Day Three Hospital
Woke up at 4am to Moma calling me on my cell phone. I answered and all she said was “I’m Scared” “Come up here”. I jumped up and got ready to go to the hospital. When I was in my car, she called me back twice asking where I was. My sister called me shortly after and said she had called her as well. She told me she was getting ready to go to the gym but was turning around to come here. She said she had been moved to the ICU floor and finally had put in a room. Moma called me back telling me she was scared again. Now this is extremely difficult to hear your mother say on the phone and hear her rapid breathing. In school when patients have that pending doom sensation you really need to follow what they are saying if it is matching clinically. I asked her if she was still in the Emergency Department, and she said no “525”. All I could think was this the last time Ill ever hear your voice. I can’t handle not having a Moma yet, not ready. So I get to the hospital and start the hunt for the ICU. Well that was a challenge. The unit she is in is at the end of what looks like an abandoned unit. You walk down the hall and there are rooms in disarray looking abandoned and dirty. Finally after searching for 10 minutes I was able to track down where she was in NICU 525. I walk in and find her nurse standing there. The nurse said she had been moved shortly after I left that night before. The nurse said she wasn’t being compliant and was irritable. So automatically I say that’s her sometimes and asked if she had gotten anything for pain or anxiety and she responded “no”, odd why not? Aren’t you supposed to think of stuff like this on your own? I walk in the room and find her sitting on the side of the bed breathing 52 times a minute. In obvious distress with saturation in the 80s. In my opinion out of all the discomfort and anxiety a patient can have a respiratory patient is the is the worst. Someone that can’t breathe is the most uncomfortable situation for everyone. So we are at 38 hours into the breathing difficulties, and she has made no improvement only getting worse. She couldn’t speak much and was extremely exhausted from breathing. The nurse came in and said she was going to give her a “little” Ativan IV push. Within a minute she started to slump over, and her saturation dropped. The nurse helped me throw her in the bed and pull her up. This did settle her down some, but she still had the persistent air hunger and breathing so rapidly, but the saturation came up some. My sister got here at this point. She was very displeased she was given a sedative instead of morphine for the air hunger. Not sure of the justification, but it was over and done with. The pulmonologist/intensivist was on shift now. He was supposed to come see her soon. That morning the Respiratory Therapist showed up in the room making rounds. This woman was like an angel, you could tell she cared, and it was so relieving to see her. She was looking at the Bipap and made a “hmmm” sound moved around a few settings and said that’s odd. At that point I asked is that the same Bipap that she’s been on since she’s been here, she said yes. Now I know a few things about Bipap and vents so I kinda of know what I’m looking at just may be laid out differently than I have seen before. Apparently, my mom had been put on foolish settings. Now mind you she had been on this Bipap for about 35+ hours now. She hadn’t had the humidifier the entire time, that’s why her mouth was so dry when I noticed the night before. They didn’t have any kind of settings like peep or the humidifier to help with her inspiration or respiratory quality. The RT Heather took time with her and just invested in her care and that just made me so thankful that she was on shift today. Now the ICU nurse we had Barbara; she was less than desirable. Gave that stare off into space look with any question you had. Roughly five hours later my sister showed out, showed her full self. She wanted a provider to come in there and she wanted one now. I mean obviously these two women are where I get my attitude/passion from. It was overdue for her to be evaluated especially when you hear from the RT and nurses that Moma was one of the sickest patients in the hospital. The Doc had even had a conversation with my brother-in-law when they both pulled in the parking lot that morning. Not only did he ask for a physician-to-physician favor he informed him of how critical she was. Fortunately Dr Garwood walked on the floor and realized Moma was on the floor. She had worked on a HIV project with Moma when she ran the Open-Door Clinic in Statesville. Dr Garwood popped in and said boy She did a brief assessment, and I was like ok tell me what you’re thinking. She was very hesitant. My sister said don’t sugar coat it we can handle it. The NP said I can say she has a long road ahead of her. As far as intubation that would be up to McGuire the pulmonologist. The NP then said she wanted to give her Clonazepam (sedative) instead of anymore Ativan. My sister said she didn’t want to do that because the clonazepam would last way to long and that wouldn’t be ideal for the unpredictable state, she was in. We asked about intubation again and she said she would consult with McGuire that was not her domain. Roughly an hour passes McGuire comes in to assess her and he decides he wants to intubate her. Finally after all this time of her struggling to survive he visually saw how bad she was and decided to tube her. My sister and brother-in-law are furious he took so long. I’m just happy something is happening. I needed to go outside to breath a minute at this point. Ricardo text me and said they’re getting ready to intubate her, so I head back up to the room. As I walk in the room Moma is laying there still breathing 64 times a minute. Ivy is holding her hand and crying. Ivy said, “she knows and she’s ok with it”. This gave me a huge sigh of relief. I grabbed her other hand so both babies were at her bedside, and she could see us both. I told her I loved her, and she said, “I love you too honey”. Dr McGuire comes in the room as they move the vent in the room. The RT we like, and the nurse are there. He told us he was about to put her under and intubate her. I’m sure she could hear it all, I am unsure what she felt. I know what I felt that large hot mass in my throat. He asked us to walk out. This was the absolute worst part looking back through that glass as the door shut waving. Was this the last time ever? What was going to happen? As my sister and I walked away all I could think was its just us two now. I didn’t want Ivy to look at me or talk to me because I was a ticking time bomb. She looked at me I would look away. She put her arm around me, bam couldn’t talk and had the lump in my throat and hot tears running down my face. Ivy had to head home to finish her case load of patients. I sat in the ICU waiting room staring out the window just thinking about everything, crying like a baby. I would have thought this almost abandoned floor and this waiting room would become my new comfort zone. I set up right by the window with the blinds pulled up and was able to stare out the window. This floor also has a chapel it was ugh ok but this lobby is my go-to. Eventually the Doc came in and said he had a hard time sedating her, but he had the tube in now and she was stable. He said they were still doing some last-minute adjustments and I could head back in. So here I am in my little safe space lobby feeling a little better that she didn’t die through the process, and they were able to secure an airway. All I could think of is what is next. Apparently, this was going to be a question I was going to have over and over. I walk back into her room and see her lying there with a tube in her mouth. The breathing rate dramatically decreased from when I last saw her. Just the factor of her being so sedated was difficult to take in. Her vitals were funky. Obviously, she just went through a lot so my eyes were glued to the monitor. The nurse that I didn’t love came in and was frantically asking me to sign a paper. I asked her what I was signing she said for the central line. I'm looking over it like oh god its something else and I felt like I needed to not trust her. It in fact was for the central line so I signed the consent for placement. Within moments the attendings nurse came in and said they needed to set up for a central line and asked me to step out. Once again, I'm like damn I just got back here but ok. No reason to act out for any reason I didn’t want to delay any care on my mother's behalf. Fortunately, the nurses were very friendly and let us walk freely in and out of the unit, so this was no concern for me. I also didn’t take advantage of this so anytime I would leave the room I would get everything I needed done like a drink break, mask break outside or bathroom break. I tried to stay at bedside as much as possible because it made me feel better and made me feel like she could tell I was there. So I walk off the unit and Ricardo had gotten me a salad. It was roughly 3pm by this time. I hadn't really ate since the day before around noon so I figured it would be best I should eat. He had me come in the hospitalist lounge where all of his fellow teammates were. They were all friendly and spoke and asked Ricardo how mom was doing. It was nice to sit and eat. He tried to make light conversation, but I just couldn’t commit to talking about anything and only really had short answers. We ate pretty quickly, and he asked me do you want to go back and check on her and without hesitation I said absolutely. Just worried about what I would find. Just the anticipation on the brief walk back made it feel like forever. We arrive back in the room through the doors that do not have a lock on them that we were told to use. Walk in the room and there she is laying there blue as a blue berry fighting the vent just looking like hell. Shear panic, I think about the times on the vent unit we would reposition them or suction them and it would clear up. I ran through my head what can I do, she was positioned fine, she had high flow O2, he had confirmed the tube placement what else was it? The nurse walks in and I was like can you get respiratory or something she isn't doing so well. She lays eyes on her and was like her BP is low let me go check on something. I'm like the hell lady, patient is in here. She goes out of the room. We continue to stare at the monitor and her saturation is in the 70s and she's just fighting the vent. Another nurse walks in the room (thank God). She said oh yea we need to fix that. She felt she needed her sedatives adjust. She cut the sedative off and did some short IV pushes to help settle her down. Once again, another angel. This nurse was built for ICU she was made to do this. She also was very compassionate about it. She was roughly 6’5 maybe taller. Ricardo said watch your head and got tickled. He said it's always something when they show up together on the rapid response team with the major height difference between them. That did not bother that girl, she was good, and she had what it too. So, she finally starts to settle down. Ricardo goes on to do his assignment. I sit down beside her and just tell her I'm going to need her not to die. I didn’t really know what to talk about honestly. I still was at the point thinking how sedated is she? Is she going to remember any of this? If so, I won't hear the end of it when she does wake up, she will be mad as hell. On the same note I want to hear her be mouthy and mad about it. I'm ready, I want everything back to normal right now. So, I sat by her bedside just there, I didn’t really have any concept of time at that point. My best friend showed up, the one that brought her in. She had a vase with fake flowers, a balloon and a box full of stuff. This kind of gave me relief, it was relaxing to see a face I knew. Ricardo walked in at the same time, and we had a little reunion. Kristen was talking to Moma, and we talked about how they had weaned her down some on oxygen and just talked about how it all happened. Kristen talked about some stuff from her work which was a nice distraction. I read her card Kristen got her and got a little choked up. Kristen wanted to pray with her, neither one of us made it through without crying. Kristen went on her way, and I stayed a little while longer just sitting there. About an hour after shift change, I decided to go home. I felt guilty again for leaving her but there honestly was nothing I could do. My sister was going to track her through the night. I headed home.
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