Sunday, April 7, 2013

Hospital Life...Day 12 & 13

It seems like yesterday was a busier day than I thought it would be when I wrote the Day 12 update.  I thought I would take a moment now while it's quiet to write a quick post on how the rest of the day went.

Peyton's leg began to swell above the splint again.  It hadn't gotten completely better by any means, but it was a little improved.  However, it was actually quite swollen, going further down towards the splint.  It was warm to the touch, tight feeling, and red.  I called the nurse in to come and look at it.  The splint definitely seemed like it was too tight around that area.  Her toes still looked good, so we weren't worried about lack of circulation down her leg.  Of course, because the splint is involved, Ortho needed to be paged.  This was mid to late afternoon yesterday.  They weren't really responding so peds came and looked at it and they got back on Ortho to get them to come over.  The issue was not that we thought it was a problem that could be addressed by Ortho - it was that she has a problem with her leg and the splint may need to either come off or be re-done a little more loosely.  At some point around 4pm or so, we were told the Ortho doctor on call was down in the ER with a trauma and would be up in about 30 minutes.

LONG story short, he came by sometime after 10pm.  Maybe closer to 11pm or later.  He'd been paged multiple times.  No one up here was happy.  When he did come in {and I will spare you the actual conversation}, we were definitely made to feel like our little swollen leg wasn't as much of a priority as the slew of traumas that were apparently coming in to the ER.  I will tell you that our nurse last night was not impressed in the slightest.  Nor was I.

As a sidebar, here is my word of advice to anyone in medical school, in the medical profession, or anyone who is seeking to be in the medical profession.  You need to check your ego at the door.  No patient is more important than another.  I'm not speaking clinically - I agree that there is a triage system in place for a reason.  However, when you come up to a patient room, you need to be aware that that body lying there in a bed hooked up to all kinds of stuff...that is a person.  And those bodies in the room watching over that person...there's a good chance that that is their family.  And if you take a moment to look at the patient's chart for half a second, you might find out that the person and family in that room might just be dealing with something that is potentially life-threatening.  So, what you consider to be an inconvenience or interruption to some, perhaps, more "exciting" medical drama down in the ER, might just be something that is of extreme importance to the people waiting upstairs for hours for you just to hopefully give some relief to that child.

All that said, a little while later, that doctor was back and one of the issues we wanted resolved was taken care of.  I am not thrilled with that whole experience, but I am not going to allow it to define this hospital stay.  It doesn't.  It was just a bump in the road of this whole experience.  Peyton has received excellent care this whole time.  While we did have a not so nice experience, I want to place more emphasis on a) what can be learned from this as I shared above, and b) that there are people in the medical profession who are willing to go to bat for you when something like this happens.  Peyton's nurse was right there when it happened and I can assure you that when she left the room, people in the right places knew what happened.  I had more than one apology for the experience from people who weren't even there.  I want to focus on the good of the situation and how things can be made better if there is just a better understanding of people's situations.

With regard to the swelling, prior to Ortho coming in, the peds attending came back in the evening to check on Peyton.  They are being very cautious about how much testing is done - whether it's in the form of x-rays or lab work.  If there isn't something obvious or they aren't sure what they will do with the results, there's a good chance that they will hold off.  They are being very cautious about how much they are putting Peyton through.  After much discussion, it was decided to put her back on an IV antibiotic to cover any type of infection that might be happening.  They also decided to get a urine sample and some blood.  I haven't heard back on those things specifically.  It did appear that Peyton might have been dehydrated so they gave her a bolus of fluids as well.  It seems strange to think she's dehydrated when she's retaining all this fluid.  It's just that the fluid she's retaining is not in the right places.

This morning, Peyton looks much the same as she did last night.  The bolus seems to have helped a bit.  She has been having a lot of diarrhea lately so that's probably why she's been dehydrated.  The addition of the IV antibiotic won't help in that area.  Her hemoglobin is very low again this morning.  I want to say it was around 8.6 or so yesterday {maybe a little higher}, but this morning it was 6.7 and then 7.1 when they rechecked. Recall that it was 7.2 when they did the blood transfusion a little over a week ago.  The team hasn't rounded yet, but I am going to assume that another transfusion is likely.  She may also need albumin.  Peyton has also gotten a couple infusions of potassium because that is also low now.  They want that number to be around 3.5 and hers was in the 2s {maybe lower but I can't remember how low it got}.  Today it's 3, so they may do another one.  Lots to look forward to.

I mentioned that Peyton's attending had rotated off and the new one came on for the weekend.  When he came back in last night, we wound up having a bigger talk about the whole picture.  I know that the doctors have this optimism but as the mom, just sitting her watching Peyton, I would love to be that optimistic {and I'm not sure on a scale of 1 to 10 just where their optimism lies}, but I honestly don't see how we can get to where she needs to be to even consider going home.  If that is the road, it's a very long one.  When we sat down to talk, he felt that maybe my "mom radar" was going off about things as my responses to his questions earlier in the day were maybe not ones he expected - perhaps lacking in the optimism would be the best way to describe that.  Anyway, you know, I hate crying in front of people here.  I don't know why.  I cry on my own no problem.  It was a good talk.  I am sure I needed that.  I know we're all on the same page as far as how much we do for Peyton, but it was good to let my thoughts known as well so they know where my mind is at.

After finishing that thought, the residents were by and discussed the Ortho issues and the issues with her potassium, hemoglobin, albumin, etc.  So, we will see what happens today and I will update later.

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