Sunday, February 10, 2019, 2:00 pm

Good news: He's stable.

Bad news: He's not quite as good as yesterday.  Neutral news: He will be receiving a blood transfusion.

            Last night was freezing cold.  I felt like I was sleeping in a New England farmhouse in the early 1900s in the winter.  The bedrooms were upstairs but unheated. You had to warm your own bed with your body, once you had your nightcap on and were under the blankets.   I didn't put a nightcap on, but I did grab a big thick blanket to put on top of the one I had on already.

            When I left in the morning around 9 am, the car thermometer said it was 59 degrees.  Holy cow. That means that last night it might even have been below 50.  To all you scoffers on the east side of the mainland who consider 20 degrees a reprieve, remember we have no indoor heating here unless, of course, you're staying in a 5-star hotel.  I did well with the warm blanket and the body heat God gave me.  Had a good night's rest.

            I got up and called to speak to Mike.  The aide said, "He can't talk to you. He's on bi-pap. This suggests to me that his condition has taken a turn for the worse. I'm shaking. I call Judy, who is my main life-line. I then try to reach family members to warn them that again he has taken a turn for the worse. I'm shaking. 

            I pack to move out of this Bnb and into the ashram. Besides being cold, it's raining.  Periodically, it pours – hard.  I wait until the rain takes a soft turn, and then walk out to the car to load my stuff.  This takes several trips both because I have a fair amount, and because some of it is very heavy. 

            I'm lugging this heavy duffel bag up the driveway to my car, and two perfectly healthy 20-year-old males pass by me without a nod. Hello! I'm thinking you see a little old lady struggling with this, and you can't stop and offer help. Then I think, "Hmm! They know I'm having trouble, but they don't have any idea if I'm a man or woman or young or old. Let me see, I have jeans on and two sweatshirts on top of my tee-shirt, a vest on top of my sweatshirts, and one sweatshirt over my head.  Still, I was rocking back and forth, struggling with the weight.  They could see it was hard for me.  For the most part, I have only seen kindness and concern.  This was a first.  If I had had the energy, I would have given both of them a swift kick in the pants. (It finally occurs to me: they thought I was homeless. Homeless usually means some sort of mental illness.)

            Aside from the fact that it continued raining as I drove, the drive was uneventful even though I was deeply concerned as to what I would find when I got to the hospital. When I walked in Mike's room, he was on the nasal cannula again. (Note I finally figured out how to spell the word.) However, it was on considerably higher pressure than he had been last night when I left.  He was on 50% oxygen rather than 35%.  Still not feeling hunky-dory about this situation.

            I spoke to the nurse.  She said, "Well, he's suffering from respiratory failure. "I nearly suffered from heart failure.  What!!!?!! This is the first time I heard this term.  What!!! No, he is suffering from severe pancreatitis. No, she tells me he has respiratory failure.  He has pneumonia.  Huh? We go round and round a few times. I finally ask her," Do you know why he was placed on the bi-pap last night?"  "No." Got it, you don't know.  Good, now I will go get my breakfast, and I will speak to the doctor when I get back.

            I went to the cafeteria.  I brought some left-over soup from yesterday's lunch for breakfast and some left-over chard for lunch.  (I just discovered chard.  Love it! It's my new go-to salad.)  I call Jean, Damon's mother, to tell her that the bi-pap doesn't signal a drastic downturn, and no one needs to think of rushing back out to HI. I also call Judy to assure her everything's stable.

            Then I spoke to the nurse.  I explained to her that I have never heard the term "Respiratory failure," before.  She explains to me, that's why he was in the ICU.  Damon may have gotten this information from the doctors.  He was the go-to person while he was here.  It looked to me like the doctors actually preferred talking to him than the distraught potential widow.  Hmm!  I don't know why.  A young competent man versus an old woman.  Who would you rather explain complicated medical matters to??  I also suspect that the woman doctor in the ICU who addressed all four of us, who NEVER looked my way, and kept her focus on Damon  may have been flirting with him. I'd argue I'm pretty cute too, but I don't think that will cut it.

            I explained to the nurse that I had already been told the Mike had kidney failure and possibly pancreas failure.  Since the other two means that those organs are on permanent respite from their job of keeping him alive, I assume respiratory failure meant that his lungs had decided to resign too.

            No, that's not what it means.  Okay medical details: He had respiratory failure last week when he put him in the ICU. That's why they put him there.  He had respiratory failure because he had pneumonia.  He had pneumonia because he aspirated some fluid that came up from his stomach, and the lungs started producing fluid to wash it out.  He no longer has pneumonia. He has some damage to his lungs from the pneumonia.  This is not permanent damage, as the doctor explained to me.

            Later on, the nurse came to talk to me to apologize for shocking me. She then shared her computer screen with me, showing me all the information she had on him.  We went through each item, checking that I was familiar with them already.  Respiratory failure was the only one I didn't know. There was also something about his heart.  But it was just that everyone in telemetry gets their heart checked. His is A-Okay. Yeah, one organ we can count on!

             I had asked the doctors to tell me all that was going on, so I didn't get any shocks. So much for that request. Too many people to deal with.  This fellow suffering wife who I have been running into  suggested I request a Patient Care Coordinator.  Never heard of such a thing. At least not until I got back to the room and saw it listed on the whiteboard on the wall. I didn't know that I had to request it.

            On this fellow sufferer:  She is a lovely woman of probably Japanese descent who I keep running into on the floor and sitting outside at the tables around the driveway. I finally asked for her name. She said, "I am here."  That's what I call her now.  She gave me more information on her husband. He's in for a collapsed lung. Didn't pursue the why. I know he's going home on Tuesday. 

            When I got back to the floor, I immediately requested a Patient Care Coordinator.  I was told the regular one will be back on duty tomorrow, and she will contact me. There are so many things to learn. Fortunately, I speak to people randomly and find out a lot of information that way.

            The surgeon in charge of his pancreatitis came in, Dr. Izawa.  He started telling Mike something about his condition.  Besides the fact that the good doctor mumbles, I was by Mike's good ear and took over.  He said he couldn't have done a better job.  I am expecting to be hired soon.  He also said he was considering a blood transfusion. 

            He needs a blood transfusion because his red blood cell count is low. I had this one doctor explain it to me.  First of all, the kidneys have a roll in producing red blood cells.  The kidneys inform the bone marrow when more is needed. To keep that command in working order, Mike receives an injection of something starting with a P each week at the dialysis clinic.

            Now on to his bone marrow.  It is normal for the bone marrow to slow down red blood cell production when we are sick. Doesn't sound like the best idea to me, but what do I know?  Also, whatever blood cells he does make are rushing off to deal with his pancreas.

            In summary, the manager is knocked out; the factory is on strike; and, the supply isn't enough to deal with the body as a whole.  This is why he is getting a blood transplant.

             Yes, Milt. I grilled the doctor thoroughly on the possibility of transmitted diseases through the blood transfusion.

            He is spending most of his day sleeping.  He got two phone calls.  One from his son and one from one of the parishioners from St. Michael's. He enjoyed both phone calls, although he wasn't able to be very responsive.  I asked both callers to talk about their own lives.  He needs situation.  While he said very little, I could see him smile, and at one point, he actually looked like he was laughing – although maybe it was just gas.

            While he is drowsy and dozing, he periodically calls out, asking what is happening and when will they do something.  No matter what his condition, I explain everything to him as I would if he was okay. I don't know how much he understands.  That well-exercised brain of his isn't getting enough nutrition right now to be able to do a lot of work or work for long periods. When he doesn't respond to my question, "Do you understand?" I know he has had it.  I promise to start again when he is ready.