Monday, June 24, 2013
Sunday, June 09, 2013
Mom has spent a lot of the last month in the hospital. Not all at the same time; sometimes in telemetry so they could just monitor her, but most of it in ICU. The first batch of visits were focused on her heart, because she was tired and weak and has atrial fibrillation issues. The last stretch was the longest and scariest.
Even though the emergency room sent her some from the previous visit without admitting her at all, she remained very weak and couldn't support her weight, even with assistance. She had Dad take her back to the ER, even after we all discussed it and made sure she understood she would most likely end up in a home where people could care for her better than we can. That's when we knew she was terrified of what was happening within her.
At the ER, they decided to do bloodwork that was ignored on the previous visit. The bloodwork showed that she had been in renal failure (kidneys) for five days - if they'd done the bloodwork on her previous visit, they would have caught it immediately. They put her in Telemetry again because they wanted to get her phrenologist in on the case, which meant she'd have to wait until the next morning. During the night, the a-fib decided to have a go, and they moved her back into the ICU.
Lots of doctors looked at her; lots of tests were run; lots of blood was drawn frequently. They were trying to get her INR down (she's on blood thinners and you have to bring the level down below 1.5 something or other or you risk a bleed-out during surgery). They wanted to install a pace maker. The heart was evidently the most urgent issue, so the kidneys were simply monitored while they tried to get her to where she could have the surgery.
Meanwhile, her body started filling with fluid because she couldn't move around and keep things circulating out. So her lungs also filled with fluid and she developed a terrifying rattle. Seriously terrifying. My Dad's immediate response on hearing it was, "Oh, no, that's not a death rattle!" This is actually what we were all thinking and trying not to talk about it. Mom was not really very lucid during that first couple of days; sometimes, but usually not. It was really frightening. I can't say that enough. We had conversations in the waiting room about what would happen if she didn't make it. Dad wanted to make sure we were prepared. It was very difficult to keep from crying.
The pile of doctors conferred some more and started her on a major Lasix drip to clear the fluid out of her body. She started coming around, and so did her kidneys. Her lungs started clearing up; the rattle steadily improved and she began staying lucid more often and longer. They started her on breathing treatments to help her lungs regain strength, and then she began improving faster. Her INR was still a little high, but they have a platelet procedure they can give to thicken the blood when it's close enough, so they eventually decided it was a good and necessary risk.
Almost two weeks after being admitted, they were finally able to perform the surgery to install the pace maker. She made it through that just fine and recovery took on an even faster pace. Within a day she was moved back up to Telemetry and a day or two later was moved to a rehabilitation facility just 10 minutes from the house. The hospital was a 30-minute drive each way, so the nearness of this facility is appreciated by all! They expect her to be there about a month.
All I can say is that she is so much more like the Mom I know and love that I get a little teary when I think about how far from that she was. And her behavior is much more in line with normal. I still fear that Alzheimer's will get a grip on her, and I really hope that once she is cleared from rehab, she and Dad will seriously look into it with her primary physician. I told Dad what I thought, and he agrees with me. So maybe there's a chance.
So I visit her for a while every day. So does Dad, so does Ann; though Ann is staying away right now because she's sick. I have so many hopes for her recovery, but the biggest one is that she won't follow the same pattern she usually does - puts up with the dietary restrictions until she gets home and immediately starts frying everything in bacon grease. I know she loves flavor, and fat and salt have tons of flavor. I understand that after a 70+ lifetime of eating that way, it's no fun trying to stay out of it. But maybe this time she'll remember just how close it brought her to the end, and will be a little more careful for a little longer.
Even though the emergency room sent her some from the previous visit without admitting her at all, she remained very weak and couldn't support her weight, even with assistance. She had Dad take her back to the ER, even after we all discussed it and made sure she understood she would most likely end up in a home where people could care for her better than we can. That's when we knew she was terrified of what was happening within her.
At the ER, they decided to do bloodwork that was ignored on the previous visit. The bloodwork showed that she had been in renal failure (kidneys) for five days - if they'd done the bloodwork on her previous visit, they would have caught it immediately. They put her in Telemetry again because they wanted to get her phrenologist in on the case, which meant she'd have to wait until the next morning. During the night, the a-fib decided to have a go, and they moved her back into the ICU.
Lots of doctors looked at her; lots of tests were run; lots of blood was drawn frequently. They were trying to get her INR down (she's on blood thinners and you have to bring the level down below 1.5 something or other or you risk a bleed-out during surgery). They wanted to install a pace maker. The heart was evidently the most urgent issue, so the kidneys were simply monitored while they tried to get her to where she could have the surgery.
Meanwhile, her body started filling with fluid because she couldn't move around and keep things circulating out. So her lungs also filled with fluid and she developed a terrifying rattle. Seriously terrifying. My Dad's immediate response on hearing it was, "Oh, no, that's not a death rattle!" This is actually what we were all thinking and trying not to talk about it. Mom was not really very lucid during that first couple of days; sometimes, but usually not. It was really frightening. I can't say that enough. We had conversations in the waiting room about what would happen if she didn't make it. Dad wanted to make sure we were prepared. It was very difficult to keep from crying.
The pile of doctors conferred some more and started her on a major Lasix drip to clear the fluid out of her body. She started coming around, and so did her kidneys. Her lungs started clearing up; the rattle steadily improved and she began staying lucid more often and longer. They started her on breathing treatments to help her lungs regain strength, and then she began improving faster. Her INR was still a little high, but they have a platelet procedure they can give to thicken the blood when it's close enough, so they eventually decided it was a good and necessary risk.
Almost two weeks after being admitted, they were finally able to perform the surgery to install the pace maker. She made it through that just fine and recovery took on an even faster pace. Within a day she was moved back up to Telemetry and a day or two later was moved to a rehabilitation facility just 10 minutes from the house. The hospital was a 30-minute drive each way, so the nearness of this facility is appreciated by all! They expect her to be there about a month.
All I can say is that she is so much more like the Mom I know and love that I get a little teary when I think about how far from that she was. And her behavior is much more in line with normal. I still fear that Alzheimer's will get a grip on her, and I really hope that once she is cleared from rehab, she and Dad will seriously look into it with her primary physician. I told Dad what I thought, and he agrees with me. So maybe there's a chance.
So I visit her for a while every day. So does Dad, so does Ann; though Ann is staying away right now because she's sick. I have so many hopes for her recovery, but the biggest one is that she won't follow the same pattern she usually does - puts up with the dietary restrictions until she gets home and immediately starts frying everything in bacon grease. I know she loves flavor, and fat and salt have tons of flavor. I understand that after a 70+ lifetime of eating that way, it's no fun trying to stay out of it. But maybe this time she'll remember just how close it brought her to the end, and will be a little more careful for a little longer.
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