Tag Archive | emergency room

If it’s not one thing…

Friday was one of those days. Mom had her first session with the physical therapist, and it did not go well. He had her lying on her back on the bed doing leg stretches and she was having trouble breathing, and he got snippy with me because I “undermined his authority” by responding to her needs without clearing it with him first. Even with the oxygen cannula in, her sats didn’t get above 91 and she was laboring so hard to breathe that he cut the session short and let her go back to sitting in her recliner.

I was so relieved that she already had an appointment with the cardiologist that afternoon because I felt sure it was a CHF (congestive heart failure) episode. But the cardiology PA who treats her didn’t hear any congestion in her lungs or heart. They had the results of Monday’s labs sent over and noted that she’s almost dangerously anemic, which might explain the difficulty getting enough oxygen even when the fluid build-up is gone. Since we are seeing the kidney specialist next Monday, and this is something he’s been tracking, cardiology PA left it for him to determine the best course of treatment. I took Mom home and she almost immediately fell asleep in her recliner.

Worn out from a stressful day, at 9:00 p.m. I got into my pajamas, poured a glass of wine and settled in for a West Wing marathon on Netflix. At 9:30, I got a call from the owner of the board and care: Mom had a nosebleed that thet couldn’t stop and they were taking her to the ER. I met them there shortly before 10:00, and it was a LONG night. They got her into triage very fast, considering the unusually large number of people in the waiting room, and had a quick temporary fix to stop the bleeding.

Mom nosebleed ER picBut then, as you can see in the photo, they sent us back out to the waiting room. Where we waited… and waited… and waited. It was cold in that room and Mom was thankful for the cozy flannel pajamas, though she was a little embarrassed about being out in public without her dentures in.  And though she complained that the clamp on her nose was uncomfortable, I would have been thankful to have one myself when a young woman sitting across from us suddenly vomited.

It was three hours from the time we were checked in until Mom saw a doctor. He removed a massive blood clot from her nose and thought that would solve the problem, but the bleeding started up again. The culprit, a broken blood vessel, was too high up in her nose for the doctor to see or cauterize, so they had to insert a balloon catheter in her nose to stop the bleeding — a last resort because it’s “uncomfortable” (the doctor’s word). Mom cried out in pain when it was inserted and kept exclaiming that she couldn’t stand it because it hurt so much.  It was 3:00 a.m. by the time this happened, and 3:30 by the time we were leaving the ER. The owner of the care home and her husband had waited with us the whole time, and they drove Mom home once she was discharged. I got in my car and immediately began to sob from exhaustion and helplessness at not being able to ease her pain.

I got about five hours of sleep before I got another call from the care home telling me that Mom had pulled the balloon halfway out during the night. I drank a big mug of strong coffee, threw some clothes on, and headed over there. The balloon catheter was supposed to be left in place until Monday, when we had been directed to see an ENT doctor to remove it. I called the ENT office and left a message for the on-call doctor, who called me back quite promptly and said that we could leave it as is unless it started bleeding again. Thankfully, that did not happen. And the balloon didn’t hurt when it was only half inserted, so Mom was much more comfortable for the duration of the weekend than she would have been otherwise.

All’s well that ends well, I guess.

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Two Scares in Two Weeks = Too Many!

Early Sunday morning, February 8, I got a call from my sister in Colorado. My oldest niece, who is in her first year of college here in California, was in a hospital with a fractured skull following a surfing accident. I called the hospital, who confirmed that she was still in the ER and that I would be allowed to visit, and arranged for a friend to go with me. All that I knew when we left for the hospital was that my niece was lucid and able to talk. I clung to that on the 90-minute drive down, praying that her ability to talk (and even joke) meant no brain injury. When I arrived at her bedside, one of the first things she did was wiggle her fingers and toes for me to show me that she wasn’t paralyzed. Thank God!

She was incredibly fortunate. A hairline fracture at the base of her skull, two fractures in her C1 vertebrae – but no brain injury, no paralysis, no need even for surgery to repair the bones. The neurosurgeon got her fitted for a neck brace, which she’ll wear for about six weeks to allow the bones to heal themselves. I spent most of two days in the hospital with her, until her Mom could get a flight from Denver. Then I went back to work, exhausted but grateful.

Last Wednesday night, I turned my phone on at the end of my evening class to find multiple messages from the owner of my mom’s board and care. Call me as soon as possible. Gulp.

Mom had a nosebleed that wouldn’t stop and the blood was draining down into her throat. The caregivers were worried that she might choke. The owner had taken her to the ER. I jumped in my car and met them there. The nosebleed had mostly stopped by the time I arrived, and I wondered if we were going to waste 4-6 hours at the ER for nothing… but no sooner had they taken her into the back to get her vitals and medical history, she vomited a dark bloody substance into her lap. Twice.

I was horrified at the sight of it. And I saw the alarm in the eyes of the nurses and techs, who rushed her to a bed in the back to get her hooked up to the monitors. Her blood pressure was dangerously low. For the second time in two weeks, I faced the possibility that everything could be coming unraveled in an instant. I didn’t know what vomiting blood might mean, but it didn’t look good. And I was especially worried because I was scheduled for surgery myself in just one week – who would take care of her if we were both in the hospital at the same time?

Thankfully, again, we were lucky. Her labs checked out just fine, her blood pressure returned to her high normal range, and there were no further symptoms during the three or four hours they kept her for observation. The doctor concluded she had simply swallowed blood that was trickling down from her nosebleed, and her stomach rejected it.

It was a long night. We had been taken to a room in the back of the ER, so I didn’t see how much activity was going on up front, but apparently they were very busy. After the labs came back and the doctor paid an initial visit, we were pretty much ignored. Mom complained of a bad taste in her mouth (no wonder!), but when we asked for water or ice chips none were forthcoming. I did manage to track someone down to get her a blanket because she was shivering. The blanket they brought was heated, which helped her get some rest for a while. When she got cold again, I put her corduroy coat over her for some extra warmth. And we waited…

It was 1:30 a.m. by the time we were given the OK to take her home. And the miracle of all of this is that the owner of the facility (AND her husband, who had driven her over to check on Mom and then brought them both to the ER) stayed there with us until the very end – and then they took her home, so that I could go home myself and get some sleep. When this woman says “the residents are my family,” clearly she means it. Once again, I left a hospital feeling completely exhausted but deeply grateful.

Wednesday I go in for laparoscopic gallbladder removal. Mom has been doing fine – no more nose bleeds, more active than usual with my brother visiting – so I’m not worried. I also know now that if there WAS an emergency when I couldn’t get there, I can trust her new “family” to take good care of her.

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.