On life and death...
Working in the ICU, it's kind of a given that periodically, you will have a patient code - or try to code - on you. It sucks, but it's part of the deal. About all you can do is be aware and catch the signs of impending disaster and get help quickly.
However, tonight I managed to take things to a whole new level. I had two critical cats - one with kidney failure who'd also had a seizure that afternoon, and another with severe anemia, feline leukemia positive status, kidney disease, a recent limb amputation, and probable cancer - and they both decided to try to die AT THE SAME TIME.
Basically, the first cat, Tiger, developed a significant heart arrhythmia and while the doctor was evaluating her, she started breathing agonally - the gasping breaths that mean death is pretty much imminent.
So we got her out of her cage and on the table, get her intubated, and started drugs. Her heart was still beating, however irregularly, and generating pulses in her limbs. She responded to the drugs and eventually started breathing on her own.
While we had Tiger on the table, before she was breathing on her own, the other cat, Precious, started vomiting. She somehow ended up heaving with her face pressed to the floor in the back corner of her cage. I asked someone who was nearby to check on her and she was blue with a ridiculously low heart rate and blood coming out of her mouth.
Before we were able to do much of anything, she started breathing on her own and her heart rate came back up. The theory was that she may have had a vagal response, essentially the same thing that made President Bush pass out when he choked on that pretzel a few years back. The blood was from where she bit her own tongue.
And into this mess, with two of my patients laid out on the table in mid-resuscitation, one of my coworkers comes back from his lunch break and exclaims "Margo, what did you do?!?" I'm laughing about it now (we're good friends, it's not like he meant anything bad by it), but at the moment...well...not so funny.
It's really unusual to be able to get a patient back to relative stability after they've tried to die, especially when they have severe underlying disease. About the only time it works reliably is when a basically healthy animal has severe complications from anesthesia. So as much as the whole thing sucked and amounted to pretty much the most stressful 30 minutes I've had in about as long as I can remember, I am really pleased and mildly shocked that we were able to stabilize both of them.
In these cases, it's not really about saving lives. Both are still ridiculously sick little kitties with underlying problems that are impossible to resolve. To be perfectly honest, I don't expect either one of them to be alive when I get in for my shift tomorrow afternoon. But when I left, they were both comfortable and still alive several hours after almost dying. It means their families have time to visit with them one last time. That's about the most that could have been accomplished, and I'm incredibly grateful for it.
So I got home, completely exhausted, and logged into my work email - to find an email from one of the doctors, to the whole staff, thanking me personally for my work in catching these things while there was still something that could be done.
After everything I've been through in these past few years, it's hard to put into words just how much something like that means. Life really is good.
However, tonight I managed to take things to a whole new level. I had two critical cats - one with kidney failure who'd also had a seizure that afternoon, and another with severe anemia, feline leukemia positive status, kidney disease, a recent limb amputation, and probable cancer - and they both decided to try to die AT THE SAME TIME.
Basically, the first cat, Tiger, developed a significant heart arrhythmia and while the doctor was evaluating her, she started breathing agonally - the gasping breaths that mean death is pretty much imminent.
So we got her out of her cage and on the table, get her intubated, and started drugs. Her heart was still beating, however irregularly, and generating pulses in her limbs. She responded to the drugs and eventually started breathing on her own.
While we had Tiger on the table, before she was breathing on her own, the other cat, Precious, started vomiting. She somehow ended up heaving with her face pressed to the floor in the back corner of her cage. I asked someone who was nearby to check on her and she was blue with a ridiculously low heart rate and blood coming out of her mouth.
Before we were able to do much of anything, she started breathing on her own and her heart rate came back up. The theory was that she may have had a vagal response, essentially the same thing that made President Bush pass out when he choked on that pretzel a few years back. The blood was from where she bit her own tongue.
And into this mess, with two of my patients laid out on the table in mid-resuscitation, one of my coworkers comes back from his lunch break and exclaims "Margo, what did you do?!?" I'm laughing about it now (we're good friends, it's not like he meant anything bad by it), but at the moment...well...not so funny.
It's really unusual to be able to get a patient back to relative stability after they've tried to die, especially when they have severe underlying disease. About the only time it works reliably is when a basically healthy animal has severe complications from anesthesia. So as much as the whole thing sucked and amounted to pretty much the most stressful 30 minutes I've had in about as long as I can remember, I am really pleased and mildly shocked that we were able to stabilize both of them.
In these cases, it's not really about saving lives. Both are still ridiculously sick little kitties with underlying problems that are impossible to resolve. To be perfectly honest, I don't expect either one of them to be alive when I get in for my shift tomorrow afternoon. But when I left, they were both comfortable and still alive several hours after almost dying. It means their families have time to visit with them one last time. That's about the most that could have been accomplished, and I'm incredibly grateful for it.
So I got home, completely exhausted, and logged into my work email - to find an email from one of the doctors, to the whole staff, thanking me personally for my work in catching these things while there was still something that could be done.
After everything I've been through in these past few years, it's hard to put into words just how much something like that means. Life really is good.