I see you

Netnet Camomot

THERE are two sets of initials that a patient and his family may have to face: ICU and DNR. The Intensive Care Unit of a hospital is not the best place to be. Anyone who has been there, done that, or who is an immediate family member of a patient in the ICU knows that.

The ICU is one place that a patient and his family dread. They don’t want to stay there longer than a day. They’ll keep on asking the doctors how long the patient will be staying there, when can he transfer to a private room, if there’s any hope for the patient to get better. For the ICU is kind of the point of no return.

I remember distracting Daddy’s attention whenever a dead patient was wheeled out of a room in the ICU, or when nurses would run to another room with their red crash cart. Red as in the color of blood. The ICU room had no curtains so that the nurses could easily see the patients. But the patients could also see everything outside the aquarium-like window.

And then, there comes a time when the doctor would suggest that you sign the DNR–the other set of initials that you, the family member, would dread. Do Not Resuscitate. If the ICU isn’t enough to convince you that your patient’s condition is way worse than bad, then there’s the DNR to slap you with reality.

Aside from the scary thoughts that an ICU could evoke, there’s its price which can soar to Mars with all the tubes and needles attached to the patient.

Doctors will usually advise for a patient to be discharged instead of allowing him to stay in the hospital where his weak condition can attract the invasion of more diseases. As soon as he’s fit enough to leave the hospital, doctors prefer recuperation at home, which could mean bringing along the tubes and needles that are attached to the patient, buying or borrowing a hospital bed, having oxygen tanks by his side, and hiring caregivers.

Doorways leading to his bedroom have to be covered with plastic to ensure it’s dust-free, the family members and caregivers who enter his room have to wear surgical masks, and they should always disinfect their hands with rubbing alcohol. This is when you’ll learn to look for the best alcohol. For us, it was the spray kind–easy to use, and not that harsh for the skin. Also, how to prevent bedsores. My sis found this particular kind of powder for that. Whenever friends had to take care of their own patients, too, we would recommend that powder, but it’s not available at the supermarket anymore the last time we checked. You would be calling doctors at dawn when you want to know if your patient’s presently worsening condition requires another trip to the hospital. This could happen a day after he had gone back home, or even hours after he had returned home, which could mean calling an ambulance, facing the coldness of an emergency room, and going through the whole Q&A process with the ER’s doctors. Again.

The list of your patient’s medicines and their intake schedule should be placed in a visible area in his bedroom at home, preferably pinned to the wall above the table where you have arranged his meds, so that if he has to be brought back to the hospital again, you’ll know where to get that list which serves as a reference for the ER’s docs.

If there’s one thing you’ll develop a phobia for, it’s the sound of an ambulance’s siren. Or even the sound of the hospital’s elevator–you know, the ding, ping, whatever. And then, these can become scary names for you: dopamine, albumin, creatinine. Your patient, however, would be too weak to ask what those terms mean.

If only curing a patient is possible with the snap of a finger or with a miracle. Like, Voila!
You would be desperate for miracles, though. The dopamine is gone from the liquids hanging above the patient’s bed, and you’re happy. His creatinine level decreases by 1, and you’re happy. The albumin is stopped, and you’re happy. For these could mean there’s a chance for your patient to fully recover despite the doctors’ prognosis that he won’t.

Now, here’s a hint: Once a formerly stern doctor is now kind to you, the prognosis can be worse than you thought. There will be times when all you can do as a family is to hug each other and cry. The doctors tell you about dialysis and tracheostomy, and all you will have is the family to be always there, together forever, walang iwanan. And you will schedule shifts for the family members to be at the hospital–who will be there for breakfast, lunch, dinner, overnight. Should you hire nurses and caregivers.

The availability of money, however, is a tricky thing for you will always find ways, yes, like that bank’s mantra. My guiding light that time was a friend’s advice: Make sure your patient is comfortable. So, that became the question each time the family had to gather and make a choice again on what to do next based on the doctors’ prognosis. Is he comfortable? Will he be more comfortable this way, that way?

Before signing the DNR, that was the question again: what would be less painful for him. Even now, we still ask ourselves if he felt pain during those hospital confinements and home recuperations. Have you ever had a headache? Imagine having that for the rest of your life. Or a tummy ache. A toothache. Muscle pains. There are patients with pain all throughout their body, and not even the strongest medicines are strong enough to remove that pain completely.

That’s why you don’t want your patient to feel pain. ICU may also mean I See You with its aquarium-like windows, and the assurance for the patient that we do see him and his daily struggle to be well again.

If ever you’re going through all these right now as a patient’s family and caregiver, here’s what helped me survive once upon a time: faith and food.

Sometimes the availability of lots of money can make you pick the wrong choices for your patient, so be careful and be able to discern if your decision is for him or for you.