Tag Archive | hospitalization

Not how I expected to spend my Sunday

I’m writing this perched at the foot of my mom’s hospital bed. We were at church this morning and the service was just starting when she said she had to use the bathroom. She was sitting on the toilet and I was crouched on the floor in front of her, helping with her pants and shoes, when she suddenly grabbed the handrail and slumped sideways against the wall.

“Are you OK?” I asked. No response. “MOM, are you OK?!”

The third time I asked, she mumbled something unintelligible. It sounded like her mouth was full of marbles. She was leaning so far over, I was afraid she’d slide right off the toilet and hit her head. I stood in front of her, holding her arms, tried to get her to sit straight again but she kept slumping back against the wall.

I thought she might be having a stroke. I was terrified. I told her, as calmly as I could, that I needed to take her to the hospital. It was probably only a moment or two before she said, softly but clearly, “I’m OK.” It felt like hours. I asked if she thought she could stand so that I could pull her pants up. Holding onto me and the handrail, she managed to do that. I got her dressed, seated on the seat of her walker, where she slumped forward again, and rolled her out of the bathroom. Then I ducked into the sanctuary and saw the pastor’s wife standing just inside the door. “I need help!” I told her. “I have to get my mom to a hospital.”

The pastor’s wife brought two men to help, who between them were able to lift Mom’s walker down the two steps to street level. One of the men scooped Mom up like she was a little girl to put her into my car. I pulled out my phone to get directions to the nearest hospital, and my hands were shaking so much I could hardly type. I still didn’t know what had happened to my mom, and all I could think was that I was wasting valuable seconds.

Thankfully, the hospital was less than five minutes away. Miraculously, there was no line in the ER when we arrived. They took her back right away, took her vitals and history, got her into a room where she was seen by the doctor. Everything looked fine except her heart rhythm, which he described as “very slow and irregular with long pauses.” He said that would explain her fainting spell and also the periodic episodes of lightheadedness she’s been having for the last six months or so. She was admitted for observation. They are making some changes to her medication, which might correct the issue. If it doesn’t, the next step is a pacemaker.

By the time we got up to her room in the cardiac ward, she was feeling like her usual self. They brought her a lunch tray and she ate heartily. Same with dinner. She doesn’t remember anything that happened at church and keeps asking me why she’s in the hospital when she doesn’t feel sick, but she’s lucid and her voice is strong… and I am so SO thankful that it was not a stroke.

And even though she probably took five years off my life with that scare this morning, I am hopeful that getting this properly diagnosed and treated is going to improve the quality of her life – and, by extension, the quality of mine.

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.

Losing My Cool

Despite my best intentions about being the “voice of calm” for my mom right now, I lost my cool yesterday. I arrived to take her to a doctor’s appointment, found her room warm and stuffy (the portable AC not working properly), and couldn’t figure out how to get her switched from the oxygen generator to the portable oxygen tank. And I melted down, right there in front of her. I panicked. I raised my voice. I was the exact opposite of calm.

I rang her call button and got a caregiver to come help me with the oxygen, and then I pulled it together. But navigating a wheelchair and a portable oxygen tank on a little wheeled stand is a skill that will take me some time to master, and the whole trip to the doctor was difficult and stressful. After my little freakout, I held it together – but I wasn’t the calm, soothing presence that I always try to be (and usually am) with her.

We stopped at Foster’s Freeze on the way home from the doctor and I bribed her to eat with a caramel milkshake, which I think was the first food she’s taken more than two or three bites of all week. (At this point, I don’t even care about healthy food. I just want her to eat something. Anything.)

I’m worried that she’s still so weak and her oxygen levels are still so low. I’m afraid that when we get a new blood culture done next week it’s going to tell us there’s still infection. But there’s nothing I can do about it right now except keep a close eye on her. As a result of this worry, when the home care agency told me that the home health nurse who evaluated her on Tuesday had determined there was “no further need” for nursing care, I lost my cool again and almost shouted at her: Are you freaking kidding me?!

Deep breaths.

Another “Nurse Ratched” Vent

I was in the middle of a meeting with my boss when my cell phone started buzzing – a call from my mom’s phone, and she NEVER calls me (I don’t think she remembers how). I excused myself from the meeting to take the call, fearing an emergency. It was the Care Director (aka Nurse Ratched). I asked if something was wrong, is my Mom OK?

“Oh, she’s fine,” said Nurse Ratched. “But she is ADAMANT that she won’t get up, won’t get dressed, she just wants to stay in bed.” Her tone sounded cross, impatient.

“She’s sick,” I said, startled. “She just got home from the hospital.”

“So I should just let her stay in bed?” she demanded, in an incredulous tone like she can’t believe that’s going to be my answer.

“She’s been very sick and she’s still weak,” I replied. “Let her rest. Just don’t give her pills on an empty stomach. Make sure she has some food with them.”

I explained that I have to take my mom to the doctor this afternoon and would be there to pick her up between 2:00 and 2:30, so she would need to be dressed in time for that. But until then, yes, it’s perfectly fine if she stays in bed.

For crying out loud, has this woman NO empathy?! This is an 85-year-old cardiac patient on oxygen, who was just discharged from the hospital the day before yesterday. Isn’t it understandable, even necessary, that she get a lot of rest? Why does this b*tch need to bully her into getting dressed at 8:30 in the morning?

Man, I can’t wait to get my mom out of there! Counting. The. Days.

Discharge

Mom was discharged home on Tuesday evening. I thought for sure they’d send her to skilled nursing rehab first, not straight back to her assisted living facility, and I have mixed feelings about it.

I don’t think she was ready to go home. She’s still so weak she can’t get off the toilet without help, even with the grab bars in her bathroom. They sent her home with oxygen, thankfully, but I called yesterday morning and discovered she’d taken the canula off when she went to the bathroom and forgot to put it back on. She barely ate yesterday, only half an Ensure shake for breakfast and a few bites from the lunch and dinner trays they sent to her room.

If my aunt and cousin weren’t arriving on Saturday, I would have pushed for her to be sent to rehab for a week. I think she needed a few more days of bed rest. Then again, hospitals and nursing homes can be the worst place to be when your immune system is vulnerable; so maybe she’s safer at home in her room. Still, I will be so relieved to have family here to spend time with her during the day while I’m at work next week. We just need to get through two more days…

Fastening My Seat Belt: Turbulence Ahead

I was bracing for another cognitive decline to follow this hospitalization, but she seemed so lucid and aware yesterday that it caught me off guard when I got a voicemail from her shift nurse this morning saying my mother was concerned that I might not know she was in the hospital. I was with her for six hours in the ER on Sunday night and for about seven hours yesterday. She seemed as sharp and aware as she ever is when I left last night. But this morning, all of that had been erased. She didn’t know where she was or how she got there.

I had to go back to work today; I couldn’t afford another day off and it’s a day full of meetings that require my support. I had no choice, but I felt guilty for not being there. At my first opportunity to get away from my desk, I called the hospital and was transferred to her room. She fumbled a bit with the phone, dropping it twice before finally answering. In a halting voice, with long pauses as she struggled to find words, she tried to explain something about the phone, about why she’d had trouble answering. Finally she gave up and concluded “Oh well, I’m talking now.”

I asked her how she was feeling and she told me she feels fine, just really confused. “There are huge holes in my memory,” she said. “I don’t know where I am or what’s real.” She sounded frightened. I tried to reassure her by explaining that she’s in the hospital because they found an infection in her blood which is being treated by IV antibiotics. I told her that I had brought her to the ER on Sunday night and had stayed with her most of the day yesterday, but I had to go back to work today. “I don’t remember any of that,” she said anxiously. I gently told her that it’s OK, that she’s safe and in good hands, and she just kept saying how confused she felt. I suggested that the confusion might be caused by the infection because the last time she was sick enough to go to the hospital she experienced the same thing. Then I just kept reiterating that she’s in good hands, getting good care, and has lots of people praying for her.

The last time she was hospitalized, she took a significant cognitive decline and never recovered a lot of her prior functioning. If that happens this time, I don’t know how much more of her essential personality and nature will slip away from us. I’m scared, but I can’t let her see that. I have to be the voice of calm, like the flight attendant reassuring passengers startled by turbulence that if there is a loss of cabin pressure oxygen masks will automatically drop. Meanwhile, I’m fastening my own seat belt because this is going to be a bumpy ride for a while.

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.