Events preceding admission - he was feeling worse and insurance was dragging feet about pre-authorizing a heart cath. Cardio people were very uncomfy about the delay so advised us to go to the ER. He could get the cath done as an emergency procedure. Direct admit wasn't an option due to the insurance not being contracted with the hospital. But emergency admission would be covered.
Day 1 - arrive at the ER, things move promptly. Three hours after arrival he's off for the heart cath. Then admission afterwards. He vaguely remembers the doctor exclaiming "How old is this guy? His heart is very bad!" and that the ejection fraction was 5%. No one comes to see us afterwards. My husband is stable at this point but has pulmonary edema still.
Day 2 - labs are mostly ok except creatinine is a little elevated, BNP is horribly high (13,000). More waiting. The doc finally comes by and discusses the cath and results. Yes indeed, the ejection fraction is now 5%. He's amazed that someone my husband's size is still alive. Well, I guess that's reassuring....or not. He wants to put in a BiV pacemaker but after further reviewing the chart determines he is not a candidate. Insurance will not pay for the pacemaker so he has to meet the criteria for a research program to get it. So next plan is to recheck labs and chest x-ray in the morning and send him home if all is well. The following week, the doc will get him set up for a transplant consult. Traumatic afternoon involving som crying and statements such as "I don't want to die!"
Later that night - another cardiac doc comes strolling in. He wants him to have the pacemaker. This particular doc is actually my husband's doc (even though we have never met him - we had been seeing the PA the past couple months) while the first doc is on call for the weekend and did the heart cath. He says he's gonna get my husband fixed up and it's too soon for a transplant.
30 minutes later - my husband has a very scary bout of chest pain treated with MONA (morphine, oxygen, nitro x 2, aspirin). I was ready for him to code. No ecg changes though. Uneventful remainder of the night.
It's gotten around the staff by this time that I am a nurse . Most are receptive to that. Which is good cuz I sure would hate to have to be a b*tch. But as anyone knows that's been ill in the hospital - he's not just another patient....he's my husband and father of my children - I'll guard dog him more than I have ever guarded a laboring women. And that's saying a lot!
Day 3 - first doctor comes in and says we can go home and to call his office in a couple days and he will get a transplant consult. Other doc comes in and says he has a research person coming to take a look at my husband.
The doctors argue. The second doctor wins. They will go for the pacmaker. No one consults us as to what we would like to do. The second doc never comes to see us after winning my husband.
Day 4 - we spend a lot of time waiting. First doc stops by and says my husband's care was taken over by the second doc. The plan is to have an electrophysiology eval for the pacemaker. But it's the weekend so probably not until Monday. Still haven't seen second doc although he is apparently a bit of an nightowl.
And before you ask....the docs are from the same practice (but different offices) and have worked together for 20+ years. I plan to push for both plans - the pacemaker and the transplant consult.
I'll keep you posted.