* up 6ish; S=6:22; exercises
% right hip pain p=4 -> heat. Not clear whether the exercises helped
* call to Freeland clinic asking about a provider who makes zoom calls. left message
~ 8:45am Dr. Jason Harper & Dr. Eric Snyder zoom log in 10m early
-> DAMN wanted to talk directly to her. So I fscked up. Again. -> 0720Tu 9:30
(S thinks I made the right call; there's no privacy in the ER, and I had no idea when
C would be transferred so she might not even have been there. But... But...)
x Colleen 1:30 checkin for 3pm upper endoscopy, Swedish First Hill
covid test 72-48 hrs full PCR Need it on paper if not at a Swedish.
* singing: Ship of Stone, Mother I Climbed (which needed some chords fixed)
& call to WhidbeyHealth hospital to ask about insurance. Left callback # with billing
-> callback transferred me to the "insurance verifier" who said that if it's
"medically necessary" Medicare will pay for it. Presumably it is, since WH can't
do what she needs.
% I am in a rather bad place mentally. Probably shouldn't be surprising.
/ possible UW PCP's: Dr. Chopra at Shoreline -- accepting returning patients
Dr. Martin Cahn at Fremont -- family members (e.g. N)
* Go to Freeland Clinic and ask. They have one doctor there who does telemedicine, his
next available appointment is in August, and he's only going to be there until the end
of September. So,... no. I Do. Not. Understand. what the problem is with telemedicine.
/ call UW and schedule appointment for Colleen with Dr. Chopra, Shoreline Clinic (video)
-> Th Jul 15 11:30 telemedicine Dr. Chopra
/ 7ish call from the ER doctor - she's been admitted (just a few minutes ago) Rm. 2209
no word from UW; that plan could change. Apparently she's been doing better today
Colleen called a couple of minutes later. Reminded me that it's R's birthday, so I
& sent R a birthday email.
% drained. Also headache.
% 8pm meloxicam with evening drugs
% 10:10 tizanidine. Maybe it will help with the pain p=4.5
0707We
* up 7:15; S=5:48; exercises (reduced set)
% hip/leg pain p=4
-> go in to urgent care to get it checked out (Colleen and S insisted)
-> Dr. Rookstool; x-rays of hip; there for ~2h
-> signs of osteoarthritis; prescription for prednisone (5 days)
* 15min: tweaking wssetup
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* up to visit Colleen; stayed until ~6pm
-> she's on a clear liquid diet and feeling much better after a bout of stomach pain
yesterday. (May be why they decided to admit her)
-> Also, she has a central line (about time) -- may be another reason to admit her
% 8:45 hip pain p=4.5-5 -> meloxicam with evening drugs
0708Th
& Awake 1:50; back to bed 3:25; gave up 4ish; S=3.9; back to bed 5am
% no hip pain; a bit unsteady just after getting out of bed
* up 6ish; S=5:00;
% took evening pills by mistake. Fortunately switching isn't too bad
% took prednisone. Having cereal because directions say take with milk/food
% hip pain 5 -> acetaminophen 6:30ish; using cane
/ up to Coupeville. Nurse said her kidney function has actually improved slightly since
she arrived. (OTOH it's all going through the fistula)
: E and M found a nice house in Tacoma. Putting an offer on it and getting a tour Mon.
(relative order of offer and tour unclear at this point)
~ _carefully_ inspect middle (wallet) section of backpack to find whatever stabbed me
... and of course now that I'm trying to find it, it eludes me.
@ Amanda Palmer: The art of asking | TED Talk finished book
% meloxicam ~10:30. Pain negligible
0709Fr
* up 5am; p=3.5; acetaminophen 5:30ish, prednisone 5:40
% back pain ~3.5; all in one knot on my hip, so that's almost certainly a muscle spasm
-> acetaminophen, heat
: fire alarm beeping often enough to be located -- the one in the hallway outside the
bedrooms. S volunteered to go up the ladder and change the battery. Apparently it
also blinks, but that wasn't obvious in the daytime.
& hack `make save` so that it preserves previous `Saved on` messages.
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* up to Coupeville noonish after stopping at Payless to see if I could find beef tea.
Couldn't, of course, but picked up glass cleaner which I used on the front windshield
in the parking lot, and a fritter, which I only had time for a few bites of when I got
to Coupeville because bladder.
/ Longish conversation with (Hospitalist)Dr. Yousef, who came in after talking with UW.
The only reason she'd need to go to UW would be surgery (waiting for a bed in the
surgical unit), and it looks like there's a good chance she won't be needing it (and
is a very bad risk), so she'll be staying here for a while longer while they see how
things are progressing. Kidney function continues to improve. Scheduled for CT scan
to check catheter position and fistula. She should be getting PT soon. Asked to talk
to social worker -> they're busy and leave at 4pm but will definitely touch base
today either in person or by phone. -> didn't
/ PT came in ~3:30. She'll be working tomorrow too.
/ 5:37 (Nurse)Bea (pronounced Bayah) came in to say she's NPO, presumably because of
something they saw on the scan - Dr. Yousef came in ~5:40 the radiologist said she may
have a bowel perforation, which would indicate surgery. But labs and exams don't seem
consistent with that, and she's not in nearly as much pain as would be expected.
Surgeon will look at scan results, should have more info in half an hour or so.
Colleen is not happy... 6:24 nothing
/ 7:50ish Seems like adjusting the catheter position (pulling it out a little) has
restored normal urine flow. Dr. Yousef and the surgeon agree that it doesn't look
like a perforation; they've been consulting with the radiologist and also sent the
images over to UW. My guess is that she won't need surgery, but of course things are
still a little up in the air.
: Colleen called to say that someone in the medical center went to Jr. High and High
School with me. Garth Miller? If I remember him it's only very vaguely, but he looks
about the right age -> C thinks she remembers Ortiz, but that's not on the staff list
% meloxicam 10:35
0710Sa
& Awake 1am; down 2:25
* up 6:35; S=5:34, BP=139/77 (H), P=66, W=200.0; exercises; done 7:10
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" QOTD: tw:@FreyjaW:
"It’s a well known fact that the coconut isn’t actually a nut. They are covered in
hair and contain milk, so coconuts are technically mammals. -Tony Cowards" "
/ called Colleen. Stomach cramps.
* 15min: attached a piece of rubber to the long end of a cane handle. Works well for
hanging. I have another piece that I'll use on my other folding cane.
/ social worker. Whidbey Drives; Island Sr. Resources. Thinks C may be transferred.
Talking about it I realized that she's getting telehealth from Dr. Juaire, so
insurance should cover it.
/ at Coupeville 12:15ish; considerably more pain than yesterday, no urine in
bag. (nurse)Mary is off to fetch morphine. Asked to speak with Dr.
2:10 Doctor just left; going to talk to surgeon again. Probably going to UW, because
what they've been doing -- over the last 3 1/2 months -- hasn't worked.
-> (Surgeon)Dr Angelos knew a Kieth Savitzky in New York. He remarked on C's lovely eyes
-> They're going to do another CT scan, with contrast. The fistula is large and has
been there for a long time. (Disturbing parallel with the water-line break we had
fixed last October.) Likely to get emergency surgery tonight or tomorrow, possibly
before transfer to UW)
/ N has permission to visit Colleen; she'll be on the 5:30 ferry.
/ 5pm nasal swab for COVID test.
/ 6:30ish X-rays to see how far the contrast solution has been getting.
/ called V, E, R, and S. Sent around an email. Will probably be draft for a post,
maybe tomorrow. N arrived 7ish
/ 9ish CT scan. Stopped giving her contrast fluid because nausea, possibly indicating
an obstruction. She'll get more rectally. (Ugh. I remember having a barium enema
for a bowel obstruction; I think I was somewhere around four years old, give or take
a couple. The imaging tech agreed that it's not something one forgets.) Back 9:30.
/ back ~9:30. No sign of a perforation/peritonitis, but a lot of colon distension and
it's not clear what else. Pain localized in one area on the lower left
-> surgery probably tomorrow afternoon unless she can get a transfer
0711Su o litter boxen
* awake 6ish; S=5:35; short exercise
% back pain mostly left side, p~=3.5 -> heat
% trying to decide whether to try to go back to sleep -> 6:45
* up 8:30ish; S=7:26; shower
/ Colleen called 10:48 to say that she was going in to surgery -- they moved the
schedule up because her white count was going up and they didn't think it would be
safe to wait until afternoon. Updated kids and V via email, discord and text.
~ call to update kids, V
~ head to Coupeville ~11:30 -> 11
/ Spoke to (RN)Ellen in the ICU, where Colleen will be after surgery. Plan is still to
do damage control (clean out the infection, remove things that can't be salvaged)
here, then keep her sedated and on life support until she can get transferred to UW to
have the specialists there finish the repairs.
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/ Came out of surgery ~3:15. Dr. Yousef came out first and gave us a summary; then
(surgeon)Dr. Angelos came out with the details. She was a mess, and he did a lot.
Stitches to the bladder to close the fistula, removing ~7cm of bowel (which she was
way short on to begin with), strictureplasty (widen narrow spot), loop colostomy,
remove calcified, probably-infected mesh from earlier hernia repair, adhesions, other
cleanup. 3-way call with UW around 5pm. The next 12-24 hours will be the most
dangerous time. She's going to need more work when she gets to UW. Call with UW
scheduled for 5pm; rumor has it that there _is_ a bed available.
@ Is a Loop Colostomy Permanent? no.
" Loop colostomies are usually temporary and generally preferred over end colostomies
if the intention is to reverse it at a later date. "
& A bit of Linux evangelism after (respiratory therapist)Chris complained about his
computer having been down, and I said "I could make a disparaging comment about
Windows, but it would be a cheap shot."
/ 6:20 Dr.Yousef came in to report that they'd gotten off the phone with UW; they have a
bed; they want to get her BP stable before trying to transfer her -- raising her BP
using a vasoconstrictor has to be balanced with the danger of reducing the blood flow
to the bowels
* Dinner at China City on the way home. Comfort food.
* start laundry
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Date: 2021-07-12 04:55 am (UTC)no subject
Date: 2021-07-12 05:15 am (UTC)no subject
Date: 2021-07-12 05:52 am (UTC)no subject
Date: 2021-07-12 07:27 am (UTC)Much Sympathy
Date: 2021-07-12 02:17 pm (UTC)