Precautions?

April 27, 2016

Den and I found out yesterday that we could fit in his bed, but it is a very tight squeeze. So I pulled the recliner chair up next to the bed and we slept holding hands. This helped us both sleep better than we have in weeks. But Den woke me up at 2AM. He was very confused about where he was and why he was there. Luckily, it didn’t last long…about 10 minutes. I reassured him, as usual, and we went back to sleep. The nurses are great about us needing to be close to each other. They have helped us find a configuration that is workable for everyone. They also know that I will move on a moments notice if needed.

At 5AM, I helped again with Den’s dressing change…I think I am getting the hang of it now. We had to get Den up and out of bed at 6AM. He had missed the urinal and soaked the bed again….another changing of the sheets and his gown.

Den had a good breakfast today. Three hard boiled eggs, and some apple juice. At least he is getting some protein.

Den’s vitals are stable and in range for his new equipment. I am learning what is normal and what is not for his new “body”. The nurse gave Den his morning meds…aspirin, lexapro, and potassium pills. He also got his diuretic His blood sugar is starting to stabilize, so the nurses are checking it before and after his meals.

Dr. Bloom, from Speech, came in to check on Den’s progress. She did another assessment which consists of Den eating progressively harder foods to make sure he was not going to choke. He passed all of the levels and she released him to a standard cardiac diet. Now Den could order anything on his menu! She told Den that he still needed to do the chin tuck when drinking to ensure he didn’t get any of it into his lungs.

The LVAD doctor was in  to increase Den’s speed to 5300. He also told us that Den’s kidney function was returning to normal…really good news! We asked when it would be possible for Den to have cataract surgery. He said he would bring it up to the team and let us know how long we needed to wait before he could have this done.

Den was ordered a bagel, cream cheese and hot chocolate for lunch, so I went to get myself something to eat. When I came back at 1PM, it was posted on his door that he was now on contact precautions. This meant you had to wear a gown, gloves and mask as well as complete hand washing before entering and when leaving.  Before I went into Den’s room, I asked the nurse what had changed in the last 20 minutes. She said that it was because it was suspected that Den had a bowel infection (clostridium difficile, or C. diff.) because he had been having loose stools since surgery. I went through all the protocols to get into Den’s room. Den was NOT happy when he saw me in the gown, gloves and mask. He asked why I had them on….no one had told him that he had been put on contact precautions. I took out the laptop and did some research. The symptoms of C. diff. are

• Elevated white blood cell count
• Fever
• Abdominal pain
• Blood in the stool
• Rapid weight loss

Den had none of these symptoms, and he had been on a near liquid diet since surgery…very little “filler” in his meals. I talked to Den about all of this and we decided to ask to talk to the person who had ordered the contact precautions. It took 2 hours for that person to come to the room. We had a discussion with her about why she had ordered the isolation. She told us is was just a precaution. When I confronted her with the fact that his diet sucked and he had no other symptoms she agreed to remove the precautions with the proviso that if any stool sample came back positive Den would go back to isolation.

After all the stress of the last few hours, Den lost his appetite and only ate one bite of his bagel.

PT came in and got Den moving again. They had him stand and sit several times from the bed and chair. They also had him march in place. He decided to stay in the chair for the remainder of the afternoon. He got his diuretic, one unit of insulin and his coumadin and potassium pills.

Den didn’t want to eat dinner again tonight. This is the second day that he has promised me he would start eating 3 meals a day and barely eats one. When will he understand that no food means that the body will take a lot longer to heal and his muscles will continue to get weaker.

Respiratory came in at 8PM for Den’s breathing treatment. He was asleep so, they sent the meds through his Bi-Pap. One of the doctors came by and said that they would stop the last IV pain med sometime tomorrow. Den would get his follow up echo cardiogram tomorrow also.

Den’s weight today is 228…with his equipment….218 without.

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