Good Lord

Today was MRI day at the Lawler family household. And a long one it was! Diane and I awoke around 7:40 to head on over to the Hall’s house for our morning stick-a-roo with Sammie. We have to give Sammie IV/pill meds every morning and night to help keep the renal failure at bay. Though we (or Erin) have been sticking him for the past year -- and should be used to it by now -- he’s typically an uncooperative little kitty cat. His favorite trick is to hide under the bed, forcing d-spot to bring out the broom. Why he likes to make his life so difficult is beyond me.

Anyhow, so after the kitties, D and I walked home from the Halls – just as we did 20 years ago. D started breakfast while I helped mom out of bed. Seeing her big brown eyes greet me each morning makes waking up at the butt-crack worth it. Like Erin mentioned, she’s usually too tired to speak and resorts to ‘hmmm’ and ‘yes’ to questions like ‘did you sleep well?’ I look forward to hearing her sleepy voice each time I wake her up. So, after waking her up and cleaning her bed-sheets this morning, I helped her walk to the kitchen to join D and dad for b-fast. After a nice breakfast together, dad and I helped mom into the Honda and headed for the hospital for what would turn out to be an all day affair.

First, they were unable to do a blood drawback on her pick line (sound familiar?). Then, a nurse noticed that her insertion site looked inflamed, and suggested that we have a doctor look at it to make sure it wasn’t infected. I had asked a nurse to come to the house last Monday to look at her site, as it seemed ‘angry.' The nurse’s concern only validated our initial worry. They scheduled mom to see a doctor after her four MRIs (including brain and spine). We wheeled her to the MRI area, and all was going well until I heard a yelp and then crying. I immediately stood up and tried to go in, but only hospital staff were allowed in the MRI area. I stood there with my arms crossed waiting for info. Apparently, one of the techs banged her head on one of the MRI coils -- and right on the scar, no less. Yowsers. She’s alright, but talk about kicking a girl when she’s down.

After the MRIs, we wheeled mom to a doctor's office for him to check on her pick. The guy was less than impressive and seemed unconvinced that mom’s pick could be infected. He acknowledged that the incision site looked irritated but not infected, and that if it was infected, it probably hadn’t leaked to her blood. Maybe I’m confused, but I’m pretty sure that’s exactly what they said just before mom fell septic. Hmmmm. Now that we have the beauty of hindsight, perhaps we could go the extra step and, oh I don’t know, hedge on the thing being infected?? What’s the harm, right? Oh yes, it’s expensive. Or that’s at least what the doctor said. After a short back-and-forth, we finally agreed to have the thing removed and a new one placed in the other arm.

Aw, but we hadn’t anticipated Nurse Ratched down at ER. It seems only ER nurses are able to place pick lines. Yeah for us. As soon as we entered the ER, Ms. Arrogant was there to greet us. Anyone who’s had run-ins with medical personnel probably knows this story: arrogant nurse/doctor who bristles at questions as if they’re a direct challenge to their God-like ability to save lives. When mom had sepsis, Diane was told ‘you don’t talk, he (my dad) talks, he’s the head of the house.’ Back in August, we were told not to worry – that’s why we pay the big bucks. Today’s nurse was another doosy. She was not only condescending to the other staff, she was visibly ‘impatient’ to the patients. At one point, the nurse asked if the site was warm to the touch. I told her yes. She said ‘what’ so I said, ‘you had asked if the site has been warm to the touch and yes it has been.’ She then said ‘oh yes, I asked HER if it was warm to the touch.’ Geez lady, are we going to go there??

We eventually moved to a private room upstairs for the nurse to change her pick. I helped her get mom on the bed, and then took a seat on mom’s wheelchair, which happened to provide a nice birds-eye of the lady as she cleaned the site. We discussed mom’s prior history, and the fact that they’ve been unable to receive a blood drawback for awhile. That alone should be enough to remove the pick, but no, this nurse wouldn’t drop the topic. Dad asked me what the problem was with not having blood drawback so I told him what the folks at Uni-C said – that you need blood to prove the line is positioned correctly. The lady immediately said that it was impossible for a line to be inserted incorrectly, and that the nurses/doctors watch via monitor to ensure that it’s in right. I told her about Craig’s experience and she, again, said it was impossible. Uh?? So, I said, well, sometimes they can slip out, like in Craig’s case, and anyway, it’s just a good idea to get blood drawback. Sheesh, it’s not a big deal, for God’s sakes.

So after that discussion, she continued to clean mom’s site. She told mom that she couldn’t in clear conscience change moms pick line because it looked 'too good.' We talked about this a bit, but bossy wouldn’t have it. She then proceeded to cover mom’s site without changing the pick. At one point, I asked if we should cover the gauze she had placed on mom’s arm. (We’ve been told not to use gauze, as it traps water and allows bacteria to grow, but … ). She then said the following, which is classic: “You need to trust me. I’ve been doing this a time or two, and know what I’m doing. Nurses are experts on pick lines and I’m not here to hurt your mother and if you have advice for me, I’d appreciate it if you would leave it for when I’m done.” Nice. It was all I could do to refrain from saying “ring your neck back in, sweetheart, I asked you one question about freakin’ gauze, and if that’s a challenge to your professional ability, then it appears we have a bigger problem than originally thought. And pardon if I’m not shocked-and-awed by your superhuman ability to insert pick lines. You wouldn’t be the first human to make an error, and anyway, it was a nurse who missed my mom’s infection in the first place.” Thank you, Erin!

I was just shocked to be insulted so quickly and for so little. Once she stepped out, I told dad that I wouldn’t stand to be bullied and that we need to ask why the doctor had said to remove the pick after 6 weeks. When she returned, dad asked her, and she said that “doctors don’t know anything; I teach them what they need to know.” Classic. We then asked how often we should flush mom’s pick, and she said that she'd need to ask. Well, not quite the expert now are we?? She then said that we’re not supposed to use Heparin in her line. Uni-C, however, said we’re to flush it every day and follow with Hep? With the gauze, the flimsy time-frame, the floppy saline job (she was spraying the thing everywhere and touching it on unsanitized surfaces), and bad advice, I think we’ll be seeking a second opinion. I’d trust Uni-C over the Stilly cock-of-the-walks any day.

Our philosophy is simple: we’re friendly (probably too friendly) but we’re not there to make friends. Mom is our priority, and we’ve dealt with enough doctors/nurses to know that mistakes happen, and it’s a patient’s right and duty to ask questions about their care. So, save the faux intimidation for Monday night WWF -- our street-fights are real.

Anyhow, after spending seven hours in the hospital -- and not before a head bonk and a scolding -- we finally returned home to find two irritated dorky dogs waiting for us. We’ll head back to the doctors Monday to review the MRIs with mom’s oncologist, and to have another treatment of Avastin. Let’s hope this one will be a quick turnaround, and sans a lecture. -- J