Mea Culpa, Sort Of

I’m convinced now more than ever that the best way to stay healthy is to never need a doctor. Sounds oxymoronic, but allow me to explain.

My mother wasn’t exaggerating or feigning illness to get attention. Turns out she was very ill. She’d had minor surgery (bladder suspension) a month or two back. The intubation screwed up her throat making it difficult for her to swallow. It also caused a cough. So the doctor gave her a cough syrup with hydrochodone. My mother doesn’t do well on hydrochodone. She gets dizzy and sick to her stomach. She didn’t know the cough medicine contained a drug to which she reacts badly. When I realized what they’d given her, I told her to stop taking it immediately. In the meantime, she went to her primary care doctor, who decided my mother was suddenly suffering from dementia. Never mind she’d been managing all her financial affairs following the death of my father in October, continuing to run his business, and running her household.

My mother also is diabetic and her blood sugar was bouncing around like crazy. Not surprising since she was having difficulty eating. She’s also lost two sons and her husband within eleven months. Perhaps grief and stress had something to do with a scattered memory. Rather than taking any of this account, because she suddenly was confused and forgetful, the doctor reached for his pad and wrote her a prescription for Aricept.

Just because it’s the illness de jour doesn’t mean everyone has it.

My mom stopped taking the hydrochodone and didn’t start the Aricept. She tried to eat to stabilize her blood sugar, but was still having a very difficult time swallowing anything that wasn’t liquid. Her new caregiver gave her soups and scrambled eggs. Her throat continued to get worse.

Two weeks ago on a Tuesday, shortly after my rant, my mother called her caregiver, confused, anxious, and upset. When her caregiver had left hours before, my mother was okay. My mother sounded so upset and disoriented that the caregiver returned and called me from my mother’s side. My mother was sweating and having difficulty sitting up. They called an ambulance.

She was admitted to ICU. My mother clearly was very sick. Since my family members are prone to dying of late, I made a list of all the things I’d need to do over the coming days and weeks. I’ve gotten good at completing these lists over the past year.

  1. Cremation
  2. Obit
  3. Home for cat (my aunt?)
  4. Plan Service
  5. Clean out house
  6. Make appointment with Captain Joey for the ash scattering

I wrote on my list that I didn’t have to stay in Houston when any of this was happening. I could come and go as I pleased. I could stay in my own home. There was no one left to tell me how to do things. When to do them. I could do them exactly as I needed to, and when it was all done, I wouldn’t have to deal with my sister ever again.

I’d gotten so used to everyone dying, I simply prepared myself before I’d heard what the doctors had to say.

It turns out my mother had DVT (deep vein thrombosis). She had blood clots in both legs. This is what happens when you have surgery, are given a medication that makes you sick and dizzy, and you can’t walk. Since she couldn’t walk after surgery, blood clots formed. Unbeknownst to me, my mother had a VCF (vena cava filter) from years back when she’d had her hip replacement, or one of her two knee replacements (one of which had to be redone). A VCF stops blood clots from traveling from the legs to the lungs–pulmonary embolism–often fatal.

If my mother didn’t have the VCF, the doctor said, most likely she’d be dead right now. The universe is cruel and random, but not this time.

My mother spent five days in ICU. Along with DVT, she had a bladder infection and was severely dehydrated. They pumped her full of Heparin and two IV antibiotics, as well as oral warfarin, which she’ll be on for the rest of her life. I traveled to Houston and saw her four days after she was admitted. I forced myself to wait until the weekend. Setting a precedent. Boundaries. This took discipline.

When I saw her, she looked better than she had in some time. Years younger. But her legs were swollen like two balloons. (I’m thinking of Pink Floyd, Comfortably Numb.) My mother didn’t get out of bed for five days. On day five, the physical therapists assisted her in moving from the bed to the chair. They left her in the chair and forgot about her. Two hours later, a doctor came by and found her sitting in the chair, crying. She’d soiled herself and she was in pain. But she couldn’t reach the call button from the chair. She couldn’t get up. The doctor called the nurse. My sister made heads roll. (She’s good at this, and for that I am grateful.) The hospital administrator did a thorough investigation.

In the meantime, the doctor was considering next steps. My mother couldn’t go home. She needed too much care now. It was either a rehabilitation facility (if she was lucky enough to qualify) or a SNF. I hate SNFs. My father was in a SNF after his brain surgery. They’re horrible places. People go there to die. And the staff treat them as if they’re dead already. (Yes, I base my opinion of SNFs on the one experience.)

I pushed the case manager and doctor for rehab. The doctor wrote the orders and the rehab intake person went to the hospital and evaluated my mother. She had to be capable of getting better. She had to be capable of doing three hours of physical therapy a day. My mother feared she was going to be sent to a SNF to die. After all, that’s how things have gone of late. But she was approved for acute inpatient rehab.

What a lucky break. My mother has been needing therapy for years. It took a terrible illness to get her there. But she’s there. She moved from the hospital to the rehabilitation facility last Wednesday evening, where she is currently. It’s a wonderful facility. It was built in 2012 and has all the latest bells and whistles. She’s completed two full days of therapy, and a half day on Saturday; yesterday. She’s now able to get out of the bed, but her legs still are terribly swollen and painful. It could take months for the swelling to go down, and it may never dissipate entirely. Nevertheless, my mother is optimistic and working hard to get discharged.

She’s getting occupational therapy (improves her ability to complete tasks of daily living), physical therapy (increases her strength and mobility), and speech therapy (helping her regain her ability to swallow.) After just two days of therapy, my mother can get in and out of bed and a chair, with assistance. Her swallowing has improved. She’s been able to eat pureed food and even some rice. Her confusion is gone. (As I said, dementia my ass.) I brought her cat to visit yesterday. He was happy to see her. She was happy to see him. Her nurse is lovely. She hugged my mother when she left for the night. My mother tells me she does that every night.

My mother also is benefiting emotionally. She’s been visiting with the other patients. They are encouraged to socialize. And my mother loves to socialize. In turn, she’s less needy and clingy with me. My mother needs people. We’ve got to remedy that upon her release.

We’ve been having lots of conversations about self-care. She’s understanding (with much explaining) of my need to care for myself. I tell her I’m setting an example for her. All the time and energy she devoted to taking care of my brothers and father, she needs to turn toward herself. And I need to take care of myself, first. So I’ve gone down Saturday morning for the past two weekends, and returned late Saturday night. That way I sleep in my own bed with my kitties. And I can get up Sunday morning and do my long run for the week for my C25k program. (Today I finished week 6, “running” 25 minutes without stopping.)

The past two weeks have given me an opportunity to be there for my mother, and also to practice setting boundaries. To take care of myself first. To show my mother what self care looks like.

I had a shrink appointment Thursday. I gave her the update and at the end of our meeting, she said, “Do you want to set something up, or do you want to just call me?” I opted for calling. I think this means I’m now prn. And I decide when it’s needed.

I was wrong about my mother exaggerating her illness. But I wasn’t wrong about boundaries. So yeah, only a half mea culpa is in order.

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