Sunday, May 9, 2010

"But I was only gone for two days!"

Steve has been recovering from his aortic valve replacement and coronary bypass surgery since early March. Slowly eeking towards a stint on Rehab, we have seen progress daily -- but it has been very slow. He hasn't been able to stand up. He can now sit up with help, and only last week he wiped his chin for the very first time!

I had a medical conference to attend in New Jersey Thursday and Friday of last week -- a training event offered only twice a year. I orchestrated my flights so I'd spend the least possible time away, leaving late Wednesday afternoon and returning Friday evening. Besides, I could speak to Steve on the phone.

When I spoke with him on Friday noon, he sounded fine.

But when I got to the hospital at midnight, he had a temperature of 101.5, his white blood cell count had doubled to 26, and he was disoriented.

And I mean really disoriented. The choppers were landing behind his sister Carole, and he was begging to get out of his birthday suit! He couldn't get comfortable, and the focus of his pain was his right upper abdomen.

While there were a number of possibilities, acute cholecyctitis was the leading differential diagnosis. Blood cultures were drawn -- and were growing bacteria (enterococci) by Sunday. A trio of heavy-duty antibiotics was started, and as I write this, Steve is in the Interventional Radiology Department having a drainage tube placed in his gall bladder. He's far too fragile for either a laparoscopic or open cholecystectomy; that will have to wait for a more stable time.

The trip to Interventional Radiology affords Steve another advantage: he needs more IV access. Already dialyzing through a tunneled subclavian catheter, Steve needs more lines for the raft of antibiotics needed to fight his sepsis. The right arm -- with its "curing" fistula-in-development -- isn't an option.

I'm pretty sure there's nothing I would have picked up if I hadn't gone to my conference - if I'd stayed in Seattle. But, a flash of guilt assuredly did pass through my mind.

Caregivers need clones. We can't be everywhere; we can't anticipate every bump in the road. But we somehow feel we should be able to protect our loved ones from fates beyond our control!

As I was reminded on the plane from Newark, "place your own oxygen mask on your face first, and THEN tend to your children or other passengers who need assistance." We have to give ourselves a break! And everything is simply NOT within our control.

Take care. Linda Gromko, MD

3 comments:

  1. 最敏捷的,未必贏得競賽:最強大的,未必贏得戰爭:時間與機會才是主人 ..................................................

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  2. You CAN'T be there all the time. I have to remind my husband of that frequently. And beating yourself up doesn't help you or Steve. Take care of yourself, too.

    Hang in there.
    Sending psychic antibiotics to Steve and vitamins to YOU!

    Love
    Miriam

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  3. Miriam, thank you for your encouragement -- and, of course the psychic antibiotics and vitamins! Believing we have control over everything is, simply, magical thinking. But I think that's a common part of the hypervigilence caregivers often feel. BTW, I am sending you karmic wishes and courage. Take care, Linda

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