An Aortic Adventure, Part 3

25 10 2008

I was glad that Vera could make the trip with us to Vanderbilt Medical Center on Saturday.  She had stayed behind on Friday to take care of our animals and to send an email out about Jim.  When we arrived at the ICU–Jim was no longer talkative.  No more “happy” medicine was administered through his many IV’S.  It was important for Jim to tell the nurses when he was in pain–especially if he had any tearing sensations in his chest.  Jim wasn’t allowed anything to eat except for broth, clear juices, and geletin.  He wasn’t very happy about that situation at all.  I don’t know what the thinking was about food–except that Jim might have to have emergency surgery.  There was a funny moment when we couldn’t find Jim’s broth.  Vera went down the hall to catch his nurse to inquire about what happened to her dad’s broth.  The nurse came into the room with a flustered look on her face and showed us the cup she had poured the broth into so Jim could drink it –instead of trying to use a spoon. 

I could tell that Jim’s body was swelling because of all of the fuid and medicines being pumped into him.  The doctor was writing orders for blood pressure medicines given by IV– to work on getting Jim’s blood pressure and heart rate down.  Such was the course of his entire  week in the ICU–having his medicines or dosages changed.  The ICU nurse was in at least once each hour.  There was a computer in our room where the nurse on duty  sat and typed in information concerning JIm’s health.

Sandy and Vera stayed until about 4:00 p.m. that afternoon.  When they left me–I certainly felt a void.  I was glad that I had a bag full of books to read.  I have the kind of personality that enjoys being still and reading for hours.  At home–I rarely get such opportunities.  Thus, if I was going to be confined mainly to the ICU–I would use the time to read.  I especially enjoyed reading a  biography about  Daniel Boone.  Being a Kentuckian–I wanted to learn what was folklore versus what was the truth about Boone’s life.  I also had some Russian novels and a book by C.S. Lewis.  Lastly, I had my Orthodox Study Bible. 

I had made the decision not to stay with my brother who lives in Nashville this time.  I enjoyed their hospitality three years ago, but now I knew that I didn’t want to miss anything that might be happening to Jim.  I wanted to know every detail.  The doctors often didn’t come until later in the evening or early in the morning.  I missed most of those times when Jim was at Vanderbilt in 2005.  My decision was the right one because on Saturday evening the surgeon’s assistant came to talk with us.  He drew another picture for us about what was going on in JIm’s aorta.  He explained that the surgeon would be taking the bovine valve out and replacing it with a “piggy” kit that included new aorta roots and a valve.  He also told us that the vascular surgeons were looking at the aneurysm on the descending aorta.  Those doctors had some decisions to make.  It probably wasn’t possible to fix the descending aorta during the open heart surgery.  Also, a heart cath was scheduled to check Jim’s arteries. The picture of what Jim’s surgery would be like was getting giganic.  I didn’t have a good feeling about any of it.

Meanwhile, Maria was the only one of our children who hadn’t seen Jim.  At last, she was able to visit with us on Sunday.  Vera had decided to drive again to Vanderbilt and picked up Maria.  Jim didn’t feel well at all.  He had been having nausia which resulted in dry heeves.  The graveness of the situation was telling on us all.

Monday, I had a break when a girlfriend of mine came and took me out to lunch.  When we got back to the ICU–Jim was having an ultra sound done. And earlier that morning, a heart CT scan was done. I wondered what all the tests would reveal.  A couple of hours later the surgeon’s assistant came and told me that Jim’s “widow maker” artery was blocked.  So along with everything else –Jim would have to have bypass surgery done, too.  It was just too much for me to absorb.  I had been having shooting pains in my left side– especially down my left arm.  I told the nurse about the pains and he insisted that I have them checked out in the ER.  So they put me in a wheelchair and off I went to the ER.

My brother Brad and his wife had gone to visit Jim and found him asleep.  They called me on my cell phone and I told them that I was in the ER.  They came down and stayed with me for a few hours.  I had an EKG, a chest x-ray and some blood work done.  By 7:00 p.m. they had told me that I was staying the night in the ER to be monitored.  I had another EKG done before midnight.  I felt so silly because all I expected was just a routine checkup and that I would be back up to the 5th floor to be with JIm.  It seemed a bit much to me but I obeyed their orders.  They monitored me all night and I had another EKG and more blood work done early in the morning.  By mid morning, I had a Heart CT scan and the cardiologist told me that I was in great shape.  Finally, by noon I was back with Jim.

I was glad that all three of my girls were visiting that day.  They came down to the ER to be with me until I was released.  It was getting tiresome wondering when surgery would be.  It was also getting tiresome wondering when the heart cath would be done.  They told us that it couldn’t be done the regular way through the leg.  Instead, the cardiologist would go in through the arm.  Jim would have to fast before the test was done.  They had started giving him regular meals so I knew that the heart cath was ruled out for Tuesday. 

I decided to settle down and read my Boone biography.  It was going to be touch and go for a couple of more days.  I needed to relax and get my mind off of thinking about the upcoming, long 11 or 12 hour surgery.  I didn’t see how Jim could survive such a surgery.  He had already been through one such surgery and didn’t fully wake up from that ordeal for several days.  How could his body stand another long surgery?  How could I stand seeing him hooked up on all kinds of tubes again –laying in bed unconscious with a ventilator in his mouth?  As I read about Daniel Boone–I tried to put those horrible thoughts out of my mind.

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2 responses

30 10 2008
Roads

How stressful this all must have been – no wonder it caused you to feel unwell yourself. At least you were in the right place to be checked out – and I hope the heart mechanics gave you a good rate in the light of all the business which Jim was sending their way.

Joking aside, the medical team and the care you have at your disposal sounds to be first class. You’re very lucky to have all this available, even if you might not have wished to use it.

What’s especially vivid from your descriptions is how the doctors take the time to describe to you exactly what is happening, and to keep you involved in the decisions. Relaxed thinking time with the consultants isn’t always a luxury available under our National Health Service, wonderful as it is.

It’s still possible here to take private care if you desire, but you need to be paying for additional private medical insurance.

But under the NHS, which is how 90+% of patients are treated in the UK, they are necessarily more budget-conscious and inevitably they have to get on to the next patient rather more quickly than if they were being funded by a medical insurance company. The most excellent and exceptional doctors, like those at the Royal Marsden (cancer) Hospital in London always manage that trick of appearing to give you time, whilst actually still moving at an impressive rate.

It’s all in the bedside manner. Technical skill is one part of being a doctor. And people skills are most definitely another.

Kind regards and best wishes from London.

30 10 2008
nichole3

Roads,

Yes, the medical care that Jim and I received was very top notch. Doctors and nurse practitioners were very detailed with us. Our questions were answered in detail. No one ever brushed us aside.

Still medical care is very costly and we have a large segment of our nation that has no coverage at all. They would get the same care but the bills would take several lifetimes to pay.

We just received Jim’s bill for the hospital only-not the doctors. It was a little over $200,000 dollars. Thankfully, our insurance will cover all but about $4,000 or $5,000.

There are pros and cons to both systems. Still, I think it is wonderful that people in the UK don’t have to worry about medical bills.

Thanks again for your comment. I always enjoy hearing from you.

Blessings,
Nichole

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