Monday, July 25, 2016

Our Weekend in the ICU...

Well we've had an interesting weekend - Melinda spent 2 days in the Intensive Care Unit at Banner University Medical Center (BUMC)! Saturday started normally enough - we were sitting around relaxing, mostly controlling Min's back pain w/her Vicodin and my taking care of her needs. She took a dose and laid down for a nap about 4pm, while similarly, I laid down back in the bedroom dozing in front of the Tour de France replay on TV.

When I returned to the living room nearing 6 to do the cat-feeding chores, she was lying funny, as if about to roll off onto the floor. She was sort of "out-of-it" and only partially responsive. Her extremities also had Parkinson's-type tremors. She said she was cold, so I put another blanket on her, turned up the AC a degree and warmed her up some food, which she didn't want once done... After feeding the cats, I queried if she needed anything and she wanted help to go to the bathroom. All this is normal, I've been assisting with most of her bathroom trips the last couple weeks. But she couldn't get up on her own, and once I hoisted her up, she couldn't stand... My first priority was to get her to the bathroom so I fetched the wheelchair we've rented to get her around the hospital, hoisted her up, rotated her and set her down in the chair, and did the same in reverse in the bathroom for her to go. She continued to be only partially responsive and had difficulty holding herself upright, even keeping her head up seemed difficult. I figured there was certainly something going on, so called 911 to get them on their way. After some confusion about our address and how to get there, they arrived in about 15 minutes. Six buffed-out EMTs and firemen hoisted her out of the bathroom onto the cart and rolled her into the ambulance and hauled her to BUMC.

Once there, her heart rate (HR) was 220 with a very low blood pressure (BP). When she saw me, she asked for me to be near her head and I was positioned with a good view of the action. At one time I counted 14 people in, or trying to get into ER room 19 to assist. On two occasions they injected a drug to slow her heart, but both times after the initial drop to near normal, it sped back up over 200. Finally the third time it stayed down. Had it taken a 4th time, they were going to shock her to reset her heart rhythm! She ended up getting 3 liters of fluid, and giving about a gazillion blood samples, many of which were contaminated somewhat with all the saline she was getting.

By about Midnight they moved her up to the ICU, where they took very good care of her. After she got settled in I headed home about 1:30am, and was back about 10. We saw a slew of doctors, and I recounted the above story every time, since Melinda didn't remember anything before getting to the ICU... Tests showed an elevated white blood count and even the preliminary blood culture indicated an infection. So while that is what they were zeroing in on, they took a CT scan, x-rays, ultrasounds, and likely other auxiliary tests I've forgotten. We had a few friends stop by - at left our buddy Erica is shown chatting it up with the patient. Coming back from the CT, the nurses rearranged the bed and equipment so she could enjoy the view out the window from the 3rd floor room.

Today (Monday) we also talked to doctors from infectious diseases and our radiation oncology doctors. Melinda had been getting daily radiation treatments last week, and I called their offices this morning to make sure they knew she was an in-patient, in case the treatments were contributing to her condition, or affect her receiving treatments this week. She got put off for today, but will likely start up again soon. The infectious disease docs came in and talked to us about the likely diagnosis - that her infection was identified as Pasteurella - likely given to her by one of our cats! The bacteria is part of the normal flora in the saliva of cats and can get into humans through a scratch or bite, where a serious infection can result. Once brought to our attention, Melinda had developed a red blotch about 8cm (3") in diameter early on Saturday, which had grown to about 20cm (8") by Sunday before fading today from the antibiotics. While we typically don't get bites from the cats, since they lick themselves, if they were to sit on our laps, get startled and jump down, their claws can break the skin and pass the bacteria. Since Melinda's immune system is diminished from cancer and treatments, she is ultra-susceptible! Sure enough, near the center of her red blotch was a little puncture...

As of 10pm tonight, she was moved out of the ICU do the oncology ward 3NW, where she will likely stay for a day or two before possible discharge to a rehab facility. Well that is the latest - I didn't think life could get much stranger than taking care of her and getting her to her daily radiation treatments, which tend to stretch into 5-hour long affairs. But a trip to the ER and ICU is a kick in the pants that life is easy to shake up even more!

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