Sick of hospitals

It's my fourth straight day of coming to the hospital to visit my grandfather. On Saturday 1/10 he was admitted for fluid buildup in his lungs and when they examined him it turns out he had a small heart attack and his kidney function was only at about 5%. Remarkably, he was still very active and talkative on Saturday despite all that was going on with his body. All they did on Saturday was put in a catheter and give him medication to help with urine output, then they just wanted to monitor him to see if his kidney function improved.

I spent the night with him in the hospital that night. With the language barrier I thought it would be scary for him to be here by himself and not understand what's going on. It was kind of a long night since he only slept for 20 mins. or so at a time and every time he woke up he instinctively tried to get out of bed to use the bathroom. The catheter often makes you feel like you have to go even if you don't, plus it turns out he had a UTI. But catheter + IVs = no getting out of bed. So, every 20 mins. I had to explain to him that he had a catheter in, that he couldn't get out of bed, that, no, he wouldn't wet the bed and it was all OK. Every. 20. minutes. He just couldn't remember and I think there's also just the fog of just waking up and not really being with it. My grandfather can be a really stubborn man so it's a wonder he put up with me constantly telling him what to do.

He got through the night OK and some other family members took over the watch around 1:30pm on Sunday. He finally got tired just before they showed up and started nodding off since he didn't sleep well the night before. I went home for some sleep myself and came back in the early evening. Apparently he hadn't waken up at all since I left and when family members decided maybe he shouldn't sleep for so long and tried to wake him, he wouldn't open his eyes and was generally non-responsive.

We were obviously really upset because he'd been doing pretty well before this. They took him for a CT scan but it turns out he didn't have a stroke. Unfortunately they had to intubate him for fear his brain wasn't functioning enough to tell his body to breathe. So now he can't communicate with us beyond nodding or shaking his head. Later that evening though he appeared to become lucid again and when the neurologist examined him he was able to lift both arms and legs, push with them, and generally seemed to be doing well considering the scare.

I didn't stay with him Sunday night as it seemed he would sleep through the night given how tired he was. Plus they had restrained him to the bed so he wouldn't try to pull out the intubation tube so he couldn't get up. I definitely felt some guilt at not staying because I kept thinking about how he was confused when he woke up the night before and I had to calm him down. But I knew I'd have to be here a bunch this week since I'm the only one not working so I figured I'd better get some rest.

Monday (yesterday) morning he went back to being non-responsive. According to the nurses he was alert when they went to brush his teeth and stuff around 9:30 or 10am. But my dad got to the hospital around 10am and between then and when I arrived around 1:30pm he was not really responding at all. Wouldn't open his eyes, though he moved his arms and legs a bit sometimes. Then he took to pulling his gown down with some serious force. I mean, I couldn't break his grip on the fabric! So I teased him that if he had enough strength to do that, surely he had enough strength to open his eyes and look at us! Stubbornly he still refused. I think he was just hot because the room was fairly warm so we turned down the temp a bit and he seemed better.

More family members arrived around 4:30 and 5:30pm yesterday and, finally, he opened his eyes for us! First it was just his eyebrows lifted up high, like he had to do it a step at a time, then finally, slowly, he opened up his eyes. Such relief! He responded to a few yes/no questions but we weren't 100% sure if he understood everything. This was important, because we needed to know whether he wants to be put on dialysis. Apparently there were two possible reasons he was suddenly being less alert: (1) the urinary infection or (2) his low kidney function leading to buildup of creatinine in his blood. His kidney function was not improving, in fact it had declined a bit in the few days he'd been in the hospital. The UTI was being treated with antibiotics but it didn't seem to change his alertness. That left just the creatinine increase, and the only way to treat that is dialysis. If he could decide for himself whether he wanted this invasive procedure, we wanted to give him that option.

The first couple of times we asked him if he wanted to go through it, he shook his head no. It was really difficult for us to deal with that answer, but if he meant it we would respect his wishes. Then again, we weren't sure if he was totally with it. Right around then the team of doctors--cardiologists and a nephrologist (kidney specialist)--asked to meet with us to discuss options.

I asked the nephrologist a bunch of questions. Most importantly I wanted to make sure he wasn't going to be put through a lot of pain. Because he already has a tube into his stomach in addition to the intubation tube they said they can sedate him for the procedure of putting in the dialysis catheter and he wouldn't feel any pain or remember any trauma from the procedure. We explained this to him and he decided that he wanted to do the dialysis. Hopefully he'll respond to the treatment, get extubated, and we'll take it from there. If he doesn't respond...well, we're no worse off really.

So now I'm sitting here waiting for the kidney team to come and place the line to start the dialysis. They're late, of course (by more than an hour at this point). Will update when I can.