Yesterday’s call shift was an example of getting my hopes a little too high for a patient, and being quite disappointed, and things going from bad to worse, and then watching them overnight and just praying they don’t crash. It’s hard to believe how easily I had put so much faith into this patient, who I was advocating for to get her a feeding tube that she desperately needed. How after weeks of getting consent forms and convincing family and finally convincing the patient, she underwent the procedure, only to pull out her tube within a few hours. It was like we had set ourselves up for this, being so happy as things were finally falling into place, assuring her the operation went great and we would start tube feeding the next day. How upsetting to know that she has this gaping hole in her stomach now, and how upsetting to think of how limited our options are now. Will the tract still be open enough to put the tube back in? Will GI even have a second look at her, after how much convincing it took? If they don’t, what the heck are our options–that tube was the only thing we had left.
Without going into great detail about her case, suffice to say it was a journey over a few weeks that reached the pinnacle as she got her tube, pulled it out. started to get febrile, me and the resident panicking, seeing free air on her xrays, and just not knowing what to do with her anymore. There are behavioural issues, there are family issues, there are tons of things factoring into this, but we had been hopeful. And now I’ve been home post-call and the excitement overnight has quelled, and I’ll find out tomorrow what ended up happening with her. And hopefully I’ll learn to keep my expectations reasonable for all patients, or better yet, not form any at all and just try to go with the flow.