I called him as I was leaving work, because as I said before I like to be prepared and once again I proved the wisdom of that safeguard. He didn't sound right. He was distant and his speech was just a bit too slow. Before I could figure out what was going on I reached the Black Hole of Cell Phone stretch of my commute.
I reach his bedside an hour and fifteen minutes later and to sum it up he looked drunk. He's been getting dilaudid for the past five days and up until now, you could wake him up and he could tell you the last time he got pain medication and when it was due next. He could relate everything that had happened since I'd seen him last and who he'd talked to and what they'd said.
Now he's telling me he doesn't remember when he got his last dose. He's paying way too much attention to the ceiling and scanning like butterflies are floating above his head.
I decide to convince myself that he's just sleep deprived because they wake him up every two hours round the clock. I find the NCIS channel and curl into bed beside him. I realize he's crying and I decide it's because it's a particularly sentimental episode. So I change the channel and find The Family Guy. He's crying again and it's a hysterically irreverant cartoon, but one of the characters is getting teased.
I refuse, I refuse, I refuse to panic. I try talking to him and refuse to acknowledge that he is not responding appropriately. His responses are time-delayed, his words are slurred and his visual focus is on the empty spaces in the room. It's fine, he's fine, we're fine. I put my hand on his incision and close my eyes.
It's fine. He's fine. We're fine.
I think I dozed off for a few minutes. I woke with a start as Tanya came in the room. I aksed her when his last dilaudid was and it had been hours. In fact he'd only asked for pain meds once all day. And she told me he had been mostly sleeping all day, and very drowsy.
Suddenly I was wide awake as I realized that any minute now the snakes were going to come through the wall and swarm across the floor, followed by the dancers, and the children who should go home, and the parade of invisible people that Rich would rather talk to than talk to me.
“Tanya, is Rich getting Reglan?” The words spill out of my mouth from an unknown source. If I hadn't recognized my own voice I would have wondered who was speaking.
“Yes.”
“When did they start that?”
“Two days ago.”
Going from major panic to huge relief in 6 seconds gives you a major nausea rush.
Thank god for the wonderful nurses he's had every single day. I asked her to get the Reglan stopped and explained why and within twenty minutes it was taken care of. AND! She made me stop beating myself up for failing to make sure that Reglan had been added to his allergy list.
It was a year ago, and no one knew what was causing his hallucinations, and mostly they were guessing brain damage from the sepsis. It was Dr Kelli, who wasn't even our doctor yet, suggested I stop giving him the Reglan. I thought I told his doctors, and then I didn't think about it again. On admission they asked if there were any new allergies and I said no, because the Reglan was old news and I had forgotten all about it. Who thinks of a medicine to stop nausea and calm the stomach while encouraging digestion to be a threat in the face of major surgery.
Horrible doesn't begin to describe how I felt before I could even enjoy feeling relieved.
Med allergies are a basic responsibility of the patient and/or caregiver. I want to claim the fact that none of us were certain the Reglan was to blame, but that is beyond lame. I dropped the ball. I figure I'll beat myself up until he's 100% himself again and then I'll toss it on my guilt pile.
I felt horrible into nausea and Rich was disconnected so I figured I'd head home. I was craving privacy. There is a big distance between three weeks of Reglan and two days of Reglan. I explained the situation to Rich and why he was feeling “not right” and he seemed to grasp it.
He squeezed my hand and said, “see, pupshun, you saved me again.” He closed his eyes and smiled. “I'm glad you fixed it....because I HATE the snakes.”
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