Just after I posted my blog on Tuesday morning Margaret phoned me to say that she had been told that she was coming home that morning which surprised me as I had been told Wednesday. I phoned the Nurses Station and they denied that she had been spoken too. When I got into visit at 9.30 am all her medications had been removed and were returned at 10.30 am all packed up and listed as if for discharge which gave some support to Margaret being told that she was coming home.
I hung around until her specialist dropped by and he said that her arm was strong enough to steady her on her wheely walker so she could go home on Wednesday. They had to unpack her meds to give them to her during the day. We had managed to dress Margaret in a proper nightie for the first time since her fall and she sat up until after lunch when I put her back to bed to rest.
She had a quiet night but her legs were still weeping and were very swollen.
On the way home I bought a commode chair to prevent Margaret having to get into her tiny en-suite during the night which is when she has had several falls. By re-arranging the bedroom furniture she now had clear access to the commode and most of the other furniture is the other side of the bed. This took some time and effort but I managed to complete it on Wednesday morning.
Louis continued to improve but was very quiet all of Tuesday. When he woke up on Wednesday he was back too his old boisterous self. This would make Margaret's homecoming much happier.
I arranged to pick Margaret up at 10.00 am and she was dressed in a clean nightie and a full length housecoat. I had brought her wheelchair from home. Before she left her specialist dropped by to wish her well. I asked about her legs and other problems. He had said that it was all up to her GP from now on as there was no real remedy to her problems and it would remain a balancing act to keep her kidneys functioning without causing a heart attack by fluid overload. He had arranged for Margaret to have a follow up visit to an orthopaedic surgeon in two weeks time but he wouldn't see her again. Apparently the hospital policy is to treat acute patients only and Margaret was now classed as chronic and could be cared for at home as she could "transit from bed to the toilet"
We got home at 11.00 am and Margaret sat up until after lunch before going to bed and resting while watching a DVD on her Television. I hid the remote control so she could not switch it off. I did show her how to activate the intercom on our house phone system and she called me 12 times in two hours and then forgot how to use it once again. She had a very small dinner and went to bed early. At present she has a Valium, sleeping tablet and a powerful pain killer before going to sleep and this works so I had a quite night.
On Thursday the Blue Care RN called and she was very blunt about Margaret's condition which she believes will not improve and is probably terminal. She is arranging more support as Margaret is now a high care patient requiring special palliative treatment. She was also very kind to Margaret and showered her and settled her back in bed. This RN was normally called "that woman" by Margaret but is now her best friend who gives her loving support.
The rest of the day passed quietly. Margaret has a lot of pain but the patch and Endone tablets keep her comfortable most of the time and I can supplement them with Osteo strength paracetamol. She spent her day watching DVDs in her bedroom and sitting with me in the lounge.
Today I will take her to see A. her GP. To top up he prescriptions and ask his advice on her future care. Providing she remains mobile and upright I can cope.
Friday, July 30, 2010
Tuesday, July 27, 2010
Problems with Louis and Interesting News
Poor little Louis has had and embarrassing problem. On Saturday he appeared to have difficulty pooing this was much worse on Sunday and he collapsed half way through his afternoon walk. I had to carry him most of the way home. As he is a solid (fat?) little dog and weighs 15 Kg I had to put him down and he walked the last 100 M. I think I carried him for about a kilometre. I managed to get into see an after hours vet who took X-Rays which showed that he was blocked up pretty solidly. She kept him in overnight, gave him an enema and put him on a drip for hydration and giving antibiotics. In the morning he was no better and in some distress so they anaesthetised him and using instruments cleared the bowel. I picked him up at 4.30 pm and he was still groggy but I was told to take him for a short walk as there was still a plug to come out and he was being coy in the hospital. Luckily the walk in his home park did the trick and he is performing OK this morning, He is still very quiet so I cut his walk short.
There was no obvious cause for the blockage but a as a precaution chicken wings are out from now on and all bones are banned for four weeks to allow his tummy to recover. The only pain left is to our bank account which is nearly $1,000 lighter.
Over the weekend Margaret has been very emotional and actually lost her temper with a nurse. She appears to have had too much Valium and they are weaning her off it. The DVD keeps her happy and the nurses busy sorting it out when she switches it off. On Sunday morning I walked in to find her in tears complaining that she had been "locked up". Actually the nurse who she had been rude to on the previous day had found her fast asleep right on the edge of her bed and had raised the rails to prevent her falling out. On waking Margaret has panicked as she could not get out. She began to scream and the nurse soon sorted her out and was comforting her when I arrived. The silly thing is the rail was only up on one side of the bed and Margaret had forgotten about the nurse's call button which was right next to her.
After her shower she said that she wasn't going to bed again as "they locked her in!" Margaret has bars on her bed at home to stop her rolling which she used to do regularly so the nurse's action was well justified.
While I was away having my morning coffee she was visited by her specialist. On my return she said that she was being discharged!! I managed to catch up with the specialist who said that he had arranged for her to be discharged on Wednesday. This was a big surprise as the first hospital had said seven weeks minimum before she would be safe to send home on a wheely walker and her specialist had originally said six weeks at Noosa Hospital which would have been a couple of days under seven weeks total. Wednesday is five weeks and two days so she must have had a miracle healing. I shall follow this up with the specialist this morning.
There was no obvious cause for the blockage but a as a precaution chicken wings are out from now on and all bones are banned for four weeks to allow his tummy to recover. The only pain left is to our bank account which is nearly $1,000 lighter.
Over the weekend Margaret has been very emotional and actually lost her temper with a nurse. She appears to have had too much Valium and they are weaning her off it. The DVD keeps her happy and the nurses busy sorting it out when she switches it off. On Sunday morning I walked in to find her in tears complaining that she had been "locked up". Actually the nurse who she had been rude to on the previous day had found her fast asleep right on the edge of her bed and had raised the rails to prevent her falling out. On waking Margaret has panicked as she could not get out. She began to scream and the nurse soon sorted her out and was comforting her when I arrived. The silly thing is the rail was only up on one side of the bed and Margaret had forgotten about the nurse's call button which was right next to her.
After her shower she said that she wasn't going to bed again as "they locked her in!" Margaret has bars on her bed at home to stop her rolling which she used to do regularly so the nurse's action was well justified.
While I was away having my morning coffee she was visited by her specialist. On my return she said that she was being discharged!! I managed to catch up with the specialist who said that he had arranged for her to be discharged on Wednesday. This was a big surprise as the first hospital had said seven weeks minimum before she would be safe to send home on a wheely walker and her specialist had originally said six weeks at Noosa Hospital which would have been a couple of days under seven weeks total. Wednesday is five weeks and two days so she must have had a miracle healing. I shall follow this up with the specialist this morning.
Saturday, July 24, 2010
Whose Smart Idea Was It to Buy A DVD PLayer?
Actually it was mine! As I said last time Margaret was getting bored so a DVD player appeared to be a good idea at the time. For Margaret it has been a great but for me it is a PITA. It has a remote control with no less than thirty buttons on it and I have given up trying to teach Margaret to use it. I have been trying to teach her how to use the manual controls on the player itself istead. The player sits on her over bed table within easy arm's reach so it is quite easy for her to use.
There are four buttons on top, two of which are set up and she doesn't need to use them. The other two are play/pause and stop. There is ,of course, the normal control for navigation through the DVD i.e. an OK button surrounded by four buttons with arrows. On the side is a volume control and an on/off switch plus a couple of socket for headphones, AV connections and the external power pack. These are all too much for Margaret. I forgot the cover for the DVD which has its own release button.
The first problem is getting her to remember how to insert a DVD. She should press the release button and the lid flips up. Now she should press the centre of the DVD with her finger while easing her thumb under the DVD to lift it out. She can't do it in spite of having a good right arm. No worries I load a new DVD each morning and evening and she has up to four hours of play time to keep her happy. She just has to switch player on and use the DVD's menu to play what ever she wants.
Next problem she can't remember where the on/off switch is - I shall put a label next to it and while I am at it label the volume control and play/pause and stop buttons. Another problem when a DVD starts it normally presents a menu which you use the navigation controls for. There is no standard menu and therefore Margaret can't get past the menu or if she does ends up where she dosen't want to be. She then just unplugs the power supply - she has forgotten the on/off switch and lets the DVD players internal battery discharge or if we are lucky the screen-saver kicks in and it shuts down after 10 minutes.
The solution is that I load the DVD and set it to play all the normal contents i.e. the complete movie or all episodes of the TV series she is watching. She remembers that she can use the play/pause button (I think) so she can go to the loo etc. At the end the DVD returns to the menu, the screen-saver kicks in and after 10 minutes it all shuts down, The nurse removes the power pack from the wall and I set it all up again when I next come in.
Luckily she loves it. She has watched the complete first series of "Some Mothers Do Have 'em", "Father Ted" and "George and Mildred" all UK comedy series from way back. Last night I left her watching "Beauty and the Beast" which she says she hasn't seen before but she bought it for herself several years ago and watched many times. I shall have a bit of a problem keeping her supplied but I think that I can start rotating them every couple of weeks and she wont notice.
On the health front it is not too good. The leg binding and TED stockings have been discontinued as her toes were not receiving any circulation and turning grey. Gangrene was a distinct possibility. Her feet and legs are once again very swollen. I don't know where she goes from here.
Her arm is still very painful but healing. She can use a wheely walker under supervision. It helps her stop wobbling but she cant use her left arm for support. If it was only the arm she would probably come home in two weeks but now I don't know.
There are four buttons on top, two of which are set up and she doesn't need to use them. The other two are play/pause and stop. There is ,of course, the normal control for navigation through the DVD i.e. an OK button surrounded by four buttons with arrows. On the side is a volume control and an on/off switch plus a couple of socket for headphones, AV connections and the external power pack. These are all too much for Margaret. I forgot the cover for the DVD which has its own release button.
The first problem is getting her to remember how to insert a DVD. She should press the release button and the lid flips up. Now she should press the centre of the DVD with her finger while easing her thumb under the DVD to lift it out. She can't do it in spite of having a good right arm. No worries I load a new DVD each morning and evening and she has up to four hours of play time to keep her happy. She just has to switch player on and use the DVD's menu to play what ever she wants.
Next problem she can't remember where the on/off switch is - I shall put a label next to it and while I am at it label the volume control and play/pause and stop buttons. Another problem when a DVD starts it normally presents a menu which you use the navigation controls for. There is no standard menu and therefore Margaret can't get past the menu or if she does ends up where she dosen't want to be. She then just unplugs the power supply - she has forgotten the on/off switch and lets the DVD players internal battery discharge or if we are lucky the screen-saver kicks in and it shuts down after 10 minutes.
The solution is that I load the DVD and set it to play all the normal contents i.e. the complete movie or all episodes of the TV series she is watching. She remembers that she can use the play/pause button (I think) so she can go to the loo etc. At the end the DVD returns to the menu, the screen-saver kicks in and after 10 minutes it all shuts down, The nurse removes the power pack from the wall and I set it all up again when I next come in.
Luckily she loves it. She has watched the complete first series of "Some Mothers Do Have 'em", "Father Ted" and "George and Mildred" all UK comedy series from way back. Last night I left her watching "Beauty and the Beast" which she says she hasn't seen before but she bought it for herself several years ago and watched many times. I shall have a bit of a problem keeping her supplied but I think that I can start rotating them every couple of weeks and she wont notice.
On the health front it is not too good. The leg binding and TED stockings have been discontinued as her toes were not receiving any circulation and turning grey. Gangrene was a distinct possibility. Her feet and legs are once again very swollen. I don't know where she goes from here.
Her arm is still very painful but healing. She can use a wheely walker under supervision. It helps her stop wobbling but she cant use her left arm for support. If it was only the arm she would probably come home in two weeks but now I don't know.
Wednesday, July 21, 2010
Margaret is having a lot of pain.
Since Monday morning Margaret has been having a lot of pain. It is mainly in her broken shoulder but her back is also causing problems. She has osteoarthritis of the spine and has also suffered a few crush fractures in the lower spine due to osteoporosis. These are not helped by only having one arm to manoeuvre herself in bed. Monday night she got very little sleep and was absolutely exhausted when i saw hew yesterday morning. She was kept in bed for most of the day and didn't have her usual physio session.
I managed to speak to her specialist who has prescribed morphine injections at night to help her sleep. He also believes that the bandaging of her feet and legs has failed to reduce the fluid build up and there were signs that the circulation to her big toes was failing and he was scared of gangrene setting in if he continues. The only alternative will be more diuretics which always affects her kidney function. At present she has about a 40 mm build up of fluid all over her feet and ankles which could cause a stroke and/or congestive heart failure. She would be in hospital even without her broken arm.
To help her feel a little happier I am going to buy her a portable DVD player so that she can watch her favourite comedy DVDs from home. I will set up a DVD when I leave her in the evening which should run until she gets her pain killer at 10.00 pm and hopefully she will be able to sleep in a happier frame of mind.
Today I am going to present a short tutorial at my computer club. It wont affect my visiting but poor old Louis will miss out on his afternoon walk.
I managed to speak to her specialist who has prescribed morphine injections at night to help her sleep. He also believes that the bandaging of her feet and legs has failed to reduce the fluid build up and there were signs that the circulation to her big toes was failing and he was scared of gangrene setting in if he continues. The only alternative will be more diuretics which always affects her kidney function. At present she has about a 40 mm build up of fluid all over her feet and ankles which could cause a stroke and/or congestive heart failure. She would be in hospital even without her broken arm.
To help her feel a little happier I am going to buy her a portable DVD player so that she can watch her favourite comedy DVDs from home. I will set up a DVD when I leave her in the evening which should run until she gets her pain killer at 10.00 pm and hopefully she will be able to sleep in a happier frame of mind.
Today I am going to present a short tutorial at my computer club. It wont affect my visiting but poor old Louis will miss out on his afternoon walk.
Monday, July 19, 2010
Back on the Job
My enforced break in visiting Margaret ended on Saturday so I visited her as normal just before 10,00 am. She was in the shower and then having her feet and lower legs bound to try and ease the fluid away. Her feet were still very swollen but she was in a pretty good state otherwise. Her heart and kidneys are stable, her skin tears are healing and her arm, while still very painful, is now out of its sling and she has begun physio on keeping the shoulder joint working. I should stay away more often:)
I sat with her until after lunch and helped her to the loo a few times and cut up her lunch for her. This gives the nurses a little more time for their other tasks around the ward. As Margaret is still in isolation anybody caring for other patients have to wear gowns and gloves when attending to Margaret so it is really a chore to come and tend to Margaret for the minor things which she can't manage by herself.
I visited again for dinner 5.00 - 6.00 pm and she was quite happy watching TV when I left her.
When I visited on Sunday morning she was showered and back in bed. She had had a bad night with pain and had little sleep. The RN looking after her had checked her medication and discovered that she had not had her overnight painkillers due to a mix up. When I saw the stand in specialist, actually the hospital's Chief of Medicine who knows Margaret well, he apologised to Margaret and assured her that her had re-written her medication charts to ensure that their would be no more mix ups. She spent the morning resting apart from her daily walk with the physios and her simple arm exercises. Imagine being a monkey and swinging you arm gently from the shoulder. She does this to and through and in small circles ten times each twice a day. As the arm is unsupported it gets quite sore at the break but it beats a permanently frozen shoulder. The physio commented on how much better Margaret was from the previous couple of weekends when he had looked after her. She is much stronger and gets less puffed when walking. She is still very wobbly but this is normal and they hope that she can get back to using her wheely walker in the near future.
In the afternoon I took my laptop in and logged into Facebook to look at M's photographs of her son's wedding and R's photos of her Mum and Dad's fiftieth wedding anniversary. Margaret loved them and I now have the task of copying them to a SD card so she can see them on her Electronic Photo Frame.
Margaret looks like being in hospital for another three weeks. I hope that she will be able to come home for a while before we have to make the final decision on what the future holds. I have deferred having her Aged Care Assessment carried out until she is at home.
I sat with her until after lunch and helped her to the loo a few times and cut up her lunch for her. This gives the nurses a little more time for their other tasks around the ward. As Margaret is still in isolation anybody caring for other patients have to wear gowns and gloves when attending to Margaret so it is really a chore to come and tend to Margaret for the minor things which she can't manage by herself.
I visited again for dinner 5.00 - 6.00 pm and she was quite happy watching TV when I left her.
When I visited on Sunday morning she was showered and back in bed. She had had a bad night with pain and had little sleep. The RN looking after her had checked her medication and discovered that she had not had her overnight painkillers due to a mix up. When I saw the stand in specialist, actually the hospital's Chief of Medicine who knows Margaret well, he apologised to Margaret and assured her that her had re-written her medication charts to ensure that their would be no more mix ups. She spent the morning resting apart from her daily walk with the physios and her simple arm exercises. Imagine being a monkey and swinging you arm gently from the shoulder. She does this to and through and in small circles ten times each twice a day. As the arm is unsupported it gets quite sore at the break but it beats a permanently frozen shoulder. The physio commented on how much better Margaret was from the previous couple of weekends when he had looked after her. She is much stronger and gets less puffed when walking. She is still very wobbly but this is normal and they hope that she can get back to using her wheely walker in the near future.
In the afternoon I took my laptop in and logged into Facebook to look at M's photographs of her son's wedding and R's photos of her Mum and Dad's fiftieth wedding anniversary. Margaret loved them and I now have the task of copying them to a SD card so she can see them on her Electronic Photo Frame.
Margaret looks like being in hospital for another three weeks. I hope that she will be able to come home for a while before we have to make the final decision on what the future holds. I have deferred having her Aged Care Assessment carried out until she is at home.
Thursday, July 15, 2010
Resting At Home
I had a full day doing absolutely nothing at home. Well I did drop four rolls of Mentos and some little chocolate bars into Margaret at 9.00 am but other that that I played with my computer, read or watched a replay of the Tour De France.
I called Margaret twice and she appears to be getting on OK. Her legs are still very swollen and she has now had her feet bound to try and assist her lymph glands move the fluid up to her abdomen. She told me it made her feet warm for the first time in days.
Today I shall make up a new set of photos for her electronic photo frame using pictures from Facebook posted by my two nieces R and M. She will love the wedding shots and photos of my stepbrother and his wife, C and G, at their fiftieth wedding anniversary.
Apart from some shopping and a little housework its back to reading and the tour.
I called Margaret twice and she appears to be getting on OK. Her legs are still very swollen and she has now had her feet bound to try and assist her lymph glands move the fluid up to her abdomen. She told me it made her feet warm for the first time in days.
Today I shall make up a new set of photos for her electronic photo frame using pictures from Facebook posted by my two nieces R and M. She will love the wedding shots and photos of my stepbrother and his wife, C and G, at their fiftieth wedding anniversary.
Apart from some shopping and a little housework its back to reading and the tour.
Wednesday, July 14, 2010
Now Its my Turn
First, I visited Margaret early Sunday morning and she was quite calm. The hallucinations had stopped but she still believed that they were true. I spoke with her doctor who put them down to a bad reaction to her painkillers which are morphine based. He has changed them from one big dose every eight hours to half the dose every six hours and has allowed her to have an additional sleeping tablet. The main concern was her swollen legs which was still posing a threat of a stroke or congestive heart failure. They still haven't been able to get a blood sample to check her kidneys so are laying off the diuretics for a while.
The rest of Sunday wasn't too bad but Margaret's short term memory was very bad and she demamded more painkillers just ten minutes after I witnessed the nurse giving her some. This makes it very difficult for the nurses as Margaret gets very annoyed if she thinks that she has missed some medication. See some of my earlier posts. Fortunately the painkillers kicked in quickly and she settled down and, of course, forgot about them.
Monday was much the same. She told me that she was in pain and needed her patch replaced. I ignored this as, normally, it has been replaced on Tuesdays. When the nurse came in she complained. The nurse, who after giving her a painkiller, said that the patch had been replaced about ten minutes before i came in. This I checked for Margaret's sake and there it was signed and dated for that day. I explained to the nurse that I hadn't doubted her but it is really necessary to make sure that Margaret understands that she has received the correct medication or a patch has been put on. As her dementia increases this is becoming more of a problem. Later the doctor told me that they had been able to get a blood sample and we will know how things were with her kidneys tomorrow, Tuesday.
On Tuesday I visited early and she was being looked after by a first year student nurse, He was a mature age student, married with three kids and had really made a hit with Margaret. He was dressing her skin tears and I helped get Margaret's arm back in its sling. Margaret was much brighter due to the nurses lovely nature. He looked like a footballer and used to drive ambulances for a living but now, with his wife's support, was trying to make a new career out of nursing. I can only say if he maintains his caring and kind manner hr will be a great nurse.
I found out that Margaret in still a "no contact" patient. I must wash my hands before and after entering her room and have no contact with any other patients on the ward. The nurses, physios, doctors and ward staff must wear gowns and gloves before entering the room. Meals are left at the door and I normally bring them in to Margaret. I also help Margaret to and from the loo otherwise the nurses have to gown up each time.. The problem is a highly resistant urinary tract infection, which although responding to antibiotics, is spread by physical contact and can remain in the system for many months. She will be a "no contact" patient for all her stay in hospital and for the next six months.
Her normal specialist returned and checked her blood test results. Her kidneys are stable, albeit at a chronic failure level, and he is beginning to increase the diuretics to see if they can get her fluid overload down before it causes more problems.
Now I start to cause problems. About a week ago I had a funny turn while walking Louis. I was on my own as B, my afternoon walking companion, was away. I was quite coherent in my thoughts and actions except that I had difficulty walking straight and felt extremely tired. I ended up with an back ache. I had a brief rest before I visited Margaret and had something to eat and drink. As I felt better I forgot about it. On Monday I was walking with B when she asked me what was wrong. Apparently I was walking tilted to the left and I was also having the same problems from the week before. B is a retired nurse and told me to see my GP ASAP so I made an appointment for Tuesday afternoon.
When I saw him, C who is a London born and trained Indian and also a personal friend, did a few tests which eliminated a stroke or anything more sinister. Apparently I have a chest infection which is why I have also developed an irritating little cough in the last week or so. I have fairly restricted breathing which in some way causes me to run out of puff when walking and causes my problems. The treatment is a course of antibiotics for ten days which should clear it up. If I am still having problems by Saturday I must see him again but I must finish all the antibiotics in any case.
Now comes the problem, because of Margaret's poor health I must not visit her until Saturday morning. I phoned the hospital to let then know and tried to explain to Margaret that I was in no danger but more a threat to her and would keep in touch with her by phone. I can also drop off anything she needs at hospital reception for the next three days. I thought she had understood but later i got a concerned phone call from Helen as Margaret had told her that I was very sick and wouldn't be visiting for at least two weeks. She also complained that I hadn't left her any mints to eat. She gets a roll of Mentos everyday from me. I shall drop a few rolls later this morning.
The rest of Sunday wasn't too bad but Margaret's short term memory was very bad and she demamded more painkillers just ten minutes after I witnessed the nurse giving her some. This makes it very difficult for the nurses as Margaret gets very annoyed if she thinks that she has missed some medication. See some of my earlier posts. Fortunately the painkillers kicked in quickly and she settled down and, of course, forgot about them.
Monday was much the same. She told me that she was in pain and needed her patch replaced. I ignored this as, normally, it has been replaced on Tuesdays. When the nurse came in she complained. The nurse, who after giving her a painkiller, said that the patch had been replaced about ten minutes before i came in. This I checked for Margaret's sake and there it was signed and dated for that day. I explained to the nurse that I hadn't doubted her but it is really necessary to make sure that Margaret understands that she has received the correct medication or a patch has been put on. As her dementia increases this is becoming more of a problem. Later the doctor told me that they had been able to get a blood sample and we will know how things were with her kidneys tomorrow, Tuesday.
On Tuesday I visited early and she was being looked after by a first year student nurse, He was a mature age student, married with three kids and had really made a hit with Margaret. He was dressing her skin tears and I helped get Margaret's arm back in its sling. Margaret was much brighter due to the nurses lovely nature. He looked like a footballer and used to drive ambulances for a living but now, with his wife's support, was trying to make a new career out of nursing. I can only say if he maintains his caring and kind manner hr will be a great nurse.
I found out that Margaret in still a "no contact" patient. I must wash my hands before and after entering her room and have no contact with any other patients on the ward. The nurses, physios, doctors and ward staff must wear gowns and gloves before entering the room. Meals are left at the door and I normally bring them in to Margaret. I also help Margaret to and from the loo otherwise the nurses have to gown up each time.. The problem is a highly resistant urinary tract infection, which although responding to antibiotics, is spread by physical contact and can remain in the system for many months. She will be a "no contact" patient for all her stay in hospital and for the next six months.
Her normal specialist returned and checked her blood test results. Her kidneys are stable, albeit at a chronic failure level, and he is beginning to increase the diuretics to see if they can get her fluid overload down before it causes more problems.
Now I start to cause problems. About a week ago I had a funny turn while walking Louis. I was on my own as B, my afternoon walking companion, was away. I was quite coherent in my thoughts and actions except that I had difficulty walking straight and felt extremely tired. I ended up with an back ache. I had a brief rest before I visited Margaret and had something to eat and drink. As I felt better I forgot about it. On Monday I was walking with B when she asked me what was wrong. Apparently I was walking tilted to the left and I was also having the same problems from the week before. B is a retired nurse and told me to see my GP ASAP so I made an appointment for Tuesday afternoon.
When I saw him, C who is a London born and trained Indian and also a personal friend, did a few tests which eliminated a stroke or anything more sinister. Apparently I have a chest infection which is why I have also developed an irritating little cough in the last week or so. I have fairly restricted breathing which in some way causes me to run out of puff when walking and causes my problems. The treatment is a course of antibiotics for ten days which should clear it up. If I am still having problems by Saturday I must see him again but I must finish all the antibiotics in any case.
Now comes the problem, because of Margaret's poor health I must not visit her until Saturday morning. I phoned the hospital to let then know and tried to explain to Margaret that I was in no danger but more a threat to her and would keep in touch with her by phone. I can also drop off anything she needs at hospital reception for the next three days. I thought she had understood but later i got a concerned phone call from Helen as Margaret had told her that I was very sick and wouldn't be visiting for at least two weeks. She also complained that I hadn't left her any mints to eat. She gets a roll of Mentos everyday from me. I shall drop a few rolls later this morning.
Sunday, July 11, 2010
Margaret is having Hallucinations
Yesterday started off OK. Margaret was in a bit of pain but quite bright. At lunch time she asked the nurse for some painkillers and was given Endone which helps a lot. The problem was that five minutes later she had forgotten that she had taken it. Fortunately I was there when she took it and, due to the nature of the drug the nurse had got another nurse to witness her give it to Margaret. In a little while I got her settled and the pain did lessen. I had seen the doctor earlier who said that they had to take off her TED stockings as they were putting too much pressure on her swollen legs but hoped that the injection to her tummy would ward off any stroke. He wants to increase her Frusimide but can't due so until they can take a blood sample to check her kidney function. They will try again on Monday.
I left Margaret after cutting up her lunch and helping her eat it. She is having very good food, roast turkey and cranberry sauce with veggies. I left her resting in bed as she felt a little weak.
I returned at 4.45 pm to find her sitting on the side of the bed in tears and obviously in some distress. I sought out her nurse who said that Margaret had become more and more upset as the afternoon had progress and they had consoled and settled her down a couple of times. I managed to get her calm and ask what the problem was. In her own little world her room had been invaded by teenagers who had threatened to hurt her arm, thrown Big Ted away and had told her that if she laid down they would hurt her. Of course none of this had happened and she was having hallucinations.
She has had hallucinations before during periods of steroid induced psychosis brought on by steroid drips to reduce the effect of massive infections. These have been harmless and amusing. Once she had seen a film crew in her room making a documentary about the hospital. Another time the hospital was taken over by Aboriginals over the weekend as they buried their leader. These she found interesting but now she was terrified. I got her settled and told her that the nurses had alerted security and she would have no more problems. She was still afraid when I left. I got Helen to phone her and the first time Margaret hung up as she thought it was the teenagers phoning and they had threatened her again. Helen phoned back and got the nurse to calm Margaret down and let her know that is was Helen on the phone. Gradually she calmed down but by now the teenagers had assaulted me and hurt my arm. Helen told her that I was OK and finally she settled. Helen was on the phone for an hour.
The nurses gave Margaret valium to reduce her anxiety and later her sleeping tablet.
I am off to visit her now.
I left Margaret after cutting up her lunch and helping her eat it. She is having very good food, roast turkey and cranberry sauce with veggies. I left her resting in bed as she felt a little weak.
I returned at 4.45 pm to find her sitting on the side of the bed in tears and obviously in some distress. I sought out her nurse who said that Margaret had become more and more upset as the afternoon had progress and they had consoled and settled her down a couple of times. I managed to get her calm and ask what the problem was. In her own little world her room had been invaded by teenagers who had threatened to hurt her arm, thrown Big Ted away and had told her that if she laid down they would hurt her. Of course none of this had happened and she was having hallucinations.
She has had hallucinations before during periods of steroid induced psychosis brought on by steroid drips to reduce the effect of massive infections. These have been harmless and amusing. Once she had seen a film crew in her room making a documentary about the hospital. Another time the hospital was taken over by Aboriginals over the weekend as they buried their leader. These she found interesting but now she was terrified. I got her settled and told her that the nurses had alerted security and she would have no more problems. She was still afraid when I left. I got Helen to phone her and the first time Margaret hung up as she thought it was the teenagers phoning and they had threatened her again. Helen phoned back and got the nurse to calm Margaret down and let her know that is was Helen on the phone. Gradually she calmed down but by now the teenagers had assaulted me and hurt my arm. Helen told her that I was OK and finally she settled. Helen was on the phone for an hour.
The nurses gave Margaret valium to reduce her anxiety and later her sleeping tablet.
I am off to visit her now.
Saturday, July 10, 2010
Update on Margaret
I managed to catch up with Margaret's specialist on Thursday afternoon. There was still some concern about AF and Margaret had been fitted with a halter monitor once again. Her legs were still very swollen and weeping fluid in spite of the increased Frusimide. They haven't been able to find any suitable veins to take a blood sample to check her kidneys and finally Margaret is still very confused.
As I have said before I visit over lunch and dinner times to help her with her food this means 10.00 am to 12.30 pm and 4.45 pm to 6.15 pm visits. After lunch on Thursday I told her that I would be back at 5.00 pm. When I walked in at 4.50 pm the nurse was consoling her and Margaret was in tears. She had asked the nurse to phone me as I was late and had probably had a motor accident. Of course I wasn't home which really upset her. She calmed down when I arrived and I pointed out that I wasn't even late let alone in an accident. It took some time to work out what had caused this concern but I think it was because I had our car serviced that day and had used the bus to get to the hospital in the morning. This left Margaret with the belief that there was something wrong with the car and thus it could be in an accident. Another problem is that Margaret firmly believes that the nurses call button which is contained in the TV control and speaker pod is the telephone and the actual phone in used for something else which only works if she dials 66!. This really gives the telephone receptionist a pain as it somehow or other wakes her up:) When Helen phones she gets a nurse to to make sure that Margaret uses the phone. Once she dropped it and Helen could hear Margaret carrying on the conversation using the Nurses call/TV control pod. Helen hung up, called the nurses station back and they went and put Margaret back on the phone. Even so, to call me she had to use the nurse.
Margaret's specialist is away for a few days and another Physician has taken over. I met him yesterday, Friday, and he is very concerned with Margaret's condition plus the fact that somehow or other Margaret had lost her sling overnight. She was in great deal of pain so I went looking for a nurse and found the ward sister with the new doctor just about to visit Margaret. The doctor was upset when Margaret's sling was found folded up on a high shelf where Margaret could not have put it. I had thought that Margaret might have removed it and it had fallen under the bed but this meant that somebody had deliberately ignored that it was off or even worse removed it and put it out of reach. The doctor explained to me that and mild pressure on the break could cause it to open and misalign the fracture and it must be kept immobilised at all times.
Next he was concerned with her swollen legs. She was, in his opinion, on the verge of developing blood clots in both legs which in turn could cause a stroke. He had her put in long TED stockings and clot busting injections. She is to keep her feet up most of the time but also go for short walks under the supervision of a physio once or twice a day. Her heart appears stable but as she hasn't had a blood test for several days he was concerned that the increased Frusimide could be affecting her kidneys.
All in all I am still very worried about Margaret's future. As for the arm there is nothing to do with it for the next few weeks except, perhaps, start Physio on it to prevent the shoulder joint freezing up.
As I have said before I visit over lunch and dinner times to help her with her food this means 10.00 am to 12.30 pm and 4.45 pm to 6.15 pm visits. After lunch on Thursday I told her that I would be back at 5.00 pm. When I walked in at 4.50 pm the nurse was consoling her and Margaret was in tears. She had asked the nurse to phone me as I was late and had probably had a motor accident. Of course I wasn't home which really upset her. She calmed down when I arrived and I pointed out that I wasn't even late let alone in an accident. It took some time to work out what had caused this concern but I think it was because I had our car serviced that day and had used the bus to get to the hospital in the morning. This left Margaret with the belief that there was something wrong with the car and thus it could be in an accident. Another problem is that Margaret firmly believes that the nurses call button which is contained in the TV control and speaker pod is the telephone and the actual phone in used for something else which only works if she dials 66!. This really gives the telephone receptionist a pain as it somehow or other wakes her up:) When Helen phones she gets a nurse to to make sure that Margaret uses the phone. Once she dropped it and Helen could hear Margaret carrying on the conversation using the Nurses call/TV control pod. Helen hung up, called the nurses station back and they went and put Margaret back on the phone. Even so, to call me she had to use the nurse.
Margaret's specialist is away for a few days and another Physician has taken over. I met him yesterday, Friday, and he is very concerned with Margaret's condition plus the fact that somehow or other Margaret had lost her sling overnight. She was in great deal of pain so I went looking for a nurse and found the ward sister with the new doctor just about to visit Margaret. The doctor was upset when Margaret's sling was found folded up on a high shelf where Margaret could not have put it. I had thought that Margaret might have removed it and it had fallen under the bed but this meant that somebody had deliberately ignored that it was off or even worse removed it and put it out of reach. The doctor explained to me that and mild pressure on the break could cause it to open and misalign the fracture and it must be kept immobilised at all times.
Next he was concerned with her swollen legs. She was, in his opinion, on the verge of developing blood clots in both legs which in turn could cause a stroke. He had her put in long TED stockings and clot busting injections. She is to keep her feet up most of the time but also go for short walks under the supervision of a physio once or twice a day. Her heart appears stable but as she hasn't had a blood test for several days he was concerned that the increased Frusimide could be affecting her kidneys.
All in all I am still very worried about Margaret's future. As for the arm there is nothing to do with it for the next few weeks except, perhaps, start Physio on it to prevent the shoulder joint freezing up.
Wednesday, July 7, 2010
No Real News
I saw Margaret's specialist yesterday morning. Margaret had had a restless night and was feeling very tired. She still showed signs of AF but the specialist wanted to review the records from the halter monitor she had worn overnight. If there were ongoing problems he would arrange for more tests. I left after lunch with no more information.
Later in the afternoon Margaret was taken to see a Cardiologist who carried out more tests and she was told to "take it easy". The rails had been put up on her bed to stop her getting up without assistance. When I visited at 4.45 pm she was sitting up in her chair and I helped her with dinner. Afterwards she wanted to go to the toilet and I rang for a nurse who took some time coming. I tried to save time by lowering her foot rest and just before the nurse arrived she tried to stand up and fell against the bed. It took the nurse and me some time to get her back into the chair and then into the toilet. Fortunately no harm was done. Margaret was told to ring for assistance to get back to her chair. After a little while she rang but rather than waiting got herself up and walked to the door with her pants around her ankles and called me. I managed to get her pants up and the get her back to the chair. I cancelled the call for the nurse but she arrived in a couple of minutes and wasn't happy that Margaret hadn't waited as she is now classified as a high risk falls candidate and she must not move with out a nurse's of physio's assistance. I am not supposed to move her.
After checking with the nurse that Margaret had a sedative to help her sleep I left to get my own dinner about 6.15 pm. Later Helen phoned her and the nurse told her that the specialist had been called because she was still upset and that he had given some Valium to ease her anxiety. She was back in bed with the rails up and Helen managed to talk to her for a little while before she hung up.
I shall try and catch up with the specialist this morning for an update.
Later in the afternoon Margaret was taken to see a Cardiologist who carried out more tests and she was told to "take it easy". The rails had been put up on her bed to stop her getting up without assistance. When I visited at 4.45 pm she was sitting up in her chair and I helped her with dinner. Afterwards she wanted to go to the toilet and I rang for a nurse who took some time coming. I tried to save time by lowering her foot rest and just before the nurse arrived she tried to stand up and fell against the bed. It took the nurse and me some time to get her back into the chair and then into the toilet. Fortunately no harm was done. Margaret was told to ring for assistance to get back to her chair. After a little while she rang but rather than waiting got herself up and walked to the door with her pants around her ankles and called me. I managed to get her pants up and the get her back to the chair. I cancelled the call for the nurse but she arrived in a couple of minutes and wasn't happy that Margaret hadn't waited as she is now classified as a high risk falls candidate and she must not move with out a nurse's of physio's assistance. I am not supposed to move her.
After checking with the nurse that Margaret had a sedative to help her sleep I left to get my own dinner about 6.15 pm. Later Helen phoned her and the nurse told her that the specialist had been called because she was still upset and that he had given some Valium to ease her anxiety. She was back in bed with the rails up and Helen managed to talk to her for a little while before she hung up.
I shall try and catch up with the specialist this morning for an update.
Tuesday, July 6, 2010
Off We Go Again!!
I am sorry if the title is a little flippant but yesterday started, as i said in my blog, with nothing to report. How things change.
I got into hospital at 9.45 am and Margaret was being showered and she was pleased to see me as for some reason she thought that I wasn't visiting that day. The nurse told me that there had been some excitement that morning as it had been impossible to take her blood pressure due to the fluid build up in her arms. Her oxygen level was a bit low 92% and more alarmingly her heart rate was over 160 and erratic. Apparently she was in Atrial Fibrillation (AF) which is another thing to add to her long list of ailments.
Her Specialist came in about 10.15 am and said that it was essential, considering Margaret's poor state of health that they reverse the AF using medication and that he would be increasing her Frusimide to try and get some fluid off her. She was doing a pretty good job on her own as fluid was now seeping from her broken arm and hand and both legs. The kidneys will have to take their chances for a few days. If the AF is not reversed she will have to go into the ICU and be placed on a drip. She was told to stay in bed and her steroids reduced from 15 mg to 10 mg a day which means that she will have little energy reserve.
The specialist came back at midday to check on her and ordered more medication at 4.00 pm. He returned at 5.00 pm and appeared pleased with her state but attached a Halter Monitor to check her long term heart state. It showed that the heart rate was up over 150 once again and he immediately prescribed even more medication which was given within 20 minutes and would be repeated throughout the night.
I haven't had any reports overnight and shall be visiting early this morning.
The big worries are a heart attack or a a stroke.
I got into hospital at 9.45 am and Margaret was being showered and she was pleased to see me as for some reason she thought that I wasn't visiting that day. The nurse told me that there had been some excitement that morning as it had been impossible to take her blood pressure due to the fluid build up in her arms. Her oxygen level was a bit low 92% and more alarmingly her heart rate was over 160 and erratic. Apparently she was in Atrial Fibrillation (AF) which is another thing to add to her long list of ailments.
Her Specialist came in about 10.15 am and said that it was essential, considering Margaret's poor state of health that they reverse the AF using medication and that he would be increasing her Frusimide to try and get some fluid off her. She was doing a pretty good job on her own as fluid was now seeping from her broken arm and hand and both legs. The kidneys will have to take their chances for a few days. If the AF is not reversed she will have to go into the ICU and be placed on a drip. She was told to stay in bed and her steroids reduced from 15 mg to 10 mg a day which means that she will have little energy reserve.
The specialist came back at midday to check on her and ordered more medication at 4.00 pm. He returned at 5.00 pm and appeared pleased with her state but attached a Halter Monitor to check her long term heart state. It showed that the heart rate was up over 150 once again and he immediately prescribed even more medication which was given within 20 minutes and would be repeated throughout the night.
I haven't had any reports overnight and shall be visiting early this morning.
The big worries are a heart attack or a a stroke.
Monday, July 5, 2010
Nothing to Report
Margaret is much the same. She still has fluid leaking from her legs which makes it very uncomfortable in bed. She is still confused and expects me to stay and have dinner with her and she still believes she is coming home "tomorrow".
She tries to read but is not getting very far with her latest book. I sit with her for four to five hours a day and read while she is resting.
I haven't seen her specialist since last Thursday and am not really aware of her actual medical condition. Physically she appears stronger.
I shall drop in early today on the way home from shopping to see if I can catch her specialist.
She tries to read but is not getting very far with her latest book. I sit with her for four to five hours a day and read while she is resting.
I haven't seen her specialist since last Thursday and am not really aware of her actual medical condition. Physically she appears stronger.
I shall drop in early today on the way home from shopping to see if I can catch her specialist.
Saturday, July 3, 2010
Another Skin Tear
Thursday night Margaret was being helped to the toilet when she stumbled and hit her right arm against the striker plate of the door latch which has resulted in another large skin tear.
Here you can see the clean dressing on the one she did at home near the wrist band and the new one, still bleeding above it. This photo was taken 15 hours after the event. The bruising is from the new skin tear.
Margaret was now also leaking fluid from both her arms and weeping fluid from from another mysterious dressing on her left shin. She is decidedly unhappy with life at present as she hates being "dirty" and lying in "dirty bed clothes"
She only had one walk with the physio on Friday because she didn't feal well and I took a video of it and placed it on my Facebook page.
I dropped in this morning to see Margaret and she was a bit brighter but still leaking from her left arm and right leg. She has been given Endone to help with her pain and has also been fitted with a new sling which holds her arm closer to the body.
I stayed and cut up her lunch for her. She is going to rest this afternoon having sat up all morning.
I shall see her again at dinner and assist her if she needs it.
Margaret was now also leaking fluid from both her arms and weeping fluid from from another mysterious dressing on her left shin. She is decidedly unhappy with life at present as she hates being "dirty" and lying in "dirty bed clothes"
She only had one walk with the physio on Friday because she didn't feal well and I took a video of it and placed it on my Facebook page.
I dropped in this morning to see Margaret and she was a bit brighter but still leaking from her left arm and right leg. She has been given Endone to help with her pain and has also been fitted with a new sling which holds her arm closer to the body.
I stayed and cut up her lunch for her. She is going to rest this afternoon having sat up all morning.
I shall see her again at dinner and assist her if she needs it.
Friday, July 2, 2010
A Down Day
Margaret had a lot of pain in her arm Wednesday night and was given Morphine. During Thursday her lower arm was weeping copious amounts of fluid which messed uo her bedding and gown. She only had one walk with the physios as she felt really down all day.
I bought a little video camera and took a few shots of Margaret in her room and a video of her walking with physios.
I bought a little video camera and took a few shots of Margaret in her room and a video of her walking with physios.
Sitting Up in Her Chair
A General View of Her Room
Big Ted
The View From Margaret's Window
Helen's Get Well Card
I will post the video later.
Thursday, July 1, 2010
Margaret is Improving
Yesterday Margaret had two sessions with the Physiotherapists who are getting her up to walk for a few minutes. Her breathing difficulties have reduced but her swollen feet/calves are still bad. The broken arm is incredibly swollen and last night she was weeping fluid from the back of her hand, It was dripping like a leaky tap.
In the morning we were interviewed by an occupational health therapist who is worried that Margaret wont be able to cope at home after the arm heals. Apparently after healing it will take up to a year for the arm to regain its full strength. Using a wheely walker or safety rails to steady herself will be difficult. she also has to use both arms to get herself up from chairs and the toilet. A Nursing Home was suggested which upset Margaret and she was also more upset when I told her that her GP, A, had also said that this was now the time for residential care. Fortunately her dementia is so bad that she had forgotten about it an hour later. I shall seek an Aged Care Assessment before she is released from hospital and take their advice.
Today she will be visited by an Orthopaedic Surgeon to check how the arm is going. It is likely that they will be able to start manipulating her shoulder in a few days to stop it freezing up.
I am back in my normal routine for when Margaret is in hospital. Up at 5.00 am, shower shave and breakfast. Walk Louis between 6.00 and 7.00 am. Odd jobs including Blogging and shopping between 7.00 and 9.45 am. Visit Margaret between 10.00 am and 12.30 pm including cutting up her lunch. Rest after lunch at home. Walk Louis between 3.30 and 4.30 pm. Visit Margaret between 4.45 and 6.00 pm including helping her with dinner, Prepare and eat my own dinner between 6.15 and 7.30 pm then snooze in front of TV until 9.30 pm and off to bed.
Now I am off shopping,
In the morning we were interviewed by an occupational health therapist who is worried that Margaret wont be able to cope at home after the arm heals. Apparently after healing it will take up to a year for the arm to regain its full strength. Using a wheely walker or safety rails to steady herself will be difficult. she also has to use both arms to get herself up from chairs and the toilet. A Nursing Home was suggested which upset Margaret and she was also more upset when I told her that her GP, A, had also said that this was now the time for residential care. Fortunately her dementia is so bad that she had forgotten about it an hour later. I shall seek an Aged Care Assessment before she is released from hospital and take their advice.
Today she will be visited by an Orthopaedic Surgeon to check how the arm is going. It is likely that they will be able to start manipulating her shoulder in a few days to stop it freezing up.
I am back in my normal routine for when Margaret is in hospital. Up at 5.00 am, shower shave and breakfast. Walk Louis between 6.00 and 7.00 am. Odd jobs including Blogging and shopping between 7.00 and 9.45 am. Visit Margaret between 10.00 am and 12.30 pm including cutting up her lunch. Rest after lunch at home. Walk Louis between 3.30 and 4.30 pm. Visit Margaret between 4.45 and 6.00 pm including helping her with dinner, Prepare and eat my own dinner between 6.15 and 7.30 pm then snooze in front of TV until 9.30 pm and off to bed.
Now I am off shopping,
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