Deja Vu, the VA, etc.

October 30, 2011

Mike, Veterans Benefits

 Talk about Deja Vu…!  Tuesday I got a call that my youngest brother had called an ambulance to take him to the hospital as he couldn’t breathe.  Turns out he has multiple pulmonary emboli which are causing the right side of his heart to strain and have periods of hypoxia…and a big clot in his leg for which they put a IVF in that night.  He’s on a heparin drip.  So he’s been in ICU and the same docs who took care of Mike are taking care of him.  In fact, one of the residents from his one hospital stay was on duty in the ER…it was like old home week.  It was also gut wrenching and felt like I was watching history repeating itself. PHEW.  Last night he was moved to a regular room and will start to wean off heparin to coumadin in preparation for going home.  I’m glad he’s OK and hope he’ll be up and about soon.  I hope I don’t have to see the inside of a hospital again any time soon.  

Meanwhile, Mike stayed with his sister after therapy on Tuesday so I could be with my mom at the hospital.  When he came home last night I went through the usual questions.  How was your day, how was therapy, what did you have for dinner, what did you do today?  The answers were less than satisfying. He went cantalope fishing off the pier at San Diego.  When I pointed out he couldnt’ have been in San Diego because it’s 3000 miles away and he wasn’t gone long enough to get there, he told me he had forgotten…they had left last night.  (pretty clever!)  When I spoke to Mel and told her of this story of fishing at San Diego, she told me that they had talked at length of San Diego because Mike had been stationed there and they had visited later and her husband remarked that if he had seen it when he was younger he would never have come back.  (My sentiments exactly about San Diego!  The perfect place!!)  Anyway.  Who knows?  Mike’s a long time fisherman and he could have fished off the pier while he was there.  As for the cantalopes…I hear there’s a big listeria issue with cantalopes right now.  He must have heard it on the news or something and bulked the two together.  From this I get hope.  He is retaining information.  It gets muddled…but he’s retaining it.  To me that is a hopeful sign that if we can begin to figure out how to un-muddle it we are on the road to a more complete recovery.

We visited the VA clinic this week.  They’re really busy there.  Phew.  I feel sorry for those docs..I don’t think they can ever get their heads up above water.  His doc was kind of perfunctory and inquired what the VA could do for us (since he’s priority 8 which means it takes a while to get an appointment so you cannot count on them for your primary doc if you have any kind of big medical conditions if you can’t get in quickly right?)  He looked at me kind of funny when I answered for Mike…and explained he had dysphonia.  The doctor was like, what does he have?  Dysphonia…the result of a 55 minute cardiact arrest, ECMO (and again he said what?) subsequent vent acquired  MRSA pneumonia, urosepsis, septic shock, hypovolemic shock secondary to a retroperitoneal bleed and profund hypoxia which caused a basal ganglia infarct. I pointed out that as a result of the intubation his airway had been damaged and his false vocal cords were irregular but not really damaged.  He had the presence of mind to look stunned.  He recovered quickly and  inquired when this occurred.  Suddenly I had his attention.  When I responded in February he began taking serious notes, asking serious questions and going through my box of medical records.  Ultimately, it was a pretty successful visit. 

Mike had answered yes to all four PTSD screening questions.   I pointed out I was certain it was not related to his military service but was probably related to the events of Feb-June.  And that I was surprised he remembered enough to be stressed since he says he doesn’t recall his hospital stay.  Doc pointed out it didn’t matter where he acquired it…they would treat it and referred him immediately to their mental health folks for the next day.  He also said we would start there for cognitive therapy for him.  Thus, they’ve scheduled him to see the VA psychiatrist…and the psychologist who does cognitive behavior therapy…but that’s not the cognitive therapy I was requested.  We’ll see where we get to.  I’ll talk to the shrink about what I need.  Meanwhile, he has also referred him for physical and speech therapy though I’ll have to take him to Wilkes Barre for it.  I’ll manage though.  I’m hoping for a mild winter!  He goes back to the PCP in 5 months…hopefully they’ll have shingles vaccine in stock and I can get him innoculated then.  He suffers enough, he surely doesn’t need to suffer from that too.  

We also saw the family doc this week.  He ordered blood work.  Cholesterol looks great.  Kidney function not so great.  He’s in the moderately reduced function category.  I’ve got a question out to the doc to see if I need to have him seen regularly by a nephrologist.  I’ve also decided to change cardiologists.  The regular cardio told me that because of his incomplete neuro recovery Mike would not  be a candidate for cardiac surgery if he ever needed bypass.  The family doc says that is not true and I fear because this doc seems to view life/death differently than I do, that he won’t treat as aggressively as somebody else might.  I just don’t think I can work with him.  He’s young.  I think his cultural beliefs about life and death may bias his medical decisions.  I though he was just a smacked ass.  Thus, I’m switching. 

Mike’s been havng great days for the most part.  We have days where he seems so with it…then days where I scratch my head wondering what happened.  Somehow he has the area of his healed bedsore open and I’m watching it closely.  But overall, things are pretty darned good.  We had snow yesterday…and he was completely fascinated with checking out the status of the snow.  Last winter was the worst for snow…and he pointed out we hadn’t had as much snow as we were getting yesterday for a long time.  I guess he doesn’t remember much of last winter at all.

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