The saga continues! Wednesday Dad was looking really bad again. He had no energy and his blood pressure continued to be off the charts. I asked the nurse to page the internist and he came in a while later and prescribed a blood pressure drug that required constant monitoring for heart function. So, we had to move back to Progressive Care for this. In the meantime, they started him on Vasotek (which we used last time we were there and it did not work) and put a Catapress/Clonidine patch on him which I found out doesn't start working for 2 to 3 days. The drug that must be monitored is called metoprolol.
When we got to Progressive Care, it was shift change (of course) so nothing was done by the day shift who waited for the night shift to take over. In the meantime, my Dad's pressure was approaching 200/88! When the night shift came, it was a male nurse that we had previously had three nights during our stay there last week. He is a know-it-all and likes to talk down and lecture to me when I ask a question. He's probably 25 years younger than me. Needless to say, he was not real happy that I was staying the night. He hung the drip of Vasotek and I mentioned to him there was also supposed to be a drug that started with an "m" that was to be hung and monitored and that was the ONLY reason we were back to PCU. He said "No, there is not another drug." As you all know, I write EVERYTHING down that the doctors say and prescribe. I had a hard time understanding the internist who is from Africa, so I only knew the drug started with an "m" and was for blood pressure and must be monitored as it can slow the heart rate. I kept insisting and the nurse kept ignoring me.
As my Dad's pressure kept creeping steadily higher (a few times going as high as 207 over 91!), I kept asking him to check again for the order for that other drug. Instead, he kept lecturing me on how fluids in the body effect blood pressure and how we want to lower it slowly. I told him the key word there was LOWER and that was not happening. A few times he was down right condescending and really angry. Now I know I should have picked up the phone right then and paged the doctor at 2AM. I will not hesitate to do so if this situation comes up again.
About 5:45 am, this same male nurse came in with the missing medication that started with "m": metoprolol. This was after about 12 hours of INCREDIBLY high blood pressure numbers. All I could think about was stroke. Anyway, he proceeds to tell me that the medication HAD BEEN ORDERED, but it was at the back of all the orders and he just missed it. HE JUST MISSED IT?? He then had the nerve to say "I wish I had found the order sooner." Ya' think?? My Dad wished he had found it earlier, too.
When the day shift came on, it was also a nurse who had been assigned to Dad last week. I expressed my concern on the blood pressure numbers (measured by one of those portable machines that roll from room to room for taking vitals). After a few hours of monitoring the numbers, some of which were as high as 207/99, I INSISTED that she page the doctor. The doctor called back and added hydrolazine (or something that sounds like that) and Lasix to the mix. What he really needs is to take his REGULAR blood pressure medicine, Tenex, which works great for him. Only problem is that Tenex does not come in IV form and he still has the NG tube. We may try to see if he can swallow a Tenex pill and then they will clamp off the NG tube to allow it to absorb. That's what the nurse and I talked about anyway and may present that idea to the doctor.
Dad had a bowel movement without any suppositors today and has been passing gas. I think that's a great sign, but the cocky general surgeon really rained on our parade by saying a bowel movement is not that big a deal since the stool could have been there a long time. What difference does that make? Something is working in order to have the movement, right? Dad's abdominal x-ray taken this morning showed distention and the general surgeon wasn't pleased with the x-ray outcome. He does NOT want to have to open Dad up again to fix a bowel problem as he said intestines after surgery like Dad's "turn to concrete." He also said that 80-year-olds do not have the surgery Dad went through as this procedure (cystectomy/prostatectomy) makes 20-year-olds cry. But he did say it was the best way to get rid of the cancer. Remember, he's the guy the urologist called to handle the bowel obstruction possibility (which all 3 doctors still think is ileus).
Dad was very down today and feeling crappy. He is now questioning his decision to have the surgery to begin with and wonders what will go wrong next. He says they fix one thing and something else goes wrong. Unfortunately, up to this point, that has been the case. The urologist regaled us yesterday, after we transferred to PCU, with a list of "things that can go wrong". This included blood clot, heart problems, bowel obstruction, to name a few. All this thanks to him and his inability to sew a proper suture (in my opinion anyway.)
I came home to sleep for a few hours before I go back to spend the night. Hopefully, the new meds have gotten the pressure under control and I won't have to battle with the night shift again. If I hadn't experienced this nightmare of incompetence myself, I would be hard-pressed to believe that this stuff could happen in today's hospitals in the US! I'm here to tell you, IT DOES!!