Remember the guy from two posts ago that was the "happy" guy from a sad one and a happy one? Well, things didn't go so well for him after that. He remained NSR but that's about all that went well for him.
The next morning he got up to go to the BR for a BM (I've come to hate BM's ya know!!) and passed out with bradycardia to asystole. After a minute of CPR he came back to and said he had quite the good feeling like an endorphin release. Luckily I was at home sleeping to miss all of it!!
Needless to say, this earned him a pacemaker once we had corrected his INR. So, I come in after 2 days off expecting to not see him there. Not only is he still here now with a pacer, but in the cath lab during the pacer insertion they nicked his lung and his post-pacer CXR showed a moderate to large pneumothorax..........uggh. What next?!?
I'll tell ya what. Being allergic to PCN they Rx'd vancomycin as his pacer antibiotic. Not long after his dose I go into his room to check on him (and he and his SO are so nice that I had been in and out practically all evening anyway) and he's red from the clavicles up..............WTF is going on now I ask myself. Could this actually be Red Man Syndrome? I have read about it but had never actually seen it. But then again, I tell myself, he's had practically every other complication.......RAFl, pauses, then intractable RAFl again, does ok with the TEE and cardioversion but then has asystole so what more could go right for this poor guy!!!!
So was it Red Man Syndrome? We aren't fully sure as no doc laid their beady eyes on him (one of the joys of a community hospital) but it certainly fit the symptoms of a mild case of it.
Oh and want to hear something funny..........I'm going to teach sex education with him to his 7th & 8th grade science class!!!! Yup, you read that right!! He teaches science to middle schoolers and his school nurse doesn't feel comfortable helping with the girls (WHAT???) so right now he teaches it co-ed but we've gotten along so well that he asked me if I'd be comfortable teaching it with him. Hey, why not. I'm always up for an adventure. How bad could it be???