The patient was jaundiced. 'Jaune' is the French word for 'yellow'.
When liver disease gets advanced, not only the liver but the kidneys fail too. This combination is lethal, but it takes some time for the end to happen.
Recently a patient was DNR, but 'wanted everything done' for palliation. The GI doc and I had a heart to heart for a good long time before--because 'this could be IT'--death due to sudden massive blood loss that was unable to be stopped.
We decided together on conservative management for the anesthesia, which involved intubating the patient, who didn't want mechanical ventilation.
Everyone had to be on board to proceed.
This is what happened:
- a conference call with family, durable power of attorney, patient, GI and anesthesia in presence of the RN.
- The DNR was rewritten to allow for the procedure and possible cardiac arrest--yes to electricity, chemicals, chest compressions and intubation until stable after the procedure.
- This took three phone calls to high-ranking nurses and much documentation
- A chaplain came before the procedure
- I went to the washroom and sent Reiki ahead 'for the highest good'.
It took a while to get my equipment ready. Due to risk of infecting myself with a blood-transmitted disease the patient had, I put on a full gown, gloves, and mask with eye protection. As I walked over to the head of the bed, the patient said, 'I figured it out! You know who you look like, doc? The lady from Heat, you know, the movie with Al Pacino...'
It was surreal. I was all gowned up and expecting Rene Russo in one of those Ebola Virus movies! Instead it was 'you look like some famous actress' (I get 'you look like somebody' often.) I gave some off-handed comment about looking Italian (I am half Sicilian), and positioned myself at the head of the bed. I instructed Respiratory to start preoxygenating the patient. I took a big deep breath myself, asked everyone if they were ready, and committed to starting anesthesia for the case.
When I gave the drugs to start deep sleep of anesthesia, I made sure the patient was comfortable and ready. I had selected my safest drugs in advance to keep the hemodynamics stable while on pressors. Tube went in, it got secured, and the vent started to go.
It was surreal. I was all gowned up and expecting Rene Russo in one of those Ebola Virus movies! Instead it was 'you look like some famous actress' (I get 'you look like somebody' often.) I gave some off-handed comment about looking Italian (I am half Sicilian), and positioned myself at the head of the bed. I instructed Respiratory to start preoxygenating the patient. I took a big deep breath myself, asked everyone if they were ready, and committed to starting anesthesia for the case.
When I gave the drugs to start deep sleep of anesthesia, I made sure the patient was comfortable and ready. I had selected my safest drugs in advance to keep the hemodynamics stable while on pressors. Tube went in, it got secured, and the vent started to go.
Surgeon came in and looked. A big nothing! No blood. No terrible findings.
It took about forty-five minutes to get everyone together enough to 'take the risk'. And about seven once we did.
Reiki is of immense help to the healer such as myself. It is 'zen' that calms the room and the patient. It allows for 'the situation to play itself out' with complete and total acceptance on all parties involved.
We didn't want for that patient to pass today during the procedure, although it could have happened.
We are most fortunate that it did not.
I will never forget the sister crying on the phone when we agreed 'it was a go'.
The first thing I asked the nurse to do after it was over was to 'call the sister and tell her the patient is still alive'.
The nurses in the unit thought that was funny.
I didn't think it was funny at all.
Aloha and Mahalo,
Namaste,
Reiki Doc
