Wednesday, December 9, 2009

Hospital Hospitality

Ever since Friday, Nov. 6, my mother and I have been spending a lot of time together. We would have enjoyed it much more if it hadn't been in the hospital and doctor's office.

It all started simply enough. She fell and hurt her foot. No big deal. There was a lot of swelling, but she got x-rays and nothing was broken. Her foot was so sore and swollen that we rented her a wheelchair. However, the swelling never went down.

Instead, her leg began to swell also and turned red. Then this weird, clear yellow liquid started to drain out of a cut just below her knee. She said that she had put some salve on the cut, and that was why it was yellow. My mom has been smoking a couple of packs of cigarettes a day for the last fifty years, so I teased her that it was excess nicotine. It wasn't pus, so I was not too concerned.

I figured the leg swelling was from sitting in the wheelchair all the time, that it was restricting her circulation. I told her to lie on the couch with her legs propped up as much as she could, which for her was about once a day for five minutes.

Then a blister formed on her foot, and it started draining the same mysterious yellow liquid. . .


I got very scared and took Mom back to her doctor. We didn't even get to see him. The nurses looked aghast at Mom's foot and leg and sent us directly to the emergency room. There we found out that she had developed cellulitus. The doctors and nurses who passed by her all said, "Ooooh!", recognizing a dangerous infection from 25 yards with one eye closed. Meanwhile I died a thousand deaths of pure shame for being so stupid as to not recognize such an obvious problem.

Still, we realized that now we would get it resolved, and she would soon be back on her feet, performing her normal routines. We guessed that she would be given IV antibiotics, stay in the hospital overnight, then go home. Our biggest concern was how to sneak her out of the hospital on a regular basis so that she could smoke, because combining her hospital/doctor anxiety with nicotine withdrawal can be devastating on my mental health.

Obviously, we were ignorant. Doppler tests revealed that she had no blood flow in the affected leg from the groin to the knee. The other leg had a 95% blockage. More tests revealed an abdominal aneurysm and a significantly blocked left carotid artery.

Drat and double drat!

The initial ER visit turned into a 6-day stay to get the cellulitus treated and to do an atherectomy of the affected leg. The atherectomy involves going into the artery in the groin and motoring through the artery with this little tool that shaves and collect the plaque from the artery walls.

The next week we saw the vascular surgeon in his office. He divided up the two remaining blockages and aneurysm into individual projects, so as not to overwhelm my mom. Despite his good intentions, she nearly collapsed when he told her he wanted to do the atherectomy on her other leg at the beginning of the following week.

She tried to convince him that the arrival of company at her house on Dec. 13 would prevent her from being able to rendezvous with him the first week of December, but he would have none of it. She meekly listened as he reminded her that he had told her from the beginning that it was a waste of time to address only part of the problem and that they needed to keep making steady progress.

So it was scheduled. Although it was a day surgery, the recovery from this second atherectomy was much longer. She had a lot of pain, swelling, and bruising that she didn't have with the first one. Somewhere during that time, we returned to the hospital for a CT scan with dye of the abdominal aneurysm.

Yesterday we went back for the carotid angiogram, which shows exactly how much blockage there is and where. It involves going back into the artery in the groin, injecting dye, and I really don't know what else. That information got lost in all the medical details that I have been trying to absorb lately. We both thought it would be a walk in the park compared to the atherectomy, but again, we were ignorant. We arrived at the hospital at 6:30 a.m. and got back home about 6:30 p.m.

Next week we go back to the vascular surgeon's office for him to go over the results in detail, tentatively schedule carotid bypass surgery, and hopefully tell us the plan for the abdominal aneurysm. Also, we will be going to the cardiologist for a work-up to make sure Mom is in good condition for the bypass. And that is the week when the company arrives. Mama ain't gonna be happy.

Overall Mom has received wonderful care. We have enjoyed getting to know the nurses and have been lucky to renew acquaintances with some on return visits. One male nurse that Mom had two times is a particular favorite. At first she had trouble understanding him, which frustrated him. He asked me why she had a problem and wanted to know if she was hard of hearing.

I asked him where he was from, and he said, "China."

"That's why," I replied. "Are you from north China?"

"Yes," he said.

"Even worse," I said. "Mom's from south Alabama. If you were from south China, she could probably understand you better."

The only real negative we encountered is that the nurses seem to consider TV viewing as part of the standard of care and can't quite believe that Mom doesn't want it. In fact, I have felt on a few occasions that Mom was going to be asked to sign a medical release confirming that she had denied TV treatment at her own risk. Even in recovery they are convinced that you secretly long for television but are just in too much pain to express it properly.

After the second atherectomy, we arrived in the curtained recovery cubicle to find the TV already on and tuned to "Ellen". Dear Ellen had some rock and roll guest, and when I suggested to the the 50-ish nurse that the performer was not Mom's favorite, hoping she would take the hint and turn the thing off, she replied, "Oh, that's so and so," correctly identifying the rock star. Then she turned back to the computer. Finally, I was able to locate something with which I could reach the power button and successfully sent Ellen into blackscreen oblivion.

The bright side of all this is that we have discovered that morning doctor's appointments usually result in finding ourselves far from home right at lunch time. Furthermore, we have learned that a large bowl of steaming pasta with shrimp and alfredo sauce works more effectively on mom's doctor anxiety than IV morphine and doesn't cause the unsightly bruising.

Seriously, though, we have so much for which to be grateful. It's a wonderful life!

1 comment:

Emily G. said...

Goodness! What a story! I will be praying that your mother's remaining procedures go well and she completely recovers her health. I hope you are holding up okay. In-and-outs with the hospital gets stressful fast.