To begin with, after she first rejected all Hospital Home Care (HHC) assistance --that their family doctor recommended (actually their favorite nurse set it up)-- I finally convinced Bitchy of the idea that Hunk might actually benefit from some Physical Therapy and Occupational Therapy. So she allowed me to set up the appointments again.
Mike the Visiting Nurse came on July 29 and pronounced Hunk's vital signs to be excellent. Evaluation visits from the Occupational Therapist (OT) and Physical Therapist (PT) happened on Monday, 8/16. They both took Hunk's vitals (which were good) and said he would definitely benefit from therapy. (His engagement and enjoyment of life would improve, and Bitchy and I would learn how to continue those benefits.)
The next morning (THIS morning) the OT returned to give Hunk a shower (to evaluate his needs and show me how to assist him). She also took his vitals, and his blood pressure was good (132/68 supine and 132/70 sitting). He showered well with her help, and was resting comfortably in his l.r. chair, enjoying his Ensure concoction when she left around 9am.
Now last night was a little out of normal, as Bitchy came in to my room around 10pm to say that Hunk had taken off the (last) Depends and she needed me to get another pack from the basement. He did not normally change them in the "middle" of the night like that, but fine...
Then this morning around 7am she came to my room all upset to say he had wet the bed two or three times since getting up. (Since she decided to let me help him shower --only in the last few weeks-- she wanted to have him sit on the shower seat in his jockey shorts. I would help him wash most of his body, and she would take over to do his private parts.) She had put him in jockey shorts in anticipation of the shower appointment, but he had been incontinent a couple times after that. She was almost beside herself with concern over the sheets getting wet and him not being ready for his shower!!
I took it all in stride (as much as possible with her freaking out over it), got him back in his pajama bottoms like she wanted, and stripped the bed down for laundering. She only has/wants one set of sheets, but today she says she's ready "to go to WalMart" and find another set -- which she will evaluate for softness before purchasing!!
Did the laundry and had it back on the bed before she went in for her nap around 10:30. Hunk was dozing on his chair in the l.r. and I was in "my room" at the computer when the doorbell rang about 11:30am. Bitchy answered and it was "Lee" -- the case worker head nurse.
She had called Bitchy earlier (shortly after the OT left, probably prompted by her) in order to check in. Lee was not expected back here until Thursday, but when she spoke with Bitchy, who was in tears, she decided to stop in today, around noon.
She arrived early and Hunk was still asleep in the chair. Lee wanted to check Hunk's buttocks, which Bitchy said had a red spot on it. (She never allowed me to see this red spot -- I think Bitchy is uncharacteristically modest about this, but I am Hunk's daughter.... she doesn't want me to help him with anything of a very personal nature!)
During the discussion in the l.r., Hunk started getting up from his chair. "Where are you going, dear?" asked Bitchy. (No answer.) Well, we all allowed Hunk to go where he wanted -- which turned out to be into the bedroom to lie down on the bed. Before letting him lay down, Lee had Bitchy drop his pants so she could see the red spot, which she thought might turn out to be a pressure spot. I peeked into the room and saw the red area on his left buttock, but also, as Lee was turning him, what looked like a serious case of "diaper rash" all across his bottom.
From dealing with Bitchy and her reluctance all along to take Hunk's growing incontinence seriously or openly, I figure it's a result of his sitting in damp Depends! He has only been in them since his birthday (early July) and she has fought against checking for wetness, and even against changing him into dry ones at night. ("Oh, they aren't that wet, daughter!!!") And she won't let me be proactive on monitoring it myself... Grrrrrrr!!!!!
So anyway, when Lee got him down on the bed and took his blood pressure, she was shocked to see it register at 68/44 with a pulse of 48. She was concerned that he was dehydrated and that was the cause of the low bp. She thought he should go to the hospital and called the doctor for an ambulance.
One arrived in just a few minutes, and Hunk was monitored on the bed first. The paramedics saw the low bp and what they called an "atrial flutter" -- which means his heart rhythm was irregular and could have gone into a regular sinus rhythm or defibrillation. They decided to take him to the hospital and hook him up to an i.v.
Bitchy was freaking even more, of course, even though Lee had told her this was mostly a cautionary move and that he would probably be fine once he got some fluids pumped in him. She was sobbing about how he was such a good husband, etc., and how he had never been like this before.
I was sitting on the bed with him while the paramedics were around, talking quietly to him that they were here to help him feel better and they were just going to do some checking and monitoring, and then take him in their cool ambulance to the hospital so he could get better. That mom and I were going to be there soon as well, and we would see him pretty quick. He smiled a bit and said ok and nodded now and then, but he also looked pretty weak and small...
When we got to the ER and found him he was a snarling tiger. "Get me the hell outta here! This is a nightmare. What the hell are these people doing and why am I here!!!"
The ER doc wanted me to explain why he'd been brought in and I told him all this, basically, and he said that this man did not need to be in the ER. He wouldn't let us just take him home immediately though, because he wanted dad to be quiet and settled first. Plus they had some blood to work up and evaluate, and that would take time.
I had gone to him immediately and said that he should settle down a bit but he would certainly be going home as soon as possible. They brought him a barco-lounger to sit in, and gave him a lunch, and mom and I sat with him while we waited for the boot. At one point he needed to pee, so they got to check his urine.
All his tests came back "normal" with no dehydration showing in his urine (how do they know that??), and all his blood work came back normal. The doctor eventually said he should cut back on the blood pressure meds, as Dr. D. had said earlier this morning when Bitchy got through to her favorite nurse.
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