The Plan Starts To Take Shape

January 17, 2017

Den had a hard time sleeping during the night. At one point, he wanted to sit on the side of the bed. While he was trying to maneuver into this position, the bed alarm went off. We had never been told that it was even set, so we were startled out of our wits! Den decided to lay back down and it stopped going off…thank goodness!

Around 1:30AM, Den has more episodes of V-Tach. The LVAD on-call came in to check him out and dropped his speed again. This time to 5200. We were told that EP (electrophysology) would be in soon to interrogate Den’s pacemaker to see if there were any problems looming.

Den got is now getting only one IV antibiotic, since we know exactly what we are dealing with now. The new antibiotic should be ordered up for this evening. After they started the IV, the echo cardiogram tech came in to do the imaging. We would get the results later when the doctors came in for rounds. The nurse brought Den his usual meds, minus his Warafrin. His INR this morning was 3.4, too high/thin, so no blood thinner today and he was reminded to eat some green vegetables.

The doctors came in for rounds before lunch. The bacteria had been identified. It was called Klebsiella, and it was suspected that it stemmed from a urinary tract infection. (Remember….Den had gone to the ER with one back in July.) The doctors said that they wanted to do a heart cath this week because of the runs of  V Tach that Den had been having. This way they could check the pressures in his heart while they were there. They also let us know that the Infectious Disease doctor would be in later today to go over the plan going forward. She would recommend the correct antibiotic and how long Den would need IV antibiotics daily after leaving the hospital. Den would go home with a PICC line in his arm for the duration of the IV antibiotic treatment.

Our next “guest” was not so pleasant for us. The nurse manager came in to talk to us about the bed alarm issues last night. She told us that Den must call for help to get up for ANY reason (go to the toilet or use the urinal). We tried to tell her that when he gets the urge, he cannot wait. She was emphatic about calling, so we said we would. We told her that they would need to keep an extra stock of sheets, blankets and gowns on hand for tonight.

About an hour later, Den needed to go to the toilet. He pushed the call button as soon as he felt the first urge. No one came for 10 minutes….needless to say, we had to change the sheets, and clean up Den and the bed. We had tried to tell them this was going to happen!

EP came in after Den was all cleaned up and fresh again. The tech interrogated his pacemaker. She found no episodes that had needed treatment. Den was in AFib 100% of the time now. His fluid levels looked good. Finally, the battery in his device was down to 2.63….we would need to make an appointment to have it changed out in the near future.

Dr. Landon, from Infectious Disease, came in to give us a plan to treat Den’s infection going forward. He would need 6 weeks of IV therapy at home. She told him he needed to eat yogurt every day. Once the PICC line was inserted there would be no further need for masks and after 7 days the gowns would go away also.

Just after Dr. Landon left us, Den need to go to the bathroom again. He pushed the button right away, again. It took 3 minutes for anyone to answer, and they said they would be there as soon as they could. Well, 10 minutes later we were changing the sheets, and cleaning up again. I actually asked the Aide if they liked cleaning up soiled sheets. She gave me a look that said it all…NO.

After Den was all cleaned up, again, the nurse came in to give Den his new IV antibiotic, Rocephin. While she was there Den needed to go to the toilet again, so she helped him get out of bed and to the bathroom. Well, it was already too late. Den left a trail from the bed to the toilet. I think this was when the staff realized that waiting for help was not going to be a good option. The nurse came back and cleaned up the floor the best she could and told me to get him to the bathroom if he needed it, but to let them know I was taking him out of bed. This could work for all of us. (It did work well for us all, Den got to the bathroom in time for the rest of his stay and we didn’t need to clean him or the bed again.)


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