Saturday, January 13, 2018

It's Not Funny Anymore

On Thursday, Carolyn’s drug regimen was changed to take away the restlessness and keep her in bed until her pelvis could knit together and heal. 

She was given Haldol, and Tramadol together to make her sleepy and keep her off her feet at about 8:00 AM. It did the job well. She slept soundly until nearly 2:00 PM, missing lunch. I fed her some yogurt and Ensure to tide her over until 5:00 PM, when she ate dinner. She ate about half, maybe. She wasn’t too hungry.

She was given the drugs again at 8:00 PM and when she fell asleep, I went  home to my own bed and slept soundly through the night, having spent most of Thursday with Carolyn.

They repeated the dosage at 8:00 the next morning after a big breakfast, and she went to sleep again. Assuming that she would sleep until about 2:00 PM and wake up again, I went back home and ran a load of clothes through the washer and dryer.

When I came back to her room in the after noon, she was still sleeping soundly. Her shirt was wet on the back, and I was afraid she had wet herself in her sleep, but her underwear was dry and clean. We had left her covered all day, and she was sweating. I changed her shirt to a dry tee shirt, and moved her to the couch and left the bed open so the sheets could air out and dry.

I stayed with her until 5:00 PM, and she was still sleeping, so she missed dinner . She looked really drunk. I made a joke to the nurse about never having seen anybody that drunk since I was a soldier on Okinawa.

I went home and ran the dryer again because the clothes didn’t get dry enough, and got a bite to eat for myself. I went back to be with Carolyn, and her condition was unchanged. At about 9:00 PM we all decided to skip any more drugs—she could not have swallowed them anyway. I went home and slept again.

Friday morning came, and she was still out. The nurse told me that there had been a miscommunication on the drug changes. When they added the Tramadol to the twice day day regimen, they were supposed to have removed the Risperdol, but it didn’t get on the aide’s chart, so Carolyn got all three drugs. The combination gave her a big overdose, and that is why she didn’t wake up. (Not true—corrected later in this narrative) She could not focus her eyes, and her head lolled to one side, and she couldn’t turn it back. I sat her up on the couch, and held her up and tried to put a little water in her mouth for her to swallow, but it just dribbled down her chin.

Today, Saturday, she smiled when I told her who I was, and was focusing on me. and lifting her head. Her shirt was wet on the back again, even though we only covered her with a sheet last night. I lifted her into the wheelchair, and took her to the bathroom, and got her clothes down and her sitting on the toilet. Her diaper was a little wet, and she had made a small mess in the diaper, but it was all contained and easy to clean up.

After a clean dry shirt and underwear, I put her back on the couch.

Her level of consciousness varies minute to minute. At about 10:30 I thought she was trying to cough, and then as it got stronger, it looked like she was going to vomit. I picked her up to a sitting position, and realized that she was having seizures. The convulsions lasted for about 30 seconds and then subsided. 

Soon thereafter, she started breathing fast and heavy. I checked her with the pulse oximeter and her heart rate was dropping down to about 40 bpm and oxygen saturation was down to 88-89. I called the aide and she took a blood pressure reading at 96/56. 

It’s not funny any more. I’m worried.

Her respiration has increased to 37 a minute, as her body tries to compensate for the heart slowdown, I think. 

I turned her oxygen concentrator up to four liters, and her oxygen level is back up to 95%, but her heart rate is still down at 44 bpm, and she is still panting at 35 breaths per minute. 

Could this be a repeat of the sudden seizures that have making her pass out and fall for all these weeks? Or is this part of the recovery from the drug overdose?

It’s a weekend, many of the nursing staff are dealing with their own sicknesses, but we have a nurse on the way. 

It’s now 12:30 PM on Saturday, the nurse has arrived, and reassured me that it is not a drug OD, that they did not give her Risperdol—that was discontinued before this happened. The miscommunication was not about Risperdol, but about another drug Restoril, a sleeping pill. 

In any case, that is not what is causing this problem. She hasn’t had any drugs at all for over 30 hours. Something else is going on, maybe related to the seizures that she was taking Mysoline for until the doctor took her off to determine if that was causing her memory problems. She has not taken that drug since May of 2012.

The doctor has been contacted by the nurse, and he is concerned about the rapid breathing and, with a pelvic fracture, maybe a blood clot in the lung. He has ordered x-rays of her chest to see if pulmonary emboli might be present. We’ve been here before. She still has less than full lung function from an earlier pulmonary emboli event. 

It’s now 3:00 PM, they got the x-rays, and they will have the results later. Nothing obvious showing up on the monitor.

Carolyn is waking up slowly. She wanted to go outside, I think. She kept pointing at the wheelchair. So after I checked her oxygen (96%) I put her in the wheelchair and took her around the building. She started with her head held up, but halfway around she got tired, and her head fell back, so I held her head up for the last part of the ride.

I am so relieved she is coming alive again. I hope it is a continuous process. She was able to drink a few sips of cold Dr. Pepper a minute ago, and she is laying on the couch snoring now. 

For the moment, her color looks good, she is breathing normally again, and she’s snoring peacefully. 


And I’m breathing normally, too, now. These days are getting harder and harder.

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