Eh, A workday in the life of....

Current mood: accomplished

So....because I had quite an adventure working the other night, I figured EVERYBODY needs to know. Normally, I don't have any problems with my patients. They are, for the most part, very pleasant. But over the years, I have had a handful of....Doozies. I encountered one such patient the other night. We'll call her "Ms. Black".

I should have recognized it as an omen that Ms. Black showed up almost an hour late. A family member wheeled her up.......because as I was soon to discover......Ms. Black weighed close to 500 lbs. and was almost totally non weight-bearing (meaning she could not support her own weight, or stand up under her own power).

As an aside, I just have to wonder.....there has to be a way to screen "special needs" patients before they show up and I meet them cold.

Ms. Black's family member, before leaving as quickly as humanly possible, shouted over her shoulder, "By the way, she'll need a portable bedside toilet"....great.....due to circumstances I can't really divulge, a bedside potty chair was unavailable.....I don't want to bore anybody with technical procedural details, so let's just say that the patient has to sit upright for a little while as I get them ready for the test (anywhere from 45 mins to an hour, depending on the hairstyle, cleanliness, and co-operation of the patient). Ms. Black was NOT accustomed to sitting up for very long (when I inquired, she told me that reclining was her position of choice) and would, every now and again, let out a long, low moan.....as though she were being interrogated under duress. The reader can safely assume it took me quite awhile to prepare Ms. Black.

Now that she was hooked up, it was time to get her all settled for bed. Because Ms. Black was a lady of substantial girth, and could support only minimal weight on her own feet (translation.....I would have to do all the work) I asked her if she needed to use the bathroom before I began the Herculean task of getting her into the bed (Ok, maybe I worded it a little more diplomatically). "Nope", she said "I'm ok for now. I didn't take my lasix tonight so I wouldn't have to pee"

Wait....Didn't take her fluid pill? WTF?!? That just means that her heart will have to work much harder, less efficiently, and eventually fluid will back up into her lungs. Hello Congestive Heart crisis!

So, after a protracted, complicated feat of miraculous proportion, I got Ms. Black into bed. I walked out of her room, and before I could take 10 steps, she hit her call button. Back in I go. "I have to go to the bathroom". Great.....It's not like I just asked ya, or anything. And it's soooooo easy for me to get you into/out of bed....no problem....In the middle of the struggle to get her out of bed, she casually says "Can you hurry? My bowels are about to move"....AWWWW, COME ON !!!! GIVE ME A FRIGGIN BREAK!!! Dear reader, because I care about your constitutuion, I will spare you the details of getting her to the bathroom (let's just say after I yanked her gown up so she could collapse on the toilet....well, I won't go there....). But I tell you that when I went back in to get her back into bed, the smell was.....not at all pleasant. In fact, it smelt as if Satan himself had farted.

Back into bed Ms. Black goes. Did I mention that she was a diabetic, and had these huge, weepy non-healing ulcers all over her legs? No? Well she did. Our next conversation went a lil' something like this:

HER: "My legs are starting to hurt."

ME: "Ok. What do you do for that when you're at home?"

HER: "I take my Lortab"

ME: "Did you bring any with you?" (The day people are pretty good at explaining to patients to bring any needed meds with them)

HER: "No. I'm getting low and wanted to save my pills at home"

ME: "I can't give you anything like that, Ms. Black"

HER: (in a very sarcastic tone) "I thought I was in a hospital"

ME: (showing god-like restraint to avoid punching her in the face) "Well, yes....But this is the sleep lab. We can only give sleep meds"

HER: "With what they charge, you'd think I could get whatever I needed"

ME: (silently thinking "Yup, Medicaid sure covers everything")

Skip ahead a little in time. Ms. Black has fallen asleep, and has terrible Obstructive Sleep Apnea. Terrible. Knowing in my heart how this will turn out, I decide to try and put the CPAP mask on her, because she is my patient no matter how big a PITA she is, and this is an intervention that could literally save her life. Well....it was a semi-success.....After numerous adjustments and re-assurances, Ms. Black was able to fall asleep while wearing the mask. If I didn't get her fixed, then she's at least very close. She probably slept for 2-3 hours wearing the mask.....then she woke up and refused to wear it any more. Oh well.....that's her choice.....

So that was but one night in the life of the lowely sleep therapist. It was, however, in its own way, one of the more memorable nights.