It’s been exactly one month today since Aunt Shirley was admitted to the MICU at Froedtert with death nipping at her heels. Her blood pressure was falling fast with the Septic Shock coursing through her body. Doctors were amazed that she was even conscious with her 43/16 blood pressure reading. What immediately precipitated her admission was her 911 call for excruciating hip pain. The full story of her medical mayhem would unravel over the course of the next week. To make this easier to follow, I’ll back up to the beginning and tell the story in chronological order, rather than with the messy patchwork of facts that have unfolded since August 10th. While the critical medical issues were going on, it was just too fatiguing, aggravating and frustrating to blog about it all. You will benefit from my delay in sharing this information as it will now come to you in a neat and comprehensible package.
Prior to Shirley’s August emergency, she’d been living in her apartment (since her May discharge from rehab) with the support of my sister Karen, who was paid through a home health care agency to help Shirley several days per week with household matters (i.e., grocery shopping, laundry, etc.). Without Karen’s help, the unambulatory Shirley could not have lived “independently”. During this time, Shirley did not follow through on her physical therapy, her ability to do anything for herself dwindled, she lived her whole life on the couch, and eventually showed signs of medical distress that she refused medical care for. We believed she had a UTI (urinary tract infection) that was affecting both her physical and mental functioning. And she did. Her bad kidney – a kidney with a “staghorn” shaped stone growing in it – was often infected frequently causing UTI’s. This kidney only functioned at about 17% of it’s capacity because this staghorn stone was filling it up, however, due to all of her other medical conditions, surgical removal of the kidney was not warranted over the years. Well, at some point, this staghorn ruptured her kidney, which then leaked out infected bloody fluids into her abdominal cavity, leading to septicemia (essentially blood poisoning, which can kill a person). This fluid also broke out of her abdominal cavity, possibly through a herniation in her back, and pooled under the skin of her hip, leading to the terrible pain that forced her to call 911. The septicemia was at a critical level when she arrived, as evidenced by her precipitously low blood pressure. She was lucky she wasn’t DOA (dead on arrival).
Shirley has literally dodged death on many occasions (an exploded ovary, two episodes of pulmonary embolisms, pneumonia and septicemia earlier this year, I’m sure there are more times that I’m not recalling) and came close to death 3 times this past month. The septicemia, raging through her system, did not respond to the first line of treatments. Doctors felt that she would die unless she had drain tubes surgical implanted in 3 locations to begin draining the toxic fluids inside her body. The infection continued to keep her blood pressure dangerously low, and her heart was pounding as fast as mine does when running, but she was just lying in a bed! Shirley refused to have the tubes placed for nearly 5 days, eventually relenting only if she talked to me about it first. Of course, I told her to do it, and she did. Several days after that, her persistently high heart rate needed to be addressed before the strain on her body became too much and caused her death. A special medication needed to be administered to reset her heart rhythms. She refused this until she could speak to me, and eventually agreed.
I was growing more and more frustrated with the situation. Shirley, through her volitional refusal of medical help and in-home care in recent months (not to mention a series of bad life choices) led her to this point. If she had done all she could for herself and still landed in this position my feelings would have been different. As Shirley’s primary contact, I resented the constant phone calls from hospital staff intruding into my busy workdays (as I prepared for vacation no less), taking hours out of my day to communicate not only with Shirley, and hospital staff, but with my mom, Uncle Jim and my sister, Karen. I felt Shirley’s refusals to have emergency medical care done without talking to me were manipulative, as each time I spoke to her she’d already internally decided to do whatever procedure, and just wanted me to reinforce it. I took off for vacation 8/24, leaving my mom in charge. And it seems I got out of Dodge just in time.
The day we left for vacation, yet another critical life or death situation arose. The site of one of the drain tubes had become infected, and the flesh around it was necrotic (dead). This could quickly kill her if not stopped from spreading. Emergency surgery to remove the dead flesh from her hip was needed, and if possible, they would remove the bad kidney at the same time. Shirley refused this surgery until she could speak to me. She was told, “Joy is on vacation until 9/1, this cannot wait”, and so she relented. On 8/27, Shirley had a massive amount of dead tissue, along with her sickly kidney removed. The surgery went well. So much skin was removed that closing the surgical wound was not possible. Along her left side, lower back/hip area, there is a wound 4” wide and 8-10” long, and DEEP, that will have to heal from the inside out. This will take a loooooooooong time.
Shirley is very weak, has basically had little food (by choice and in part due to a sore mouth) in the past month, cannot stand, use a bedpan or even raise her arms to the handrails of her bed without pain and exhaustion setting in. The septicemia is still present, she still has drain tubes, and is on oxygen to help her breathe more easily as there is an extra 6-7 gallons of fluid in her body with her systemic infection. She has been medically stable for the past week, and there is talk now of transferring her to a wound care facility soon. Where she goes, months down the line when/if her wound heals more and her other threatening conditions subside, is yet to be determined. Stay tuned….