My alarm went off at 5AM and I pushed 'snooze'. The blanket was heavy when I went to push it back and heard a "meow," that jogged my memory I was home in my own bed. I reached down to my hip and
stroked Sam's chin.
When Sam first came to my doorstep as a stray kitten, I was unsure of her gender, so I gave her a name that could work for either sex. I began to set food and water out for her, and soon was able to pet her. She hated being picked up, but at least I could pet her. Sadly, she continued to get thinner and began to scratch her ears until she had visible sores on them. Against her will, I placed her in a small animal carrier I purchased, and took her to the vet. After vaccinations, drops to treat ear mites, and deworming her, we were sent home with strict instructions to keep her in the house until she was putting on weight again.
After setting up a litter box and buying treats and canned food, Sam began to grow normally and looked healthier. The vet said she was a lucky kitty. At about six months of age, I brought her back in to be spayed, and she has been in my house ever since. We bonded quickly since it's just me, my housekeeper Charlotte, and Sam. Food really is the way to a cat's heart. Well, and attention.
I heard my phone buzz and it brought me out of my morning haze. 'Incoming text from Kynlee'. Thinking something might be wrong, I hurriedly opened it and read the text. With every interaction, I liked Kynlee just a little more. She was checking on me and offered to cook supper Friday. How sweet. No one other than family tried to take care of me. Usually, they wanted something from me. They wanted money, a recommendation for a job, or my professional opinion without having to pay for it. Kynlee was definitely a breath of fresh air. Since it was obvious Kynlee sent the message last night and it was likely too early to message her now, I'd wait until after work.
"Sam, I cannot wait until you meet Kynlee. I know you'll love her just as much as I do. Did I say love? I meant like." Sam looked at me with eyes half closed and pushed into my hand as I scratched her chin and ears. I could hear her purr all the way from my hip. She sounded like one happy kitty. "I missed you too Sam. Unfortunately, I have surgery so I have to get up baby."
Sam opened her blue eyes and glared at me because, I had the audacity to stop petting her. It was as if she understood what I said. I lifted her off of me gently and threw the blanket back. Sleeping naked made getting ready in the morning much more convenient. I looked at myself in the mirror, flexed my muscles and moved side to slide slowly. "Not bad Wam," I told myself while looking in the mirror, "but gotta get back to the gym today. Enough slacking off."
I donned my boxers and pants, then headed into the bathroom. I shaved with my electric shaver, washed my face, put on aftershave, deodorant, brushed my teeth, put everything back in its place, and returned to the bedroom to finish dressing. I turned on the single cup coffee pot to brew my liquid energy, put on shoes and socks, attached my work badge, grabbed my travel mug (now full of black coffee), and headed out the door with my computer bag over my shoulder and my brief case in the hand opposite my coffee. Setting my coffee in the cup holder, I place my bag and brief case in the passenger's seat. Once my phone connected to the SUV hands free system, I began sorting my emails using voice commands, and commence to the hospital.
Once in the locker room, I donned my scrubs, grabbed a lab coat, attached my badge, and headed to the ICU to check on Halian. Mona had not yet arrived. Hal was still in a medically induced coma, but had continued to improve during the night.
Wam's first surgery today was to place a ventriculoperitoneal shunt in an infant with hydrocephalus. If not repaired, the fluid would begin to cause brain damage and would eventually death if the fluid was not drained. The procedure generally only takes ninety minutes, but may be longer due to the tiny infant. More compact areas tend to take longer and require more precision. The smaller the patient, the smaller the work area.
Two hours later, the infant was in recovery and stable, the parents were updated, and I was on my way to check on Wanda. She was on the general surgical floor, and I was going to visit quickly while my team prepped the next surgical patient.
Alec was with Wanda today instead of My mother. I knocked and entered to find my sister looking "off". Upon further inspection, I found her pulse and respiratory rate increased, she kept clearing her throat or coughing slightly, and she was slightly pale. I went into doctor mode, "Wanda, how long have you been feeling like this?"
Wanda shrugged but Alec answered, "less than an hour. She keeps changing position like she just cannot get comfortable. She made me put the head of the bed all the way up because, she said it felt better."
I pushed the call light for the nurse to come. "Alec, why didn't you call someone?"
"I wanted to, but Wanda told me not to be a bother."
I sighed and ran my hand down my face. The nurse came in and said, "yes Dr. Teton?"
After applying oxygen to help increase her blood oxygen saturation level (SaO2), I and the nurse discussed Wanda's physician. Apparently, everything was normal during rounds, and at last vital sign check, so the nurse began to gather a new set of vital signs. An order for venipuncture was sent to the lab, to check for elevated D-dimer in the blood. An X-ray was ordered to help rule out other causes of the symptoms. Last but not least, I reassured Wanda we would get to the bottom of this and I would return after completing my scheduled surgery.
After giving the nurse strict instructions to call me in the OR with results, I headed down to start the lumbar laminectomy that was next on my schedule. This surgery generally took four to six hours, barring any catastrophes, and would wrap up the day for me and my surgical team.
About sixty minutes into the surgery, the nurse called about Wanda's results. The call was put on speaker phone so I could talk while I operated. The nurse reported, "The D-dimer test was elevated, suggesting a clot and the X-ray ruled out other causes for her symptoms. Dr. Kahn is here if you'd like to discuss this with him?"
Dr. Kahn and I discussed heparin versus a clot buster. I knew that with the recent trauma and without a definitive diagnosis, heparin was the safer choice. Between the two of us, we decided on intravenous heparin. Dr. Kahn agreed to review all the medications for contraindications and moved Wanda to the ICU until she was stable. Wanda would receive closer supervision in the ICU.
The theory was that because of the external fixation device, they could only put the alternating compression devices on one leg to help with circulation of extremities and keep clots at bay. Thus, a clot must have formed in the injured limb and traveled to the lung.
The laminectomy went smoothly, and I was finished in a little over four hours. After updating the family in the waiting room, I headed to see Wanda and Halian. Both Mona and Mom were in Hal's room. Alec remained with Wanda.
Wanda appeared slightly more comfortable with the head of the bed elevated, heparin running in her IV, and the oxygen mask in place. Alec's hair was sticking up like he had been running his hands through it. Hand on Alec's shoulder, I asked Alec in a quiet voice so I didn't disturb Wanda, "how you holding up man?"
Alec looked up and met my eyes with a frown. Alec didn't say a word, but that look said it all. "That good huh? Is there anything I can do to help?"
Alec shook his head. Finally he spoke in a quiet voice, "nah man. Thanks for offering though. Mona is going to pick up Kara from daycare so I can stay here tonight with Wanda and Hal. I'm so grateful we have such supportive family to help us out. I just don't want to leave them. I feel like if I let them out of my sight, something else will happen to them."
"I understand, but you need to take care of yourself too. The ICU has the best nurses and doctors. The heparin starts working right away, that's why it's a good choice. It also stops working almost immediately after they stop it. So much safer than oral versions that remain in the system for an extended time."
Alec didn't speak, but nodded in response. He continued to sit at the bedside, holding Wanda's hand. He seemed like he was here physically, but off mentally in his own little world.
"Well, if you need something Alec, please call me. I can be back in like twenty minutes. Anything I can get you before I go?" I asked as I prepared to leave.
"Nah, I'm good. Thanks though."
I did quick rounds on my surgical patients, all resting quietly with stable vital signs, and returned to Hal's room. Mona had left to pick up Kara and stay at Wanda and Alex's home tonight. Mom sat in the chair next to Hal's bed, reading him a book. I wasn't sure what book, but it had a sci-fi feel it, whatever it was.
I walked up and placed my hand on Mom's shoulder, "what you two reading?"
Mom smiled and showed me the cover while keeping a finger in the book to keep her place. "Halian use to love it when I read to him when he was little. I hoped maybe hearing my voice would be calming for him."
I bent down and kissed her cheek, "that's wonderful Momma. Hopefully one day soon we can wake him and he will tell you, "again!! Read it again Grandma!" She smiled up at me from her chair. "Momma, is there anything I can get you before I head out?"
She shook her head, "no. Unfortunately I think it's just a waiting game. Something none of us are very good at."
A smile crossed my face as I nodded. "Well, promise me you'll go home tonight and try to rest. Alec already said he is staying since Mona took Kara home. Wanda seems a little more comfortable but not out of the woods yet. I'll be back first thing in the morning. I love you Momma and you too Hal."
Mom gave me a squeeze from her seated position, I squeezed Hal's hand, showered, changed, and headed home for the night.
On my way home, Using my hands free system, I texted Kynlee.
Wam: Hey, got a bit to talk, or is it a bad time? I can wait if so. Please call me at your convenience.
Charlotte had left me a meal in the refrigerator. All I had to do was warm it up. One would think I hadn't eaten in days the way I inhaled the Tex Mex Casserole. I gave Sam fresh food and water, used the facilities, and headed off to bed.
So much for working out today. I'd have to make time tomorrow for sure.