Monday, May 23, 2011

My MissShuganah Mame Goes To The ER. And Yet Again

As my husband and I sped down the Kennedy, I called my mother's helper. The ambulance siren in the background confirmed for me that she and my mother were on their way to the ER. Wasn't sure what was going on with my mother, except that I knew that she wasn't herself. I had called her up that Tuesday morning just like I do every morning. At first her voice sounded garbled. I asked her how she felt. "I don't know," she answered.

When I walked into the ER, I discovered my mom was already hooked up to an IV. She had a temperature of 104.8, and her blood pressure was steadily dropping. Last thing I wanted to do was be scared in front of my mom. I needed to be able to give my brothers information, and I needed to be to ask and answer questions of medical staff. My mother never lost consciousness, but whatever she was fighting clearly wiped her out. My mother is normally a light olive, and she looked very pale.

"Would your mother like a priest or a chaplain," the nurse asked me. "We're Jewish," I explained. "Oh, we've got a really great rabbi," she responded. I felt like I was being told menu options. "We're out of walleye, but the chef makes a really great chicken vesuvio." I refrained from asking,"So, you don't expect my mother to survive?" Part of me wanted to ask if they had a secular humanist on staff. Neither my mother nor I are particularly religious, may all the rabbis on the family tree forgive us.

The resident asked to speak to me outside my mom's cubicle. Asking for family member to step out of earshot of patient suggests things may not bode well. Does she have a DNR, he asked. I am pretty sure she did, but I wasn't sure where. He told me they could insert a blood line, which I later learned was called a PIC line. I consulted my mom and my brothers. We all agreed that as long as a PIC line didn't mean cutting her open to install it then they were to go ahead and do it. The PIC line was to allow for more medicine to enter her bloodstream to help her fight the infection she had. Other than that, they were going to try to make her as comfortable as possible. In other words, let her die.

I was very philosophical about it as I waited to hear back from my brothers. My mom is 91. Assuming she were to make it that far, she will turn 92 in August. I was in the ER and thinking, well, we will all miss her but she is 91 and has had a good, long life. I was also thinking and if she were to depart it would be on top of her mental game. I hope to be so lucky some day.

As I was pondering my mother's fate, I watched her blood pressure tumble to 104/47 I tried to get the attention of some nurses. ERs are insanely busy places, and, this time was more chaotic than usual. They had a patient they had to restrain and whose ravings could be heard clear across the entire ER. Finally, with what felt like much arm waving, I got the nurse's attention. I was told that 104/47 was nothing to worry about. I asked her, when do you start worrying? More like say 80/30. All righty. Was good to have a guideline. Right then my mom's blood pressure stopped being in free fall, and started to slowly rise back to normal.

My mother motioned for me to come closer. In a barely audible voice, she asked me about bin Laden. She asked me if she could have a newspaper. I knew then she wasn't ready to check out. I breathed a sigh of relief. A few days later it was revealed that she had had an e coli infection.

Six months earlier, my mother needed to be given BP meds intravenously. Her blood pressure had been too high after she had done a face plant in her apartment. "What are they doing to me," my mother asked, as the weird beeping noise of the blood pressure cuff going off had startled her awake. My mother knew where she was, but she panicked. She was breathing shallowly. When I finally got a nurse, she told my mother that her blood pressure had stabilized and that everything was being monitored. That did little to convince her that she was OK. Finally the man who had placed the IV in returned and he helped calm her down. He demonstrated deep breathing for her, and she copied him. After that she started breathing more regularly.

I was settling into listening to Garrison Keillor when the phone rang. My mother had managed to drag herself back to her bed after falling on her carpeted bedroom floor. She asked me to come downtown, and retrieve her walker from her kitchen.

When I arrived about an hour later, her apartment was dark. I rolled her walker to her bedside, and she went to the bathroom. I examined her bedroom floor. Didn't take a forensics expert to figure out which direction she had fallen. There was a huge imprint and pool of blood where her nose had hit. At first I thought she had just broken her nose. Then I saw her bruised right arm. I knew, at the very least, that she needed to have her arm looked at.

"Where's your pendant," I asked. "On the dresser," she responded. The pendent was nowhere to be seen. I finally found it over a doorknob. I sighed.

I called my mother's helper who thankfully was able to drive down and help me double team her. My mother was bargaining with me. Couldn't we wait a few hours? Couldn't we "sleep" on it? I told her I was either going to take her to the ER now, or I was going to go home. As we stood and debated the issue, my mother's face developed bruises under her eyes. She looked as if she had gone a few rounds with a mugger.

I thought of ways to try to convince her to go to the ER. First I brought up how I'd catch hell from my eldest brother. That only caused her to scowl. Her helper agreed with me that she needed to go to the ER, but my mother still dug in her heels.

I decided then that I needed to fight dirty. I reminded her how, just the previous May, I had been investigated for medical neglect by DCFS. I told her that if we waited until morning to bring her into the ER, the staff would be suspicious of me. A face plant could just as easily look like a fist plant. I told her that any delay could case medical staff to report me for alleged elder abuse. My mom didn't want to get me into trouble. She grudgingly agreed to let her helper get her dressed and into helper's car.

Both times my mom was in the ER, she naturally wanted to go home. One time was during the day. The other time was late evening and in the middle of the night. The time in the middle of the night was tiring but pretty much uneventful. These trips to the ER were between six to eight hours, with another half hour to an hour to stick around and talk to hospital staff once she had been admitted.

Last October, when I left the hospital at about 3:30 in the morning, I decided to walk the entire distance back to where I had left my car. "No one can get any action in this town," a man muttered as I waited for the light to change on Michigan Avenue. "Except at my house." I was silently responding, "No thank you," as I crossed. Window washers were just starting their day. Lovers paused at the bridge before crossing the Chicago River.

I thought for a moment about sacking out at my mother's apartment. Then I decided, no, I was going to drive home. When I got home at about 4:30, I called my brothers and gave them an update. They thanked me for the update. I logged into Twitter. Surfed a bit. Then I fell into bed at about 5:20 AM. I had put in a twenty-three hour day. I thought, this is what it must feel like for interns and residents. I also decided that even if I were about twenty-five years younger, I wouldn't want that grueling schedule. One twenty-three hour day was enough. My mother has been advised that I don't want to do this again. She agrees.