Monday, November 15, 2010

The Other Shoe

Perhaps the other shoe has dropped. Every day, my mother tells me that things have been going so well that she keeps waiting for the other shoe to drop. Me, too. Perhaps today it did drop.

Mom had a really rough night last night. She was up all night with a headache and needing to go to the bathroom every few minutes. She seemed a bit weak, and I was definitely concerned. I sent an email to her oncologist to inform him about her cough and her headache. At 7:30 this morning, there was a knock on the door - the home health aide from the agency showed up one hour early. She looked like she was about 12 years old, and I was really irritated that I was unable to sleep because she showed up early. She sat out on the couch while my Mom napped and the kids slept.

Around 8:00, the house started to come alive. Micah woke up first, and I sat him at the table and made him pancakes. Maya woke up next, and I had DH spend some time with her before I nursed her. My Dad got up and showered, and by 8:45, my Mom was waking up, too. I sent the caregiver in to help get her ready. She was clearly inexperienced...she had a very long list of all the things she did not do (like transfers from the bed or to the wheelchair or commode), so I ended up doing all of that this morning. She did manage to get my mother bathed and dressed (but I had to run in and explain a whole lot of things to her). I can say that I was relieved to let her go after a few hours.

I became worried about my mother when there was blood in her stool...and shortly thereafter, her nose started bleeding. The home health nurse was present and drawing her blood, and we were waiting for PT to show. We had been told by the doctor to call if we saw any signs of abnormal bleeding like nose bleeds, so I gave him a call. As I suspected, he told us Mom would need a platelet transfusion again. We then learned that they expected us to drive to their office to pick up a prescription. Then we were supposed to drive to a lab to have her bloodwork done for type and cross (and wait an hour or so). Then we were supposed to drive to the hospital for the transfusion.

I explained that all that traveling would be a hardship on Mom. They were not sympathetic - all they said was that the transfusion was important and I should want her to have it. I tried to explain that I did want my mother to have a transfusion, but that it would be logistically impossible to jump over all those hoops with her. I asked if the blood the home health nurse drew would work, or if the hospital could draw blood when we got there. They kept insisting that there was no way to do all these things in one place. Finally, they agreed that Mom could get the platelet transfusion if she went to the ER to get admitted, and she would be released after a few hours.

Mom did not like the idea of going through the ER, but when I told her our options, she agreed that the ER route seemed the easiest. We were supposed to wait for them to call us when a bed was available, but after 2 hours, we decided to head in to the ER. When we arrived at the hospital, Mom got nauseated and started to vomit.

Because she wasn't feeling well, they did a CT scan to check for brain bleeds. Good news - no bleeding! They told us Mom had a fever, and the CT scan picked up a sinus infection. They drew some blood cultures to see if Mom had a blood infection, and they expressed concern over possible meningitis. Mom's hematologist and her medical oncologist are working together to manage her case. Both have privileges at the hospital down here, but the hematologist is the lead. They decided to treat Mom with broad-spectrum IV antibiotics. Because of the infection, she was admitted for observation. They are giving her platelets, they decided to give Mom a shot to boost her white blood count (her oncologist was initially against this because he thought it might trigger the cancer cells to grow, but the hematologist felt her white blood count was too low to fight off this infection, so they eventually worked out a treatment plan), and they will monitor her there to make sure she recovers well. We are hopeful that she will be released on Wednesday.

Dad and I stayed with Mom until almost 8:00. We made sure she got dinner, and we think (well, we hope) that they have her medications sorted out. She is in a nice private room on the oncology floor. Her nurses seemed nice, and we decided to hire a caretaker for overnight so Mom would not feel alone or scared. Krystal will meet Mom at the hospital in the morning, and Dad and I will return as well. We had to cancel her therapy and our interview with another caretaker, but we hope to do all that tomorrow.

Dad and I got home around 8:45, and so far both children are in bed. Anyone want to bet about whether we actually get to sleep through the night? I say the good money is on screaming children overnight!

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