Today marks a week of Roy residing in this room. His kidney function is improving and he’s almost, almost able to take his normal liver medications. The week behind us is a little blurry – him dozing, meal trays in and out, medications dispensed or IVs being started/stopped, vitals being taken, and nurses or patient technicians helping him up to the bathroom or adjusting his position in his bed. It’s very much a traffic circle and he is the island in the middle. The personnel change as shifts and service rotations click along through time, but he’s here in this bed (or recently in the bedside chair) through it all. Most of the hubbub happens in the hallway with an occasional bout of screaming from other extremely confused and ill patients nearby. Roy is tired.
The hospitalists and the in-hospital nephrology team are once-a-day folks. There have been periodic visits from the floor manager, the social worker, nutrition, the patient education team, and specialized attention from wound care, ultrasound or X-ray, but mostly the traffic is floor-specific: housekeeping, nurses, and patient technicians. I am a bystander watching it all, occasionally helping when I can, but mostly here early to catch the hospitalist on his rounds and then until shift change and a bit after to catch the other care team members as they move in and out of this circle. I have learned a lot of new terminology and simple things like how to help slide him up in the bed or make the bed alarm stop blaring temporarily. Lisa and Derek came to visit but didn’t actually get to talk to him – he slept through the conversation – and he had a quick visit from Russ.
Roy has shed some of his accoutrements, but is still tethered to a Foley catheter and a cardiac telemetry machine consistently. He periodically gets albumin or fluids by IV and some medications by injection. They haven’t used the very smart port. He gave back the oxygen canula and only wears the gait belt when required. He has not been able to take his normal diuretics so he’s a bit puffy and uncomfortable, but they decided against doing paracentesis for now.
If his kidney function continues to improve, after they let him try to begin his liver medications again, then he might be released. Where he goes from here is still being determined – he might go to an inpatient rehabilitation facility or he might get to come home and have home health, or he might get to come home and depend on me and the feline helpers. It’s still up in the air. He’s likely to be bringing the Foley catheter with him until he can see a urologist post-hospital.
Occupational Therapy and Physical Therapy came for the first time today. His body has been through the wringer so he is much weaker now than he was before and needs to build up his strength. He did a short hallway walk with them and they will become part of his traffic circle while he is in the hospital.
His oncology treatment is on a pause. He won’t have the next infusion (scheduled for June 25) and what his options and steps are regarding the HCC will be determined after he has recovered a bit more than he has now. We’re keeping all the teams in the loop and checking to make sure that we don’t make a glaring misstep on this path.
Waiting 
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