Monday, April 30, 2012

Day 46

Today was a better day than yesterday....I got there about 1pm and she was lying in bed without oxygen again.  Her oxygen numbers were good enough not be on it.  Her lunch tray was sitting untouched on her table.  I tried to get her up and she said..."I'm cold" so told her to get up and she can sit on the patio and eat her lunch, she got in the wheelchair.  I took her to the patio with the help of a CNA.  It was warm out there and my mom ate a little...but she drank almost all of her liquid.  She was very clear today while I was there.  The speech therapist came outside while she was eating and talked to her about keeping her mind busy which would help to keep it a bit clearer.  Jen said that she would put together a packet to keep my mom's mind busy and she said that she was writing an order to get my mom to the dining room for lunch each day.  WOW my mom agreed to that.  Jen thought that the interactions would be important not to mention that she eats and drinks a lot better when she is upright instead of lying in bed.

I decided to try a new strategy in regards to the "mask" and not bring it up....so I didn't BUT my mom did.  She was talking to Jen (speech therapist) and she said that she had been told that the best way to keep her mind clear was to wear the Bi-PAP....did I hear that correctly??  Jen confirmed what she was saying (I said nothing) Jen explained how Co2 can be very bad for all systems in your body and using the mask at night would help to keep the good air.  I did ask/say that I thought that this mask was only going to be temporary until she builds her strength up again.  She already was doing so good without the oxygen tube for a long part of the day.  We shall see.

Then it was time for therapy...I decided that this was a good time to run to my moms house to get a couple of things she needed, an iced latte and a croissant warmed up.  When I walked in she was walking down the hallway back to her room.  She was standing taller than usual, she is usually hunched over...still she had no oxygen on and her number was 98 which is normal for everyone.  Wow what was going on? was she going to get to go home without oxygen?  Tomorrow we will know if they are discharging her on Thursday...we shall see.

If anyone if available to peek in on her tomorrow morning that would be awesome as I am getting a root canal and probably can not get there anytime before 130pm...thanks all.  She just does so much better when she is socially stimulated.

Good night all

Sunday, April 29, 2012

Day 45

Today my mom had a few visitors, I could see the names in the book.  Someone brought her home-grown roses.  I arrived about 1pm, I had to wait for a sitter as it is easier without kids, Sonia had just arrived too.  We walked into my moms room together.  I had talked with to my mom about 9:15 and she was eating breakfast and I told her that I would be there in the early afternoon.  When we got into her room she was very asleep and didn't wake up for us at all.  Her lunch was sitting there completely untouched.

Evelyn came to me and told me that my mom had been up for awhile and had been to physical therapy..ok so she is tired from that.  After about an hour Sonia decided to leave.  My mom had heard some of our conversation as she would interject little comments every now and then.  Evelyn told me that she had been waiting for me to arrive...ok so I was here...and she was sleeping and not about to wake up...I tried and tried - so I just grabbed her laundry and left at 2:30....I am not going to lie I felt frustrated.  I could tell that she "probably" had not worn that stupid mask which meant that she didn't wear much oxygen.  I think it is a vicious circle...no mask....no oxygen....mental status a bit down.  I can not help but worry about her home coming...although I do believe that home is her best bet but I am concerned none the less.

I have not noticed her trying to do any crosswords lately...or reading too much.  I think SNF's are not good for one's psyche because the patients tend to sit in their beds or sleep a lot which reeks havoc on their night time sleep - another vicious cycle.  I sure hope that getting home will cure my mom of that and that she will do what she needs to do to continue healing.  It has to be so hard to have been away from home for so long and to be in a hospital and not on vacation.  She has been through soooooo much but I really feel that it is important that she not wallow too much in that....that she redirect her frustration into getting on her feet completely.

Virginia and Darryl went to see her this afternoon and said that she was great, sitting and talking to them for awhile...they stayed about an hour.  Virginia said that they chatted about lots of things and had a nice visit...and she promised my mom that she would make minestrone soup when she gets home....something to look forward too.  Virginia did bring up the dreaded mask...and my mom told her to "go to %$&*" if you know my mom then that is so her....and Virginia told her to not hold back and tell them how she feels... I think that I am going to try not to bring up the mask - do it like my kids....IGNORE it and see if it takes care of itself - she is going to do what she is going to do....

Take care all.  Thanks for everything




Saturday, April 28, 2012

Day 44

Saturday....I decided not to call before I went since yesterday she accused me of waking 5 people.  Thought I would wait and see what she would say.  I arrived there about 11am and my mom was fast asleep her breakfast pretty much not touched....Evelyn, the CNA, came in and told me that my mom had a shower...that is why she is tired??  She opened one eye and I said hi...she went back to sleep.  After awhile I asked her if I could put the mask on to see how loud it was (she makes it sound like it is a loud as a freight train) I put it on her and watched my watch....I am not kidding when I say there was NO sound...I kept checking it as I didn't think it was on.  There is a little sound in the mask of air moving but it is silent when it is on her face.  Within 10 minutes she was messing with it....I said "no just leave it alone", 5 minutes later again I said the same....3 minutes later it was ripped off.....I am not sure what to do about it.  When she gets home I am going to take her to Apria and let them tell her everything about it and try on a bunch of masks.  I am interested to see how this goes.

She snoozed off and on until 12:30 then she had to get up to use the restroom...so I really didn't let her lay down again...lunch came and she sat at the side of her bed...she at first tried while she was laying down but I reminded her that she could choke in that position.  So she gave in and sat up although she didn't eat much...she did take a few bites.  I kind of forced her to drink water, OJ and 7-Up.  The PT came in and said that she would be in a 1:00 to take her to therapy....right at 1 my said "I have to go"..."go where?" I said....she just pointed out the door....ok.  The therapist came in a little after 1:30 and she said that she would wait and come back since my mom was eating...my mom started to say "OK" and I chimed in and said "oh no she's done eating" so off she went.

Today she did leg exercises with weights...and a balloon to squeeze between her knees (note to self - cheap way to tighten up the inner thigh).  She seems to get easily distracted by what is going on...she was paying attention to the others in the room and the PT had to redirect her a few times (this is just like preschool).  She did good maintaining her Oxygen level while she worked out - (she wasn't even wearing it).  She walked all the way back to her room again.  They left the oxygen off and her numbers stayed in the ok range.  Maybe as long as she stays elevated then she can maintain good oxygen.  She does get a hospital bed at home so she can sleep at an angle.  Tonight my kids and I waited at my mom's house for Apria to deliver a bed, commode, and wheelchair...they were supposed to come at 7pm and got there at 8:30...my girls are usually in bed by 6:30pm...so they were way off.

It is 10:30pm and I just called to check on my mom and they say that she walked from her bed almost out of the room.....she has an alarm on her because they do not want them to get up on their own.  Also she had taken her mask off already.

Just in case you need it here is the exact address to Windsor Elk Grove 9461 Batey Ave. Elk Grove, Ca 95624

Thank you everyone for your visits my mom is pretty good about remembering who has been there.  Take care.


Friday, April 27, 2012

Day 43

Today I went to Windsor about 1'ish.  My mom was sitting at the side of her bed leaning on her table...with her lunch partly eaten.  I could see that the had only taken a couple of bites...she really isn't eating much.  I really want her to drink her fluids but she doesn't do that too good either.  She was pretty good about drinking a fair amount of water before this all happened but not right now.  She was dressed in regular clothes as compared to yesterday when she had a hospital gown on.

My mom said that Arlene had been there with another friend (I can not remember her name-sorry) and she said they had a nice visit....

I had called on my way to work to here how she had done with the mask....no surprise that she had pulled it off many times.  I told them to leave it on until she is awake instead of shutting it down at 6am they said they would.  I also told them to put it on earlier last night which they did....they put it on about 8:30 and by 10pm she has taken it off 2x and one of the times totally took it apart and the mask ended up under the bed.

After a few minutes she told me a story about nurses yelling at her because I have been calling in the middle of the night to check on her....I assured her that I am not calling as I am asleep....she had me go and get a particular nurse (which I did)..she asked the nurse about me calling....and then retold an interesting story that really sounded like a dream....the nurse just nodded and winked at me.  She made me go out and asked the front desk...and her morning therapist says that she had told her the same story.  Interesting...she is still not completely clear although once she starts getting into conversation everything clears up and she can keep up with most of the conversation.

Her occupational therapist came in to take her to therapy.  She didn't really want to go but I told her that I was going with her and she said "well ok then".  The therapist told me that she has been working with my mom and dressing and grooming....she got my mom's hairbrush and handed it to my mom...who turned and tried to hand it to me so I could brush her hair....the therapist said "no mame you brush your own hair...come on now" and my mom did...I giggled a little.  In the therapy room they removed the oxygen and my mom maintained a good level the whole time.....she had to do 3sets of 10 arm lifts straight up with 2lbs weights in her hands...it was funny that when the OT turned her back my mom quit and said "I did 10"....I "helped" her realize that she had only done one set so she did 2 more sets.  She also had to stand and catch a beach ball and then throw it back all while maintaining her balance...she did good.  Then the OT had me hit a balloon to her in all directions and she had to bat it back....when she was done (she said she was done and sat down) she said "see I beat you" to me.  Ann and Ray arrived at the end of her session and the therapist had my mom walk down the hall to the main room where the 4 of us sat and talked.  My mom was very clear at this point, keeping up well with the conversation and interjecting when appropriate, which makes me believe that she will be fully back at some point.

Anyone who would like to visit would be great....she does a lot better when she is kept engaged...she may not recognize you at first glance especially if she has just awoken but soon it all becomes clear for her and she is right there in the conversation.

You all rock...thank you all for your support.

Thursday, April 26, 2012

Day 42

Tonight marks the 6 week mark since this all began.  My mom ruptured her abdominal aortic aneurysm at 7pm on March 15...hard to believe that it has been 6 long weeks.  Her surgeon said that the pains of surgery would be gone by this time and I think he is right...BUT he also said that at the 6 month mark she would feel more like herself.  I think that with her setbacks it could take just a wee bit longer.

Today I called at 7:30am to check on my mom on my way to work (day 2 - it feels good being back) and they told me she did OK last night.  Pulled the mask off a few times but had a good dinner and was friendly and happy.  She was still asleep this morning so I didn't try to talk to her.  I didn't go to Windsor until the "Care Conference" at 2:30pm.  This meeting was just like and IEP (special education) meeting.  The 3 people present each had things to say about my mom's progress....the kitchen lady (dietician) said that my mom was still getting a no salt added diet (not easy for someone who likes salt) and they were still chopping it up to make it easier for her to chew and swallow - she said that my mom is eating about 50% of her diet.  The social service person wanted me to fill out another DNR form...the 3rd one at this place...they are worded so crazy that it gets confusing when filling it out...hopefully that was the last one I had to fill out.  The other person there was Joesphil, the discharge coordinator for Kaiser patients, she read the report of the physical therapists.  She said that my mom had been walking 250feet with a walker and no assist from the therapists...that she walks to the right (a side winder) and she needed to verbal cues to stay "inside" the walker as she tended to lean too much onto it.  They were currently working on her oxygen saturations (keeping her oxygen up to normal without the use of O2).  As I sat there I thought "ok so when is she being discharged?" because that wasn't even brought up....I thought that is what this was about.  We talked about her equipment that she already had and what she may need when she comes home.  They told me that the therapists would be training me on how to take care of her.  They talked about medic alert buttons and hospital beds and wheel chairs.  There would be a therapist to come over about 2x a week and a visiting nurse to check meds.  I shared with them how I am having a hard time completely tusting any SNF right now and that I question if the staff is telling me the truth or just telling me what I want to hear...they just listened. Then they asked me if I had any questions....YES "when is she being discharged?"  the answer was that there will be another meeting on Tuesday and then most likely it would be next Thursday....ok - so I have time to get it all together.

Shirley was with my mom this morning and she told me that my mom wasn't as "awake" as yesterday.  We all go in day to day and wonder what is the day going to bring?  Today seemed like a down day, my mom didn't really want to get out of bed.  I think today was a little "pity party".   She was a little pissy with me and told me that I was scaring everybody into believing that she was going to die...I told that maybe the events of the last 6 weeks scared them and not me.  I arrived in her room about 3pm and she was dozing on her bed.  I noticed right away that she didn't have her oxygen in her nose...I asked her and she said that "I don't need it anymore" - really??  So I excused myself to ask a staff person.  The nurse told me that they were testing her on room air and that my mom had a good number when she finished with the therapist - her number was 98 (yesterday Shirley told me that her number was 99) so I supported them trying especially after she came in and tested her and it was at 92 and when she breathed deeply it went up to 94.  I did call Sonia, who was coming next, and asked to have it checked before she left.  Thank goodness they had it checked (even though the nurse was sassy at them for asking) because her number was done to 86 and my mom was hallucinating that there were 2 men in the yard and a scary man in a trench coat trying to get into the place.  They told the nurse and I also called to talk to them about it.  I then asked to talk to my mom and she sounded ok just tired.

I talked with the staff before I left about putting the mask on earlier and they said they would and one of the CNA's told me that my mom had "reminded" them last night.  I was in shock and he said really - that when he had gone in to check vitals she said that no one had put the mask (she motioned over her face) on...WOW really........then quit pulling the f'en thing off mom.

I am hoping that she continues to get better with that mask....and I keep thinking that her confusion will get better at home...but I can not help but be nervous about her coming home and maybe 1 week more will help her....RIGHT???


Wednesday, April 25, 2012

Day 41

Today...I returned to work.  It was good to get back but I can not help but feel that I would rather be at Windsor watching over things.  My mom stays awake more when someone is around otherwise she tends to lay in bed and sleep which is bad for her Co2 retention - vicious cycle.

My mom still complains about the stupid mask and the nurse told me that she pulled it off so much last night that the night nurse had to go in every hour instead of every two hours.  Bummer I guess the chat about the importance was not enough.  I still worry that she must not totally get it and wondering if it is because she just isn't all there yet OR is because she is stubborn (I am thinking a little of both).  So today I went on a hunt for a smaller mask and I found one.  I went back to WIndsor to try it on her and "show" her that it is much smaller then the one she has.  The man at Atria Medical told me how to see if it was the right size and if it wasn't then a "small" could be ordered.  I think she needs the small but I am waiting to talk to the staff in the morning to see if she left it on.  PLEASE mom just do this - the alternative is not what you want...I know, you told me.

My mom told me that she was tired....nothing new - she usually gets tired after lunch.  She told me that she had "really" worked out and she had been very busy with the therapists.  Shirley told me that my mom had walked a long distance with a walker and the therapist, she had also done some stretching.  SO I understand that she is tired.  They put her on a "normal" diet...she had been having all of her food ground up so she wouldn't choke (a fear the doctors had especially after being intubated her seizures) - because she had been intubated she stands a bigger chance of aspirating.  She was happy about the change and said that the food was a little better.  I still worry that she doesn't drink very much that is another reason I like being there....I can remind her.

Tomorrow at 2:30 I will be attending a "Care Conference" for my mom.  I guess they will be telling me what my mom will need when she goes home.  I am still thinking about how it can all work.  Will she be able to be alone?  Will she need someone with her all the time?  I am sure that she will need someone there most of the time for the first couple of weeks to a month.  Tonight I talked to Deborah - my friend and fabulous nurse - and she said that she believes too that my mom will be able to be alone at some point but for now it would be very important that she be not alone until she is really steady.

Tomorrow will be very informative.  Thanks for visiting my mom...it really means a lot.  And thank you all so much for the "cyber" support I really feel it.

Tuesday, April 24, 2012

Day 40

40 days...hard to believe.  Today I got a little done in my own house which felt good...I wish laundry would do its self.  So I arrived at Windsor about 11am.  I had called my mom earlier to let her know I wouldn't be there as early that I was doing some laundry including some of hers so she was fine as she was in need of the clothes I was washing.

I went in looking for Josephil who was still in the meeting and I let the desk know that I wanted to talk to her before she left...they said they would give her the message.  I talked to mom a little and helped her get dressed.  She is still unsteady but able to stand and move from chair to bed with little help.  I asked her how she slept and she ok but she took the mask off a few times.  About then Shirley arrived with In & Out Burgers and milkshakes.  My mom ate a cheeseburger and talked about how slow she is eating these days - she has always been a slow eater but now it was even slower.  She finished about half and I the other half.  We all sat and talked about my moms dislike of the mask and again Shirley and I repeated how important it was and my mom got frustrated with us and said that we had no idea how bad the "bastard" was...we both agreed that it may be annoying but many people that we all knew used one.  I told my mom that I would sleep in one to see how bad it is.  She seemed to be having a hard time coming to grips with the changes that have occurred (her battle scars).  We kept telling her that is a matter of life and death that she wear it or one day we would find her unconscious and then what??  She asked if we would wear one - and I said ABSOLUTELY that if that was all I had to do to stay alive I most certainly would wear one...to get to be with my family....YES no problem.  Shirley said YES as well.  My mom seems to be in a bit a pity-party again....after the initial surgery I heard her say many times how hard it is and how big of a deal she had.....There is no doubt that it all sucks.....BUT, as I told her, the alternative is much worse.  I was really frustrated and kind of hurt thinking that she didn't want to live bad enough to wear the f'en thing.  We shall see what happens.  I am concerned about how she will handle it at home when she takes it off in the hospital at least there are nurses making rounds every 2 hours and can put it on.  I am hoping that she gets used to it before she goes home.

Overall she seems pretty clear although she does get confused off and on...and sometimes when she is trying to explain something I can see that she knows what she wants to say she just can't get it out correctly and get frustrated when I ask for clarity.

I talked with Josephil finally and she told me that they decided to continue their work with my mom and that there would be a "care conference" on Thursday that would include me and they would talk about her needs and how they can be met at home....that she would probably be discharged Monday or Tuesday of next week.  Wow...there is a lot to do before she gets home....I am going to get LifeAlert hooked up and equipment will need to be delivered, a care person figured in, friends to come and go and someone to sleep there at least for awhile.  I really believe that much of this will be temporary....I just hope that my mom wants to live bad enough to wear the mask but it is ultimately her decision.

Well tomorrow I will try to return to work so any visitors in the morning would be great....I will be there in the afternoons.  Thank you

angels angels everywhere....Kathy and Steve, Virginia and Darryl, Shirley and the staff at Windsor