I'd really like to dedicate this blog entry to my nice relaxing evening at Castle Inn, but I got home yesterday to a sick husband and he went downhill throughout the day.
I called our primary care office and talked to the on-call doctor. I explained what the kidney doctor had told me to do if Ron got sick and she had me take him on to the hospital.
Long story, short version - he's been admitted with congestive heart failure. His potassium and creatinin were both good. He's gained nearly 30 pounds in 3-4 weeks and is just puffed up with fluid. His legs are so big they look like they're about to split open. I've never seen Ron with legs. He's a big man, from the waist up. He has no butt and not legs. Except not right now. He was resting his leg against the bed rail last night and when he moved it, he had about a one inch dent in his thigh/calf. It was awful.
When we got to the ER he was so out of breath that everyone who talked to him asked if he was on oxygen at home. They put him on oxygen there. He had blood work, antibiotic IV started, chest x-ray, and a bunch of other stuff. The PA came back and asked if he'd been diagnosed with any heart disease before. He was diagnosed with congestive heart disease and pulmonary hypertension in 99 or 2000 (I think). He does have an enlarged heart but I don't know how much bigger than normal it is. The PA seemed to think that it was really enlarged right now, with lots of fluid around it and his lungs. He may also have pneumonia in his right lower lobe. Not sure because they were having a hard time telling with all the swelling.
I spent the night in the hospital with him because he was having such trouble getting up and he didn't have his electric scooter there with him. He's not supposed to walk on his right foot at all and with all of his other difficulties, it would have been difficult for him to transfer to the toilet by himself. He ended up sleeping all night except for when they were doing vitals and such. I, on the other hand, did not. I tossed and turned on a pull-out sofa and was also awake when they came in, but I stayed awake much longer.
I started coughing (my wonderful nighttime companion) and could not stop. I finally got up at 5:00 am and came home. I showered, changed my clothes, got his C-PAP machine and headed back. I walked back into his room at 7:00 am and he said, "you still here?" I told him that I was on my way back in and that I'd told him when I left. He didn't remember.
The on-call doctor came in this morning and went over some of the things we'd talked about on the phone last night. She said she was ordering the heart specialist, kidney specialist, and infectious disease specialist. The heart doctor was the first to arrive and he remembered Ron vaguely from the last time he saw him, but not enough to remember everything. Ron was scheduled to have a heart cath the last Tuesday of March 2006, three days before his foot was amputated. Since he had a temperature that day, they didn't do the cath and Ron just never went back.
Dr. Francisco is his heart specialist and he's a great doctor. Very nice and very thorough. He said he was going into his office, TODAY, to go over Ron's previous chart to see what had been done and diagnosed in the past. I was impressed that he was going to take part of his Easter Sunday to go review Ron's chart.
The kidney on-call doctor was next. He prescribed Bumex via IV for 24hours to help flush some of the excess water off. The Lasix via IV had done nothing. He said the regular kidney doctor would come see Ron in the morning.
The infection doctor was last and he was looking at all the symptoms - right heel surgery, fever, diarhhea, shortness of breath, month-old PIC line, no appetite, chills, a bit of nausea, swelling, and kidney pain. He ordered Daptomycin IV. The nurse said it's so expensive that Security had to come with the pharmacy delivery person.
I don't know what is going to happen next for the most part. Dr. Francisco has ordered an echocardiogram for tomorrow. I'm supposed to have a heart cath on Tuesday (kind of freaky - the last Tuesday of March, just like Ron's was scheduled two years ago) and I asked Dr. if I needed to cancel it. He said to wait and see what Monday brought. It could go either way.
Either way, I'm taking Monday and Tuesday off.
I'll have to post about the Inn another time.
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