Monday, December 24, 2007

Grandma

I has been suggested that I should use my BLOG to post an ongoing status on Liz's mother. In spite of the unquestioned fact that a BLOG is a personal expression, with no other person's opinion or desires relevant in any degree, here is what is happening.

As you know, Grandma fell a week before Thanksgiving, resulting in a subdural hematoma of which we were not aware. At Thanksgiving time, she fell again and hurt herself very much more, breaking her hip (technically the break was in the pubi-lateral portion of the acetabulum in the ischium, or just in front of the socket part of the hip joint), and starting another subdural hematoma. In the weeks following she has been hospitalized most of the time, with the subdural hematoma being the most immediate worry, but the hip being a long-term concern. Both these injuries can lead into a decline and ultimately death.

After she was stabilized in the emergency room, she was moved to Baylor Hospital's physical therapy center in Dallas for a 3 week course of "intense" P. T meaning three hour-long sessions per day. She made great progress during this time of closely supervised therapy and regained her ability to get out of bed and walk with a walker. When she was released, the doctors she should never be left alone. We understood him to mean that there should always be someone in the house who could help her.

Ten days ago, after 5 days at home, I was in the family room when I heard her screech. I went into her apartment and found that she had fallen again. I was a little hesitant because she was only wearing garments, but she needed help. She had been standing in her closet, putting on a sweater with a tight neck and in the process of pulling it over her head she lost her balance and fell forward, over her walker, and in to a pile of stuff. Her head was between two shelves. She was fortunate that the stuff in her closet kept her from falling all the way down, but she was far enough over her walker that she was stuck. I pulled her back and got her seated in her closet chair, then left to get Liz. We determined that she had hit her head against a shelf while falling, so Liz took her to the Emergency room where they saw via CAT scan that the subdural hematoma was bleeding again. At this point we decided that the doctor had not meant merely for someone to be in the house with her, but that she needed someone immediately by her, all the time. Meanwhile, they pretty much stopped the subdural bleeding chemically (it was still seeping a little), but daily CAT scans showed that fluid was building up, putting pressure on her brain. Last Tuesday the local doctor wanted to put a drain into her skull to relieve the pressure. Liz decided to consult with her regular neurologist, so she had the films couriered to him. Wednesday, she talked to her neurologist and discovered he had the films and had looked at them, but didn't realize we wanted him to talk to the doctor at the hospital, so that day was lost. Thursday the doctor came in to get her ready to go into the O.R., but after talking to her for a while, he said, "She looks pretty good now. Why don't we just send her home and we'll do another CAT scan next Thursday and re-evaluate." That was a surprise. So she is home, and we have someone with her 24/7. It is a strain on us because it's not exactly how we planned to spend our holiday, nor did our guests, and Liz and I still have jobs.

Physically, Mom is fairly good. She is getting feeble and we worry that she won't keep up her exercises, which could easily lead to the dreaded gradual decline. She isn't self-motivated and she doesn't remember how to do her exercises like they taught her while in P.T.

Mentally, she is much worse. She still talks intelligently and can easily engage in games and conversation. But she is now forgetting common things. For example, when she tries to get up from a chair, she strains against the arms of the chair or onto her walker, but she doesn't remember to put her feet on the floor. She just lets them wag and wiggle around in air and can't make any progress. When we remind her to put her feet on the floor, she gets enough purchase to get up. More worrisome is that she forgets her limitations. Her last fall, for example, was simply the result of forgetting that she can't stand unaided, so she was getting dressed while standing instead of sitting in the chair at her side. She will turn off a light by leaning way over her walker instead of taking one more step to get in reach. She simply doesn't remember that such moves are risky in the extreme. A full-on fall to the floor may well be the end of her.

We are glad to have her with us at Christmas. Joe's children love her and have been afraid because she wasn't in her apartment when they've come to visit us. She responds to them very well and likes the attention they spawn on her. Now Mark and Kelley are here, too. What joy to have a house full of fun and love!

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â Merry Christmas â ]

J Earl J


1 comment:

Nancy Sabina said...

Thanks for doing that, Dad. I know it's YOUR blog - but it's so hard for me to be apart from such a high stress situation and not know what's going on any given day. An update makes me feel less out of the loop.
Thank you.

And Merry Christmas!