Recently my mom, who's 86 years old but a real pip, required surgery to fix a hernia that had already been fixed once last summer but had been messed up when she fell and broke her pelvis this fall. Got that? Anyway, she got through the operation fine and settled into my brother's house to recuperate. We figured that would be easiest; if she went home she'd only have my dad, who can't hear a thing and is gone four hours a day (yes, he still works part-time) and if she came here with me we'd watch off-color movies and eat chocolate, for sure, but I live alone, and might need to call my brother for help anyway. (As I did at 10 P.M. last June when poor Mom, still very weak, was teetering half on, half off the sofa and I couldn't lift her by myself even though she's a skinny little bee-atch). So with a spare bedroom and three people on duty (my brother, Bob, his wife, Rosemary, and their 20-something son, my nephew Russell) you knew somebody was always there to cover.
When you're 86 nothing is minor, even a minor surgery. This one was outpatient, even though the one last summer was inpatient, and I'll tell you why: the original date for the fix-the-fix was late January. Mom stopped her long-acting bloodthinners several days ahead of time, as instructed, and began once-a-day short acting (24 hours) bloodthinning medicine injected into the stomach (yes, ow, and guess who had the job of shooting her up every morning? Take THAT, Ma!! This is for not letting me go out with Bruce Cassidy when I was 16 years old!! Yeah!!) So anyway we reported to the hospital as scheduled, but after routine pre-op bloodwork the surgery was cancelled since her blood was still a bit too thin for the surgeon's liking (and she already had her gorgeous flowered gown, sexy elastic stockings and fetching bonnet on, too! Damn.) The new surgery was scheduled for February 15th. So there'd be a couple more weeks of belly shots...not that either of us was too thrilled to hear that, but what the hell, you do what you gotta do.
And then all of the procedures which the surgeon had scheduled for that day were moved in one fell swoop to the Outpatient Center. I didn't like this, Mom didn't like this, my bro didn't like this, Dad didn't like this, NOBODY liked this. Mom is still recuperating from her broken bones and has a number of other fairly serious conditions. I'm no great fan of hospitals, but if anything went wrong, we know hospitals have a bit more in their arsenal than outpatient surgery centers. You'd better believe I called and questioned them. The surgeon's coordinator sighed and said "they just looked at the procedure...not the patient. They figured it was a safe one to do as an outpatient. Let me call and see if I can have her moved back to the hospital." Well, the outpatient people called; not only did they tell us there were no hospital beds available until April, they also reassured us that the surgeon goes over every scheduled procedure and if he didn't think it was safe to do as outpatient he wouldn't have okayed it. They just swept us off our feet; really, the thing is that Mom didn't want to have shots every day until April, nor did she want to contemplate surgery any longer. It had been an awful few months for her and she just wanted everything over with. I get that.
Anyway this is all background stuff, just to set the stage. So off to the surgical center we went, Mom, Bob, and me. The surgery was done accordingly. It took a while for Mom to wake up from whatever it was they used to knock her out, but even so we figured it probably wasn't as strong as what they used for the original hernia repair, so hopefully we wouldn't hear talk about loud Italian people holding a wake at the end of the hall or, worse, nurses and doctors walking through walls and a barking dog just outside the door. (If you think these are good ones, you should've heard Dad after he had his knee replaced. Chinese people made out of papier mache'??) Indeed, after we got Mom back home to Bob's and tucked into bed she was quiet, comfy and not the least bit out of her mind -- except for what's normal for our family.
When you're a bit doped up on pain meds and still have anesthetic in your system, it's understandable that you might think you're somewhere you're not...in your own bed, for example, when you're really bunked in at your son's up the road a ways. It's also not atypical to think you hear someone talking in another room when they're not there. These little drug-induced quirks and confusions aren't really too scary or unpredictable. Frankly the way Mom was lurching sideways onto my brother's shoulder as he spooned scrambled eggs into her I could swear she was, in fact, still under. I mean, she was perfectly capable of feeding herself, except she couldn't find her mouth. But this, too, we figured, would pass.
"Rosemary," said Mom the next day, "There was a bird in this room last night." Bird?? Rosemary assured her she would open a window and shoo the bird out. And no, there were no fish anywhere around. Even though Mom could smell fish. Or clams. And they were sticking to the bed clothes. "Were you, like, dreaming about this?" I asked. "I don't know," Mom said, "I think there really was a bird in here. I felt its feathers." Oh....kay. "Not just that," my brother told me, "She said she was at the Shoreline Clinic and Jerry Stevenson was there." The Shoreline Clinic is a satellite emergency room of our nearest hospital, and Jerry Stevenson is one of our cousins. "All night long," Bob said, "We heard her. 'Oh Jerry...you know I always loved you so much, you're such a good boy.'" Mom, it seemed, was having a little difficulty distinguishing between dreams and reality...and was rambling aloud in her sleep. "Gotta be the painkillers," I said. We were nonplussed by this, and we hoped it would stop soon...it's disconcerting to be a Baby Boomer and come from the generation of mind-bending drugs only to have your MOTHER be the one taking a trip.
Next morning my phone rang. "Laurie," said my brother, "We're gonna have to get the ambulance for Gramma." I asked him what was going on, and things had taken a bad turn. Apparently Mom had believed there to be a 6-car accident during the night, and no one was helping the people, so she felt compelled to take them some blankets. She'd grabbed the comforter from the foot of her bed, gathered it up in her arms and started to walk out of the bedroom unassisted -- and she'd fallen again.
The words were chilling. In September Mom had fallen at her own house, in the middle of the night, onto a hard wooden floor. My father had not heard her. For 45 minutes she lay there, unable to move, until she finally made a noise loud enough to wake him. From that point on it had been a steady diet of ambulances, hospitals, and convalescent homes, an abrupt departure from the normal, everyday world so reassuring in its constancy. (A walker became Mom's new best friend.) Mom had done incredibly well despite all this, and had finally been judged well and strong enough to go through this second abdominal surgery. And to recover at home (well, not her home, you know what I mean). We knew it was going to be a setback, and we all wished it didn't have to be done but, if wishes were fishes, etc. etc. etc.
Mom was very, very lucky this time. She had fallen on wall-to-wall carpet that had cushioned the blow somewhat. She only hurt her shoulder and it was only a bruise, not a break. We didn't know that or much of anything else that morning -- when I got to my brother's house (in record time) Mom was sitting on the bed, unsure of where she was (though she knew all of us) and talking about big bubbles hanging from the ceiling with crawly things in them. Things were crawling on the rug, too -- bugs, and cats under blankets that had been thrown on the floor. "You don't see this??" she asked calmly. Apparently she'd had a bad night, again jabbering, as well as asking why I didn't come in to help her since I was right outside -- she could hear me talking -- and I had broken the window to get in, not to make mention of the fact that I had gold front teeth.
We knew it had to be medication, since to the best of our layperson knowledge a person does not develop dementia that suddenly, unless there is an injury to the brain, maybe. So along comes the ambulance and a group of firefighters and Emergency Medical Technicians -- heroes all of them, believe me -- and they gently carry Mom out to a stretcher, and off we go. At the E.R. they did an EKG and some blood work, took vital sign readings, x-rayed the shoulder, gave Mom an I.V. treatment since she was a bit dehydrated (she isn't one to drink water), and took a CT scan of her head to make sure she wasn't having a stroke. All came out great. Mom was still goofy, insisting in an annoyed fashion she had two pennies and had dropped them in the sheets. She had not. After four hours she was discharged with instructions to call her own doctor in the morning. Mom did manage to yell down the hall "Look at that doctor, he's so good looking -- hey Dr. McDreamy!!" I told you she was a pip.
As it turns out the diagnosis did indeed appear to be a combination of the anesthetic -- which had not entirely left her system -- combined with some heavy duty painkillers. We were to force fluids to dilute the stuff as much as possible and switch from the hard stuff to Tylenol whenever we could, or break one pill in half. When I left my brother's house she was extending both arms out straight and fidgeting with her hands because bugs were still crawling up her arms, plus she had some stuff she wanted to fold -- towels and blankets I think. When I asked her about it she was pissed and said "Stop getting mad at me!" My sister-in-law simply brushed the "bugs" off, gently, and Mom lay down to rest. When I asked her if she knew where she was now she said "Chester Elementary School." I don't know why, but she had a smirk on her face and when I asked her what day it was she said "Fart day." Leads me to think she really had no idea but by kidding around she figured she'd be off the hook.
The next morning she was fine and back to having her wits about her, though when you are 86 you expect the occasional memory lapse, repetition or word retrieval problem. We're used to that and so is she. Here's the deal, though: no one told us how to handle a woman with delusions and visual plus auditory hallucinations. We simply had no clue. Before, when she and my father both had taken their post-surgical "trips," we'd just been quiet and waited for stuff to wear off. But really, what do you do? Do you agree with them? Ask questions? Argue? Reassure? Shut up??
Having a parent with Alzheimer's or another kind of dementia has to be close to unbearable, I'm guessing. Two of my aunts -- my father's sisters -- developed dementia late in life and had to go to convalescent homes. One of them was happy as a clam to be there and be waited on hand and foot, zoom up and down the hall in a wheelchair, have all her meals brought to her and just generally soak up the surroundings...and I miss her dreadfully, as do we all. But she's the exception. What if your mother or father or husband or wife is seeing things, hearing things and doesn't know who you are any more?? Mom's dementia was temporary and curable. In fact we were teasing her about it at first. Nonetheless, it was dangerous: she didn't know what she was doing, and she fell. She was very, very lucky when she did.