Since Danny no longer had the NG tube I decided I needed to sleep at home Monday night. I had been at the hospital since Thursday. So he calls me at 7:45 this morning and tells me he had a horrible night. Danny has been running a low fever (around 101) for the last two days. Not often and it didn't make him feel bad. So the ID (infectious disease) doc was in yesterday morning and said that if he spiked another fever over 101 again she'd start looking at her "smoking guns". This would be the PICC line, the surgical site, his blood, and his urine. She really believed the fever was coming from the PICC line and would order it out if he spiked a fever again. She also informed us she had jury duty Tuesday so would have a partner covering for her. The partner came in at midnight last night to do his rounds for Tuesday b/c his wife was on another floor having a baby. Well Danny had spiked another fever of 101.2 on Monday. The ID doc saw that and decided to order Vancomycin. So they hung a bag at 12:30 am today.
For those of you that have been following our nightmare...it was pretty much understood that he was having allergic reactions to this drug and another antibiotic about 20 days ago. The surgeon at the time believed his fevers and violent shaking were due to antibiotics and fought the other docs to take him off. She won and within 24 hours he was better. So again all of the docs agreed he was having allergic reactions to Vancomycin or Merripenum (sp?).
So they bring in the Vanc and Danny asked what they were hanging. The nurse said the covering ID doc ordered Vanc. Danny immediately said that he was allergic. The nurse called the pharmacy and nobody had any record that he was "officially" allergic to Vanc. It was the middle of the night and Danny said fine..whatever..just let me go to sleep. 20 minutes after hanging the antibiotic he was violently shaking. The shakes were even worse and because of his incision so was the pain. He called the nurse who immediately unhooked the drug. Within 4 hours he was running over a 104 fever. It eventually went up to 105. So he fought the shakes, fever, and nausea all night over 20 minutes of Vancomycin. I get to the hospital at 8:30 and am fit to be tied. I was honestly in a fit of rage. How could some doc that has seen him maybe 3 times in the last 42 days order him an antibiotic without referring to his chart?? So I had the case manager up there asking her what the hell I can do and explaining that this hospital was going to wind up killing him! I also wanted to file a complaint against this doc and was seriously considering consulting a lawyer so I called my rep in patient relations. While I'm on the phone with her crying and screaming the case manager walks up to tell me that his regular ID doc had actually ordered the Vanc. I was blown away. I honestly didn't believe her. How could a physician that has been on his case since day 1 and knew everything he's been through and admitted that it must have been the antibiotics making him so sick a while back--how could she have written for this drug?
So the patient relations rep told me to stay there and she'd be right up. We got the paperwork filled out so I could review his chart. She sat in that room with me for an hour while I read all of the orders from the last week. Sure enough Dr. Yancy, the ID doc, wrote in her progress notes that if fever spiked she'd remove the PICC and add 2 antibiotics including Vancomycin. She made a poor decision and didn't even tell us she was considering this. I can't wait to see her tomorrow.
So about an hour after I got there this morning his kidney doc came in. She is such a sweet and caring doctor. She listened to me go over what had happened through the night and said "bleep bleep! These doctors are making all of us look stupid!" Of course at the time she thought she was talking about the covering physician. I can't wait to see her reaction when she finds out it was Yancy. She went on to say that all the docs assumed he was allergic and it was in his chart--she wrote it herself. She removed the PICC line which is still believed to be the source of the 101 fever and made sure the nurses were on top of things to get his fever under control.
Then we were told that Dr. Newton had been called and he wanted another IV line immediately to get fluids in Danny. They put the order in and radiology said it would be close to 3 before they could fit him in for another PICC. It was around 10 am at this point. So they call an ICU nurse to try to get a regular IV in him temporarily until he could get a PICC. His left hand was swollen from the IV they used during surgery so she could only stick the right hand. She found a few veins and tried to stick him. He wasn't even bleeding. The nurse was blown away and said she didn't feel comfortable doing the IV while he was running a 105 fever. So the nurses said well we will have to wait. Again we anticipated this would be 5 hours so once again I went into a fit of rage. I told the nurses-about 5 involved in his care at this point-that Dr. Newton wanted him to have fluids immediately and they needed to get the orders for the PICC line changed to STAT. Of course they argued saying that radiology had procedures scheduled and couldn't get him in. Hence the word STAT!!!!!!!!! I stopped arguing with her and said just do it. Call a doctor, any doctor and get the orders changed to stat. They were up to get him within about an hour.
So around noon they had another PICC line in him and we could tell his fever was coming down. Dr. Newton was at the nurses station when we got back up to the room and assured us that this wasn't a set back and that everything would be fine. He put Danny on a clear liquid diet and by about 2pm Danny's fever was gone. Except for exhaustion he was feeling okay again. I also explained to the nurses that we want literature on anything they give him. Additionally, Danny will question anything new they give him. He will ask what is it, what is it for, and who ordered it. If it wasn't ordered by Dr. Newton-the surgeon/specialist or by Dr. Kraish-kidney doctor who we just love, the nurses will have to get the drug approved by 1 of those 2 doctors. I told Danny if it is in the middle of the night or he is just too tired to question it then pick up your cell phone, call me, and put the nurse on the phone. There will be no more mistakes or chances taken with his care anymore.
Danny is feeling better now. He took a big nap this afternoon and still walked this evening. When I left around 8:30 tonight he was watching TV and sipping on water. It was a minor set back that he has already overcome. I just wish I could get over it!
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