Wednesday, December 1, 2010

Wednesday, December 1st

When last I posted, Vernell had tried to get out of bed and fell. We did get to talk to Kathy Wheeler and she assured us the Vernell did not hike herself over the side rail on her bed. The nurse was not completely truthful with us because the side rail was apparently not in place, thus allowing Vernell the freedom to get up (and fall) on her own. They were going to make more frequent visits to her room and possibly put a bed alarm on so they would know if she was trying to get up without help.


Don got a call a call yesterday (Tuesday) evening. Vernell had a fall in the bathroom. This time she had been walked with the nurse to the bathroom and was left sitting on the commode... the nurse turned around to do something in the room and apparently Vernell had finished and was attempting to stand and walk back to bed and she went down right there in the bathroom. They checked her over carefully and have been monitoring her... so far she is just achy - no majors issues.

We went this morning to see her. She is back to herself cognitively, no confusion or paranoia stuff - Praise God! The results of her UA came back clear, no UTI. We found out that the confusion and cloudiness for her was probably due to her dr stopping the med that regulates her low blood pressure - aggggghhhh that should never have happened. Not sure why we never get to share our input with the drs. We are her caregivers and have been for 3 years now. We know her better htan anyone and understand how she responds to various meds - but nobody asks us what we think. Our primary care dr keeps telling us that we should go to school to finish medical training because we already know more than most people going through training. We take our privilege of taking care of Vernell very seriously. I love to shock medical professionals with the extent of our knowledge regarding her conditions. They are always so surprised that we know thier medical jargon.

The rehab staff had their weekly progress meeting yesterday. When we talked to Kathy this morning, she let us know that other than the falls, Vernell is doing great with therapy. Now that her bp is back to being regulated with meds and she has her wits back about her, she realizes how this is the best place for her to be to bulid her strength. Vernell did not ask us today to "just get me out of here". It was hard to hear her ask us that for the past couple visits.

They are looking at a minimum of 4 more weeks, re-evaluating progress along the way. So she will be there through Christmas and New Years - it stinks. We did breathe a sigh of relief though, to finally have SOME kind of information. Now we can plan and prepare for her return home and also try to do things away from the house with the kids while we have this respite time. Once she is back home, we will need to be here with her all the time.

Vernell is still very weak and has a long way to go, but she is getting better each day. When we saw her today, our first thought was not "gosh, is she going to die soon?" It has been a hard 4 weeks and we are sure to ride these emotional waves until she gets home. Vernell will be there on the 19th of December, which is the day that Pop died. That is going to be a very hard day.

So, for this day, we are feeling better about her progress. She seems to be more at ease being there. Now we just watch and wait while the therapists work with her every day. We pray that she gets stronger and stronger. God contiunes to hold us together day by day.

Sunday, November 28, 2010

Sunday, November 28th

We took the kids to see Vernell this afternoon. We were able to stay about 2 hours with her because she was actually awake the entire time.

As soon as we got there, her nurse came to us quickly and asked if we got her message... apparently Vernell tried to get up on her own?? The nurse said that another patients family saw her sitting on the floor beside her bed. When the nurse first told us, we thought that Vernell had fallen out of bed. When we asked for more details, the nurse told us about her sitting on the floor. The best they can figure is she was trying to get up, but didn't make it very far. The odd part is that her side rail was in place, so she would have had to climb over it to get out of the bed. The last we saw her she still could barley even sit up on her own. We are still quite confused about all of it. Vernell does not know why she was trying to get up.

Although she was awake the entire visit, she was not really "there" with us, We saw a great deal of confusion, stumbling for words, paranoia, suspicion, etc. She was asking us if she had been committed, said they were trying to make her feel like she was crazy, and we could not trust anything the staff told us about her. It was wonderful to see her able to be awake that long, showing a bit more stamina and endurance, but sooooo hard to watch her state of mind. She asked us to just get her out of there.

We talked to the nurse about how this behavior is out of character for Vernell. The nurse asked our permision to request that the dr order a urine test. Based on her confusion and agitated state, there is a suspected urinary tract infection.

While we were talking to the nurse, she indicated that they have bene getting Vernell up and walking with her to the bathroom. That stumped us because last we knew, she could not even sit upright without passing out. So we are thouroughly confused and wonder what information is accurate. (sigh)

We are hoping to get to talk to Kathy Wheeler tomorrow and see if she can shed any light on this situation.

Keep praying!!

Thursday, November 25, 2010

Happy Thanksgiving!

Today is Thanksgiving and we will be taking the kids to visit with Gogo later this morning.

Don and I saw her on Tuesday and she was looking quite washed out. We got to chat briefly with the director of nursing, she went to see Vernell on Monday, but Vernell was asleep. She said that it will be a little while before we can really get a true assessment of a prognosis.... it will depend on Vernell's atttiude and willingness to work hard at her therapy. In a couple weeks, we should be able to gauge how she is progressing.

For now, we are sad in our hearts that she needs to be in the rehab center on Thanksgiving. She has no strength and still cannot even sit up without feeling nauseous and almost passing out. We wish we could have her out for this day to be with us, but she just is not up for it.

Five years ago today Pop was in "treatment" at a rehab facility in Tucson after having been diagnosed with terminal lung cancer. Don talked with him on Thanksgiving day presenting his "options" and Pop chose hospice care. They shared a conversation about salvation and making Jesus the Lord of your life. Right then and there, he was ready and Don was blessed with the honor of baptizing him into God's family. What an honor it was to to be his caregivers in his final days, especially knowing that he would soon be in his forever home. On December 19th, at hospice care in our home, we stood with Pop as he took a final breath and went to be with Jesus - and it all began on Thanksgiving. Thank you for the precious memories, Pop.

When we go visit Vernell today, we are going to celebrate Pop by enjoying one of his favorite treats - vanilla ice cream with Hershey's syrup. This was the ONLY thing he ate for the last couple weeks of his life. I remember sitting in his room in the wee hours of the morning in the glow of the Christmas lights, feeding him bite after bite of deliciousness. Toward the very end, I knew something was changing for him when he stopped eating the ice cream I would fix for him.

So today, we celebrate Pop and Gogo. We hope to keep her spark lit and pray that she will keep pushing forward to regain strength.

We are hoping in a few weeks, we will be able to talk with her and give her some vaild options regarding her own future. For now, we wait and she how she progresses over the next weeks and find out what the doctor, nurses,and therapists see for her and what quality of life she can get back to. I cannot even stand the thought of her being in the facility over the Christmas holiday (sigh).

From our home to yours... we send warm wishes for a wonderful day of thanksgiving. We are thankful for you - who care so much about our family. Thank you for your continued prayers and support. We love you all!

Monday, November 22, 2010

Monday, November 22nd

We took the kids to go see Vernell yesterday afternoon.... it does a grandma good to see her grandbabies. She was pretty clear minded and we got to spend some time talking with her.

When we got her settled at rehab on Friday evening we made sure to have a conversation with the nurse to be SURE they are fully aware of her special diet. The paperwork that came with her from the hospital indicated that she is on a mechanical soft diet... grrrrr.... we had to explain that she is on a strict pureed diet. While visiting with her yesterday, Vernell told us that they have been sending her a regular food tray... uh, are you all trying to get her sent back to the hosptial?? Maybe we are too hyper-vigilent about her diet, but we KNOW what works for her. She spent from January through April this year going in and out of the hospital with gastrointestinal problems and we worked really hard to find a diet that keeps her from having vomiting issues. The medical staff really has no idea how very ill the worng foods can make her.

She had physical therapy on Saturday. She couldn't really give us many details other than she felt really dizzy.

So we are now waiting for the director of nursing, Kathy Wheeler, to see Vernell and compare how she is doing now compared to her last visit at rehab. We talked to Kathy this morning and she is going to talk with Vernell today. We are hoping for her honest opinion...

We still see such a different picture with Vernell than we did 3 weeks ago. She could get up on her own and walk with her walker (and one of us with her to monitor for safety), she could sit up in bed, we would fix her meals but she was completely able to eat on her own, she could walk to get to the bathroom and use the toilet, she wa able to dress herself and maintain personal hygiene (she had a cna for showers twice a week).
Upon seeing her yesterday, she still cannot sit up on her own ( no core strength), she is needing assistance to eat her meals, she cannot get out of bed. They took out her catheter and now she is having trouble feeling when she needs to pee. It is so hard to see her like this and she would probably skin me if she ever found out how many details I am sharing. I am not trying to steal her dignity... I am tryng to keep her loved ones current on her true condition. I am sharing everything we know as we know it. Some of our questions we are tryng get answered are: if she works her butt off in therapy, how much better can she expect to get; what quality of life can she expect; is she more sick than we are being told; how do we know when her body is just wearing out; what is her prognosis considering all of her diagnosis... (sigh) We will let you know when we get some answers.

Friday, November 19, 2010

Friday, November 19

Sorry... it has been several days since I posted. We are just completely drained and exhausted around here. Don has been dropping me off at the hospital early in the morning and I have been there helping take care of Vernell. You have no idea how many times they can mess up her special diet. Almost every tray I saw delivered has a mechanical soft diet which is a dangerous step beyond the pureed diet that we KNOW works for her. Vernell has been very confused lately and if they give her the wrong foods, she doesn't remember that she should not eat them. Getting any pieces of food into her stomach that are not in pureed form will cause her an episode of vomiting, which leads to dehydration, etc...

The doctor discharged her from the hospital today. All of her acute illnesses have been dealt with and all that can be done now is to continue to manage all of her chronic conditions. Her list of maladies was pretty extensive before this hospital admission and now we have more for the list. I am trying to get a copy of her medical records so I can see for myself the details that the doctor left out. I don't know what any of her new official diagnoses are at this point. I do know that her low blood pressure is now a chronic condition that can not be cured, but managed with medications. The neurologist that consulted mentioned autonomic dysfunction. When I researched it to give us greater understanding, I told Don that I was certain that Vernell's symptoms fall into the Multiple Systems Atrophy diagnosis. When talking with her attending doctor the other day, she used the term Multiple System Atrophy. Now I see why our primary care dr keeps telling Don and I that we should have a career in medicine.

We do not have a clear understanding of what comes next in this process. Vernell was discharged to Mesa Christian for physical rehab. This is the same place she has had rehab after each hospital stay. The Director of Nursing, Kathy Wheeler, knows us well and understands Vernell and how to work with her personality. Vernell arrived there this evening, so Kathy did not get to see her. However, Kathy did get to peek at the admissions paperwork. The nurse said that Kathy's comment was that Vernell is really sick this time.... so we are anxious to talk with Kathy on Monday and see what information she can give us. I know that she will be honest about Vernell's condition and prognosis. In previous visits, Vernell was transferred to rehab to rebuild her strength and regain mobility. This time she was transferred still with the need for oxygen and still with her catheter. She does not even have core strength to hold her body in a sitting position and struggles with being able to feed herself. I pray that rehab with change this for her... but we somehow have a feeling that she will not be springing back anywhere close to where she was three weeks ago. Our emotions are on a constant roller coaster. Some moments she seems clear minded and appears to have the oomph to take on this task of rehabilitating her body. Other moments she is so far from what even resembles the Vernell that we know and she seems to have lost the twinkle of hope.

For now, we wait for Kathy to get her eyes on Vernell and give us her take on the differences in Vernell since the last time she saw her back in May.

I will let you know what we find out on Monday - it feels like an eternity away.

It is so very late as I am posting all of this.... I hope it makes sense.

Tuesday, November 16, 2010

Tuesday, November 16th

I went ot the hospital at 6am to be sure I could talk with the dr. I actually got the opportunity around 9am. The dr is still concerned about her inability to eat without getting sick. We are going to try a liquid diet today and the dr asked if I could stay to observe how she does. At lunchtime, I was out running an errand with Don and the nurse fed Vernell. She ended up throwing up part of her lunch, bummer. But at dinner time I was there to help her and she stopped after a few bites when she felt full. When we left at 7:30pm, she had not thrown anything up. Vernell literally slept ALL day. She woke up long enough to swallow pills and at meal time for a very short period of time. The rest of the day she slept.... and got some great healing rest for her body. She is still on some kooky pain meds that makes her loopy. The dr is weaning her down to lower doses. She will also be weaning off oxygen. The main thing we need to see is for her to eat and keep it down. I anticipate that tomorrow will still be a liquid diet. Her blood pressure was on the low side but not as low as usual. I wish I could articulate all of the information in my head. I am so tired, please forgive me. I hope to be refreshed for tomorrow and do a better job of keeping you up to date.

Monday, November 15, 2010

Monday, November 15

Today I was at the hospital from 9am until 7:30pm - long day. I was hoping if I stayed long enough that I would get to see her doctor... sigh. I am going to get there by 6am tomorrow and see if I have better luck.

When I got there, the transport was there to take her down for a chest x-ray. As of 7:30pm, we still did not have any xray results. Vernell thinks that she has pneumonia and the nurse said there is crackling in the lungs. Vernell was given a dose of lasix this morning to help reduce the fluid. She has not been feeling any nausea for several days now. She is still not eating. She HATES the clear liquid diet and refuses to eat it/drink it - ugh. I have been trying to remind her diet cannot be advanced until she can tolerate the clear liquids. The dr won't know if she is tolerating the clear liquids until she actually consumes them. By dinnertime she still not eaten all day. I asked her what WOULD she eat... "country fried steak" LOL... she does not even get that on her BEST day. We settled on mashed potatoes and asked the nurse if it would be okay. The nurse said lets try it. I picked the skins out of the bowl because the kitchen sent skin-on mashed... they would certainly have messed her up BIG. I added broth to thin the mashed potatoes. She loved them, but unfortunately, the potatoes did NOT love her. They made her very nauseous, so the nurse came to the rescue with a dose of Zofran to take away the nausea.

I am finishing htis on Tuesday night. Last might my computer ran out of power in the middle of my post... thank goodness it saved the work I had done. The computer zapped out of power at about the same time I did. lol

I don't even remember what else I was going to tell you last night.... dang it!

Sunday, November 14, 2010

Sunday, November 14th

Don and I went to visit Vernell this afternoon. She was very incoherent and could not finish her sentences. It was really hard to see her like that. We took the Brett Favre jersey to show her and I am not sure she will even remember seeing it. We talked to her nurse and he informed us that she was really sleepy, but had overall a better day than yesterday. She has not been throwing up - yay. She still is not really eating, so they have her back on IV fluids.

When we left visiting with her, we went to grab some dinner. While at dinner, Vernell called Don and asked for us to come back to the hospital... she was scared and confused. We stayed with her for a while and tried to help her understand why she was feeling so foggy and confused. We talked with her night nurse and we are attributing these new changes in moods and level of confusion to the increased dose of IV pain medication. Her blood pressure was reading high tonight. We are comforted by the fact that we were able to have conversation with her tonight. When we left this afternoon, we were very, very concerned about her maybe having lost her oomph to fight this... but now we realize that she must have been affected by the medications. Whew! She still has a long way to go to get stronger. We are praying that God will bring her peace so she can rest well tonight - no nightmares.

We are hoping to catch up with her attending doctor tomorrow to kind of get a feel for where we are at. Don did get to talk on the phone with the GI doctor earlier today... I'll ask him to post about that conversation.

Until tomorrow... wishing everyone sweet dreams!

Saturday, November 13, 2010

Saturday, Nov. 13

This is being posted by Don. We called and spoke with her nurse early in the day, and he told us that she was having a lot of pain and nausea today. He said they had increased her pain meds, and she was very tired. We opted to go see her later in the day, and so when we got there this evening, she was in the middle of a very deep sleep, so we left notes for her and told the nurse that we would be back to see her tomorrow. We left and I got a call from her tonight, letting me know that she had had a really weird dream that had seemed very real, and she just needed to call to make sure whether or not it actually happened. I assured her that it was not real and that she needed to get some more rest, and we would see her tomorrow. She is really having a hard time staying plugged into reality the last couple of days. As far as the physical aspects of what is going on with her, it is still pretty much how it was before - just not much improvement. We will post again tomorrow to let you know what we know new. God Bless you all!! DG

Friday, November 12, 2010

November 12, 2010

We went to see Vernell this morning. Physical therapy was in the room with her when we arrived. The therapist was having her sit up on the edge of the bed... but Vernell was very weak and droopy. She said she felt like she was drunk. She had a really good physical therapist today who was going to recommend to the dr that they get support hose/tent hose and an abdominal band to help increase blood circulation.

Vernell's color was not great, very pale and her blood pressure is low again. She has not been throwing up today, which is great, however, she is not really eating, so the nurse said she was going to start her on a liquid nutrition supplement to get some calories into her.

We didn't get an update from the doctor today. We would rate her status as unchanged in most ways, and worse with the low blood pressure.

This is a very long journey...

Thursday, November 11, 2010

November 11, 2010 nightly update

Don took the kids to visit Gogo this afternoon. I was attending "therapy" at Goodwill... I love bargain shopping and it helps me de-stress. Vernell has been wanting a Brett Favre jersey, but didn't want to pay the ridiculously "high dollar" price for a nice jersey. I FOUND her one at Goodwill today... a really nice Reebok brand. The jersey is black with green and yellow. While I was showing it to the rest of the family we discovered that it is a reversible jersey... the other side is green with yellow and white. I am excited to take it and show her!!

Vernell had a better day today... she took her meds by mouth with liquid and everything stayed down. Hooray! She is still very worn out and weak and her speech is a bit slurred. The results of the upper GI from Monday did not show much because the contrast did not make it very far before it came back up. The GI doctor is holding off on ordering a Nasal-Gastro feeding tube because he was encouraged that she was able to keep liquids down today. He plans on running a second upper GI series once she has kept liquids down for a couple more days.

Her blood pressure was 90/65 which is significantly lower than 156/86 yesterday. Her fever is down, but she has been getting lots of tylenol. Her blood sugar was really high today.

So now we wait and see if she can keep liquids down for the next couple days and go from there. This is such a step by step journey.

I'm going to wrap the jersey and give it to her tomorrow. I'll let you know how she likes it!

November 11, 2010

Oh my, Vernell is currently in the hospital at Mercy Gilbert here in Arizona. We have been wanting to call all of her friends and make them aware of her health status... we kept hoping with each new day that we would have uplifting news to report.

Vernell has been in the hospital since Monday, November 1st, so we are now in day 11.

The weekend prior to her hospital admission she was have vomiting issues and by Monday afternoon, she could barely sit up on the edge of her bed without slumping over. We helped her transfer to a bedside commode and she passed out. After lifting her back into bed, the paramedics were called.

At the hospital, it was determined that she had a really bad kidney infection along with dangerously low blood pressure. The doctor decided pretty quickly that she was going to admit Vernell to the hospital while they got the kidney infection under control and then investigate the low blood pressure (hoping that the infection may be causing the low blood pressure).

Once the infection was cleared, Vernell's blood pressure still maintained at very low readings, which dropped even lower when sitting or standing. A consult with a cardiologist was ordered. A new medication was added to increase her blood pressure to normal levels, however, this medicince has now caused her blood pressure to be too high. There is a fine balance to this medication and we are praying that the doctors can figure it out soon.

Over the past few days, she has begun vomiting again, with no apparent reason. The doctor ordered an abdominal x-ray to check for blockages - results did not show anything alarming. The doctor then ordered a GI consult. She had an upper GI series 2 days ago and we are still waiting on the results. The doctor also called in a neurologist to evaluate for autonomic dysfunction.

Don and I went to visit her yesterday morning and I stayed for the afternoon to sit with her and hold her throw-up bin and keep her face wiped clean. The nurse let us know that Vernell had been running a high fever through the night. I was able to speak with her doctor and she let me know that they are still not quite sure what is going on with Vernell. Right now, they are running more labs and cultures to determine the cause of the fever. They are still waiting on the results of the upper GI series. The doctor also ordered a chest x-ray to check for aspiration from the vomiting. Once the source of the fever is determined and treated, they will continue to work on balancing her blood pressure and controlling the vomiting. The neurologist will step back in once the other systems seems to be better managed. Although the doctor cannot give us any indication of how much longer she will be in the hospital... it seems like it will be many more days. At this point, Vernell has not been up out of bed for almost 2 weeks and she is extremely weak... she will most likely be going to a skilled nursing facilty for physical rehabilitation. As history shows us, she typically stays in rehab between 4-12 weeks... which means she will be there through the holidays - that stinks.

Don called and talked to Vernell's nurse this morning. She let him know that Vernell was still vomiting through the night, but it seems to have stopped for the moment. Her fever had spiked to 102. during the night, which is super high for her considering her normal temp runs 97.6 instead of 98.6. We will be heading over to the hospital soon to visit and get the latest updates.

Vernell is blessed to have so many wonderful friends. We appreciate your understanding our need to keep you updated on her health via this blog. I know that Vernell is so thankful for your support and prayers.

I will do my best to post new information as we get it.

This is THE day 5 years ago that we were hit with the devestating news that Papa was dying of lung cancer. He hung in there with us until December 19th. I know that this must be having an affect on Vernell's current health issues. We are not ready for her to leave us yet... so please pray that God provides comfort to her spirit and healing to her body.

Until my next post... hug your loved ones and tell them you love them! Life is so precious!