Posted by: wrmcnutt | September 18, 2009

My, Just LOOK At All The Cardiologists!


Well, that was exciting, and not at all how I planned to spend my morning.

Today started bleary-eyed after only about five hours of sleep.  I’ve been prone to insomnia lately since my Dad’s cancer diagnosis, but it was compounded by my desire to blow up all the virtual mutants with a virtual rocket launcher last night.  I’ve been relieving stress by playing a very old computer game, Fallout (I). It was like being halfway through the last chapter of a novel.  I wanted to defeat the insane master of the evil mutant army before I went to bed.  A particularly poor choice on my part.  I, naturally enough, overslept.  I had planned to just stick my head in Dad’s hospital room for five minutes and then head for work.

You know, I should probably start this story at the end, like I did when I reported out to my sister.  Dad is calm, lucid, as comfortable as can be expected, and jabbering his head off to anyone who comes by the ICU.  But that’s where we end up.  The trip is an entertaining ride.

When I got there, he was moaning, and he had two nurses working on him.  One of them greeted me with, “He’s having a little problem this morning.”  I raised an eyebrow and stepped back.  They bustled around for about two minutes and then one of them stepped out of the room, walking quickly and with a purpose.  She had apparently grabbed the nearest doctor and dragged him in by his elbow, while at the same time signaling the desk to page assorted other people.

I knew he was in trouble, but when the census of medical personnel in your immediate vicinity rises above the number one per square yard, you’re in trouble.  As near as I can tell, at the height of the “fun,” that number almost reached above 1.8 medical professionals per square yard.  We had three doctors, three nurses, and two technicians in that tiny room all at once.  I was trying to stand flat against the wall so I wouldn’t get pitched out on my ear.

His heart was racing and he couldn’t get enough air.  They started using the ‘stat’ word a lot and gave the order to have him moved back to the ICU.  Instead, the head of ICU nursing showed up.  “We don’t have any beds,” she said, “so you got me instead.” She hooked up a portable defibrillator so that they could monitor his heart rhythm, and sure enough, it looked very familiar.

Atrial fibrillation with rapid ventricular response I’ve had this myself.  The condition occurs when the small chambers of your heart start to spasm instead of beat in standard rhythm.  When this occurs, the the large chambers can get confused, wig out, and start racing.  The signals from the pacemaker are misinterpreted and the heart speeds up in an effort to “keep up” with the small chambers.  That, of course, doesn’t work, because they’re not racing. They’re not beating at all, they’re just quivering.  When your heart is racing too fast, especially when you in a condition like my Dad’s, fluid builds up in your lungs, and quite quickly.  The reason he couldn’t catch his breath was that he was drowning.

I didn’t find all of this out until later of course.  All I knew at the time was that everybody was excited, nobody was smiling, and I was in the dark.  So I broke out the cell phone and started texting all the jargon I was hearing to my wife.  Now, she wasn’t at the Emergency Room where she works, but when she said “I’ll be there in ten minutes,” I knew we were in the deep woods.  (When I can call her out of the ER on a moment’s notice,  you know that something is either on fire or bleeding.)  But by the time she got there (in the promised ten minutes) the crisis had passed.  We were back down to two nurses and a professional patient transporter who was about to move Dad down to the ICU bed that had freed up during all the excitement.

Did you know that there’s a drug that can drain fluid from your lungs?  The brand name is Lasix, and when pronounced, sounds just like the eye surgery they use to get rid of near-sightedness, Lasex. The design effect of this drug is to make you pee like a racehorse.  It apparently sucks water from all over your body, including your lungs. There are risks of dehydration, but when you are already on an IV drip, they can predict the amount of fluid it’s going to rob from your system and crank up the IV to the same rate.  So, water out via the Lasix, and in via the fluid drip.  Net loss to Dad, zero.  All very neat and tidy.  I’d imagined the operating room and some kind of wet/dry shopvac to get him cleared out.

So now he’s on a maintenance dosage of Lasix to keep his lungs clear for a little while, and on a drip of cardiazim to keep his heart from racing off.  Now if we could just get his heart back in a normal rhythm, all would be right with our world.  Having had afib-RVR myself, I know that it makes you washed out and tired.  It doesn’t hurt. But you just don’t feel right. But he’s going to be well enough to watch the game tomorrow. I’ve explained to the ICU nurse that he will be stressed AND agitated if he doesn’t get to see the UT/Florida game.

Oh – and today’s excitement was not without its humor.  One of the things that got them excited was that his chest tube appear to no longer be working.  It’s a rather appalling bit of medical doodadery that is currently stuck into his chest cavity through an incision under his ribs.  All manner of appalling red fluids and semi-fluids are constantly being sucked out through it.  Well, in the midst of all the goings on, our medical team got all excited because the suck-o-matic wasn’t clearing the build up of fluids.  Instruments were being checked, machines were going ping, and the status of the Operating Room was being checked. Then, from the foot of the bed came the announcement: “Wait!  No!  His leg is just on it.”

The other humorous moment came much later, as I was explaining to Dad what had happened.  He said, “I thought I was having a heart attack, on top of everything else.”  When I asked him why, he said it was because all those doctors around were cardiologists.  By mischance, Dad’s bed was in the Cardiopulmonary Observation Unit, because that was where they happened to have space when he came out of the OR.  So when he had his crisis, cardiologists were handy. If they had happened to have a bed free in Labor and Delivery when they needed to place him, his crisis would have had him surrounded by obstetricians. I’ll bet that would have confused him.

Ok, one more note – I finally tracked down the surgeon who took out that chunk of faulty lung, and there’s some good news.  The size of the tumor was distorted on all the sensors.  I’ve said before that Dad’s lungs are mulch from the smoking, but that’s not really accurate.  They’re more like lumps of gristle.  The COPD has left him with a lot of scarring, and I think he may have had tuberculosis when he was very young.  And that scarring caused no fewer than three doctors to over estimate the size of the tumor.  When the pathologist dissected the lung node, he discovered that the cancer was only in stage one.  That means that not only have we probably thrown the cancer in a bucket and sent it to the medical waste incinerator, from which it will never return, but that there is no chemo-radiotherapy called for, post-op.  We thought he was looking at at least one course of it.

So all-in-all, it’s actually been a good day, despite its rather stressful beginning.  I’m going home to a martini after work, but I’m all out of virtual mutants.

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Responses

  1. Oh, I am SO with the both of you there. I really, really want some reposado after this damnable week but mixing Vic and tequila is a bad idea, I’m told.

    I’m glad that things with your dad’s lungs are better than originally suspected. I hope you get the martini.

    • Well, the good news on that front is that apparently Fallout 2 should run on my computer just fine. It’s six dollars and has more virtual mutants.

  2. I can so see you *telling* that! 😀

    I’m just thrilled beyond belief that things turned out so well == and that the cancer news was so much better than expected. Same with my friend Lauren — the second spot turned out to be benign. 🙂

    Martini? Have 2.

  3. Wooohooo!!! good news at the end is always a plus. So glad to hear the cancer was much less than expected and no chemo will be needed. You have earned more than one martini today

  4. Once again, “whew!” And Jerusha’s right – have two. (Besides, wouldn’t more than one martian technically be “martini”?) Big hugs!

  5. That is all really good news. I think because we got the storyteller voice instead of the reporter voice I knew it would be okay.
    Either way, it sounds like quite the ride. I am glad it was all good news.

  6. wow. You had quite a day. so glad everything turned out alright.

  7. Bill, I’m so glad that things are better than feared. i’ve been hoping for your dad and family. Wish him well for me .N

    • It’s really great to hear from you. I’ll tell him you sent your best when I speak to him this afternoon.


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