She's Back!

 Man, what a roller coaster ride 2023 has been.  It all started in May and continues into the next year.  When last we checked in with our heroine, she was having a tough time and had gone back into the hospital, leaving us to wonder if she would come back out.  She did!

After spending the entirety of the day after Thanksgiving in the Emergency Room, Mom was admitted to the hospital with a severe infection.  Her white cell counts were sky high (97 when they should have been around 5) and she had cellulitis in her left foot.  The index toe next to the big toe that had been amputated looked swollen, red and angry.  There was little blood flow and after two days of intense IV antibiotics, the vascular surgeon thought amputating that second toe was the way to go, provided he could restore blood flow to her foot sufficient enough to heal the wound.

The antibiotics were VERY strong, and yet the white blood cell count was reducing very slowly.  Keeping the IV functional turned out to be a real challenge, as Mom's veins kept blowing, causing the IV to leak.  She was poked so many times trying to get a good IV going that she looked like a street fighter who'd lost.  Her arms and hands were bruised and thin.  This continued to be a problem.

After getting the infection to an acceptable level, the surgeon decided to try getting blood flow going to the foot and if he could restore it enough, go ahead and take that index toe.  I went to sit with her while she waited to go into surgery.  They'd taken her down at 7am.  I arrived at 11am (I'd been told she'd be taken later in the morning) and Mom was sound asleep.  A young nursing student was sitting with her and hoping to observe the surgery.  We sat and chatted while we waited and they FINALLY came to get mom close to 2pm.  She was back in her room at 5.  I peeked under the blanket and to my surprise, her toe was still there!  They did the angiogram (roto-rooter for the veins), and found a blockage, but were unable to restore blood flow to the level they felt comfortable doing the operation.  She was put on blood thinners to try to help things along, and once they felt she was recovered enough from the angiogram, discharged her to rehab.

**RANT FOLLOWS**  I am very disappointed in our hospital.  The communication is horrendous.  I am my mother's legal health surrogate.  They have the paperwork.  I was the only one who was there for this entire ordeal and AT NO TIME during this whole thing, from the ER to discharge, did a single doctor speak to me or send a nurse to inform me of anything.  What information I got, I had to ask the floor nurse for when they came to her room to tend to her.  I never got an official diagnosis or was told what the plan was.  I got one phone call from a person in the doctor's office asking for consent to do the procedure, but she had no knowledge of my mother or her case, just that they needed consent.  I wasn't told she was going to be admitted; I wasn't told about a treatment plan; I didn't know when she would be discharged or what follow up, if any was supposed to happen.  She was in the hospital for two weeks, and NO ONE bothered to tell me anything about what was going on.  I intend to write a letter to the hospital and let them know how disappointed I am in their lack of communication.  I was too tired to do it before.  I'm still tired, but just writing about her experience has pissed me off all over again.  **RANT OVER**

Mom's an old hand at rehab.  The previous two times she's been in rehab this year, she was at Seven Hills.  It's an old facility and looks it.  The nursing staff is caring and capable, but understaffed and overworked.  The CNAs are hit or miss in ability and caring.  The food was awful.  Mom felt like she was being tortured just by being there.  On the upside, the actual physical therapy was excellent and it's located literally 200 yards from my house so I could be there at the drop of a hat.  She never wants to go there again.

So this go round, I told the nurses at the hospital that it would be Encompass or nothing - home healthcare and physical therapy would have to do.  She got into Encompass.  It's undergoing some major renovation and I got lost every time I went the first week she was there.  The rooms are clean and big and pleasant.  I could almost live in the bathroom space.  The staff is competent and attentive and the physical therapy had Mom back to strength after two weeks of staying in bed at the hospital.  She was standing and transferring easily by the end of her stay.  And the food was good.  Mom ate everything they brought her and she LOOKED healthier than she has in a while.  Towards the end, some of her dementia issues with food started cropping up and she wouldn't trust fruit.  She sees something on TV and doesn't understand it, so applies what she heard to everything.  In this particular case, it was bacteria on melons, especially the hard to wash ones like cantaloupe.  Sigh.  Nothing to do with the fresh apple slices, but she still refused to eat them.

Another benefit of her being in this rehab is that Dad was able to visit her.  He only did it a couple of times, as the construction made navigating difficult for him, but he was so happy to see Mom!  Realizing he wouldn't be able to see her as often as he wanted due to the construction, he decided to write her a love letter.  Her abilities have diminished quite a bit, and I wasn't sure she'd be able to read the letter, but I gave it to her and offered to help if she needed it.  She said no, she would do it herself.  It took a lot longer than it used to, but she did it!  She read her letter, smiling that little secret smile women get when the men in their lives profess their love in writing.  Made my heart happy to see it.

 

While she was in rehab, she started complaining that her teeth hurt.  One of her falls had chipped her front tooth and over time, the sharpness of the edges began cutting her lips.  I puzzled over how to help until I could get her to her dentist.  She's not quite with it enough to follow a plan of applying something like Orajel.  She would either forget or use it all, so I thought why not give her something soft to bite down on, that's firm enough to apply pain-relieving pressure?  I was thinking about a silicone "bone", but not finding anything like that, tumbled to a teething ring.  That did the trick.  I guess it's kind of soothing too, as she's still using it at night to soothe herself to sleep.

Two weeks in rehab saw her strong enough to transfer easily, her infection was pretty much gone and her toe was looking better.  She's on antibiotics until mid-January, but she's well enough and strong enough to return to the home.  And she was READY.  She missed her room.  She missed her stuff.  She missed Mr. Tommy and the games and activities he leads there.  She missed her friends.  And she missed seeing Dad.  At the home, he can visit as much as he (and she) wants.  Too much visiting and she gets cranky, but three or four short visits a week suits her just fine.  So on discharge day, I cleaned her room, changed her sheets and restocked her necessities while Matt got Dad's car and went to pick her up.  She was finishing lunch as I packed up her room, and we all departed, happy that she'd be at the home in time for Christmas.

Once she was back at the home, I called our dentist.  Explained Mom's condition and what we needed.  Mom has always been terrified of the dentist.  She was lucky in that she had pretty good teeth that survived without a lot of dental "interference".  But this chip chopping up the inside of her mouth was not something she could live with - especially now.  So we got an appointment in fairly short order.  I picked her up and took her in.

She was happy to be there.  The nurse took a picture of her mouth so they could see the problem in detail.    She got to stay in her chair while she was examined, and it was decided she could stay there during the procedure.

I guess one of the good things about dementia is that fears you had before aren't always remembered.  Mom forgot she was afraid of the dentist!

Mom sat very still while the dentist filed and smoothed her chipped tooth.  Once she was satisfied with that, she filed the tooth next to it to lessen the stair-step effect.  She also smoothed a few other teeth that had been interacting with the chipped tooth and getting sharper themselves.  Lots of "drill" work, then polishing with a higher-pitched sounding head.  In the end, Mom had nice smooth teeth.  She was so happy!  So happy, in fact, that she wanted to go back and get her teeth cleaned.  We have an appointment near the end of January to get that done.

Mom has always had a beautiful smile, and now she has one again!

Late November and all of December has been way too eventful - here's hoping that January is a far more peaceful month.  We'll be celebrating her 85th birthday in January!