Nyel – May 19, 2019

Day 24 — Ever since the swing bed facility at Ocean Beach Hospital refused to accept Nyel, he’s been known here at St. Vincent’s as “complicated.”  The term is used somewhat affectionately by the doctors and nurses who have worked with him over the last few weeks, dealing first with one issue and then with the next.  No one denies that he is, indeed, complicated, and they also have some understanding of the limited size and capability of our little hospital.  Even so, it would still be our first choice of places for Nyel to gather his strength for eventual homecoming.

But, we are also resigned.  His heart issues are complex enough and with no cardiologist on the staff of OBH, safety becomes a challenge.  Because of the removal of his entire hip joint and the ensuing need for a wound vac plus the additional evacuation of a hematoma  and shoring up of the wound site he has required orthopedic doctors and wound care specialists — also probably not available at Ocean Beach Hospital.  Complicated.

Add to that  the PICC line that goes from his right arm directly into his heart to deliver the antibiotics that are fighting his MSSA infection.  (To say nothing of today’s news that his recent surgery has revealed yet another infection.  Fortunately, this one not is not a staph infection and his antibiotic has been changed to one that will deal with both problems.  Very complicated.

Physical Therapy

I’m not sure if Ocean Beach hase an orthopedic doctor or an infectious disease doctor on staff, either; probably not.  And then there is the entire issue of physical therapy for a man with one seriously impaired leg who has been almost totally inactive since February 28th.  Yes.  Complicated to the max.

Now, added to the “complicated” descriptor is another, even more intriguing adjective:  mysterious.  That is one word that I’ve never really considered when thinking about Nyel.  The closest I might come to such a description is probably “the strong, silent type.”  I guess the silent part could indicate mysterious, although Nyel has always maintained, “what you see is what you get.”

Here at the hospital, his mysterious side has more to do with his reactions to certain medications.  Not only that, but his rather erratic reactions to certain medications that heretofore followed predictable patterns.  His blood pressure is one such mystery — it continues to plunge to unacceptable depths — but only in the mornings.  Each health care professional has a different explanation and, one by one, the obvious “fixes” have been tried and found lacking.  “You are a man of mystery,” they tell him.

Ultrasound

Another mystery seems to be why it’s his right leg (which is his good leg) that has swollen up to an abnormal degree, perhaps due to the fact that diuretics were withheld for some days before and after various surgeries.  “Probably.”  But his “bad” (left) leg has remained far less swollen.  “Hmmm,” said several of the doctors.  Finally, one of the cardiologists ordered an ultrasound to see if, possibly, he has developed a clot.  That mystery, however, will not be addressed until tomorrow (Monday.)  “You’re not supposed to get sick on weekends,” teased today’s nurse.  “Not in the hospital, anyway.”

Meanwhile, Nyel is feeling better than he did a few days ago.  His appetite is fairly good.  He is eager to work on some specific therapy goals — like transferring from bed to wheelchair to commode and back again on his own steam — without the use of Sara Stedy.  Those are things he will need to be able to do on a regular basis, once he gets home.  The hospital staff may consider him complicated and mysterious.  I say, he’s determined and forward-thinking.   Thank goodness!