Ups and downs today.
On the up side, today is Jean’s 22nd birthday!!! Happy birthday Jeano!!
On the up side totally, mom was awake, alert and talkative today. She even laughed at some of the things dad and I said to her. Claudia began mom’s day and found her to be awake, alert and talkative too. Mom ate all her breakfast, lunch and dinner (not independently). We didn’t do much in the way of formal work with mom today. I began to do the writing boards with her but that was around 2:30 and she fell asleep for a bit (just a nap). We talked a lot, hugged a lot, she stroked my and dad’s faces. One of the male nurses said he had to leave the room yesterday because he got so choked up looking at mom stroke dad’s face as he whispered loving things to her. These few days have been medicine for dad…seeing mom awake, alert, talkative and interacting with him so much.
On a slight down side, the speech therapist is keeping mom on pureed food (she never even started with this texture of food before) until Monday. The therapist realizes that mom’s trach displacement, allergy coughing…all contributed to her aspirating some small pieces of food in her trach line the other day. Mom has been fine since. Hopefully, mom will be back on mechanical soft food again on Monday as promised.
On the up side, mom’s wound on her sacrum is doing better. AND, it is NOT a pressure wound (bed sore). It IS an abrasion type of sore most likely due to sitting in feces or urine too long. The wound is pink and looks good even though the first layer or so of skin is still off.
On the down side, terrible side… The burn under mom’s arm is open and looks ulcerated. Please pray for healing. About a week or two ago, one of the CNAs found a cyst under mom’s right arm. She was prescribed keflex and warm compresses. One of the nurses put a scalding compress on the cyst and burnt under mom’s arm badly. At first, the site was bright red and tender (about 5 inches around…maybe more). Then, part of the site cleared while the other part blistered. When I looked at the wound today, it is now, bright red with white rings and 2 1 inch round yellow, pusy looking centers. I inquired about the wound and found out that no wound care specialist had seen it to date. So, I asked for the wound care specialist to come check the wound however the person is not available until Monday at the earliest. Mom’s night CNA, in particular, is very diligent about caring for mom’s sacrum wound. She positions mom special ways and checks on her constantly.
Mom had a huge coughing fit after dinner was finished. She kept coughing up a lot of stuff and needed to be suctioned a lot. Finally, a respiratory person gave her a breathing treatment. She fell asleep for about an hour then and looked peaceful, but woke up coughing again after that.
On the up and down side, the results of mom’s CAT Scan came in today. As per the pulmonologist, respiratory therapist, and building MD, a comparison of a prior CAT Scan to this one (examined by the hospital) showed that mom has “Normal Pressure Hydrocephalus.” This means that the ventricles (tunnels) that run through the brain are swelling. Inside the area of swelling is fluid…some of which is spinal fluid. Right now, the pressure this is causing on the brain is normal (though it IS DEFINITELY causing unusual pressure on the brain). But something must be done to stop the swelling. The swelling is a residual side effect of the stroke and aneurysm (with a head injury, side effects can happen many years later). If the swelling is not controlled, then the fluid can accumulate and cause undo pressure on the brain which would go as far as the skull before compressing back into itself…fatal. Right now, mom is not in critical condition but she needs to see her neurologist asap. It appears that the plan would be to have a shunt installed in mom’s head again. The shunt maybe a temporary, exterior shunt (in which case, mom cannot go back to the facility she is in because they don’t take people with exterior shunts). Where she would stay while she had the shunt is unknown right now. Maybe the hospital??? The neurologist would know best. The other option is an internal shunt which but inside her head and forever. If she gets this shunt, she can go back to the facility she is currently in now. The next issue is that there is only a 14 day bed hold with Medicare/ Medicaid. Mom already has 13 days in the hospital from her last stay around Christmas. This means that she has only 1 day left. What that means is that if someone needs a bed and hers is the only one available while she is in the hospital, the person gets her bed and room. Her things are packed and put in the basement until her return, at which time, she would get a different room AGAIN…. (that would be her 4th room change). If there are no empty beds when she is ready to return to the facility, then she can’t go back there and has to go to a new facility. Hopefully, the room thing won’t be affected.
On the up side, the pulmonologist told the respiratory therapist that a procedure like this can correct the problem and be like someone “turning on a light switch” in terms of mom’s symptoms of being awake and then out, and sleeping so deeply she can’t be woken up, and having periods of apnea, and all her troubles and problems. I pray this is so.
Mom had difficulty breathing due to many, many secretions tonight so I stayed with her late into the night. We played “church music” and I held her hands and we “bed/chair” danced and sang together. We had church tonight. Mom, me and her roommate. Even though she was coughing on and off, she sang and prayed. At one point, the filter in her trach line became saturated but it was so saturated it didn’t like it was saturated at all…mom began to labor to breathe and then her total volume went to 0 and then to maybe 75 and back to 0 again. I held her tightly and rang the call bell and yelled for help. Help was slow to come but finally did. Mom was able to breathe on her own!! Sort of like a woman in labor --- breathing like they teach us ladies to do in Lamaze classes. She was fine. They changed the filter and suctioned her and she was at peace immediately. Shortly after that, she continued to hold my hands and sing and pray and then she fell asleep.
I tucked mom in tonight and prayed with her and anointed her with oil as always.
And still we look forward. Still there is hope.
"Don't ever be afraid or discouraged...Be strong and courageous" Joshua 10:25
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