Post-Stroke

I fully planned on going to work this morning. However, I received a phone call from Sis, telling me Mom was having chest pains yet again.

It seems as though Doc had been in and tried to convince her to have the angioplasty. It apparently upset her so much that she started in with chest pains, proving that, HELLO, she needed the angioplasty.

When I got there things were under control again. Sis was ready to leave for work, and I had decided to take the day off to sit with Mom. And then the cardiac doctor came in.

I explained to him exactly how she felt. That she was scared, that she didn't want to hurt any more, that she was tired of being tired. And in a very gentle way, he somehow managed to convince her that there would be very little pain, almost nothing to be scared about, and that the procedure would give her more energy. In an amazing turn of events, she changed her mind and agreed to the procedure.

We took her down to the Cardiac Cath Lab about 11:00 a.m. About an hour later the cardiac doctor came out and told us they had found a significant blockage in the right artery leading to her heart, and he believed that was the cause of the heart attacks. He told us his associate would be putting a stent in to open the passage, and they'd keep us updated on the progress.

Mom came through it just fine, although it took a total of over four hours to complete. It seems as though her artery had many twists and turns, unlike the average bear, which caused the doctor no end of grief. However, when it came down to it, he stuck it out like a man and did what had to be done. He ended up placing two stents, and this after using four different sizes of balloons to compress the plaque built up inside the artery.

The artery was 99.1% blocked.

After she returned to her room I stayed with her to make sure she didn't move the leg they had to cut into in order to reach the vein that led to her heart for the time prescribed by the doctor. The first few hours were a piece of cake, but the last couple were a trial. She kept complaining of cramping feet and aching ankles, sore knees and an aching back. She kept me busy until I was able to talk a nurse into some pain meds for her that knocked her out again. I finally left the hospital at 10:30 p.m.

Needless to say, this day has been 243 years long. I'm headed to bed, but with a very, very grateful heart. God answered a huge prayer of mine today, and I couldn't be happier.

Today was joy and agony all in the same day.

Mom got to do her video swallow test again today. She's been on nectar-thick liquids since the last time she was in the hospital because the video swallow test she did then showed she was unable to swallow thin liquids without danger of aspirating some of them. However, today she passed the test with flying colors!

We were so happy that we called her speech therapist at the rehab center to tell her. Mom told her that whenever they asked her to swallow she kept hearing Kelli, her speech therapist, saying, "Norma! You're not paying attention to me! Tuck your chin!" and that got her through the test. Kelli was thrilled to hear it.

Mom has decided she does not want to go through with the heart cath. We tried several times to explain to her what was involved, but she keeps associating it with the bypass surgery some of our relatives have had rather than a less invasive procedure. She keeps saying, "I don't want to hurt anymore. I've hurt for the past two months, and I don't want to hurt anymore." Nothing we say can convince her it won't hurt or will hurt very little.

The problem is that her right carotid is blocked 95%, and her left is blocked 89%. Without the cardiac cath, there will be no surgery on her carotids. The doctors believe she would have another heart attack on the table if they attempted surgery without first trying to fix what they now believe to be a blockage in her heart.

So we're stuck.

The only other option I can think of is to let it go for now, then possibly get her to have the procedure done at a later date along with one of the carotid surgeries. Then again, she may never want to have it done. Of course, there is always the chance of another heart attack or stroke.

Yes, she suffers from dementia. No, she doesn't think clearly a lot of the time. But in the end, it's her life. If it's going to scare her to death to have the cath, we aren't going to force it on her. We'll just hope and pray she comes around to it in her own time.

And we'll hope that time is soon.

Remember those chest pains I mentioned Mom having? It seems as though they weren't so banal.

They were her second heart attack.

This morning I found out from her doctor that he believes she did indeed have a heart attack in addition to the stroke, and that before she received a transfusion this time she suffered another heart attack. He assured me it was a mild one, but a heart attack nevertheless.

How much more does this woman have to go through???

Now he's talking cardiac catheterization to see what's going on inside her heart. With the anxiety she felt from the scope alone, I can only guess what will happen to her blood pressure when she finds out about this. She'll be scared to death.

Five pints of blood, two pints of plasma and a partridge in a pear tree later....

The GI doctor did another scope today. Mom was much more able to tolerate it and a deeper sedation, so more could be accomplished. Today there was no blood to be seen anywhere, so we're blessed that the doctor was able to get in yesterday to get the lay of the land and find the general area to look today.

There were three tiny spots, each about twice the size of the end of an earring post. That's all. Just those three little spots. But add Coumadin to the mix and those three spots become bleeders. The bleeders seep rather than bleed heavily, so it takes a while for Mom's hemoglobin to change. But since they don't clot off, the bleeding is a dangerous thing.

The doctor was able to cauterize all three spots, hopefully eliminating the bleeding problem. Our prayer is that it doesn't show up somewhere else. Mom seems to be doing well, other than having some chest pains. They did an another echocardiogram on her heart today just to make sure all was well, and they've had her on the telemetry unit to keep an eye on how her heart is doing throughout all of this.

Today she was able to eat for the first time in three days. The diarrhea has stopped, but then again, there really hasn't been anything in her stomach except blood. We'll wait out the next couple of days to see how things go. We've asked for her to be able to sit in a chair and perhaps have physical therapy come in so that she doesn't lose what she's gained so far. Throughout this whole ordeal it seems it's been two steps forward, three steps back. We're hoping it turns around as of today.

After the scope today the GI doctor came out to tell us that Mom does indeed have a bleeder. However, due to her weakened condition he was only able to sedate her lightly and to keep the scope inside for a very short time before he had to stop.

During that time he saw both old blood in the stomach as well as fresh blood in the duodenal area, though he couldn't stay long enough to see exactly where it was coming from. Mom's vital signs started dropping, so he stopped. His plan is to build her up with more blood, which was done today, and then try again tomorrow.

What we didn't realize was that her hemoglobin was again down to dangerous levels. We were told initially it was 7.5, then 7.1, which is still bad, but not as bad as the 4 she was at the last time. However, it turned out she was at 5 this time. With all the blood and plasma she's had, she's now up over 11.

On a positive note, she's been cleared of the C Diff. She's had two negative tests so far, so that means no more isolation for her. However, she's still suffering from lots of stools, probably from all the blood. The nurse tonight said she wants to give her Immodium if it keeps up.

I had to get mean today. Mom hasn't been up and about in a few days, and that causes her muscles to cramp up. Mostly her back, hip, leg and foot. Today she was hurting so much she was crying no matter what we did. I asked the nurse if we couldn't get her something stronger for the pain, and she told me our doctor likely wouldn't order anything stronger because he was known for that.

And she left it at that.

And I almost left it at that.

And then I looked at Mom again and saw how much she hurt. So I went to the nurse and told her that I'd like for her to call the doctor anyway, and if he gave her any guff about giving Mom something that was stronger I wanted to talk to him personally, because it was ridiculous in this day and age to have someone suffer when drugs are readily available to ease pain.

I went back in to Mom's room, and she told me we'd probably be fired from that doctor. I told her if we were that doctor could take a big bite out of my nether regions, because there were plenty of others in the city.

We got morphine within fifteen minutes, and Mom finally got some rest.

And it's after 10 p.m., so I plan to do the same. Only without the morphine.