Tuesday, February 28, 2017

Sleepless in Honolulu

I had a really sleepless night. I had to pick Mom up off the floor last night; she ignored my request to call me to help her get to the bathroom, she ended up trying to crawl there but couldn't make it; I had to also clean her up. Fortunately, each of the last 3 times she had to stay in the hospital she came back with a can of no-rinse foaming body wash, which is what I used to clean her up. Mom turned the TV on after she got back to her room; I listened to it all night on the monitor so it made it difficult to tell if she was having problems. I ended up checking on her for 3 false alarms. She didn't get up again to use the bathroom until after 8 am.

Today I spent about 4 hours trying to find a home care company that could provide a caregiver from 11 pm to 7 am, beginning tonight for the next week. I started with Safe Harbor, who provided caregivers for us last November; they couldn't do it. I called 7 other companies; 6 were unable to provide anyone for any of the 7 days we are definitely wanting to have someone around to help with Mom at night. The last one is working with us and thinks they can start providing someone beginning on Thursday night. In the meanwhile, Curtis took a nap and came to sit in the hallway to keep an eye on Mom tonight.

One thing I have noticed is that when Mom is on a lower surface, she has trouble using her legs to lift her body weight. I have taught her to move her center of gravity forward, leaning part of her weight on the walker, & that has made it easier for her to stand up. I sent an e-mail to Dr. Pham, asking for a referral to a physical therapist to come to the house to work with Mom to strengthen her legs. She called & said she could only do it after a face-to-face assessment, so we will discuss that next Monday when Mom has a follow-up appointment with Dr. Pham for the pneumonia.

Curtis brought a frame for the bed that Mom is using. The original frame broke about 2 years ago, so we got rid of it and we put the box springs & mattress on the floor. Hopefully, that higher surface will help. I will also look in to the 'booster seat' that raises the level of the toilet seat.

A couple weeks ago I got a card notifying me that I was now a member of Kaiser Quest health care, the state of Hawaii's medicaid program administered through Kaiser Permanente. Back in December 2016 I was told Kaiser Quest was closed and I did not qualify for any of the exemptions, but if I paid full price ($810/mo) for health care through the regular Kaiser Permanente for 6 months I could transition to Kaiser Quest at the next open enrollment period. Shortly after I got the Kaiser Quest card, I got a bill from Kaiser for the March premium. I spent an hour on the phone today asking questions to figure out exactly who is providing my healthcare. The good news is that I have healthcare. Twice! I was advised to send a letter to Kaiser's membership administration department, requesting a retroactive termination of my regular Kaiser Permanente membership to 02/01/2017, when the Kaiser Permanente Quest membership went in to effect.

Happy Birthday to Peggy, Roger, Winnie, & nephew David! Happy Fat Tuesday, Chocolate Souffle Day, Floral Design Day, Public Sleeping Day, Tooth Fairy Day, Rare Disease Day, and Spay Day! Tomorrow the month of March begins; it is the month for Asset Management Awareness, Caffeine Awareness, Celery, Cheerleading Safety, Colorectal Cancer Awareness, Craft, Credit Education, Flour, Frozen Food, Kidney, Music in Our Schools, Noodle, Nutrition, Peanut, Professional Social Work, Sauce, Trisomy Awareness, Umbrella, and Women's History. Get ready to celebrate Dadgum That's Good Day, Fruit Compote Day, Horse Protection Day, Peanut Butter Lovers Day, and Pig Day tomorrow.

Monday, February 27, 2017

Mom's Back Home Again!

Dr. Kamai gave Mom the green light to leave the hospital today and she was very happy; she was dressed and ready to go an hour before she was officially released. It was a good thing Aunty Judy dropped by to see her before she went to her dentist appointment, otherwise Mom would have been gone when she came to visit! Mom has completed the course of intravenous antibiotics so now she continues her recuperation at home. Xander was really happy to have her back home. He was not sure what was happening and didn't know where to sleep. Almost every morning I found him in the living room either on the sofa or on the floor.
Best buddies!

Soon after Mom got home she changed and got in to bed to sleep; she's still fighting off the bug. We are doing the incentive spirometer every hour she is awake. I need to watch for increased shortness of breath, fever, chills, or more pain. She is on a neutropenic diet, which means nothing raw, so no fresh salads, fresh fruit, poke, or sashimi. The cats are really happy that Mom is back.
None of the cats slept on Mom's bed while she was at the hospital.

While we were waiting for the release paperwork the contractors were working just outside Mom's room. On Friday, Curtis had seen them cut down a rainbow eucalyptus that was standing right next to the building. Today they were removing the stump and roots. We think they might be enlarging the paved area to make it easier for delivery vehicles to get in. Because of all the construction activity near the building I didn't see any cats today.
Root removal.
Stump grinder.

We also saw some of the staff putting cardboard in to the recycle bin. I think they should add a set of movable steps so staff doesn't hurt themselves trying to throw the cardboard up in to the bin. It was kind of windy today, at least 1 armload of cardboard went airborne and ended up scattered across the pavement.

Mom has gotten a lot of encouraging messages and prayers from friends and family. She would love to get phone calls now that she is home; the home phone is the best since she frequently has trouble hearing her cell phone ring.

As I was just about to publish this post, Mom started yelling for me. She tried to get up and go to the bathroom but couldn't make it because her legs were too weak. She ignored our requests to call us for help to get to the bathroom, like she did when she was at the hospital. I had to pick her up off the floor and sit her on the rolling walker. (Glad I have been doing things to keep my upper body toned! I think I'll do more of the Wii Fit strength training...) I used the rolling walker to get her to the toilet, then helped clean her up. I asked about having someone from Safe Harbor come to help us while she is still recuperating; she was less than thrilled with the idea. We'll have a longer discussion tomorrow.

Happy 7th Anniversary to Brianna & Key! Happy Kahlua Day, Polar Bear Day, and Strawberry Day! Get ready to celebrate Fat Tuesday, Chocolate Souffle Day, Floral Design Day, Public Sleeping Day, Tooth Fairy Day, Rare Disease Day, and Spay Day tomorrow.

Sunday, February 26, 2017

Transfusion #23

When Curtis talked with Dr. Kamai today, he was told that Mom was low on platelets again. Dr. Kamai ordered another platelet transfusion, she already had one on Tuesday. And in the evening on Friday they gave her 2 units of packed red blood cells (transfusion #22). This evening they did the platelet transfusion. When the platelets were done, they did a vancomysin drip for 4 hours.
Platelet transfusion. They will start the vancomycin drip when the platelets are done.

Mom gets zosyn 4 times a day and vancomysin once a day. Like other antibiotics, she has to take them for 7 days. Mom was admitted to the hospital on Monday, however the antibiotics weren't started until the early evening. So it is most likely that she will have to stay until Tuesday.
Zosyn drip.

One of the big problems we have had is trying to get Mom to stop scratching; she can't understand what her scratching is doing to her skin. This started in November, her skin was very dry so it was itching all over. Her scratching damaged her skin so badly that even after we started using moisturizing lotion twice a day the healing process caused some of its own itching. We have not been completely successful in stopping her from using all kinds of things to scratch her back. It looks much better now than it did a few days ago when it had a checkered look like alligator skin and was falling off in large flakes like after a bad sunburn. Being in the hospital has eliminated the things she uses to scratch it.
Peeling skin on Mom's back.

When I went to wake Dad up for breakfast this morning, I found that Xander had slept with Dad last night. In fact, he apparently forced Dad to sleep on the other side of the bed.

Sunday is the day I go through the house and empty all the rubbish cans and take the recyclables out to the recycle bin. Today I took all the old phone books that were in the guest bedroom to the recycle bin. Now I hope the bin is not too heavy for me to wheel out to the road on Thursday for pick up! The oldest book was 2005; I don't think we need that one any more.
There are 14 books here, another 3 were in the room I am in. I also threw out the old powerhead for the broken Shark.

When I arrived at Kaiser Moanalua, I looked for Momo's twin again; he wasn't there. Only one of the white cats with black patches was there.

As I was sitting in Mom's room, working on the blog, I saw another cat walking by. I was able to get a very good look at this one. It also is white with black patches but on its right side it only has a small sort of oval spot, some on its hindquarters and tail, and a 'bonnet' that does not cover its eyes. On its left side it has a patch a little larger than the one seen here but a little farther back on its body along with a small round spot on its hip and one on its knee. It has no black on its back.

Both of these cats are different than the first cat I saw in December. The first cat had a lot more black on its back. There are now 5 different cats that I have seen at the Kaiser Moanalua facility. I will have to check with Kim & Rowena at the ATC and find out if any of these are the cats that they feed.
December 21, 2016, photo.

I talked to Curtis more about the location of the cat he was looking for last night. Isaac said he was driving on 12th Avenue between Maunaloa and Kaimuki avenues when he saw an orange cat cross the street; he called as soon as he got home. Curtis went and looked over a several block area but did not see any cats; he saw a lot of people walking their dogs. I told him it might have been Lefty, who lives between Maunaloa and Kaimuki about 3 blocks from there. I met Lefty and his humans in January when I was handing out fliers about Momo.

For dinner, Mom only ate a few mouthfuls of miso soup, gelatin, and green tea; she said she doesn't get hungry because she only sleeps all day. I went to the Sunrise Cafe and tried their teriyaki meat loaf; it was pretty good.
Teriyaki meatloaf with mixed vegetables. You can ask for vegetables to replace the carbs that would normally be served with the meal.

Happy Birthday to Leah & Glenda! Happy Pistachio Day and Happy Tell a Fairy Tale Dayt! Get ready to celebrate Kahlua Day, Polar Bear Day, and Strawberry Day tomorrow.

Saturday, February 25, 2017

Lots of Visitors Today!

Mom had a lot of visitors today. Curtis said Nurse Staci stopped by this morning at 7:30 (before she started her shift at the ATC). Then Aunty Judy came by on her way back from a service in town. Later Curtis & Lori's neighbor Anita dropped by with a freshly baked pie! And Lori brought her parents by for a visit. Everyone was still there when I arrived. (Yes, just call me Captain Obvious; would not have been able to get the photo if they weren't there!)
L, front to back: Lori & Aunty Judy; R, front to back: Anita, Mrs. Nomura, & Mr. Nomura. Curtis & I stayed outside.

I came a bit later today, 4 pm. I was finishing handing out fliers about Momo to the last 2&1/2 blocks or so in the 1 block radius from the house. But I had problems with the printer last night, the black cartridge ran out after 4 pages; I picked one up this morning as soon as Office Max opened so I could make 96 more fliers. But after about 10 pages the color cartridge began to run out! Auwe! Fortunately I had bought the set of black & color cartridges so I didn't have to run back to Office Max. I got 86 fliers out of that color cartridge but the last 3 were streaky. All total, it took me 3 hours to hand out 100 fliers and I still needed 4 more to finish the final block that I was on. (The app on my phone says I walked 5.4 miles today.) I had not realized how dense the residences were in our area. In the block bounded by 7th Avenue, Maunaloa, 8th Avenue, & Kilauea I found 58 residences and there still might be a couple of units that I missed. That's residences, not people, and these are single family residences not apartments. According to census data, the average household size in this tract is 3.1, so that would mean there are about 180 people on that block; that's a lot of people that might see Momo! (All total I have handed out 200 fliers, that means there are potentially 620 people on the lookout for Momo.)
Screen shot of Google Maps

As I was walking around the neighborhood I saw a pair of mejiros eating something from the aloe flowers at one woman's house. She said they are there whenever there are flowers. She removes the flower stalks after they are totally dry so the mejiros can feed on whatever it is they are eating.
Mejiros (Zosterops japonicus) on Aloe barbadensis flowers.

As I was walking around I met a couple of people who had a connection to us. It was interesting to  hear what they remembered. Norma remembers playing with Mom & Dad's dog Rina, who passed away about 1980. (Norma also has a light orange cat that has a similar body type to Momo, as well as a tortoiseshell cat.) Her neighbor Elizabeth remembers Curtis' yellow mustang with the black top that he had about 1975. Here's the flier that I was handing out to people.

After nearly 3 hours of walking around the neighborhood looking for Momo I arrived at the Kaiser Moanalua facility. As I was walking from the parking garage elevator to the hospital entrance I looked over to see which cats were in the construction area by the building and saw a Momo look alike! Usually there is a white cat with small black patches and sometimes a black & white tuxedo cat is also there; this is the 1st time I have seen Momo's twin.
Momo's doppelganger.

After leaving the hospital and dropping Aunty Judy off, Curtis went to drop off food for Dad and got a call from Isaac who thought he saw Momo! Isaac said he was driving along, about 4 blocks from our house, and saw an orange cat crossing the road. So Curtis went out to look for the cat but could not find it. I am expecting more calls since 2 other people that I talked to today said that they had seen orange cats near their house in the last 3 weeks.

The cafeteria called Mom about 5:45 to see if she wanted to order dinner. I showed her the menu & she decided she wanted the fish entree with steamed vegetables, miso soup, gelatin, & green tea. But 45 minutes later when everything arrived, she ate one bite of the salmon & said she wasn't hungry. She only ate the miso soup, gelatin, and green tea. I ended up eating the salmon & vegetables.
L to R: grilled salmon with rice & steamed vegetables, miso soup, & gelatin.

The nice thing about dementia is that everything is new! Tonight Mom watched the 48 Hours episode "Stalked". It was aired twice, one immediately after the other. And she watched them both. The 2nd time she reacted as if she had not seen it before. We can leave the TV on one station and she is content.

Happy 1st Anniversary to this blog! I started this blog one year ago at the request of CJ. Thanks, Chris! I have really been enjoying putting things together for this blog.

Happy Birthday to Paul, Gregory, & cousin Justine! Happy Chocolate Covered Nut Day and Clam Chowder Day! Get ready to celebrate Pistachio Day and Tell a Fairy Tale Day tomorrow.

Friday, February 24, 2017

Not Cold Today

I took the heated vest to the hospital this morning. We put it on Mom shortly after I got there, she really liked it. For the most part it kept her warm when it was at the lowest setting, 90 degrees F. But there was one point where she got cold, right after they changed her gown, that I put it on the 2nd setting at 105 F until she warmed up about 30 minutes later. The heated vest kept her toasty warm so she even removed some of the blankets they had given her that morning. At 90 F the battery will last about 10 hours; the plan is for Curtis to switch batteries before he leaves at night so that she is warm through most of the night. He will put the used battery on the charger, then switch it out the next morning.

You may have noticed she is still on the infusion pump, she was getting zosyn when the photo was taken. They also started her on the incentive spirometer again (at far left in photo). Before the pneumonia she was able to reach 1000 cc about half the time with the remaining reps at about 750 cc. Now with the pneumonia she can barely get to 500 cc.

Aunty Judy was there again this morning. She joked that she was going to come every day to eat lunch at the Sunrise Cafe! I told her that she has been lucky that the meals she has had are good since Curtis & I had a few meals that were not very good. Today, however, they had good meals; Aunty Judy had the pork tofu and I had the grilled monchong (Taractichthys steindachneri).
Grilled monchong with steamed vegetables and macaroni salad.

They mowed the golf greens this morning and the cattle egrets (Bubulcus ibis) were following the mower, like it was a large metal bovine, catching insects and other small prey stirred up by the mower.

Curtis talked with Dr. Kamai this morning. He is contemplating giving Mom a transfusion because her numbers are dropping. But he had not put in the order today, so no transfusion today. It could be tomorrow though, the phlebotomist came in the early evening to collect blood for the cross match & give Mom the yellow wrist band for transfusions. Her lungs sounded "a little wet", so they started her up on the incentive spirometer again; we help out by working with Mom to do those.

Before coming to the hospital, I took the Subaru to McKinley Car Wash (across the street from McKinley High School). As part of the wash, they also vacuum the car out; they got all the sand out from the beach trips that Sarah, Kaia, David, & Randi made while they were here. (One of the guys vacuuming asked about all the sand.) All total, from the moment I drove up until I got back in to drive away it was 24 minutes; some of the on-line reviews said the wait could be up to 45 minutes because it is such a popular place. It cost only $15; next time I think I will add a wax to help protect the finish. I also have to take the RAV4 in and have it cleaned up.
Vacuuming, another worker joined him later from the other side of the car.
The start of the wash cycle. Continuing to the left inside the part of the building I am in is the snack display and cashier where you pay for everything before exiting to pick up your car; a well thought out flow pattern.
Almost done! They wipe down the inside, too: windows, dash board, control panel, & door panels.

For my snack today I got some whole wheat fig bars from Kokua. They are very nutrient-dense, but tasty! Fig bars were also one of my favorite snacks to take to the field.

Happy Birthday to Rich! Happy Skip the Straw Day and Happy Tortilla Chip Day! Get ready to celebrate Chocolate Covered Nut Day and Clam Chowder Day tomorrow.

Thursday, February 23, 2017

It's Soooo Cold!!!

Mom's biggest complaint at the hospital is the temperature, it's too cold for her. They will give her warm blankets, if she asks for them. But she says its too much trouble for the nurses, so I have let them know that they should get a blanket for her if she seems cold. And if I'm there I make her push the call button and ask for one, to train her to ask for a warm blanket. Today I also brought her a pair of leggings (to replace her soiled ones) and the vest her mahjong buddies gave her for her 90th birthday. She was very happy to get those things to help keep her warm. As soon as they covered her with the warm blanket she fell asleep. (She said she couldn't sleep last night because she was cold.)
Mom in her vest, enjoying the nice warm blanket that is being placed on her.

When they came to give Mom a bath she loved the warm water! One thing we discovered is if the outer door is closed it gets cold in the room; when the door is open the warmer air in the hallway comes in. The Mobile Warming battery-heated vest that I ordered for Mom arrived today, so she will have one more thing to help keep her warm. (This is the same brand of vest I used to keep me warm when I did field work in the winter.) The lowest setting is 90 degrees F and will last for 10 hours; I got 2 batteries so Mom can use it all day.

I arrived at the hospital a little after 10 this morning and was pleasantly surprised to see Aunty Judy was visiting with Mom. (She joked that she had to come and see the rainbow eucalyptus.) She stayed several hours, so we got to talk for a bit. While Aunty Judy was there, Mom called to talk to Aunty Florence; Aunty Judy also got to talk to Aunty Florence. We also got lunch from the Sunrise Cafe. I had the pork posole and Aunty Judy got the chicken hekka.
Pork posole, it was pretty good!

Mom got another surprise visit, this time from Nurse Staci from the ATC! Nurse Staci got off early because they did not have many patients at the ATC today, she stopped by before she went home. She had seen Mom was in the hospital so came to say Hi!

Dr. Kamai came by to check Mom's lungs and rib. He said they have not been able to culture anything from her blood yet, so that is good news. But he said they wanted to make sure so they would be keeping her for at least another day. The first day Mom was here, Dr. Thaludi said if there is a high bacterial load it takes about 2 days to see results. She said if there is a low bacterial load, it could take up to 5 days for them to get anything to grow so they would keep her here until then to find out what is causing the pneumonia. Every day they draw blood to check the levels of antibiotics in her system and also to check the levels of her red blood cells, platelets, and white blood cells.

Mom also got a phone call from cousin Gladys. There has been a lot of flooding going on in northern California, it was nice to hear that they are in a part of San Jose that is not flooded.

Curtis left this morning about 10:30 to go to a luncheon. In the afternoon, he stopped to pick up Dad, who asked last night to come for a visit today, but Dad was not feeling well so he decided not to come.

I've been using the Wii Fit every evening for 4 days straight now. I try to do at least 1 exercise from each of the 4 categories (Yoga, Strength Training, Aerobics, & Balance Games), for a total of 1 hour. The Yoga one tells me I need to get stronger to do a bunch of the poses. The Strength Training one tells me the same thing. I keep trying to do the Step Dancing activity of the Aerobics category but I have 2 left feet. The Balance activities seem to be the most fun, especially the ski jumping. I figured out when you are going down the ramp the more you keep the red dot on the blue dot the faster you go. Then extend your legs as soon as you hit the red line at the bottom of the ramp & keep your balance; if you wait too long to extend you wipe out and become a big snowball with skiis.
The maximum speed is 50 mph.

Here are my highest rankings. Guest F is actually Randi. She is also the No. 1 ranked ski jumper; I think her high score was 280 m.

Happy Birthday to Mickey! Happy Tile Day, Banana Bread Day, Dog Biscuit Day, Toast Day, and Chili Day! Tomorrow get ready to celebrate Skip the Straw Day and Tortilla Chip Day.

Wednesday, February 22, 2017

Mom is Getting Bored

Mom called me at about 8:15 this morning to complain; so she must be feeling better! She said she had not seen any doctors or nurses. She found the activity booklet that they brought in for her yesterday but said she didn't like their crossword puzzles. She asked me to bring her crossword puzzle books; I told her I would also bring the adult coloring books.
Mom organizing the colored pens for her coloring books.

A short while later, Dr. Rodriguez called; she is the ER doctor that saw Mom on Sunday evening when we made the deal about going back to the ER if she got worse. I was impressed that an ER doctor would take the time to make a follow-up call. I told her Mom did have pneumonia & was admitted to the hospital on Monday morning so they could administer intravenous antibiotics.

Sandy from Mom's mahjong group also called this morning. She wanted to come by & drop off a gift for Kaia & Sarah! But she got her dates mixed up, she thought they were arriving on the 20th, not leaving on the 20th. Auwe! She will come by next week when Mom is home so she can visit with Mom as well as drop off the gift.

After Dad & I had breakfast, I took Xander to the Cat Clinic for his annual geriatric kitty check-up; he will be 15 years old on May 1st. He needed some blood tests; I also needed to refill his prednisolone prescription for his asthma. (The vog affects him, but fortunately the mango pollen does not.)
Xander hiding out in his carrier.

This morning my phone said there was a lot of traffic and it would take me longer to get to work. So I checked to see where my phone thinks I "work". It turns out it thinks I work at the Kaiser Moanalua facility; I think that's because I make so many trips there and about half of them are at the usual commute times.

When I got to the hospital about 1 pm Mom was awake; she had eaten breakfast then taken a nap, getting up shortly before I arrived. Curtis had been with her since about 8:30 and left shortly after I arrived. She stayed up for the rest of the afternoon, working on crossword puzzles and looking at her coloring books. Later she switched over to watching classic old television shows like "Hazel", "The Roy Rogers Show", "The Andy Griffith Show", and "The Lone Ranger". Then she took a nap before dinner.

Dr. Kamai came in around 2 o'clock. He is the doctor that took care of Mom back in September when she had blood in her stools, just before we took her and Dad to Las Vegas. Dr. Kamai coordinated with Dr. Chan to get her back on her feet and able to go to Las Vegas. He remembered Mom because of the Las Vegas trip.

Sarah left some beet juice with turmeric from Bluetree Juice along with some coconut water. I mixed the 2 together and took it to the hospital with me. It was a tasty and nutritious drink to have. You can return the bottle to Bluetree to get a discount on your next juice drink or recycle it.

The rainbow eucalyptus was in full sun when I arrived and looked really nice. This one doesn't have as much color as some of the other photos I have seen of them. Apparently the bark peels off naturally, exposing the bright green inner bark which changes color as it matures, going to blue, purple, orange, and finally maroon before it detaches from the tree to start another cycle. Since the bark peels off at different rates it creates colorful stripes. The one outside Mom's window seems to be only through part of its cycle and doesn't have all the colors yet.

Looking north from Mom's window we can see the Moanalua Golf Club, which surrounds the hospital on 3 sides. It is apparently the oldest golf course in the state, having been established in 1898. It has 9 holes, each with 2 different tee locations to provide for an 18-hole course.
Moanalua Golf Club in the background. The glassed-in area in the shadows of the building to the left is the Sunrise Cafe at the hospital.

Lori sent me a photo of Kaia & Salty from Saturday night's dinner. Kaia is in Pepper's cat bed. Usually Pepper sleeps in Salty's bed, forcing Salty to sleep in Pepper's bed. Since Pepper doesn't stick around when there are strangers, Salty got to sleep in his own bed.
L to R: Kaia, Sophie the Giraffe, & Salty. (Photo by Lori)

I did the sheets from the guest bedroom this morning before I went to the hospital. And I discovered that Mom had put 3 sheets on one of the beds, one on top of the other! (There was only 1 sheet on the other bed.) I'll be reducing that to 1 sheet and also rotating the sheets; Mom has more than one set of matching twin bed sheets so she doesn't need to keep putting the same ones back on the beds.

While I was at the hospital Mom asked me if I got the bag of beans. Huh? Apparently she was dreaming and could not tell that it was not real. She said there were beans in the kitchen and wanted me to cook the beans tonight. I know she frequently talks in her sleep but this time she was awake telling me about the beans. Curtis said she also did that to him earlier today.

Happy Birthday to Shannon! Happy Cook a Sweet Potato Day and Happy Margarita Day! Get ready to celebrate Tile Day, Banana Bread Day, Dog Biscuit Day, Toast Day, and Chili Day tomorrow.

Tuesday, February 21, 2017

Transfusion #21

We talked with Dr. Thaludi this morning. She is the floor doctor keeping tabs on Mom for today. She said Mom's platelet count had dropped to 7K so they gave her a transfusion of 2 units of platelets. She said Mom's red blood cell count, which is at 8.7 now, might also drop lower due to the infection; if it does she will get a transfusion of those as well. Today is Dr. Thaludi's last day of the week, tomorrow Dr. Kamai comes on duty & will be here for the next 5 days. (I think Dr. Kamai was the internist that saw Mom in September the day before we were leaving for Las Vegas.) Dr. Thaludi said if Mom has a lot of bacteria in her blood, the culture they are doing should begin showing signs tomorrow. If she has fewer organisms it may take until Friday to see anything. In the meanwhile, Mom stays in the hospital with an antibiotic drip to knock out whatever is causing the pneumonia. She will not be excited to hear she has to stay for a few more days.

Mom was very confused today when she was talking to Larry, the volunteer from the church. Larry asked where she lived and she couldn't remember; I told him Kaimuki. He asked what it was like and she began to describe where she grew up on the Big Island. As she started to tell him about a tunnel at the edge of the cane field she asked me if I knew about it; I didn't. She said she would show me when we got home after she got out of the hospital, so I thought she meant the Diamond Head tunnel. She said no, not Diamond Head, but at the edge of the cane field behind the chicken coop. She could not distinguish between things in Honolulu and things on the Big Island. She referred to both as "home" and appeared to think they were the same place.

When they came to get a signature for approval to do the transfusion Mom also could not remember why she came to the emergency room. In fact, she could not remember being in the emergency room at all. She did not remember about fracturing her rib either. So they had Curtis, who has medical power of attorney, sign the paperwork for her. We found out that I am second in line for the medical power of attorney, so if Curt is not around, I can sign for Mom.

Curt and I are taking turns sitting with Mom during her "waking" hours; though she sleeps most of the time during the day. He was at the hospital at about 8:30 this morning, which allowed me to feed Dad, do dishes, and a load of laundry. I also stopped by to check for Momo and got to the hospital around 11:30. Curt left about 12:30 to do errands and the Costco run. He brought the supplies back to the hospital and we did the transfer in the parking garage. I left at about 4:30 to get back to make dinner for Dad. Curt stayed until about 10 pm, similar to last night.

This morning I started cleaning up the used towels & sheets. I found only 4 items that Sarah, Kaia, David, & Randi forgot. Although they might have left the aerosol can on purpose.
I'm sure the little towel is Kaia's. Not sure who the others belong to.

I also found a stash of disposable Handi-Wipes that Mom apparently washed, dried, & neatly folded for future use. Many are stained, so I threw them out. Since it was at the back of the drawer I don't think she will miss them.

And I also found a stash of used masks; 22 to be exact. There were 16 in several bags in the bathroom closet, 4 are from Mom's purse (some were loose), and 2 were in her bedroom. I can tell that they are used because almost all have lipstick on them. Mom doesn't understand why keeping old masks around can be hazardous to her health; she thinks its a waste of money to get rid of a mask after one use. This bout with pneumonia has only reinforced how dangerous an infection can be for her.
Clockwise from L: saved in bathroom closet, from Mom's purse, & from Mom's bedroom.

I had lunch at the hospital. I decided to try the panini sandwich. It had smoked turkey, pepper jack, & avocado. The Sunshine Cafe is really close to Mom's room, probably about 100 feet down the hall; we can see the dining room portion from Mom's window. The prepared food portion is open from 7 am to 6:30 pm; the dining area is open 24/7 and has vending machines for food, juice, water, and coffee.

When the sun came out, the trees outside Mom's window looked fairly nice. I finally figured out what these trees are: Eucalyptus deglupta, aka rainbow eucalyptus.

Happy Birthday to Barbara, Jackson, Amelia, & Darwin! Happy Sticky Bun Day! Tomorrow get ready to celebrate Cook a Sweet Potato Day and Margarita Day.

Monday, February 20, 2017

ER #4/14

When we left the ER last night we made a deal with Mom; if the pain got worse or she had difficulty breathing or she developed a cough or she developed a fever, she had to not argue with me and go back to the ER immediately. When she woke up this morning she had pain on her right side but she said it wasn't any more sore than last night. When I had her do her breathing exercises, she had to repeat 7 out of the 10 reps to hold it for the right amount of time; normally she might have to repeat 1 or 2 of them. About 15 minutes after the breathing exercises she called me back in to her room and said the pain was worse, twice as sore as the broken rib on the left side. That is, until I said I was going to take her to the emergency room; then she said it wasn't sore! Her temperature was 97.7 degrees F; she had no cough. So she was showing 2 out of the 4 criteria for going back to the ER, so here we are again!

Since Sarah, Kaia, David, & Randi were leaving today about mid- to late afternoon, they said their good byes as we were getting ready to head to the ER.
What's that over there?
You lookin' at me?
We are not amused  :<
L to R: Mom, Sarah with Kaia, & David (Randi was busy making breakfast, she popped in later).

I checked Mom in to the ER and even though they were very busy they got her in to a room right away. Dr. Fujiwara was her ER doctor again; he saw Mom on 02/01 when she broke her rib on the left side. Nurse Alika was Mom's main nurse, assisted by Nurse Natalia. By the time we got to the ER Mom had developed a low-grade fever of 101 F. Dr. Fujiwara started a series of tests to sort out what is going on with her. In the meanwhile Nurse Alika started an intravenous fluid drip to keep Mom hydrated. Dr. Fujiwara also cleared Mom for eating, so I ordered breakfast for her from the cafeteria. I had a bag of the Cuckoo for Coconut Trek Mix. And Mom's leftovers. (I am avoiding the QuestBar Double Chocolate Chunk free sample for as long as possible!)
Eggs over easy with white rice, mixed fruit cup, vanilla yogurt, & chamomile tea. (She wanted green tea but its not allowed at this time.)

Nurse Trixie took Mom for her CAT scan and Nurse Nancy brought her back. Rowel the phlebotomist took blood for the tests to find out whether there was an infection and other things. Of course, she kept saying she could go home after each one of them finished doing their portion of the work. As it turns out, the CAT scan showed she had developed pneumonia in spite of the prophylactic levels of levofloxacin & acyclovir that Dr. Chan has had Mom on and the incentive spirometer breathing exercises. Dr. Fujiwara had her checked in to the hospital; she will stay at least overnight while she gets vancomycin & zosyn intravenously to fight the pneumonia. Dr. Chan has told us that due to the acute myelocytic leukemia Mom needed to avoid infections since she does not have the ability to fight them off herself. Hopefully we have caught it early enough.

Dr. Tamiya, the internist that was the primary person working with Mom for the transfer to the hospital & the day shift, gave me some additional information. Although Mom has had the pneumonia vaccine, getting pneumonia now doesn't necessarily mean she did not produce any antibodies. It could be a different strain or it could be caused by a fungus; they will know more after the 1st round of antibiotics.

Because I was at the ER with Mom, Curtis took David & Randi to the airport around lunch time. They stopped to pick up some snacks for the plane & Curtis bought some things for the house also. Later he took Sarah & Kaia to the airport. They have a long trip ahead of them; they will arrive back home around 10 am on Tuesday.

At the hospital end of things, Mom started out with Nurse MJ and Nurse's Aide Irene. The room was warm and toasty because it faces southwest and also has a familiar view! We have actually seen this view from the other side; it overlooks the walkway from the parking garage elevators to the main entrance. In fact, last Thursday as we were leaving after Mom's transfusion, she asked me about this specific tree in the center of the photo.

Darn! They had to move Mom because the original room they put her in was a double room & today space is at a premium. She's in a private room now because she can't have a roommate due to the neutropenia; they want to minimize her exposure to others. Everyone coming in to her room has to wear a mask, everyone doing a procedure around her, including just changing sheets, has to wear gloves, the door is closed and has a sign alerting people to the neutropenia. Unfortunately this room is on the opposite side of the wing and is very cold. Plus the window is broken so it won't close properly & is allowing cold air to come in; they have called for Maintenance to come & fix it.
Trees on the shady side of the building, Tripler Army Hospital in background.

I had a late lunch. Since I was trying to avoid the QuestBar I waited until after they transferred Mom to the hospital side. The Double Chocolate Chunk flavor was just a little bit better than the chocolate peanut butter last night. I think having the double chocolate in it provided a hint of chocolate flavor.
Also NOT recommended for ER snacking.

Well, if anything can go wrong with the physical aspects of the room, it did. First, they put Mom in a double room though she is neutropenic. The new room was cold & drafty because the seal on the window was broken; they taped it shut. The machine that powers the leg massagers kept beeping, indicating the battery was low even though it was plugged in; they reset it 3 times to no avail so they got another machine. And finally, the transfusion pole would not stay in the extended position to lift the bags high enough for a good gravity flow; they got another one of those, too. This is very unusual, we have never had problems with the room in any of Mom or Dad's hospital stays before.
Another use for red tape.

One of the last chores David did before leaving was to spread the last 5 bags of red cinders. The chore was to finish off the last corner of the area that I had started and extend it around the water meter.

Happy Birthday to Chris, Gus, & Rebecca! Happy Love Your Pet Day, Happy Cherry Pie Day, and  Happy Presidents Day! Get ready to celebrate Sticky Bun Day tomorrow with a batch of sticky buns, recipes included in link.