Thursday, July 17, 2008

Ron's in the hospital again

I had to call an ambulance this morning. Ron had an MRI yesterday at noon because of his continued confusion, lethargy, and coordination issues. The doctor’s office had called in two 10mg Valium tablets to take 30 minutes before the MRI. When I told the receptionist what I had, she was a bit surprised but we both figured the doctor’s office knew what they were doing. I even asked Ron if he thought he needed it because he was already sleepy and not very responsive prior to his appointment. He said yes so I gave it to him.

He didn’t really wake up much after we left, even when going to two other doctor appointments and having lunch in between. He fell asleep with his sandwich in his hands and spilled the contents all down his shirt and on the floor. Both of those doctors were quite surprised at how he was and how unresponsive he was to stimulus and conversation. In fact, I had to actually drive his scooter from the front, driving him backwards because he was not physically capable of doing it. He would either not go because he couldn’t find the lever or he would go too slowly – or even worse, drive right into things.

By the time I got him and Isaiah home it was nearly 6:00 PM. It took me until 6:30 to get him out of the car (I had to tell him several times that I was going to call an ambulance if he didn’t open his eyes long enough to help me get him moved; I said I was not able to pick him up and if he fell, it would be worse on both of us), onto the scooter, into the house (with me driving up the ramp), and into the bed. He didn’t move from that position all night. I took his sugar and it was 401 so I gave him a shot and called the doctor.

Our doctor was gone already but I talked to the nurse and she said 20 mg Valium was too much and he might be 4-5 more hours sleeping it off, but wanted me to call back in an hour to let her know what his sugar and blood pressure were. I did and asked if she thought I should call an ambulance then. She said she couldn’t advise me to or not to as that was totally my decision. Ugh – but I said OK.

I literally stayed up all night taking his blood pressure and his sugar every hour. Keith came over and stayed until about 10:00 pm and when I wasn’t doing it, he was. Amy came home from school because I told her I just didn’t think I could take care of Ron and Isaiah. Good thing she did. I did doze off between 1:30 and 3:00-ish because he jolted me awake with tremors – or more like violent shaking.

I watched him all night and then at 6:30 got up and got dressed, and fixed myself a bowl of cereal. I had decided I was going to the hospital and knew I needed something to eat beforehand. I had just checked on him and talked to him so I knew he wasn’t in any immediate danger.

It took me an hour to get him from the bed, to the scooter, to the toilet (and he was not able to go), back on the scooter, and then to the living room chair. I put an ice pack on his sore shoulder (he has bursitis) and called the paramedics.
They were here about 45 seconds and asked what hospital was my preference.

Once we got there, they did the usual routine of blood work, asking what medications he’s on, when did this start, etc. etc. etc. I had all the answers and when I got to the Valium part, they were very concerned. The doctor said that it was obvious that they could not let him leave like this so he would be staying at least overnight while he slept off the effects of the Valium.

That was just the beginning. His creatinine is 3.1 and his potassium is 7.2. Those are both indicators of kidney failure so to ICU he goes. Once Dr. Alvarado got the call that he was in the ER, she knew without them saying his whole name who it was. She came up to the hospital not long after he made it to the ICU room. We were in the ER for about five hours while we waited for a bed.

She said she received the results of the MRI and it showed that he’s got Normal Pressure Hydrocephalus (I did a little bit of research and came up with this website: - there is a lot on that site and some of it doesn't sound good but overall I'm getting that early diagnosis is good and has the best outcome after surgery). She wants to start with some nuclear studies (least invasive) before they just assume that’s the whole problem. His body is still twitching, his right hand won’t stay straight (it curls up), and he hasn’t really been responsive for over 30 hours.

Dr. Alvarado ordered consults with nephrology, neurology, neurosurgeon, his foot doctor, his cardiologist, and his infection doctor. Nephrology and neurosurgery came by this afternoon while I was still there. The nephrologist ordered medication to lower his potassium and creatinine, is stopping some meds, searching for any infection in his body, and going from there. The neurosurgeon’s physician assistant said they’d start with a nuclear medicine study to see what it showed and they want to start with the least invasive procedure and move forward. The concern is that the hydrocephalus is a secondary effect of some other cause and they don’t want to jump right in with surgery to put in a shunt and then find out that it’s something else entirely.

I told Dr. Alvarado that I didn’t want him to get sent home after they literally put a band-aid on it – I want him to stay there long enough to find out what’s wrong and treat it. This is the 5th hospitalization since February 18. Not only is it hard on him, it’s expensive for us and for insurance. I’ve got $100 deductible for each visit (I know that doesn’t sound like much but I’ve got $1,000 per month in our share of the wound vac). This stuff is adding up and the co-pays, deductibles, and travel time is taking its toll on us and our finances.

She agreed and said to plan on him being in there for maybe even a week. I’m good with that – as long as we get some answers.

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