Mom's Condition 22 JAN 2010

I'm sorry, but this is not good news.

I saw Mom at 1730 at the nursing home. She seemed physically better, but was restarting the generational war with the staff. Linda visited as well, and we agreed that things were looking up. She was able to stand, and walk a bit, and was using the facilities. The only bad sign was her downer outlook, and her refusal to eat very much (to avoid the bathroom). I left, and Linda did a little later.

At 2030, I got a call from the nursing home: Mom was collapsing; her BP was way down, and her O2 saturation levels were dangerously low. Back to the ER for Mom. I got there first. Linda arrived an hour later.

He BP was 90/35, and her O2 sats were in the low 80's. A "pressor" drug was used to raise her blood pressure, (it once got up to 110/60 or so) and she was given pain medication for her legs. Antibiotics were still being used for her right leg's infection. The white blood cell count was down to a near normal level.

But Mom had issued a stricture before the pressor drug was applied: If it didn't work to increase her oxygen levels, all treatments were to be suspended except for pain remediation.

Bad news. Even with the elevation of her blood pressure, her oxygen saturation levels hovered, at best, in the low 80's. X-rays showed advanced congestive failure patterns, and fluid was building up in her lungs. Around 0200, her BP started dropping as the pressor drug wore off. Her hands were cold, and cyanotic. She was coughing up constantly, and her urine was dark. Dr. Brown, the ER doctor, stated there was little chance of a full recovery, and she would need to go to ICU for intensive therapy. If she was not maintained on the drug, her low blood pressure, and low oxygen levels would mean permanent tissue damage. Even if she recovered, she would be on O2, and need continual assistance permanently. A blood thinner would also be likely prescribed, to forestall a pulmonary embolism.

Mom refused further treatment. At 0245, in the presence of the doctor, and witnesses, conscious, and competent, she requested that all treatment, except for pain, be withdrawn. This matched the medical directive that she had drawn up for herself in 2002. Linda stated that we should honor her wishes, and I reluctantly agreed. Both of us hold jointly the medical Power Of Attorney.

Linda, and Chuck, her boyfriend, stayed. I said goodbye to Mom, and left. I didn't want to watch the end of the show. Her BP was roughly 60/35, and dropping, when I left.

She will be taken to an ordinary nursing floor. How long she will live is unknown, but with the condition of her pulmonary system, it is unlikely to be long.