A night on the floor

I'm going through my normal morning routine, reading the paper, eating a bowl of cereal and having a cup of coffee.  There are normal noises in the house for this time: Nana's oxygen enricher, coffee pot making noises, refrigerator running, that kind of stuff.  I hear a noise coming from down the hall leading to Nana's room.  Our cat gets put to bed in our downstairs bathroom at night, so it could just be her starting to make her "let me out" noises.  But it doesn't sound right.

I went upstairs to get Laura, and encounter my daughter who's getting ready for work. "I think I heard Nana" she says with a nervous voice.  Okay, that confirms it..something happened.  I get Laura and she goes in to investigate.

She finds Nana sitting on the floor between her bed and her bookcase.  Nana had gotten up sometime during the night to use the bedside commode and stumbled.  She couldn't reach her cell phone which was on the other side of her bed.  She couldn't call out loud enough for us to hear.  So she pulled the covers off her bed and made a little nest out of it.

Needless to say, she's been pretty sore today and moving slowly having sat on the floor for who knows how long.

And the odd thing?  Her oxygen cannula was off and placed by a box of tissues on the other side of the bed.  She spent the night on the floor, wrapped up in blankets without oxygen.

I sure hope this doesn't happen again.

Disaster Averted....for now

Laura started calling Dr. M's office yesterday about Nana's midodrine prescription.  They called her back today, and, after speaking with Laura, Dr. M. called the prescription into The Pharmacy.  The Pharmacy at first said "No," but Dr. M can be very persuasive when necessary.

Laura went over about 5:45pm to pick up the prescription!  And we can get this prescription refilled twice!  Praise God!  This will allow Nana's blood pressure to be at a level where her kidneys will function (albeit at a lower-than-normal efficiency).

Now we won't have to fight this battle again for 90 days.  Sorry for the lousy cell phone shot...it was the quickest way to get a photo online.

All in all, Nana had a good day.  She had a visit from the nurse's aid, some friends came by to visit, and even our Pastor stopped by.  We're currently playing musical beds in prep for the hospice to deliver a hospital bed tomorrow.

A punch in the gut...

Well...more like a body blow followed by an upper-cut to the chin...

So the hospice doctor came out on Monday with a nurse to check up on Nana.  The visit went pretty well, and they discussed some options with Laura.  What Laura found out yesterday was not encouraging at all...

One of the medications that Nana receives to keep her blood pressure up (so that her kidneys are able to do their job) is midodrine.  Her supply runs out Thursday morning.  The nurse called the pharmacy and found out it's been pulled off the market, and that there are no meds to take its place.  We're going to do a bit of research in this, as it looks like the FDA called for it's withdrawal from the market in August 2010, and relented from this in September 2010.

If we aren't able to get in a supply of midodrine, Nana's blood pressure will drop.  The doctor said that a pacemaker would help, and possibly extend her life several extra months.  When Nana heard the cost of such a device (around $20K), she said she didn't want it.  :-(

Laura was saying that she thinks it might be time to start making some phone calls...

Home Hospice Care

The other day when the visiting nurse was checking out Nana, she suggested hospice care as an alternative to having to continually take Nana in to see different doctors.  This would provide a means by which a doctor and nurses could continue to come to Nana to evaluate her.  So Nana decided to go with it.  This started last Thursday...

My big problem with this is that it's hospice care.  EOJ  EOT  exit(0);  halt -q  margin :0,:1  That's it. Your done. End of the road.

In talking it over with Laura, they (Laura and Nana) felt it would be best for Nana to be able to receive care at home instead of having to go through all of the stuff they need to do when taking Nana out.

So far, we've gotten a new oxygen enricher, new oxygen tanks, new transport chair, and I think they'll be trying to deliver a hospital bed next week.  She'll be getting a visiting nurse coming by twice a week, and some sort of assistant two other days of the week.  And a doctor will be stopping by from time to time to check up on her.

The good news is that Nana can go off hospice at any time.  I first thought that it was a one-way street, or like a roach motel--once you check in you can never check out. Until you Check Out.  I'm still not entirely certain about whether or not this is a good thing, but Laura has spoken with several of the people who have come out and she's much more at peace with it now.

I'm really hoping that she can build up enough stamina that she doesn't need all this support, and I certainly hope I'm not disappointed.  Things are so crazy hectic in the house right now, we just need to get to some form of stability going.  I'm glad that the kids are old enough to mostly take care of themselves, but school work seems to be coming less and less of a priority.  Especially as Laura has to spend more and more time daily helping Nana with just simple little things.

Good Friday, Good Dr. Visit

Today is Good Friday, and it really is a good Friday.

Things have been going pretty well this past week.  Although Nana's surgery recovery seems to be taking a very long time, we're having more good days than bad ones.  It is taking a long time for her to build up her stamina.

We had started looking into how much transport chairs cost, and requested one from the insurance company on Apr 18th. The transport chairs are small wheelchairs, so they are much lighter and easier to get in and out the trunk.This will be very useful for when Nana has to go visit Dr. M, Dr. W, or just going out in general.

When the company delivered the wheelchair on the 20th, it was a full size one. It's heavy and doesn't fit in Nana's trunk without taking off the feet pedals. It was quite a workout manipulating the thing, but it let Nana ride instead of walking for her doctors appointment!

Nana went to see Dr. M yesterday, and saw Dr. W today.  Both trips went very well.

Dr. M removed most of the bandaging on the hand Nana hurt when she fell in her bedroom.  Her poor hand looks like it's quite painful, but it doesn't seem to bother Nana.  It could still be a while before it fully heals up.

Dr. W is reducing the amount of sotalol from 2 pills to 1.5 pills a day.  He said it should help Nana with more energy since the medicine slows down her heart. Her next appointment with Dr. W will be in a couple of months, and it's likely that she'll go down to just one a day.

It was also a busy day for phone calls, with different care providers wanting to schedule a time to come out.  The visiting nurse, occupational therapist and physical therapist called, and even someone from Nana's insurance company.  The only one who managed to get time in today was the physical therapist, so I'm expecting Nana to be tired tonight.

Have a happy Easter!  Don't forget the real Reason for it.

He is not here: for he is risen, as he said.

Come, see the place where the Lord lay.

Matthew 28:6

A little forward, a little backwards

Wednesday was such a good day for Nana.  She was feeling better, had an appetite, and could taste her food.

However....  Laura and I were startled out of a deep sleep at 3am with Nana calling Laura's cell phone to say that she fell.  We got downstairs to find Nana sitting next to her bed, and daubing the back of her hand with some sort of gauze.  We got her on the edge of the bed easily enough, and were able to get a better look at her hand.  She managed to whack something while she was on her way down, and cut the back of her hand pretty badly.  Laura and Nana just left to go to the ER to get her hand checked out.

Edited to add:

Laura and Nana got home from the ER around 6am, so this was a quick trip.  The doctor decided that since Nana's skin is so thin on her hands, he wouldn't be able to use sutures.  So he used some skin tape to get things back together.  Nana's poor hand is just one massive bruise.  The doctor said that it will take a few weeks for her hand to heal.

Nana was on her way back to bed, and was within two steps of getting back in bed when she fell.  The problem was that her legs became wobbly.  She described it as she was staggering like a drunkard.  Laura reminded her again that when she feels this way, either lean up against the wall or sit down for a few minutes to catch her breath.  We might just have to locate another chair in Nana's hallway so she has a landing space between her bathroom and her bedroom.

It's the little things

One of the things that has been a bit of a downer is that all food seems to taste mushy and bland to Nana whenever her lungs are affected with the fluid retention.  Part of this might be attributed to her low salt diet, but even with fruit?

Yesterday was a busy day for Nana.  Both the home nurse and the physical therapist stopped by.  She did fine with both, but her pulse always seems to be on the low side and the nurse was worried about the increased swelling in the legs. She called Dr M. to tell him about the changes and he changed Nana's medicine.

Today, Nana's weight was down about 6 pounds from yesterday, and she's breathing a bit easier. We're thankful for that!  Laura says that her legs are still swollen, but when Nana ate a banana for breakfast, she was able to taste it!  For the first time in a long while, it didn't taste like mush. We're hoping that means her lungs are clearing up!

Long days

It seems that with the time change, the days truly are getting longer.  A feeling of ennui is starting to set in, and this isn't a particularly good thing.  Laura's days are a flutter of activity between school for the boys, running Mom's Taxi Service, the routine household chores and now caring for Nana, coordinating doctor and in-home health care visits, doling out medications, and a new one: working with the insurance company.  Laura really does deserve a gold star for doing all this, but I think she'd just settle for a good long nap.

One piece of good news is that the catheter incision on Nana's leg has stopped seeping, and has been dry for the last couple of days.  We had just gotten enough supplies to deal with this and that's when it stopped.  Even though that's a bit ironic, I'm happy that her leg healed up.

The down side is that Nana is having a harder time breathing, she's still swelling, and it's getting progressively more and more difficult for her to get around the house.  We've had to put one of our sturdy kitchen chairs in the hall way leading to Nana's room so that she has a good place to grab or sit if she starts feeling weak while moving in our out of her room.  Also, one of her medications has a side effect that causes her to feel itchy, and this is making it difficult for Nana to sleep at night.

A fairly rough night

Last night / this morning was pretty rough.  Nana was using her little walker to get into her bedroom when her legs decided to no longer support her.  She had a slow speed fall just at the door to her room.  Laura was there to keep her from hitting the sharp corner on a book case.  Nothing was broken, but she did bruise herself on her arm.  This all happened about midnight.

With some help from my son, we got Nana sitting on the seat of her larger walker.  She was pretty tired, and not terribly pleased that she fell.  Laura and I were very puzzled about why her legs gave out.  Laura thought of several culprits: a side effect from one of her medications, her low blood pressure, or a sodium imbalance due to the fluid that's still seeping from the dialysis catheter incision in her leg.

Laura and I were discussing what to do given that Nana has an appointment with Dr. M later today.  I thought that if it were an imbalance or side effect, that might clear up (or change) by the time the appointment rolls around.  Laura went to talk to Nana about going to the ER, and they decided to go.  So about 1:30 or so in the morning, Laura drove Nana over to the ER.

I haven't had much of a chance to speak with Laura about what transpired at the ER as they got home a little after 7am.  When I got downstairs today, Nana was sleeping and Laura was ready to go take a nap as she'd been up all night.  She did tell me they didn't find anything.

I guess they now have something to talk about with Dr. M...

Nana is Home!

Nana was released from the hospital today.  Laura brought her home this afternoon, and it was so much easier than the last time.  Nana had no trouble walking from her car to the house, as we still have the oxygen concentrator.  We had a good evening together.

Laura still has to get some of Nana's medication from The Pharmacy.  The pharmacy called because some of the medications were tagged as allergic, so we still have to figure that out.  The pharmacy spoke with Dr. M, and Nana will be seeing him next week.  There's a bit of confusion about when the appointment is, but that'll be easy to figure out Monday morning.

One thing that's a bit of a concern is one of Nana's incisions is seeping clear fluid.  It seems like walking around encourages this.  It's more of an annoyance than anything, but Laura's keeping an eye on things.

Nana's heart rhythm is still normal.  We're hoping that the a-fib rhythm is a thing of the past.