It's Back and I Still Don't Like It

It’s a palpable feeling.  A blast of anxiety causes your heart to speed up and your breathing become shallow and too fast.  You can almost feel the adrenaline surge through your body as all of your senses kick into hyper drive.  

Everyone, I mean everyone feels it at some point in their lives. I don’t like the way if feels, it’s an uncomfortable feeling but it’s an important part of our survival mechanism, it’s our bodies way of reacting to the powerful stimuli of the vagaries of life.

For me it’s a very keen, borderline obsessive alertness.  I liken it to a really good German Shorthair on point, everything rigid, all senses hyper aware.  Just like the dog my tail sticks straight up in the air (not a great look for a 63 year old man).  It’s like someone is squeezing the adrenalin out of where ever it comes from and it floods your body and boom, a magnified anxiety and sense of awareness has taken over your very soul.

Sometimes I forget how it feels.  I like that I forget.

As good as our lives have gone lately, as healthy (relatively speaking) as Marty has been it just takes a moment, an event, an instance and the flood of bad memories, the overwhelming anxiety comes back.

Marty threw up the other day and that’s what revived all of those feelings.  

We were eating a peaceful supper (okay, I’m from the country, I call it supper, you call it dinner) when she started doing that heaving thing we all do as a precursor to puking.  And then, of course came the real thing.  As bad as it sounds, at least if you are at the table you have a plate to collect the stuff coming up.

The only good thing about this event is there is no thinking, there is no muddling around thinking wondering what to do.  Marty pukes, we go to the ER, it’s just the way it is because when Marty does that thing there is something wrong that will not get better by ignoring it.  

This was about six p.m. (obviously….it’s supper time).  The ER was really crowded so we had to wait and wait and wait some more.  We finally got back to an ER room about 7:30.  I go into my spiel, trying to explain and convince everyone who comes in that we actually have done this before and we know Marty is sick, we know it’s not a 24 hour virus, it’s something else.  It helped that her blood pressure got too low and that always gets everyone’s attention.

Suffice it to say I pace a lot, I talk a lot, I explain a lot, I ask a lot of questions and I had to explain the real meaning of supper to a doctor and then we discovered Marty had pneumonia.  I was wrong because I would have sworn it was a UTI.  Oh well.

We got up to a room about midnight or so.  With the help of really great nurses and Nykkie, our care giver, we got Marty settled into a room at Providence 3 south.  It was a year, almost to the day, since we had been there last.

Our good doctor, Great and Wise, who normally checks us into the hospital and follows Marty’s care was out of commission due to his own illness.  It was bad timing for us, we really didn’t want to be sick when Great and Wise was broken. 

Since Marty’s strokes I have discovered the value and importance of continuity of care for someone with a chronic illness.  Having to explain our situation to new doctors, listening to them ask familiar questions, having new doctor’s orders issued that are really old orders we have done before, and repetitive tests done remind me of how important that continuity is.  Besides, we miss the comfort and confidence of his face.

We worked our way through the strange doctors; they are well meaning and highly skilled men and women.  Mostly it means we have to be more attentive and aggressive in our advocacy for Marty, and that’s fine, that’s why I make the big bucks.

We only stayed a couple of days and found our way home on a Saturday.  We washed the hospital funk off Marty’s body and out of her hair and were back in familiar confines with the pneumonia well in hand.  I know Marty always loves that first post hospital washing.

As a result of this little foray I am reminded of a couple of things:  there is a real adrenaline rush when Marty gets sick and I don’t like that feeling at all, we have been really lucky this year avoiding any real hospital kind of illnesses and we really value the skills and love of our own Great and Wise. 

And just as an aside, in spite of the recent downtime, I can still catch Marty’s vomit in a bucket and not puke myself.  I still got it baby.

She's Doing Five to Seven With No Chance of Peerole

Damn it.  We are back in the hospital.  Since Tuesday, damn it.

I never said it but I thought it.  I was driving and against my better judgment I thought it.  It was a fleeting thought but there it was, me thinking everything was normal, me basking in the glory of not worrying about the next shoe to drop.  That was Monday; I was riding high tempting fate.

Marty gets urinary tract infections, it happens with some regularity and it is part and parcel of her strokes.  To combat her propensity for UTIs Marty takes a daily prophylactic antibiotic that has helped but not completely stopped the infections.  UTIs can be debilitating, causing some pain, causing a general funky feeling and even causing a little cognitive impairment.  That’s why we take these infections seriously and react quickly.

Months ago, through the direction of Great and Wise we started working with a home health nurse that comes about every three weeks to get and test Marty’s pee.  The most recent test indicated a urinary tract infection.  That was last Friday.  We started the typical antibiotic and frankly Marty seemed to be doing great.  

Monday, the day I was driving, the day the thought of normalcy flashed through my melon, the home health nurse called and said the normal antibiotic was not going to work.  Marty had Pseudomonas Aeruginosa in her pee and we needed something different.  Okay, no biggie, I called Great and Wise, just change the antibiotic, we will be good as new.

Then it got a little complicated.  I talked to nurse Wendy and she said yep, Levaquin was not going to be our friend this time.  The only friendly antibiotic that Marty wasn’t allergic too required intravenous feeding, thus she is sentenced to five to seven days in the hospital with no possibility of peerole or pardon. 

After consultation with the Great Office of Great and Wise we delayed our check in just a tad.  I had a meeting with the fabulous Sheryl, our financial guru, and we badly needed haircuts.  We did both of those things and checked into Providence Hospital on Tuesday at 3:30, just like The Hilton but without the mini bar but a really cool moving bed.

This whole process is a little scary because it is exactly what happened five years ago when Marty had her last and worst seizure, a seizure so powerful she broke her left arm as she laid in bed being treated for the exact same illness we are dealing with today.  It’s a little déjà vuie and not in a good way, in fact, in a very bad way, that was a dark time.

That hasn’t happened this time.  We got past that first day and no seizures.  All of Marty’s blood work is coming back with good numbers, her chest is clear and she is actually feeling okay.  I give her about two days before she gets really stir crazy.  She will probably get a little nuts and her dirty hair will bother her because she is doing her five to seven days for possessing bad pee.

When the new nurse came last night she asked several Marty several basic questions to determine her cognitive functioning and orientation as to time and place.  She never knows the year and bless her heart she still thinks George Bush is President which is kind of like living in the Twilight Zone forever.  

She answered all of the other questions perfectly and with vim and vigor with just a hint of sarcasm.  

To conclude the visit the nurse turned to Marty and asked, “Do you know why you are here?”

Marty, without pausing, jerks her right thumb to me, the poor goober sitting to her right minding his own business and says, “Yeah, him.”

Okay, yes I brought her here; no I didn’t have anything to do with stinky pee.  I’m just glad we have good people taking care of her so I will take the rap and play the snitch, this time.

She's Not My Mother

It was a new clinic for us but we are practiced enough in the medical arts to simply assume our normal positions.  Marty was in the dental chair looking around the office, surveying the exam room looking at the doctor’s diplomas, checking his credentials.  I was sitting in the chairs at the wall.  I was behind the nurse answering her questions, trying to put a face on Marty.

The nurse, focused on her computer screen, asking questions, looked up for just a moment and asked, “Now is she your mother?”

It was not the first time this question had been asked.  With my reading glasses on the end of my nose I turned, looked at the nurse over the top of my glasses and said, “No, I appreciate the fact that you think I look 30 but I’m her husband, have been for 36 years.”

The nurse looked up, looked at me, looked at Marty, “Oh.”

Yeah.  I get it.  When you look at Marty’s chart, when you look at her meds, when you look at her medical history it reads like someone who is 80, not a 58 year old woman.  I get it, when you look at your computer the patient doesn’t necessarily match the real person.

Trust me on this, I don’t look young enough to be Marty’s son, our son does.  And trust me on this; for a woman who has been beat up by not one but two cerebrovascular accidents, Marty doesn’t look 80, given her history she looks great.  Sometimes people just don’t look. 

It really doesn’t surprise me…..too much.  These people, people in the health care business, men and women dedicated to the healing arts, see hundreds of people a month depending on where they work.  Those people, those good people, get a routine; they get into a work rhythm and sometimes lose sight of the person sitting in the room with them.  It’s hard for them to understand this might be your first time as a patient.  

Personally I’m a rhythm kind of guy, I really get it.  Routine works and the questions asked are important questions.  I want them to know Marty’s history; I want them to know and to notate all of her medicines and everything she is allergic to, that stuff is life sustaining information.  Data is good. 

The good folks get the data and then they start mentally collating that data and how that pertains to why the patient is there.  That collation then gets them to a norm, it gets them to something they deal with multiple times in a given day and they make reasonable assumptions based on that data.  In Marty’s case, they assume she is an older woman with a litany of health issues.

She’s not; she’s too young to have endured what she has endured.  I know it’s hard, when you see a lot of people, when you repeat the same procedures day after day, to see past the data, to look up from the computer screen.  The big bright eye of the computer monitor pulls the focus away from the human in the room.    

It’s not just in health care.  It happens in any environment where you deal with repetition and a lot of people, the human gets shoved aside and only the patient or the customer remains.  It happens everywhere, but, when that it happens at Subway they are just making you a sandwich.  That’s not near as scary as oral surgery.

There are a lot of nurses and doctors and therapists and x-ray techs that somehow avoid that sort of dehumanizing trap.  They are the real practitioners of health care.  

We are really fortunate with all of Marty’s doctors.  They run good ships.  They know Marty; they see Marty as more than a brittle, complicated patient.  They see her as the person, the human she is.  The nurses and the office staff at the office of Great and Wise greet Marty, hug her and talk to her and see her as someone special.  To them she is famous, she is Ms Marty and they care for her and see her as an individual.  

Some of these folks have known Marty for years, some knew her before the strokes, most know her only as she is today.  We have loved and lost several good nurses and office folks at that office.  But the new folks treat Marty as a person too,  they have taken their lead from Great and Wise himself and he insists on having patient care be care for a person, a fellow traveler, not just another patient.

I know it’s hard, I know it requires extra work, extra effort to break out of the routine.  It means you have to look up and truly look at the people sitting in the chairs in your room and that sometimes takes time, it means you have to slow down just a bit.  

I know, I understand it’s hard when to look at so much stuff, so much critical data and not be entranced by that data.  I know gathering and coalescing the data sucks focus from people.  But you know, some day that person, that patient who has never been in the office before, might be you, , some day it will be a loved one in that chair and I guarantee you will want whoever is caring for them to remember that they are not one of many, they are unique, they are people.  

In the grand scheme of things, it wasn’t a big deal.  Marty wasn’t paying attention and she is not easily offended.  The nurse doing our intake was pleasant, competent, professional and kind.  She wasn’t the first to ask the question, she won’t be the last.  I just want them to be sure and look at us before they ask any questions.