Margaret has Problems

This is a difficult blog to write as the future for Margaret is on a knife edge but first lets go back to last Monday when Helen made her goodbye visit to Margaret.  She stayed over lunch and caught the 3.00 pm bus home.  I think that she cried all the way home as we both know that Margaret is in a bad way.  We spent a quiet ev evening together and went to bed early as Helen was catching the 2.45 am, Tuesday, shuttle bus to the airport.  I got up an saw her off.  She was clutching a handful of tissues.

At 11.45 am Helen phoned to say that she was home back in the Adelaide Hills so I was able to let Margaret know that she was safely home when I visited at 12.30 pm with Louis.

Margaret was in her big chair with her feet up as her legs were still very swollen but she was quite bright and had eaten some lunch.  I had taken in the remains of the bottle of wine which we had on Sunday and Helen had forgotten to take in on Monday.  There was enough for a good glass full for Margaret and a small glass for me.   It was quite a good visit with Margaret chatting away as she had been to concert in the dining room in the morning.   I left just after 2.00 pm and left her watching TV in the knowledge that I would visit again on Thursday .

On Wednesday I cleaned up the house and mowed the lawns which had got in a bit of a mess during Helen's visit.

I visited at 12.30 pm on Thursday and Margaret was in a good mood and I took her and Louis for a walk around the block.  She was grumbling a bit about wanting to see her GP and I agreed that, if he didn't see her on Friday, I would phone him.  We agreed that if Margaret was OK we would take the bus to Tewantin to have lunch at the RSL.

On Friday I took a day off from visiting as previously agreed with the home.  Helen phoned her and was concerned that she didn't sound OK and was in some pain with her swollen legs.  She phoned Margaret's GP and left a message  and was assured that he was visiting Friday evening and would let me know if there were any concerns.  As I received no phone calls I assumed that Margaret was OK.

I turned up at 11.00 am in good time to get Margaret ready and in her wheel chair to catch the 11.30 bus into Tewantin only to find Margaret tucked up in bed on oxygen.  I sought out the RN who said that Margaret's GP had visited the previous evening as promised and found that Margaret was in a bad way.  The fluid had spread to her lungs and she was literally drowning.  He got her on oxygen and reluctantly put her back on diuretics over the weekend as he was going away.  Apparently Margaret was a little better in the morning but if she sat up for any time her legs were going purple  so she was being kept in bed with her feet and head elevated - in a U shape.  She was upset that I could not take her out but her carers didn't even like taking her to the toilet as she was very weak. her legs swelled up and she became very breathless.

She continued like this over the weekend.  She had also stopped eating once again.  Yesterday Morning I finally got a phone call from Margaret's GP.  He had been trying to contact me over the weekend but had the wrong number, more later.  He repeated what the RN had said and added that there was a strong chance that the diuretics would cause Margaret's kidneys to fail once again.  I aske that if they did that Margaret should remain in the Nursing Centre to quietly slip into a coma and die peacefully.  He said that that was his plan but he hadn't given up on her yet.

I met him at the Nursing Centre at lunch time.  He said that Margaret was a little better but still in some distress.  He would give it another day and if things hadn't improved would increase the diuretics and take a chance with her kidneys.  Apparently death from acute kidney failure with the correct palliative care is much better that dying gasping for air.   Margaret has also developed another Urinary Tract Infection, UTI, and in is on antibiotics and morphine is also being given which should improve her breathing while the diuretics kick in . He is visiting her again today.  I stayed with Margaret for couple of hours.  She is very grumpy (who wouldn't be?)  and I assured her that I would visit every day until she is stable once again.

The story about the phone number was that her GP had visited her on his way for a weekend trip.  He had asked Margaret for our home phone number and she had got it wrong!!  At present she is quite normal with no hallucinations but still has memory loss problem.  I expect the UTI and morphine will bring back the confusion for a while.

I shall take Louis in after lunch.