July 30. 2012

Outside Temp: Not sure... didn't go outside again.
What I cooked today:
Nothing... boy, do I miss home cooked food.

Update:
Day 5 in Seattle:
I woke up this morning around 7:30, excited about Ryan going to the OR to get his new line.  The doctors had come in last night to get signatures and stuff like that.  I knew he was on the schedule for the morning, although they didn't tell me what time.

So, around 7:45, the GI resident came into our room.  In a kind of simple way, he said:

"Ryan has been taken off the schedule, because the surgeon was worried about pus in his line site, so they aren't going to put in a line, but they'll talk to you about putting in a PICC line."

The worst part was that this poor kid, a first year resident, had absolutely no idea how that news would be taken, or how to handle it.  As anyone who has ever seen me argue with Dr's about Ryan's medical care can attest, I got a little upset.  I informed him, in no uncertain terms, that I was not happy about this turn of events.  There were a few very strained terms, followed by some critical words, a little bit of undesired tears (I can't really control them when I'm upset) and a blanket comment:

"You can let the team know that I'm very upset."

The poor kid couldn't get out of the room fast enough.  He apologized and made a few references to not shooting the messenger.

Around 9:30, the social worker came by.  She was going to discuss our plans to go home, since I have no idea how we get from the front door of the hospital back to Great Falls.  She was lucky, that my rage and frustration had started to calm down a little and I was able to talk calmly.  She was very nice and, after discussing my concerns about lack of communication and frustration with the turn of events, let me know that she would work on how to get me home.

By 10:45, the team came by for rounds.  I was lucky, in that I actually recognized the GI attending who is covering Ryan this week, a really nice guy who we met in clinic last month.  I explained why Ryan was taken off the schedule, and my concerns about how the surgeon may have been confused and we really needed a line.  The GI doctor came in and checked out Ryan, and essentially said that there was no problem and surgery must be confused.

Around 11:45, a surgeon came in to discuss the problem.  He looked and Ryan, and felt around, and said that he thought there might be some infection in the location of the original line, and wasn't comfortable placing a line.  At this point, I asked him, "if you think there's an infection, why was there no cultures taken, and no changes in his antibiotics".  In other words, they weren't treating the infection they were using as an excuse to not place the line.  The surgeon also had some criticisms about the GI doctor's assessment.  I explained that I was not happy or comfortable with his analysis and could he please discuss the case with the GI doctor.

Around 1:00, the surgeon came back and said that he had talked to the GI doctor and they had come up with a compromise.  They would take Ryan back to the OR, and explore the original site.  If there was an active infection (i.e. pus), they would stop and wait a few more days.  If there was no pus,. they would attempt to place a new line on the left side.

For the next hour, I tried to be patient, and not let my mind run away with me.  Thoughts of how the surgeon would make there be pus, even if it wasn't really there, just so he could be right, floated through my head.  I'd never met the surgeon, since it would be someone different than the guy I'd been talking to this morning.  Of course, cooler heads prevailed (i.e., I talked to Patrick and his mom and they both told me to get over it), and I was relaxed by the time we got to pre-op.

By a little after 2, we were in pre-op, where I finally met the surgeon.  He was a really nice guy, (reminded me of our surgeon at UCLA, who I really, really liked) and listened to me when I described how important the line placement was, and complications we'd had in the past, and so on.

By 2:45, they wheeled him back to the OR, and I went into the cafeteria, to eat for the first time today (yea, by this time, I had a headache and I was cranky, with no food in my tummy).  I figured that, if the had any problems, I would get paged by about 3:15.  3:30 came and went, and still no word.

By 4:15, I got a page, and was sent to a consult room, where I waited until about 4:45 for the surgeon.  They had no problem and the line went in on the left side.  No pus, at all, and no complications.

Woo hoo!!!!!!

By 6pm, Ryan and I were back up in his room.  He was still a little woozy from the sedation, but there was a brand new line in his chest!  It turned out that the PIV we had been using in his arm blew during the procedure, so they had to put in a new PIV on his hand.  I knew the PIV in his arm wouldn't last much longer, but boy am I glad that it waited until he was in the OR to blow!

At 8:45, I ran downstairs to get dinner and when I got back up to the room, there was blood all over his bed.  Okay, it wasn't that much blood, but it looked like a really bad bloody nose.  Nope, it was Ryan, pulling out the new PIV they put in his hand.  I guess he knew that we didn't need it anymore, so he took it upon himself to remove it, without permission.  Boy, was I glad that we had our new pretty central line!

I have no idea how tomorrow will work out, but at this point, I'm just super glad that he has a new line!  Maybe, we can even start discussing the 'going home' issue... how are we getting back to Montana?  I have no idea.