Tom's Diary

Summary

Mom’s had a rough go of it the past two months.  She came home in early November, but unfortunately was regaining much of her upper body strength that she had prior to this latest stint of hospital visits that began in late July, 2010.  She’s discouraged however, that neither physical nor occupational therapy produced continued improvement in her ability to get around the house on her own. 

Further, she’s been coping with a urinary tract infection (UTI) since returning home.  Complications from this sent her back to the hospital on Christmas Eve. 

She came home again three days later with more abdominal pain than before the hospitalization, and noticably less upper body strength.  At this time, she’s not able to reliably transfer herself from bed to wheelchair to easy chair, and I can only lift her so many times before my back starts hurting.  Apparently, the attendents did not verify Mom’s physical abilities before sending her home.  So she had to go back to (a different) hospital a day or so later. 

She’s also developed some vision problems (halos around objects in her view and extreme sensitivity to light).  She’s seeing her eye doctor about this. 

There’s been much speculation as to what caused the disappearance of her lower body strength.  Some professionals say it could have been a spinal stroke (a stroke of the spine).  Others suggest that the diabetic neuropathy that’s plagued her for over a decade may have suddenly accelerated and expanded to include not just the sensory (feeling) nerves, but also the skeleto-muscular nerves (those that drive the muscles in her legs).   Then of course, there’s also the original belief that a pelvic hemotoma damaged her nerves.  However, no one in the know in these matters has said specifically what triggered her loss of leg use.  They really don’t know for sure. 

Mom has an appointment with the neurologist in early February.  Coordination problems with her transport service made it impossible to get her to his office before this time.     

We have no idea when she’ll be coming home.  In fact, she may have to return to the nursing facility in the coming days for another round of physical therapy.  She’s not strong enough at present to live here, I’m sorry to say. 

Completed Objectives

• Call Mom’s insurance company and find out what sorts of in-home rehab visits they cover — how many of them over how long of a period.  Sister Mary Ann recommends that we spread these out over the entire coverage period, and not use them all immediately.  The nursing facility is handling all this for us.
• Track the dissipation of Mom’s pelvic hematoma. 

Log

09:15 PM: Nothing significant occurred today. 

Tom Hesley

Related Posts

• Today’s Business: 2011-01-06

Today’s Activities

• Shower.  DONE.
• Cat duty.  DONE.

Log

03:30 AM: Mom called for help.  Low blood sugar again.  I thought we’d taken care of this by lowering her nightly dose of long-acting insulin from 32 units down to 20 units.  But apparently, it’s still too high.  Blood sugar reading: 43.  I gave her some orange juice and pretzels to get it back up.  She quickly and positively responded. 

03:50 AM: She’s back in her bed, and I’m going back to mine.  Good night.

08:50 AM: I’m up.  Mom’s home nurse just arrived to evaluate how she’s making out so far now that she’s home/ 

09:45 AM: The home nurse just left, and I think I’ll do some serious blogging; I’ve gotten pretty behind the last few days with all the business around here. 

10:45 AM: Today’s repeater song:  Mercy Mercy Mercy   by   the Buckinghams.  I discovered this repeater while waiting for sister Jojo the hygienist to get to me at the dentist’s office yesterday.  This is one of so many of those oldies that I’ve heard a million times before.  But it’s brassy and electrical instrumentation and passionate yet harmonious vocals never really grabbed me much until yesterday.  Now, I just can’t stop listening to it.  Hmmmm.  Perhaps it was from this song that I learned to look for women who “knock me off my feet” and settle for no one less capable. 

10:55 AM: Posted the   Mom’s Status: 2010-11-16   piece.

12:00 PM: Watched the 2010-11-14 episode of CNN’s   State of the Union with Candy Crowley   news show, titled: Bush: Two Years Later,   which featured an interview done recently with president George W. Bush along with his brother, Jeb. 

01:45 PM: Called Mom’s PCP with list of prescriptions we need called in.  No one available.  So left message, requesting them to call me back.  I’ll probably have to call again tomorrow, as these requests usually go unanswered. 

01:50 PM: Posted the   DJ Gig: 2010-12-31   piece and began preparing for this performance in earnest. 

03:00 PM: Mom’s home nurse arrived to check her out.  No major problems discovered.  However, the pull mat we’ve been placing underneath Mom in her bed tends to wrinkle up and become lumpy.  Mom then develops impressions on her skin with a similar contour to these lumps.  So we need to locate a better mat; one that does not wrinkle so much, in order to avoid irritating Mom’s skin. 

04:30 PM: Two of Mom’s friends dropped by as the home nurse left.  Also, sister Christine came and washed up the dishes in the sink and changed Mom’s bed for her. 

06:15 PM: Watched today’s episode of   The Young and the Restless   on the DVR.

10:30 PM: Helped Mom perform her preparations for bed.

11:10 PM: Worked the   DJ Gig: 2010-12-31   project throughout the afternoon and evening. 

12:15 AM: Sat with mom in the back room and chatted.  She decided to stay in her easy chair a while longer.  So I’m going to bed.  Good night.

02:30 AM: Mom called for help; low blood sugar again.  Very strange since I gave her only 15 units of the long-acting insulin tonight. So, I got her some orange juice and some cake from sister Diane.  I also helped her transfer to her bed.  Good night again.

05:30 AM: Mom called for help; low blood sugar yet again!  More orange juice and cake provided and I helped her to the restroom.  We may have to quit the long-acting insulin altogether as Mom seems hypersensitive to it these days. 

05:50 AM: Back to bed again.  Have a great night. 

Tom Hesley

Received Mail and Shipments

None today.

Related Posts

• DJ Gig: 2010-12-31
• Mom’s Status: 2010-11-16
• Today’s Diet: 2010-11-16
• Weight Loss: 2010

Summary

Now that Mom’s been home now for nearly five days, and we’re getting comfortable with her new assistive equipment and settling in with her care routines, I can take a few minutes to write out her status.  She’s experienced low blood sugar episodes for three of the past four nights she’s been here.  I believe her dose of long-acting insulin started off too high (32 units).  We backed it down to 20 units after the first couple days.  However, she still developed the sweats and shakes at 3:30 this morning and her blood sugar value was 43.  So tonight, we’ll try 15 units.

She’s getting very good at transferring herself from bed to wheelchair to toilet to easy chair.  We must be careful not to pinch her legs between the board and source surface when sliding the transfer board underneath her.  She already got one cut on the back of her thigh from this. 

She wants to become more active in her life. Last night, she cooked some poached eggs and accomplished most of the cleanup on her own.  Her upper body strength continues to improve and the time it takes for her to transfer herself from one surface to another has dropped to half of what it was when she came here for the in-home evaluation a couple weeks ago. 

She has no fever,   She’s still not very strong, but is getting stronger.  She’s not quite so sleepy these days, as she’s required no pain meds since she’s been home.  Her color is good and alertness and comprehension seems normal. 

Ongoing Objectives

These objectives are on hold. 

• Locate Mom’s living will.  IN PROGRESS.  Given that Mom has expressed her wishes to both us and the nursing staff and doctors, I’ve deferred this item.  With us nearby to instruct them should a crisis arise, there’s less need for a hard copy of the living will.          

Completed Objectives

• Call Mom’s insurance company and find out what sorts of in-home rehab visits they cover — how many of them over how long of a period.  Sister Mary Ann recommends that we spread these out over the entire coverage period, and not use them all immediately.  The nursing facility is handling all this for us.
• Track the dissipation of Mom’s pelvic hematoma.  IN PROGRESS.   We have to follow up on this one. 

Log

03:30 AM: Low blood sugar; a reading of 43.  Gave her two cups of orange juice and a small bowl of peanut butter pretzel nuggets to counter.  She felt better pretty much immediately. 

08:55 AM: The home nurse arrived.  He interviewed Mom and asked us to demonstrate her transfers.  He also provided tips to help lower the effort level of these transfers for both Mom and myself.  His outfit will provide some physical as well as occupational therapy for the next few weeks, he said that a physical therapist will come by sometime during the next couple days, to get Mom started on upper body strength workouts here in her home. 

09:45 AM: The nurse departed and I gave Mom her morning meds. Today, I must call her doctor and request that several prescriptions be called into Mom’s pharmacy; we’re running out of the ones they gave her at discharge from the nursing facility. 

Tom Hesley

Related Posts

• Today’s Business: 2010-11-16

Today’s Activities

• Shower.  DONE.
• Cat duty.  DONE.

Log

08:15 AM: Mom called for assistance.  She had a pretty good night last night.  The lower amount of long-acting insulin seemed to effectively head off a third straight night of low blood sugar attacks. 

08:20 AM: All symptoms of that   whatever-it-was   I had the past few days are gone, and I feel 100% good once again.  Phew.  I’m so glad that didn’t turn ino a third cold for this year. 

08:20 AM: Our cat, Baby, did not scratch nearly as much the last night or two.  Apparently that flea medicine I applied Friday is working.  Hope so, at $15 per dose. 

11:00 AM: Watched the 2010-11-12, 2010-11-13, and 2010-11-14 episodes of   NBC’s Nightly News   news show on the DVR. 

11:05 AM: Sisters Christine and Diane stopped in for five minutes to check on Mom on their way up check out some clothing sales in Altoona. 

02:30 PM: Watched the 2010-11-11 and 2010-11-12 episodes of   Dr. Phil   on the DVR.

02:35 PM: Sister Jojo just arrived to help Mom bathe. 

04:15 PM: Jojo finished with Mom.  No problems with the bath.  In fact, they encountered fewer issues than expected.  There was very little water spilled on the floor, and Mom was able to easily utilize her new bath bench. 

04:45 PM: Watched today’s episodes of CBS’s   Face The Nation   and NBC’s    Meet The Press    news shows on the DVR. 

09:00 PM: Watched a bit of the Steelers game and various news channels. 

10:00 PM: Helped Mom to bed.  Now, talking with   [Emmy]   on the phone.

11:00 PM: Heading for bed now.  So good night.  Back tomorrow. 

Tom Hesley

Received Mail and Shipments

No mail delivered on Sundays. 

Related Posts

• Today’s Diet: 2010-11-14
• Weight Loss: 2010

Today’s Activities

• Shower.  DONE.
• Cat duty.  DONE.

Log

08:15 AM: Mom called for assistance.  I may stay up.  But I’ll see how I feel after I finish helping her. 

08:30 AM: Yes, I think I’ll try and sleep a little more.  Back later. 

09:00 AM: I’m up, and feel a little more improved from yesterday upon waking.  Yep, I think I’ve been playing with the flu.  My joints still feel weak but less achy.

09:00 AM: Sister Jojo and her daughter arrived. They’re baking several batches of chocolate chip cookies, and a few batches that include walnuts as well.  They’re doing it here in our oven because theirs is on the blink. 

10:40 AM: They finished  the cookies and left some nut ones for Mom.  They’re going to a tailgate party and football game today at Jojo’s eldest son’s college. 

10:50 AM: Gave Mom her morning meds, and this one darn cat of ours just threw up all over Mom’s med sheet. Of all the floors and tables she could have picked to get sick, she chose Mom’s med table and these important papers.  Anyone want two cats?  Now, I have a rather gross transcription job ahead of me.  Grrrrr. 

11:00 AM: Finished cleaning up the cat mess.  Nap time.  Back later.

02:30 PM: I’m back up again. 

03:30 PM: Moved Mom into the living room to watch the Penn State Vs. Ohio State football game. 

05:05 PM: Half time.  Penn State is winning, but I forgot the score. 

07:30 PM: Well, Penn State didn’t stay winning for long.  OSU clearly dominated the second half of the game; although I bailed out with nine minutes left in the forth quarter. 

07:45 PM: Sister Jojo stopped by and is helping with Mom.

09:30 PM: Jojo went home and I called   [Emmy]   to take in the last period of the Penguins hockey game together.

10:45 PM: The Pens won their game.  Nice job, guys!

10:55 PM: Mom’s all situated in her sitting room.  She’ll sleep there until she needs a bathroom break.  After that, I’ll move her to her bedroom for the rest of the night.  Hopefully, we won’t have another low blood sugar incident.  I’ve cut way back on her long-acting insulin dose (from 32 units down to 20 units).  That should help. 

11:00 PM: I’m off to bed.  Good night. 

Tom Hesley

Received Mail and Shipments

• Misc. bank papers.
• Advertisement and coupons from Holiday Hair.
• Request for donation to the Salvation Army.
• Kohl’s $10 gift certificate.
• Mom’s auto insurance bill. 

Related Posts

• Today’s Diet: 2010-11-13
• Weight Loss: 2010

Today’s Activities

• Shower.  DONE.
• Cat duty.  DONE.

Log

09:00 AM: I’m up. I feel about the same this morning as yesterday upon waking.  No chills or fever.  This is probably not a cold, as I have no runny nose, sore throat, or cough to write of.  Perhaps it’s some strain of the flu.  My joints still feel weak and achy; particularly my neck.  But it’s closer to normal than yesterday, so I am making progress against this bug.

10:30 AM: [Emmy]   called to check up on Mom and me.  She went shopping today and contacted me from the road.  I couldn’t talk to her much however, because the nurse just got here to draw blood from Mom and go over her current meds list with me.  So I’ll catch up more extensively with [Emmy] tonight.

12:15 PM: Heading out   shopping.   Back later.

03:15 PM: I’m back home.  Checked on Mom, and she wants to sleep a little more.  So I think I’ll do likewise for a couple hours, in the new “bed room” on the first floor in the den.

05:30 PM: Sister Diane briefly stopped by to drop off Mom’s cell phone charger and her long-acting insulin that they forgot yesterday at the nursing home to include with her discharge meds.

06:00 PM: I helped Mom get from bed to her wheel chair.  She’s getting quite good with using the transfer board.

06:15 PM: Sister Christine brought some lasagna for Mom’s dinner tomorrow.  Sister Jojo will stop in later tonight to check on Mom.

07:00 PM: I blogged for the past hour or so and now I think I’ll look in on Facebook.  Back later.

09:25 PM: Watched yesterday’s and today’s episodes of   The Young and the Restless   on the DVR.  Now, I’m listening to the rest of the Penguins hockey game with [Emmy].  Not too much left to go.  The Pens are currently wining, 3 to 1.

10:30 PM: The Pens beat the Tampa Bay Lightning, 5 t0 2.

10:45 PM: I just helped Mom get into bed and gave her her night meds.  Now, I’m going to bed.  Good night.

12:30 AM: Mom called for assistance.

12:45 AM: She’s okay; just a bathroom break.

03:30 AM: Mom frantically called out for help.  Looks like low blood sugar again.

03:40 AM: Yep, Blood sugar reading: 42.  So I gave her a big glass of orange juice, some cheese with mustard, and a slice of sister Mary Ann’s pumpkin cake.  After several minutes, she felt better again.

Tom Hesley

Received Mail and Shipments

• Weekly coupon mailer.
• Verizon cell phone sale catalog.
• Cuna Mutual Group advertisement for their Medicare plans.
• UPMC For Life advertisement for their Medicare plans.
• Misc. bank papers.
• October bill from Mom’s nursing care facility.

Related Posts

• Shopping Trip: 2010-11-12
• Today’s Diet: 2010-11-12
• Weight Loss: 2010

Summary

Now that Mom is settled in at the hospital, she had two grueling sessions of physical therapy today along with one session of occupational therapy.  Her voice sounds very sad; she’s definitely seen happier days in the past week.  She’s still fearful over what might happen once they conclude her IV antibiotic run at the end of next week.   Will the MRSA return?  To reiterate what I said yesterday, Mom wishes to have no visitors during this crucial time in her healing.  We don’t want to risk her catching colds or other bugs from people stopping by.  Plus, she needs to  focus  much energy on her convalescence, and so will likely be very tired after a full day’s workout such as she had today.   

Deferred Objectives

These objectives are on hold until Mom returns to the nursing facility. 

• Track Mom’s extreme weakness and loss of feeling in legs. IN PROGRESS.  This has gotten notably better over the past week or so.  We still feel that the nerve damage is reversible.  She’ll continue full PT workouts (including   standing   exercises on Monday). 
• Monitor Mom’s overall pain status.  IN PROGRESS.  Her pain continues to lessen so that now, she has little in her legs when she’s laying still.  So the static pain seems all but gone.     
• Track the dissipation of Mom’s pelvic hematoma.  IN PROGRESS.   Can’t measure further progress on this one until Mom has another EMG test next week. 
• Locate Mom’s living will.  IN PROGRESS.  Her attorneys called a couple days ago, and want me to visit their office.  I’ll try them again next week, and hopefully, they can come to the hospital for Mom’s signature on these papers if needed.  Or at least, they’ll be able to FAX me the living will.        

Completed Objectives

• Order podiatrist for regular checkups on Mom’s feet.  DONE.  A doctor who makes regular visits to this hospital is now monitoring and treating Mom’s foot troubles.   

Log

05:55 PM: Sister Jojo, [Emmy], and myself arrived at the hospital.  Details of the visit follow:

• 05:57 PM: We arrived on-floor.
• 06:00 PM: Mom says she likes her new digs, but does not like the food.
• They’re performing her blood sugar readings and insulin injections twice per day; once in the morning, and once in the evening. 
• They used tape on her to which she had an allergic reaction.  They’ve given her meds to counteract those symptoms.
• Her overall mood: Down in the dumps.  But she’s somewhat hopeful today since she actually took a few steps, twice, in her physical therapy this morning.
• She needs her blue jacket with the pumpkins on it along with the hat from Dad’s dresser drawer.  We’ll take that up over the weekend.
• Sister Jojo noticed the the swelling in Mom’s feet is down considerably today.
• A resident podiatrist examined Mom’s feet.  He says that the ulcer and the callous on the right big toe look okay.  Nothing there is getting any worse. 
• 06:30 PM: Mom wants to be alone now.  So we’re leaving.  More in future posts. 

Tom Hesley

Related Posts

• Today’s Business: 2010-09-16
• Today’s Business: 2010-09-17

The big decision made today is that Mom is to be transferred to a hospital in Pittsburgh where they’ll conduct an evaluation of the overall condition of her heart, the bacteria that have lodged there, and determine the best treatment option. 

She’s appears better than on previous days; she does not look quite so pale.  But she still feels very sick and weak, and she’s called members of the family several times over the past couple days for help with pain management. 

Now here are the tid bits I picked up throughout the day in phone conversations with sisters and cousin, and my visit to her this afternoon:

• They have Mom on fluid restrictions to avoid working her heart too hard. 
• She’s suffered severe pain periodically throughout today.  They gave her morphine this afternoon to quell it.  But they’re reluctant to administer to much of this drug due to the negative effects it has on her breathing; her breaths grow shallow when she’s under this medicine’s influence. 
• As an alternative, the sisters have found that rubbing and pressing her legs at various points soothes the bulk of the pain.
• 01:30 PM: She had some lunch today but could not keep it down.  Cousin observed severe right leg pain in Mom. 
• 02:30 PM: They administered Loritab for the leg pain. 
• 03:00 PM: But the pain persisted.  So cousin asked for more pain meds for Mom.  Further, Mom’s stomach was sick again. 
• 03:30 PM: They administered morphine. 
• 03:30 PM: Mom’s oxygen level was a bit low; between 90 and 96.  But the nurse cousin was not alarmed at this; particularly since Mom has been breathing room air (no additional oxygen) all afternoon. 
• 04:10 PM: Her chart is inaccessible at present while they prepare it for transfer to Pittsburgh along with Mom.
• 04:17 PM: Mom refused the scheduled pain meds, saying that she’s too sick at the moment. 
• 04:20 PM: Mom’s medical insurance will definitely not cover a flight to Pittsburgh unless her situation were to be dubbed as ‘urgent care needed.’  The doctors don’t feel that she’s urgent, saying that the bumps and jostling in a helicopter are likely just as dangerous to her heart as that of ground transport.  So we’re going the much cheaper route of ambulance-provided transportation for Mom. 
• 04:40 PM: Mom refused supper as her stomach is still unsettled.  But she did drink some diet Pepsi. 
• 05:00 PM: Blood sugar reading: 141, and they covered with 4 units of insulin.
• 05:00 PM: Mom’s transfer case worker stopped in to say that arrangements were underway for Mom to be moved to Pittsburgh.  However, it’s not likely that her insurance company will fund a life flight there.  The case worker is checking with the doctors on this and she’ll come back presently with their answer.
• 05:00 PM: The morphine seems to be working; though Mom still has some pain in the right leg.  A cousin, who has extensive background in nursing and anesthesiology visited Mom today and feels that these pains are likely spasms.
• Nausea meds taken.  Though her pain may be less, she still says that she feels very sick overall.
• Mom’s on several different pain meds but unfortunately, they’re not removing all of the objectionable part of the pain.  We may have to ask for another pain management strategy once she gets to Pittsburgh.
• Finally, she’s been eating ice a lot today; though her hemoglobin count has not fallen further since yesterday. 

Tom Hesley

Related Posts

• Today’s Business: 2010-08-09

11:00 AM: Mom is scheduled to have a pick line installed today that should make administrating intravenous medications to her easier as she won’t have to have so many IVs applied. This will reduce therefore, the bruising on her arms.

Yesterday, she suffered much pain in the legs due to her diabetic neuropathy, and they’ve begun pain medication to remedy.  She appears to be continuing her slow recovery from the MRSA infection.  We must wait until she’s stronger to discuss her options for complete eradication of the bacteria. 

Again, should any one wish to send her get-well cards, just send them here to the house and we’ll take them to her when she’s able to enjoy them. 

Tom Hesley

Related Posts

• Today’s Business: 2010-08-06

09: AM: Mom went to hospital in ambulance on Friday. Symptoms: Shortness of breath, fatigue, sleepiness. Low hemoglobin and blood pressure were discovered. So far, she’s received 2 units of blood. Internal bleeding found.  So they stopped her coumadin (blood thinner) for now until they rule out other causes.

Visited yesterday. Suster She feels better but is still weak. They think that the bleeding has stopped.  But upper and lower GI scopes are planned for early next week to rule out tumors and other lesions inside.

We took her cell phone cable to her.

Facebookers: Forgive the delayed post. But I wanted to wait until sisters returned from vacation, at Mom’s request.  Now that they’re home, I’m sharing.

10:00 AM: Mom called to say that she experienced a drop in blood sugar this morning (53 was the reading).  However, she’s recovering but is very cold.  So she asked for a sweater the next time someone goes to visit her.  Sister Jojo is going up in an hour or two.

01:00 PM: Sister Jojo called to say that she has visited Mom and though her blood sugar is at normal levels again, she still feels shaky and cold.  The nurses are investigating.

05:00 PM: Sisters Christine and Diane report that Mom is being moved to ICU and that she’s very sleepy.  So nephew Garrett and I will not visit her this evening.

09:00 PM: Mom has been moved from a private room to ICU. She’s developed a temperature over the past 12 hours that has the doctors puzzled, although they think it might be a blood infection. They have however, ruled out the blood she received yesterday as the infection source, saying that if that blood was contaminated, that she would have developed symptoms much faster than she did. She’s also unable to stay awake and doesn’t feel very good when she is lucid. We’ll visit her again tomorrow to follow up with the doctors and nurses. Thanks to all for your concerns and well wishes.

09:55 PM: I FAXed Mom’s power of attorney papers to ths hospital, and we’re planning to visit there tomorrow to stipulate that they are not to put Mom on a ventalator or other machines to keep her alive, per Mom’s wishes.

Tom Hesley

Related Posts

• Today’s Business: 2010-08-01