Saturday, March 5, 2011

Dead in the MRI and broken sacrum = long recovery IF mom can make the trip at all

In the past 5 days Mom’s died once, received 9 IVs and one epidural.   Last Friday, Mom was in so much pain that the nursing home insisted she go to the ER.  They called her doctor to meet her at the ER but he was too late to stop the ER doctor from attempting an MRI.  They did an EKG before the MRI but didn’t look at the results before giving her propofol (Diprivan) as a sedative.   Though they only gave her a small amount –about 1/5 the “usual dose” for an adult – it was enough to stop her heart.   If the ER doc had looked at the EKG, he’d have seen that she was in atrial fibrillation – her heart was beating erratically and not in regular sinus rhythm.    The technicians gave her epinephrine (also known as adrenaline) and did chest compressions to successfully restart her heart in normal rhythm.  

She was transferred to the ICU and hooked up to every monitor known to man and medicine.  I arrived in town to find her confused and begging for God to deliver her from such torture.  She was on a fentanyl patch and 2ml (milliliters??) of dilaudid (hydromorphone) every 2 hours.  The nurses in the ICU were great; they came in every hour to give her 1 ml and were quite attentive to her every need.  They even tried to feed her but she would not budge – she wanted no food at all.  On Monday she was in and out of it, she recognized us all but had a hard time focusing on a thought.  

The doctor developed a whole plan to administer certain drugs on Tuesday to complete an MRI to see exactly what was happening with her back and hip.  The results were poor – cracked sacrum, severe osteoporosis and arthritis that is compressing her sciatic nerve and causing extreme pain.  Tuesday was a rough day. She was terribly confused by the drugs and didn’t want to go into the MRI machine.   Luckily, she made it through just fine but the drugs she had to take made her feel awful well into Wednesday.   Every 5 minutes she repeated that “everything is backwards”.   It was as though she developed severe dementia overnight.  She told me that she saw God sitting next to her while I had some lunch.  All afternoon I had to share my chair with God.  It was the only chair so I had to sit on the forward part of the seat so that he had room to sit down with me.  If I tried to move back she’d correct me and tell me to leave room  for God.  She realized it sounded crazy and said she was embarrassed to tell me; she could not actually see God in the room but she was certain he was there.   As the day wore on, I wondered if it was metaphorical and if she really was trying to tell ME to become more spiritual; that I should make room for God...   What ever the purpose, we laughed about it a bit and she remembered it the next day on Wednesday.  

Wednesday morning Mom was less confused but still agitated.  She was scared and wondered why she had to suffer so; why they could not fix her pain and return her to “normal”.  She was tired of laying down and wanted to sit up but it hurt too much.   In the afternoon she went for an epidural and returned changed – more alert, more at ease and less agitated.  During the epidural, my brother and I sat nearby and heard her yelling out. We nearly cried, believing she was in pain.  Soon after the yelling the doctor came out and told us that she was yelling because they had to move her into a bath and it was cooler than she wanted.  On the way out of the epidural, again, she was asking “why” – “I’ve been a good girl, all my life… why must I suffer like this…”  It was hard to hear but she looked so much better that we still felt relieved.  

The “pain” doctor had good news and bad – the epidural went well but…. The fracture in her sacrum was worse than we thought, it was in pieces and healing was unlikely.  Generally, they could glue a crack with surgery but there is no way they’d put mom out again.  Given her osteoporosis, it might just break again soon anyway.   He said she’ll have constant pain for the rest of her life;  laying flat or sitting probably won’t hurt but moving up or down will.   So – how do we tell her that?  Having to tell her is worse than learning she had the break… dammit!  My poor momma!