ICU

E. hasn't been feeling great.  That's probably a pretty big understatement.  The pain level is creeping up.  The nausea is creeping up.  The general misery is creeping up.  He's not eating.  He's not drinking.  He's not doing much.  After jumping through a bunch of hoops, I was able to make him an appointment with palliative care for Wednesday, because whatever they've got up their sleeve, it's got to be better than this.

He spent all Friday throwing up.  He kept nothing down.  We tried some toast.  Up it came.  We tried some Ensure.  Up it came.  I gave him some Zofran (anti-nausea meds) and waited.  Then we tried some Ensure again.  Up it came.  Nothing, and I mean nothing, stayed down.  It looked like brown bile, so we both thought maybe it was a good thing.  Maybe some of that bile was coming up and out.  Maybe it would bring that bilirubin number down.

Saturday, it seemed like he was feeling better.  Then he began throwing up again. As I went to pour out the puke bucket, I noticed the color wasn't brown, but dark red.  And it was filled with clots.  Like lots of little chicken livers.  I looked closer.  Yup, blood.  I quietly said to E., "I think we might need to head to the hospital because you're throwing up blood," and the man who usually fights and argues about anything medically related began to look for his shoes without another word.  (In hindsight, I'm now wondering if he wasn't throwing up blood yesterday as well.)

By the time we reached the Emergency Room, his pain level was topping an 8.  I got him into a wheelchair and they were able to triage him immediately and get us straight back into a room.  Unfortunately, they could give him nothing until he was seen by a doctor and that took a while longer.  Eventually they ran some labs on him (his bilirubin is STILL a 5.8! but he's not anemic yet which means he hasn't lost too much blood).  He began throwing up in the E.R. and the color was then a brighter red, whatever than meant.  They were able to give him some IV Zofran which helped settle things down quickly and the IV Dilaudid brought his pain down to a 5.  Just so happens that a great Internal Medicine Doctor was on-call, which pleased the E.R. doc greatly.  She chatted with us at great length and made the decision to admit E. ... to ICU.

So, E.'s in ICU (the one on the 5th floor instead of the one on the 1st floor, which is waaaaay nicer)  This is definitely a step-up from the ICU post-brain surgery.  They've got him hooked up to a variety of meds ... some to try to stop the bleeding, some anti-biotics, some of his regular meds now delivered via IV, some hydration, etc.  He's getting the nausea meds, which are helping.  They've also switched him to Morphine for pain.  His pain is still at a 4, with break-through pain of a 6 here and there.  The Morphine is lowering his blood pressure and making his breathing really shallow though, so they've had to put him on oxygen.  The plan is to do a scope on him in the morning to try to see where this blood is coming from and go from there.  When I asked about an anticipated length of stay, I was told, "Let's plan on 3 or 4 days right now and go from there."  E. says, "3 or 4 days my a$$."