Um...sure...
It started with a phone call to me from the nurse going off duty at 7:00AM. She reported that at 3:00 in the morning, Tim had gone into atrial fibrillation (see the sidebar) and his heart rate had zoomed to more than 150. Dr. P. ordered cardizem drip to bring the heart rate down. His blood pressure, she assured me, had not been high.
When I arrived at 7:00, it was obvious that Tim was experiencing a failure of his Foley catheter. I had to run home and get the latex one that for some reason they don't stock and didn't order on Sunday when they said they would.
Everything about this chapter was an exact repeat of January 27, when after four days in the hospital, Tim's catheter had failed, he'd gone "afib", his temp went up to 103, etc., etc. Notable this time was that it was the day after we talked about autonomic dysreflexia.
I had brought with me this guide for healthcare professionals on spinal cord injured patients and AD. I asked that it be posted in the nursing station and added to Tim's chart. I circled the part that said that systolic BP >150 must be treated, and the cause located.
We think now that the catheter problems as well as a couple "mis-steps" yesterday (his foot being jammed against the foot of a deliberately shortened bed all night, and the catheter being taped to his leg pointing upward--preventing flow--have all contributed to his symptoms over the past couple days.
An infectious disease physician who visited in the afternoon today also believes that the Zosyn is very likely responsible for the elevated temps: he says he sees it in certain patients (cancer patients; those with pneumonia) very frequently.
So all is calm again tonight, and we're on the watch for all these triggers, and focusing once again on lungs. Wish us well. See how much happier we can be?
It's all good.
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