Friday, February 28, 2014

Report from Pillville: The Echocardiogram

Bad hearts run in my mother's family. Both of her parents died of heart attacks when they were in their 70s. One lingered in a hospital bed, the other dropped to the floor. He was dead when he hit, my mother is fond of saying about her father. Her oldest brother died of a heart attack when he was in his 50s. My mom herself has had a pacemaker for years, and has been on warfarin to keep the blood from pooling in her heart. It's all worked pretty swell. She hasn't had a heart attack or a stroke--so I guess things have gone according to plan. She will be 90 in September.

I've seen changes in her in the past year and a half that she's lived with me. She grew stronger at first. Quit smoking. Put on weight. But lately she's slowed down. She sleeps more. She has more pain. Her blood pressure fluctuates sometimes causing nausea and headaches. Mentally, she's slower too. Last night she asked me how to spell my first name. Most mornings it's a crap shoot as to how she'll wake up feeling--too queasy for coffee? Neck pain? Back pain? Head ache? Too wobbly to fix her own breakfast?

Today she had an echocardiogram and has other heart tests scheduled as well this month. Then there will be a consultation with the cardiologist. The echocardiogram is the rorschach test of diagnostic tools if you're like me with a wild imagination and not a fucking clue as to what the image on the screen actually shows. One minute, her beating hear looked liked a malevolent serpent opening and closing its mouth, (Heart valve? Ya got me.) and the next, this guy in his little pointy hat was in there beating his drum, first one arm rising up to strike the drum, then the other.

And then later it was a weather map in there. Red, yellow, blue. Colors swirling around like there's a hurricane brewing in her heart.

The next test is a type of stress test sans treadmill where she will be injected with some nuclear substance or another after fasting for four hours and foregoing the morning coffee, after which she will be expected to eat a fatty meal that we have brought with us--or we can go out to McDonald's for an Egg McMuffin---hahahaha, after which there will be more testing. The whole thing lasts 3-4 hours. Fasting for the blood test a couple of weeks ago sent us off to the ER with non-stop nausea and a splitting headache, so I asked the receptionist if this particular stress test was ever done in-patient in the hospital. "If the doctor orders it," she said. 
"Then I guess I'm asking the doctor to order it," I said. "I don't think my mom can handle the fasting--especially if she needs her pain meds."
"It's only four hours of fasting," she said. "And we don't need to administer pain meds for the test." I explained that my mother is routinely taking oxycodone and can't function without it. That I was most definitely requesting that the test be done as an in-patient in the hospital. She gave me a form to fill out--a tad bit grudgingly. And a little hurricane began brewing in my own heart.


Allison said...

It's only four hours.... no pain meds required for the tests. What part of going into withdrawal is not understood here? Every time my mother in law ended up in the hospital, she also ended up in withdrawal. It was just horrible and completely unnecessary. Good luck to you getting this done in patient.

lily cedar said...

At your mom's age does she really need to go through the test? Doctors like to believe they can fix anything but they can't fix old. I probably sound harsh but I've been a nurse for almost thirty years. It's not always appropriate to intervene. I know you love your mom but it sounds like she is getting close to the end.

I say this, knowing how much it hurts. My mum died a year ago and the last year of her life was very similar to your mom's. More and more emergency visits. I felt helpless most of the time and what I wanted most was for my mum to be comfortable and at home. In retrospect I wish that I could have taken a year off and cared for her at home. She had no specific illness, just old and worn out.

What does your mom want? Is she ready to die? It's not something we talk about a lot in our society but it should be. It's something we're all going to do.

Take care Denise. Sending hugs for you and your mom.

Anonymous said...

I think Lily Cedar is completely correct. In what way will your mother benefit from this test? Have you considered declining it?