Too Familiar with the ER and ICU

Sometimes, I feel like I am using my blog as a daily journal and little else. So be it. The blog is as good a place as any to capture experiences and thoughts and emotions that, otherwise, might disappear into the mist of a flagging memory—or become muddy and unreliable recollections.

Yesterday’s experiences will remain sharp in my memory, I think, but I will document them here just the same.

Things went haywire.

I had not expected my wife would be able to enroll in an at-home care program because we had explored hospice. I was wrong. I got a call yesterday morning from a nurse who wanted to visit to arrange for my wife’s enrollment. We set up an early afternoon meeting. The nurse who came, Katie, went through the normal enrollment process during the initial period of her visit. But when she began evaluating my wife’s medical condition, she encountered several issues that were of considerable concern to her. Ultimately, those concerns led her to recommend that my wife be taken by ambulance to the ER.

My wife’s blood oxygen saturation level was considerably below 90%, versus acceptable low normal levels of 92% and higher. The “weeping edema” in her arms, hands, legs, and feet had the linens to be soaked under those extremities. Unlike the staff at the rehab center (but like me), this nurse was highly concerned with the fact that my wife’s arms, hands, and legs were extremely swollen and filled with fluid.  We agreed that Katie’s concerns warranted her to call an ambulance, which she did. I wish Katie, or someone like her, could stay with my wife around the clock; she was so incredibly thorough and caring.

The ambulance arrived in short order and the EMTs quickly moved my wife from her hospital bed to the stretcher and into the ambulance. I followed the ambulance to the ER. No lights and siren, as the issues were not immediately life-threatening.

New procedures and protocols required my wife to be placed in isolation for a period; before I could see her, she had to be evaluated for COVID-19 symptoms and judged unlikely to have the infection. When I finally was allowed to see her, three hours after arrival at the hospital, she was in the ER, attached to a machine much like a CPAP machine to help oxygenate her blood and get fluid out of her lungs. While at the rehab center, my wife was on oxygen for the last two days, but I was not told on her release to arrange for oxygen for her; they did not tell me it was needed, nor did they even mention oxygen. The ER medical staff also gave my wife lasix by IV, with four times the lasix that she takes orally.

My wife drifted in and out of consciousness while I sat with her in the ER. Before I was allowed in, technicians had X-rayed her lungs, drawn blood, taken her vital signs, given her lasix, and hooked up the CPAP-like machine. After I arrived, other technicians came in to take arterial blood (which I did not know was any different from blood from veins, but which is somehow related to pulmonary function measurements) and perform a sonogram on her left arm. The ER nurse, Carmelita, was extraordinary; she kept me informed throughout the process while I was there. I left for home just after 7 pm.

At any rate, while I was there, my wife was admitted to the ICU, but because the hospital had run out of ICU beds, she will remain as an ICU patient, but in an ER room, until a space opens. Normal visiting hours for the ICU are 1 pm to 7 pm, but I could have stayed longer, since my wife remained in the ER, though formally was an ICU patient; I was tired, though, and she was asleep, so I thought it best to go home, eat some dinner, and rest.

I called and spoke to Carmelita just after midnight (her shift was to end at 1 pm) and she told me an ICU bed still had not opened up.

I will call after a while to learn whether my wife has been moved to an ICU bed. If so, I will not be able to visit until after 1 pm. If not, I will stop to see her after my 10 am follow-up appointment with my oncologist.

Each time I witness committed, well-trained medical professionals do their work, I become more and more impressed with them. But though doctors, like Dr. Jensen who was in charge of my wife’s care in the ER, are impressive, the people who really amaze me are the technicians and, especially, the nurses who are all business while simultaneously are incredibly compassionate. I am so very grateful that so many people view healthcare as a calling. As angry as I get at the medical bureaucracy, I am in awe of the truly exceptional medical professionals who treat patients in spite of the constraints placed upon them by bureaucrats.

Although I do not want my wife to spend a minute longer than she has to in a hospital setting, I wish I could sit and observe an ER and/or an ICU for a 24-hour period. I am certain my faith in humanity would receive an enormous boost by watching people work. But otherwise, I do not want to become too familiar with the ER and ICU.