Can I get a Revolving Door Installed here?

Rich was admitted this morning. That sentence alone should be enough to let you know that I cannot consume enough Scotch to keep my head from exploding. Why, you ask? Because no matter how many times I have to take the bus to Stupidville, it just never gets old. Always new sites to see and new people to meet.

First off, I had some concerns because they recently fired all of their (seventy-plus) LPNs. Apparently, overworking their RN's and relying more on nursing assistants who are addicted to their iPhones seems like a cost effective way to go. I kept my concerns to myself.

Out of the gate we sit at the Admissions desk where we learn that the insurance Rich has had for 20+ years has mismatched policy numbers. The number on his card does not match the number in their computer. I could write another five pages on this situation, but why bother.....why bother....

Then we get up to his room. Because somebody was called over to walk us up to the room. Despite the fact that I assured him I had worked here for over five years and we could find our way. Nope. Someone had to escort us up to his room. Where there was no pillow OR blanket, but there was a washcloth folded into the shape of a teddy bear. I was impressed. I'm just relieved that these cost-cutting measures are working.

The RN –who was lovely—did his admission. Directly on the computer. And while I understand that sometimes things change, I don't understand why I have to explain who his doctors are and his diagnoses and what procedures he has already had done AT THIS FACILITY.

So all the admission stuff is done and Rich lays down because part of what's going on causes him to be either sleeping or exhausted. I read while we waited for somebody to get this show on the road, and it was not too much later that the Hospitalist came in and I liked that he first introduced himself, shook our hands and then pulled up a chair and sat next to Rich. He did an extremely thorough intake, including my detailed account of Wednesday night and the past 2-3 weeks of this situations, and that's when I should have left, my hopes intact. But no. For a foggy, sleep-deprived moment, I don't recognize that I really am in Stupidville.

We are now at the point where Dr. P starts explaining what they're going to do. A twelve hour fast, with blood draws at critical points because this information will tell them what's causing the constant flood of insulin in his body—the liver is not releasing sugar or there are tumors producing insulin. Distracted by his excellent first impression and the origami terry cloth bear perched next to him, I have confidence in asking a couple of questions......

I explained YET AGAIN, that if Rich goes more than 3 hours without eating, his blood sugar drops into the forties. When I found him Wednesday night it was 31, and at most that was a 10 hour fast. So, and here's my question, “how are you going to do a 12 hour fast and keep him from going into hypoglycemic shock?” Dr. P just stared at me with the too familiar expression that tells me I have just spoken a foreign language.

I decided to throw him a bone. And asked....”how often will you be checking his blood sugars,” because, AND I'm PROVIDING THIS INFORMATION AGAIN.... “he will not have any symptoms.”

Dr P rattled off the signs and symptoms of hypoglycemia AGAIN, and Rich and I both shook our heads with each one AGAIN. So I 'splained it again, Lucy. “He does not have any signs of hypoglycemia. He closes his eyes and goes to sleep and you won't know he's in trouble unless you check his sugars, OR he reaches the point of death-rattle breathing, gurgling, foaming at the mouth and unresponsive. “

You would think that after last year's sepsis sans symptoms, I could get them to understand that Rich doesn't have symptoms. I suspect this is because he doesn't want to inconvenience anyone so he just swallows it all down, which according to my scientific research, is why he developed pancreatic cancer in the first place.

Now Dr. P looks at me like not only I'm a speaking a foreign language but he'd really like me to just leave the room. Wait for it....

the Babble fish kicked in and Dr P decides to respond to me with “I can order 2 hour blood sugars, but that's not going to make the staff very happy.” The words were wrapped in just enough of a smile that I wasn't sure if he was failing at humor or calling me demanding and/or stupid.

I explain AGAIN how this has been working---”I'm not saying you have to test him every two hours, I'm just suggesting you might want to come in, check him, make sure he wakes up”, and if you pull your nursing assistants away from their iPhones, I think they can handle that task. Sorry. I can't forget the night Rich spent 45 minutes on a bedside commode and the nursing assistant came into his room texting.

But Dr P has a better idea. “How about you stay the night and check him every two hours.” I swear to god it sounded like an innocent suggestion but my head wanted to explode. I smiled sweetly and explained that “I've been doing the two hour gig non-stop since Wednesday night, so I'd sort of like to get some sleep.” Because when I get the bill for this trip, I'm going to be a little pissed that it's not discounted for my services.

My next question is “You're going to put a hep-lock in, right?” (That's an IV access that's waiting and ready if needed) Again someone looking at my two heads. I splain it for him, Lucy..... “When he crashes during this 12 hour fast, I'm just thinking you might want that IV access quickly, and I'm just letting you know he's a very difficult stick” He nods and writes on the chart, which could be a hep-lock order OR “wife is pain in the ass.”

We've pretty much covered everything to the Doctor's satisfaction. Rich is exhausted, I'm exhausted, and repeating a thing don't make it better so I'm ready to go home and Rich wants to sleep. We are now 2 hours 45 minutes from last food consumption. Since I didn't think to bring my video camera, I don't need to stick around and watch this parade, and there's going to be a huge bill for someone else to clean up the elephant poop, so....I'm good. It's 11:30, I'm leaving. I warned you people. In triplicate.

Around 3 pm the phone rings. I cannot explain what a bone jarring sound that is when you're half asleep and part of your brain is programmed to be ready for a call from the hospital.

It was Rich. He sounded drunk, which meant he could only do a half-assed job of telling me what was going on.

“They were running around like crazy, Pupshn. They kept running in and out of my room and giving me shots. They said I can't stay here. They're moving me to intensive care. ...I don't know what they're doing....” Click.

Geez. Sorry I missed that. The Elephant pooped and I wasn't there to see it.

The only reason I didn't call the hospital is because I'm thinking they really don't need any distractions right now. An hour later I get a call from his nurse to let me know that he's being moved to ICU because they don't have enough staff to do two hour checks. Right now I cannot even comment on that because I can't get past the 72 LPN's who lost their jobs. Neither can I get past the fact that I warned these people how it was going to go down, so how did you not know at admission that you couldn't handle two hour checks?!?!?!

Another hour later and Rich calls me to tell me where he is and what happened according to what he was told because he doesn't remember SHIT about it. He sounds good. Because he's been eating. So the bad news is, he has to eat the hospital food anyway. Update goes like this.... the doctor's now have no idea what they're going to do because they couldn't collect the fasting data they needed. They want to know if this problem is the result of the liver not releasing glucose, or tumors starting to produce insulin, and that requires 12 hour fasting bloodwork. And they seemed shocked that their plan didn't work. It was a good plan!

Well, here's a plan. I call it “What the Fuck?!?!?” Either the liver isn't working or tumors are producing insulin. Either way, I don't care. FIX IT! If you can put a goddamned pump in someone to release insulin as needed, why can't you insert a pump to release a steady flow of dextrose as needed?

Whatever, nobody's listening to me anyway.

A definition of insanity is repeating a behavior with the expectation of a different outcome. Doesn't look good for me, now does it?

Last night, as we're bracing ourselves for the return to Stupidville, I asked Rich if he remembered anything from Wednesday night. Mainly I wanted to know if he'd had any awareness, fear, pain or discomfort. No to all. Shit. That is information I should not have been given.

In hindsight, I've been asking myself all evening if I did the right thing Wednesday night. I'll admit it. For a split second before calling 911, I thought of crawling into bed with him and just holding him until it was over. It was barely a complete thought, not even recognizable until after the fact. In remembering that nano-second I realize I didn't call 911 for Rich. I called for me. Because I'm not ready to be here without him.