Monday, September 19, 2011

What's Wrong?! What isn't Wrong!

We have a laryngectomy patient who is having some complications. Last time I saw him, he was still in the ICU, and he has moved out to the wards now. I saw him twice yesterday. The first time I had a student with me and, lets be honest here, she did the bulk of the work. So the issue is that due to bleeding there are many blood clots that need to be cleared out of his airway. We do this using sterile swabs, tweezers, gauze, and finally instilling saline and suctioning the crap out of his lungs. So. That went well the first time. When we arrived he was on the phone with his wife. Except he can't talk - so he would listen to the phone and then hand it back to the nurse who would listen to what the wife had to say and then convey what the patient was trying to say. Very frustrating. For everyone. At one point the nurse said, "Your wife would like to know what is wrong." I laughed to myself. This poor guy has had so much trouble in  hospital - What's wrong??? What isn't wrong. Anyway. She wasn't interested in coming down to the hospital so he was going to have to wait until morning to see her. And lucky us would get to continue to care for his laryngectomy site.

Later that evening, after my student had got home for the day, I had to see him again. Now the poor guy was vomiting up copious amounts of bile. Luckily for me, because I wasn't that interested in irritating a vomiting patient, the ENT resident was there with her little scope and she said it looked pretty clear in there. I just cleaned up some superficial clots and got the hell out of dodge.

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