Margaret is Back In Hospital

On Thursday the Bluecare RN dropped in to check on Margaret.  She expressed concern that Margaret was very lethargic and looked much paler than usual.  I told her that I would be taking her in to see my GP, her's being on holiday, to get some prescriptions renewed and would ask him to check her out.

At the time Margaret wasn't talking to me as i had told her that I couldn't take her on holiday to an hotel while she was incontinent.  I probably was a bit too blunt and she really went mad at me.  Surprisingly she didn't carry on with it and went to bed early in quite a nice mood.

Good Friday morning  looked in on her before taking Louis for his early morning walk and she said that she was OK.  When I returned I could her her calling out as I walked up the driveway.  She had had another fall and couldn't get up.  She didn't look too bad just shaken and she had sore knees.

I got the paramedics in to assist in getting her up and they decided that because of he medical conditions she should be checked out in emergency so took her off in the ambulance to the local hospital.  I followed behind in our car but noticed that the ambulance slowed right down for a few minutes before speeding the rest of the way to the hospital where she arrived at 7.30 am.

On admission handover they described her fall and alerted the Emergency Room staff of chest pains during the ride in and shortage of breath.  She was given an Angina tablet and her normal blood pressure tablets and her heart rate dropped from 190 to 80 and her blood pressure from also 190 over 90 tho 130 over 75,

They took blood and urine tests which showed that her renal function hadn't deteriorated and was at a eGFR of 26.  She had low calcium levels but no infections.  At 11.30 am the ER was packed with more patients coming in so they removed Margaret's canular and catheter and told her to sit on a chair with a blanket around her.  At 11.45 am they decided that perhaps they should do more blood tests but , Oops no canular, so they didn't bother and sent us home at 12.15 pm with a 'take it easy' warning.

I got Margaret changed into a clean nightie as she had a lot of blood all over her fron the problems that they had had inserting the canular.  I tucked her up in bed and gave her a sandwich for lunch then settled myself for a snooze while she rested.  At 2.15 pm I got a call from the ER Doctor and she asked me to bring Margaret back for the additional blood tests.  We were back at 2.45 pm and the blood test attempted by a very bad tempered nurse, who was also the one that tossed her out earlier in the day.  He couldn't find a vein and after 15 minutes called for the ER Doctor who had inserted the original canular.  She got the blood after a little while and we sat in the waiting room for about an hour for the results which should have been available in 15 minutes.

At about 4.30 pm they asked me to wheel Margaret back into the ER room where, while nothing was said, they hooked her up to a sophisticated Heart rate monitor and left us for another hour.  At 5.30 pm they serve Margaret dinner so I asked did this mean she was going to be admitted and was told that was the normal procedure with heart attack patients and she would be going to the ICU.

Finally the ER Doctor who had come on duty at 7.30 am told us that there was no doubt that Margaret had had a heart attack in the ambulance and the enzimes in her blood had increased indicating that the was probably heart damage.  Margaret would be monitored over night in the ICU and possibly transferred to the closest hospital with a Heart Clinic over the week end.

A little later a Consultant Physician who had treated Margaret back in September came and talked to us.  The facts were, that Margaret was in an incredibly weak condition,  her renal function was still holding up but causing concern,  her colesterol had gone through the roof and her blood was clotting quite badly.  She would be put on aggressive blood thinners to lower the risk of another heart attack or stroke.  It was unlikely that she could see a heart specialist before Tuesday but she may be transfered to the Sunshine Coast Hospital on Sunday or Monday as her condition stablised.  She would need an Angiogram to determine the extent of the damage to her heart.  Privately he told me that she was not in any immediate danger from the present heart attack but was a prime candidate for follow up attacks and he was usure that there was much they could to about it.

I left the ICU at 9.30 pm last night after she was settled.  We had the usual problem with her medication and a very patient ICU nurse let me talk Margaret taking each of her normal tablets before I left.

There is one more disturbing feature of her treatment.  They are now treating her as infectious.  They and her visitors will have to wear masks,gloves and gowns.  The were swabbing her mouth, vagina and rectum when I left.  The nurse said that  they would let me know the results today.

It is possible that Margaret has CJD akna "Mad Cows Disease".  She was treated with  humane growth hormones back in 1969 as a final attempt to increase her fertility which failed.  She showed up on the Canberra CJD register of at risk patients.

More later.