Thursday was a good day/bad day. The surgeon came in about 5:30am and said that things were good. He removed her chest tubes and Mom was in heaven. So far, the tubes were the source of her greatest pain. She was still on a regimen of lasix, insulin, hydrocodone, BP med, and a baby aspirin. Lasix has always been a problem because it make her pee so often. Getting up to go to the bathroom was hard for Mom with all the tubes and wires.
I tried to go to work for a while and got a call shortly after lunch. Evidently, one of the leads that went from her new pacemaker to the ventricle had become dislodged at the heart and would have to be reattached. Dang.
The Cardiologist that installed the pacemaker was on vacation for the rest of the week, so we were in the care of another Doc. He explained that it was something that needed to be fixed and that it may be done in the afternoon. Later, a Cardiac Electrophysiolgist came by and told us that he was to perform the fix Friday morning.
Mom was really depressed by this news. Scared is a better description. A bump in the road, but not a sink hole. Bad Day
Again, I met the Surgeon at 5:30 Friday Morning. It was Moms 72nd birthday. The Doctor was generally happy with Moms progress on the stuff for which he was responsible. The latest schedule was that the procedure was to be done at 7:30am Friday (not by him but by the electro doc). Mom had not had dinner or breakfast and she was in the very lowest place in her mood.
The procedure was delayed until 12:00 noon. Dang.
Finally, they took her down to the cath lab. She was back at 2:00. The electro Doc was a little harder on her and she was very drugged, sore and the wound dressings were much more elaborate. Her lunch was still there and she was starving, so we fed her a chicken wrap and 3 desserts.
At about 3:00pm, we decided that a long rest was needed for Mom (and us). We put a "NO VISITORS" sign on the door and left to come back later.
Marty, Nathan and Carley went over later that evening and tucked her in.
Early this morning, I met the Surgeon and had a nice long breakfast with Mom and talked about her last few weeks. Since the surgery, she had a lot of gaps in what and how she remembered and I tried to clear that up. The Doctor had said that all of the anesthesia and vascular swelling can have an effect on mind. Until Wednesday morning, she was a little kooky and said many funny things. I will post some of the funny, drug addled comments from Mom is a later post.
Late morning, the representative for her new pacemaker came by to test the operation. Everything was great. The new leads to her heart were working perfectly.
This news relieved an enormous amount of stress for Mom and she wept uncontrollably. Apparently, Mom believed that the pacemaker was the only thing keeping her alive(it wasn't). I explained to her that it was merely an insurance policy if she should have any problems with her rhythm. Actually, her rhythms were very good without the pacemaker. Now, in her mind, she could now go forward. Until then, she was certain that she was going to die.
Her spirits are great now. I took a nice long walk with her (200 Ft) and she waved to all of her fellow heart patients. A good day.
In the afternoon, she was moved to Transitional Care (TCU). There, she will receive 4-6 hours of physical therapy every day for a week. She is assessed for every day for risk. It is a very nice, large room with big windows and a large bathroom. She is happy.
Marty and Carley went over in the evening to help her get her room set up. Marty brought some new pajamas for Mom that were easy to get on and off. They were newly washed.. When Mom got them, she was mad. The tags were taken off. She glared at Marty. " I told you to leave the tags on....just in case," she said. At first, Marty thought that she meant that "just in case" was about the fit. It wasn't. Mom was planning for the possibility of never needing pajamas again.
When Mom arrived at the hospital last friday, she was ready. She had her will re-done, her bills paid, her power of attorney signed and her "goodbyes" were possibly forever. She thought that she was going to die. Her fear was unbounded, but her poise was typical Mom.
She sent a text a few minutes ago with her "needs."
Get ready, she is getting ready to dance again.
Saturday, November 13, 2010
Wednesday, November 10, 2010
Quick Update
Hey folks- in order to pick up a few lost days, here is the short versions of what has been going on since Saturday night. I will make it all pretty and fill in with the colorful language in a few days. I will have plenty of time when she moves into our house for a few weeks.
Sunday- In ICU. Sitting up in a chair more. Chest tubes hurt but otherwise OK. Heart a little erratic, but still within normal after such a big surgery.
Monday- Still in ICU. Chest tubes still in. Man in room next to her dies. She has a hard time with that. She thinks that she is next!! Moves to COU in the afternoon. Marty decides to spend the night. Catheter out, some of the other hardware removed (iv's ect). Walks around the unit about 100 feet.
Tuesday- COU. Chest tubes still in. Mom had some Atrial Fibrillation and pauses that warranted the attachment of a temporary pacemaker (temp wires implanted during friday surgery). Walks around the unit about 100 feet.
Docs are concerned about the electrical stuff in her heart.
Wednesday- COU. Chest tubes still in. Docs decide to put in permanent pacemaker. Schedule for 10:am.
She is awake and resting well. She is on another 8 hours of bed rest and loopy on meds from the Cath Lab procedure.
So, this is all fairly normal (I guess). A little hiccup with the electrical system in her heart, but I still feel that we are extremely lucky to have her alive. She is in good spirits and surrounded by a whole team of compassionate and caring folks that want the best possible outcome for her.
Sunday- In ICU. Sitting up in a chair more. Chest tubes hurt but otherwise OK. Heart a little erratic, but still within normal after such a big surgery.
Monday- Still in ICU. Chest tubes still in. Man in room next to her dies. She has a hard time with that. She thinks that she is next!! Moves to COU in the afternoon. Marty decides to spend the night. Catheter out, some of the other hardware removed (iv's ect). Walks around the unit about 100 feet.
Tuesday- COU. Chest tubes still in. Mom had some Atrial Fibrillation and pauses that warranted the attachment of a temporary pacemaker (temp wires implanted during friday surgery). Walks around the unit about 100 feet.
Docs are concerned about the electrical stuff in her heart.
Wednesday- COU. Chest tubes still in. Docs decide to put in permanent pacemaker. Schedule for 10:am.
She is awake and resting well. She is on another 8 hours of bed rest and loopy on meds from the Cath Lab procedure.
So, this is all fairly normal (I guess). A little hiccup with the electrical system in her heart, but I still feel that we are extremely lucky to have her alive. She is in good spirits and surrounded by a whole team of compassionate and caring folks that want the best possible outcome for her.
Sunday, November 7, 2010
New Lease
I got to the ICU at @5:30am. She was loopy but awake. Ernie had been her nurse all night and he had nothing but glowing reports about her progress.
He used all the words I wanted to hear:
Strong
Fantastic
Beautiful
Vibrant
Feisty
Super Woman
Spirited
Spunky
They had the ventilator turned off since about 5:00am. Effectively, she was breathing on her own. At 6:30, they removed ventilator completely. Sweet relief. Important milestone.
Because of the pneumonia, the greatest fear and concern was that she would have a hard time getting off the vent. She exceeded the expectation.
After a few minutes, she squeaked out a few commands. "Water." Next, she winced, "Ouch." "What day is it?" "Where are my glasses!"was followed by "Hi Ninny."
The cardiac surgeon was doing rounds and was just working on Moms chart. He glowed about her progress. He tells her that she needs to sit up in a chair today and start eating some liquids. She had some oatmeal and coffee right away.
Again, I am not clinical in any way (I did stay at a Holiday Inn Express last night), but the monitors in her room seemed to be tracking a very stable set of vitals. I can say that only because I was intent on understanding the stats in the holding room before the surgery. Those numbers were wildly erratic. Before the surgery, her heartbeats were arrhythmic and very fast. Today, it was seemed perfect.
He wants to keep her in ICU for a few days. Might go to COU on Monday.
We went back again at 10am and again at 6pm. Steve and Pam were there most of the afternoon. Mom was seldom without a family member there for more than an hour or so. She is doing great. She sat in a chair for a few hours and had some soup. Her favorite Nun, Sister Pat came by.
A spoon full of ice chips. Nap. TV."Where are my glasses! TV. Nap. TV. "Fix my hair!"
She's doing fine.
I'll go back on Sunday morning and meet with the Cardiac Surgeon and Pulmonogist.
Time to rest and heal.
The Vols are on tonight and she wants to see the game.
She thinks that Dooley is cute.
She's doing just fine.
He used all the words I wanted to hear:
Strong
Fantastic
Beautiful
Vibrant
Feisty
Super Woman
Spirited
Spunky
They had the ventilator turned off since about 5:00am. Effectively, she was breathing on her own. At 6:30, they removed ventilator completely. Sweet relief. Important milestone.
Because of the pneumonia, the greatest fear and concern was that she would have a hard time getting off the vent. She exceeded the expectation.
After a few minutes, she squeaked out a few commands. "Water." Next, she winced, "Ouch." "What day is it?" "Where are my glasses!"was followed by "Hi Ninny."
The cardiac surgeon was doing rounds and was just working on Moms chart. He glowed about her progress. He tells her that she needs to sit up in a chair today and start eating some liquids. She had some oatmeal and coffee right away.
Again, I am not clinical in any way (I did stay at a Holiday Inn Express last night), but the monitors in her room seemed to be tracking a very stable set of vitals. I can say that only because I was intent on understanding the stats in the holding room before the surgery. Those numbers were wildly erratic. Before the surgery, her heartbeats were arrhythmic and very fast. Today, it was seemed perfect.
He wants to keep her in ICU for a few days. Might go to COU on Monday.
We went back again at 10am and again at 6pm. Steve and Pam were there most of the afternoon. Mom was seldom without a family member there for more than an hour or so. She is doing great. She sat in a chair for a few hours and had some soup. Her favorite Nun, Sister Pat came by.
A spoon full of ice chips. Nap. TV."Where are my glasses! TV. Nap. TV. "Fix my hair!"
She's doing fine.
I'll go back on Sunday morning and meet with the Cardiac Surgeon and Pulmonogist.
Time to rest and heal.
The Vols are on tonight and she wants to see the game.
She thinks that Dooley is cute.
She's doing just fine.
Saturday, November 6, 2010
Mercy
Friday, 11/5, I met Steve and the hospital at 8:00 in the morning.
We checked her in and sat in the waiting room for the nurse to come and get her. I can't say that she was nervous. She was tired, relieved, anxious, and weepy. A distant stare seemed a little ominous.
The nurse came and took her away to start the preparation for what would be a very traumatic and long surgery. We would see her again before they put her to sleep, but right now, there were plenty of things that were going on that didn't require a cheering section.
Some of the Sisters of Mercy stopped by to pray. Loving arms and thoughts were closing in around Mom.
It was starting to get serious.
I think that one of my automatic functions when stressed is levity. A little humor helps me avert overbearing thoughts and I always assumed that it does the same for others. It doesn't. One of the nurses made it clear to me that it was time to talk in a quiet voice and to not say anything other than sweet, peaceful comments and plenty of affection toward my Mom. Reality was getting un-funny.
Sitting there and watching my Mom pant was torture. Her skin color was pale and she was fighting to keep her oxygen up and her blood pressure and heart rate down. Terror was starting to show on her face. All of the medicines that they were giving her were not getting the desired result. The anesthesiologist was watching her close. They would add a little something to her medicines then stare intently at the monitors. Something else was added and they watched some more.
As we feared, another heart case came in from the ER and the cardiac surgeon that was going to work on Mom was obliged to work on another case. Now I know why they call that area of the hospital the "holding" area.
At @ 1:15 they took her back. She was gasping for breath and the attending nurses wheeled her away.
We had a phone with us that was used by the "circulating" nurse. Her job is to be the messenger. We were to get updates about progress and milestones.
In a nutshell, Moms surgery will go like this (I'm not a doctor, so do not try this at home):
The Cardiac Surgeon will start opening the chest while another will remove a vein from her left leg for the bypasses. The surgeon will also get another vein from the chest wall. When the veins are ready, they will put her on a heart bypass machine (circulates the blood in lieu of the heart), stop her heart and start the 5 bypasses (think of that as a detour around a bad place in the road). After the bypasses, they will remove the offending aortic valve and replace it with a valve made from the pericardium of a cow. They attach some temporary pacemaker wires in case they need to restart her heart later. After everything is complete, they restart her heart (high tech jumper cables), watch, take her of the bypass and sew her up. She will have chest drain tubes, a plethora of wires attached everywhere and she will be on a ventilator.
From surgery, she goes to the Intensive Care Unit. She is closely monitored. About 6+ hour later, the try to get her off the ventilator. Within a day, they have her sitting up and starting a clear diet. Next, she goes to the Coronary Observation Unit and then home in a few days after that. They don't waste time.
1:45- The nurse called and said that they had started and that they would call when she was on the bypass machine.
2:45- on heart bypass machine
3:45- Dr. finishing 5th bypass
4:41- New valve in place
6:00- Mom removed from bypass machine
7:00- Mom moved to ICU
We were invited to the nurses lounge to wait for the Surgeon. He will tell us the story.
About 7:30, the cardiac surgeon came by. A day of surgery for him was evident by the impressions left on his face from all of the masks and lights. He had to be exhausted.
He said she did great. Her heart is fixed. She is very stable but he won't celebrate until she goes home.
He did offer a caveat. She nearly died before they even started the procedure. Not even 5 minutes after we left her and they wheeled her away, she "crashed." They had to do an emergency intubation and bring her back, get her stable, and start the procedure.
Good call by the cardiologist to do the procedure and not wait until next week. She probably would have died before she got to the table.
We went to see her at 10:00pm. She was heavily sedated. The nurses and doctors said she was doing great. Steve, Pam, Marty and I kissed he goodnight, told her that we loved her and left her to get some much needed rest.
Even with the tubes, buzzers, beepers and wires, she looked good.
We checked her in and sat in the waiting room for the nurse to come and get her. I can't say that she was nervous. She was tired, relieved, anxious, and weepy. A distant stare seemed a little ominous.
The nurse came and took her away to start the preparation for what would be a very traumatic and long surgery. We would see her again before they put her to sleep, but right now, there were plenty of things that were going on that didn't require a cheering section.
Some of the Sisters of Mercy stopped by to pray. Loving arms and thoughts were closing in around Mom.
It was starting to get serious.
I think that one of my automatic functions when stressed is levity. A little humor helps me avert overbearing thoughts and I always assumed that it does the same for others. It doesn't. One of the nurses made it clear to me that it was time to talk in a quiet voice and to not say anything other than sweet, peaceful comments and plenty of affection toward my Mom. Reality was getting un-funny.
 |
| Holding Room |
As we feared, another heart case came in from the ER and the cardiac surgeon that was going to work on Mom was obliged to work on another case. Now I know why they call that area of the hospital the "holding" area.
At @ 1:15 they took her back. She was gasping for breath and the attending nurses wheeled her away.
We had a phone with us that was used by the "circulating" nurse. Her job is to be the messenger. We were to get updates about progress and milestones.
In a nutshell, Moms surgery will go like this (I'm not a doctor, so do not try this at home):
The Cardiac Surgeon will start opening the chest while another will remove a vein from her left leg for the bypasses. The surgeon will also get another vein from the chest wall. When the veins are ready, they will put her on a heart bypass machine (circulates the blood in lieu of the heart), stop her heart and start the 5 bypasses (think of that as a detour around a bad place in the road). After the bypasses, they will remove the offending aortic valve and replace it with a valve made from the pericardium of a cow. They attach some temporary pacemaker wires in case they need to restart her heart later. After everything is complete, they restart her heart (high tech jumper cables), watch, take her of the bypass and sew her up. She will have chest drain tubes, a plethora of wires attached everywhere and she will be on a ventilator.
From surgery, she goes to the Intensive Care Unit. She is closely monitored. About 6+ hour later, the try to get her off the ventilator. Within a day, they have her sitting up and starting a clear diet. Next, she goes to the Coronary Observation Unit and then home in a few days after that. They don't waste time.
1:45- The nurse called and said that they had started and that they would call when she was on the bypass machine.
2:45- on heart bypass machine
3:45- Dr. finishing 5th bypass
4:41- New valve in place
6:00- Mom removed from bypass machine
7:00- Mom moved to ICU
We were invited to the nurses lounge to wait for the Surgeon. He will tell us the story.
About 7:30, the cardiac surgeon came by. A day of surgery for him was evident by the impressions left on his face from all of the masks and lights. He had to be exhausted.
He said she did great. Her heart is fixed. She is very stable but he won't celebrate until she goes home.
He did offer a caveat. She nearly died before they even started the procedure. Not even 5 minutes after we left her and they wheeled her away, she "crashed." They had to do an emergency intubation and bring her back, get her stable, and start the procedure.
Good call by the cardiologist to do the procedure and not wait until next week. She probably would have died before she got to the table.
We went to see her at 10:00pm. She was heavily sedated. The nurses and doctors said she was doing great. Steve, Pam, Marty and I kissed he goodnight, told her that we loved her and left her to get some much needed rest.
Even with the tubes, buzzers, beepers and wires, she looked good.
Serendipity
I must have been on the phone for hours yesterday. Instant messages and emails were clogging my phone.
We had a plan. A little breathing room for us and some more Jerry Springer for Mom. Next Tuesday, we were going to see some magic. A brilliant surgeon was going to add 20+ years to Mom's life.
A light afternoon created some time to blog and I hammered away at the previous post.
Not even one minute after I published "Hurray up and Wait," and turned off the computer, my phone rang. It was Marty. The cardiologist had just called and said that he was going to do the surgery on Friday morning. THIS FRIDAY!
Moms congestive heart failure trumped everything.
So, we are to be at the hospital at 8:00 am.
The rest of the evening was spent making sure that all of the last minute items were complete. Steve came over to Moms to spend the night and make sure that she rested.
Mom struggled. Her breaths were shallow and labored. Generally, she looked exhausted.
Steve, Marty and I sat in her living room and watched here fade in and out of sleep in her big yellow chair. Mom talked to all of her Grandchildren. All wished her luck and sent their love. Nathan was even so bold to proclaim---"I'm 100% sure that your gonna make it, Gramma."
Sweat pants, blanket and some nice warm slippers. One of her cats curled up by her head. We whispered our conversations and had a glass of wine. Avoiding any morbid subjects.
We decided that before Christmas, we would take Mom to Biltmore and see the Christmas lights and a candlelight tour of the house. A trip to St. Croix in the late winter was also planned.
Marty and I left at about 10.
It's always strange to sleep in a house that is not your own. Steve could barely sleep for the unfamiliar noises. Ice maker, an archaic heat system bellowing every few minutes and two jet-black cats that seldom had visitors stay the night, meant that Steve would hardly sleep.
He had to get up and rub Moms back the middle of the night. She was restless and fought for a breath when she lay prone. The big, yellow chair was the only place she could rest, sitting up, and surrounded by her jet-black, feline guardians.
We had a plan. A little breathing room for us and some more Jerry Springer for Mom. Next Tuesday, we were going to see some magic. A brilliant surgeon was going to add 20+ years to Mom's life.
A light afternoon created some time to blog and I hammered away at the previous post.
Not even one minute after I published "Hurray up and Wait," and turned off the computer, my phone rang. It was Marty. The cardiologist had just called and said that he was going to do the surgery on Friday morning. THIS FRIDAY!
Moms congestive heart failure trumped everything.
So, we are to be at the hospital at 8:00 am.
The rest of the evening was spent making sure that all of the last minute items were complete. Steve came over to Moms to spend the night and make sure that she rested.
Mom struggled. Her breaths were shallow and labored. Generally, she looked exhausted.
Steve, Marty and I sat in her living room and watched here fade in and out of sleep in her big yellow chair. Mom talked to all of her Grandchildren. All wished her luck and sent their love. Nathan was even so bold to proclaim---"I'm 100% sure that your gonna make it, Gramma."
Sweat pants, blanket and some nice warm slippers. One of her cats curled up by her head. We whispered our conversations and had a glass of wine. Avoiding any morbid subjects.
We decided that before Christmas, we would take Mom to Biltmore and see the Christmas lights and a candlelight tour of the house. A trip to St. Croix in the late winter was also planned.
Marty and I left at about 10.
It's always strange to sleep in a house that is not your own. Steve could barely sleep for the unfamiliar noises. Ice maker, an archaic heat system bellowing every few minutes and two jet-black cats that seldom had visitors stay the night, meant that Steve would hardly sleep.
He had to get up and rub Moms back the middle of the night. She was restless and fought for a breath when she lay prone. The big, yellow chair was the only place she could rest, sitting up, and surrounded by her jet-black, feline guardians.
Thursday, November 4, 2010
Hurry Up and Wait
The stress of anticipation is cruel.
As a kid, I remember that big box under the Christmas tree that was placed days before. So big, that the wrapping paper was applied in several directions and often in several styles. It dominated the room. Inevitably, a little bit of the outside of the box could be seen, or a tear from sliding the monstrous cargo, exposed just a few words on the box. "Turbo" or "Ammo" or some other joyous word for boys would be just enough information to force an immediate, explosive dance and many sleepless nights. The gift of gifts.
Mom is in a similar situation but it is much more macabre. In addition to a wonderful gift there is also a time-bomb.
Her pending surgery will likely completely abate the bulk of her health issue. I see that as a wonderful gift. On the other hand, until she has the surgery, her very life is hanging in the balance.
Yesterday, she went to the pulmonologist. The appointment had been scheduled since the middle of last week. In short, the visit was to define the status of her pneumonia. A positive report would allow for a schedule to get her heart fixed and begin the healing process.
The cardiac surgeon is holding a spot for Friday morning.
A chest X-ray and more blood were taken. The X-ray showed some congestion in one of here lungs and she had a mild fever. Not the data we needed. The pulmonologist confirmed "no surgery until lungs are clear."
In the last week, Mom has devoted her "couch potato incarceration" to getting everything in her life in some kind of order. Lists upon lists. Her phone rings constantly.
Dog food, cat litter and cable bill. Check.
Cat food, plants brought inside and real-estate. Check.
Power of attorney, will and bequeathments. Check.
Hair. Check
She's ready to do battle.
We have heard from the surgeon that he doesn't want to touch her if there is some infection. The new valve is at great risk of being bombarded by all the little repair cells in her blood. The cardiologist approaches her malady with valid and measured concern. Infection present during a surgery like this can make for a less confident outcome. Risk. Much more risk.
Additionally, the pulmonologist believes that the lungs are still "too wet." Might require a longer stint with a respirator. Risk. More Risk.
Her blood test results came back today. Her white blood cell count was elevated and her BNP (a marker for congestive heart failure) was positive. So, there is still some infection too. To make matters even more difficult, Moms heart is still in distress. Risk. More Risk. Too much Risk.
Right now, it is "Damned if you do, damned if you don't."
Early Monday morning, they will test again. If all goes well, next Thursday, Mom will get her gift.
She is in her party dress. Adrenaline is at an all time high. Hair is done. Lipstick is on. Cats and dogs are fed.
She is ready for the dance.
We just need the band to show up.
As a kid, I remember that big box under the Christmas tree that was placed days before. So big, that the wrapping paper was applied in several directions and often in several styles. It dominated the room. Inevitably, a little bit of the outside of the box could be seen, or a tear from sliding the monstrous cargo, exposed just a few words on the box. "Turbo" or "Ammo" or some other joyous word for boys would be just enough information to force an immediate, explosive dance and many sleepless nights. The gift of gifts.
Mom is in a similar situation but it is much more macabre. In addition to a wonderful gift there is also a time-bomb.
Her pending surgery will likely completely abate the bulk of her health issue. I see that as a wonderful gift. On the other hand, until she has the surgery, her very life is hanging in the balance.
Yesterday, she went to the pulmonologist. The appointment had been scheduled since the middle of last week. In short, the visit was to define the status of her pneumonia. A positive report would allow for a schedule to get her heart fixed and begin the healing process.
The cardiac surgeon is holding a spot for Friday morning.
A chest X-ray and more blood were taken. The X-ray showed some congestion in one of here lungs and she had a mild fever. Not the data we needed. The pulmonologist confirmed "no surgery until lungs are clear."
In the last week, Mom has devoted her "couch potato incarceration" to getting everything in her life in some kind of order. Lists upon lists. Her phone rings constantly.
Dog food, cat litter and cable bill. Check.
Cat food, plants brought inside and real-estate. Check.
Power of attorney, will and bequeathments. Check.
Hair. Check
She's ready to do battle.
We have heard from the surgeon that he doesn't want to touch her if there is some infection. The new valve is at great risk of being bombarded by all the little repair cells in her blood. The cardiologist approaches her malady with valid and measured concern. Infection present during a surgery like this can make for a less confident outcome. Risk. Much more risk.
Additionally, the pulmonologist believes that the lungs are still "too wet." Might require a longer stint with a respirator. Risk. More Risk.
Her blood test results came back today. Her white blood cell count was elevated and her BNP (a marker for congestive heart failure) was positive. So, there is still some infection too. To make matters even more difficult, Moms heart is still in distress. Risk. More Risk. Too much Risk.
Right now, it is "Damned if you do, damned if you don't."
Early Monday morning, they will test again. If all goes well, next Thursday, Mom will get her gift.
She is in her party dress. Adrenaline is at an all time high. Hair is done. Lipstick is on. Cats and dogs are fed.
She is ready for the dance.
We just need the band to show up.
Monday, November 1, 2010
A Little Background
It was just a normal Sunday in October.
At 6 am, I was awake, but still loafing in bed. My ringing phone startled whatever peace was available before the kids and dog awoke.
It was Mom. She couldn't breathe and thought that she needed to go to the ER and get an adrenaline shot or breathing treatment. Asthma.
I was there in 8 minutes. She was fixing her hair and putting on lipstick. I helped her to the truck and away to the ER.
Never, in 47 years, have I had to take my Mom to the hospital. Other than childbirth, I am not aware of any hospital trip for her. Yes, it was out of the ordinary, but she had had some respiratory issues over the last few weeks, some chronic, and had been through a round of steroids and antibiotics. We assumed that with the change of the weather and her allergy asthma, the burden on her lungs was just too much. So, we were alarmed, but more cautious than concerned.
I got her to the ER and they got her right in.
The ER physician came in and listened to her lungs and heart and asked the normal barrage of questions. Yes, she was congested. He ordered some oxygen, blood work, albuterol breathing treatment, and probably a chest X-ray. He promised to come back after the chest X-ray. He ordered some additional blood work. Mom tried to sell him some real estate and she thought that he was "just darling."
A hospitalist started on the case and came in and basically asked the same questions and promised the same return after a consultation with radiology.
Her lungs and initial blood work pointed to pneumonia. A room was ordered on the CVIU (cardiovascular) floor. A three to five day stay. Mom was not happy. She had an open house that afternoon and was certain that she would be home in time for the showing.
Very subtly, both doctors were sniffing around coronary issues. Mom wasn't listening, but Marty and I could sense a change in direction, demeanor and specific lines of questioning from the attending physicians.
Although she did have pneumonia and pleurisy, they were not convinced that those maladies were the only culprits. The second blood test was to look for an enzyme called troponin that is present when a coronary event has occurred. I'm not clinical, so don't judge my layman explanation, but when the heart muscle is in distress, and as the muscle breaks down after a heart attack, it releases some enzymes that are easy to identify. The presence of these enzymes don't apparently quantify the severity of the attack, but only that the attack has occurred. Mom had an MI. Myocardial Infarction. That's a fancy way of saying HEART ATTACK.
We were all stunned. My Mom is the picture of heath. At 71, she looks like she is 59. She still sells real estate and flits about. She helps us with our kids and wrangles 2 dogs and 4 cats. She makes lots of time for her family. In the temperate months, she plays tennis and until recently, walked the malls a few times a week. She eats clean, has a daily glass of wine (or two). We would all be lucky to have her vitality.
Mom believes that all ills can be handled with a family physician, an asprin, a regular visit to the hairdresser, a cat on her lap and a chiropractor. She's probably right. She has always been suspicious of doctors and over the last decade has developed a powerful phobia of hospitals. At 71, I am certain that a senior view of mortality helps to feed that apprehension.
Now the wave starts and the momentum increases. A room, more tests. X-rays, angiogram and ultrasound. She is on oxygen. She can't keep her levels up without it. Now she has a Cardiologist, Pulmonologist, Radiologist, RN, and a constant stream of people asking her if she smoked. She thinks the Cardiologist is really cute.
In between the breathing treatments, blood pressure checks, fever checks and needle punctures, Mom keeps her lipstick fresh and picks her hair. She has pneumonia and has had a heart attack and yet one would think that she was getting a pedicure. She waits for the doctor as you would imagine a lady waits in the parlor for a gentleman to call for afternoon tea.
She had some really low moments during the day. Mostly, she had trouble breathing but I'm certain that the fear of uncertainty was a huge burden.
After a restless night, Monday was a day of rest and therapy. Most of the focus was getting a handle on the pneumonia. The Docs were concerned about a murmur and her heart rate continued to be elevated. She was, in effect, running in a marathon in bed.
The frequent blood tests for the presence of troponin did not trend in a direction that was desired by the cardiologist. Tuesday, a heart catheterization was performed.
Marty, my brother Steve and I were there during the catheterization and waited for the results anxiously. We were called back to recovery and met with the Doc. So, it turns out that she needs 5 coronary bypasses and an aortic valve replacement. Wow. No heart damage from the heart attack was good news.
We have all heard the buzz words. "Silent Killer." "Walking Time-bomb."
Mom came in for pneumonia and a much bigger issue was revealed. A blessing, really.
So, now the heart surgeon is on the scene. He is ready to go, but defers to the pulmonologist and other cardiologist in his group to decide the timing of the surgery. It was determined that the pneumonia must be completely resolved before surgery.
She was released on Wednesday to come home and recover. A chest x-ray will be done 11/3 and then a schedule will be set.
For the last few days, a near constant stream of folks have been offering help, companionship and food. Her coffers, cupboards and larders are full and the sheer volume of support is a testament to the love that all have for my Mom.
Chicken soup is good for the soul. She just hopes it freezes well.
I will update important times and try to keep her phone from ringing while she recovers.
For all of the prose police out there, I do my best. Spelling, sentence agreement, frequent fragments, tense and usage will be totally wrong, frequent and blatant. I'm not sorry.
At 6 am, I was awake, but still loafing in bed. My ringing phone startled whatever peace was available before the kids and dog awoke.
It was Mom. She couldn't breathe and thought that she needed to go to the ER and get an adrenaline shot or breathing treatment. Asthma.
I was there in 8 minutes. She was fixing her hair and putting on lipstick. I helped her to the truck and away to the ER.
Never, in 47 years, have I had to take my Mom to the hospital. Other than childbirth, I am not aware of any hospital trip for her. Yes, it was out of the ordinary, but she had had some respiratory issues over the last few weeks, some chronic, and had been through a round of steroids and antibiotics. We assumed that with the change of the weather and her allergy asthma, the burden on her lungs was just too much. So, we were alarmed, but more cautious than concerned.
I got her to the ER and they got her right in.
The ER physician came in and listened to her lungs and heart and asked the normal barrage of questions. Yes, she was congested. He ordered some oxygen, blood work, albuterol breathing treatment, and probably a chest X-ray. He promised to come back after the chest X-ray. He ordered some additional blood work. Mom tried to sell him some real estate and she thought that he was "just darling."
A hospitalist started on the case and came in and basically asked the same questions and promised the same return after a consultation with radiology.
Her lungs and initial blood work pointed to pneumonia. A room was ordered on the CVIU (cardiovascular) floor. A three to five day stay. Mom was not happy. She had an open house that afternoon and was certain that she would be home in time for the showing.
Very subtly, both doctors were sniffing around coronary issues. Mom wasn't listening, but Marty and I could sense a change in direction, demeanor and specific lines of questioning from the attending physicians.
Although she did have pneumonia and pleurisy, they were not convinced that those maladies were the only culprits. The second blood test was to look for an enzyme called troponin that is present when a coronary event has occurred. I'm not clinical, so don't judge my layman explanation, but when the heart muscle is in distress, and as the muscle breaks down after a heart attack, it releases some enzymes that are easy to identify. The presence of these enzymes don't apparently quantify the severity of the attack, but only that the attack has occurred. Mom had an MI. Myocardial Infarction. That's a fancy way of saying HEART ATTACK.
We were all stunned. My Mom is the picture of heath. At 71, she looks like she is 59. She still sells real estate and flits about. She helps us with our kids and wrangles 2 dogs and 4 cats. She makes lots of time for her family. In the temperate months, she plays tennis and until recently, walked the malls a few times a week. She eats clean, has a daily glass of wine (or two). We would all be lucky to have her vitality.Mom believes that all ills can be handled with a family physician, an asprin, a regular visit to the hairdresser, a cat on her lap and a chiropractor. She's probably right. She has always been suspicious of doctors and over the last decade has developed a powerful phobia of hospitals. At 71, I am certain that a senior view of mortality helps to feed that apprehension.
Now the wave starts and the momentum increases. A room, more tests. X-rays, angiogram and ultrasound. She is on oxygen. She can't keep her levels up without it. Now she has a Cardiologist, Pulmonologist, Radiologist, RN, and a constant stream of people asking her if she smoked. She thinks the Cardiologist is really cute.
In between the breathing treatments, blood pressure checks, fever checks and needle punctures, Mom keeps her lipstick fresh and picks her hair. She has pneumonia and has had a heart attack and yet one would think that she was getting a pedicure. She waits for the doctor as you would imagine a lady waits in the parlor for a gentleman to call for afternoon tea.
She had some really low moments during the day. Mostly, she had trouble breathing but I'm certain that the fear of uncertainty was a huge burden.
After a restless night, Monday was a day of rest and therapy. Most of the focus was getting a handle on the pneumonia. The Docs were concerned about a murmur and her heart rate continued to be elevated. She was, in effect, running in a marathon in bed.
The frequent blood tests for the presence of troponin did not trend in a direction that was desired by the cardiologist. Tuesday, a heart catheterization was performed.
Marty, my brother Steve and I were there during the catheterization and waited for the results anxiously. We were called back to recovery and met with the Doc. So, it turns out that she needs 5 coronary bypasses and an aortic valve replacement. Wow. No heart damage from the heart attack was good news.
We have all heard the buzz words. "Silent Killer." "Walking Time-bomb."
Mom came in for pneumonia and a much bigger issue was revealed. A blessing, really.
So, now the heart surgeon is on the scene. He is ready to go, but defers to the pulmonologist and other cardiologist in his group to decide the timing of the surgery. It was determined that the pneumonia must be completely resolved before surgery.
She was released on Wednesday to come home and recover. A chest x-ray will be done 11/3 and then a schedule will be set.
For the last few days, a near constant stream of folks have been offering help, companionship and food. Her coffers, cupboards and larders are full and the sheer volume of support is a testament to the love that all have for my Mom.
Chicken soup is good for the soul. She just hopes it freezes well.
I will update important times and try to keep her phone from ringing while she recovers.
For all of the prose police out there, I do my best. Spelling, sentence agreement, frequent fragments, tense and usage will be totally wrong, frequent and blatant. I'm not sorry.
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