I haven’t written for a few days, but it’s been with good reason. We brought Grandma to the hospital Saturday night. She was admitted and our journey has carved a new path for us to take. Being that it is Wednesday and this story really begins 6 nights ago, I will do my best to account for all the major turns we have taken since then.
Friday, July 27 – 9:00 p.m.
Robyn came home from work around 5:00 p.m., but left again to meet some friends for dinner. I wasn’t feeling too well and since Grandma was resting, I laid down, too. The next thing I remembered, Robyn was nudging me to wake up. It was 9:00 p.m. I hustled out of bed and woke Grandma up to take her medicine. We made our way down the hallway and into the kitchen. She took what she could, but said she really wanted to get back to bed. A short time later, we heard her start to gag, cough and vomit. Robyn and I rushed to her room to help her calm down and get cleaned up. Grandma would calm down for a few minutes at a time and then start vomiting again.
Saturday, July 28 – 12:00 a.m.
After several bouts of vomiting, we realized she wasn’t able to stop because she couldn’t calm down enough. We gave her half of a Xanax tablet as the doctor directed us to. This helped her calm down enough to fall asleep. She slept through the rest of the night.
I got up to give Grandma her morphine and then went back to bed.
I got up to start the day. I got Grandma’s medications ready for her and then brought her in the kitchen. She was very unsteady on her feet and I was grateful we had the walker for her. She sat down and we went through the usual routine.
Grandma starting vomiting again. Robyn helped get her calmed down and cleaned up. Once Grandma was resting, I asked Robyn what we should do. She said, “If we can’t get this under control today, we need to take her to the hospital. She isn’t intaking much and when she does, she can’t keep it down.” I agreed with her and we made the plan to get some food in her well before her medication and see if she was able to keep it down. Then, we would proceed with her scheduled medications at 2:00 p.m. If that stayed down, we would continue with that pattern. We knew that Grandma wanted to stay home and not go to the hospital if she didn’t have to.
Grandma ate some instant mashed potatoes mixed with cream of mushroom soup. She ate about 1/4 cup of the mixture. It seemed to settle ok so we decided at 2:00 p.m., we would give her a bit more before her medicine.
We gave Grandma some of the soup mixture, which she said burned her throat and mouth now even though there was nothing different about it. Grandma took her meds as scheduled with no problems. She coughed up a little bit of phlegm, but no vomit. Afterwards, Grandma went back to bed.
We woke Grandma up and started her medication process. She spit up a couple of times, but it was only because the pills got caught in her throat. We got some soup in her and finished her medications, then got her back to bed.
We heard Grandma gagging. Rushing to her room, Robyn saw her vomit quite a bit. She got her calmed down and cleaned up. While she was changing Grandma’s sheets, she looked at me and said, “We need to take her to the hospital. We have done everything we can here, but we need to get her on fluids and get her nausea under control and we can’t here.” I sat and thought about that for a while. Grandma was resting. I got online and talked to a few friends about the situation while I thought about what to do.
Grandma started gagging again. Robyn sat on the bed with her and I called the doctor. The answering service connected me with Dr. Ballou, the chemo doctor, and he told me to take Grandma to St. Mary’s. I called Linda to let her know what we were doing and told her where we were going. I started packing my computer up while Robyn packed a bag for Grandma. Once we felt we were ready, we got on our way.
We arrived at St. Mary’s Emergency Room. We were immediately taken to a curtained area and after about 10 minutes, we were taken to a patient room in the ER. The ER doctor came in to take a look at Grandma and I told him that we were told by Dr. Ballou to bring her in. The ER doctor gave Dr. Ballou a call and returned to say that Grandma was a direct admit to the hospital and after a few tests, she would be taken to a guest room. After the ER nurse failed to place an IV, the LifeFlight nurse came to do it. He placed it in the crook of her arm where we had to continue to remind Grandma to not bend her arm. I started getting flashbacks of the one chemo visit where Grandma couldn’t sit still. Linda showed up about midnight and sat with us until Grandma was taken to her guest room.
Sunday, July 29 – 1:15 a.m.
We were taken to what would become Grandma’s home for several days – the sixth floor of St. Mary’s. Thankfully, it was a private room with a full bath, two chairs (one is a rocking chair) and a fold out sofa bed. The nurse and tech got us settled in and got Grandma’s fluids started. We were told that Dr. Ballou had reviewed Grandma’s tests that were done in the ER and that he planned on doing a stomach X-Ray in the morning and he should be in around 8:00 a.m. to check on her. They put a yellow bracelet on her wrist indicating she was a ‘fall risk.’
Linda went home and Robyn made a trip back to the house for a few things to make the room more hospitable.
Robyn went home and Grandma and I began our first night in the hospital. The night was somewhat of a blur because Grandma was so restless and kept trying to get out of bed. I had to keep telling her to stay in bed and to keep her arm straight. Finally around daybreak, I was able to sleep because she was asleep.
We were awoken by the nurses who were administering Grandma’s oral morphine.
She was taken to X-Ray to do the stomach test on Grandma. I asked when the doctor would be in. They didn’t know. Throughout the day, Grandma continued to be restless and began talking nonsense. She would go through periods of confusion where she didn’t know where she was for a moment and then suddenly would say, “I’m still in the hospital, aren’t I?” It was scary and hard to handle because I couldn’t explain anything to her. She knew who I was and recognized people, but got very confused about her surroundings and circumstances. Because of this, I had to keep a close eye on her because she kept trying to get out of her bed on her own. At that point in time, she was still recovering from her vomiting spells and hadn’t had any sustenance other than IV saline in more than 24 hours. Besides being hooked up to machines, she just didn’t have the strength to stand unassisted.
Robyn came back to the hospital after she helped her dad at church and had some lunch for me. It was a relief to have her there because she could help watch Grandma while I tried to rest. Grandma continued to be restless and confused throughout the afternoon. She would sleep for about 5-10 minutes, wake up confused about her surroundings and start talking about how she needed to make dinner. We would say, “If you need dinner, we’ll ask them to bring you some.” Then she would realize where she was. At one point she told us she had sauce in her pockets and that if she had 10 minutes, she could finish dinner. She fell asleep and when she woke up, she looked around the room and said, “where’s that garlic bread?” Robyn asked her if she wanted some garlic bread to eat and Grandma said, “Oh shoot. I’m still in the hospital.”
My friend Kevin and his girlfriend, Wendy, stopped by to say, “Hello.” They brought some flowers for Grandma and a couple of sodas for Robyn and me. They couldn’t stay long, but said that if we needed anything to let them know. Robyn said after they left that she felt like crying because it was so nice of them to do something like that. After they left, we discovered that the air conditioner in the room was good for keeping soda cool.
Robyn went home for a little while to get some laundry done, check on the dogs and get some dinner for us. Around 4:45 p.m., Linda and her kids came to visit Grandma. They stayed for about an hour and then went to get dinner for themselves. While they were visiting, Grandma was acting halfway normal. I took this as a good sign until Linda tried to feed her some pudding and Grandma said, “Don’t give me that. I already had blood this week. Quit trying to shove blood down my throat!” She thought the pudding was blood.
The nurse gave Grandma her oral morphine.
Robyn came back with dinner and additional clothes for me. We settled in for the night and took turns keeping Grandma in bed. Throughout the evening, I continued to ask the nurses and techs when Dr. Ballou would be visiting. The night nurse, Jenni, said that he comes at odd times and it can sometimes be as late as midnight before he checks on a patient. I also told her that I was concerned that she wasn’t getting her medications as scheduled. Jenni then explained that they had to administer them as the prescriptions were written. Most of the medications state ‘as needed,’ including her liquid lortab, which means that legally, the staff can’t dispense any other way. Even though the doctor instructed us otherwise and we found a good balance of what worked for Grandma at home, now she wasn’t receiving her medications until she asked for them.
My friend, Brian came to visit Grandma. He said hello to her and then took a seat.
The nurse, Jenni, came in to let us know that Dr. Ballou was on the floor and he should be down to see Grandma soon.
The doctor still hadn’t been in the room.
Monday, July 30 – Midnight
The new night nurse came in to check Grandma’s vitals. I asked her if Dr. Ballou was on his way in to see Grandma. She had a shocked look on her face and said, “He didn’t come in here?” From that question, I knew he had already left the hospital. I told her, “No. He didn’t come in here. At 11, Jenni came in to let us know he was on the floor, but we never saw him come in.” She responded with, “Oh. Well, he left around 11:30 p.m. I swore I saw him come down to this end of the hallway and Charlotte is his only patient on this side. Maybe he peeked in and thought you were asleep.” Robyn hadn’t fallen asleep yet that evening and she would have heard someone step into the room. Needless to say, we didn’t see the doctor that night. The nurse did tell us the plan of action. Dr. Ballou was concerned about Grandma receiving enough nutrition so he ordered a PICC line be installed the next morning so she could start receiving supplemental nutrition through it.
Brian left for home and Robyn agreed to stay at the hospital and help me watch Grandma overnight. She made a trip back to the house to change clothes and check on the dogs before settling in for the night. Around 1:45 a.m., she returned and I tried to go to sleep. She told me the next day that she didn’t get to sleep until around 4:00 a.m. because Grandma kept trying to get out of bed and it wasn’t until she fell asleep that Robyn was able to sleep herself. The blessing and the curse is that Robyn is a very light sleeper and when she would hear Grandma shuffle in the bed she would sit up with a jolt to see what she was doing.
The nurses and techs came in to change Grandma’s IV. Robyn left to get ready for work at 6:30 a.m. She ended up taking two hours off work to rest at home because she didn’t feel like it was safe for her to drive.
They gave Grandma her oral morphine.
The team came in to prep Grandma for a PICC line. Robyn was about to head back to work after bringing me some lunch. They installed the PICC line in Grandma’s room, but needed it to be as sterile as possible, so I had to wear a gown and mask. They were done with the procedure in about 35 minutes. After they were done, they rehung her IV saline and electrolyte replacements. We were told that she would start receiving the nutritional supplement later in the evening. Later in the afternoon, she started talking nonsense again. She thought we were in L.A. and was looking for her file cabinet.
Robyn arrived with dinner for us. We settled in to watch some TV while Grandma rested. She was still trying to climb out of bed frequently, but was much more coherent and knew where she was. Brian showed up for a visit and insisted that I take a walk with him. Since Robyn was there, I felt comfortable enough to leave the room. We were only gone for about 15 minutes, but it was good to stretch my legs. Brian left after about an hour and half and Robyn and I finished our television program.
Dr. Ballou walked through the door. He took a seat and spent a few minutes with us explaining what was going on. He said that her electrolytes were in much better shape – he said they were pretty much at normal levels and that the challenge was to keep them there. With that in mind, they were going to continue with the electrolyte replacements and IV saline. He gave us some goals for Grandma to meet before he would release her. He said he wanted to see her eating 1,000-1,500 calories per day and moving around unassisted. He said she would have to demonstrate she was doing that for a few days before he would consider releasing her. We felt better knowing what his goals for her were.
While the tech was checking Grandma’s blood sugar level a random male patient wandered into the room. The tech’s back was to the door and she didn’t see him come in. He simply stood in the doorway and stared at Grandma. Robyn was laying on the bed and I was sitting in one of the chairs. I noticed that he had an erection and was most definitely ‘out of it.’ That gave me one more reason to continue to stay with Grandma.
Tuesday, July 31
The nurses and techs came in as their routine dictated. Grandma seemed to be acting stubborn about her eating habits again. She started saying that her throat burned and she was in pain and she couldn’t eat. The past few days she had been on the morphine and hadn’t had a problem with pain when eating, but found herself getting full quickly. Now, she was complaining of pain again.
In the afternoon, Grandma had a small vomiting spell and it soiled her bed clothes. I called the nurses/techs and told them what happened. A tech came in and simply flipped the pillow over and folded the blanket down rather than changing the bed clothes. With the continuous change of the nurses and techs, we have had some very good ones and some rather poor ones. I was not happy with what that tech did and when the shift changed, I mentioned it to the nurse and she immediately changed the bed clothes. There have been other times where the nurses and techs help Grandma out of bed, but don’t replace the rails on the bed. We have been told that since she is a ‘fall risk’ that they should be accompanying her into the bathroom so she doesn’t slip and fall. Some of the nurses/techs get her into the bathroom, but don’t stay with her.
The nurses came in to check on Grandma on their shift change. I asked them if she received her morphine at 7:00 p.m. They looked at their notes and then in the computer in the room and said, “We don’t have an order for morphine on her schedule.” I told them that she’s supposed to receive it at 7:00 a.m. and 7:00 p.m. by mouth. One of the nurses said she would go check the doctor’s orders to see if he stopped it. A few minutes later she returned and said that the doctor had deceased the order for the morphine the night before. This was something that he did not mention to us. The nurse then told us that she still had a standing order for the liquid lortab, but that it was ‘as needed’ and they couldn’t administer it until she asked for it. Grandma was a little out of it and when the nurses left the room, we told her what was going on and told her that she didn’t have any pain medication in her system at that point. She called the nurse and said she was in pain and said she was around a 5 on the scale of 10. Since Grandma never complains, I had an idea that she was probably in more pain than that. Robyn found the example of the scale in the guest book in the room and I decided the next time Grandma was asking for pain meds that I would show her the chart again. As expected, she said she was more like a 7, which is ‘severe’ pain.
I asked Grandma how she was feeling. She said she was in pain, but that she was doing better. She asked me to stay with her because she didn’t want to be left alone. I told her I wasn’t going to leave.
Wednesday, August 1
Today went by slowly. It was fairly routine. The nurses and techs came in and out with the shifts. Rick called and talked to Grandma for a few minutes. She had to request the lortab twice throughout the day. Each time she did, her pain was at a level 7. The lortab seemed to help, but only for a very short period of time. She wasn’t able to eat very well due to the pain.
Dr. Ballou came in to see Grandma as Robyn arrived with dinner. He did a quick rundown of her progress and where she stood in relation to the ‘goals’ he set for her. He said that her potassium level was a little low and they were giving her some to help replenish it. They were continuing with the nutritional supplement and IV saline through the PICC line. We told him she had pain and that the lortab wasn’t helping enough to allow her to eat. He prescribed time-released oxycontin for her. He then told us that he thought he would probably be able to release her by Monday – maybe the weekend, but most probably Monday. It was a little disheartening to receive that news since we hoped for a Friday release. But, again, he wants her to be eating 1,000-1,500 calories a day on her own without nutritional supplement and right now, she just isn’t able to do it.
The nurse came in to change Grandma’s nutritional supplement bag and administer her evening medications including the oxycontin.
Grandma started groaning and wiping her forehead. I asked her if she was sweating and if she felt nauseated. She said, “Yes.” Then she said she needed to go to the bathroom. We called the tech in and she took Grandma to the bathroom. After Grandma was situated, we heard her start gagging like she did at home before we brought her to the hospital. The tech went to get the nurse for assistance and I checked on Grandma. She was sitting on the toilet and using the bedpan from the bedside toilet to vomit into. The nurse came back in and she and the tech helped Grandma back into bed. Another tech brought in a cup of Sierra Mist for Grandma to sip on and the nurse said she would give her some phenergan by IV to help with the nausea.
Grandma is settling into bed and starting to fall asleep. I hope she is able to rest tonight since she’s had a rough couple of days. I also hope that the oxycontin does not continue to have this kind of effect on her.