![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
whitewriterBed 30. Another Alcoholic liver disease patient. This seems to be the theme for this set of shifts.
The worst kind of patient can be those high functioning, Type A personalities.
When their sick, they really feel it keenly and their mood is strongly related to how well they are doing - or how well their environment suits their desired needs.
They're demanding for the best.
On Sunday, my patient was one of these. On initial assessment and appearances I couldn't tell.
He was from a fairly average suburb.
Alcoholic liver disease and cancer history, which really didn't point to anything specifically.
His skin was very thin and bruised and he had these bubble like lesions on his arms which made me think of those with IVDU histories, however this is what general ICU nurses termed "liver skin". Long term steroid use and liver disease -- I looked up the official terminology: Porphyria cutanea tarda.
is due to the deficiency of the enzyme uroporphyrinogen decarboxylase; which is directly related to the over consumption of alcohol.
The lesions made him look much less kept (hence my thoughts of a potential IVDU history). Like those depicted in this link:
https://www.medigraphic.com/pdfs/hepato/ah-2007/ah073k.pdf
It only served to reveal my judgy naturel when I asked his wife what he did before he was unwell and able to work.
Lawyer.
Damn.
Should have picked it.
Lawyers often drink a lot of alcohol..
His anger at his wife listening to me ask him questions for his GCS and his getting the date wrong (Can you stop staring!! he snapped at her).
His moodiness and calling the woman next door who was yelling YA YA YA, YA YA to everything and anything due to her fluid overload/confusion/multi organ failure/intense need for dialysis. "we're in a mad house! She's a nut."
His intense concern as to why he was kept intubated for an extra day post operatively; and further concern when he asked how long the surgery took and I said "9 hours". I don't know what the surgeons told him pre-operatively.
Meanwhile his bed friend next door was making jokes about oldmate YAYA in the corner.
He was the complete opposite (and just as unwell as) of Mr Bed 30.
He joked with us that Yaya was just like anybody's grandma and the noise wasn't a bother. That he was used to it.
I joked with him that his family must be very loud if he's used to it- and that I would be back at 2am to ask him if he was still bothered by her yelling. He encouraged me to come visit him.
Hopefully she was quiet at 2am. I wasn't going to be back at work until the following Wednesday(2 days time).
It was valentine's day (and fewer managers) so I was playing from a top love songs playlist on spotify at my computer.
The worst kind of patient can be those high functioning, Type A personalities.
When their sick, they really feel it keenly and their mood is strongly related to how well they are doing - or how well their environment suits their desired needs.
They're demanding for the best.
On Sunday, my patient was one of these. On initial assessment and appearances I couldn't tell.
He was from a fairly average suburb.
Alcoholic liver disease and cancer history, which really didn't point to anything specifically.
His skin was very thin and bruised and he had these bubble like lesions on his arms which made me think of those with IVDU histories, however this is what general ICU nurses termed "liver skin". Long term steroid use and liver disease -- I looked up the official terminology: Porphyria cutanea tarda.
is due to the deficiency of the enzyme uroporphyrinogen decarboxylase; which is directly related to the over consumption of alcohol.
The lesions made him look much less kept (hence my thoughts of a potential IVDU history). Like those depicted in this link:
https://www.medigraphic.com/pdfs/hepato/ah-2007/ah073k.pdf
It only served to reveal my judgy naturel when I asked his wife what he did before he was unwell and able to work.
Lawyer.
Damn.
Should have picked it.
Lawyers often drink a lot of alcohol..
His anger at his wife listening to me ask him questions for his GCS and his getting the date wrong (Can you stop staring!! he snapped at her).
His moodiness and calling the woman next door who was yelling YA YA YA, YA YA to everything and anything due to her fluid overload/confusion/multi organ failure/intense need for dialysis. "we're in a mad house! She's a nut."
His intense concern as to why he was kept intubated for an extra day post operatively; and further concern when he asked how long the surgery took and I said "9 hours". I don't know what the surgeons told him pre-operatively.
Meanwhile his bed friend next door was making jokes about oldmate YAYA in the corner.
He was the complete opposite (and just as unwell as) of Mr Bed 30.
He joked with us that Yaya was just like anybody's grandma and the noise wasn't a bother. That he was used to it.
I joked with him that his family must be very loud if he's used to it- and that I would be back at 2am to ask him if he was still bothered by her yelling. He encouraged me to come visit him.
Hopefully she was quiet at 2am. I wasn't going to be back at work until the following Wednesday(2 days time).
It was valentine's day (and fewer managers) so I was playing from a top love songs playlist on spotify at my computer.
