Impatient inpatient insights

I left my home at 6:15ish a.m. on Monday. I was in the ER within walking distance of my home by around 6:30, blood drawn around 7 a.m. and admitted shortly thereafter. I was transferred to another hospital, arriving at 3 pm, and I haven’t left my 9th floor room every since.

It is 9:30 am on Thursday.

I had a cat bite. One tooth. Punctured my finger. 3 pound kitten.

The almost instantaneous cellulitis was scary.

The fact that it got infected is not unexpected—most people don’t realize that 50% of cat bites get infected versus 5 to 10% of dog bites.

This whole adventure taught me a lot about animals, emergency medicine and hospitals.

My favorite nurse Michelle just announced I am being discharged as soon as she can fill out the paperwork. They cultured my blood— that was those bottles I posted the other day—and nothing grew!

So now that these have come back clean, I can head home. My neighbor, Jan, little dog Sobaka’s mom, is on her way.

I have set up my follow up appointment with my primary care physician, who will be very glad to see my blood pressure has reached normal levels.

I can’t even remember what I wanted to write in this because I’m so excited to go home.

  • I drink a lot of water and also urinate a lot. If the average person urinates 2000 ml a day, I probably hit almost 3000 ml.
  • I heard a “rapid response team” code 3 times while in the hospital, once each night around 8 pm. Last night, it was in a room a few doors from mine. Seeing the red cart fly by and people streaming from every direction, including the corridor I could see from my window. It was sobering.
  • I always feel like I’ve ordered half the hospital menu and when the food comes, I’m always shocked at how little food is on the tray.
  • My blood pressure was consistently about 117/75.
  • Being in the hospital for 3.5 days allowed me to follow the routines and “get to know” the staff and the other patients. In this time of Coronavirus, I couldn’t leave my room without mask and what not and really where would I go?
  • I saw the nurses deal with several difficult situations.
  • I watched the patients walking the corridors for exercise, in their gowns and with their IV poles.
  • I loved watching shift change, and when the residents and interns gathered for rounds.

This didn’t work out like I expected

I spoke with the teenager early this morning and asked for some pet updates throughout the day and this is what I can tell you:

Zeus and Artemis

Zeus and Artemis are allowing the teenager closer. Hermes doesn’t do more than a token flee when the teenager administers his meds.

Misty

Misty has taken to sleeping in my purse, which is balanced on a stool.

Good news: Ortho, the department supervising my wound care, has released me to go home.

The teenager brought me a cute top for discharge.

Bad news: My attending physician will not release me until I have 72 hours of normal blood draws just to ensure that there is no infection lingering in my system.

When I got to the ER on Monday morning, my blood work drawn at 7 am was normal, my blood work drawn here 24 hours later was also normal. So, and the attending physician specifically said this— If they draw my blood tomorrow at 7 am and it is also normal, I can go home.

This explains why I unexpectedly had another IV bag of antibiotics. Last night I slept well enough to dream and my brain transformed the chime from the IV pump in the room neighboring mine to Diana Ross’ “I’m coming out.” I dreamt I was dancing in a disco.

The noise: Explanation of the noise in my dream on YouTube

And if you don’t know the song: Diana Ross “I’m coming out” on YouTube

Upon hearing the news that my discharge would be delayed, I’ll be honest… I cried. Not in front of the doctor or my favorite nurse but I did cry.

Then I called “the meal hotline” and told them I was stress eating dinner tonight. I ordered a garden salad, cheeseburger with lettuce, tomato and ranch dressing, broccoli, tator tots and a fruit cup.

Speaking of food, I tried the pancakes for breakfast with turkey sausage (that had a bite) and the chicken salad on rye for lunch. I promised the teenager I would try the sugar cookies.

Good news: The pancakes tasted as good as a diner. I was craving honeydew melon and it was so delicious. And the chicken salad also hit the spot.

Bad news: The breakfast was too small for me— if I do that again I am going to have to get scrambled eggs as that was not enough food for me and I was physically shaking by lunch.

Nala

Now that my meals are situated, I FaceTimed my cockatoo. That always cheers me up. I don’t have any clean clothes, except for a pair of jeans, so I asked Gayle to bring me a t-shirt and some dental floss.

She said yes and offered to stop and get me Dunkin so I placed an order. First I got her an iced tea and then I ordered munchkins. I checked out and realized I forgot my order. So I placed a second order.

Apparently that Dunkin’ closes at 2 and they were no longer accepting mobile orders— even though I had placed one one minute earlier.

And they were out of munchkins. So we got doughnuts in the munchkin flavors.

When Gayle left, it felt so good to wash, floss and put on the closest thing I had to an outfit.

Dawn: The Big Reveal

For those who haven’t read the whole saga— I am in St. Luke’s Hospital Bethlehem/Fountain Hill because a 3-pound black kitten I am fostering managing to bite me while the teenager and I were giving her eye meds.

One of her teeth punctured my left index finger above the middle knuckle and I developed cellulitis that was spreading into my hand.

Thanks to a maceration dressing (again read the last few blog posts for details) and IV antibiotics every four hours, it seems to be calming.

Last night was not easy. Something was going on— I don’t know if it was the tropical storm or something happening with the other patients (this is the cancer floor)—and they didn’t even do basic checks on me for almost six hours.

The entire staff kept running to the other end of the floor and when the PCA did come down to this end, she apologized and ran back out again.

I was on IV meds for that time and when they came in it was business only. No chit chat.

And my needs right now are far from life threatening.

But around 7, I started to get really hot. I took my sweatshirt off and saw what I thought was the beginning of a rash.

And then I started to freak. Because I thought about the course of the day. My eyes were dry, burning and itchy most of the day. My skin had been itchy on probably 65% of my body.

I was taking an IV antibiotic from the penicillin family every 4 hours and I know I have issues with penicillin.

Was I having a reaction?

The nurse increased my fluids just in case. I have similar symptoms today.

As if that scare wasn’t enough, my dressing fell of my finger. But the nurse rewrapped it.

So I had my last bag of antibiotics at 4 am. They have no meds in the system for me today. My only meal ordered was breakfast.

It all relies on what the specialist says.

The residents turned up at 6 am. It was time for the big reveal.

The residents, “the babies” as my favorite nurse calls them, took photos to share with the doctor supervising my care. I haven’t met him.

It looks like I will be going home today.

The nurses are all amazed at how quickly “that contraption” worked. The maceration dressing works on the same concept as a hyperbaric chamber, just a lot more low tech.

Certainly much less invasive than surgery.

Random Hospital Tidbits during a tropical storm

I think I have a sense of humor

My daughter brought extra dry erase markers so we could have fun with the nurses and my care team. Yes, as the a patient with cellulitis from a kitten bite I drew paw prints all over my board.

Today was my second day in the hospital at St. Luke’s Bethlehem/Fountain Hill and also the day that Tropical Storm Isaias wreaked havoc in the Lehigh Valley.

This is the only unplanned hospital stay I have ever had and will also be the longest. My other other experience in the hospital was giving birth to my daughter.

There are only two parts of this experience that I have disliked: IVs, though I have learned to ignore them, and collecting my urine so everyone can monitor my fluids.

Everyone on staff has been kind, and most downright enjoyable and intelligent. But Nurse Michelle has been my favorite.

Michelle finally arranged all my IV tubes into a double Dutch arrangement so they don’t have to keep swapping them out on my arm. She labeled everything meticulously. Attention to detail is the perfect trait for a nurse.

The hospital has lovely old architecture and picturesque views.

I started betadine soaks today. I’m tickled that such basic medicine still works well. I also feel like I’m hanging out with Marge from the Palmolive commercials.

“You’re soaking in it.”

Old Palmolive Commercial on You Tube

The teenager stopped by so that was fun— we took silly pictures. Speaking of the teenager and silly photos, I FaceTimed my cockatoo last night.

And in the category of things that make me happy—

Checking in to the 9th floor

The charge nurse introduced herself and asked me if I had Covid or any signs of Covid. I said no. She was curious why I had been swabbed and tested for Covid. I told her that they had told me that it was required before my transfer.

She discusses this with the doctor.

Then I discovered I had been admitted to the cancer floor and anyone with Covid or Covid exposure can’t be on the floor. The patients here are all very immunocompromised.

I read the hospital menu as I want for my admissions tests. It’s torture as it is after 3 pm and I’ve had about 350 calories of food and 6 grams of protein all day. And then I see Monday lunch features maple glazed Brussel sprouts.

If you follow my blog, you may now Brussel sprouts are my favorite and I narrowly missed them. I was heartbroken.

** side note** Every staff person I have met at both of these facilities (I started at St. Luke’s Easton Campus) has been amazing.

The nurse finished most of my paperwork when a very handsome doctor strolls in, with sandy light brown hair and big eyes, swoops in to check my finger. He’s the specialist, the regular doctor and the nurse have all seen the cellulitis from the puncture/bite caused by a 3-pound kitten.

He tells me his plan for treatment—a maceration dressing. Now at first, I got this word mixed up with “eviscerate” and thought maybe they planned to make a brace of nails to poke holes in my flesh and let whatever was beneath the flesh ooze out.

The reality is far less gruesome but probably just as uncomfortable.

He carefully explained, but I’m going to summarize and share pictures. They put wet gauze around my hand, wrap it in a splint, wrap it in some soft stuff, tape it like a candy cane, put a plastic bag over it, wrap it in a heated blanket, put it in a big sling and hang it over my head.

“Ah,” I said. “The height of 2020 technology here.”

“It works,” he said.

He returned with a resident and an intern and they set to work. I love being in a teaching hospital because I learn so much.

I finally ordered some food and I meant to ask the kitchen staff if they had any Brussel sprouts left over from lunch but I forgot. I went with the beef brisket. And a sweet potato. Applesauce. Lemon meringue pie. Salad.

When it arrived, my tray only had spoons as utensils.

I have my left arm suspended from an IV pole. My right arm has an IV in the elbow. And I have to eat salad and cut meat with a spoon.

So the nurse came in for one of those routine things that nurses do, and I asked her, “Is it customary to not receive forks?”

She looked at my tray and started to laugh.

I must have looked a good tad baffled.

“It’s usually hard to get a spoon around here,” she said.

“They were saving them for me,” I replied.

Note the utensils

She found me some plastic utensils and I was able to dine more delicately. Later at shift change, the nurse and I managed to convince the night nurse that I was under doctor’s orders not to have a fork.

I should know not to joke about food as I had an NPO go into effect at midnight just in case I needed surgery in the morning.

I slept from about 1 to 4 a.m., and the resident undressed my contraption shortly after 6. The swelling had reduced, the redness gone, only one knuckle still swollen. The resident squeezed and poked and prodded but no discharge or puss oozed out.

This means no surgery!

The morning after

We will be doing another 12 hours of fluids, electrolytes and unasyn. And betadine soaks. I have noticed the knuckle is no longer swollen!

Transfer to St. Luke’s Fountain Hill on the full moon

This is part of an ongoing series typed in the hospital on my iPad during my stay for an infected cat bite.

The ambulance arrived ten minutes early for my transfer.

They let me climb onto the fancy gurney and strap me in. The Easton Squad paramedics were jovial despite the fact that they had been working for almost six hours—the halfway point of their shift—and the truck had been full non-stop. I think they said I was call #16.

I pointed out that is what the full moon.

“Don’t say that,” he replied.

“But it’s true,” I said.

He looked it up on his phone.

“You’re right,” he said.

I didn’t tell him I was a witch so it’s my spiritual obligation to observe the full moon.

Getting wheeled out of an ambulance through the hospital was a strange feeling. And a woman joined us in the elevator with an egg salad sandwich. It was 3 pm and I had a small pastry at 6 am. My companions hadn’t had lunch either.

We were all staring at the egg salad sandwich. It was awkward for me because I hate egg salad but I was thinking about it anyway.

“They didn’t feed you?” my ambulance guardian said.

“I might need surgery,” I replied. “So my lunch was ginger ale. It was a lovely ginger ale. The perfect temperature.”

They rolled me into my room and dropped me off. I overheard them tell the charge nurse that I was “a lovely little lady.”

“But she did upset me,” I heard a voice say. “She told me it was the full moon.”

Waiting for my ambulance

If you look at my last few entries, you will read about the tiny, little cat bite that sent me to urgent care and then to the ER at St. Luke’s Easton Campus. I never expected what happened next,

Right away, at 6:40 or so a.m., the doctor in the emergency room explained my options. They preferred to start IV antibiotics, then transfer me to one of the larger hospitals in the network.

Which would require an ambulance.

So I asked, “Could I just go to the hospital myself?”

And he explained I could, but he would be discharging me against medical advice, and then I would start over in the other emergency room. Which might mean two separate emergency room charges. And not being monitored. And losing my spot in the triage line.

And he recommended asking for removal of the transfer charges.

Now they have drawn on me with surgical marker at this point and i can see my finger swelling and my infection spreading. Two knuckles are completely swollen and angry.

I want to get this treated ASAP. So I agreed.

I’ve seen every episode of House MD, I know infections that spread are bad.

That was an attempt at levity. I don’t think all doctors are like House.

This is only my first real hospitalization— unless you count childbirth.

Now, Easton Hospital has a long history in the small community where I live. When I moved here, Easton Hospital was still a small, independent hospital. A few years ago, the Steward Group bought it and made it a for-profit hospital.

Which, for the sake of trivia, increased the tax base in our borough.

But over the course of the last year, Steward closed down entire departments. When Covid-19 hit, Steward threatened to close the whole damn hospital if the state didn’t offer massive financial support.

In May, St. Luke’s University Health Network bought the hospital. My doctors are all affiliated with this network so when the urgent care suggested going to the emergency room, this one is about 600 steps from my house.

I didn’t know that in the transition, the hospital has not fully rebuilt its services and wasn’t equipped for my care. I would have gladly driven to the larger hospital. Oh well.

By about 10 a.m. my ER nurses have given me a second antibiotic (the urgent care had given me oral Bactrim), hand x-rays, and fluids. They also swab me for Covid as a safety precaution prior to transfer. That was squiggly. The hospital where I must go is full, so I have to wait for another patient to be discharged.

And it is the full moon.

I have my own triage room in the ER. At about 11:30, my neighbor, Sarah, comes and brings my phone charger, iPad, teddy bear and my favorite sweat shirt.

We talk, play cards, watch TV and learn that I am not allowed to eat. My hand may need surgery. The nurse apologetically offers me clear fluids but also offers me a milk. I ask for the ginger ale.

Lunch was Shasta. It was a perfectly tasty and cold Shasta that hit the spot.

Sarah and I play cards as I drink my Shasta

The Easton squad arrives at 2:20 p.m. for my 2:30 transport. I am happy to report that my blood pressure has been good. I joke around as they strap me on, which this is really the silliest medical transport ever.

It’s almost 9 p.m. I’ll finish this tomorrow.

The wound at the time of transfer

The unfortunate cat bite

So yesterday in our first attempt to medicate Hades’ eyes, she bit me.

As I wrote yesterday, I went to the urgent care and was prescribed antibiotics. But this morning the bite and finger was much worse.

Ironically we were able to give both kittens their meds today without a hitch. And Hades even stayed out and didn’t hide after we smeared antibiotic ointment in her eyes.

The black cat at the teenager’s witchy shelf

After we got them treated, I went downstairs, had a little pastry and took my bactrim.

Then I headed to the emergency room at St. Luke’s Easton Campus. I walked over. It’s a gorgeous morning.

Now I left home shortly after 6. I didn’t open the curtains or feed the birds because I figured I could do that when I get home.

The ER has other plans. I need to see a hand surgeon. He will decide whether he needs to open the hand and clean it. Personally I believe he does.

So I have had an X-ray, IV antibiotics and fluids, and a variety of blood work that has also returned normal.

I am sitting and waiting for a room to open at the main hospital in Bethlehem as this one doesn’t have an OR let alone a hand surgeon.

I thought they could just poke a hole in it and be done.

How wrong I was.

Once the room opens, I will ride the ambulance to the other facility.

Have I mentioned I have a high deductible medical plan?

Greek Pride Day 2

So four out of our five kittens in the “Greek Pride” we are fostering for FURR had a great day.

Left to right, kind of clockwise: Hermes (white nose), Zeus & Aphrodite (not sure from this angle who is who), and Artemis

Hermes and Hades both get antibiotic cream for their eyes. Hermes now has no probably with us giving him medicine, though he hisses a bit and puts up a token fight.

Hades, the little black kitten not in the photo, let me scoop her up and bring her to the teenager for her medicine. As I extended her face toward the teen, Hades panicked and started flailing.

I didn’t have a good grasp on the scruff of her neck (she’s 1/3 to 1/4 of the size of all my boys) and when I lifted my hand up to push her front paws against her chest, she bit me.

One tooth made a puncture above the knuckle of my left index finger. The teenager demanded I put the kitten down and go wash.

I washed my arms and hands with soap and water and then poured hydrogen peroxide in all the scratches and covered the puncture with a band aid.

Hades hid. All day.

An hour or so later, before going to the grocery store, I changed the band aid and added some triple antibiotic ointment.

I got the cats some sardines— the teenager deboned one can to share between all nine cans. The kittens, especially the runt, enjoyed them. Hades wouldn’t partake.

Sardines

Over the course of the day my finger swelled and I couldn’t bend it. When I did bend it, some discharge (relatively clear looking with a bit of blood) came out of the wound. It was starting to feel like I slammed it in a car door. I took an Epsom salt bath and headed to the Urgent Care.

Now I love my local urgent care.

This is what I looked like:

Lost the kitty battle

The bite is that small dot above the knuckle on my left index finger.

The assistant who took me to the exam room noticed my wounds and asked if I was there for the scratches. No, I said, showing him the puncture. “Cat bite?” he asked.

“I’m fostering unsocialized kittens and this one needed medicine in his eye,” I replied.

The doctor comes in.

He suggested I have an infection in my fingernail/cuticle and that it traveled into the knuckle. I suggest maybe it’s the puncture. He insists it’s the fingernail and prescribes bactrim, an antibiotic, but he wants me to go to the ER.

I grab a pizza, come home, take my first pill and help the teenager with the kittens. Hermes takes his evening meds like a champ and we scoop up the runt and think we see two little testicles.

We named him Zeus. Zeus likes to eat and likes to play. Artemis plays a little, but Zeus really likes to play.

Video of Zeus playing

When the teenager returned to her room to shower, three of the babies were sleeping on top of the desk instead of under it.

Day Two!

I’m so proud of them!

Discount Cookies

Today’s haul

Sometimes your days don’t go as planned. I thought I’d get up, feed the pets, and head to the Dollar Tree to get our foster kittens some sardines to soften their tender feline hearts.

The thunderstorm scared the cockatoo, and the rain must have slowed me down as I finished feeding the pets and having a coffee on the porch at 10 a.m.

But Sunday is the day of rest, so that’s okay.

I headed to the Dollar Tree and spent $9.

  • Three cans of sardines
  • 1 small box of generic golden crisp cereal or “sugar crisp” as it was called in the 1980s
  • 1 four-pack of individual boxes of cereal
  • 2 packs of Chips Ahoy sandwich cookies
  • 2 bags of Cajun gator dill potato chips
  • 1 jar mayonnaise

Then I went to the Grocery Outlet where for $14.75 I got everything else in the photo. Now, note, this is all processed breakfast foods and various snacks as the teenager starts band camp tomorrow and I know she will need to get something in her system at 7 a.m. and she will come home starved.

So snacks. And cereal. And Pop Tarts.

When I got home the teenager and I decided to try the Doozie cookie bar and the Sour Patch Kid cookies.

The results were exactly as I expected.

The teenager loved the Doozie bar. It was a cookie dough bar— so if you love edible cookie dough this was a nice treat. I thought it was too big for one sitting, that the sweetness got to be too much. I’m sure the teenager disagrees.

Doozie Birthday Cake Edible Cookie Dough Bar

I purchased three of these for 29 cents.

Now the Chips Ahoy cookies, with Sour Patch Kids, were definitely a purchase for me. I bought them at the Dollar Tree.

They tasted like sugar cookies with candy in them.

I liked them. The teenager did not.

Chips Ahoy Special Edition Sour Patch Kids