Thursday, June 10, 2010

Patience is a Virtue

Grams and Grandad spent the last two days at St. Luke's Episcopal Hospital in Houston.  Tuesday was spent with Grandad having a TEE Scan and a CT Scan in preparation for a Cardiac Ablation on Wednesday.  

Yesterday we had to be at the hospital at 6 a.m.  That meant a 4:30 wake up and a drive across Houston.  We were cautioned that if we were late they would give Grandad's spot to someone else and we would have to wait until later in the day.  We arrived at St. Luke's right on time and were directed to the Denton Cooley Building of the Texas Heart Institute.  A quick ride up the "green elevators" and we emerged into the intake waiting room on the cardiac catheter floor.  The first thing I noticed were several people who looked like they'd already been there a while.  Remember, at this time is was 6 a.m.  Grandad signed in and they immediately took him back into an intake area to check his vitals.  I took a seat to begin my wait.  After just a few minutes Grandad emerged and we were assigned a room and escorted to it.

Another short wait and a nurse arrived to review medical history.  Before she even finished, someone else arrived and began "prepping" him for the procedure.  These prep rooms are tiny and hold two beds.  They were obviously originally designed as single-bed hospital rooms.  We were in this room for about 30 minutes and then Grandad was wheeled into the Cath Lab and I was escorted to another waiting room.

I was particularly struck by how thoroughly everyone in the hospital made sure Grandad knew what procedure he was going to have and that he responded with the same procedure they had on their paperwork.  At every step along the way, every person he interacted with asked the question and compared his answer with their paperwork.  They were very thorough.

After they took him in to the Cath Lab, a nurse came out told me they were beginning and gave me a password that could be used by family members to access information about Grandad.  No one would get info without that password.

At this point I left the waiting room, went down to the cafeteria and ate breakfast, then went in search of coffee.  I walked through the Texas Children's Hospital and emerged in the center of the medical center on Fannin Street.  I crossed the street and the railroad tracks and got my usual order from Starbucks.  I was probably gone 30-45 minutes all told.

When I walked back in, another waiting wife told me that a nurse had been looking for me.  I immediately thought to myself "probably not good news," but I took a seat and began to wait again.  It was just a few minutes before they rolled him out and called me over.  The nurse explained that his blood was too thin, they were going to start an IV drip of Vitamin K and attempt the procedure again at 2 p.m.  They took him back to another small room and told me to wait there with him, the doctor had been paged and would be in to talk to me.  Then we really began waiting.   At this point, I called my kids, explained to them that the procedure had been postponed until 2 o'clock and told them to get some sleep.  Katy and Travis had driven in from San Antonio after she got off work at 9 o'clock and Nick had waited up for them.  I knew they needed some sleep.

We waited and no one came in and hung the bag of Vitamin K.  After an hour I went to the nurses station and asked about it.  I explained that I didn't want to be a nag, but we were on a tight time schedule with the doctor hoping to perform the procedure at 2 o'clock.  They sent in the charge nurse who told me that they were still waiting for it to come up from the pharmacy. Then, literally about two minutes later a nurse came in and hung the bag.  The doctor still did not come, so we waited.

At 1:30 the surgical nurse came in and drew blood to test it again.  Around 2:15 the doctor finally came to talk to us.  He explained that he could do the procedure but he would not be comfortable because Grandad's blood was still too thin.  He explained that, while the risk is small, it's higher than he likes.  If Grandad started to bleed out during the procedure after having both blood thinners and vitamin K, the only thing he would be able to give him is frozen blood plasma which would increase the risk of clotting.  Blood clots are the number one risk of this procedure.  A blood clot would almost certainly lead to a stroke.  The doctor indicated that he would prefer to adjust Grandad's medicines and wait until next week for the procedure.  But he left the ultimate decision up to us.  If we said go, he would perform the procedure.

Grandad and Grams had a quick huddle.  This was a difficult decision.  We live three and a half hours away and Grandad had already taken off work.  But most of all he had already waited a month to get on the doctor's schedule.  During that month, he felt horrible most of the time.  He would have preferred to go ahead with the procedure in spite of the higher risk just to get it done and start feeling better.  I preferred to err on the side of caution.  I really wished my kids had been there to join the discussion, but I knew in my heart that they would feel the same way I did.  So the decision was made; we will wait.

We are comfortably ensconced in a bedroom at Nick and Marie's beautiful home in Northeast Houston and here we'll stay until next Wednesday, when we'll repeat our early morning drive to the hospital.  He's on the schedule again for 6 a.m.  Hopefully, we'll get a different outcome next time.

As my good friend Diane reminded me, "Patience is a virtue" and "If at first you don't succeed ..."

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