April 8 – “Anatomy of a ‘cardiac event'”

I have officially realized why I prefer blogging over twittering.  Other than the obvious birdie-ness in the name, I mean.  Blogging lets me get all the facts and present them as a unified, albeit often goofy fashion.  Just posting a little at a time gets frustrating.  Just when you feel like you have communicated the essence of what has been going on, everything changes in an instant.  And before you can correct everything, it has changed again to something completely different.  Yes, that is foreshadowing about what all happened with Mom yesterday.

So with the help of some good paramedics, Stacy and Jim, I think, we got Mom to the ER to get her hips checked out.  Preliminary x-rays showed no signs of a hip fracture, but did show signs of inflammation and of her bones thinning.  I found out what “preliminary” means at a teaching hospital, too.  It means the “junior high guys” have looked at it and made their best guess.  You know, “junior high” - the first through third year medical students.  Once they give it their best shot the “big boys” (fourth years, residents, fellows and the like) come in and make their assessments.  They’re usually pretty right on, but just to be on the safe side, the faculty finally follows up with the final look by a pair or two of experienced eyes.  I suppose in this case the system worked pretty well.  Final results matched up with the prelims.  No fracture, but still pain.

Now at this point someone finally heard Chris saying that Mom has had some trouble urinating.  We always watch that issue closely since she does have a history of urinary tract infections (UTI’s).  With the hip situation in hand, they agreed to do a urine check to cover that base as well, since we were already there.  Kind of an after-thought.  And apparently the urine tests came back looking not-so-good.  They started her on a hefty dose of IV antibiotics - levoquin.  The ER doc was going to let us decide whether to take her home with some oral antibiotics or let her stay overnight in the hospital so she could be monitored to make sure they got the infection under control and maybe even get a physical therapy consultation to help with walking.  We voted to let her stay, so he made the call for an internal medicine doc to take over and admit her.  That new doc ordered a baseline chest x-ray, so they did that.  But during that procedure Mom started with the shivering again, and insisting that she was freezing.  They took her temperature several times and it was always normal, so they just kept bringing her another of those warmed up blankets. 

The shivering continued, however, and in fact began to get much worse.  Her breathing was strained and quite rapid.  We were concerned that she would break what few teeth she had left because she was clenching them so tightly.  One of the RN’s came in to draw some more blood for new tests since the urinalysis had come back indicating a definite infection.  She saw what was happening, and right away started her on some oxygen.  The guy who came in to take her blood pressure was surprised at his first reading – 60 over 40.  So he took it again.  No reading at all.  So he took it again.  Again, no reading.  On his third try it came up something like 178 over 80, so he decided to keep that one.  By this time Mom was clearly in distress.  Two other RN’s had joined the team and were working in tandem with the first one.  Their coordination was amazing.  But then, I have a thing for RN’s anyway.  After all, I married one.  Mom coughed a few times and they had to suction out her mouth.  They brought in a heart monitor and hooked up the leads to monitor that.  Her heart was racing in the 170’s.  In the middle of all that frenzy the admitting internist returned with a batch of those “junior highs” and a geriatrics professor.  So they all joined in on the action.  Actually, most of the youngsters kind of shrunk into the background and watched with their mouths open.  New orders were flying through the air. They shot some meds into her IV that were designed to bring down the heart rate rapidly.  Don’t remember the names.  We were asked at least three different times what our wishes were about resuscitation.  Mom has a physician’s directive, so that made it much easier to reply to the questions in this heated frenzy.  Medical interventions were fine (like medicines), but nothing invasive.  No chest compressions or shocking or breathing tubes down her throat.  Oxygen was fine, and external breathing assistance was fine (like what they were calling a C-PAP). 

All that behind us, Mom finally started calming back down and breathing more easily.  The ER doc came back and joined the others in shaking his head at how quickly she had taken the turn for the worse.  No longer was going home in the picture at all.  Now the decision was a matter of how soon she could be moved to ICU.  That, and which follow-up tests they could run.  A guy came in and did an echocardiogram of her heart.  He said it was functioning fine, but showed some signs that she could have had some kind of cardiac event.  Tell me about it.  The ICU docs came by and said their course of action would be to treat her as if she had had a small heart attack.  The blood work was indicating that she had.  In fact, I can’t remember which doc it was that finally gave us an “official” diagnosis for whatever that spell was.  But the decision was that she had a massive infection and was slipping into sepsis (“total-body infection” I think is what that word means.  I’ll have to look it up).  That infection had begun to wreak havoc on her body and had caused her heart to react with a “cardiac event.”  I guess they don’t like to use the words “heart attack” any more.  I imagine it’s too scary. 

So … Mom is settled into her ICU room.  They ran us out at around ten last night.  I actually didn’t have all that much trouble getting Chris to leave.  But that’s because Nathan read her the riot act last night about getting some rest.  It would not have been pretty to see a team of fire fighters hauling her to the car, kicking and screaming.  Hmm.  Now that I think about it, that would have been quite a sight to see.  I do want to say thank you to all who have expressed love to us.  The array of encouragement and prayers offered up by friends and family has been phenomenal.  Guess that’s one good thing about FaceBook.  You get to see the nice things people have to say about you.  Keep ‘em coming.  I’ll post as I can.

John 11:25-27 says, “Jesus said to her, ‘I am the resurrection and the life. He who believes in me will live, even though he dies; and whoever lives and believes in me will never die. Do you believe this?’

‘Yes, Lord,’ she told him, ‘I believe that you are the Christ, the Son of God, who was to come into the world.’”

Father, thank you for cluing us in on what really matters.  This whole life thing is all about you.  Amen.