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.
Monday, July 19, 2010
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.
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