It's Friday and plans for surgery are off for the moment as Darla's hemoglobin dropped to 7 requiring a blood transfusion. The normal range for females is 12-16. She is given 2 units of blood in the morning. In the afternoon, her lab results show only an increase to 8 and she is given another 2 units in the evening. Her hemoglobin is now 10.
Her physicians decide to shift their plan, which happens frequently in healthcare, and target operating on her shattered ankle on Monday if her H&H remain stable. They want to start with a shorter surgery before targeting the necessary and lengthy surgery to repair her pelvis now scheduled for next Friday. Darla's pain medications are increased to a higher continuous level to better manage her pain. She dozes on and off throughout the day. When she is awake, she continues to be alert and coherent. Family members take turns sitting with her so she is not alone.
Darla is frustrated and emotional about the constant reassessment of clinical plans and changes. She wants to hear one plan and move in that direction without deviation. She is feeling a strong loss of control and organization that she is used to having in her life. The doctors and nurses try to explain the reasons for the changes to her without much success in alleviating her frustration. Darla hasn't lost her sense of humor though. She told me "I'm stuck in Groundhog Day and I just want to move forward!" She is referring to the movie, Groundhog Day, where Bill Murray starts reliving the same 24 hours over again for many months.
Her nurse suggests that we start a journal for visitors to write chronological messages and for family members to write down clinical plans so she can read them while she is awake. She felt it may help decrease her frustration level. If you visit the hospital, please be sure to write a note in the journal by her bed.
