Mom's Health - Jill - 12/9/10

Today is a better day than yesterday...lots of good reports...some not so much...so here we go...

When I first got here at 8 am, Mom was asleep. They had just given her morphine at 6 AM, and she is barely getting it out of her system. I tried to be in the room, but the new nurse said no. Had to keep up ICU visiting rules. Well, I think she's slacked off on that...

Right after I arrived, I saw the internist, Dr. Wade. He immediately took me aside, showed me test results and we consulted together for a good 20-30 minutes. This was what he told me:

The results of the tests are this: Mom's carotid artery is 80-90% blocked. Her heart valve is only functioning 45-55%. Her body "machinery" has lots of problems with it, not just the heart, the lungs or the kidneys. However, her stats are pretty good. They've taken her off the bi-pap machine, and although her oxygen saturation is remaining at a constant 86-89, it's not dipping lower than that. But just like when an exhaust valve or other part goes wrong, if not repaired, it can affect other parts of the car and engine, making them all weaker. Her kidney output is lower than yesterday. She really wouldn't eat anything yesterday other than water. So his recommendation was this:

She has to have the heart valve replaced or she will eventually get weaker and then die. So he said we need to talk to Dr. Thorn and if he feels like she's not a candidate for the valve and bypass surgery, we need to talk to the cardiologist, Dr. Kenwood to see about the alternative solution which is done at another hospital (Intermountain Hospital). It would be less-invasive, but could buy some time for her to strengthen and then have the surgery. If she ends up not being a candidate for either, they could make arrangements for her to go home with hospice so that she could be with her family and enjoy them until she eventually dies...maybe weeks or months...

So...I talked to Dr. Thorn, the surgeon, who actually came back to the hospital. Curt was here so both of us talked to him. We REALLY liked him, and he LIKED us. He said that Mom's (he liked Curt's phrase) strength of mind needed to be stronger as well as her strength of body before he could operate. He said the valvoplasty would NOT be a good solution at all, but another procedure at Intermountain, although not a permanent solution, would maybe buy her time to strengthen so that he could do the surgery in a couple of months. He felt the value of deciding whether surgery would be the best thing for someone Mom's age, or being able to go home to be with her family would be important, rather than spending maybe her last days in doctors offices and operating or recovery rooms. We talked to Mom some about this, and she realized that if she didn't WORK to become better, she would eventually die. So as she has come out of morphine-utopia, she has really been making an effort to keep herself actively alert so that she can respond to doctors. Yes, she might be alert for only 3 or 4 minutes before she is dozing off again, but when she is alert, she definitely seems like she is fighting it...she has swallowed the clear liquid diet we've given her and as Elise has been here, she REALLY has responded to her granddaughter. Elise was so good...she would cajole Mom into taking a bite of jello while I offered her a sip or two of broth. Then we would reward her with some apple juice, which was the first one gone. Elise tried to tell her that the vitaminwater that she got was really good. Mom wasn't quite convinced so I explained to Mom that kids these days like the yuppie-type things like vitaminwater...it's a modern thing...

When Dr. Thorn expressed concern about her mental alertness, he asked Curt how she had been when she came into the hospital. Curt said that aside from coughing up blood in her sputum, she had been alert, walking in on her own and pretty much herself. Then Curt made the comment, we've got to get her out of the hospital...it's KILLING her!! Dr. Thorn laughed, but then said that for someone Mom's age, that's more true than you'd like to think...because they give you all kinds of drugs and medications so that you're drugged up, and you don't get up and exercise, so for someone Mom's age, her health can quickly deteriorate. He was all for getting her into a regular room, both so she could have visitors and so that they would not drug her as much and try to get her up more. In fact, he was not opposed, if they could do it, to getting her home, off all hospital medication and back to her normal routine where she can get exercise, etc. So that is our goal. When I mentioned that to Mom that they might be able to get her home, she smiled and explained, "I need to get home. These are my people and that's what I live for." So maybe kids and grandkids (on a limited measure) are really the medication that she needs to get her strength up and maybe get her in for surgery. St least it gives us a goal, anyway...

Of course, we'll have to watch her kidney function and to see if she becomes more alert. Curt just had me talk to Cynthia, which was a HUGE help, and she helped me know what to look for. She was not discouraged by Mom's lack of alertness and her sleeping. After all, she said she had gone through a HUGE day yesterday and it was very appropriate for her to be out of it for awhile. So we'll have more to look for. She said that most surgeons will not operate without taking care of the carotid artery first, so we're going to pursue that...a much less invasive surgery...

Well, with all the phone calls and visitors and going in and out of ICU to visit Mom, it is now 5:00 and I am finally getting this out. Hope this all will be of some help and comfort to you. Sid, Kyle, Jann, Bruce and Liz are all on their way to Utah over the next day or two, so we will all be together for a couple of days. That will be good, as we can meet together to discuss with Mom the path that she wants to take. It will also be fun to get together. I have always said that Mom really knows how to "throw a party", and in true Bassett form, no Bassetts want to be left out. So there it is!

Mom, we love you and pray for your continued progress to health.. Everyone else, have a safe trip here...
Love, Jill