PHARMACIST STEVE

It all started about three years ago… my Mother in law… had been living alone for some 10 years since her husband had died… she was in her early 80’s. She was still driving herself around… but always staying on the city streets in her small town of about 20,000. We lived about 15 miles away. My Brother in law lives 600 miles away, so all the responsibilities fell on us. She was having some trouble driving… small fender benders… so we had to make that difficult decision of telling her that she was going to stop driving and I sold her car. She continued to live alone and my wife became her chauffeur and personal shopper, I started managing all her bills & money. That lasted for about 6 months.. she was having falls and we decided that it was no longer safe for her to live alone…

Moving in with us not a option… my wife and her Mother, at times, where like putting two wet cats in a small cage. Off they go to find an acceptable ADL ( Aid to daily living) facility. She settled on one that was even closer to us that her home. She had her own one bedroom apt, they cleaned her unit, did her laundry, gave her medication and provided three meals a day. We supervised moving some of  her furniture into her apt,  got her house ready for sale.  After the first week, she insisted that she have the meals brought to her unit.. according to her… “.. there was nothing but a bunch of old people in the dinning room…” That was Feb 2011. My wife continued to be her chauffeur and personal shopper

During the first year, there was a fall … ended up being sent to the hospital and ended up in physical rehab for 30 days.. then back to the ADL unit.

In my eyes, she was becoming more and more frail. In Aug, 2012 she had another fall… cracked a few ribs.. back to the ER .. admitted for a few days and back to physical rehab. I told Barb when she went to rehab..that I didn’t think that she would go back to her ADL unit… probably a ICF bed in a nursing home… of course.. my wife is in absolute denial.

The last of Sept Barb and I had a meeting with the rehab staff about her prognosis.. she had not been able to do PT for nearly one week.

We were there Monday Oct 1st visiting her and she was indicating that she was not feeling good… we stayed for a while and left to let her rest…

About 18:00 we get a call from the rehab… they had drawn some blood that AM and her cardiac enzymes were elevated… she may have had a mild heart attack.. they are sending her to the local hospital.  We arrive at the ER and she is sitting on the gurney “bright eyed” and joking with the staff… we stay a couple of hours.. they were going to run tests most of the night .. and we go home…

We come back in the next AM (Tues)… we are told that she had a MAJOR HEART ATTACK and left vent is GONE… and that she has hours/days. We authorize a DNR order on her. We have had for some time a advanced health care directive on her. She is sitting up, alert, lucid .. we had already been in contact with the immediate family the night before – all of whom is 600 miles away… so we send some more texts and phone calls.. better come home.

We stay until supper time… her condition had not changed we were tired so we go home…

The next day (Wed) we go back in again in the AM… her condition seems unchanged… her two sisters come in and they talk, laugh… it is getting close to supper time again and she is developing a wheezing cough and they give her a Albuterol treatment.. which worked for about 15 minutes.. the RT suggested the nurse call the MD for a solumedrol injection… a few minutes later the nurse comes in and tells us the doctor said NO. The nurse apologized over and over.. and I told her.. that I have been in her place on that side of the fence, but I was FAMILY and I was on the other side of the fence and FAMILY can have a lot more influence on such decisions.

Barb gets on the phone and calls the doctor… he is giving her some sort of  BS about sodium retention..etc…etc… so I take the phone… I explained to the doc that we understood the circumstances and prognosis  and that we were trying to gain 48 hours until the family who hadn’t seen her in about a year arrived .. why can’t we use inhaled steroid little/no systemic absorption…  he agrees and within minutes it is administered..  We head off for the home.. we are exhausted

06:00 the next AM (Thursday) we get a call from the hospital … you had better get in here… we arrive.. find her eyes closed, no verbalization , no response to “squeeze my finger”, they had pulled her IV fluids and now on a O2 mask at 15 LPM as opposed to the nasal cannula at 2 LPM the day before.. they are giving here 2 mg MS IV every 30-60 minutes & prn  for labored breathing..but .. her respiration rate was 12. Around 15:00 all the family rolls in… we go on and leave.

The next morning we check in with BIL at the hospital.. she was getting 2 MS IV every 15 minutes and her respiration was 24… Barb had a 10:30 appt to have some staples removed from some out pt surgery she had done the week before… 09:30 we are headed to the clinic to get her staples removed.. We are half way to the clinic, we get a call… Mom is gone… we are headed in the right direction.. she was in a hospital on the north side of the Ohio river and we were headed to a hospital in downtown Louisville on the south side of the river.

Long story… short…we buried her on Oct 8th. The family came together in this time of grief… some frayed family connections that had happened over the years are now healed. In the end, no matter how smart you are… how much you know or care or do.. the grim reaper’s time table cannot be altered.

Filed under: General Problems