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Misadventurous Melissa

Everyday is an adventure, or misadventure as the case may be. It is the latter that makes for the best stories, inspiring the name of my blog. I'm a nurse and an attorney (and way too silly sometimes). I am retired now. WELCOME to my blog! This is a work of fiction inspired by true events. The patients I refer to are a patchwork quilt of various patient's problems mixed together. If you think you recognize someone, you are wrong. These people do not really exist.

Friday, May 15, 2009

Getting Dad Home

Negotiating my dad's release from the nursing home was harder than expected. After finally convincing my mother to let me bring him home, I showed up at the nursing home, unannounced, and said that I was taking him home. They wanted to know why and I told them. In a calm, professional voice I told them how unhappy I was with their facility. How, while under their care my father had gone from being able to walk to now, just lying in bed, day after day, with no one getting him up. He was so weak, he couldn't even roll over. He had also lost an alarming amount of weight. He looked deathly ill and was barely responsive. They called the doctor for discharge orders..

The doctor suggested that my dad go to the ER . That was fine with me. I knew dad was sick and would die if he stayed in that nursing home much longer. The ER sounded great to me.

The nursing home called an ambulance and we met up at the ER. Dad was admitted to the hospital with severe dehydration, malnutrition, urosepsis and aspirational pneumonia. Dad had lost 15 pounds during his two or three months in the nursing home and he was skinny to begin with. That is criminal.

After a week, my father was discharged back to the same nursing home. My mother is not in her right mind and no one consulted with me in advance. As soon as I heard about the transfer, I called the nursing home and said that I would be over to take him home. The director of nursing called me back and begged for another chance to get my father better. She said they had a team of physical therapists who would get him up twice a day. A speech therapist would work with his swallowing difficulties. The hospital had discovered that he couldn't swallow safely and had inserted a G tube (gastric tube) into his stomach through which he was now being fed. She convinced me they had skills that I lacked and that his best chance of recovery was with them. Sometimes, I'm such a fool. I gave her one week.

After the week was up, dad looked as bad as ever. No one had gotten him up and the speech therapist did not even try to get him to swallow. I was livid, but said nothing about the care. I asked for the discharge instructions. While reading through the list of medications, I felt a growing rage. They had been giving him thorazine. That is a drug which is used to chemically restrain out of control psych patients. No wonder dad was such a zombie.

The explanation was that they were giving it for hiccoughs. That is a possible use for the drug, but they were giving it around the clock, regardless of whether dad had hiccoughs or not. They were sedating an old, bedridden man as though he were a young, violent maniac.

Then, I noticed the absence of a critical medication. Dad has A fib, which is a type of heart arrhythmia that causes blood clots to form, if not treated. It leads to strokes. Coumadin is the treatment for this problem. Dad had been on coumadin, but now he wasn't getting it. I looked up from the paper with my eyes in a death glare. The nurse winced.

In a soft voice, I said that my father had A fib. I asked if he had received any blood thinners. The nurse said no. I didn't know who I wanted to kill first, the doctor or the nursing home people who failed to bring an obvious oversight to the attention of the doctor. I took a deep breathe and left to go get my dad in a wheelchair.

Once we got home, I somehow got dad out of the car and into the wheelchair. It wasn't easy. He is dead weight, but somehow, I did it. While going through the garage, dad suddenly stiffened, his eyes rolled back and he started sliding out of the chair. I grabbed him under the arms and yanked him back up. He was stiff as a board. I couldn't stop the fall, so I helped glide him gently to the floor.

I thought he was dead.This couldn't be happening. I went into nurse-mode and quickly determined that he was okay. He had just fainted. He had been laying flat in bed for so long that sitting upright caused his blood pressure to drop. Lying flat on the cold, concrete floor, he was fine. But, now what? I'm strong, but I can't lift a grown man off the floor and into a wheelchair.

I went in the house, got a throw rug and rolled dad onto it. It was a cold day, the concrete was cold and I figured that he was going to be there for a while. It was time for a beer.

While drinking the beer, I considered the options. Calling 911 was tempting, but the paramedics would just take him back to the hospital. It seemed doubtful that they would pick him up and put him in bed for me. My mother suggested having him live in the garage. We could put a mattress on the floor and make it nice. Mom may be nuts, but at least she still has a sense of humor. We laughed at our predicament.

Once the beer buzz took effect, I went in the garage, picked up my dad and put him in the wheelchair. Soon, he was in bed. Then, the real work was about to begin. I had to teach mom how to take care of him.

To be continued, if I get around to it.

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