This is officially "not good."

Man, i am exhausted. I am just now sitting down at about five pm for the first time since six this morning. So I prop my throbbing feet up on the ottoman and sit down to reflect on my day. Today is my clinical shift at the hospital on an IMC/Telemetry floor. (for you lay people, that means that half the people are intermediate care (IMC) or on cardiac monitoring (telemetry) although mostly they're both. My patient that i cared for today was not doing well. As my professor put it, this is officially (with air quotes) "not good". He came into the hospital for a GI bleed, and most likely will not be getting out. He is one of those people that lived his whole life eating whatever he chose and sitting on the couch. One nurse description was, "he's been a non-compliant patient his whole life". While i think she was a bit of a grouch and left some things to be desired in her nursing care, it's true. Most likely people have been trying to tell him for the last thirty years (he's only in his early seventies) to take better care of himself and eat well or exercise at least a little bit. But, as one of my classmates reminded me, there is something to be said for living on your own terms but dying a little sooner.

When i checked his labs this morning, his BUN and creatinine had shot up to 60 and 2.5, and one of the first things we learned this summer was that when BUN and creatinine rise together, it signals renal failure. I just wish that were his only problem. I don't want to violate any patient privacy issues, but just to make a long sad story short, he ended up with multiple organ system failures. The treatment for one caused the other, but when they stop that treatment, the first gets worse... it was all one big mess. So all day i just tried to keep him as comfortable as possible. But I don't think I will ever get the look on his face out of my mind. His eyes got really big when we had to move him because of how much pain he was in, and all day he just kept repeating, "oh my God". By the end of my shift with him, the doctor came to evaluate him and sent him to get a CT scan done to, as he put it- "I'm not ruling out retroperitoneal hemorrhage- I'm confirming it". After that, he was moved down to ICU where hopefully he'll make a recovery, but the way his bloodwork looked and what the Doctor and my professor said, it did not look good.

When i first realized how bad off he was I had to choke back some tears because he reminded me of my dad. No, let me rephrase that- he was my biggest fear of how my dad would end up. Severely obese with multiple organ system health problems. But my dad has impressed me so much with his progress. He has lost over forty pounds, and is on his way to taking back his life and his body. (although apparently he'd prefer to have cartilage in his hips, so that needs to be fixed, but other than that he is doing wonderfully). So i just choked back those tears and silently thanked my God (and my dad) for listening to my pleas. I just wish him and his family peace and strength to endure what has got to be a really hard couple of days ahead. Blessed Be.