Tag Archive | hospital stay

Dear Dad…

Dear Dad,

It’s been almost 11 years, and I don’t know that I’ve ever missed you more than I do right now. I’m writing this in a chair beside Mom’s hospital bed. She’s been in the hospital for four days, as I suppose you know, and she doesn’t seem to be improving yet. In fact, there’s been a new complication every day. I sure wish I could ask you what to do.

She’s having trouble eating. She ate pretty well on Saturday (after two days of keeping down nothing but liquids), but on Sunday she had no appetite at all and had to make an effort to take a few bites. A couple of times she muttered wearily, “Gotta eat to stay alive.” It reminded me of the last year or so of your life, when you had to take in all liquids through a feeding tube because otherwise you aspirated into your lungs, and how you used to talk about all the hours you spent in a day “just staying alive.” I remember when you asked me to find that Bee Gees song, and I decided to make you a whole CD of music I thought you’d like, including “Stayin’ Alive”… but I didn’t finish it in time. Sorry about that, Pops.

Anyway, back to Mom. She ate almost nothing yesterday, and when I was there at dinner I discovered that the issue was more than having no appetite or feeling too tired to make the effort. She couldn’t seem to remember HOW to eat. She let me spoon feed her a little bit of pudding and I think that was all she ate all day except for a Boost shake at lunch. This morning I fed her breakfast and she actually seemed interested in the food for the first time, telling me “Now the applesauce” or “Give me a bite of that yogurt.” But when she tried to feed herself, she was missing her mouth and dribbling food down her chin. What does this mean, Dad? Is it going to get better, or is this where we are now?

I wish you could tell me what it means that Mom is “dreaming with [her] eyes open” and talking to people who aren’t here. A couple of times she’s seen someone in the room. I don’t know if it’s just the multiple infections, or a side effect of one of the many medications, or if she’s starting to see between the worlds. She hasn’t mentioned seeing anyone who I know to be on your side of the veil yet, which is a comfort to me. I’m not quite ready to let her go. You’ll have to wait a little longer for your dance partner, OK?

* * * *

LATER: I put this aside to help Mom, and then they brought her dinner tray. I started feeding her some mashed potatoes and gravy, and after a couple of bites she said, “Let me feed myself!” She moved slowly and a little clumsily, but she didn’t miss her mouth this time. She ate some mashed potato, a couple bites of the fish (too tough), some applesauce and some pudding. And when she’d eaten all she could, she actually picked up the word search puzzle book I brought her for the first time. She didn’t do more than flip through the pages and put it down again, but it’s an improvement. I feel much more hopeful than I did a few hours ago. If you had anything to do with that, Dad, thank you.

One more thing, Dad… I wish I could have seen your reaction to the smug know-it-all hospitalist, though I’m pretty sure I know what it would have been. His behavior was just like the surgeons you used to complain about at the dinner table back when you were an anesthesiologist. I wanted you here to put him in his place when he was so condescending and dismissive to the nurse who had been so wonderful with Mom. No wonder the nurses at Franciscan appreciated you so much.

I have to get some sleep now. Thanks for keeping an eye on Mom. I love you.

Dad Sleeping

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If it’s not one thing…

… 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…

It Takes a Village

After four nights in a hospital, tonight my mom is sleeping in her own bed. Today was a pretty challenging day for both of us, and I’m glad it’s over.

They had intended to discharge her yesterday, but the radiology department got backed up with emergencies and couldn’t do the thoracentesis of the left lung until this morning. They got her in first thing (about 8:15), and I was anticipating another quick and easy procedure… but this one was tough. She flinched multiple times while the doctor was injecting the anesthetic, and while the fluid was draining she had a hard time staying still, saying that she hurt and couldn’t breathe. By the time the nurse removed the tube and bandaged the injection site, Mom was clutching her side (just under her left breast) and almost gasping with pain, saying “It hurts!” with wide, scared eyes. I was scared, too, especially when she told us that the pain was going all the way down her side and up to her shoulder.  I was afraid she was having a heart attack and couldn’t understand why the chatty ultrasound tech wasn’t more concerned.

They had ordered a “stat” chest x-ray following the procedure, and the x-ray technician was waiting outside her room when we got back. I told the nurse about her pain and he listened to her heart  to confirm it wasn’t “a cardiac event” before they proceeded with the x-ray. She kept telling us over and over how much it hurt, which is so not like her. Mom has never been a complainer. It wasn’t until the nurse said gently “It hurts because you just had a procedure. They stuck a big needle in you. Do you remember?” — and she said “No” — that I realized she was scared because she didn’t understand WHY she was in pain. Once the x-ray was completed and all looked good, the nurse brought her pain medication and an ice pack.

I’m happy to report that the intense pain subsided very quickly after that. More good news: Her oxygen saturation quickly got up to 100% on only 2 liters of supplemental oxygen (she was on 4 liters yesterday and still only getting to about 94% at best).

They cleared her for discharge at noon, and I got my second scare of the day shortly after the nurse removed her IV port. I was packing up her things and Mom said from behind me, “What’s this?” I turned around and there was a spreading red stain on the sleeve and lap of her robe. Thankfully the friend who had come to help me out today has had CPR training and volunteers in a hospital ER, so while I stabbed at the call button she calmly slipped a glove on her hand and applied pressure to stop the bleeding. By the time the nurse responded to the call, it had stopped.

Which brings me to the title of this post. I am so fortunate to have a support system here. My wonderful niece, Sarah, came three days in a row to sit with her grandma for a few hours — bringing along her books so she could study for midterms in the hospital room — so that I could go home and get some rest or get some things done. Rora, who came today and helped me manage the discharge, is going to help Sarah get Mom to her three follow-up doctor’s appointments next week while I’m out of town. The owner of the board and care visited with her husband on Saturday and brought some things Mom needed from home, saving me a trip to pick them up. And then there are all the family members and friends who checked on us, prayed for us, offered support in so many ways. I love my “village” and I don’t know how I’d have gotten through the last five days without them. Thank you all.