August 10, 2024 - Delirium
Yesterday I had two procedures (Endoscopy and Endometrial Biopsy with IUD insertion), both requiring me to go under general anesthesia. Today, I lost my mind!! I was extremely listless. I would respond to nursing questions, but my responses were delayed, and I was very inattentive. I was alert and oriented but slow to respond and would get forgetful at times. I was experiencing complete delirium more than likely due to the anesthesia.
My mom had headed back to Spokane yesterday evening to take care of the dogs while Tim was on family vacation (I insisted that he still go because there wasn’t anything he could do for me in Seattle) but I was now all alone and struggling to remember anything, even how to do simple things at times. I can’t tell you how many times I changed the password on my phone and my computer, or at least tried to, because I could not login for the life of me. I remember simply trying to unlock the lock screen on my phone and seeing double. I was typing in my password, and it was always either too long or too short, and it was the same password that I’ve had forever but my brain function was just gone!
I learned quickly how to operate the phone in my hospital room to call my mom, and call my mom I did, about every 5 minutes for the entire evening! My mom told me later that I would call her up and tell her, “You know that thing over there?”, “like that thing over there, on the wall,” “I can’t get it to work” and then I would hangup and call her back and do it all over again, for hours! Of course, she’s in Spokane so she has no way of figuring out what was wrong with me. She called the nursing station to make sure I was ok, and they had noticed that I wasn’t acting quite like myself, but they didn’t know how bad it was until now. This alerted them to monitor my condition a bit closer, and my mom could rest a little bit easier knowing I was being looked after.
My mom wasn’t the only one I would call obsessively! I called my aunt Sheila a few times too and would try to tell her what I had for breakfast that day. I would tell her I had 4 things, start to list them off and get to the 2nd or 3rd item and forget what the 4th item was and start all over again from the beginning. I don’t know how many times I did this or if I ever even got it right but it’s hilarious to look back and laugh at now. I also had called Tim’s mom (Tim probably wasn’t answering) and had a conversation about God knows what? All I know is that Tim told me I had made no sense and seemed completely out of it.
I was supposed to be reading my information packets regarding organ transplant, the tests and procedures required to undergo prior to transplant and the post-operative care I needed to expect for long-term success, but I had absolutely no focus! Plus, I couldn’t get on my phone or laptop to work so I felt completely defeated! They later diagnosed me with Hepatic Encephalopathy which is the loss of brain function when a damaged liver doesn’t remove toxins from the blood. Early symptoms include forgetfulness and confusion while advanced symptoms include shaking of the hands or arms, disorientation and slurred speech. I was experiencing almost all of this!!
Other than obsessively calling everyone and becoming extremely frustrated with not getting anything to work, the day was relatively uneventful. My back pain had subsided, and my menstrual bleeding finally stopped after having an IUD inserted yesterday. Because of my electrolyte imbalance and continued acute kidney injury with increasing Creatinine levels, I underwent a Renal Transplant Consult. The purpose was to evaluate the candidacy for simultaneous kidney transplantation. Thankfully because I have no known history of kidney disease, no history of diabetes, recurrent UTI, autoimmune disease, kidney stones or NSAID use, I was determined to not need a kidney transplant at this time. Instead, they would continue to monitor daily and administer dialysis if needed and revisit transplantation if there was significant decline in kidney function.
Update vitals and MELD score for today were:
MELD 3.0: 36 (female), 35 (male) at 8/10/2024 5:05 AM
MELD-Na: 33 at 8/10/2024 5:05 AM
Calculated from:
Serum Creatinine: 2.36 mg/dL at 8/10/2024 5:05 AM
Serum Sodium: 133 mmol/L at 8/10/2024 5:05 AM
Total Bilirubin: 22.9 mg/dL at 8/10/2024 5:05 AM
Serum Albumin: 3.1 g/dL at 8/10/2024 5:05 AM
INR(ratio): 1.6 at 8/10/2024 5:05 AM
Vital Signs:
Temp: 36.3°C (97.3 °F) BP: 118/76 Pulse: 83 Resp: 20
SpO2: 97 % on L/min room air
