Saturday, November 08, 2008
Another Really Long Post, And Why? Because I Have Time On My Hands.
It turns out that what we had thought of as our wits end, was just a portal to the next level of the inferno. Over the last few days, Karen had seemed to be slipping away from us. She was almost never awake, and when she was awake, she was confused, disoriented and hallucinating. Finally on Friday, she never was able to wake up at all. I called her doctor's office and insisted on talking to someone. Eventually, the PA said that she would send the visiting nurse over to turn down Karen's pain pump and to add a saline drip. She called a few minutes later to say that, no, Karen should just go to the hospital where arrangements had already been made to direct admit her. We found out later, that was because the visiting nurse refused to turn the pump down as drastically as the doctor wanted. That's why it was such a surprise that the EMT's gave her Narcan, which completely counteracts the effects of Fentanyl. So that rather than have a debate about how quickly to titrate her down, the EMT's just threw her into immediate withdrawl. Apparently if they don't find an emergency, they have to create one. I suppose by the same token a fireman should bring his own matches. By the time she arrived at the ER, she was having DT's. They're called the shakes, but that doesn't really do justice to the bed-shaking, uncontrolled writhing, and arm and leg flailing. About then, the ER doctor told me that, in fact, there were no orders to admit Karen. I'm afraid that I used a very bad word to explain how I wouldn't have come at all if I'd known that, since we've made so many fruitless trips to the ER. They did admit her after a few hours with a promise to not make any changes in her meds till we came back this morning. Which, of course, was one more lie. When we got here, her meds had been cut by almost 80%. When Dr. Childs, DO. finally showed up, I asked him if that wasn't a pretty big drop in one day. "Do you want to take over her case?" he asked. Really, he said that. I told him that, no, I didn't, but, gesturing at Karen, I told him I wasn't all that impressed with the job he was doing. "Well, maybe we should arrange for another practice to take over." Amazingly, Leah, of all people stepped in and smoothed things over. It's like we were playing good cop, bad cop and I was the bad cop this time. Playing bad cop was fun. Sometimes, I bet the bad cop isn't even playing.