[RavenSong]

I'm sorry that I've left you all in the dark about how my mom is doing and what's going on. I'll try to give you a rundown:

Thursday -- Mom calls ORU Prayer Tower, saying she doesn't feel well and asking for prayer. ORU calls Tulsa EMS when Mom's speech suddenly becomes slurred and she suddenly stops talking. EMS transports her to hospital as a "probable" stroke victim.

CAT scan shows embolic (ischemic) stroke in left hemisphere of Mom's brain. She loses all fine-motor control on right side of body and face. Speech becomes garbled, and Mom has "expressive aphasia", which means she knows what she wants to say but cannot find the word she's looking for ~ this is really frustrating for stroke patients. Mom is transferred from ER to Cardiac floor.

Friday -- After spending a fruitless night trying to get any information at all on Mom's condition from medical staff, they finally authorize me to receive medical information, and my mom okays the HIPAA release form. (I *think* I have durable power of attorney, but I need to remember to ask that specifically tomorrow when I talk to the doc.) For the first time, the hospital contacts me. Of course, it was the hospital social worker, wanting to jump the gun about discharge planning (after Mom being there for about 16 hours!)

Social worker probably thought I was totally insane. I was not in a good frame of mind after being denied any medical information since Mom was admitted. I admit I kind of let loose on the poor woman. I disclosed a lot of things I wish I had not disclosed. (I later called and asked that nothing I revealed be entered into the hospital record...she says it won't be.)

I called head nurse and was informed of all the specifics. She tells me that Mom is refusing all medications, except for a couple intravenous heart meds. They tell me she is being totally noncompliant (which turned out to not be true...they weren't taking the time to explain things carefully in a way she would understand, and they didn't take the time to listen to what she was trying to say.)

I finally get the courage to call Mom's room. When I heard her garbled voice, I became a pile of Jello. And then something weird started happening. She was trying to talk to me, but she couldn't find the words she wanted to say. And suddenly I felt like I was doing some kind of ESP with her. I knew what she was trying to say before she said it, and I could follow her line of thought. And she was SO relieved when I would ask her if she meant this or that. Her voice became that of a little girl, and she just gushed out, "YES, YES, YES!" And then I realized that we have always had this connection, as long as I can remember. I know that probably sounds weird to some of you... Anyway, I tried to get her to take her meds, but she wanted to hold off until she saw the doctor in the morning.

Saturday -- I am awakened by a phone call from her doctor. He sounds frustrated, and is already complaining about wasting his time and the hospital's resources on a noncompliant patient (only 36 hours have elapsed since she was taken to ER). He tells me she is refusing anticoagulants and insulin. Her blood glucose is hovering around 310.

He informs me that the stroke has been caused by sustained atrial fibrillation and atrial flutter...she has rapid ventricular response, a very dangerous heart condition. The blood clots (emboli) formed most likely in the atrium and traveled to the brain. Her EKG patterns are not good, and she stands a good chance of having a "catastrophic" stroke within weeks or even days.

He informs me that she is alert, her mental status is great. Therefore, he cannot force her to take the meds. If she is not going to comply with his treatment plan, he wants her to authorize a "No Code" or "Do Not Resuscitate (DNR)" order. He tells her what that means. She refuses to sign...she is scared out of her wits...she is frustrated, and she cannot get the right words to come out of her mouth. And nobody will take the time to be gentle with her, to be kind to her.

Doctor hangs up, and I call Mom. I carefully and slowly explain to her what is going on. And that's when I discover that the communications between her, the nurses, and the doctor are ALL messed up. When I tell her she needs to take the anticoagulant, she says that she IS taking it thru her IV. When I tell her that the staff think that she is refusing blood thinners, she becomes horrified...she WANTS the blood thinners, she thought she WAS getting them...she starts to cry. I go thru all the drugs with her, one by one. She agrees to take them all except for insulin. She is scared of insulin because of something some doctor told her last year. She will take an oral diabetes medication, however.

I call the nurse's station and talk to her nurse...who has an attitude right off with me. She tries to lecture me about my filial responsibilities, how we all must take care of our parents the same way they took care of us as children. (BTW, I kept my mouth shut when she said that.) I told her I wasn't interested in defending myself or my actions with her, that I wanted to discuss my mother's condition. I tell her that Mom has agreed to take ALL of the medications. And I begin to notice how the story of Mom's noncompliance is starting to change, according to who is telling the story. I now have five different stories that are varying quite a bit: one from the doctor, one from the head nurse, one from Mom's nurse, one from the social worker, and one from Mom. And I'm starting to wonder if these people at this hospital EVER try to get their stories straight, which starts my normal paranoia wondering what, if anything, is getting covered up here. Nurse hangs up, and immediately gives Mom all of her meds.

Saturday evening, I telephone Mom to say good-night and tell her I love her. And she tells me that her latest blood glucose level has come down 60 points!! She has taken ALL of her meds that day, and she has even allowed the physical therapist and nurse to get her up to walk around the room (with a walker). She's still resisting getting out of bed much, but she did let them walk her around a bit.

Sunday -- Phone rings...it's the nurse from yesterday...the one with an attitude who didn't like me. And she's being really, really nice to me, even laughing a little. She tells me that Mom's glucose levels have come down even further...that her response to the diabetes meds is really good. Her heart has been in sinus rhythm now since yesterday, which is great. However, they want Mom to undergo an MRI today...no way she wants that done for some reason. Nurse says that Mom's emotions are all over the place, changing minute to minute. She says it's like dealing with two different people, multiple personalities. Welcome to my world...

I'm transferred over to Mom's phone. The amazing thing I notice is her speech sounds a hundred percent better than last night. It's clearer, less garbled, and she seems to be using longer sentences. I talk to her about the MRI...she refuses to have it done. She had one the other day and does not want to go into that loud machine again. I don't push the issue...I can hear her voice rising. I do not want her to stop taking her meds, and if she gets ticked off at me, she just might dig her heels in. The MRI is a "no go".

Sunday night: I call Mom to say good-night and tell her I love her. Her speech still sounds improved, although she sounds a lot more tired than this morning. She's still taking all of her meds, but the good news is that the doctor decided she didn't have to have the MRI. She actually talks to me about the rehab facility that is in her near future. She tells me that she'll be there for three months or so. And then she starts talking about recovery and getting better. I think she's starting to associate the fact that she's feeling better with the fact that she's taking her medications...I keep emphasizing that to her in a positive way. There is a case conference tomorrow...I'm hoping the social worker, who thinks I'm insane, will talk to me afterwards. I'll let you know...

PS: William, if you are lurking here and reading my posts, you really need to call me. If you don't want to talk to me, would you please call Mom? She's asking for you....