Good morning from the hotel :-)
Nancy is sleeping this morning, with little change from yesterday. All vital numbers are good, although she is back on the respirator. Her nurse tells me that her oxygen levels were dropping a bit, and they think all the edema (extra fluid) in her body is creating some congestion around her lungs. So she is getting another few hours of dialysis later today, as they try to help her body get rid of some of the fluid. Otherwise, she looks good, her color is good, and the swelling in her cheek (parotitis) is down a bit. We are still waiting for her kidneys to wake up, although there is a little urine in the bag each hour. She is on three antibiotics, an antiviral, prednisone, IV saline and electrolytes, tachrolimus, hydrocortisone cream, occasional pain medications, and a feeding tube in her nose. Hard to believe she is comfortable, but she says she is fine.
I should tell you a little about the place, this ICU. It's pretty amazing how good the quality of care is. The unit is L-shaped, like one big room with a desk and entrance at the crook of the L. There are 16 rooms, positioned all around the periphery, eight at either end. Outside each room is a computer workstation with a large chart spread in front, at bar height with a roll-around stool, carts and equipment positioned as needed. So it's very easy for any individual or piece of equipment to get to any of the beds in a few seconds, and all of Nancy's data, days of history are right there for everyone to access.
Nurses work 12-1/2 hour shifts, with a half-hour overlap for briefing, and are responsible for one patient for their entire shift. They have ALL been excellent: sharp, knowledgeable, they know what is going on, why, welcome my observations and questions, treat us both with kindness and compassion. The ICU doctors are similarly on top of things, and the entire staff seems to work together really well. Some commute from places like Sacramento or Modesto. They all seem to be in the 30-50 age range, and like being able to focus completely on one patient for their shift. Almost every other kind of unit in the hospital assigns nurses to multiple patients, as you would expect.
It's intense. The patients who come here are critical, so there are alarms going off, little storms of activity when something serious happens. I don't think they've lost a patient while I've been here, but I'm sure it happens regularly. The forces of Vishnu and Shiva are very present, as some actions are completely about preservation, and some require penetration, some form of destruction to create life. I could never put a catheter into someone's neck, suction phlegm out of a tube deep in their chest when they are struggling to breathe. Or perhaps I could, I'm just doing what I have to do every day we are here, and if I had to take uncomfortable action to save a life, I imagine I would rise in the moment.
Those of you who have done voice dialog or "parts work", read Hal & Sidra Stone's books, will appreciate the splits I sit in every day. This is a place that demands solid interior relationships...by this, I mean that I have to negotiate and manage the parts of myself every time I step in. Child voices are in safe places, except for the one that looks upon the miracles in wonder. My fear of losing Nancy is ever present, so we bring him along with clear understanding that he does not get to run the show while I am in the ICU. The medical dude inside has grown quickly, can assess the monitors, IV pumps and respirator and urine bag in a few seconds while looking Nancy's pallor and breathing. I'm surprised at how grounded and calm this part of me is, and can feel the pull to be that, to be a nurse or a doctor. He is the one who runs the show most of the time right now, and he is good with the staff, putting them at ease, respecting them, doing what he can to make everyone as effective around me as possible. There is the reiki initiate, who helps manage the energy in the room, brings healing energy to Nancy, calls on resources I scarcely understand.
And then there just me, personal and feeling, loving Nancy, wondering what kind of relationship we will have as she recovers. I long for my partner, and reach for the patience and capacity to hold all of this in the coming weeks and months.
* * * *
Little gifts continue to delight. My engineering group at work sent flowers yesterday, so I came home at midnight to a lovely vase of roses and a note by the front door. Another friend made a rice bag compress for Nancy, that can be heated in a microwave and used to relieve aches and pains...and I cannot bring it into the ICU, because it's not sterile, dammit.
Nancy had a few friends and family visiting yesterday, and visitors are fine in ones and twos. She is in Moffitt Hospital 9ICU (505 Parnassus, on the 9th floor). 8am to 7pm are the best visiting hours. Come if you would like to be with her, talk to her, read to her. Hopefully her breathing equipment will be changed soon so she can converse, but right now, she's communicating mostly with her eyes, with nods and shakes of her head, with a squeeze of her hand. If you want to give me a call first, my cell number is 415 272-3565.
Love,
-tdc
