Another Trip to the ER

It was a fine Monday afternoon. I was in my ruby red car ("Petunia"), on the highway, on my way to see my beloved, listening with satisfaction to the audio version of Pride and Prejudice, when my dash display indicated an incoming call from a number I didn't recognize. Because the hospice folks call from their cell phones, I do my best to answer now, just in case. I always hope it's a spam call, though, because calls from hospice or the facility always throw me into panic mode. There has simply been so much stress, so many not-so-good-news calls, and so many fight-or-flight reactions that my heart automatically skips a beat. Breathe in. Breathe out slowly. Breathe in. Breathe out slowly. Stay calm.

I pressed the answer button on my steering wheel. It was the facility, and the voice of the medical technician came through the speakers. My husband had suffered a major seizure as he was walking; hit his head while falling, unconscious, to the floor; and been unresponsive long enough to cause alarm before "coming to." Hospice had been called, and the hospice doctor deemed it best to send my husband to the emergency room for a CT scan to rule out a brain bleed. If so, it would be an important thing to know.

Somehow, I managed to maintain my composure behind the wheel, arriving at the facility just as his  ambulance was leaving. I followed, and within minutes he'd been transferred to the emergency room, where I tried to keep him calm and comfortable while we waited. His blood pressure, heart rate, pulse, oxygenation, and temperature were all normal.  I was happy that it wasn't necessary to draw blood, do an IV, or try to get a urine sample. Sticking him with needles would have caused him such distress, and he was trying to pull off the monitoring gadgets that were fastened to him as it was.

Ultimately, the CT scan results were also okay, though that experience was good for a chuckle:  "Ma'am, we need your husband to lay flat on his back and keep his head very still for this," said the technician. My response? "Good luck with that!" But they somehow managed, my husband was discharged and returned to the facility, and that was that.

I stayed with him for several hours, watching over him so he wouldn't be alone. Just in case. It wasn't exactly the kind of visit I had hoped to have with him, but all's well that ends well.

By the way, in case you're wondering about his weight, it had to be checked twice again this month. When I asked if he'd been weighed and his chart was checked, the weight shown seemed too high. I asked that he be weighed again, and he seems to weigh the same as last month. But who knows? It would be fantastic to have confidence in that number.

The First Infection

Infections that begin in warm, damp places spread like wildfire. Just ask any parent who has changed a baby's diaper only to discover fiery, angry redness where a happy, healthy bottom had been just an hour before. What starts out as a rash or a mild urinary tract infection in a person who is incontinent and spends a lot of time sitting can suddenly become a life threatening event.

Last Saturday, I had just returned from shopping for birthday celebration supplies for my husband's Big 7-0 the next day. I was getting ready to make my daily visit to him* when I got a phone call from the facility letting me know that he had collapsed, his blood pressure was dangerously low, and he was being taken to the nearest hospital via ambulance. I rushed to his side.

I haven't spent a lot of time in emergency rooms, thankfully. The doctors and nurses and techs and aides were rushing to and fro, and the whole experience quite took my breath away, to be frank. I was in shock, and I was being asked to make on-the-spot decisions about my husband's care that I just wasn't emotionally ready for.

Noting his DNR (do not resuscitate) status, the staff bombarded me with questions. Did I want them to continue pumping fluids into him to bring his blood pressure up? Was it okay if a course of antibiotics was started for the sepsis? If he needed help breathing, was it okay to administer oxygen? If he "crashed," what did I want done? My head was spinning. What to do? Treat? Not treat?

We had talked about this. We had talked about the fact that he doesn't want heroic action taken, doesn't want to be intubated, doesn't want to be resuscitated. We had talked about at what point to decide whether or not to treat illnesses and infections. When to "let nature take its course." It's important to have these discussions sooner rather than later, and we did that. I'm okay with the DNR and the DNI (do not intubate). But I just couldn't bring myself to forego treatment for an infection. Not this one, anyway. Weak and shaky, he returned to the facility today. He had given the hospital staff a run for their money, but he had come through it.
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Did I do the wrong thing? I can't tell you. All I can say is that I wasn't ready to make a monumental decision that I might regret for the rest of my life. We'll see how it goes from here. From past experiences of others, I know that the first infection like this is a milestone of sorts. It will no doubt happen again, and probably sooner rather than later. I'm hoping for later. I need time to think.

*What started as a respite stay at one place has become long-term placement at a third place. Long story. I'm working on some posts about this, but I thought it was important to go ahead and post this one instead of waiting.