First, I'll see the only patient that I have in the hospital. Maybe some sort of crisis coming, as he was oliguric (only a little urine, forthcoming) yesterday after getting a bit too much attention for his hypertension, and sustaining BP's around 90/ this is enough for most, but not maybe for him. It didn't help that this seem to go unnoticed until I made my late rounds after office hours and met the patient in a wheel chair being rolled up from the Cardiovascular Intensive Care Unit to the Cardio-Renal Medical floor. The nurse casually mentioned to me that he'd had only 180 cc of urine, and his BP was 90/ Well, unfortunate division of labor here, with a hospitalist, vascular surgeon, interventional radiologist and nephrologist sharing the responsibility for the patient. It was a trip back to the intensive care unit for a dopamine drip with a BP of 90 as a starter.....seemingly, overkill, or stopping the antihypertensives and waiting for the BP to go up and the urine to flow. Not a comfortable place to be when your creatinine jumps from ~3.3 to 4.9 (essentially, almost no renal function.) So this AM will be interesting. And all this after he made it through an arteriogram using CO2 instead of the more toxic iodinated contrast, and an angioplasty. The hospitalist and the vascular surgeon are looking at his feet, in detail, and to me, happily superficial, they (it, the right one) looks better.
Then, Lin and I are going to a luncheon at UCI (University of California, Irvine) to hear her neurologist talk about something to do with Multiple Sclerosis. The talk is for patients.
Then we'll take in a movie at the art theaters across the street. Not sure which one.
I'm still thrilled about identifying the marauding bird as a female Lesser Goldfinch, and lightly mourning the disappearance of my sunflower's guardian praying mantis who has been gone about four days, without a trace. Could that little goldfinch have added protein to her diet?
I love the end of the month, when I have time to think and read and wonder and write.