Saturday, May 3, 2008

When Rita Smiles . . .

How happy I was this morning when I entered the hospital room and saw Mom smile!  She actually seemed somewhat cheerful!  It seems as if her personality is normalizing as her health gets better.  She sat up for both breakfast and lunch today, feeding herself well and eating better than I've seen so far.  That's not to say, though, that she is happy about this enfeebled state she's in.  

Mom has always been so engaged with people and her surroundings.  She seems unwilling to become old, a senior whose feeble physical condition and waning senses force her into observing more than participating in life's activities.  

I suppose I should celebrate Mom's rebelliousness against the inevitability of aging.  Dylan Thomas wrote his magnificent poem "Do Not Go Gentle Into That Good Night" at his father's deathbed, begging him to do something other than sink peacefully into the eternal sleep.   He would be glad if he could see my mom.  
  
Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.

Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.

Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.

And you, my father, there on the sad height
Curse, bless me now with your fierce tears, I pray
Do not go gentle into that good night
Rage, rage against the dying of the light.
  
 


Friday, May 2, 2008

Juiced up!

They pumped Mom full of stuff yesterday.  At one point, they had two IV pumps going at the same time.  She got antibiotics, two units of blood, and potassium.  Her face has filled back out; it was looking gaunt for a while. 

For those interested in her vitals: her temperature this afternoon at 4:00 is 100, blood oxygen is 91%, blood pressure 117/61.   Her white blood count this morning was .7, up from .3 yesterday.  The goal is 1.0.  So she's definitely not as sick as she was. 

Sometimes the better you feel, the harder it is to be sick.  I asked her if she was getting bored.  She said, "Yes."  We always said that Mom was not likely to be a happy camper as a patient, when and if she ever got really sick.  And that is indeed the way it has turned out.  Nurses generally make unwilling patients, though, don't they?

This morning when her doctor came around, she told him that she was mad at him for making her feel better.  He took it well.  I think he even was glad that she was getting sassy with him.  

Although she mainly just briefly asks and answers question, she is interacting more lucidly now that her vitals are starting to pick up again.   She's just still too weak for conversation.  


Thursday, May 1, 2008

Sometimes when you're sick, life doesn't seem worth living

I've been with Mom in Spokane's Sacred Heart Medical Center since Wednesday morning. 

When I got here Wednesday, she seemed to be getting on top of the infection and even was able to sit up and feed herself.  Then Wednesday night, her fever spiked again, and it was like starting over. She is weak, shaky and somewhat out of it, although that comes and goes depending, Peg thinks, on the fever.

On Wednesday, her brother Adrian and sister-in-law Rose came to Spokane from Lewiston, where they have been visiting for the past week.  Adrian and Rita had intended to have a nice long visit together, but this medical crisis deep-sixed those plans.  They're having to go back to their home in California with the image of Mom at her sickest in their minds.  Distressing for them, I know.

Peg and I have been tag teaming so that Mom has one of us by her most of the time.  The nursing staff and other caregivers have been wonderful, but both Peg and I want to be around to make sure that she gets water or coffee when she wants it, that she eats as much as she is willing to eat, and that she is kept entertained or at least distracted.  

Because she has been out of it as much as she has, they did an MRI yesterday, just to ensure that the CAT scan on Saturday hadn't misled them about the state of her brain. Thankfully, it showed no problems.

Her spirits are low--she has NEVER been this sick physically in her life--and she is saying, "what's the use?" But we know that once her white blood cell count improves, she will feel more positive. We hope so, at least. Poor thing.

White blood cell count was at .1; this morning it is at .3; it needs to get to 1.0.     

At least we're going in the right direction. We who are not sick as dogs, as she is, cling to this hope.

Tuesday, April 29, 2008

Hospitalization

Sad news to report. Mom is in the hospital with an infection. It came on her overnight this weekend. On Friday (April 25), she and Peg had a nice evening together and Mom ate heartily. The next morning (Saturday, April 26), Peg couldn’t wake her up. She knew Mom was alive because she was breathing and had a heartbeat, but still wouldn’t come to complete consciousness. Peg called 911, and Mom ended up in Sacred Heart. The EMT’s suggested that she go there because of the possibility that she had had a stroke.

By about 11:30 AM, they began a CAT scan, and by about 1 PM were able to determine that there was no sign of a stroke on the CAT image. They had also taken a complete blood count and found that her white blood cells were “down to zero.” So they delivered antibiotics and took cultures. It wasn’t until the next morning, however, (Sunday, April 27) that they knew what bug it was and could be sure of the diagnosis: bacterial infection in the blood.

Saturday was a bad night for Mom and for us. She was quite sick. She would occasionally become alert, but Peg, Bill and I all thought she was clearly delirious. She was refusing treatment: “No chemo; no antibiotics; let go, let God” she said over and over again with great vehemence. That really affected Peg, Bill and me. And some of the hospital staff decided that she was lucid enough that her wishes had to be respected. As a result, it was a late night that included lots of discussion with the medical staff about appropriate treatment.

Sunday morning, she showed signs of improvement. I had spent the night there, so I was ready when she was coming to. She seemed a little bit more alert than she had been the night before.

Poor thing, her mouth was so dry. I asked and she agreed to take some water by mouth. She couldn’t lift her head so I held the cup and straw for her. As I helped her, I became aware that she smelled the coffee on my breath. I asked her if she wanted a cup of coffee. She said yes to that, too. I got some nice hot coffee for her, put the straw to her lips, and, boy, did she suck it down. I asked her if it seemed to be too hot. Of course, old iron mouth said, “No, it’s good.” Hallelujah! She sucked down I think three cups in very short order, and from that point on, she was more much more receptive to other assistance.

I firmly believe that the taste of a good, hot cup of coffee brought back her will to live.

Peg and Bill came back to be with her within an hour or so. We were all glad that she seemed to be a bit better but still very, very sad and concerned about her refusal of treatment

When the doctor showed up about noon, he spoke to her very clearly. He said he needed her to accept the antibiotics and the electrolytes, and he needed her to let the nurses draw blood. She said, “OK,” and I can tell you that Peg, Bill and I all erupted with glad relief and gratitude to Mom and many thanks to the doctor. I even hugged him! We hurried the nurse to get the antibiotics and start them up before Mom or anyone else could interfere.

By Monday (April 28), Mom was alert enough to hold conversations with Bill in the morning, me in the afternoon and Peg in the evening. She was strong enough to stand up in the shower and to sit up in a chair to feed herself.

As you might imagine, the weekend was a complete blur to her, so each one of us went over the events of Saturday and Sunday with her. We have downplayed somewhat the fact that for about twelve hours, she was refusing treatment, and about the effect of that on us. We recognize that she is still having a hard time putting it all together in her mind. But we have hopes that when she gets better, we can come to a clearer understanding of her desires.

She has always said that we should refuse all heroic measures to sustain life, and we definitely will respect that, but we did not regard the intravenous administration of antibiotics as a heroic measure. We were distressed that, in her delirium, she was able to persuade the medical staff to terminate that assistance. This is going to take more talking about, definitely.

Today, her fever has risen a bit again. She says that her mind feels foggy, that she feels “silly.” The treatment is continuing: antibiotics, injections to stimulate white blood cell production and hospitalization. We don’t know what will happen next, and we are taking it day-by-day, hour-by-hour.

Thank you all for your kind thoughts and prayers.

This is a photo of Bill's, Peg's and Mom's hands as we were with her in the hospital room.

Monday, April 28, 2008

Sad turn of events

Our mom took a turn for the worst on Saturday, April 26th. She is currently in Sacred Heart Medical Center in Spokane but hopefully will be released later this week. She was looking forward to returning home to Asotin for a week when she was struck with a bacterial infection which hit suddenly on Saturday. Because of the depleted immune system it took rapid control of her body. She is bouncing back slowly, but it was touch and go for a while. Please keep her in your thoughts and prayers.

Thanks to those of you who have commented on the blog. We share your comments and best wishes with her. If you haven't figured it out- Charmaine says all you have to do in click on the blue "comment" word. Thanks to Lisa, her friend and banker, for sending your thoughts. I will pass them on to mom tomorrow! She has friends everywhere!