At about 10 o’clock Sunday morning, my phone rang. It was the nurse on mom’s unit at Carillon House. Mom was having nausea, vomiting and stomach pain and they’d called an ambulance. She was en route to University Medical Center (UMC) emergency room. So, I suited up and, since I am BTDT* status when it comes to hospital emergency rooms, I found and packed a small carry bag with a bottle of water, knitting and an extra purse pack of tissues, and scrambled the fighters.
As the grackle flies, UMC is only a hoot and a holler to the east of us. However, in order to go east, I had to first go south because streets. Evidently, they had called me right when the EMS folks got to her room because I beat her there by about 20 minutes (that’s counting the 10-minute hike from where I had to park, which was, thankfully, just east of the county line). I had about a 15 minute wait in the ER waiting room before they would let me back.
I have all the papers — the POA, the POA for health care, her insurance cards, and the sheet with her medical history and medication list. and I have no trouble hearing and understanding English Second Language speakers and women (who have higher pitched voices and “mumble”). (Her most profound hearing loss is in the higher frequencies, oddly enough.)
IMPORTANT ASIDE: I cannot stress too much how important it is to make a list of your medications and dosages, a list of all the operations you’ve had and (approximately) when you had them, and a list of all your medical conditions, keep it up to date and carry it ***PRINTED OUT ON A SHEET OF PAPER*** in your purse or wallet, ***NOT ON YOUR PHONE***!! If it’s in your phone, the doctors have no way to get it out where they can put it on your chart for all your treating medical professionals to have access to. If you have it on a sheet of paper, they can copy it and put it in your chart. Doing this could save your life. If you come to the emergency room, your treating medical people have no idea what medications you’re taking or what your medical conditions might be. They’re essentially flying blind. If you are unresponsive or badly hurt, obtaining a coherent medical history could be difficult to impossible. But if you have this sheet and your family member/spouse/friend know you carry it in your purse or wallet, they could save your life by letting this sheet speak for you when you can’t.
Now, back to our regularly scheduled programming, which is already in progress. It was sneaking up on 11 o’clock before I made it back to where they had her. I got out all the cards and papers, and one of the admissions people, who was really on the ball, noticed that on my POA for health care, mom is DNR/DNI – she wants no cardiopulmonary resuscitation of any kind and she does not want to be intubated. Carillon House had her status as “full code,” meaning using any and all heroic measures to keep her alive at all costs, which is not what she wants. We also discussed the fact that my durable POA for health care does not cover “out of hospital” codes. It also does not cover if she codes while the EMS personnel are in the process of transferring her from her room at Carillon to the hospital. (I’ve also got to get with the Carillon House people and get her code status sorted out with them, too.) This helpful person got us the proper form, which I now have in my purse with the other papers, which has that covered. I will also put up a copy of it up on the wall in her room so EMS people can note it and honor it. So, that was one good thing that came out of this episode.
Naturally, we waited and waited for lab results, x-ray results, doctors — It’s why they’re called “patients.” Mom is a class M patient. (Think about it; it’ll come to you.) Her kidney function tests were out of whack (what a surprise NOT!), and her bilirubin (a liver enzyme) was 4 times what it should have been. They were most unhappy with her liver enzymes (and weren’t thrilled with her kidney functions either). She was very dehydrated, so they gave her two bags of fluids. They took her for an ultrasound of the liver, pancreas and gallbladder. Her white blood cell count indicated she had some kind of mild infection, so they hit her with the good stuff — Flagyl and Rocephin.
The upshot of it all was that the ultrasound showed mom had a gallbladder full of gallstones. There was concern that one was lodged in the duct that goes from the gallbladder to the intestine, which would explain her symptoms. This could be serious in a patient of any age, but especially at her age. (My 78-year-old paternal grandmother died because she had a lodged stone they didn’t know about and her gallbladder ruptured. The 98-year-old lady who used to live up the hall from me also required emergency gallbladder surgery and didn’t survive it.) There is an endoscopic procedure where they can use an endoscope to go down the throat, through the stomach, into the intestine and grab the stone from that end, but it obviously requires sedation, which is risky in a patient her age and with her lung function.
Ultimately, about 1 p.m., they decided to admit her for observation. She didn’t get up to a room until nearly 6 o’clock. The ER is on the west end of the hospital. The room she went to was on the east end of the hospital.
One of the ER nurses pushed her bed up there because transportation was too busy. She was going at a pretty fast clip, considering she was pushing this hospital bed with my mom in it. I tried to keep up with her but she left me in the dust! Fortunately, I knew where she was going.
However, her liver enzymes gradually trended back to normal and her kidney functions normalized once they got her rehydrated. She may actually have passed a gallstone, which would explain her symptoms, especially her belly pain. It would also explain her periodic bouts of nausea and vomiting if she’s got a gallbladder full of gravel. (The liver makes digestive enzymes — bile — which is stored in the gallbladder. When you eat foods that contain fats, proteins and carbohydrates, bile is squeezed out of the gallbladder into the small intestines as part of the digestive process. If the liver can’t put bile in the gallbladder, it backs up into your blood and causes jaundice — you look “yellow.”)
The GI doctor decided that since her liver enzymes were coming back down to normal, no intervention was warranted, and she went back home to Carillon House Tuesday afternoon. The same song, third verse, is that she does not drink enough water. Period. Certainly not enough to keep her kidneys flushed out. As a result, her bowels are going to recover all the water they possibly can from her food to keep the kidneys functioning, which is why she’s frequently constipated. Drink water, folks. It’s your kidneys’ job to keep garbage flushed out of your blood. You can’t flush a toilet if there’s no water in the toilet tank.
In the knitting news, I realized that all the projects I’m working on right now are shawls, and big. Also in knitting group last week, one of the ladies mentioned knitting chemo hats. Chemo hats are small and almost as portable as socks. I’ve got a big bag of suitable (acrylic -because it’s hypoallergenic and machine washable) yarn to make chemo hats left over from my last attack.
I’m contemplating creating a Scots bonnet and there were some techniques I wanted to try out. The first one was using Judy’s Magic Cast-on instead of a provision cast on for a rolled hat brim. Worked like a charm, I’m happy to say. The secret is to use two circular needles, a 16-inch and a 24-inch, for the cast on. When you use this method, you don’t have to go back and pick up your provisional stitches. They’re already on the needle. Just make sure your 16-inch needle is the needle you start knitting with as that’s what you’ll use for the hat. Then, when you roll the brim (working stitches in back, provisional stitches in front), you can take the provisional stitch off knitwise, put it on the 16-inch needle and knit two together through the back loop (k2tog tbl) to secure the brim without having to go back and sew it. Then you just keep knitting on your hat.
If you orient the stitches right when you take them off the “keeper needle,” the join is “invisible.” I like to rib the inside part of the rolled brim to make it more elastic.
I started this hat Sunday night, and I’m on the decreases at the top now. I’ve got two more balls of yarn earmarked to try some other versions. I didn’t get a lot of sleep Sunday and Monday nights for one reason and another. I slept all Tuesday night and most of Wednesday though. I was just exhausted. I spent Wednesday evening watching YouTube with my feet up, taking it easy. I think YouTube does not consider you to be a a legitimate homesteading channel unless the guy has a beard and/or the lady has long hair . . . .
*BTDT — Been There, Done That