{Karlton Bontrager}

Note: Monday was a much better day. Details will be posted tomorrow. The following is an account of Sunday in New Zealand.

Sunday started out so well. There was no warning that everything was going to go berserk. Karlton sat up for a long time in the morning, taking a shower and washing his hair. He ate all his lunch, the best he has eaten since returning to hospital. And he got a haircut. A worker at ISIS came to the hospital and evened out the two halves of Karlton’s ‘do’.

From then on, the day became surreal. An anesthetist came to look at the shunt and its connections. It was not draining into the bag. Moreover, CSF (cerebral spinal fluid) from the tubing had leaked out into the bedding. The neurosurgeon had given the anesthetist orders to replace the shunt.

That procedure did not go well. Karlton pleaded for the work to be done quickly and painlessly. “Please don’t hurt me,” he begged. But it was painful. And initial results were unsatisfactory. The anesthetist was already talking about repeating the procedure as he wheeled Karlton’s bed back to the ward.

The anesthetist left it to the nurses on the ward to connect the shunt line to the collection bag. I walked in late and saw a lone nurse standing with sterile gloves on, staring at the tools before her and trying to figure out how everything should go together. Then she walked out of the room, using a sterile gloved hand to pull open the door as she left.

This situation was too much like the one of the lumbar puncture. That time I had gone along despite increasing concerns with the way Karlton was being treated. Jenn had given me a pep talk afterwards, and it helped me figure out that I needed to intervene here too. I expressed to the nurse my concerns about the sterile technique. Choy-Lang chimed in demanding that the nurse have an assitant, someone to run errands if necessary. But no one was available. The ward was dangerously understaffed that evening, and one shift of nurses had gone to dinner. We ended up running to the Intensive Care Unit and borrowing a nurse for the procedure.

But things got even worse as the evening wore on. The new spinal shunt was not draining CSF into the bag. The nurses wanted to flush it. At the same time, the vein line receiving the IV fluids had infiltrated. The nurses asked the house surgeon to cut a new line into a vein. Moreover, Karlton was experiencing new sources and higher levels of pain.

Again we had to be assertive. When the medications nurse came to give Karlton the injection of anticoagulants into his stomach, he refused to permit it. Next, the three of us had our own confrontation with the nurses. We said we would permit no more procedures for the night. Karlton would accept oral medication, but they were not to stick him, prod him, flush him, tear tape off the hair on his arms, or do anything else that would disturb his rest. We would consider re-starting all the procedures in the morning.

It surprised us how quickly our “No” got people’s attention. Suddenly the house surgeon had time to talk with us. And he made several telephone calls in the night to the neurosurgeon. In the end, we backed down on the vein line. We weren’t willing to take the risks involved in suspending antibiotics for so long. But the medical staff kept their distance from Karlton’s room for the rest of the evening and all night long, entering only when required to.

I spent the night in Karlton’s room, dozing in a chair. He did not rest well. And he had a lot of pain. But I was there each time he awoke. I gave him the bottle and the bedpan when he needed them. And he had me to bug the nurses for his next round of pain relievers. Best of all, there were no new prickings, proddings, or other such irritations.