Sunday, March 16, 2014

The long slow nothing

With the exception of the incident with the therapist the hospital was just a long slow crawl of waiting and worrying.  I'm sure even more so for my mother who felt crummy and looked worse. She did insist on having some makeup and her own underwear. You have to have at least something to make yourself not feel like you're fading into the woodwork. Even getting the green Jello instead of the read Jello makes you feel a little tiny bit different.

The doctors are the most frustrating part. Her hospitalist was great but syncing with her schedule was practically impossible, and unless it's an emergency it's pretty impossible to just talk to a doctor on your own schedule. By the time I left California between conversations I had had with her and my mom's confused and confusing description it seems that the lost blood had probably gone into her lower bowels. Sautrday mom had had a particularly lengthy and upsetting bout of diarrhea that apparently had some old blood in it. Her overflow of Coumadin was probably due to her not eating, which was probably due to her not feeling good from the back pain and anemia; a vicious circle.

Sunday when I came in ( the day after the bad therapy incident). The first thing mom did was give me a grocery list of clothes to bring, punctuated by "I'm going home tomorrow. No matter what anyone says." I gave her my skeptical look which set her off on a rant with me responding that she needed to cooperate with the next physical therapist. Fortunately just at that moment  the new therapist came in and the first words out of her mouth were "Let's see what we can do to get you out of here." Later I found out that she had heard our conversation out in the hall; timing's everything.

Apparently all went well and Monday, while I was flying home to Seattle mom was discharged to her house. She'll have a nurse and therapist visiting her regularly. I'm still not sure she doesn't need to be in a managed care facility of some sort but one battle at a time.
__________________________________________________________________________________
Just a few notes before I leave this story. My apologies to the very nice orderly who I unknowingly kept saying "hello"  to in the elevator until she finally laughed and said "Hello again." I looked at her blanklyand she laughed, "I had my scrubs on before. We've been in the elevator twice already" I was so tired I hadn't even noticed the first two times.

That hospital smell sticks with you all day. It's an odd mixture of chemicals, cleaners and human smells. It clings likes cigarette smoke in a bar.

For future reference - The cafeteria closes at 2:00 on Saturdays, is closed on Sundays and closes at 7:00 on weekdays. And at lunch during the week forget it, the local highschool kids come here for burgers and fries and you can wait twenty minutes to order. I just missed it every time.

For future reference - Don't break your mother on future trips. If she falls put her in the car and go to the ER immediately.

This is how the bruise looked Tuesday before she went to the hospital. It faded in color but doubled in size by Thursday.

Wednesday, March 12, 2014

There Will Be Consequences

Day 3, Saturday, started out quietly.  I got to the hospital and saw yet another bag of blood slowly dripping it's way into my mom's arm. Since it was the weekend there were fewer staff running around and, surprisingly, fewer patients in rooms. Later in the day the doctor said she had done a lot of discharges.

My dad popped in for a quick visit but he was visibly tired and I could tell he really wanted to sleep but he also wanted to be there so I put it on me and told him I wanted to take him home now rather than around 2 like other days so I could make sure I saw the doctor.

I ran him home and came back and when I entered the room I saw this guy standing there. Rapid firing questions at my mom. "How did you fall?" "When was the last time you walked?" The problem was she was answering with her slow speach and he was literally not waiting for answers;clearly running a script in his head. He was her physical therapist

So I need to describe this guy, he was probably in his late twenties with a deep tan, a Polo shirt under his white coat(I was surprised he didn't have the collar popped), a pair of chinos and suede slip on shoes. He looked like he'd just come from his fraternity reunion; I expected him to call me bro.

He kept firing questions, and then roughly grabbed my mom's leg to show her some exercises. He had a good theory about how you breathe in before you start an action and then do the action as you breathe out to minimize the pain. But my mom is always on oxygen and it takes some time for her to breathe in, so basically he was just pushing her leg up and down completely out of sync with her breathing, which made her hurt and me wince every time he did it.

The whole time he kept firing questions at both of us. He was very focused on the hand railings to her stairs and got really annoyed when I couldn't remember which sides they were on on which flights of stairs.

Then he asked me when the last time she had walked was, which I had already told him was on Tuesday just before she fell. Then he asked how she had been walking and I told her she'd been fine the first week I was here and also 6 months ago when I was  here. "That's a long time ago," he said this like I was a complete moron and I fired back very frustrated and slightly annoyed "I'm just answering your question."

I felt like his alpha maleness was feeling threatened so I asked if he'd rather I step out while he was working, but he told me to stay. I think he was pretty freaked out by my mom's age and her tough speaking style. He was really annoying me but I didn't say anything.

Then as he was trying to get her out of bed I saw this strange look in my mom's eyes. He had abruptly  ripped off her velcro leggings that kept her from getting blood clots. And he was roughly swinging her portable catheter container around. Then he grabbed her legs and started to swing them off the bed. Her eyes got wide, she started breathing heavier than usual, and she went rigid. But he kept pulling on her legs. Then she said loudly "I don't like you!". This was the first time he stopped running his script he looked at her and I saw a brief flash of fear mixed with anger in his eyes.

He tried to egg her on again and then she actually yelled again"I don't like. I don't like you. I'm not doing this with you. STOP."

There was that look in his eyes again but he quickly put her back in bed, put her leggings on and then said ominously"There will be consequences you know."

At that point she started sobbing and as he left I followed him out. He looked at me and said "I don't know why she doesn't like me I get along with everyone. I'm kind of hurt."

Despite my anger, I very calmly looked at him and said "Truthfully, I didn't like you either when I first came in. You're very aggressive." I thought he'd get mad but this actually seemed to get through to him and he said he'd send someone more relaxed tomorrow and shook my hand. I didn't tell him how mad I was about his "consequences" comment and just let him slink away.

When I came into the room. She was loudly sobbing and breathing very hard. "I'm not going to a nursing home. I'm NOT. I'm NOT." This went on for a few minutes and when she calmed down. I told her that I didn't want that either but she was going to have to work with the next therapist they sent in and she nodded and closed her eyes to rest.

(Next- the thrilling conclusion)

Tuesday, March 11, 2014

Misery Train

Hospitals, whether patient or family, are never a linear experience for me. It' just hours of sitting, waiting, staring at walls punctuated by little bursts of activity from doctors, nurses, therapists social workers and everyone else. It all just sort of morphs together as one big chunk of time with a few moments that I remember.

The good news is that my brother showed up. My brother for some unknown reason has disconnected himself and his family(wife daughter and son) from everyone. I've spoken to him 3 times in 10 years, usually when one of our parents is sick; he didn't even call me when I was in the hospital a few years ago. But whether it's genuine or just an act he does play the "good son" when there's an emergency.

When I walked in he had just talked to the discharge nurse who is really essentially a social worker who decides when and how you go home. In this case there was a question of whether mom could go home or to a nursing home for a few weeks. But he really didn't know enough about my parents situation so that was left up in the air for a conversation with me.

Then the doctor came in and told us what she knew (Dr. Lindsay is a fantastic doctor and very patient). My brother is a school principal and has affected this whole cool teacher look with a goatee, John Lennon glasses and a cool looking suit. I was wearing my grimy clothes from the night before( I had planned to do laundry this day), I hadn't shaved and my eyes were red from no sleep. She directed most of the conversation at him which irritated me since I was the one who had been there and would be there later.

The bad news is that he left a few minutes later with promises of keeping in touch and offers of help etc. But here it is the following Monday and I've left a half dozen texts with information and received one terse message back "thanks for the info"

Aside from that it was mostly boredom and sitting around. Her room was small so I spent a lot of time in the tiny waiting room which also doubled as what I started calling the "sad room". That usually meant a doctor, a social worker and family members having quiet sad conversations about hospice care or advanced directives; I was hoping that room wouldn't become the sad room for me.

When it wasn't the "sad room" it was the Misery Train depot. People who had just heard terrible news about a family member shuffling off the elevator with tired, sad eyes and slumped shoulders. The bathroom was in there so when people would come by we'd exchange brief nervous hellos and then they'd shuffle of to their loved ones rooms. It was a shifting parade of people, some terrified of what was to come, some happy to be taking their loved ones home, some who would never see their loved ones again.

(to be continued)

Sunday, March 9, 2014

Where's your blood?

ERs are always strange but never more strange than at 4:00 AM. There always seem to be the same guy polishing the floor no matter what city no matter what floor. They made us sit outside while they wired my mom up, but after two minutes they called me in because they couldn't understand her; they thought she was "drifting". It took me a few minutes to get them to believe that her mind was fine, it was just her slurred "strokey" speech.

Anyway it's hours of sitting and waiting, and tests and worried looks. And finally some doctor told me she'd need a transfusion because she was anemic and had severe  blood loss for some reason. As a kid I'd always thought that it was some kind of complicated procedure usually involving a mad doctor and people changing personalities. Really it just means they hang bags of blood in your IV. 

A really calm, nice nurse named Doug walked us through the process which has surprsingly few possible complications. They give Bendadryl in case there's an allergic reaction; Benadryl really can be used for everything. It's very strange looking at a big bag of blood looping around and going into your mother's arm. It looked like a big Red Vine.

So of course we sat there for hours while more doctors came in. Her night doctor came in and,, he he was very good but he was also being interrupted every 2 minutes by pages so it was hard to give him information. I had to keep making him and every new doctor, nurse and technician clear her odd speach was just from her stroke 12 years ago and not somethning new. 


She had the morphine so she was calm. I was a basket case. I cam down to take care of my parents and I'd broken my mom. My dad mostly hid out in the waiting room which is good because he has some of that poopy old man smell wafting around(a battle for a different day). I was getting horror stories of kidney failure(which I fortunately knew from my own issues a few years ago is really a temporary condition), absesses, annd on and on. Everything is so fluid when you're in those first stages you can never really know what the real situation is.

The biggest issue was that she takes cumadin for blood thinning and she had a whoppingly  huge amount of it in her system. This remained a myster for several days.

We were finally ready to be admitted. On her way up Doug, the nurse turned to me and told me "I didn't want to say anything in front of your parents but they usually call me in on a case when things look really bad. Turns out things look a little better than usual."

(to be continued)

Saturday, March 8, 2014

...And then things went awry.

So monday we went to the casino...Tuesday as I had predicted she was in pain all day. Just as I was arriving at the house for dinner I got the call from my dad that mom had fallen. I got there quickly and picked her up. I did that thing you do with your milk carton when you go to pick it up and it's only half full and you end up picking it up really fast and the milk spills out; she was that light I did a really brief assessment and nothing seemed broken.

On weds I came by and she was laying in bed in an odd way and I noticed a small bruise on her arm. My dad who minimized everything insisted that this was how she usually was after having a fall. But this odd mixture of dread and deja vu kept following me around all day. Every now and then I get flashes of deja vu. I'll be watching a movie and I'll think I've been there again. Sometimes it's attached to something else bad happening. So in this case I was sitting in my hotel lobby and I had that deja vu flash of being in the lobby before and it attached to a thought about being in an Emergency Room. I always brush these off but this time I couldn't shake the dread.

When I got back to the house for dinner, she looked worse, her face and expression just had a foggy shroud around them. The bruise looked like someone had swabbed her arm with purple water color. This whole day I had to hold my hands out and let her pull herself up to go to the bathroom. Tonight she started for the bathroom and just at her bedroom door she told me she was going to faint. She's always been meolodramatic and I remember her "fainting" several times, mostly at functions she didn't want to be at. This time she fell back and I caught her and sort of drag/carried her back to bed.


She was in so much pain I couldn't even really shift her on the bed. She still had to pee so I found a big flat plastic tub and sort of managed to wiggle it under her. I saw bits of my mom that no man in his fifties should see(I don't want to talk about it). I had been arguing for several days that she see her doctor and that incident finally got both her and  my dad to agree to go to Urgent Care the next day first thing(I really wanted to call 911).

This got my dad who has become almost compulsive about schedules and routines to go on and on about how early he would call Kaisser Urgent Care and how early they'd take, when she'd have to wake up etc.

I went back to my hotel with the promise that they'd call 911 if she had trouble during the night.

3:30 I started dreaming about Oompa Loompas. Kind of a nice dream with them singing they're song and everything. Then I woke up, realizing that this was my ringtone. My dad had tried to get her to the bathroom, had tried the platic tub trick and she was in so much pain he called 911. I have this image of the paramedic wondering why she was sitting on a plastic tub.

(to be continued)

Monday, March 3, 2014

Ka Ching

Let's see. My head is spinning. We watched the Oscars last night. Well, watched is not exactly the right word. We had the oscars on and my mom mostly yelled at my dad about various things...dinner not ready, needing a social security number for something etc.etc. I don't know how the guy does it.

Today she wanted to go to some new casino which I thought, between her bad back, her breathing problems and her falling down from drinking and pills was a bad idea. I tried to tell her this which resulted in a tantrum so off we went. I loaded 3 tanks of oxygen into the car, not taking any chances. The casino was noisy and dark and very confusing. Her method of gambling these days is to stick a twenty into the machines and just press buttons. This usually result in her losing all of her money on penny machines in about 5 minutes. She did manage to win a 50 buck payout on one machine. She insisted I play so I tried one buck on one macine and won 60 bucks!!! I should always have such luck.

She wanted to try Martin Yan's new restaurant which was unfortunately all the way across the casino. Normally this would be a two minutes walk but with the back pain and breathing, she had to sit every 30 feet or so. At one point she sat and I could tell she was in distress, not getting any air.. She had me turn it up to 5(I would have preferred 11 at that point). Still nothing. The hair on the back of my neck stood up. I really didn't want to kill my mom in a casino. Then I realized she was sitting on the breathing hose. Yikes.

We finally made it to the restaurant and had a nice meal. She admitted to me that she was tired and wanted to leave right after eating which was a relief to me. She insisted she'd won a hundred bucks but I think she started with 200 so who knows?

Taking the rest of the day off; I'm exhausted.I know I complain about the bickering and such but I never forget for a minute that they're both old and sick and I may never see them again. And I'm very glad I took this time off even if I'm pretty much out of of time off for the rest of the year.

Saturday, March 1, 2014

Deep in the vortex

No. I  haven't forgotten about you. It's been fairly quiet save for the random outbursts and tantrums. Mom's been having back pain so she hasn't been out and about. I'm fairly convined it's drug seeking. The doctor wouldn't refill her codeine but ause it was too soon after the last scrip. My dad ended up refilling a vicodin scrip he's had fo his knees. I know, my family Invented codependence. I'm having to break the visit up into small bite sized chunks so I don't join the cult or go mad As it was she asked me to bring wine down to her which I had promised myself not to do but Dad wasn't around and she was tantruming(sigh).

Went to the city today but found it loud and annoying.Seattle is so smallI forget how busy and big SF is. The ferry coming home was crazy noisy and crowded which seamed odd.Turns out it was virtually every Girl Scout in Marin who had gone to SF to sell cookies; camp directors nightmare.