Plan "A"

I am happy to report much better news today. Yesterday was really quite hectic so I didn’t get a chance to post an entry into this blog until this morning.

I went to work yesterday morning because the medical student, Duy Le, who is doing a summer research rotation in my lab, was presenting a research article at his Journal Club. Faculty members are supposed to be present for the Journal Club sessions in which their students participate - so I felt that I should attend. I got to the hospital a little before 10 am surprised to find that Nancy was preparing to go home from the hospital. She told me that Dr. VanAmburg assured her that she could go home with both the NG tube and IV fluids and that hospice would still care for her. This sounded like Plan “A” to us. We weren’t very fond of the alternatives. However, as we were told earlier, most hospice groups don’t supply and administer IV fluids. However most will work with other agencies that do. So, I worked with Nancy’s nurses & a hospital social worker to make all the arrangements with Pathways Hospice to arrange for the delivery of the hospital bed, vacuum pump for the NG tube and various other home care medical equipment items. At the same time, the social worker contacted OptionCare, the infusion people, to deliver the infusion pump and several days supply of IV bags containing a variety of salt and sugar solutions. In fact, except for me answering questions and making suggestions to the staff, the hospital staff efficiently set up the whole thing.

Nancy was home before 4:00 pm and she was resting comfortably in the hospital bed that we set up in the living room. She got to have our puppy, Cricket, sit with her (and bite at Nancy’s fingers. She is still teething – Cricket, that is, not Nancy!) and Nancy got another popsicle.

All seemed well -- until we tried to use the suction device on the NG tube. Oops… when Nancy was checked out, the hospital staff had inadvertently thrown away some of the needed connections for attaching the NG tube to the suction device. To make things worse, the suction device didn’t work anyway. The suction device is a vacuum pump – and it was clear that the motor was running and the gauge registered a vacuum, but the suction never got to the tubing. Luckily, the hospice nurse was still here and she tried to get service for the pump and a replacement fitting for the NG tube. As it turned out, they couldn’t get it all done so late in the day so we just suctioned her NG tube manually with a 50 ml syringe every several hours (the old way). I say “we” because a very dear friend of ours, Ann Lowry, who is also a hospice nurse, offered to stay with Nancy for the first night to make sure I got some rest and to make sure everything went well with Nancy on her first night at home.

Ann said Nancy had a good night. The only problem was that darn NG tube. The only fitting that was left on it was a tubing plug to prevent leaking of the tube when not connected to the suction device. Well, when Ann prepared to remove some fluid with manual suction (at 1:30 am), the plug broke off and couldn’t easily be removed from the tube. She and Nancy decided it would be OK to wait for more suction ‘till this morning when I got the broken piece out of the tubing with a needle nose pliers. Ann helped Nancy with bathing and with changing her colostomy appliance – thanks Ann; you were really a big help. Now, Nancy is sleeping soundly after getting fairly exhausted with her morning hygiene routine. While waiting to see if the MedResources people will come and get the suction going, I had the time to enter this post.

Nancy really appears comfortable and happy to be home – and we are thrilled to have her here. The minor mishaps that we are dealing with are well worth the opportunity to be together at home. Thank you to all who have been so supportive. Please keep us in your prayers. Plan “A” is working out quite nicely.