For those that are not up to speed on my mother, she is in the end stages of a disease called MSA (Multiple System Atrophy) see www.acnr.co.uk/pdfs/volume3issue6/v3i6reviewart1.pdf if you want the technical details, one of the best articles I've seen on the topic. In short, you lose control of muscles, generally by muscles tightening up so you can't use them. With mom it started with difficulty in going up stairs; her hand would lock on the handrail when climbing stairs - she would have to pry the fingers open with her "good" hand to break the grip. Eventually she couldn't write - no small motor control, couldn't climb over steep objects - like the threshold. Other functions are affected: blood pressure drops when you stand, which causes falls - as if limited muscle mobility wasn't bad enough to induce "clumsiness".
Loss of vocal skills, inability to chew, inability to swallow effectively followed. We now have to insert most of the consonants (and some of the vowels) in her speech, although the occasional "Yes" or "No" are clear. When agitated, the speech becomes somewhat clearer: like "leave me alone" after a gastric tube was placed in her nose. (She was not happy with the surgeon or the nurse).
Other systems are likewise affected (hence the name MULTIPLE system). Swallowing difficulties affect the lungs with the most likely result being aspiration pneumonia. (which brings us to the hospital a week ago).
I asked the attending physician about gastrointestinal complications of MSA as mom was having difficulty keeping food down. He responded that this was not an area of expertise that he could comment on. I've done some research and found some articles:
1. Those with MSA, who were capable of participating in the study, took nearly twice as long to pass food from the stomach to the intestines as the control group.
2. Peristalsis (movement of the intestines) is slower.
3. Tightening of the muscles, makes it harder for MSA patients to defaecate. (BOTOX treatment was suggested in the literature to loosen rectal muscles).
Mom was having trouble keeping ANYTHING down (water, which had to be thickened with corn starch to make it easier to swallow without aspiration, ice cubes, not to mention "solid" foods like yoghurt and pudding). Initial thoughts were that it was pneumonia or stomach bug related. A CT scan showed a hernia with an intestine poking through and being blocked. The surgeon was able to push the intestine back into place during his initial exam and insert a gastric tube to relieve the stomach pressure (a gallon total was drained from her stomach). He also performed surgery to repair the hernia - a minimally invasive hole (about 1" long) was created to insert the patch and check out the colon, which appeared to be good. (THAT'S THE BATTLE THAT WE WON).
As to losing the war, it appears that, so far at any rate, that nothing is passing from the stomach to the intestines, and though uncrimped, nothing is making its way through the intestines and out the back door. The initial estimate was that after uncrimping in a normal patient activity should commence within about 4-6 hours. We're well past 24 hours now. With nothing coming out, nothing else is being allowed to stay in. (Water and ice cubes for comfort in the mouth are removed by the G-tube).
I was watching mom tonight before I left the hospital. She was having trouble swallowing saliva in her sleep. The choking woke her up. The aspiration can't be good for the pneumonia.
Long term, we're losing the war. For that matter, short term, we're losing the war.
2009-08-04
Google Phone... oops
On a lighter note, before I left the office, I forwarded my desk phone so that I could appear to be working while not in the office. I forwarded it to my google phone number.... and tested a call. It worked quite well.
Google phone is pretty cool. It has a number of features that let you control what phone numbers will be called when someone calls the google phone number, even letting you set up a schedule as to when what phone numbers will be called. There are even google phone groups so you can direct calls from specific phone numbers to specific phones... kind of your own mini-switchboard. If a google phone were the home number, calls from the boss could be sent to voice mail, while calls from the daughter's boyfriend could be sent to her cell phone, etc., etc., etc.
When you set up a new phone number as the destination for a google phone, there's a validation process that you have to go through. It prevents you from redirecting calls to a wrong number. You click on "validate", it calls the destination number, you type in the validation code and voila... that phone can now be a target for your google phone.
Before I left town, I set up some defaults for my google phone: send calls to the house between 5 pm and 8 am, send calls to my desk from 9 am to 5 pm, send calls to my cell phone anytime. I even validated my cell phone and my home phone. Note: the office phone hadn't been validated, so no google phone calls were being redirected to the office phone (which is just as well - I'm not in town).
Then over the weekend, I had one of my less lucid moments. (I've been out of town long enough that I've had to do laundry). I thought: I can validate my desk phone. Since it's redirected to my google phone, it will ring my cell phone. It did and I did.
I got a call on my cell phone from the office today. Seems my office phone number was being reported as "out of service". If you haven't figured out yet, I nominate myself for the genius of the year award: my google phone was forwarding calls to my desk phone, which was forwarding then to my google phone which was ...
Google phone is pretty cool. It has a number of features that let you control what phone numbers will be called when someone calls the google phone number, even letting you set up a schedule as to when what phone numbers will be called. There are even google phone groups so you can direct calls from specific phone numbers to specific phones... kind of your own mini-switchboard. If a google phone were the home number, calls from the boss could be sent to voice mail, while calls from the daughter's boyfriend could be sent to her cell phone, etc., etc., etc.
When you set up a new phone number as the destination for a google phone, there's a validation process that you have to go through. It prevents you from redirecting calls to a wrong number. You click on "validate", it calls the destination number, you type in the validation code and voila... that phone can now be a target for your google phone.
Before I left town, I set up some defaults for my google phone: send calls to the house between 5 pm and 8 am, send calls to my desk from 9 am to 5 pm, send calls to my cell phone anytime. I even validated my cell phone and my home phone. Note: the office phone hadn't been validated, so no google phone calls were being redirected to the office phone (which is just as well - I'm not in town).
Then over the weekend, I had one of my less lucid moments. (I've been out of town long enough that I've had to do laundry). I thought: I can validate my desk phone. Since it's redirected to my google phone, it will ring my cell phone. It did and I did.
I got a call on my cell phone from the office today. Seems my office phone number was being reported as "out of service". If you haven't figured out yet, I nominate myself for the genius of the year award: my google phone was forwarding calls to my desk phone, which was forwarding then to my google phone which was ...
Sukie's Right!
This past week, I've eaten several times at the Hospital Cafeteria. If the food here (at the smaller satellite hospital) is the same as the hospital she likes to frequent, she's definitely got a good deal. I've eaten twice at the grill - outside of the main meal time; the hamburger's are better than DQ's - grilled buns and fresh cooked off the grill. When I asked about the "Halibut Burger", the cook said with a twinkle - "It's good. It's deep fat fried".
The quirk is that french fries and onion rings (with REAL batter, not bread crumbs) are sold by the ounce, so you're not sure what you're getting.
I also had the fried chicken for lunch today (actually at lunch time), and the sides (mashed potatoes and gravy & veggies - broccoli and squash) were better & fresher than Popeye's (I can't eat KFC due to the MSG, so Popeye's is the fast food standard).
The quirk is that french fries and onion rings (with REAL batter, not bread crumbs) are sold by the ounce, so you're not sure what you're getting.
I also had the fried chicken for lunch today (actually at lunch time), and the sides (mashed potatoes and gravy & veggies - broccoli and squash) were better & fresher than Popeye's (I can't eat KFC due to the MSG, so Popeye's is the fast food standard).
2009-08-03
Medical Stuff
It's been an interesting past few days. The Crew was good preparation for the past few days, but I've had more "patient contact" in the past few days than all of what I've done as a First Responder on our various activities. And that patient is my own mother. Mom is nearing the end stages of MSA (Multiple System Atrophy), so at this point her movement is nearly totally compromised - including her speech. It's been difficult because of the patient. I've worn more nitrile gloves in 5 days than ever before. Most of the contact has been cleaning up, and trying to figure out what's going on with mom.
If she's healthy enough, there will be surgery tomorrow to repair a hernia that's been constricting her intestine. We'll see if she continues to respond to the antibiotics for the pneumonia.
Glad I could be here
If she's healthy enough, there will be surgery tomorrow to repair a hernia that's been constricting her intestine. We'll see if she continues to respond to the antibiotics for the pneumonia.
Glad I could be here
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