Tuesday, February 26, 2013

Too Scared To Do Reiki: Code Sepsis

Yesterday was a short day at work. I was torn between seeing mom and heading home to 'catch up' on everything that had been 'falling behind' since she got ill before New Year's Day. That included sleep.

I spoke on the phone with my sister who lives close for an hour. At her request I called the doc on staff at the nursing home where mom had been admitted by her health care plan for post-surgical rehabilitation. It is not the best place*, but the only place insurance was willing to pay for it. There are times when as a doctor you have to take your knowledge of medicine, use it like a baseball bat, and aim it at a provider who is not doing 'enough' for your loved one.  I have a list of concerns about mother. Shall we go over them one by one? There are four... and I carefully clicked off each organ system and disease process that was dramatically (read: medically indefensible) out of whack. This doc 'saw the light' and disclosed that 'she needs a higher level of care'. No Duh. Even the urology attending could hear a lung process on her follow-up visit last week!

A large part of medicine, in practice, is the avoidance of things that if left unchecked could grow into greater problems. You 'head it off at the pass'.

This is where medical ignorance and 'burnout' are deadly. I once had a fellow intern who would not check labs because then there would be more work to do and more problems to fix. He got let go from the training program a couple of years later. Checking labs is how you get your patient better.

Mom was floridly septic upon arrival to the E.R. last night. They called a 'code sepsis'. She was hanging between life and death. I dropped everything, picked up the kids from school, ate a quick bean and cheese burrito with them, and drove an hour into thick traffic to say our goodbyes.

This is where I was too scared to to Reiki. I didn't want to know with my own mother how close to death she was; there is a characteristic slowing of the chakras until they stop completely. 

Instead I said, 'I accept whatever happens. I accept. I accept.'

The full-court press in the E.R. worked. On Levophed (norepinephrine), mom had a blood pressure that was compatible with life. But her WBC count was over fifty. I have never seen anybody make it with a count as high as this. Her internist said she has seen someone make it, but it took a long time to recover.
She also asked if mom was DNR. She knew from my sister that mom was full-code, full-care.

We surgeons called the Medical ICU 'The Death Star'. Unlike our surgical one, few made it out of the MICU alive. One of the reasons is the intensivists were so quick to make everybody DNR (do not resuscitate).

So I told her, specifically--Yes for chest compressions; Yes for chemical code; Yes for electrical code; Yes for intubation.

I was surprised at how confident she was that 'her chest x-ray is clear therefore her lungs are not the source'. Everyone who has had medical training knows that the clinical picture in a CXR can 'lag behind' the clinical presentation of the patient by two days. I pointed out that her breathing was labored and respiratory rate was high, she was gurgling with ineffective cough, and although her oxygen saturations were 100% she was going to tire soon. She would require intubation. We discussed tube sizes--the intensivists like a big one (8.0 or 7.5) to do pulmonary toilet, but the last time she had a tube emergently she couldn't talk right for six months after. So 'be careful' please?

We three sisters took turns with mom and the others with the kids. She was talking but weak.

When it came time to say goodbye, as the kids have school and I have work (docs can't 'call in'), I touched her arm and gave Reiki. I did what my Reiki teacher taught me to do, but with my mind/energy, not all the positions. Great peace reached both of us. I saw mom relax. I felt myself relaxing too. Her energy system was weak but not 'checking out' like I had feared. In our Reiki tradition, we give the Transition Symbol, to help make the crossing over to the Other Side easier. I gave this symbol to her. (I had also asked for prayer,healing, and Reiki on every list I know.)

Reiki is a wonderful gift at the end of life, especially when it is a close bond. It heals both the recipient and the giver.  If you haven't taken a Reiki Class, I would suggest it, if only for this one time for its use. It is worth it to take the training to have it available when your loved ones are very sick. Mom is being kept alive by chemicals right now. When the nurse giving break futzed with the Levophed pump because of 'air bubbles', I saw mom's BP drop from 120 systolic to 80 systolic. It took the regular RN coming back to 'fix it' with the pump. I pointed out mom's vitals, and said to him, 'she missed you' and he laughed. It takes a very alert and vigilant nurse and doctor, both, to keep a person this very sick, alive.

I thank you for all the Love and Reiki that you have sent. I can feel it, and it helps tremendously.


Reiki Doc

* SIX patients from the same insurance policy were 'bounced back' to the system hospital from the SNIF rehab center that same day. My sister overheard the ER nurse comment to another RN that 'the doctor there is making rounds again', implying that the medical care was suboptimal at this place.