Thursday, January 18, 2018

The Upward Slope At Last

Well.........finally.
It was certain there were some staff clearly overjoyed to see us leaving the hospital when on March 13 George was finally released from captivity. He had a long recovery ahead, (we needed to continue his intravenous antibiotics medication at home).........
BUT HE WAS HOME !!
At last he could recover. I have not included many of the details of this harrowing time, some head-shakingly unbelievable and best forgotten. George still has many doctor visits, much medication but is on the upward slope to recovery.
What an experience !!

Finally Heading Home

Going home day actually arrived (to our delight)........Feb 11, 2014.......and now he could recover!
We were both delighted and nervous about being on our own with this recovery process. It was a struggle of discoveries not meant to last for us as the 14th dawned on a troublesome high temperature for George and in general, feeling very unwell.
Being home was not to last...........(Happy Valentines Day)
I called the ambulance on advice of the Homecare Nurse and once again George was admitted to hospital (Surrey Memorial) with a serious staff infection, with which he had been sent home from Vancouver General. Some disheartened were we both, as a whole new series of struggles placed themselves on the table.
From emergency George was admitted and transferred to a 'holding' area of the hospital. It was the OLD emergency department of the hospital and certainly not suitable to house patients who had to spend any amount of time confined. There he would remain in this dark, dingy prison-like ward until we finally resorted to (me) very un-lady-like behavior. It was while housed in this horrible place he underwent another surgery (green laser) to relieve a blockage which would hopefully help him to be rid of the catheter still in place. Trying to return him to the same location following surgery, the hospital staff experienced my little 'tantrum' (which George supported) and he was finally transferred to a decent room........actually had a window to look out of.
After this last surgery George would receive a total of 5 units of blood over a period of 6 days. He endured countless episodes and incidents of less than adequate patient care, from seemingly unconcerned doctors to obvious inexperienced staff, who on one occasion (while inserting a catheter) inflated the balloon in the urethra.........there was so much blood it could appear he had just been shot. This episode took long to repair and very long for George to recover from. The frustration of it all is not having any avenue or recourse to 'fix' the situation at the time the incidents happen.........there is a route for complaints but it is clearly written that you can expect a response to your correspondence in 10 to 14 days..........perhaps the patient may have died by then.......what the hell ???
Our medical system truly needs reworked. It probably needs no mention but hospital food was indescribably bad........(more so for a vegetarian). Did you know that all the food served in these hospitals is prepared in Calgary, packed, frozen and shipped by truck out here to BC.???? 'Tis the truth! George's weight at one point was down to 130 lbs (he only knew this because he weighed himself).......if I had not been bringing in food from home every day I'm not sure what he would have gone down to and further, if they every would have checked what he weighed.        this saga really will end soooon 

Complications Anyone?

........and now he could recover..................or so we thought.
After surgery and in Recovery, George was for many hours fighting the breathing tube which is inserted to be in place during surgery. He was unable to explain what was going on (because the tube was in place), but it was not functioning properly and continued to fight his own efforts to breathe. Not knowing the machine was malfunctioning, they would not remove the tube until he could breathe on his own...........he couldn't breathe on his own because the machine was taking over...........a vicious circle and most unbearable circumstance for him to lie there enduring such a situation (and unable to speak about it). Finally, to his relief, it was over and the tube was removed after about 18 hours of torture.......not George's finest hour or most positive experience with intubation. He was moved to ICU that evening.
After a few days in ICU where he was monitored closely (not as close as Recovery but the care was pretty good) he was moved to the Step Down Unit. This unit was, like its name, a step down from ICU. It was here I began to have issues with 'patient care' and would find repeated opportunities to question the hospital and medical system; it seemed though that George was slowly moving upward and onward.
........and now he could recover..................or so we thought.  
By January 30th (while still in the Step Down Unit) he was in Atrial Fibrillation. Karli was visiting at the time and we were told by George's nurse we would not be able to accompany him to the Cardiac Unit. Based on this advice, Karli went home and I decided I was going to go with him anyway. Quickly taken to the Cardiac Unit he was sedated and given shock treatment in order that his heart rate would return to normal. He responded well, his heart returned to regular rhythm and as it turned out there was no problem with me being there with him; it was just the nurse deciding she was in charge of the world at the specific moment we asked the question..........frustrating and had I not decided to go in spite of being advised not to, George unnecessarily, would have been alone with no one to talk to or be with. Another hurdle over but now he could begin to make his recovery.
After a few days in the Step Down Unit (where the care  was questionable) he was moved to a private room (much more pleasant). During this entire time he was also contending with a catheter which it seemed he could not eliminate from his life (little did we know how long this would prevail). While in this private room George was not being monitored closely enough (ie: doctors wanted his blood pressure to be at certain levels); his doctor visited and found his blood pressure to be extremely high; this resulted in a move back to the Step Down Unit where it was thought he could be watched more closely (and should have been because nurse to patient ratio was 1 to 2)........but that was another fallacy we learned about. There were extended periods of time when all nurses were totally absent from the unit; patients left alone and when I enquired was told "Well, they must have gone to get something." It almost felt like a nightmare from which we could not waken.
Well..........we did wake and George was moved again to a private room where he had a male nurse who took very good care of him (probably some of the best care he had during his entire stay in hospital). Alas this also was not to last; by Feb 6th it was confirmed there was still leaking from an artery in his arm for which they would perform an angioplasty to the left subclavian artery, a routine procedure to stop the leak (or so we were told). This procedure was done in Radiology; George was awake during the process which he said seemed to be performed by perhaps students being given instruction. After much discussion about how best to get the job done they finally got it done. Upon removing the instrument used to perform the coiling, a device was deployed to close the puncture; the device instead closed the vessel entirely and he had no blood flow to his left arm. Very quickly he was experiencing extreme pain and was finally taken (once again) to OR to by-pass this screw up and return blood flow to his arm before he lost the use of this limb.
I assumed he would return to his private room following this hullabaloo so I left my belongings in the room when I accompanied him to surgery. When I returned to the room to get something I was shocked to find someone else already in the bed and all our things gone. I was informed he would be going back to step-down following his surgery and time in recovery. Oh my god the nightmare continued and back to the step-down he went.
But George persevered (he had no choice really) and after many bids to have him moved from this unit (unit which was curtained, light restricted and so not conducive to good patient care) we were finally advised he would not be moved from the unit until there was a replacement patient for the space he occupied; the hospital would not leave a critical care bed empty! As unbelievable as this sounds and the implications of that statement it is the TRUTH; a truth we had great difficulty with. Eventually there was a patient who needed the critical care bed and he was evicted (so to speak) to take up residence in a room which I feel certain they chose especially for him because we had questioned their motives, actions and policies etc..........it was also less than pleasant; we had no choice but to make the best of it though.
........and now he could recover..................or so we thought........apologies for sounding like a broken record but there is no describing the hopeful times we thought he was on the way to recovery.                      this saga to be continued

And Then...........The Sky Fell In

.......or so it seemed.
Late night January 19th. would be the outset to two months of very stressful, troublesome times for George when he suffered an Aortic Dissection. Over the next weeks we would ride the roller coaster of life shrouded in the health care system and oh the things we discovered!
All manner of circumstances dictated our choices and direction, from knowing, not knowing, being told, not being told, thinking, guessing, hoping, wishing, wanting, needing; from frustration, humor, sadness, anger; and the questions, oh the endless questions seeming never to be answered. It was an interval of strife for both of us, especially George; I cannot comprehend how he managed to maintain his calm acceptance of the entire two month ordeal.
As I try to recount George's experience, our struggles and our fights, I so wish I had been keeping a diary of the whole episode from start to finish, but once more I am shown how extremely sharp hind sight is.
On admission (January 19th) to Surrey Memorial Hospital doctors told George he was lucky; his dissection went downward not up, and would not require surgery as would a dissection upward (just some healing time). Well, that was the first fallacy; by the 22nd. another scan revealed the dissection had continued down and was threatening to compromise blood flow to vital organs. A request for transfer to Royal Columbian was made by the attending specialist. To the credit of this doctor, when there was still no bed available at Royal Columbian by that evening, he used his influence to get George into Vancouver General Hospital; transfer took place on the 23rd. when he was taken to emergency and seen by leading Cardiovascular surgeons who performed emergency surgery that same evening. An aortic stent was placed and by-pass done to reroute blood flow blocked by the placement of the stent. It would seem the problem was discovered early enough, corrected and now he could recover..........                                                           this saga to be continued

Passing of Time

Greetings........
This is a precursor to the following four blog posts which have remained in draft since June 2015 when, after many difficult months of illness for George, I wrote about his medical journey spanning two months (January 19, 2014 to March 13, 2014) in hospital and many weeks of home care and recovery following his release from hospital.
During the time between January 7. 2014 and today, January 18, 2018, I have posted nothing to my blog. For whatever reason I didn't even post the story I had written about George's illness. I will post it now.