No detox zone...

When I took Riley to the doc for his arm they did blood work. I got the results on Wednesday morning when I was called and told that I MUST get him to the hospital immediately. His ammonia level was over 700 when it should be in the 100s. Also his LFT (liver function) was extremely bad as well as his potassium level. Erica is our PA and I told her that it was not my decision to make. I let her talk to Riley and he refused to go. She told him that I had agreed to take him, if he consented to go but that if he didn’t go, she would have to call the rescue squad and get him to the hospital. He agreed to go, but made it clear he did not want to detox.

But, while I was getting dressed he called her back and told her he did not want to go. Since she didn't pick up, he got in the van and went with me to the hospital.

At the hospital, as Riley went longer and longer without a drink, he became more and more agitated. I refused to intervene. I gave information when I was asked and corrected him on details that he didn't remember clearly. But, when it came to whether or not he would stay -- I shut up. Eventually, he agreed to being admitted and was placed in ICU.

He was now into more than 6 hours of withdrawal. I started my mental countdown - only about 30 more hours and he would be in full blown DTs. He was told they would only keep him overnight, but that they were prepared for the possibility of seizures since he had all the appropriate padding around his bed.  Their goal for him was to elevate his potassium and get him more stabilized.

The ICU doc came in and told us that the lab results she had used were based on a different and using her method, Riley’s ammonia levels were really not that bad. So she wasn’t that concerned. When she started asking Riley questions, the same inaccurate garbage was spewed as it had been in the ER. I started to give her the facts, but was abruptly stopped and told she wanted to hear it from Riley. Well… OK… I let it go and sat quietly marveling at how much misinformation was being bantered about.

While this whole process was going on, I was continually thinking – So now what??? Will this trip to the ER mean another year of hell with Riley? I have vowed not to pull him back from the brink of death, but when  a medical professional gets involved and makes the decision for me or for Riley – I see no way of being able to stop what could easily turn into a snowball rolling down a mountain in the Alps. I can see in my mind and follow the progression. They just want to give him some potassium; then he has a seizure and they have to keep him because he is too weak to be discharged; next thing ya know he’s in full blown detox and that silly little snowball is now an avalanche. And I feel helpless to stop it.

I was invited to spend the night in Riley’s room. They would bring in a cot and make accommodations for me. Sure, like that was going to happen. I had a Riley-free night and intended to make the most of it. I went home and cooked some of my favorite foods, curled up on the sofa with a soft blanky and watched Survivor. Then I took a long hot bubble bath followed by climbing into bed with fresh sheets. Jax joined me on one side and I allowed Jade to sleep in my room next to my bed.
That’s where we all snored the night away until almost 6 a.m.

The doctor made her rounds between 8 and 9 a.m. I had called Gill and he was going to try to meet me at the hospital to talk to the doctor. I really didn’t know what I would be walking into this morning, but I didn’t really expect to see that much of a change from the night before.

Riley was sitting up eating his breakfast complaining that what he needed and wanted was a drink. His night had been OK because they had given him Librium. He was shaky and weak. When the nurse came in and told him to push himself up high in the bed, he could not do it. His general appearance was one of a weak old man, even more so than when I brought him in.

The ER doc said Riley’s lab work looked much better and he would be released that day. I was impressed that they had actually been able to accomplish their goal without him going into DTs. In my mind, I’m still questioning the point in all of it. Why did we really go through this?

I went to get a cup of coffee and when I returned to the room, Riley was sitting up in the recliner. The nurse told me to get him dressed. Oh. Really. Was it really my job? I pulled out the sweat suit I brought with me and started the task of getting him into it. First there was the issue of the Depends – which he did not want to wear. I informed him it was not his choice to make – Depends or stay in the hospital. Once he conceded, trying to get the Depends actually on his body was still another issue. I told Riley to lift his butt so I could slip them on. He couldn’t lift himself high enough for me to slip them on. When they were half-way on, I moved on to the sweat pants and it was the same thing. I thought if I got them partially on, I’d have him stand up and pull them up the rest of the way. The sweat shirt was no problem as were the socks and slippers. I told him to stand up and I’d finish his pants – but he couldn’t stand up at all. He couldn’t walk. He couldn’t do anything but sit. At least when we came into the hospital, he was able to move under his own steam. He was worse now that he was before!

The problem-solving part of my personality kicked in. I could drive up the ER entrance and the nurses could get Riley into the van. But what was I supposed to do after that?? I couldn’t carry him into the house. He couldn’t walk. I expressed my concerns to the nurse. She told me to call a neighbor for help or a family member. WHAT?? The only neighbor I have is at work. My kids are about two hours away and at work. To me the suggestion was ludicrous. I asked if they thought I should call the rescue squad to help me get him inside. After a lot of mucking about, it was decided he would be transported home via the rescue squad. That sounded like a good plan to me.

While waiting for the rescue squad, the hospital case manager came in and told me she would be having a home health agency contact me so that I would have some assistance in caring for him. They knew Riley’s aversion to bathing and knew I needed help at that area – at least. I was extremely happy to hear it. I was also told that I might be able to get assistance from the Veterans Administration since Riley was considered a Viet Nam vet, there may be programs open to him that we didn’t know about until now. Wow! More useful information – this hospital overnight was turning out to be a pretty good deal.

I got home, fixed Riley a drink and within a few hours he was trying to make his way around the house. The more drinks he had, the more mobile he became. So, the drunker he was, the more stable he was. The irony in that amazes me.

Tomorrow I am to take Riley back to the docs office so they can repeat the blood work and see how much he has improved. OK. I can do that. I will comply.

I checked back in my records and when Riley was admitted to detox in SoCal, his ammonia level was almost 900. So while a level of 700 is alarming, Riley has survived much more startling lab results. I suppose to someone who is new to the Immortal Alcoholic, he seems in dire need of help. I know that’s their only goal – to help. I respect that and understand it. It makes my job more difficult and the medical pros don’t seem to understand my point of view.

I’m not upset over the hospital stay because Riley did NOT go into DT’s. They released them exactly as they said they would. I’m thankful for my 24 hours free of Riley insanity. Gill informs me that I have some other decisions to make and wants to meet with me as soon as things settle down. At this point, I feel I’ve made all the decisions I need to make. But, we’ll see what he has to say.