Update on Joe 10/07/11

It's been a while since my last post. Frankly, I've been worn out. However, today Joe had a mild stroke, and I know I need to update and document.

I got a call at 10:44 a.m.from Parkview Nursing Home that they had just discovered Joe propped against the wall in the bathroom sitting on the toilet after a large messy bowel movement. His speech was slurred, he didn't know where he was, and his mouth was drawn. They wanted to take him to the hospital. Yes, of course, do.

It took me awhile to get dressed, round up a sitter for Lola, and get on the road to Paducah. My 2 sitters were working their other job and going to a funeral, respectively. Aunt Agnes graciously agreed to sit but she had a luncheon engagement with someone she hadn't seen in two years at 11:00 but would gladly come after that. So I got Lola up and eating breakfast before I left. Mom does okay being left alone for a few hours, but she really is bothered if she wakes up and thinks she's alone in the house. Aunt Agnes has gone beyond helpful in helping me with this. I cannot thank her enough.

I got to the hospital before 1:00 p.m. and found Joe in the Emergency Room drowsing. His mouth was definitely drawn. His speech was slurred and very slow. He was totally disoriented and had no idea what had happened or where he was. It took all afternoon long to get various stroke assessments, CT scans, x-rays, and urinary tests done. Joe was lethargic, unresponsive unless forced, and thankfully not a bit combative this time.

There was, again, no evidence on CT scan of a massive brain event. However, I was told this time that mild events can take 3-4 days to show up on CT scans. Again, with no drastic change in outcome or treatment, an MRI was not absolutely necessary.

Finally, around 4:00 p.m. a doctor in practice with the other doctors who treated him a couple of weeks ago came into the room. He introduced himself with "I'm sorry to meet you under such sad circumstances." Uh, oh, this is not good my brain told me.

A quite intense conversation with Dr. Wilson ensued. He was the epitome of a doctor I admire - professional, compassionate, and totally honest. He laid things out honestly, which let decision making be done without misunderstanding. We discussed more of a hospice care for Dad than any other kind of treatment.

We have a DNR, no heroic measures and no feeding tube on Dad. He asked me if I wanted to discontinue medicines Dad was already on, i.e., blood pressure medicines. Okay, gulp, you just put the gun in my hand and asked me to pull the trigger.

That was far more responsibility for Dad's death than I am willing to bear. I can comfortably let Dad die as all humans eventually do. I cannot comfortably deny medicine he was previously on that I feel would actively cause his death. Dad will be treated with current conditions and kept comfortable and pain free.

When I finally got home after 5:00 p.m., Aunt Agnes and I got Mom a supper, and I checked my phone for messages. There were 3 that need responses. Great. You aren't supposed to have your cell phone on in the ER. So now it's after business hours on a Friday.

Dad was supposed to be evaluated this morning for transfer to another nursing home because Parkview doesn't have a Medicare room available for him at the present time. Dad's time where he was was fastly running out because the ward he was on is not a Medicare/Medicaid ward.

Because Medicare won't pay for both a stay in a hospital AND a room at a nursing home, I have to call the nursing home before 9:00 a.m. tomorrow to let them know if I want to personally pay $269 dollars to keep his room for him each day until he's released from the hospital. Gah. Since, OF COURSE, this happened on Friday, normal business people are off on the weekend, and he was supposed to be evaluated today for replacement, I'm flumoxed.

All I can do is try to get people on the phone starting at 8:00 a.m. on a Saturday and find out if his placement at the new place is assured, then call Parkview and deny the reservation if so. If I can't get affirmation from the new place, Medco, I have to decide to risk having to bring him home for a few days or pay $269 a day to reserve the room.

May I mention that with Mom's hours, I don't normally wake up until 10:00 a.m. and don't have a functioning brain until 11:00?

I arrived home this evening to a kitchen that was a total catastrophe because I was in the process of making a huge batch of chili when the first call came in. I left the pot of beans on the stove and a counter full of dirty dishes. When I got home I spent time on the phone retrieving voice mails, and calling pertinent people with updates. Then I tried to regroup. Then I finished the chili. Now I'm updating the blog. It's 11:50 p.m., and I'm waiting for Lola to finally go to bed, but if she doesn't go soon, I'm going to have to push the issue because I need enough sleep to make rational decisions in the morning.

Oh, yes. I must mention that in all of this, Lola hasn't once asked to visit Joe. She hasn't shed one tear. She seems vaguely concerned but totally disconnected from what is happening. That, of course, is mind boggling to me considering their total devotion to each other. I always felt in the way of their total devotion to each other, an obligation they thought they should fulfill but really resented. All I can assume, for what it's worth, is that Lola's mind is either gone enough she doesn't realize what's happening or it has refused to process a reality that she can't accept.