Nyel: NPO Again

May 17, 2019 | 0 comments

Day 22 at St, Vincent’s this time around — This was to be Transfer to Providence Seaside Swing Bed Day. Operable word: was.  Instead, it’s NPO day — NPO is hospital speak for nothing by mouth — a medical instruction meaning to withhold food and fluids. It is from the Latin phrase nil per os which, translated literally means “nothing through the mouth” and is usually the order given when surgery is anticipated.

By nine yesterday morning, Nyel’s discharge plan was in place.  He would be transferred to Providence Hospital, Seaside about two in the afternoon.  At tennish, one of the orthopedic PA’s came in to check his wound vac.  She had been in several times before and seemed efficient and clear about conveying information to us.  Before she left I asked her about the amount of blood being sucked into the wound vac cannister — “It seems to be increasing…”  and I asked about its color — “It seems lighter, not dark like we were told it would be.”

She reassured me on both counts (or tried to).  We had been told initially that there would be less and less blood except when he was moving and that the blood would be very dark (almost black) because it was “old blood” from the hematoma, not “new blood” fresh from the wound site.

Two hours later, she was back with a (new to us) orthopedic doctor who was seeking Nyel’s permission to do some more surgery.  “I thought about what you had asked me,” the PA said, “and I took a long look at Nyel’s charts and at the numbers.  I think your concerns were correct.  He may be bleeding from the wound site, itself, and not just from the hematoma.”

  

Apparently, there had then been a consultation among surgeons and other ortho doctors, the cardiac people had been consulted, and they were all recommending going back in and closing Nyel up more securely — doing what could not be done three weeks ago because he was in danger of dying on the table.  “There will be no bone involved this time,” the doctor said.  “Just tissue.  He should be fine and it will make a huge difference in his healing. Plus,” she reminded us, “he did fine when they removed the pacemaker after his initial surgery.  This one will be a similar sort of surgery — nothing like the initial one when they were removing hardware and infection from the bones.”

So… Nyel had to give up the swing bed situation.  At this point there is no projected discharge date — it all depends upon how it goes — when they can put him back on blood thinners and diuretics for his heart and any other meds they have put on hold until he recovers sufficiently from this latest surgery.  Then, and only then, will he be back to square one (or is it two or three?) in terms of getting out of here.  As always, Nyel is stoic — the most patient patient ever.

 

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