Somebody bring me some water

Memo from: The Center for the Office of Redundancy Department
Subject: It’s Déjà vu all over again

Hopes for overnight improvement were dashed. This morning brought more of the same, nausea, shooting abdominal pains, lack of appetite. I called the home health care nurse to let her know I was bringing Renee to the emergency room. She said, “I thought you were bringing her last night.” Renee sort of left out the part that the nurse said, get there NOW and the lecture on dehydration that she received. She told me it could wait until morning. The patient is now playing the doctor and botching up her own medical care. The only consolation being that the ER was almost empty when we got there.

It was a typical emergency room runaround. I’m sure that that who ever devised ER procedures was also a technical expert on the Spanish Inquisition. It was the perfect combination of questioning and torture. My hand is just starting to get the feeling back, Renee nearly squeezed it flat during the IV insertion phase. A bed of nails has less sharp points than were flying around that room and all but one were dug fruitlessly under the skin. They weren’t too sure about the one that did hit the mark either as it didn’t backdraw like it should have. Luckily it worked.

One bag of fluids was hung and put on full blast. Renee sucked it up in about a half hour. A test came back that her creatine (sp?), a kidney enzyme level, was four times what it should be but white cell counts were around normal and red were slightly elevated. The ER doc was figuring it was just dehydration and put orders for a room in so Renee could receive fluids overnight.

A while later Renee was moved to the Clinical Decision Unit. The doctor came in about two hours later, did a check-up, asked more questions and laid this out. The elevated enzymes along with the dehydration and blood tests indicate that her kidney has shut down. The shooting pain Renee is experiencing is typical of a kidney stone. Being post-op this may not be the case but a CT Scan was ordered and the staff doc is calling in a nefrologist.

For those who have joined us in progress, Renee has only got one kidney. That other one is long gone along with that nasty little tumor bearing cyst that was encased inside it.

Hearing kidney shut down freaked Renee out! But the doc was cool about it. He told her she’s been through much worse and had her smiling and laughing. He impressed on her that it all could be due to the dehydration but that we just need to make sure. He also said we need to know what caused the nausea, appetite loss and pains that led to the dehydration. This sounds better than Renee’s approach of laying there in agony hoping things will get better overnight, don’t you think?

But here we are repeating steps we took just a few months ago following surgery one. On the night of the All-Star Game we’ve got Yogi Berra to put it all in perspective for us. "You've got to be very careful if you don't know where you're going, because you might not get there."