Sunday, April 06, 2008

Checking out the local hospitals: Step 2 - Kaiser

So today Hubby managed to turn the tables on me. At 2am this morning I woke up to find that he had been vomiting for two hours already. By 4am he was dry-heaving every 20 minutes. By 6am it was both ends and I was done - we were off to the emergency room.

6.5 hours, 3 liters of saline, a narcotic, and a 'send you loopy' anti-nausea med later and we managed to re-emerge into the world.

Cripes, what a morning! It was pretty worrying there for a while because he was dehydrating rapidly, the nausea was overwhelming, and then the shivvers and joint-pain set in. I remember all this acutely because I had something similar right before Christmas in 2006. Fortunately I got myself to the urgent care facility right as I started vomiting and they stabbed my right butt cheek with some anti-nausea meds. Hubby said he knew I had to be really sick because I didn't hesitate in pulling down my pants and offering my buttocks for the on-duty doctor and his big ole needle. Any day I beg for the needle is a day you know I'm not doing well.

Unfortunately, Hubby went longer before they got him the anti-nausea meds. Although we got there at 6:30am and nobody (and I mean nobody) was in the waiting area, it took them 3 hours to get us a doctor. The nurse came in and got him started on the saline solution but no meds could be administered until we saw the doctor. Let me tell ya, it was a looooong three hours. And wouldn't you know it? The minute I went downstairs to get a coffee, he comes in! Boy, was he worth the wait though. This was one hot ER doc, not out of place on the TV show itself. Even Hubby, between shivvers, had to admit that was one good looking guy.

The wait was made even longer by the sad plight of the old man in the room next to us. He was clearly in a bad way when we came in. He had fluid on the lungs and, judging by the conversations between nurses, had been dealing with chronic illness for some time. As they were about to treat him, he said "I just want to die," which stopped the doctors and nurses in their tracks. Obviously, now they had to confirm what they heard and validate what he meant. So they set about questioning him to ensure he was of right mind (What is the year? Who is the President?) and then asked him whether he meant that he didn't want them to intubate or resussitate him if needed. It seemed that that was, indeed, what he wanted. The sad result was that the doctor told him he was probably going to die. They tried to get him to let them call a relative but he refused. He had nobody with him. The nurses continued to pursue calling his wife and son and eventually, just before we left, he agreed to allow them to call his wife but refused his son.

Gosh, what a sad state of affairs. You just have to hope that, if you're ever old and thinking about saying goodbye, the people who love you will be there by your side without question, request, or reservation. I can't imagine anything worse than being alone in that situation or, sadder still, feeling that there was nobody you wanted to be there with you.

What a moral dilemma these doctors and nurses face in these situations. This man was in a lot of pain and on a lot of pain meds. How do you make the determination that he is or is not of right mind to request an on-the-spot DNR? On the flip-side, it had Hubby and I wondering what happens when a patient with a DNR on file comes in and, at the penultimate moment, requests that they ignore the DNR? I'm sure there are procedures and policies in place for this but I can't imagine that there isn't some level of subjectivity involved. That, at least, was clear from the number of different ways in which the staff continued to probe him about his wishes

Hubby is doing better, by the way, but the nausea re-emerged late this afternoon. Luckily they sent us home with meds to plug up every possible leaky hole

In other news, while it's 72 degrees here in Sacramento, it's SNOWING in England. My parents rarely get snow as it is but snow in April is almost unheard of. Here is the pic to prove it, however.


e said...

Poor pumpkin, what did he catch?

TravelVixen said...

Well, originally he was convinced it was food poisoning but it was so long after he ate that he started vomiting that I don't think so. Also, he was still feeling bad last night and isn't perfect today, so now we think it was some kind of stomach flu/virus. Who knows? All I know is that it knocked him out for the count, which is quite something for him. He usually manages to power through whatever he has.

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