Monday, March 25, 2013

Romy's Appendix Ruptures: Day Three

It is now day three in the hospital with Romy and things are beginning to look a lot better. The report this morning on Romy's white blood cell count is good. His count is down to 13 units, whereas yesterday it was 18 units. The normal range has to be below 10 units, so he is getting there. That means that the antibiotics that the infectious disease doctor prescribed are working to get rid of the bad stuff in Romy's gut, and the white blood cells could take a little break.

Dr. Fowler came in again today and said that based on the lowering white blood cell count, he thinks that Romy will be able to take a CAT scan tomorrow. The new scan will image the rupture and help determine if it is healing properly. He assigned an anticipated discharge date today for Wednesday March 27 - that's in two days! That is good news!

Day Three
The white board has been filled out almost completely for the first time!

The PICC-line specialist also came in today to check in with Romy. He said that based on the news that he is beginning to get better, the PICC-line will be delayed again until it is absolutely necessary. He might have to have a PICC-line put in once he goes home so that he can continue the antibiotics through IV, but we aren't sure right now if that's still the plan. Since Romy has been feeling better, the nurses reduced his pain medication dose in half. On the first and second day, he needed a 2 mg dose of dalaudid (which is 7 times stronger than morphine) every 4 hours or so to control his pain. Now he only needs 1 mg every 5 hours or so. The pain is going down, so that's good. Hopefully it is a sign that he is healing.

Another piece of good news is that the nurses took Romy off the IV when he is not receiving antibiotics. This means he doesn't have to be connected to the IV rack, which is easy to get all tangled up in while sleeping. The IV has a lot of nutrients in it, so it kind of sucks that they took him off the IV, but it is also good that he is getting well enough he doesn't need it. Its easier for him to walk around without having to push the IV rack everywhere he goes. I have been going with him on mini walks around the hospital floor to get his blood moving in his legs. Romy really doesn't like the inflatable pillow massager thing, so its good he can walk a bit instead of wearing them.

Day Three
Romy can now sit up without feeling pain at his appendix but still feels tired.

Also today, the doctor ordered an upgrade to Romy's diet. He is now allowing him to eat 'full liquids,' which means he can have creamy things (before he could only have clear liquids like apple juice and soup broth). For lunch he had some vanilla pudding. Today for dinner he had cream of celery soup and some lemon pudding. He also gets tea and milk, although he hasn't been drinking the milk at all. No solids yet. We have been amazed at how void of nutrition all the hospital food has been so far. Maybe the solid food that they serve is better, but the liquid diet food is horrible in terms of the nutritional content. The juices that they give are mostly juice cocktails, meaning its about 10 or 20% real juice, and the rest is sugar water. The only good thing they gave Romy so far was the milk and pudding. Now that he can have a full liquid diet, most of what they give is dairy based.

There is a Whole Foods store one block away from the hospital. I go there every morning for a latte and I have been picking up coconut water and real 100% juices that are organic for Romy to drink while he is here. Since he is off the IV, the only source of nutrients he gets now is from what he can eat (well, drink really). Based on the labels of the food he has been given so far, the hospital food is very void of nutrition. It is a lot of sugar and fat, with little fresh food, and very few vitamins. Romy needs good food to help him heal that has a lot of vitamins. Everybody in this hospital should get better food!

Day Three
Romy is now feeling good enough to make jokes. He is drinking tea with his pinky up.

On a more positive note, the nursing staff has completely changed! When Romy came in, it was a Saturday. The weekend nursing staff was horrible (except for Elita the nurse aide who loved to travel). Sunday, the nursing staff was equally as bad. But something changed after midnight on Sunday (basically very early this morning). It seems the weekday nursing staff is so much better! Romy's first nurse this morning was named Sharon and she was from Las Vegas. She was the best nurse we had so far! She had been nursing for 20 years and you could just tell by how she operated that she was very competent and with it. She came back when she said she would, she was organized and on schedule, and she was very considerate. The nurses are supposed to narrate what they are doing to you, be it injecting drugs, taking blood pressure, etc. She was the first nurse to explain very clearly what she was doing at all times, and she went over many points of information that the previous nurses never mentioned, like how to do breathing exercises to avoid getting pneumonia, and other stuff. Nurse Bende from Denmark replaced Sharon for the day shift. She was wonderful too and also very competent and with it. The nurses so far today like to talk to Romy and in general attempt to understand what is going on and are sooooo helpful. What a world of difference from the weekend staff!!!! In comparison, the weekend staff were lazy, mean sometimes, and not prompt. They just seemed to not care, and many acted like it was only a 9-5 type thing. Elita was the only nice person over the weekend. Elita was the one to let us know about the charge nurse.

There is a white board on the wall at the foot of Romy's hospital bed where the nurses are supposed to write some information. At the top should be the doctor's name in charge, the nurse and nurse aid in charge, and the charge nurse on duty. Under that should be the plan for the day. Below that should be the time of last pain medication, and below that the current pain level. Over the weekend, the only part of that board that was filled out was the plan for the day which said, "Pain management, IV fluids, antibiotics." Occasionally, the nurse wrote her own name down. However, we were confused about who the doctor was because it wasn't written down. We often forgot when the last time Romy had his pain medication given to him, so I actually started writing it on the board! Now that the weekday nursing staff is working, that white board is always full of info, and the nurse updates it every time she walks in to check on Romy. What a nice change! If this is how it was when Romy first came in, we would have no complaints.

Day Three
Romy is now on a full liquid diet and they are allowing him to walk around if he wants!

Very very early this morning, a new patient was put in the bed next to Romy. It was a Polish guy who broke both the bones in his lower leg playing soccer at the soccer field next to the race track by I-580. The break was a complete break, so he was put on pain medication and was waiting for surgery to put a permanent metal rod in his leg. He and his girlfriend who stays with him are very nice and considerate (much better than the old dude with the hernia and his annoying wife). They were here for most of the day, and then were sent off to the basement for surgery in the afternoon. They returned later in the evening when it was getting dark, after I came back from teaching Romy's physics class at Dominican. He will be here for another day to recover after the surgery, I think.

Today is the first day Romy feels like taking a shower. But every time he felt like taking one, the nurses hooked him up to the IV for more antibiotics. Maybe he'll take one tomorrow. Also, Mike, our landlord called to ask if Romy was feeling better.