Day Five - A Raising Parents Story

 It's been a minute since we've had a Raising Parents post and whew, here we are. Pull up a chair and get a snack.  Because we're on Day Five of a hospital stay because...reasons.

I can't decide if I need to begin at the beginning or mid-way of this whole thing...   I'm going to go with mid-way because that's how the discovery of the problem rolled out. Sorta. Kinda.  Excuse any disjointedness.

Thursday found my mother-in-law in the hospital.  She was sent directly to the emergency room from the doctor's office for "stomach pain".   Kevin left work and sat with them while they waited and were admitted into the hospital.

There was a long wait because the emergency room was busy and the hospital was full.  When it was time to admit her, Kevin had to phone me for her info because I'm guessing his dad wasn't able to answer the questions?  Or wasn't available?  I'm not sure.

Meanwhile, the brother went home because "the parents said it was fine" and if I hear that excuse from him one more time, I will need bail money.  Tiny bit of advice: have discussions with your siblings about expectations when a parent is in the hospital.  Otherwise, it is possible that one child is going to shoulder the load.  *end lecture*

We thought she was being admitted for stomach pain and the fact that she wasn't able to use the bathroom in any way, if you get what I mean.  Nope, she was being admitted for ACUTE KIDNEY FAILURE with a secondary concern of possible diverticulitis.

She was so severely dehydrated that her kidneys were shut down.  Not slowed but shut down. Both.

Now, you might be puzzling about this if you've been reading here a while.  She has a G.I. tube so how in the name of Where's Waldo is she dehydrated.  Well, here's the thing: she said that because her stomach hurt, she didn't eat, drink, or do tube feeds.  Because they "got this" and don't need anyone's help.

Her dehydration was so bad that they couldn't find any viable vein and had to use her port and put in another one. (subclavian - hooray Greys Anatomy Medical Degree)   They couldn't do a CT scan because her blood was so chunky - because her kidneys were shut down - and they couldn't administer the contrast.  

Kevin ended up leaving the hospital because he couldn't risk waiting in the E.R. or waiting room for her to be fully admitted and taken to a room.  Because remember, he's had Covid twice and is in active Graves Disease now.  Yes, I am bitter, why do you ask?

He came home just exhausted, both physically and mentally.    There was nothing anyone could do at that point anyway but wait.

When he talked to her the next morning, she said that there was a mass in her stomach and that her kidneys and liver were both failing.  He was concerned and also knew that she is a terrible reporter so it's difficult to tell what's true.  Also, it appears that his dad is unable to verbalize anything that is going on very clearly anymore. 

I checked her online medical records to see what was happening. Thank the universe for this feature.  If you haven't done so, please I BEG YOU, get signed up for electronic medical records for your parents.  

Well, it turns out that she was in kidney failure because she hadn't eaten, drank, or had a tube feed for FOUR DAYS.  FOUR.DAYS.  FOUR.

To quote Kevin: she is her own worst enemy.  And we can't EVEN with his dad allowing this to happen. Their logic was they had a doctor appointment the next morning.  

Sidebar: Heads up to those raising parents: be aware of the "We have a doctor's appointment the next day/week/etc."  For some reason unknown to mankind, the elderly will put off things because of these scheduled appointments.  "Oh, chest pain?  I go to my regular doctor on Friday, I can wait." kind of situations.

Secondarily, she had colitis/diverticulitis.  They could tell there was thickening via an x-ray but couldn't investigate further until the kidneys were functioning again AND the blood could sustain the testing. No liver failure or mass.  No sign of cancer.

Kevin visited her after work on Friday and I had stayed away because I had the flu all week.  (haven't been sick in almost four years, hooray me)  There were no meaningful updates because all anyone could do was wait. But I kept checking the medical records, just in case.  I could see her blood test results and they were showing signs of improvement each time.

Saturday afternoon I went with Kevin to see her.  His brother was there (eyeroll) and left shortly thereafter.  Kevin was asking if there had been any update and she said no. She followed with kind of a flip/yet confused "I don't know what caused this, maybe they'll figure it out."

Yeah, I saw red.  Just a flicker and it went away quickly but not before I said "FOUR DAYS OF NOT EATING OR DRINKING is how you got here."  She kind of waved me off like I didn't understand and we were having none of it.

Then later in the conversation, when Kevin was explaining that there was no mention of liver issues or cancer (to which she claimed that she didn't say there was)  She mentioned how badly her stomach hurt while she was at home.  Kevin said to me that the night before she had been crying because her pain was so bad.

My head was on swivel and it spun to my husband.  "What?"  He explained that she had been crying when he checked in with them after work.  "KEVIN, that is an AMBULANCE CALL"  He looked embarrassed and the mother interjected that they had an appointment the next day and "it wasn't that bad."  To which Kevin - unwisely perhaps - said "You were crying it hurt so bad."  

THAT IS AN AMBULANCE CALL, MY MAN.  

He was appropriately contrite and agreed that if/when there is a next time, the ambulance will be called.  "Because there WILL be a next time." he said.

At one point, she stated "I know my body" and "I knew if I went to the doctor, I would have to go to the hospital"   Kevin and I both get awards for not running screaming from the room on both of those.  Instead, Kevin rose his voice a little and said "You 'knowing your body' ended up with you in the HOSPITAL" and for the other I rose my voice a little and said "Either WAY you end up in the hospital and clearly this is MUCH BETTER than going earlier. Good choice."

Now it may feel like we're being a little mean and here's why:  This has been endless.  This is the eleventieth time that she's been dehydrated. The last time the doctor said "You aren't going to get many more chances with this and you're going to be in organ failure and there will be nothing anyone can do."

There have been endless conversations about not waiting when things are going wrong and that they need to tell us so we can help make (better) decisions and yet, they continue to pull this utter dogdamned nonsense.  FOUR DAYS without water or food. AND PAIN.  

And. AND. And...

She's supposed to be on tube feedings.  She can take a little by mouth but it's supposed to be soft foods. The other night she was eating PIZZA with three different kinds of MEAT on it.  AND this is after she was having stomach pain.  But wait, there's more because there is always effing more: 

The brother served her PRIME RIB at Christmas dinner and even made a flourishy show about adding seasonings and salt.  PRIME RIB.  And no one can say anything because then the holiday is ruined and everyone is upset. 

And guess, just make a wild guess, when the stomach issue started? Yep, after the holidays.

Oh, and I nearly forgot that she is also no longer able to take her meds orally as of a week ago...two weeks ago, now.  Their solution to that problem was to just not give her meds for a few days until they could talk to the doctor.  

DEEP BREATH. Let it out slowly.  Deep Breath.  This is why we get snarky and blunt.

So, sigh, where are we now?  

We were lucky enough that the doctor came in while we were there yesterday.  We got to hear first hand the results and the plan for resolving the diverticulitis.  Luckily, it's going to be managed by medicine because we're not sure she would withstand a surgery of that kind.  (she had one ten years ago that the odds were 50/50 that she would survive it)

This also gave us the opportunity to bring up some issues that we had and that I  only learned by reading the medical records.  Because they would never, ever, tell us this next part:

The social worker evaluated the mother, the dad, and the situation.  It was determined that they needed help at home.  The parents declined.  It also appears that the brother was there and did not raise any concerns about the situation.  (shaking of fists)

The Occupational/Physical Therapist evaluated her and stated that she needed therapy to improve quality of life and safety.  She declined, again.  Those notes ALSO stated that they needed help at home.

The doctor listened and then explained that they will be evaluated again, before she leaves and then we can talk about next steps and a care plan.  THEN HE DROPPED THE BIG BOMB: "Because if you don't and you aren't strong enough when you leave here, you will have to go to a rehab facility until you are strong enough"

In my head, I was all 

As expected, that didn't go over well.  They thought about it a moment then my f-i-l says that when she has all of her tube feeds daily, she's much stronger but she "can't" have all her tube feeds.  We talked about what "can't" was.  This is where she says that she's too uncomfortable and can't have that much "food" and a quiet re-statement of "I know my own body".

I think I saw a glimmer of a smile/smirk on the doctor before he responded.  "Is there any reason you can't have LESS food but more times during the day?"  To which Kevin and I were nodding like "Yeah, why can't that work?"

They both reluctantly agreed that they would try that.  I knew it went too smoothly and was proven correct when a few minutes later, my f-i-l says "Well, that's all fine but if we have to go to the doctor or get groceries, then the whole schedule is messed up."

Um, what?  Even the doctor had a pause after that one.  "You make adjustments so that she gets everything that she needs" he stated; which I loved because it made it about her needs and not a judgement per se.   I mean, c'mon. Perhaps, then schedule the appointments differently or don't be gone for hours at a time because you know she has to EAT.  This is not rocket science. This is also Not An Option, which is the most frustrating part of this particular issue.

So, we're just waiting now. The doctor hoped that maybe she could go home tomorrow but to plan for Wednesday.  Sadly, we're not looking forward to it because we know that they're not prepared or able to deal with this recovery.  We know the clock is ticking for the next issue/disaster.

And there's nothing we can do but wait.