A visit to the ER

James has been admitted to Mt. Sinai--regular hospital.  He has pneumonia.

James was doing so well at home.  This morning, he had his cup of tea and then, looked odd.  I asked him what was wrong--his friend Doug was about to arrive for a visit so that I could go to Imogen's ball room dancing rehearsal held at the local middle school--when James said, "I am going to throw-up." I will leave out the gruesome details.

He felt hot and I took his temperature--100.  Damn it.  James said, "My head hurts." He has not complained about his head hurting since he left intensive care. Not one day in rehab did he mention his head (and I asked him often).  I called the visiting nurse service and she was at the house in about 15 minutes.  We decided that James needed to go to the ER.  We called his rehab doctor to confirm--I could hear his voice over the nurse's phone saying, yes, he needs to go to the emergency room.

Nothing is easy. I had to convince the ambulance drivers to take me to Mt. Sinai. They initially refused. I argued with them, in a nice way, and they agreed to clear it with their supervisors.  I was peeved. I told them that we were wasting time to receive clearance from their supervisors--we would have been half way there already! 

The city is tearing out the street in front of our apartment. Perfect awful timing.

James did not feel bad in the ambulance although, by the time we arrived at the hospital, his temperature had risen to one hundred and two.

We spent hours in the ER. Never go to Mt. Sinai for emergency services. It was a zoo.  I was so shocked by the amount of people in the space, I turned to the nurse upon arrival and said, "Holy shit!"  She responded, "Yeah, it's like this every day."  Trolly beds were literally squished side-by-side filling every conceivable space. To get a bed out, you would have to move another bed first.  Another nurse turned to me and said, "We need bunk beds in here."

James had a CT scan of his head--no change from the prior which is good news. He had X-rays of his lungs--hence the spot of pneumonia found.  It is all a bit inconclusive though. The neurological team want to do an MRI. I agree. 

I had a meltdown because once they decided to admit James, it took hours (of neglect) to get him into a room.  I had a team of doctors and nurses trying to make it better for me so I must have made quite a scene.  I told them that they neglected their patients and that James had gone without food all day.  I cried. It was a little embarrassing.  Just at that moment, James's rehab doctor appeared and completely backed me up. He ran back to the rehab portion of the hospital and scored James's tube food (I had left a case of it with them since James no longer needed it), in the event the doctors decide to restrict James from eating--he would have his food and not the Nestle crap.  A nurse appeared with a tray of different foods.  I think there were about six staff members crowded around his bed.

James sat in bed and happily ate the hospital food and said, "You should eat, Jen, you will feel better."

James must have aspirated food in the past few days, meaning, a bit of food went down his windpipe instead of his esophagus, and that is what caused the pneumonia. It is actually called aspiration pneumonia. 

In the ER, James's cognitive disability became shockingly apparent.  He was so vulnerable to all the chaos of the ER and was visibly frightened when I suggested that I should leave before they transferred him to his room so that Imogen would not be worried at our friend's house. 

I was torn between caring for James and caring for Imogen.  That was really what made me cry and throw the fit at the doctors and nurses.  It was agonizing waiting for hours to move James from one floor to another. It was crazy.

Once James was finally transferred to his room and the caregiver handed him the clicker to the TV--which was the exact same clicker that James had in rehab--he was calm and peaceful.  I could tell he felt cared for again, as opposed to the insanity of the ER. His nurse--Ravi!--was too perfect of a fit.  James was tucked in bed, clean, warm and snug. 

Earlier, the in-take doctor asked James if he wanted to be resuscitated and have his airway opened in the event he required it. James did not even know what the doctor was talking about. I said, "She wants to know if you want CPR and intubation."  He nodded. I do not think he knew what I was saying either--at least--not about the intubation but since I was saying it--it was probably ok.  The doctor turned to me and said, "I guess he only understands medical terminology--I was trying to make it easy for him."

James was working on his pudding while the doctor asked him these questions. He happily handed me the peach baby food to open for him.

I had a wonderful cab ride home with a Bangladeshi driver.  He insisted that I take his number so that if I ever needed a driver, he would come and get me.  Sweet man, father of two.

I am wrecked now.  Completely zapped. I have to sew on straps to Imogen's ballroom dress. I do not think I can do it right now. I have to wake myself up at 6:00 to get it done.

What an awful day. We wanted the hospital behind us.  James told me he wished to come home with me and that we should sneak out.  When I saw him in his hospital bed, though, I must say, he looked very content and relieved. 

I think he could have spent another month in rehab.  It would have been fine. Then, he would have been discharged without any eating restrictions. I think it was my fault that he swallowed incorrectly. I probably did not chop-up the food enough or I should have made him sit down in front of me so I could monitor his swallowing--made sure he chewed his food properly before taking the next bite. I was so happy to have him home and eating meals with us, I was not wearing my nurse hat enough.

Damn it.

He's like a toddler, in some regards and I treated him like a normal adult. The ER showed me his true state, like the slap that Cher gives Nicholas Cage in Moonstruck. Snap out of it!  You have to take serious care of your husband.

Tomorrow's another day.  Hopefully, James will recover from this mishap and I will be given a second chance to be a better caregiver.