Wednesday, June 17, 2009

in the ER

So the chronology is this:

1:30PM or so: Mom stops eating lunch, and we make ready to leave.

1:50: An Inova Health System nurse named Hulda comes by. We had called her central office to cancel her visit because of this PICC line business. It appears that no one told Hulda what was up.

2:05: We walk a helmeted Mom slowly to the van in the rain. Mom's very weak, barely able to stand on her own, let alone walk. It's obvious we'll be needing a wheelchair at home.

2:10: We're off to Fairfax Hospital's ER to deal with the PICC line blockage. The hope is that this will be an out patient procedure. Dad rides in back with Mom. Sean, who came by while Mom was still nibbling lunch, drives separately because he's got lesson or a performance or something later.

3:00: Mom is processed from the ER's front desk to the "sub-waiting" room, i.e., a waiting area past the double doors and inside the ER proper. Sean and I remain outside in the main waiting room. Later on, Sean decides to go inside, since he knows he has to leave soon. I nap.

4:00: Sean taps me on the arm to wake me up. He tells me Mom has been moved to Room 31 North. Not long after, Dad comes out and I go in to see Mom. I notice right away that no one has placed an isolation cart in front of Mom's room. These carts, which contain the paper gowns and rubber gloves we have to don when entering a MRSA-positive patient's room, are supposed to be there at almost the same time the patient has been berthed. My immediate thought is that Dad forgot to tell the nurses that Mom was MRSA-positive.

4:15-ish: Quite by accident, I meet Dr. Bagenstos, one of Mom's docs, in the ER. "What are you doing here?" he asks. I roll my eyes: "Mom's PICC line is blocked." I mention that Mom is MRSA-positive but that no one has put an isolation cart by her room's door. Dr. B finds another employee, who has to look around a bit to find a cart. I peek quickly past the curtain of Mom's room to say hi to her, and to tell her I'll be in shortly.

4:20: I gown and glove up, and step in to see Mom. She's once again on a gurney, with no pillow for her head. She's using her arm to support the back of her head-- exactly the sort of thing she's not supposed to be doing, because there's a chance she might unmoor her skin graft or reopen one of three long incisions across her scalp. I de-gown, exit, and ask another random employee to find a pillow for Mom; she very kindly stops what she's doing and finds two pillows.

I sit in the room and talk quietly with Mom in English and Korean, re-explaining why she's in the ER, trying to impress upon her the chain of events that have led up to this moment. Mom seems to understand, but as always, it's hard to tell.

5:50: Mom's been waiting 2 hours and 50 minutes for someone to see her. A nurse steps in; turns out she's half-Korean and has overheard me speaking Korean to Mom. She explains a bit about how PICC line blockages can happen, and describes the dissolution-suction procedure, which takes from 1 too 2 hours. She starts the procedure, then promises to be back at 6:20 to do the other half.

The procedure involves administering a solution that dissolves the blockage. A full dose is given as a 2-step procedure: 50% push, wait 30 minutes, 50% push, wait 30 minutes, then suck out the dissolved material. If the PICC is still blocked, wait another hour.

6:22: I'm back in the ER after typing all the above. I've found out from Dad that he did tell the professionals about the MRSA issue. The nurses, as it turns out, are done and Mom is ready to go. All that's left is to process out. I'm on my way to the parking lot while Dad deals with paperwork and the nurses fetch a wheelchair. Soon, we drive back home.


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