nosebleed

 
Did you know a nosebleed can kill you? Well, that almost happened to Bob yesterday (Saturday).

He fell, yesterday morning, and pretty much landed on his nose. Due to the blood thinners (he's taking about half as much now as he was at the beginning of the year, but still...) his nose would not stop bleeding. The first time I called the paramedics they said at the hospital all they would do is put a piece of tape on his nose and keep him half a day. That, and they bitched at me about not putting pressure on to stop the bleeding (what book was that in, and when did I read it?) and about his socks --diabetic socks, because the day before his feet had been swollen, instead of his usual non-skid hospital footies.

That was 9AM.

11AM his nose was still bleeding, or bleeding again. They'd left him in the recliner, but he was uncomfortable and wanted to go lay down. As soon as he stood up the nose started pouring again. Alternating between putting pressure on it and piling up towels to sop up the blood and having him blow his nose or spit ~solid chunks~ of blood... I called the paramedics again. A smarter crew, I think, came this time. They suggested he go to the hospital (which is what I wanted to happen the first time around), where he would get his nose packed to stop the bleeding.

Fine. They left, and I finished up a couple things around the house I hadn't had time to do while sopping up his blood, then stopped at the store for some laundry soap because I'd used it all up that morning on bloody sheets and towels and clothes.

When I got to the hospital --the local one, which we try to avoid-- he'd been there two hours and looked awful! He was pretty much incoherent, his breathing was raspy and labored, he was covered in blood, and the doctor said he was a DNR! WTF!??!

She gave me some reasons - "He's a very sick man," (what? he left home with a nosebleed, now he's suddenly very sick?) he didn't want to be intubated, he was CHF (what? his cardiologist didn't seem to think so, two weeks ago), he had brain atrophy (what? a week ago his neuro said the little bit of atrophy was consistent with someone his age) and he'd been calling the EMTs to pick him up when he fell many times over the past month (this is important WHY???). I countered, with all that's in the parentheses above, plus the fact he'd seen his primary doctor the DAY BEFORE and was considered healthy, PLUS, why would someone who wanted to be DNR have heart surgery lung surgery and brain surgery over the course of just 4 years??? and she said she'd have to go with "his wishes," which I think I know better than she did. In the meanwhile he was turning blue.

I figured out what had gone on is he did not want a breathing tube down his throat, but once I got him to understand it was a necessity, not an optional "lets try this" sort of thing, he said okay, if that's all they can do, let them do it.

Lucky for me a paramedic trainee was there and heard him say it, because right afterward he passed out. The doctor came back in and did not want to believe us! WTF!!!! The other paramedic then spoke up and said he heard it too. So they intubated him, and then they sent him to the bigger better hospital in Lexington.

Once there, they vacuumed at least a quart of blood out of his stomach and half a pint out of his lungs.

Tomorrow (Monday) morning they plan to remove the tube.

What if I'd been 3 hours instead of 2 behind him?