A Long, Hard Day

Sunday morning I went to pick Mom up for church, like I always do. As I approached her room, I saw a woman in scrubs talking on a cell phone. “Time of death was 7:30 a.m.,” she was saying. It gave me a little shiver, felt like a bad omen. I tried to shrug it off.

Mom was lying on her bed, fully dressed. She had forgotten it was Sunday (despite my wake-up call less than an hour earlier to remind her) and was surprised to see me. She sat up and drank half of an Ensure shake for me, but she was feeling “off kilter” and we decided to skip church. Her face and hands were puffy, and I thought her breathing sounded labored. I almost took her to the ER, but she kept insisting she was fine and I didn’t want to subject her to the ordeal of an ER if I might be overreacting. I stayed with her all morning, ordered her lunch to be sent to her room on a tray, then left to get my own lunch. When I checked on her a couple hours later, she was sitting in her chair reading. The puffiness was gone from her face and her breathing sounded normal. I was much relieved. When it came time for dinner, I started to walk her down to the dining room – but she didn’t even get halfway to the elevator before her legs felt so weak she was afraid of falling. A caregiver came and pushed her the rest of the way on her walker seat. I kissed her goodbye and went home, intending to call her doctor first thing in the morning.

Around 8:00 that evening, I got a call from the on-call doctor at her primary care physician’s office. The lab had just called with the results of the blood culture they did nine days prior, which showed that the urinary tract infection had gotten into her bloodstream. He advised me to take her to the hospital ER of our choice, tell them to call him, and he would explain about the test results and that he wanted her admitted to receive IV antibiotics. When a doctor calls you on a SUNDAY NIGHT and suggests you take your loved one to the ER, you’d better assume this is something to take seriously.

Mom was asleep in bed (still in her clothes) when I arrived. She was confused about why we were going to the ER (“But I’m not sick!”), but she didn’t argue when I told her that her doctor had called and wanted the hospital to treat her for an infection in her blood. I borrowed a wheelchair and off we went.

We spent a very long night at the ER – five hours from check-in until she was finally transferred to a room at 2:00 a.m. I told every new ER staff person who attended us, from the receptionist to the ER doctor, what her doctor had told me. I had hoped it would fast track her admission, but no… They did the full battery of tests and x-rays themselves, and we waited four hours for the results to come back before a decision was made to admit her. Her oxygen sats were very low (about 84) when we arrived and the first blood pressure reading was 213/111, which really scared me. It was clear that the ER staff were concerned by those numbers also. They got her into an oxygen mask, started IV antibiotics right away, and the doctor ordered an IV drug to bring down her blood pressure also. As the night wore on, Mom got increasingly confused and cranky. “Where are we?” she asked me several times. “Why did we come here?” “Why have they just left me lying here for so long?” I focused on being patient and positive with everyone, especially Mom. When it got to be around 12:30, Mom started telling me that I should go home and get some sleep. “You don’t have to stay with me. I’ll be fine.” Yeah, right… Less than five minutes later, she was back to asking “Where are we? What am I doing here?” I couldn’t have borne the thought of her going through that alone.

At 1:15 a.m. they told us they had a room for her and a tech would be along to take her up in about 15 minutes. Mom started asking me “how many more minutes?” — like a little kid on a road trip saying “Are we there yet? Are we there yet?” Forty minutes later, the promised tech finally arrived to wheel the gurney and a nurse escorted us up. Her blood pressure had only come down to 198/84, but the nurse assigned to her room assured me they would monitor it through the night. At 2:45 a.m., I finally left to try and get some sleep.

I called in sick to work, got about six hours of sleep, and spent the rest of the day at the hospital with Mom. It took most of the day, but they finally got her blood pressure down to a healthy range — 138/65 was the best reading I’d seen in a long time. One of the nurses told me that the hospital doctor was consulting with a cardiologist and would likely recommend changing her blood pressure medication. I also found out that, despite all my requests in the ER, no one had actually called her PCP’s office until this afternoon. When the PCP’s office faxed over the results of her blood work, they discovered that the two antibiotics they’d started her on in the ER were completely ineffective for her type of infection. Great. Not only did they keep her waiting for four hours for lab results, they also delayed effective treatment by about 18 hours. I’m not very happy with that ER right now.

I am, however, grateful that the doctor assigned to her seems very competent and proactive and that she’s getting attentive care from all the nurses and aids. I am also grateful that we caught this before she could become gravely ill or risk a stroke from the elevated BP. And I’m grateful that, despite the ordeal of the ER and getting only short “cat naps” of sleep last night, she was alert and in good spirits today. I know she’s in good hands, and tonight I hope we can both get a decent night’s sleep.

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