Just arrived home and brought in five bouquets of flowers that Kirsten can’t have in the SCU. I need to be up in five hours so I can be back at the hospital in time to stand in rounds with the medical team.
I was able to kiss Kirsten before I left. She squeezed my hand and told me she loved me. She looked like she’d been through hell, but still had that beautiful smile on her face.
Maggie, who had spent some time with Soni and I in the radiology waiting area, got transferred to SCU 4 tonight so she could be with Kirsten. She is, as I’ve said many times before, an absolute angel.
Kirsten’s SCU 4 nurse tonight is Angela.
Tomorrow will be better than today. It has to.
After two hours in the radiology waiting area, a doctor happened to walk in. He asked us if we needed anything. Apparently, they aren’t used to people being there after hours. I asked him to check in IR because I wasn’t sure they even knew we were waiting. He looked, and said the room was empty. Soni and I then rushed to SCU 4, hoping she’d be here. She wasn’t, but we were told she was on the way up. The radiologist finally met me in the hallway and told me everything had gone well. She had significant bleeding at multiple locations, but he plugged the holes full of metal and stopped the bleeding.
We’re waiting for her to arrive here in the SCU. I hope this has been our last hurdle.
I chased after the bed as Kirsten’s nurse and another guy wheeled her down to Interventional Radiology. The radiologist seems super nice, but that consent form was, perhaps, the worst I’ve ever signed. It wasn’t the kinds of things one usually dismisses (e.g. death and paralysis), but things they seemed genuinely worried about encountering, as if they were likely. Fuck!
Now I’m sitting in a beautiful waiting room. Alone. The light in the aquarium is turned off. Nobody is sitting at the desk. I’ve got my “Space” playlist on Spotify cranked. Fuck.
I just signed a consent to place in Kirsten a central venous catheter. She’s going down to interventional radiology where they’ll attempt embolization of a bleeding vessel found on her CT scan.
She is receiving a blood transfusion.
She’ll be moving to the Special Care Unit after IR. It’s our old stomping grounds. Surgical core was fun…for the 20 minutes we were there. :(
We’re now in a core surgical room. It’s single-occupancy with a lower nurse-to-patient ratio. Erin will be Kirsten’s nurse tonight.
Kirsten has been complaining of abdominal pain on her left side and back for several hours. She is constantly holding her side with her hand. The hydromorphone she can self administer isn’t adequate to control her pain. She is now soft and distended in those areas, so they are going to take her for a CT scan, stat. They are giving her ringer’s lactate solution full speed.
She was just rolled out of the core room she occupied for ten minutes.
Kris – I hope the gross of lucky rabbit’s feet came in. Start your dance, my friend.
Kirsten is doing much better. I spoke with the new attending physician, a hospitalist, Dr. Kathryn Diamond-Falk, and the endocrinologist, Dr. Irwin Brodsky. They’re monitoring her hemoglobin, as a drop would indicate internal bleeding. It’s precautionary, as they suspect the blood loss was all subcutaneous and has been stopped.
She is supposed to be moved to a surgical core room, still on R3. There was no availability in SCU. They want to monitor her more closely, which makes me feel much better. The fewer steps we take backwards, the better.
Kirsten was supposed to have an EEG today, but that didn’t happen due to the bleeding, etc. I told Drs. Diamond-Falk and Brodsky that I am concerned that the medical team is looking only at seizure activity for an explanation of the episodes of delirium, even though nothing about them indicates seizures. There is no mouth movements or grabbing of the bedding, she is able to vocalize and answer simple questions, etc. I think it’s an inappropriate stress response related to her complex endocrine issues. Her doctors were receptive to my suggestions, and appreciated the feedback. I still want the EEG to rule out seizure activity, but doing that test while Kirsten is lethargic and sleeping is futile, as all of her episodes have occurred during time of high activity or intense conversation (i.e. stressors). She is on a dose of steroids for stress that’s quadruple her physiologic need, for surgery. I am highly skeptical that she is having seizures, and that she ever had them. There is no objective way to know if Kirsten had a seizure; the only indication of a seizure is the fall and the report of a CNA who apparently witnessed a second seizure in the hours after Kirsten fell and fractures her neck. Kirsten continues to be on seizure-suppression medication Levetiracetam. I’d like that titrated soon.
The bleeding has stopped and Kirsten is sleeping. Maria updated me on the labs, which are good; all important blood metrics have improved. Now that the plasma is done, Maria will resume administration of the remaining potassium. Since Kirsten has stabilized, she might not be moved to a room for closer monitoring, which is fine with me. Let’s get back to boring, eh?
Soni and I were kicked out of Kirsten’s room while the surgeon sutures up Kirsten’s incisions. Kirsten is lethargic and very pale. What little expressions she has are of pain. She whispered that she misses me, and smiled enough for me to recognize it. She’s a trooper.
When Maria removed Kirsten’s blanket and dressings I saw the pool of blood in which Kirsten has been laying. This is the fifth time those dressings and the absorbent pad have been changed this morning.
I am worried and afraid. My hope after the past couple days of recovery has been very high. I am now plunged back into anxious worry and discontent.
A doctor just came in to check the rate of bleeding. She wants to move her to core, but they don’t have availability. She just left to check on that. I asked her why Kirsten remains on blood thinning medication. She said they’re going to stop that.
The plasma has been started.
Soni and I walked into Kirsten’s room this morning to find two nurses and a surgeon working on her. They had her johnny pulled aside, and she was bleeding from every surgical incision. The surgeon thinks the blood is subcutaneous and isn’t worried, although they are going to give her two units of plasma and stitch up the glued incisions. They will also reevaluate whether or not she should remain on blood thinners.
Kirsten is very lethargic and sleeping. Her nurse, Maria, who is amazing, wants to transfer her to a surgical core bed (lower nurse to patient ratio and closer monitoring), but there aren’t any available. She might also return to the Special Care Unit (SCU).
I hope this is just a small step backwards.
Kirsten’s roommate said neither of them slept well. People kept coming in to check on Kirsten and do tests. Apparently, Kirsten had a rough night. She was so good yesterday. This morning she didn’t answer her phone or return my text messages, which concerned me. However, I thought she might just have put her phone on silent so as not to disturb her roommate. She’s nice like that. Too nice, sometimes.