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Monday, August 17, 2015

Don't look a gift horse in the mouth

Thank you for continuing to follow our journey. Since my mother's passing, it has become more difficult, but more important than ever that I continue. Mom and I discussed my blog often and she always encouraged me to share the WHOLE story, but even with her unending support and encouragement, I felt somehow the sharing many things would strip some of the dignity I struggled so hard to help her preserve. I made a promise to my mother that after her journey home to The Lord I would reveal some of the more personal "stuff" about my role as a carer and hers as her need for care increased. As always, I will attempt to be delicate and tasteful, but some of you may find some posts to contain details that are a bit graphic.

Don't look a gift horse in the mouth

I woke early on Monday, September 2, 2013 in a panic.  It was only 6:15; I hadn’t fallen asleep much before four.  By 8:30 I had showered; packed the suitcases; emptied the refrigerator; and stuffed everything else from the previous couple months in to the boxes I had collected the night before.  As I surveyed the contents of the room, I realized I had packed everything in a daze and had no idea now where anything was.

Everything seemed so surreal and I felt disconnected in a way that I cannot even begin to fully explain.

I made a concerted effort to focus my attention to the issue at hand.  I hadn’t worked out the logistics yet, but what I knew for certain was, if the choice was for mom to return to the SNF or for me to chance taking her home, we were heading for home.

I was lost in thought about how in the world I was going to get everything back home
when mom called, “The doctor was just here and they are scheduling me for an x-ray and a couple other things.  I couldn’t really hear what else he said”.  I wanted to know which doctor ordered the tests; if something more had happened or if the tests were “routine” and/or part of the discharge process.  “What?” “WHAT?” WHAT?!!” moms voice got a little louder and a lot more agitated with each question I asked.  I grabbed my keys and shouted in to the phone “I am on my way” as my mind shifted in to overdrive.

As I drove to the hospital, I wondered about the x-rays and “other things” mom was having done, however my biggest concern at that moment was how markedly and rapidly she was losing her hearing.  I was still trying to pinpoint when I had first notice the change in moms hearing as I pulled in to the parking lot at the hospital; I was feeling very anxious because I honestly could not remember exactly when it started and was becoming almost obsessed with the fact that I couldn’t remember.  Was something wrong with me?  I reminded myself to breathe and tried to push the dark thoughts from my mind.

I was sitting in my mother’s hospital room waiting for her to return, trying to focus on a magazine I had picked up in the lobby, when mom was wheeled back in to the room and helped in to bed.  “What tests did they send you for?” I asked once mom was settled.  The surgeon had ordered several x-rays of her leg and a couple of her chest; someone would be coming soon for another blood culture.

I listened as mom complained about how her eggs were cooked; they had taken her to x-ray before she could even drink her coffee and how loud the nurses on night shift had been.  Mom went on to tell me of the various “rumors” she had heard about this person or that person.  I tried a number of times to interject in to the conversation; apparently mom couldn’t hear me.  “You’re awfully quiet this morning.  Are you OK”, mom looked concerned.  I assured mom (very loudly) that I was “fine” and “just tired”.

Realizing, even if someone had said something to mom about discharge, she very likely hadn’t heard them, I told mom I would be right back and went to find the nurse.  “Hi!  I didn’t see you come in.  She’s looking pretty good, huh?” the friendly voice of a nurse who had cared for mom last time she was here greeted me just as I stepped out of the room.  We chatted for a minute about the horror of this most recent “procedure” and how much mom had been through; she told me the surgeon had been in earlier to see mom and he’s who ordered the x-ray on the leg; she wasn’t sure which doctor ordered the chest x-ray; and of course, the blood cultures, after so many and such serious infections, were just part of life for the foreseeable future.  When I asked the nurse about the plan for discharge, she said, “I haven’t heard anything, but it won’t be today”.  I didn’t know if I should be thankful or alarmed.

As I headed back in to moms room, I was relieved that I had at least a little time to figure out how to transport mom and all our stuff the 250 miles back home, but I couldn’t help but being a little concerned as I wondered what had happened between yesterday and today that would make them change their minds about discharge?

Had the surgeon noticed something unusual with the new hardware?  Could it have something to do with her erratic blood pressure?  The nurse hadn’t indicated that anything was “wrong”, I just couldn’t imagine them keeping her unless there was a reason.  Of course, I could think of a myriad of reasons mom should have continued medical observation and care; unfortunately, the rules of Medicare don’t generally support my way of thinking.

“Am I the only one concerned that she went nearly deaf, seemingly overnight?”, I muttered to myself as I stepped back in to moms’ room with the TV blaring and mom snoring.  Mom didn’t even stir when I clicked the TV off.  I flipped through the magazine for a few minutes and then wrote mom a note, “I went to get something to eat”.  An hour later, when I returned, mom hadn’t moved and was still snoring loudly.  I wrote another note, “I’m going back to the motel to rest.  I’ll be back before dinner”.

I hadn’t been gone from the hospital for more than five minutes and was easing in to traffic on the interstate when my cell phone chimed with the familiar ring I had assigned to my mother.  Knowing it wasn’t safe to answer at that particular moment, I let the call go to voice mail.  I pulled off the interstate at the next exit and in to a parking lot before retrieving the message.

Mom pushed a couple buttons before she started leaving her message, “I don’t know if this is recording or not.  Hello?  Well, I hope you get this message; it looks like I am going to need some clothes when you come back.  No hurry.  Oh, and don’t forget my shoes.”  I quickly pushed redial and listened as moms phone rang and then went to voice mail.  Figuring there was no sense leaving mom a message that she likely wouldn’t be able to hear, I disconnected and pushed redial again; voice mail again; and again.  My anxiety level increased each time there was no answer.  By the time I gave up calling and started driving, I was having a full blown panic attack as I imagined my mother clothed in a hospital gown waiting for me in the parking lot.

I took the side street and drove a block back towards the hospital before reminding
myself that mom had said “No hurry”, she wouldn’t have said that if they had kicked her out, right?  I took my next right and turned back toward the motel.  A few blocks later, I convinced myself that I really should go back and check on mom at the hospital and start the appeal to Medicare if need be; I turned around again.  But, wait.  Mom said she needed clothes; another turn around heading back to the motel.  I really don’t know how many circles I made before somehow I got myself to the motel; gathered clothes for mom; and returned to the hospital after what seemed like hours, but was likely less than thirty minutes after moms call.

Mom didn’t hear me come in; she didn’t hear me say “Hi mom”; she just continued to study the dinner menu with a look of disdain.  I was sure mom had spent enough time in the hospital that she had tried everything on the menu at least once and was likely craving the not so healthy options she had at home.

I startled mom as I entered her field of vision; she shrieked and I jumped.  “You scared me!” mom started laughing.  Soon we were both laughing so hard there were tears streaming down our faces; it really wasn’t that funny, I think we both just needed a good laugh.

“I can’t wait to get out of here” mom started pulling the clothes out of the bag I had set on the bed next to her chair.  I started wondering if mom was planning on making a break for it and I asked her if she knew when she was going to “get out of here”, to which she replied, “No, these are fine, but I told you not to hurry.  Is my pink sweater dirty?”  It was; I assured her I would do laundry as soon as I could.

I made sure mom was looking directly at me when I asked her if someone had told her she was being discharged AFTER they had told me less than two hours before that she would not be released today.

Mom was smiling like the Cheshire cat and I thought for a minute she either had lost her mind, or she still hadn’t heard me, then she said, “Yes, but they still don’t know if it will be yet this afternoon or tomorrow”.  I knew mom was anxious to get out, but I still didn’t think it was safe to make the trip home.  I was afraid of her answer, but I had to know if mom had already signed the discharge paperwork and the “Know Your Right’s” page from Medicare, maybe I still had a chance to do something; my heart sunk when she said she had.  Moms’ smile faded when she saw my reaction; I thought she was going to cry.

“I’m sorry, honey, I thought I was doing the right thing” mom went on to tell me that they couldn’t get the paperwork done for her “transfer” until they were signed and she was afraid if she didn’t sign it, they wouldn’t let her go.  My scalp was tingling and my fingers were going numb; I thought I was going to pass out while I waited for the answer to my next question, “Transfer you WHERE?!”  Please tell me someone didn’t talk my mother in to agreeing to go back to the Skilled Nursing Facility!

Mom looked appalled that I even thought she might agree to return to the SNF.  “No, of course not” mom assured me that she was NOT going back there.  A short time later, I followed with a cart of moms things while she was pushed down the hall and admitted to the Sub-Acute Rehab unit AGAIN.  Thank you, Lord!

Although I had my suspicions, I wasn’t sure who exactly had greased those wheels, but momma always said “Don’t look a gift horse in the mouth”.