First, let me say thank you to everyone for your kind words. Yesterday was hard.
So this morning I went over to the hospital. I waited until later in the morning because he was in a room of four men, three of whom looked to be frail elderly, and I didn’t want to be underfoot when the nurses were doing their morning routine (our hospital doesn’t have visiting hours, you can visit whenever, but they do have “quiet hours”.). I also needed to wait for our GP’s office to open so I could go get Mr I’s keys. If I didn’t get his keys today, we wouldn’t have another chance until Tuesday, because Mon is a holiday, I know he will fret about the car. Before I go, I leave a note on the neighbour’s door, since I knew he was worried yesterday.
Anyways, when I walked into the ward, I immediately saw Mr I walking back from the nurses station. I asked him if he was supposed to be up, and he said he was fine. He was had a lot more spring in his step than he did yesterday, and he was lucid. We went back to the room, and he told me the Doctor had been by earlier, and he is being discharged. Then he says he has to go to the bathroom, but instead of going to the ensuite he starts into the hall. I ask where is going and he says he is using the bathroom in the visitor’s lounge. I ask why, and he points to the two frail elderly men (in the morning one of his roommates had been moved out to a private room.) in the room, and says that if one of them wants to get up and use the bathroom, he doesn’t want them to wait on his account. This was such a very Mr. I moment!
Anyways, a med student comes by and asks about his meds. She says they have no record of them. It is weird, because I gave them to the paramedics as instructed, they were in the room at Emerg, and I showed them to the nurse when he arrived in the ward, and I was sure she took down all the info, and when she was done she told me to take them home. I still had them in my bag and pulled them out. She looked at them and then asked about the prescription I had found in the pocket of his hoodie, that our family Doctor had written the day before, I thought I had stuck the script in my purse, but it wasn’t there. She asked if it was filled, but I said no, it was just the script. She asks if I remember the dosage, noting that the pharmacy wouldn’t have this info. I tell her no, but that our family Doctor’s office is open 10 to 2 today, so she could try calling them. She also mentions they are putting him on a b vitamin supplement, specifically B9 and B12.
Lunch comes, and then a nurse comes by with the discharge papers. He had had what is called hepatic encephalopathy. Basically, what happened was, his liver had gotten overwhelmed and had stopped filtering ammonia from his blood. The ammonia had built up to the point it was causing mental confusion. He had been lethargic and not sleeping a few days prior to this, which happens to him from time to time, but apparently it is also a sign of mild hepatic encephalopathy.
The nurse goes over the discharge papers. He has a perscription for a drug to help keep the ammonia levels in his intestines down. If he has any confusion he is to come back to the hospital. He has to have bloodwork and a follow up with the family Doctor next week. His Gastroenterologist/Internal Medicine specialist will be calling him next week. He also has to have an echocardiogram as they have detected a heart murmur.
He is released, and I go to th car. He tells me he is mad at me for calling the GP because he is afraid he will lose his license and be unable to work. I tell him no, I didn’t call the GP, the GP called me, because he was worried. Then he says he is mad at whomever called the ambulance because he didn’t need to go to the hospital, he had just needed to sleep. I tell him I called the ambulance on the advice of his sister the nurse, and also that if all he needed was sleep, the paramedics would not have t taken him.
We head home, but first stop off at the pharmacy to drop off his discharge prescriptions. He wants to get his car immediately, but I tell him I won’t take him until he has a nap. He didn’t sleep all night at the hospital. I spread out his paperwork, and see they have included his test results. In it I discover that his ammonia levels were twice the upper limit of the normal range when he was in the Emerg. I call my Mom and Dad and tell them what the papers say, and what Mr I is saying about driving. My Dad says to tell Mr I that being mad at me over the ambulance call is like my Dad being mad at my Mom for him losing his license after she called the ambulance when he had his stroke. Dead men don’t get to keep their licenses. I also call his Mom and fill her in.
So when he comes down after his nap I show him the paperwork , and tell him that without the drug they gave him in the Emerg to bring down his ammonia levels, he might be dead right now. He stops grousing about the ambulance being called. He tells me he wants to tell people he had ammonia poisoning, but not give the impression it is related to alcohol abuse (which apparently is what the Hospital Doctor said. The GI doctor had said that it looked like there was more to it than just drinking, and had ordered the liver biopsy that turned up the H pylori infection a few months back, but whatever.) so he is going to blame the H pylori.
Just then, I see our neighbour outside. I fill him in that Mr I is now home, and tell him that if he sees Mr I acting confused again to call the ambulance. Neighbour says he will keep that “need to know” but he will tell his adult son, who also lives next door, just in case.
We go back to the pharmacy to pick up his new drugs. Then we get his car. He says he wants to go to his family’s Thanksgiving tomorrow (drat, I thought we were getting out of that) so we walk down the street to pick up ingredients for the shepherd’s pie I am making (we are doing a potluck thanksgiving with casseroles). I am making my awesome shepherd’s pie with a cheddar-leek crust.
Then he asks if we can go to dinner at the new restaurant down the street as we have nothing planned for dinner. I remind him he needs to take his digestive pill first, and it dawns on me that the pharmacist never gave us the b vitamins the med student had mentioned. I tell him I am going to run down before they close. He says he will meet me at the restaurant. I go down, and talk to the pharmacist, the discharge papers only say “multivitamin” and he meant to ask, but forgot.
I tell him they said B9 and B12. He says, “B9? Never heard of it.” He googles, and it’s the other name for folic acid.
He helps me pick one out. Chewables so Mr. I has one less pill to gag on.
I stop by the pharmacy’s “community window” as I am leaving to take a photo because a nearby village is having an LM Montgomery event, and we have steampunk friends who might be interested.
I hurry to the restaurant, and Mr I isn’t there. I go home. Not there. I start to panic, and go outside to see him walking towards me.
Me: Where did you go?
Me What? Why?
Him: When I was walking to the restaurant, I found someone’s meds in the street, with our pharmacy’s label on them, so I took them to the pharmacy.
Me But I was there. HOw did I miss you?
Him: The pharmacist asked me the same thing.
Then I realize that while I was talking a picture of the window, he had walked into the pharmacy by the other door. Duh!
We have a lovely dinner, come home curl up on the couch with the cat (who I swear knew something was up yesterday. He was desperate to cuddle with me yesterday night.) and I fall asleep.
Then I woke up and am wide awake. I want to be rested to run the Annoying Inlaw gauntlet tomorrow. If they go. ABiL told Mr I they were, but ASiL talked to our MiL in a very rambly way that left her confused if they were coming or not. They might go to her mother’s place. If not she plans to pull chilli out of the freezer and nuke it for her contribution to the potluck.
I don’t think she wants to come, because two weeks ago she had an absolute melt down at our 15 and 12 year old nieces. It was day two of their move, and the nieces were packing in their cousin’s old room, while ASiL and two friends of hers painted the basement floor. Our MiL and ABiL were also there, but they stepped outside for a breather. ASiL came up stairs, saw the nieces packing, and started screaming at them. She grabbed boxes and literally started ripping them apart and throwing the contents in the hall. When ABiL and our MiL rushed inside to see what was going on, she started screaming at them as well for how poorly they were packing things (in her eyes). My MiL took the nieces and left. ABiL has apologized to his mother for what happened.
Fortunately the Annoying Inlaws daughter was not around when this happened. However the reason she was not there is a little odd. Apparently they asked one of their new neighbours, people they had literally met the day before, to watch her while they went back to the house to work. This seems quite unwise.
I am left quite concerned about ASiL’s mental state. I have been contemplating a report to children’s aid, but since I didn’t directly witness the event, and the nieces haven’t directly told me about it, I don’t think I can. I have suggested to Mr I’s sister she make a consult call (which is an anonymous call where one tells the story to an intake worker, who will then say whether it is something CAS would act on). From my recent training I don’t think CAS would investigate since the girls she screamed at don’t live with her, but they might keep a record, and then if our little niece’s school also makes a report for example, they would have this incident on file, and might change how they approach the situation.
My MiL has been helping them with things since the melt down but they haven’t even talked to the nieces or her mother since it happened, so I expect things to be tense. I also expect them to try and make a fuss about Mr I’s medical status, at least partially to draw the heat off her.
Mr I’s sister says that she will not put up with them trying to pry in Mr I’s condition and she will shut them down if they do.