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Hyper Vigilant Wacko?
“I’m concerned about Rodger this morning,” I said into the phone. One the other end was Jason, the tele health nurse. Jason is extremely responsive to my concerns and he is genuinely fond of Dad.
“Oh no, what’s happening?”
“His left hand and arm are swollen. The swelling goes up past his elbow. Do you have any idea what’s going on this time?”
“Hmmm. How much swelling is there?”
I had a hard time answering that question. How much is much? It didn’t come close to the pitting edema I developed in my foot and leg after falling off my step in aerobics class a few years ago. The torn ligaments and spiral sprain caused so much swelling I could poke deep indentations in my flesh that would stay there for several minutes, completely grossing out my husband every time I did it.
“It’s not huge, I replied. But, it’s very noticeable.”
He recommended I call the ER nurse and put me through to that extension.
“Hmm, the nurse responded when I told her about the swelling. I wonder what could have caused that. Did he fall or bump it?”
“No. He just woke up. He did have a stent and a pacemaker inserted in November after suffering a heart attack. Could it be related to that?”
“Maybe he slept on it,” she suggested.
Since the same thought had occurred to me I didn’t discount her suggestion entirely. Still, something felt wrong. As usual, Dad insisted it was no big deal. It didn’t hurt and I was worrying too much.
“I suggest you watch him for a while, the nurse advised, if you need us, you know where we are,” she wished me well and hung up.
A few moments later the phone rang. It was Jason.
“I’m placing a call to Rodger’s cardiologist to let him know what’s going on. I think it may be caused by one of his medications. You should hear from the doctor soon.”
“I hope you don’t think I’m some hyper vigilant wacko for calling you again,” I commented half heartedly.
“Not at all,” Jason wisely answered. “You’re doing a good job with him.”
I felt better hearing that even though I knew he wouldn’t have admitted to that feeling even if he felt it. I was so relieved to know the doctor would be reviewing his chart that I pushed back the instinct to get in the car and head to the hospital. I encouraged Dad to rest and not do the Monday morning dusting he insists is his job. “Too much loafing is no good,” he tells me.
The next time I checked him I thought the swelling had increased a bit but I couldn’t be sure. I put his hand in mine and his fingers felt cold. That’s not good, I thought. Then I laughed at myself. He’d just finished a cup of pudding fresh from the refrigerator. Of course his hand was cool. The words, “You worry too much,” echoed in my mind. I still wanted to take him to the doctor to be sure that’s all it was but pushed that feeling away again and waited for the call that would be coming. I wanted the doctor to tell me that all I’d have to do would be to discontinue one of his meds and all would be well.
An hour later I checked his arm again. I still hadn’t heard from the doctor but I didn’t fault him for that. He’s very busy and no one had indicated there might be an emergency brewing here. I wasn’t surprised it was taking a while for him to get back to me. However, this time there was no doubt the swelling had increased and it was moving up his arm. I called the hospital and left a message for his doctor that I was bringing Dad into the emergency room.
The triage nurse took one look at that arm and whisked him back into a treatment room.
“This looks like a blood clot,” the on call doctor told me, he has to be admitted.”
A Doplar test, administered the following day, showed three blood clots in his arm. The technical diagnosis was deep vein thrombosis subsequent to the insertion of a pacemaker. The very thing that is keeping him alive is now putting him at risk.
Dad is still in the hospital eight days later. He’s on three blood thinning medications and his arm is still larger than it should be. He’s going to need weekly blood tests for several months and is as high risk for internal bleeding from a bump or a fall. Even the food he eats can affect his blood clotting ability.
I’ve been looking for information on the internet all morning. This set back appears to be not uncommon and treatable. Still, I wonder how much one elderly man can cope with and what will come next. He’ll be coming home in two or three days and I’ll be watching him more carefully than ever. Hyper vigilance is exactly what’s needed here.
I spoke with Jason yesterday. He’d stopped by to see Dad and paused on his way out to reassure me that I’m not a wacko at all. “Each time you call it’s for a good reason and you did the right thing bringing him in when you did.”
“I watch him all the time,” I said. “I look at his color and the way he moves. I listen for slurred speech and keep track of how much he eats and how much water he drinks. I know he thinks I worry too much but he denies pain and minimizes his weakness. He was insisting that the swelling in his arm was normal and there was nothing anyone could do about it. If I wait for him to complain ….”
“It’s already too late,” Jason completed my sentence. “No one knows him as well as you,” he said. You are our eyes and ears and you do a good job. I tell every caregiver to use all their senses and you do it naturally. If I need care someday I’d want you to be my caregiver.”
Touched by his words I thanked him, silently praying he stays in good health for a very long time. I’ve got all I can handle right now. Thanks for listening. You can contact me anytime at bcarducci@comcast.net
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