It was a pretty typical night in the hospital for Christi. The night shift started and a new nurse came on. We found that with each change of shift we had to explain what happened as clearly as we could. The Doctor had prescribed morphine and she was on an antiemetic to help with the nausea. Zofron didn’t help her at all but phenegran did much better. She was in a lot of pain and having terrible gas pains in her left shoulder. One of the assistants brought in a hot water pad that circulated constantly and that seemed to help some. They wanted her to walk but she was in so much pain she couldn’t do much of it. She had her blood drawn around 4:00 a.m each day so the doctors on their rounds could know what her numbers were. Her Lipase number was ridiculously high. It should have been in the 24-300 range and hers was measuring 18,000. That meant the pancreas was terribly irritated and she ran the risk of having pancreatitis. We were having a really tough time getting any answers to the many questions we were wondering about.
I ran home to get a shower and a change of clothes. Erin was able to stay for the day and then Annie came for the rest of it (I think! It's all a real blur now so the girls will have to correct me on this all!). I stayed with Christi all day. We were told she would have an ERCP by Dr. Rasmussen. He described it to us and we had done research online to figure out what it was. We were told that it would be in the morning, but as the hours went by we figured out it wasn't going to be in the morning. Her nurse was Kathleen and she was just awful. Pain meds were late, and she had an attitude and know-it-allness that just really bothered. Christi was treated like her questions were just a bother and that we should just accept whatever treatment or decisions were being made without questioning any of it. Rasmussen had come in the morning and promised her she would be home eating whatever she wanted by the evening. We weren't ever sure if we would see him or not. He was definitely not forthcoming on the process or what was going on behind the scenes.
By noon we realized no one was going to tell us anything and we asked Kathleen if she could call endoscopy and find out a time frame for the procedure. Earlier she had told us there were three procedures before us so it looked like before noon. We finally took matters into our own hands and Christi called the department in the hospital herself and was told that it looked like her procedure was scheduled around 4:00 p.m. No name on the computer, but the description fit her symptoms. Christi was in terrible pain and just dozing through the morphine. She wasn't allowed any food or water and it was tough to see her so uncomfortable. Jim was at school trying to take a test he had postponed on Wednesday. I kept in touch with him by texting.
When they finally came to get us for the ERCP at around 3:00 p.m. (Endoscopic Retrograde Cholangiopancreatography) we were relieved believing this would be the end of Christi's pain and she would soon be home. Dr. Batista was the GI guy performing the procedure and everyone told us we were lucky he was the one doing the procedure. He assured us he had not had any difficulty getting stones out in the past and just patted Christi when she asked about what would happen if they couldn't get the stones out. He was pretty self-assured (bordering on cocky, much like Rasmussen) and let us know it was like 2% that it wouldn't work on. We were just happy that after a really long day we could see the end of the tunnel. He told me that it would take anywhere from 1 to 1/2 hours. At about 2 I was pretty worried and knew things probably weren't going well. They called me in to recovery and we waited to hear from Batista. The nurse was great and helped her come out of the anesthesia with some phenegren. Unfortunately, Batista couldn't get into the bile duct, though he was able to place a stent in the pancreatic duct. The scope entered through her mouth, down through the stomach and then out into the duodenum where he was trying to enter the bile duct opening. He said he couldn't even find it which made him wonder if she had an unusual anatomy. He was happy he could place the stent in the pancreatic duct which joins the bile duct before exiting to the small intestine. He seemed pretty concerned and told us he was ordering an MRCP ( An MRCP uses an MRI machine with special software to obtain images comparable to the cholangiogram and pancreatogram obtained by the more invasive approach with ERCP (endoscopic retrograde cholangiopancreatography) without the added risks of sedation, pancreatitis, and perforation.) which he wanted done right away in order for the radiologist to have the pictures first thing in the morning, and then he would read the report and go from there. By this time (getting somewhat wise to the way the hospital ran) I asked Dr. Batista three times if he had ordered the test, of if there was something we had to do to get it done? He assured me he had called down and they were aware she needed it. But it still wasn't clear how we were going to be called for the test and how the nurses on the 11th floor would know it was ordered. We also asked if he had spoken with Dr. Rasmussen, but he told us he had called several times but couldn't get an answer. He assured us he would keep trying until he spoke with him.
We returned to Christi's room on the 11th floor (room 34) where it was very hectic as she was due for her pain meds, had to have her saline placed in her IV, she needed to use the restroom, they were changing her bedding, and we were trying to get the nurse to order the MRCP before it got much later and they were closed for the evening. Kathleen denied that we were supposed to have the test that evening and by this time both Christi and I were very upset at how the day had gone and the lack of communication all around. I just walked down to the main desk and asked one of the ladies sitting there to please get Christi's chart and check and see if indeed the test had been ordered. We discovered the Doctor had written the order in the chart, but it remained for the nurses to enter it into the computer to put her in the que for the test. She told me she would do it, but boy were we mad. Kathleen argued with us about the test and told us we weren't supposed to have it. Dr. Batista was very concerned and wanted it done right away. We just sort of started ignoring Kathleen and I started playing close attention to what was being said and what was supposed to happen.
In the meantime, we had heard nothing from Dr. Rasmussen and we were pretty upset. Christi was in tremendous pain and so hungry. She called his number and pretty much let the poor kid answering the phone have it. She wanted to know why Dr. Rasmussen hadn't checked in and what was going to happen next, especially since he had joked about how easy the ERCP would be and how she would be home. A few minutes later his partner and surgeon on call came to the room and tried to passify Christi and me. She admitted she had not read the case and proceeded to tell us she was sure Rasmussen was aware and that there was nothing that could be done tonight. We explained to her what Batista had said and about the other MRCP and she said she would check on it. After speaking with her we certainly didn't feel better. If anything we realized that no one was really communicating with each other. It was really disappointing and frustrating and we just didn't know what to do or where to turn.
Thankfully they came almost immediately for Christi and performed the MRCP. We asked them for a CD of the test and they were great about it. Christi went back upstairs to her room and Kathy was her night nurse. She was great, an older lady from South Cal. who just was kind and compassionate to Christi. She was the kind of nurse who came in a few minutes after her shift was over and made sure to give Christi her morphine so she wouldn't have to wait for the next shift of nurses to get their act together. I went home that night so I could get some sleep and we knew Christi was in good hands. I promised I would be back at 6:30 a.m. so I would be there before Kathy left and I could hear what was going on, with Christi. It had been a very long day full of uncertainty and frustration. Dr. Rasmussen's foolish prediction preyed on us and we were so unhappy with his lack of concern and help. We liked Dr. Batista, but at this point we realized nothing anyone predicted was working and we had better get as educated as we could about the different possibilities. Christi was in remarkably good spirits, although completely frustrated for being made to feel like asking the what if's and the why's was some great sin. Erin spent the night again and handled the kids for us so Jim and I could get some sleep. Crazy, Crazy!
No comments:
Post a Comment