2 posts tagged “time”

MedFaire was a busy time, and I thought my schedule would free up afterwards.

It didn't.

My sister called to say my mother was being admitted to ICU.  I spent the next 5weeks traveling between states to spend what time I could taking care of her and supervising her treatments.

Her admitting diagnosis was mild enough - dehydration from a stomach flu that was past.  All she needed was fluid.  By the time I arrived (it was a 6 hour drive), they'd given her so much fluid so fast she had fluid in her lungs and in the chest wall cavity.  It took me another 6 hours to convince them she was having a breathing problem, and then another 3 hours before they did anything about it.

They got her lungs dried out, but ignored the chest wall fluid buildup and her bloating, but they were supposed to be easing off on the fluids and rebalancing her blood pressure medication (which was diluted by the rapid influx of fluids and the fact they weren't giving her anything for her blood pressure at the time).  I had to return to work.  When I left, she was improving.

Two days later, she's developed sepsis and gets treated for that.

The next day, there's not just fluid on her lungs again, there's inflammation in her lungs.  They intubate and start treatment before I can get there.  I stay through the weekend, and they say they'll start weaning her off the respirator on Monday.  So I drive all the way back to work.  She does well for three days, then I get reports of fluid on her lungs again and they're re-intubating her.  I'm also getting reports that she has a drug-resistant bacterial infection.

By the time I get there, she's stable again, so I stay through the weekend.  I ask the charge nurse how many bedsores she has, and the nurse reluctantly admits she has two.  Terry Shiavo can live 15 years in a coma without getting a single bedsore, and my mother, who is elderly but aware, gets two?  I make them change her bed out for one better suited to her needs and insist on a physical therapist seeing her and keeping her moving.  They start treating the bedsore.  I go back to work.

This repeats for several weeks - up and down, long harried 6 hour drives in the middle of the night down, slightly slower drives back up to make it to work on time.

Her lungs keep drying out, then filling back up with fluids.  As soon as they clear one iatrogenic infection, she developes another.

Then I'm back down because she's taken a turn for the worse - the fluid build up in her chest wall has gotten great enough they finally notice it - 2 liters worth of fluid.  They tap her chest wall to drain it out and instead of draining it slow, a bit at a time, they take it all at once.  Her lungs collapse.

They get her lungs re-inflated, and now they need to do a tracheostomy because they can't re-intubate her any more.

She's doing better - pinkish color in her face again, aware of what's happening around her, responsive, but not remembering who's been to see her or what was said.  That's OK, she's under heavy sedation.  That she can shake her head yes or no is remarkable enough after all the doctors have done to her.

I go back to work.

At 10:00 pm on 5/11, I get a call that they had tapped her lungs to drain more fluid and her lungs collapsed again.  This time, she went into cardiac arrest and they were working on reviving her.

Another 6 hour drive.  I arrive to learn that they did get her heart going again, and the trach is doing all of her breathing.  She's not breathing on her own.  It took them over half an hour to restart her heart.  It's not beating on its own, either, they're pushing a drug that forces it to beat, but it's a weak one and her blood pressure is too low to register on the sphagnomometer.  During that time, her kidneys and liver were blood and oxygen-starved and both quit.  Neither one starts working again.  At this point, she's a very poor candidate for dialysis - her heart and lungs can't take it.

The day she was admitted, she was bright, alert, joking.  She's been living on her own, taking care of herself, doing volunteer work at the children's hospital.  Her only health problem was her blood pressure, which was under control.  She got a stomach bug (probably from one of the kids) and ignored it a bit too long.  But it shouldn't have killed her.

Because of her medical treatment at the hospital (which was outstanding when she was in crisis and not so good when she was on an upswing - they stopped the care a little too soon and waited a little too long to act when they knew something was wrong), we had to make the decision to let her body poison itself to death slowly or to stop the heart medication that was forcing her heart to beat.

The whites of her eyes had turned a dark yellow, her nails were blue, and she was unresponsive to anything said or done to her.  My sister needed time to think, so she went home to do that and to take a nap.  When she returned 7 hours later, Mother's condition had deteriorated.  Her kidneys and liver would never work again, it was doubtful her heart would ever beat on its own or that she'd breathe on her own.

We agreed to a test, to stop the heart medication for 30 seconds.  The medication was strong enough, and she was at the maximum dose, that it should keep her heart beating at least 60 seconds after it was stopped.  If her heart stopped beating and didn't restart on its own during that time, they would not be able to restart it.

We stopped the drug.  It was just barely less than 5 seconds before her heart stopped beating, and never restarted.

Five weeks after she was admitted, Mother died in the hospital.  Their care was outstanding when she was in crisis.  They went to extraordinary lengths to keep her alive during those times.

It was the less-than critical times where their care and treatment suffered, and Mother along with it.  As soon as she started having trouble breathing, they'd wait to see if it got worse.  When it got worse, they waited to see if it would get better on its own.  When it got even worse, they waited to see just how bad it really was, and when it became a matter of life-and-death, they were in full swing, making sure she lived through it.  Wouldn't it have been much easier on her and them if they'd taken action early instead of waiting so long before responding?

And how - in a modern hospital - did a patient develop bedsores within a week of being admitted?

None of that really matters now, though.  We can't change what was done.

As a final display of their "wait until it's critical" attitude, the doctor in charge of her care didn't sign her death certificate in a timely fashion.  On the day of Mother's funeral, we had to call from the funeral home to find out why they hadn't signed the death certificate yet (it was 5 days after her death, no need for an autopsy because her cause of death was obvious, there was no reason to delay the signing), and the receptionist had the unmitigated gall, knowing we were calling from the funeral home, to yell at us in a volume loud enough to make the funeral director standing outside the room wince at the decibel level that they'd sign it when they got around to it, then she put us on hold.  So, we put that call on hold, called the clinic right back to talk to someone else, got her name and the name of the office manager, and then spoke to the office manager.  We explained the situation, 5 days, at the funeral, no body because the funeral home couldn't do anything until the death certificate was signed, we needed it signed that day.  She agreed, and we went to the clinic to pick up the signed paperwork.

Then we returned to the funeral and proceeded with it without telling anyone else how the doctor had screwed up yet again.

The rest of it was simple enough.  Mother qualified to be buried in a veteran's cemetery, and we had her interred there.

Since then, I've been going down on weekends to help sort through Mother's things, the food first.  We had to throw away bags full of food that were opened or beyond their expiration date.  What edible food remained we donated to a local soup kitchen.  Ditto for her clothes. 

Now we learn that a judge doesn't like Mother's will and wants to change it.  She complied with all the legal requirements for writing it, had it notarized and witnessed, and none of us children disagree with her choices.  But this judge thinks he knows better and that he has the right to come in and alter that will just because he doesn't like it.  It's not like Mother had a large estate.  There aren't millions of dollars at stake here; hundreds maybe, but not millions.  No one's contesting it.  Sure it stings a bit that my brother gets $5.00 and a note listing all he owes her, or that I get a dollar, and my sister gets the rest (including bills), but we understand why Mother did that.  It was her estate to divide as she wanted it.  If we are willing to accept that, why won't the judge?

Still, whatever the judge decides doesn't alter the fact that we have to sort through her things and set aside family heirlooms for my sister to keep (and share out if she chooses - which, knowing her, she will do in a couple of months), things to donate, things that are just pure trash, and things to put into an estate sale.  We're slowly inventorying everything in case there are any questions - which given the judge's orneriness, there may be.

See, the reason none of us were disputing Mother's will was precisely because she left the bulk of it to my sister.  She's one of those anal people who has to be in control, but she's also a very generous person.  Once everything was settled, all Mother's final bills paid, the car, house contents, and house sold, she'd put it all into a high interest bearing account and let it sit there a year or two because it would take her that long to decide exactly what she wanted to do with it all.  Then, she'd take out a salary and expenses for herself for administering the estate, take out expenses for me travelling down there to help her out, and then evenly divide what was left between us.  That way, she could tell herself she did what Mother wanted.  Then, later, when she felt the money was hers and not Mother's anymore, she'd share it out because that would be the right thing to do.  Mother knew my sister would do that, and even sort of knew how long it would take my sister to decide to do that, which is why she trusted it all to her, and not me (I'd divide it up right away, and that speed would make my sister feel I was being disrespectful), and not my brother (who would blow it all on some get-rich-quick scheme). 

And the judge doesn't know our family dynamics, doesn't understand that Mother knew exactly what she was doing when she wrote that apparently biased will.  He thinks he knows best, that Mother was some weak and stupid woman who hadn't a clue how to write a real will, and that we are too stupid to sort things out among ourselves in an amicable and appropriate manner.

That's a problem in our society - we don't trust other people enough to let them take care of themselves.  People who hold positions that look authoritative presume they have superior knowledge and understanding - and maybe they do in a macroscopic sense.  But microscopically, they lack sufficient information to make informed and reasonable decisions; all they will succeed in doing is anger the people they think they are helping.  We see this in our handling of Iraq (too many links, just google it and you'll see), in criminalizing the use of public space, (1), in that some public parks actively discourage adults unaccompanied by children from using them (no links, personal experience), (2) and now in a judge who disagrees with a perfectly legally written will.

Once Mother's house is cleaned out and on the market, I won't have to go down near as often, saving me gas money, wear and tear on the old car (which is holding up remarkably well under the travel).

It doesn't mean things will calm down, because my youngest is getting married on July 13th, then shipped off to Baghdad.

(1)  OK, the guy went too far in some cases, but most of the cited instances were perfectly reasonable ones.  And I can see where he'd still consider himself to be a student there, on probation until his bill was paid.  Me, I'd intended to haunt the local universities in much the same way once I retire and have the time to spend at them.  My taxes help support them, and as long as I don't make unreasonable demands (grades, degrees, taking up professional time or a seat away from a paying student....), I see no reason why he, I, or others like us can't take advantage of something our tax dollars provides.

(2)  I was sitting on a bench, watching the lake waves and the boats, enjoying a nice day out in a public park with my little dog, who was napping in my lap.  The police officer who made me leave told me the park was for families and people with children, that single adults needed to go elsewhere - and my dog was "too small" to count as a valid reason to be in a park.  If I insisted on staying, he would arrest me for loitering since I'd been there for more than 15 minutes.  It was "policy" to keep single adults out of parks to "reduce crime".  Now, mind you, I'm an old, fat woman with a little dog, reasonably well dressed and groomed.  I pay my taxes without too much complaint.  Yet, I am not allowed to be in a public park unless I have a child with me.  Or maybe a big dog.

I have been in a joining mood - I joined Library Thing, and 43 Things, and, of course, Vox.

Library Thing looks cool - catalogues books.  It means entering them in to the computer, but I have to do that anyway.  I joined under the name "Nodigio".  Who would have guessed that?

43 Things - I dunno.  I was being a lemming, and joined.  And now I'm hard put to think of 43 things I want to do enough to list them.  Things like housecleaning and ordinary tasks shouldn't go on there.  That's the bulk of what I want to do:  routine, everyday tasks.  Each day only has 24 hours in it.  I spend half on hour on personal hygiene in the morning and half an hour at night, an hour tending to pets, ten hours at work (and most of an hour going to and from, depending on traffic), eight hours sleeping, half an hour cooking a quick meal (longer for anything fancy, which rarely happens anymore), an hour or two writing, half an hour on charity or ministerial work (I can borrow from writing or sleep time if I need to).  Somewhere in there, I need to make time for little things like lawn care and housecleaning.  I make time, but I always feel rushed.

So, it seems insane to want to make lists for 43 Things.  Where will I drag the time for that?

It must appear out of somewhere, though, because when I need it, I always have a bit - just enough.

I am spending a few of my writing minutes setting Vox up.

I invited a couple of people to join.  One of them, I've been trying to convince to blog for quite some time.  I have shamelessly appealed to his geekiness, enticing him with being among the first to use the service, and to help work out the bugs.  Maybe that will be the feather that tips him over.