Friday, June 28, 2013

Checking out...and leaving, too, by god!

What I did before I left for the weekend

Visit mom
Talk with nurse about her release 
I.e. need walker
Check on meds and other instructions

Buy groceries
Sushi for m
Orange juice and yogurt for mom
Ice cream for both
Cat food for piper

Get new prescriptions
Pain pills
New antibiotic

Water plants

Fill bird feedeers

Check the mail 
Shred mom's junk mail

Change her sheets and towels and clean her room and bathroom
Lay out clean p.js. 

Give m instructions re this and that
Write notes to m re this and that
Write notes to self re this and that

Take homemeade bean soup and spaghetti sauce out of freezer

Shower
Pack 
Make bed
Make 2 out of 3 shuttle reservatioins
Check infor flight
Charge ipad and phone and camera

Notice that if feels good to have a break
Love the the fog as it rolls inland and know that I will be back
Freak out a little when I hear "Hotel  California"  in the shuttle to LAX.

Wednesday, June 26, 2013

A Brief History of My Mother's Hospital Rooms




I remember every hospital room my mother's been in--except for the first time she almost died. I was a toddler then, but heard the story many times. How my father rushed her to the hospital one evening and was told that her exploratory surgery would be at 9:00. He went back to his grocery store, assuming they meant 9:00 a.m. When he arrived at the hospital the next morning to be with her before she went under the knife, he found my mother recovering from major surgery to remove a tubal pregnancy.

The summer after my freshman year of college my mother developed pneumonia and a staff infection after surgery to remove her gall bladder. I wasn't in great shape myself that summer. A year earlier I'd given my infant son up for adoption. My pregnancy had aggravated the curve in my spine and my ribcage was twisting toward my heart and left lung. I needed surgery, too, and was scheduled for a month-long hospital stay the following January, but my mother's condition was more dire. What I remember is the shininess of the hallway where I was allowed to stand and talk to her. From that perspective, her isolation room seemed unnaturally deep, and the view out her window stretched forever into the green Iowa summer. If my mother died, I'd be expected to quit college and raise my younger brothers. This would be God's way of punishing me, I thought, for giving up my baby.

I was in my twenties when she had her first lung tumor. I flew from Los Angeles back to Iowa to see her. Her room was near the nurses' station and the kitchenette where ice and juice were dispensed was nearby, too. Her pain was excruciating, and I shuttled back and forth, asking the nurses for pain medication and permission to serve my mother a glass of juice or ice water while I craved a good stiff drink.

There were a dozen more minor procedures in the following decades. Stents, angioplasties, hernia repairs, minor cardiac procedures, cataract surgeries. By that time, my mother had moved to the east coast, and I was a continent away with children of my own. With the exception of a heart procedure meant to shock her misfiring heart into a more regular rhythm, I missed all of it.

My children were grown by the time the second lung tumor appeared. I was still on the west coast, but I was divorced and living alone. The removal of the pea-sized squamous cell tumor would require five days in the hospital, she told me. I planned to arrive on the east coast on day four, bring her home from the hospital, and spend a week with her as she recovered. Her first room in Washington Hospital Center was dark and cramped, and her bed was just a foot or two from the door. The morning I arrived to take her home, the crisis team was huddled over her. My mother looked terrified as she struggled to breathe through the oxygen mask pressed against her face. A petite woman in a white coat whisked me out of the room and told me my mother was being rush to ICU where she'd be put on a ventilator.

I spent the next month living in the guest quarters at WHC. My room resembled a slightly run-down 80s motel, but there was a laundry room, a microwave oven, free coffee, and a bank of vending machines that kept my self-soothing M&Ms habit well supplied. My mother's ICU cubicle, whirring like an engine room, was directly across from the giant control station where some ridiculous person sat at an elevated console answering the patient call buttons. "May I help you?" she'd respond in her polite and perky voice. I was polite and perky in return the first time I explained that my mother could not speak due to the ventilator tube rammed down her throat. The many subsequent times the voice responded to the call button in this manner, I assumed my psycho ax-murderer voice to repeat the explanation. Sometimes I simply shouted, "Get someone in here right now!"

The room my mother was transferred to after nine days in ICU was just as dark and crowded as the one before her breathing crisis. Finding it impossible to move forward head on, the nurses tended to every task by sidestepping between bed and walls, i.v. poles, and monitors. A nurse and an assistant performing a task together required a sideways duet that made them look like a pair of waltzing crabs. My mother's roommate had pressure ulcers and wept in her curtained bed so close at hand that it seemed criminally cold-hearted not to tear aside the curtain and comfort her.

After a week or maybe two, my mother was transferred to a slightly more spacious private room. There was a window that looked down on a courtyard, and I remember the day we finally stood together and looked down at the trees and benches. Not long afterwards she was released to a skilled nursing facility and managed to spend eight hours there before experiencing chest pains. She was transported by ambulance to Baltimore Washington Medical Center.

BWMC was the Ritz compared to the decaying inner city hotel ambience of Washington Hospital Center. While my mother was trapped in her spacious room getting sicker and sicker, I took breaks in the glass-topped atrium coffee shop, swilling caffeine and getting more and more agitated over the fact that I was about to lose coverage under my ex-husband's medical insurance. "My mother's dying and you're putting me through hell," I howled to an Aetna representative explaining for the umpteenth time that Aetna had all my medical records since all I was trying to do was switch from a group policy to an individual one. As I stood in an expansive hallway looking across a neatly mowed lawn into a row of trees explaining my woes in a phone call to a friend, she took charge and somehow convinced my ex-husband to keep me covered a month longer.

Before that month was up my mother was released from the hospital and Aenta approved my individual policy. I returned to L.A. and, after a stint in another nursing home, my mother moved in with my brother and his girlfriend in suburban Baltimore. Near the end of summer last year, she moved across the country to live with me. She's been an outpatient in two different surgical centers since her arrival here, and I've driven her to the emergency room twice. Yesterday morning she was transported to the ER by ambulance. That afternoon was her first admission to a hospital in southern California. A stay in the hospital is never like a hotel vacation, but given the jubilation I felt yesterday when my mother survived her latest crisis, this room with its ocean breezes and view of the mountains seems like the best destination this side of paradise.






Monday, June 24, 2013

If I fall, I might not get up





The good things about today:

I woke up feeling great.
There was time for coffee before I took the man who loves me to the train station.
My mother's doctor had an opening for the follow-up appointment recommended by the ER doc.
I walked on the beach while I worked out the details of that appointment.
I found lots of beach glass while walking and talking.
The doctor's office had a wheelchair.
The blue heron came to the boat dock this evening.

The not-so-good things:

I took the man who loves me to the train station.
My mom is still feeling unwell.
One of her antibiotics made her nauseated and we had to drive to the Dr.'s office with a dishpan in her lap.
She left the doctor's office for a 2nd doctor's office in a wheelchair.
She still needed the wheelchair to get back to the car.
She has new antibiotics and an anti-nausea drug.
She's had a little dinner and some Gatorade.

So there you have it. The scorecard for today. It looks pretty even. But it doesn't feel that way.

Sunday, June 23, 2013

Report from Pillville: Facial Cellulitis

The phrase "opportunistic secondary infection" popped into my head when I took a look at my mom after my return from the gym Friday morning. I think the term is mostly applied to the immunocompromised like those with HIV, but I'm guessing my mom's immune system has a couple hundred thousand miles on it and isn't quite running like a top. Things had been pretty swell here in Pillville with the circulation restored to her feet, and the digestive ills much improved, and the CPAP sorted out. There were little things--like the irritated nose from the oxygen cannula before we finally found the right CPAP mask. There was a spot on her left cheek, then another one, but they healed--more or less. Maybe the plastic from the mask was rubbing her face, we thought Then came a bigger spot on the other side of her face on...was it Wednesday? Thursday she looked a tiny bit worse but assured me she was dabbing the spots with peroxide and neosporin. Thursday night she abandoned the mask for the oxygen cannula.

Friday morning she was still asleep when I left for the gym. I phoned the doctor about a minute after I walked in the door. Yes, the doctor, a geriatric specialist, had an opening. He prescribed an antibiotic, said it didn't really look like MRSA. Are we all going to die? the lovely M asked later. Earlier on the way to the doctor, my mom said she would be really upset if she didn't make it to her birthday, and it occurred to me once again how vulnerable she is at her age with her laundry list of health conditions. Yes, a bump on her skin could be the straw that tips the old camel into the sand. I gave myself a little pat on the back for getting right on it.

Not so fast.

Saturday morning was a repeat. Mom sleeping. Me off to the gym.

Then I come home from the gym. While it would be an overstatement to say the elephant man's sister was standing in my kitchen, the fact was she looked much worse. Pink was now purple. Swollen lips. The healed spots coming back. A new patch of swollen pink creeping down her neck. Her throat was sore, she said. And she had a headache. And maybe the toothache where she had the root canal was back. "Hey, how about you get dressed and we go to the emergency room?" I ask. "No big rush, but when you're ready, let's go." So we go. Three hours later, she has a diagnosis of facial cellulitis and a prescription for a second antibiotic. Really important to nip this in the bud, the ER doc said.


Today things are improving slowly. She can't chew because she can't wear her upper plate and is sustaining herself ice cream smoothies, but the sore throat and headache are gone. The man who loves me is here with a new cocktail recipe that seems to be an effective prescription for me. So it's Sunday in Margaritaville. The warring city state of Pillville is threatening to overtake us, but we have a new thrift store cocktail shaker, and I'm about to lay in a new supply of ice cream. We have a barbeque and a piece of fresh caught yellowtail. We have classic movies on the iPad--close-captioned for my mom. We have so much good stuff here, we ought to set up a stand in the front yard and hand out samples to passersby.



But that said, people, the bear is back.




http://www.youtube.com/watch?v=R6vdMhz5pqY