Sunday, December 27, 2009

febrile

Mom's feverish right now, and the cause might be another infection, possibly from her central line-- one of several intravenous lines that have been attached to her for several days. As one doctor said, the chances that the central line might become a source of infection generally increase with time.

While we were in Mom's berth, the docs set about resolving the potential problem. They found prominent veins in Mom's ankles (Mom's hands and wrists are now too swollen for anyone to sink needles there) and installed two new IV lines, one in each ankle, thereby obviating the need for the central line. As we were leaving, the nurse began prepping to wash Mom, and the docs made ready to remove her central line. We hope this will help Mom's fever, but we're not even positive that the central line is indeed the cause of the current infection.

Apparently, Mom's other cultures came back negative for everything except MRSA. One doctor remarked that a negative doesn't necessarily mean that nothing had been going on: sometimes a negative result simply indicates that recently administered wide-spectrum antibiotics have done their job. The problem with such a situation is that, with the pathogen gone, no one will know what the pathogen was.

Mom's heart rate is way too high right now: around 140 beats per minute, which is almost twice her normal resting heart rate. Dad is extremely worried that Mom won't be able to sustain such a pace, and I agree. But no one seems quite sure why Mom is reacting the way she is right now. Are her elevated temperature, blood pressure, and heart rate due to infection, or to something else (e.g., something brain-related)?

We might know more tomorrow. Our general feeling is that we're dealing with the holiday/weekend crew, who might not be as on the ball as the regular staffers. In particular, we're displeased with the nurse taking care of Mom this evening. She's got some sort of attitude problem, and is sloppy-- bordering on slovenly-- in how she goes about her business. She heedlessly flops IV bags onto work surfaces, casts used items negligently on the floor and onto Mom's bed, and doesn't care whether the trash she tosses into the trash can has actually gotten into the trash can (several items ended up on the floor). David noted that the two doctors who came into Mom's room also obviously disliked this nurse, and that she disliked them. Wonderful. Office politics.

As Dad said to us later, in reference to the surly, sloppy nurse: "If you've got issues, keep them at home."

Uncle John and our cousins went with us to see Mom. The Texans went into Mom's berth first while David and I sat out in the waiting room down the hall. When it was our turn to go in, I noted how burning hot Mom's hands had become. Earlier in the day, I realized to my horror that merely holding Mom's hand was causing finger-shaped imprints to appear on her vulnerable skin. This evening, I avoided holding her hand, opting instead to place her hand so that it rested, warm but inert, on top of mine.

Mom remains dependent on her ventilator. Her eyes opened a few times while we were with her, but not in a way that clearly indicated consciousness. I have no idea what's going on in her head anymore, and can only hope that she's wrapped in a comforting fog, detached from the ugly reality of her situation. She now stands on the borderlands between life and death, and I wouldn't blame her if she quietly decided to hop over the fence to get a better peek at the flowers growing on the other side.

She deserves flowers. I never gave her enough of them.


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1 comment:

Maven said...

Re: Surly nurse
By all means, insist on speaking to the nursing supervisor.

Believe it or not, we had to get the nursing supervisor involved when the person coming in to take dad's BP and vitals was on her CELL PHONE, carrying on a loud, gossipy conversation. It was unsettling for everyone.