Now that I'm on the laptop and it's easier to type, I'll give some more details about tonight. We went to mass and the last few minutes of it he was not right. He had this look on his face like he knew something was wrong. He got very quiet and still and laid his head down. We left and went home and as soon as we got in the door he threw up. I called Dr. Bromberg's exchange (it was now about 8:10 or so) and Dr. Bruns was on call so he called back a few minutes later and told us to take him down to Children's since that's where they were planning to TEE and Cardiovert him anyway later in the week. We got here to the ER and I heard them telling people that the wait was over 3 hours to see a doctor! I very politely told them that he was due to have a procedure and could they direct me to a place to wait that was the least likely for him to catch something (coughing, sneezing, etc everywhere!). They gave us a private booth so to speak and it wasn't too long before we got seen.
He vomited again after his chest x-ray, which showed his heart is enlarged (it usually is some anyway) but no fluid so that was good. The EKG didn't even pick up on the flutter, just like St.John's didn't catch it in the ER either. Cardiology got involved and came in for an echo. The fellow thought his function looked pretty good. Then Dr. Johnson, another cardiologist came in and examined him and took some history and then went to look at the echo. When he came back, he said that he doesn't think that dehydration is our main issue here (no wet diapers since yesterday afternoon) and that his heart function is a little down from the echo that was done the morning he left the ICU here back in early May and definitely down from the echo done before his cath here in April '08. They are going to get him moved up to the CICU and monitor him tonight, giving him a slight amount of IV fluids (they don't want to give him much b/c with decreased heart function, he'll retain it and cause more work for the heart) and then talk to Dr. VanHare and Dr. Bromberg in the morning to come up with a plan.
About the labs. . .They gave him a shot like lidocaine in his hand so that he wouldn't feel the IV. Apparently it can cause you to "lose the vein" and that's what happened. The nurse fished around for ages looking and never could get anything. Of course he had just fallen asleep when she came in to do it. Then she went and got another nurse and this one tried the other hand. I said for her to skip the numbing and just get it over with. By this time, he'd been screaming for about 30 minutes. He was sweating and couldn't hardly catch his breath. As I type this now, he's STILL doing that whimper in his sleep thing. She got in right away, but not in the right spot, so it came very slowly. Plus, with him screaming, it made it even worse. The line was good and was able to flush so we kept it for an IV, but they weren't able to get all his labs done. I'm praying they wait until AM to try again. They did get a lactate level on him and it is elevated, another sign of distress to the heart.