Friday, September 16, 2005
A detailed report...
...on Mom's day today and my feelings about this recent Lethargic Episode is over at Mom's Daily Tests and Meds. The link will take you directly to it. On that issue I have no more to say at the moment other than what is over there.
I just finished cataloguing the particular partition of The Mom and Me Journals through Mom's early, startling recovery from her blood tranfusion in early June, 2004. Again, I'm glad I've decided to catalogue all this writing for somewhat easier access. I was gripped by the build-up to her transfusion, the transfusion itself and her recovery from her flirting with grave iron deficiency anemia. I learned a lot from rereading it. I'm so glad I record in detail in these journals. Her journey into grave iron deficiency anemia, I can see, started long before her dangerously low hemoglobin was discovered. All the symptoms I was researching, all the amateur diagnosing I was doing never led me to this conclusion. I'm somewhat better informed now, of course, but that isn't saying much. What, for instance, is the cause of this recent Lethargic Episode? I haven't the faintest idea. I think I'd be able to recognize another dangerous dip in her hemoglobin and I don't think that's happening now, primarily because there is no vomiting, no radical fluid retention and no surprisingly low blood pressure. I don't know, though. As I mention in today's Breakfast Stat post, I'm glad we've got a blood draw coming up soon.
Maybe it's just old age. It's hard to tell with her. I realized how hard this is when I reread the section about her demeanor in the ER at the hospital the night that her dangerously low hemoglobin was discovered: She was animated, to be diplomatic. I don't know, yet, if I wrote about this but I'm going to here: I remember that during diagnosis and prep in the ER behind the curtain she continually tried to get off the gurney to the point that restraints had to be threatened to keep her on it, insisted she wanted to go home and that she was, under no circumstances, going to assent to a transfusion. One of the ER nurses mentioned, before a blood test was done to confirm her dangerously low hemoglobin, that the previous test that had sent us to the ER room was probably wrong because, normally, someone with hemoglobin that low would be unconscious or close to it.
I invoked my MPOA and overrruled my mother's desire to leave without a transfusion. I did it gently, considering the circumstances. In front of one of the doctors who was fast becoming exasperated with her I remember telling her that, "...this time, Mom, you're wrong. This time you need to trust me to make this decision, even though it's not the decision you'd make. I've done the footwork, I've gone over your entire history of blood draws, the doctors are right. You need this transfusion and I'm not going to let you refuse it." I'm paraphrasing, of course.
She settled down.
I clearly recall the surprise of all her feisty, determined, crazy, oppositional energy after days, weeks really, of extremely low energy. Such a woman. Such a woman. I wonder what she has up her sleeve this time.
Hmmm. Maybe I'd better go back and read the link I published when I thought, previous to the blood transfusion, that she might be experiencing acute mitral valve leakage. She's probably not now but it wouldn't hurt to review that just in case.
She's been down for almost three hours. Despite me agreeing to a "sleep day" I think it's time to get her up and moving if for no other reason than to feed her, pill her and remind her that I'm here: Her family awaits.
I just finished cataloguing the particular partition of The Mom and Me Journals through Mom's early, startling recovery from her blood tranfusion in early June, 2004. Again, I'm glad I've decided to catalogue all this writing for somewhat easier access. I was gripped by the build-up to her transfusion, the transfusion itself and her recovery from her flirting with grave iron deficiency anemia. I learned a lot from rereading it. I'm so glad I record in detail in these journals. Her journey into grave iron deficiency anemia, I can see, started long before her dangerously low hemoglobin was discovered. All the symptoms I was researching, all the amateur diagnosing I was doing never led me to this conclusion. I'm somewhat better informed now, of course, but that isn't saying much. What, for instance, is the cause of this recent Lethargic Episode? I haven't the faintest idea. I think I'd be able to recognize another dangerous dip in her hemoglobin and I don't think that's happening now, primarily because there is no vomiting, no radical fluid retention and no surprisingly low blood pressure. I don't know, though. As I mention in today's Breakfast Stat post, I'm glad we've got a blood draw coming up soon.
Maybe it's just old age. It's hard to tell with her. I realized how hard this is when I reread the section about her demeanor in the ER at the hospital the night that her dangerously low hemoglobin was discovered: She was animated, to be diplomatic. I don't know, yet, if I wrote about this but I'm going to here: I remember that during diagnosis and prep in the ER behind the curtain she continually tried to get off the gurney to the point that restraints had to be threatened to keep her on it, insisted she wanted to go home and that she was, under no circumstances, going to assent to a transfusion. One of the ER nurses mentioned, before a blood test was done to confirm her dangerously low hemoglobin, that the previous test that had sent us to the ER room was probably wrong because, normally, someone with hemoglobin that low would be unconscious or close to it.
I invoked my MPOA and overrruled my mother's desire to leave without a transfusion. I did it gently, considering the circumstances. In front of one of the doctors who was fast becoming exasperated with her I remember telling her that, "...this time, Mom, you're wrong. This time you need to trust me to make this decision, even though it's not the decision you'd make. I've done the footwork, I've gone over your entire history of blood draws, the doctors are right. You need this transfusion and I'm not going to let you refuse it." I'm paraphrasing, of course.
She settled down.
I clearly recall the surprise of all her feisty, determined, crazy, oppositional energy after days, weeks really, of extremely low energy. Such a woman. Such a woman. I wonder what she has up her sleeve this time.
Hmmm. Maybe I'd better go back and read the link I published when I thought, previous to the blood transfusion, that she might be experiencing acute mitral valve leakage. She's probably not now but it wouldn't hurt to review that just in case.
She's been down for almost three hours. Despite me agreeing to a "sleep day" I think it's time to get her up and moving if for no other reason than to feed her, pill her and remind her that I'm here: Her family awaits.
