… It’s another, as Gilda Radner’s SNL character used to say. It’s always something!
I had a really lovely weekend planned for myself, with a restorative yoga class on Friday evening, a planning meeting for a nonprofit I work with on Saturday, gardening and a women’s circle on Sunday. But Friday morning I woke up to text messages from the owner of Mom’s care home.
Mom had vomited three times on Friday, the texts said. She had a low grade fever (99.0) and had some diarrhea. It sounded like a typical stomach bug to me, but I told her I would call the primary care doctor as soon as his office opened. I called and left a message for the nurse to call me back. I checked in with the head caregiver a couple of times before lunch, and Mom was now keeping down liquids (and half a banana for breakfast) and her temperature was back to 98.7, but the diarrhea hadn’t stopped. They were concerned about dehydration. I called the nephrologist to ask if we could give her Pedialyte (answer: no, too much potassium for someone with chronic kidney disease) and got some good advice from the nurse. The primary care nurse still hadn’t called me back when I left the office at 4:30 p.m. I still thought it was just a stomach bug, and it sounded to me like the worst was over.
Shortly after 5:00 p.m. I got another text from the owner of the care home. She said the diarrhea had gotten much worse and her pulse was very rapid. She wanted to take Mom to the emergency room. Let me call her doctor again, I said. I called, got the nurse on the phone this time, and she confirmed that an ER visit was the way to go. When I arrived to pick Mom up, it was clear to me that she was very sick indeed. So we spent Friday evening in the ER. They got her started on IV fluids, did an EKG and a CT scan, and drew blood three different times for labs. She was experiencing atrial fibrillation and her blood pressure was the lowest I’ve ever seen, around 105/51. I’m afraid it was a pretty miserable few hours for her, more so than most ER visits have been. Everything seemed to cause her almost unbearable pain, from the blood draws to the catheter to cleaning up the diarrhea that has caused a painful rash on her backside. Her face was as pale as I’ve ever seen with a yellowish cast to it.
The ER doctor suspected a C Diff infection, which is pretty worrisome as that can be very serious for the elderly. So they had to collect a stool sample for testing, which was more difficult than you might imagine, and started the admission process. It was 1:00 a.m. when they finally came to take her to her room, and 2:00 by the time I left to get some sleep.
Thirty-six hours later, we still haven’t gotten lab results to confirm or rule out C Diff… but she does have a UTI and pneumonia in her right lung (upper and lower). She’s still having some fibrillation, and they suspect a mild GI bleed. No wonder she was so sick! That’s a lot of issues for one frail 90-year-old.
I got to talk to the attending physician this morning, and based on her improvement since Friday night he doesn’t think she has C Diff (whew!), but they can’t plan for discharge until the labs rule it out definitively. They started her on three antibiotics — one for the diarrhea, one for the UTI, and one for the pneumonia. The diarrhea had stopped by midday yesterday, and she’s got some color back in her face and even a little appetite now. If the test comes back negative for C Diff, she’ll likely be discharged tomorrow.
Unfortunately, I think the likelihood is they’ll send her to a SNF for rehab for at least a week. And I am flying to San Antonio on Thursday for a long weekend co-facilitating a retreat. I hate the idea of her being in one of those places when I can’t be here to check on her, so I’m already thinking about who I might be able to line up for check-in visits for those four days.
The surprising thing is that my anxiety hasn’t shot through the roof. I’ve been fairly calmly readjusting to each new development, concerned but not panicked. That feels good. One day at a time…