BEFORE NANA WAS allowed to come home, I had to meet with Dr. Englefield one more time. In the confines of her office on the first floor at St. Anthony’s, the doctor was considerably more relaxed and easygoing and human.
“We’ve unloaded the fluid in your grandmother’s chest and gotten her blood pressure back to a baseline level, but that’s only a start. She, and you, are going to have to be vigilant. Regina won’t admit it, but she’s over ninety years old. This is a serious problem.”
“I understand,” I said. “And so does my grandmother—believe it or not.”
Nana was already on a whole new regimen of medications—ACE inhibitors, diuretics, and a hydralazine-nitrate combination that had been shown especially effective with African American patients for some reason. There was also a new no-salt diet to think about, and daily weight monitoring to make sure she wasn’t retaining excess fluid.
“It’s a lot to get used to all at once,” Dr. Englefield said, offering a rare half smile. “Lack of compliance is a major contributor to cardiac arrest for someone in her position, and family support is crucial. It’s critical.”
“Believe me, we’ll do whatever it takes,” I told her. Even Jannie had been researching congestive heart failure online.
“I’d also recommend bringing in a home care provider any time you and your wife are out of the house.” Englefield had met Bree only once in passing; I didn’t bother to correct her. “Of course, that might be a tough sell with your grandmother. I suspect it will be.”
I grinned for the first time. “I see you’ve been getting to know each other. And yes, we’ve already started looking into it.”
The doctor smiled too—for about a tenth of a second. “Regina was lucky to have someone on hand when she collapsed the other day. You’d be wise to make sure she’s just as lucky if—or when—it happens again.”
It wasn’t hard to see why Nana had dubbed this one “Dr. Sunshine.” But if she was trying to scare me, it was definitely working.