UPDATE: Thank you everyone for your thoughtful and very informative comments. Saturday, I did what I had to and slept for the rest of the day/night. Stress like this wipes me out and wipes my back out, as well (dang it, happens every time!). I am feeling better today (except my back). I really do appreciate your caring and kindness.
With dementia patients, the family gets kicked and kicked again. There is absolutely nothing, in my experience, that is anywhere near normal. Ever.
The call came in at 9:00am this morning from the doc. My 97-year old mom who as of six weeks ago began to call an Alzheimer's/memory care unit "home" (she was 5150'd... a CA term for being declared incompetent or "crazy") a needed blood typing followed by a transfusion. I was just getting dressed for outside work, Friday being the only day of the week I sleep past 6:00am, many days my rising time being much, much earlier. I was so stunned I failed to even ask why. I was there every day this week except Wednesday.
I wrote down the information, hung up the phone and wondered how the hell I could be three places at the same time today. I am pretty good at being Super Woman but not THAT good.
I shoved my life into high, flipped on the coffee maker and literally ran through my morning dog/cat rescue chores practically starting the car before I even got in. I was carrying my shoes in my hand and loaded my coat pockets with the phone, hair brush, telephone directory, etc..
I knew it was going to be one helluva day.
First stop, the veterinarian. I have 11 cats there I tend to seven days a week. I made short work of it (read an hour and some change) and got back on the freeway.
I called the care home... they would take mom to get the blood typing done (results take about two hours) at one place, then drop her off at the hospital for the transfusion (which takes three to four hours). Great. Except... there were seven messages on my phone now.
Four of them are various messages leading to the conclusion that someone screwed up somewhere and when the care home took mom for blood typing at the one location, the location referred the driver/mom to the hospital. Apparently, they don't do typing/transfusion in one day at this location though the transfusion was not to be done there. So I call the doctor and get a VERY cranky nurse who sounds pissed off and informs me that the person taking her to the blood typing location had no clue what he was doing and thus the problem.
Actually, Molly the Nurse, that is NOT the problem. Had I taken her, I would have been in the exact same position. The mere fact that YOU set it up under mom's name with her doctor's order set the stage. ALL she had to do was appear. She did. They blew her off. Interestingly, I learned from the hospital that this blood typing facility SENDS THEIR BLOOD TO THE HOSPITAL FOR ANALYSIS something YOU, Molly, admitted you didn't even know when I asked you about this mess late this afternoon.
Fer Christ's Sake!
So I arrive at the hospital at 11:45am after driving like a bat out of hell. The blood was just taken to the analysis unit. Sigh.
Mom is sound asleep and waving her arms around in her sleep like a modern dancer minus the slow and beautiful steady form. Her feet are jerking. She is talking in her sleep. I sit watching her and finally turn on the TV given these facts hold no meaning whatsoever after an hour other than to make me sad.
An hour-and-a-half later, a nurse comes in to start pre-transfusion fluids. They insert the catheter and mom doesn't even wake. The whole scenario is surreal. They try to take her temp, but she then resists... I tell them not to push it explaining that mom has vascular dementia complicated by a delusional disorder (read psychosis) and that mom can get violent quickly. Best to use the most noninvasive (read nothing in her mouth) method possible. They do this bringing back a head-swipe unit. I love them.
A half hour later, in comes the typed unit of blood and the transfusion begins. I still don't know, at this point, WHY this is happening. I called the doctor's office but Molly is out of the office. In the meantime, I get a copy of mom's bloods from 11/8/11 taken in the very hospital where I am sitting. I stare at them and notice a few things, but still don't understand. I realize that this weekend I am going to buy a lap top computer. Period. I don't care what I cannot otherwise afford. I have to have a way to deal with this kind of stuff when I need to. I am great at online research and communication.
So for the first two hours, things go pretty well. Mom is talking in her sleep though incredibly out of it. I really don't understand why. She is OFF haldol and has been for a week. That's not it. At my request, the doctor wrote a new prescription for 0.5 haldol as needed. She has not been given ANY for a week now and was only on it for four weeks. I visit her every day and she has been pretty golden in the last week.
Then mom suddenly gets irritated and shit hits the fan. No matter what I say, she gets worse. Over the next hour, mom tries to bite me and the other nurses, hits me repeatedly, tries to kick me, threatens me and throws her glass of water at me and starts literally screaming to the point that other patient friends are all now near and staring at us all wondering what kind of horrible abuse we are inflicting on mom. There are at least three of us with her at all times for the last 30 minutes. Mom is trying to yank out the transfusion line.
Mom wants to have a BBQ in the backyard. She wants to go to the kitchen. She's worried about a dog she thinks she owns. She says she hates me. The nurse warns me about getting kicked. I assure her that when I was seven and being abused I would have appreciated that concern, but at 58, and as one that works with animals at the veterinarian, I am okay. I get a very perplexed look.
Finally it's over, and amid her still trying to bite, hit and kick and screaming, we get the needle out, they wrap her wound, we get her out of the bed into the wheelchair and eventually into my car.
Fortunately, mom cannot figure out the seat belt because she keeps trying to open the door while I am driving. Thanks to modern technology, she can't. I have her door locked from my security panel. I am, however, increasingly concerned she will grab the steering wheel. I gently talk to her about Christmas and the wind and she says absolutely not one word in the 20 minute ride back to the care home other than to inform me she wants a cigarette. Geez. I will never ever put her in my vehicle again. Lesson learned. I swear. Monday I have to call the city folks and ask if the annual fee I paid for paramedics includes ambulance transportation. I can meet them wherever but driving mom anywhere anymore is out of the question.
I get back to the care home and call inside for help to get her out of the car. They ask me if I am coming in. "No," I said. "I am going to go buy a bottle of scotch and dive in." I am pretty sure they don't think I am a bad daughter given I am there every day and make sure everything is okay for her, check her med log and blood pressure log, and talk to the nurses and staff. I always tell them they are "the best". At this point, I really do mean it. They do wonders with my mom. Things I never could and never will be able to do.
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On the way home I get not one but two calls about animals that are in dire shape. I pull over, head in hands, and try to put on some semblance of rationality honestly wanting to just scream, but I don't. I got home and got them solved (for now). The cat that I was to attend to today was, in fact, picked up by a friend that I called for help. I rarely ask these kinds of favors so when I do, I can usually get them. Cat is fine now.
I call the care home at 7:30 and they say she is just fine. No behavioral problems whatsoever. Geez. Her behavior is beautiful and she wants to see me.
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Now to mom's blood work. And this is freaking scary.
When I spoke to Molly late today, I asked what in mom's blood work (taken yesterday) required this drastic measure today given mom had a very complete panel on 11/8/11, 37 days ago.
She replied the hematocrit (Hct on a blood panel workup). Holy shit. And super holy shit given the entire bunch of stuff (there's a lot more, but these are the pertinent numbers right now)/
Here are the comparisons:
11/8/11 12/14/11
RBC (Red blood cells) 3.99 (low) 2.33
HgB (hemoglobin) 11.4 (low) 6.7
Hct (hematocrit) 32.7 (low) 19.5
B12 961 (high) 1386
This is absolute bad territory.
So, I ask myself, "WHY?" Why and how did this happen in 37 days?
And I look back to an indication of multiple myeloma that the specialist thought was VERY unlikely at about 94 years of age but which was potentially indicated on a test. Given what he told me (he thought the likelihood was VERY VERY small, I did not pursue it). Who knew mom would live to be potentially 98 on Jan 6 2012? The outside event for MM is about 5 years. I am hoping this is not it but even if it was, it isn't "curable".
Is this my fault?
So onward the saga goes, with me reading constantly and seeking out everything I can get my hands on.
And now, of course, with the MM the guilt returns. I hope I did not, in my best care, make a mistake.
This entire scenario has kicked me enough.
Today I really feel like I had my ass kicked.