Monday, October 8, 2012

The Bloody Tongue, Part 2

I was alarmed by Mary's last post, Daddy's Bleeding Tongue and then lulled into a new sense of normalcy.

That's the way it's been with both Polly and Don and with Marilyn (Susan's mother) over the last several years. (I guess that's life with the super-old. Fragile illusions of normalcy punctuated by mystifying excursions into reality.)

So, I called to check-in Friday during my lunch hour. Dad answered the phone and sounded like he had four stitches in his tongue (which he did.)

"Hey Pops, how're ya doin?" I started optimistically.

"Hmm. Not 'tho goodth," he mumbled. Not a good omen. Dad NEVER admits to anything being amiss.

He told me that he thought a stitch had come loose in his tongue, that he was bleeding again, that he couldn't get a hold of the oral surgeon who had put in the stitches, and that he was getting ready to drive himself over to the Presbyterian Emergency Room.

"Hold on right there," I said. "I'm coming over to pick you up right now." He protested, saying he had driven himself while his tongue was bleeding at midnight Tuesday, but I said "NO, stay right there, I'm on my way." And I was.

His tongue bled steadily while we waited for treatment. It was a busy Friday afternoon in the ER. I got him a cup of ice, a box of kleenex and a cup in which to spit, all of which soon became a bloody mess, along with the front of his shirt. Dad was quite miserable and needless to say, soon became quite impatient.

We finally met Dr. Tran, a young man whom we really liked. He was honest about several things. Uncontrollable bleeding from the tongue is pretty unusual because the tongue usually heals quickly by itself. The cumedin (blood-thinner) was causing the problem. Dad's level was normal for him because of his animal replacement heart valve, but higher than for normal cardiac patients. Stitches are usually not used on the tongue because the tissue falls apart after several days and the stitches can fall out leaving a bigger hole. Coagulants have difficulty because they are made to work on a dry surface, like skin. The ever present and ever produced saliva in the mouth washes and dilutes.

Dr. T outlined several treament possibilities that he thought might have success and then left to consult with other doctors, including an ENT specialist and treat other patients. Because of Dad's history we were in the cardiac unit and it was obvious that there were a number of other patients whose condition was more critical. As Dad became more impatient, I suggested that on an episode of ER, the impatient tongue-bleeder would be the comic relief. He was mildly amused. At least we found the baseball playoffs on TV, but the Rangers' performance did not alleviate the tedium.

Finally Dr. Tran returned with a plan. He dried and compressed the tongue with gauze, then poured liquid Thrombin over the opening and then applied a piece of Surgiseal over the Thrombin and compressed. After serveral treatments, the bleeding slowed. After a few more, the bleeding stopped!

Now it was time for more waiting to see if the tenuous scab remained in place. Which it did.

Dr. Tran wanted Dad to stay in the hospital overnight for observation in case the scab came loose, but Dad would have none of it. He is still bothered by bed-sores from his heart surgery last summer and he had a full schedule planned for Saturday starting at the church at 8:30 the following morning. So around 9pm, we walked out into a chilly Friday evening. A cold front had dropped temperatures 30 degrees during the 7 hours we were in the ER.

Dad was put on a smooth liquid diet so food wouldn't dislodge the scab, so I wanted to go by Central Market and get him some soups so he'd have something to eat. Dad objected, saying he had some canned soup and would be seeing Helen the next day at the Farmer's Market Cooking Classes and for a minute I went along with him. But as we passed the turn, I turned to him and said, "Sorry, but I'm going to get you some soup!"

"Oh, no. You've spent too much time with me already, you need to get home." (He used Mom's arguments like a seasoned pro.)

"This has got nothin' to do with you," I told him. "My sister Mary would absolutely kill me if I didn't go to Central Market and get you some of their homemade style soups." (I placed Mary in Mom's position.)

"Okay," he said. "I see your point."

We walked into CM and he headed over to the Dinners for Two. "Country Ham with Macaroni and Cheese," he said. "That would be good."

"When are you going to eat that?" I asked. "That's not liquid."


After we selected some cold soups, he walked over to the hot soups and started to fill a container with Tortilla Soup. "This will be good for tonight," he said as he reached for a container to fill with chips and cheese.

"No, no, no, you can't eat the chips, they're not liquid!"

"I'll pour the hot broth over them and let them get real soft..." he replied.

"Oh, okay."

We drove to his apartment.

The next morning I texted Helen and asked how Dad was doing and reminded her he was on a liquid diet. "He's okay, sort of," she replied. "He's chewing his food real fine."

"Yes, but chewing and abrading is the problem. His food needs to be liquid in the mouth not the stomach!"

Good grief!

Dad was OK though and was in good spirits when I saw him at church on Sunday. With the cold weather he was back in coat and tie and looked and moved like he felt great. Once again he said he was annoyed that he couldn't listen to the organ postlude because of all the people standing in line to greet him after the service, but I didn't believe him for a minute. He was in his element.

The phone rang about midnight. It was Dad. The bleeding had started again and he was heading to the ER, did I want to meet him there?

I did. He was finishing up in triage when I arrived and I got him a cup of ice and some tissues. By the time we were called back to the room, the bleeding had stopped. We still went through the check in process and saw the doctor, but were soon dismissed. They came into to complete the registration just after Dad received his discharge papers. We were out of there by 2:30am.

Dad had another busy day today (Monday.) Echocardiagram, followed by his workout (I think) and I forget what else. Too busy for me. I slept 'til noon.

1 comment:

  1. Thanks, Dave. This makes me feel much more connected. You're a good writer. xxoomm