Tomorrow or the day after and new interns

T continues to do well with the new antibiotic. But he's not coming home today. Coram couldn't send a nurse out to our house today. There's a shortage of pediatric nurses. A nurse has to show us how to administer IV antibiotics. Never mind that C's been handling T's Broviac for months and the nurse showed me how to administer the IV antibiotic today in the hospital. A nurse has to show someone at home. Apparently it was acceptable for a nurse to show me, and then I'd explain it to C even though I wasn't sure that my movement disorder would let me actually do it. It's a crazy system.

But the pump we'll get at home is different than the one at the hospital. The pump has a few buttons and you program it with the dose and the rate. Anyone who has programmed a microwave and can do simple math can operate it. In addition we already have a pump at home a feeding pump that works the same way. The pump was never an issue for me. What was an issue was how I was going to give T IV antibiotics without jerking, spilling or contaminating his Broviac. It seemed impossible. Fortunately I was wrong.

The pharmacy will give us premixed doses of the antibiotics. And I myself pushed saline into his Broviac and hooked up the pump with the antibiotic, and then flushed it with Heparin. The hardest part for me was figuring how to twist the two ends together. At first my jerking hands really couldn't quite get it. They were twisting away and I was worried I'd drop the Broviac cap and have to start sterilizing all over again. Then I realised that if I did drop it, I'd just have to wipe it with alcohol again. No big deal. The second time I also realised connecting a syringe to the Broviac was not a gentle process. You basically shove the connector into the Broviac to open the valve, then you screw it on.

So I'm comfortable going home with T now. However I'm sure our insurance wouldn't cover any of his followup care if we just left the hospital against doctors' orders. So he's staying at another night at the hospital Hilton. Another few hundred dollars billed to the insurance. T's working his way up to be a million dollar baby.

C or I have to be at the hospital tomorrow at 7:30am to get T's final discharge instructions. Then rush over to admitting and get him checked in for an Upper GI Scan at 8:15am. The intern thinks this is possible. We'll see. Then we have to be back by 2pm for the home health nurse.

When I met the intern, she had newbie written all over her face; the deer in headlights, dazed look of someone who's trying to deal with far too much information. The new school year just started and T was one of her first cases. T was a good first case by Saturday when she started working on him. He has a lot of stuff to keep track of. Yet he's no longer seriously ill and the only thing new about him from a doctor's POV was his antibiotics. I knew she'd have to get approval for any changes she made, so I could feel sorry for her. Today she looked more relaxed. She had survived the barrage of T information and had almost managed to get him home.