It was May 29, 2015–Dad’s 5th day back in the ICU and his 18th day in the hospital. The other day they simply removed excess fluid; today, with the return of the dialysis machine they also cleaned the blood. What they didn’t tell us on either day was that his creatinine levels were about 4x above normal, which would have been disturbing to know.
Before Dad’s admission to the hospital, I never paid attention to creatinine levels in my Complete Blood Count (CBC) results for my own blood tests, but the creatinine and blood urea nitrogen (BUN) levels turn out to be pretty important markers for the kidneys. When the kidneys are working, they eliminate fluid and also clean the blood. When they aren’t working, fluid can accumulate around your heart and in your extremities, and creatinine accumulates in your blood. Sometimes the kidneys perform one function well but fail on the other. They need to perform both functions well to avoid dialysis. According to Dad’s chart, his system was also acidosis, a condition that can occur when your kidneys and lungs can’t keep your body’s pH in balance. Respiratory acidosis occurs when too much CO2 builds up in the body. Dad was so lucky; he was seen by both the nephrologists the pulmonologists. We were starting to see quite the parade of specialists.
Holly, another of the hospital’s speech pathologists, administered another bedside swallow test. Although he failed it again, Dad did show signs of improvement. For Holly to get an accurate assessment of his swallowing, Dad needed a modified barium swallow study (MBSS). Along with everything else that was scheduled for Monday, June 1, we hoped that he could have that test, too. He was getting tired of chips and sips.
After dinner, I went back to the hospital to visit with Dad and meet with his night nurse. Nighttime was scary for me and my mother, especially as my father started drifting toward a delirious state. I couldn’t relax until I knew who the night nurse was and had had a chance to talk with him or her. Dad’s needs were pretty simple: he needed to go to sleep with his suction tube in his right hand, the call button in his left hand, and his feet covered.
Meanwhile, I felt like I was starting to fall behind at work. Even with getting up at 3:30 A.M. and working between trips to the hospital and on weekends, I had a difficult time working 40 hours. Once again this week I had to take another 8 hours of paid time off. My manager wasn’t complaining about my unorthodox working hours, but I was starting to feel like I was hiking through peanut butter.
May 30 was Saturday. Stan was in Temple and he spent a significant portion of the weekend mowing my parents’ acre lot. He also handled all of the chores that we were too tired to tackle during the week. Then while Stan visited with Dad, Mom and I acquired a prepaid mobile phone for my father. He had decided that he wanted to be able to call us, although I had serious doubts that he would. After entering all of the important phone numbers (like mine, Mom’s, and Stan’s), I showed him how to use it.
It was during this time that the Infectious Diseases residents and doctors started visiting Dad’s room. They all said the same thing; because of his pneumonia and multiple infections, he’d be on antibiotics for an extended period—maybe 6 to 8 weeks.
After dinner, Stan and I returned to the hospital to run through the evening drill with Dad and the night nurse. When I removed Dad’s hearing aids, I noticed that one was missing. We looked through his bedding, to no avail. Fortunately, on May 31, when Mom and I arrived at the hospital, the nurse told us that the night nurse had found the missing hearing aid.
Dad had received quite a few cards, which Mom had brought to the hospital to show him. In addition to the cards that he received from their long-time friends, he had been the Member of the Week at their church, which significantly increased the number of cards that he received.
Every morning the nurse or the doctor asked Dad a series of questions: What’s your name, when were you born, do you know where you are, why you are here, and so on. He hated the daily drill, and as one day drifted into another, it became more difficult for him to remember the details. During the previous day Dad had had me create a cheat sheet of sorts on the dry erase board in his room. His day nurse, Sara, discovered the note and erased the board.
This week’s doctor was Dr. White. I had met him a couple weeks earlier when my mother was in the hospital. He was also her doctor in the Medical Intensive Care Unit (MICU) during her brief stay. Although I sometimes kidded him about his name, he was no relation to one of the hospital’s founders. Dr. White told me that they would move Dad to a different room later in the day. Since the tornadoes earlier in the month, he had been in an interior room. The doctors thought that he was becoming disoriented and that having a window room might help him. The doctor also told me that Dad would be moving back to the fourth floor the next day. The doctors suspected that Dad had empyema of the chest. To address it, Dr. White said that they would insert a couple of catheters in his chest to drain the pus and other infected fluids. Evidently, the accumulation of fluid was too much for the antibiotics to handle. He also mentioned that at the end of his hospital stay, Dad would be transferred to a long-term facility that could handle his various needs– provide strength building, and dialysis if necessary. I guess that they had decided he was improving; his WBC count was down to 22,000—only twice what is normal.
Dad’s dialysis ended at 4:30 P.M., and he and Mom watched a golf tournament on the television. This might have been the first television show that he had watched since his hospital stay started 20 days ago.
Keeping with our good day, bad day cadence, Mom and I thought that today had been a good day.