Gil, Lane, and Jurley

Gil, Jane and Jurley are Dalton's ICU nurses. In the past, I've used people's real names in the blog, but as I started to write this particular post, I realized that some of my thoughts might be considered, um, not so nice? So, i thought better of it and decided to use pseudonyms for these three. To be fair, the care that Dalton has received has been fabulous. For the past 36 hours, an RN has been stationed at his bedside to monitor his systems and keep him comfortable. In fact, on Monday night, it was nearly a full time job just to keep his blood pressure above 80/40. Lucky Dalton, his heart was in such good shape that the epidural which normally provides the best pain relief for an esophagectomy,lowered his "perfect blood pressure" so much that they had to hold back on the pain relief. The "Patient's Bill of Pain Relief Rights" which is posted everywhere clearly states that 1. I have a right to be free from pain and to be given medication to relieve my pain. Unfortunately, they do not include the disclaimer *** unless doing so would cause me to DIE! Consequently, Dalton was extremely uncomfortable all day yesterday until they decided that enough time had elapsed since surgery that he could have Toradol (like an advil on heroin). Since then, things have been much better for him in the pain department.

Nevertheless, what I find interesting about Dalton's care is that he has become the training patient for newbies. Gil is a very nice young man who is attentive and concerned about both doing his job well and treating the patient as a person rather than a hunk of meat. BUT, he is very green. Let's just put it this way, in the past 24 hours, we have had to remind him to reopen the valve on an iv, use the smaller connector on the j-tube to fluch it, and get all of the drainage out of the chest tube before he totals it. Thankfully, Lane is the trainer and she is very patient and very good. And, in Dalton's mind, there is a huge plus to have a male nurse - they are very careful when repositioning the catheter. Jurley on the other hand is like a bull in a china shop and has bumped him in places clearly marked fragile. She seems a bit flustered most of the time and gets very defensive when asked a question. I'm sure that the figured a healthy 38 year old guy would be the perfect "first case" for both Gil and Jurley, but the truth is that there are no easy first cases. I'm just hoping that we get a bit of a break tonight so that both of us can get some sleep.

As for Dalton's recovery goes, yesterdays concerns have stabilized and new ones have emerged. Pain, Blood Pressure, and Fever have all improved. Now, though, there seems to be some concern over decreased urine output and an abundance of drainage from the right chest drain. This drainage could indicate a thoracic duct leak which would likely need to be repaired through surgery within the week. More surgery would suck, although managing a thoracic duct leak without surgery isn't very successful (50% mortality rate)so if that's what it is, surgery here we come. Just be praying that there is no leak in the thoracic duct and that the issues with urine output are resolved. One day at a time seems to be doing the trick.