Sarah has ranged from edgy and uncomfortable to downright miserable today though no particular complaint seemed to predominate. Her chest incision hurt, her right thigh and knee were very tender, her head ached, her throat remains sore, her back aches. The theory now about her knee pain is that it really isn't a knee problem but related to the fact that the vascular surgery in her right groin required traction on her femoral nerve. This in turn caused a neuralgia-type pain over her anterior thigh and knee. We are told that this is "usually" temporary and should improve in a few weeks...
She was able to eat an entire cinnamon raisin bagel (toasted) with cream cheese for breakfast, and then, as she became more generally out of sorts, did not want to try any lunch. We would love to get past this food intake obstacle that is probably the only real barrier to her discharge.
A new problem over the last 36 hours has been (forgive me if this is more detail than you'd like) explosive "rapid digestive transit." (I am forbidden to use the D word.) There are multiple possible causes for this. However, one of the consequences (besides fluid loss, crampy abdominal pain, and urgent needs) was the discovery of completely undigested and unabsorbed pills in the "rapid digestive transit" material. Examination revealed that the pills were the long-acting (taken every 12 hours), strong pain medication that was the basis of Sarah's pain management. No wonder she has become progressively out of sorts - she is not really getting any benefit from the pain medication that she is on and may be experiencing some mild opiate withdrawal. So we are trying to get the "Sunday coverage crew" to redesign her pain management plan.
Then there is the apple sauce mystery. This mystery, which I will explain in a minute, is part of a general dietary services puzzle. The hospital seems to have a sophisticated system for taking meal orders from patients. Usually one hears a cheery voice saying "Dietary" at the door, and a helpful red-shirted person arrives pushing a COW. (COWs are everywhere in modern hospitals these days, but not the bovine type - these are Computers On Wheels - with the advent of electronic medical records everyone seems to have a COW.) Anyway, the red-shirted helper then helpfully enters the detailed meal order for breakfast, lunch, and dinner into the laptop computer riding on the COW. It all looks very efficient and individualized - you can request almost anything. However, it turns out to be a cruel ruse it seems since what arrives usually bears no resemblance to what was ordered. Today, Sarah's oatmeal with brown sugar and her apple juice were transformed into french toast with syrup and coffee - neither of which are on Sarah's list of edible foods. It has become something of a game we play guessing what will actually arrive. Computer virus??
Anyway, the apple sauce mystery...In addition to random food at meals, Sarah seems to be on a special list, maybe a sort of Dartmouth Hitchcock Awards program in which the member (Sarah) gets a bonus serving of apple sauce at 3 or 4 random times during the day - delivered with a smile by a red shirted young person with a cheerful "Dietary."
She was able to eat an entire cinnamon raisin bagel (toasted) with cream cheese for breakfast, and then, as she became more generally out of sorts, did not want to try any lunch. We would love to get past this food intake obstacle that is probably the only real barrier to her discharge.
A new problem over the last 36 hours has been (forgive me if this is more detail than you'd like) explosive "rapid digestive transit." (I am forbidden to use the D word.) There are multiple possible causes for this. However, one of the consequences (besides fluid loss, crampy abdominal pain, and urgent needs) was the discovery of completely undigested and unabsorbed pills in the "rapid digestive transit" material. Examination revealed that the pills were the long-acting (taken every 12 hours), strong pain medication that was the basis of Sarah's pain management. No wonder she has become progressively out of sorts - she is not really getting any benefit from the pain medication that she is on and may be experiencing some mild opiate withdrawal. So we are trying to get the "Sunday coverage crew" to redesign her pain management plan.
Then there is the apple sauce mystery. This mystery, which I will explain in a minute, is part of a general dietary services puzzle. The hospital seems to have a sophisticated system for taking meal orders from patients. Usually one hears a cheery voice saying "Dietary" at the door, and a helpful red-shirted person arrives pushing a COW. (COWs are everywhere in modern hospitals these days, but not the bovine type - these are Computers On Wheels - with the advent of electronic medical records everyone seems to have a COW.) Anyway, the red-shirted helper then helpfully enters the detailed meal order for breakfast, lunch, and dinner into the laptop computer riding on the COW. It all looks very efficient and individualized - you can request almost anything. However, it turns out to be a cruel ruse it seems since what arrives usually bears no resemblance to what was ordered. Today, Sarah's oatmeal with brown sugar and her apple juice were transformed into french toast with syrup and coffee - neither of which are on Sarah's list of edible foods. It has become something of a game we play guessing what will actually arrive. Computer virus??
Anyway, the apple sauce mystery...In addition to random food at meals, Sarah seems to be on a special list, maybe a sort of Dartmouth Hitchcock Awards program in which the member (Sarah) gets a bonus serving of apple sauce at 3 or 4 random times during the day - delivered with a smile by a red shirted young person with a cheerful "Dietary."
Apple sauce? Does Sarah like apple sauce? To me it sounds like a pretty good food to try giving the digestive tract a little push, along with some easily absorbed sugar carbs. Or some other fruit based things? Smoothies? The undigested pills though, what could that mean? Maybe they got caught up in the starchy bagel & cream cheese?
ReplyDeleteMaybe the COW machine is inadvertently delivering a good choice. Who knows? Jeez I hope you can get this figured out.
She's eating some apple sauce, but prefers the baby food jars of it that are available in the unit's little kitchen to the plastic covered dishes delivered by "Dietary" for some reason. The pills achieved their "long acting" character partly by virtue of a slowly dissolving, hard shell - unfortunately dissolving more slowly than Sarah's intestinal transit time. We do aim to look at a more appropriate diet for someone with (the D word) tomorrow - but wonder that this should be up to us to figure out.
ReplyDelete