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More Bad News.....She's gone to join my Dad

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Holbytla
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Posted: Thu 24 Feb , 2005 12:35 am
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Best of luck.
Be thinking about you.

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Sassafras
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Posted: Thu 24 Feb , 2005 12:39 am
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Sunsilver, Jane,

:hug:

my thoughts are with you.


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Griffon64
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Posted: Thu 24 Feb , 2005 4:26 am
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:hug: Jane/Sunsilver - thinking of you even more now. :hug: My words are always clumsy or absent in a situation like this ... but I am thinking of you and yours A LOT right now.

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Sunsilver
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Posted: Thu 24 Feb , 2005 5:06 am
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Thank you all for the good wishes and prayers.

Steve, thank you so much for your phone calls. It was 11:30 EST when I got home, and I didn't know if I should call you back that late.

Well, they got her moved to a room, which is a small miracle in itself. The lady she was sharing a cubicle with in the ER had been there TWO DAYS. Not unusual, unfortunately, as the health care system in Ontario suffered massive cutbacks at the hands of the Tory government 5 years ago, and has never fully recovered.

The hard truth is, basically, there's not one heck of a lot they can do to treat strokes. She is already on a blood thinner to prevent clots, and now, all we can do is hope that the body itself will get rid of the clot in the brain that's caused the stroke, and some function will return. The CT scan show's it's a large infarct, unfortunately, so she's going to have some major impairment if she survives. The main cause of death following a stroke is pneumonia, due to not being able to swallow properly, and inhaling food or water into the lungs. The key to preventing this is giving the patient thickened fluids, and giving them slowly and carefully. Exactly the sort of thing that nursing staff doesn't have time for these days. That's okay, that's what her caregiver, Imelda, is there for. She's staying overnight with her, then I'll go and relieve her tomorrow morning.

So, I'm going to browse for a few minutes, then I'm going to toddle off to bed. It's been a horrible day. To cap it off, the dog has an upset stomach, and threw up on the rug last night, then had diarrhea while I was at the hospital this afternoon. Oh, yeah, and my landlady wanted to come and show the place to somebody today.... lovely timing, Tasha!


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Estel
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Posted: Thu 24 Feb , 2005 5:57 am
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Sunsilver :hug: - we never ever go to bed before 12am EST, and if you need to talk, you can call anytime, day or night. We mean it! We've both stayed up talking to friends till 3am and later before, and both will do it again, no questions asked.

Please believe me on this - some people don't. If you need to call, then call!

As for what can be done about strokes :( My grandpa had two major strokes three years ago, and has had a few minor ones since. With the last one, just two days after Christmas, the family just couldn't take care of him anymore and had to put him in a nursing home. So many different drugs and exercises... it's hard :hug: I am so so so sorry that you're going through this :hug:


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TIGG
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Posted: Thu 24 Feb , 2005 8:05 am
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:(

the TIGG doesn't know what to say :(

you already must know that all my good wishes are winging their way your way.....

Take care and I am thinking of you....

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Nin
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Posted: Thu 24 Feb , 2005 8:09 am
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I don't know really what to say either, but still wanted to show you that I'm thinking of you.

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Rodia
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Posted: Thu 24 Feb , 2005 1:38 pm
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Sunsilver, I'm thinking and praying for you too. Hang in there brave lady.

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truehobbit
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Posted: Thu 24 Feb , 2005 7:36 pm
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Sunsilver :hug:

Isn't it incredibly important for people who suffered a stroke to get all possible care quickly? :(
I hope you'll be able to kick some asses in that hospital, to get people on the move!

Best wishes from here, too! :hug:

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Areanor
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Posted: Thu 24 Feb , 2005 9:38 pm
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Sunsilver, you're in my thoughts, too.

:hug:

keep us updated, please.

And don't forget to get at least a bit of rest.

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vison
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Posted: Thu 24 Feb , 2005 10:38 pm
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Hope all goes better for you, Sunsilver. Hang in there.


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MariaHobbit
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Posted: Fri 25 Feb , 2005 1:27 am
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I'm hoping for the best for her and you, Sunsilver.

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TIGG
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Posted: Fri 25 Feb , 2005 6:34 pm
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Sunsilver, I was hoping when I saw your name in another thread that as you had been on that you had more news. :( (good stuff)

sends more tiggerty wishes for sunsilvers mum to get bouncy fit as soon as possible

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laureanna
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Posted: Fri 25 Feb , 2005 7:37 pm
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Sunsilver - {{{massive hugs}}}

My mother-in-law had a series of small strokes over the course of some years that caused a dementia much like Alzhiemers. Eventually, she did not speak or understand speech. She had some trouble swallowing, so she was fed thickened fluids. But as inevitably happens, she got some down the wrong pipe, and got pneumonia. We were given two options:

1. Fight hard to get her through the pneumonia, even though she was petrified, confused, gasping for each breath, and constantly trying to tear out her IVs and rip off her oxygen mask. There was no guarantee that she would pull through, but if she did, it would only be a matter of time before she got another pneumonia.

2. Give her morphine. This would calm her down and let her rest easy. But she probably wouldn't breath deeply enough to keep adequately oxygenated, and might not make it through the night.

Her kids chose morphine. She died early the next morning. I tell you this because you will probably have to go through the same thing, and the more time you have to think it through and talk with others - especially your mom - about it, the better.

{{{more hugs}}}

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Sunsilver
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Posted: Sat 26 Feb , 2005 4:16 am
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I was in the process ot typing a lengthy update to this, and accidentally hit a wrong key. My whole friggin' post vanished, and I couldn't get it back.

So, very briefly, because I'm tired and pissed (in more ways than one)...she's alive, but quite tired and groggy. She knows people, and can even remember events that happened 5 or 6 hours ago. She is still hav ing swallowing difficulties, but they have okayed her to go on a thickened/pureed diet, whereas up until now, she wasn't supposed to have anything by mouth.

I raised a bit of shit to get this, too. The doctor yesterday had said he thought it was okay for her to have pureed foods, but unfortunately, he never wrote an order for it. The nurse promised she would get one. Well, here we are, 36 hours later, and it's suppertime, and my mom STILL HASN"T GOTTEN ANY FOOD!!! I said a few nasty, petulant words to the nurse about this, and hey, presto! Next thing I knew, she brought in a bowl of specially thickened soup, and told me "I have an order from the doctor now, and a tray is on its way from the kitchen!"

Now my main problem is that Imelda thinks mom needs someone with her at night, because she cannot ring a call bell. I thinks she needs someone during the day, to make sure she gets fed. Imelda can't cover both day and night, and my brother and I both have lives. I've put mine on hold for the last few days, at the expense of getting ready for my move, but I can no longer afford to do so. As much as I would like to have someone there 24/7, it's just not going to work. Don't know what to do. So, I'm going to toddle off to bed, and hope that the morning brings some sane, sensible answers! :help:

Goodnight, all!


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TIGG
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Posted: Sat 26 Feb , 2005 4:20 am
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:hug:

Hopes tomorrow brings the answers you need.

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Lhaewin
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Posted: Sat 26 Feb , 2005 3:51 pm
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Sunsilver, we didn´t get to know each other very well, but I know what a terrible time you had last year. I am very new on this board and I am using my first post to tell you that I will think of you and I wish you all the strength you need to get through this.

Very hard for you to see, being a nurse yourself, what the hospital stuff has failed to do. I hope you can ameliorate things for your mother and that she will recover soon. :hug:


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vison
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Posted: Sat 26 Feb , 2005 4:10 pm
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Keep on truckin', Sunsilver.

Fight the good fight.


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Sunsilver
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Posted: Sat 26 Feb , 2005 4:51 pm
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truehobbit wrote:
Sunsilver

Isn't it incredibly important for people who suffered a stroke to get all possible care quickly?
Y'know, I read all this WONDERFUL stuff in my nursing texts about these clotbusting drugs that can actually dissolve clots, but which must be given within a specific time frame in order to do any good... but they don't seem to use them here in Canada!

They never gave my husband these drugs.... despite all evidence to the contrary, the doctor seemed to think he'd possibly had a hemmorhagic stroke, (caused by a ruptured blood vessel) rather than an ischemic one (caused by a clot).

Same thing in mom's case, though with her blood vessels being so fragile, I do not think it would have been a good idea to give her one of these drugs.

If you're not administering a drug such as streptokinase, you can wait as long as you want. About all the hospital can do is do a scan to show yes, you DID have a stroke, and put you on IV fluids to keep you hydrated until they can decide if it's safe for you to have food and fluids by mouth.

Re: Laureanna's post: Laureanna, I've given morphine to help ease the dying of cancer patients, and another very elderly patient with a septic leg, who was very, very terminal, and in agony. By that point, you don't even ask yourself if this might push them over the edge. You just know you have to do something to relieve their suffering.

That one case haunts me still. She was in her late 80's, had diabetes and Parkinson's disease. Her leg had gone septic due to the diabetes, but they did not want to amputate it, because she was in such very poor health that she probably would not have survived the surgery. So, they just left things alone. Yes, she did get antibiotics to fight the infection, but there wasn't enough blood circulation left in the leg for them to be able to eliminate the infection. Essentially, it was a piece of dead meat.

We kept hoping she'd slip peacefully away, but that last night, I got a call from the daughter, asking me to come. She was conscious, aware, and in pain. She also seemed to be fighting for breath.

The doctor had left orders for the morphine drip to be titrated, so, as soon as I got there, I increased it. While waiting to see if that was enough to bring relief, I called the doctor on call, and got an order for Ativan, which is a big help in relaxing people who are in respiratory distress. (This was very stressful...I had trouble getting through to him, and when I did get him on the line, he was reluctant to do anything, in case it killed the patient....ummm....excuse me, isn't she SUPPOSED to be dying?? :scratch )

Anyway, when I finally got the order, and returned to the bedroom, the patient was a little bit more relaxed, but when we asked her, she told us she was still in pain. So, I increased the morphine dose one more step. I then tackled the dressing change on that horrible mess of a leg, doing only what was absolutely necessary, to spare her as much pain as I could. By the time everything was tidied up, and my charting done, she was drifting off to sleep. The daughter and I stood in the darkened room, and had a brief prayer together, then I went home.

The next morning, I was told she'd passed peacefully away around 3 am, while the daughter sat at her bedside, reading the Bible to her. The daughter was so grateful for what I'd done, that she had called both my supervisor, and the government case manager to tell them what a wonderful nurse I was.

I heave a big sigh of relief, because I'd been really frightened of doing something wrong, and that someone was going to complain.


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Sunsilver
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Posted: Sat 19 Mar , 2005 6:16 am
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A week ago Friday, I signed the papers for mom to be admitted to a nursing home. Now, usually this is done AFTER it is determined that the patient is not capable of making their own decisions. I guess the lady in charge of discharge planning assumed that mom WAS incapable, because she sleeps about 90% of the day.

We also had her lawyer in to try to get the power of attorney changed so my brother and I both have joint POA. Although she seemed to understand what this was all about, she was not capable of signing the documents, not even to make an 'X' in place of her signature.

So, yesterday (Thursday) the doctor FINALLY got around to assessing her competency. AAAAAANNNNNND.....I then got a phone call from the discharge co-ordinator telling me he'd found her competent!

WHOOAAAA! Whole new ballgame here! This means SHE has to be the one to sign the nursing home papers. It also means she can say NO to a nursing home, which will put us in a very, very difficult situation. The house she has lived in for the last 40 years is very unsuitable to the nursing of an invalid. There is no bathroom on the main floor, and there a lots of stairs, as it's a split level. Ad this to the fact she's said she would do 'anything' to avoid going to a nursing home, and you can imagine how we felt yesterday!

So, I decided to go in to the hospital this afternoon, and meet with mom and the discharge planner to see if mom would consent to sign the papers. Mom seemed more alert than she had on the previous visits. I explained to her that she had to go into a nursing home, as, at the moment, there was no way she could function at home. Then, I handed her the pen, and, after a few false starts, she managed to make an 'X' on the paper. The discharge planner turned the page, and asked mom to sign the second page. This time, mom signed her full name! She then went back to the previous page, and signed her name in place of the 'X'! It was kind of crabbed up, not her usual bold, schoolteacher's handwriting, but she's legally blind, and did not have her glasses on.

You could have knocked me over with a feather! :D:D:D:D

Last edited by Sunsilver on Sat 19 Mar , 2005 1:55 pm, edited 1 time in total.

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