I still don't know why she died, but I do know how she died. One of my father's ex-POW friends asked what she died of and I had to say, "I don't really know." It wasn't until she checked into the ER for the 3rd time in as many months, on December 14th, that we really knew how sick she was. It all unfolded like a series of misfortunate events, a victim of specialized medicine. Everyone treated a part and no one treated the whole. It was just during this last year that my sister and I took over taking them to the doctors. My father's vision had been failing for a while and he called upon me (I lived a block away) more and more often to drive them places, until finally he gave up altogether (thank god).
My sister and I had watched them decline for some time. in 2005 we started the discussion with them about moving to an independent living facility. But giving up your home, your independence is hard. We thought it would offer them community, safety, 3 squares a day and easier, wheelchair friendly living. We also naively assumed that they were on top of their own medical care - asking the right questions, understanding the answers, making the right decisions. Not until this year, when I sat in the examining room with my mother, listening to her describe her ailments to her doctors did I realize that she wasn't giving the right answers, emphasizing the right information. Imagine my shock when I took her for her every-6-weeks shot and walked through the door labeled Oncology Hematology Associates, a place she had been referred to years ago for her anemia. Surely if she had cancer someone would have said something. She had been going for 4 years, so no way she could have cancer without me knowing. When I asked the DR "What exactly is her diagnosis?" he said, "She doesn't make enough blood cells." Was that the elementary school answer or was I invading doctor-patient confidentiality? But I digress...
So here it is March and they are preparing to move. They need a physical before they can move in and her seldom seen GP does a cursory exam, gives her passing grades and they move in. They moved from MD to VA, and we wanted them to use the doctors associated with their facility, the ones who held office hours at that location. So she sees a new DR, but only for a cursory physical and then later for a specific ailment - back pain. He prescribes a lidocaine patch - didn't even do a urine culture. Back pain persists to excruciating, he sends her to the hospital. My sister takes her that afternoon, which drags on long into the night until they have a bed and can admit her. The ER discovers a urinary tract infection, among other things. This is back in October. After a week of tests, they finally order the MRI that shows several small spinal vertebrae fractures. We knew that's what it was because she had the same problem and surgery a year or two ago, different hospital, different DR, but they had to find out the slow, insurance-friendly way. Call in the neurosurgeon, he repairs them. After surgery she has an irregular heartbeat so she spends a few days in the CCU until that is stabilized and she goes home pain free.
She wasn't deemed healthy enough to return to her independent living apartment and had to go to the skilled nursing portion of their facility. She HATED it. You would too - pretty much a semi-private hospital room. And they asked her to exercise. Well they kept at her and she got sassy enough that her attitude was, "I'll show them! They want 10 reps, I'll do 12! And as fast as I can." Six week she spent there, endearing herself to the staff and the therapists. Six weeks of the best exercise (and new anti-depressant) and she was a new woman. We were SO, SO very proud of her. She walked that walker up and down the hallways, walked herself right out of there and back to her apartment the day before Thanksgiving.
If you are a regular reader of the blog, you know how wonderful Thanksgiving was. The Monday after, I took her to her eye DR appointment and then to her favorite place ~ Nordstrom. She said she needed some new eye shadow. I watched as the make-up sales woman gave her a mini-makeover. Wheeled her around until she found just the right t-shirts, not too long, high neckline, with a soft and loose fit. She bought 4! Even Dad got in on it, buying the new shoes that she had been begging (nagging) him to get for so long. It was perfect, except for that niggling pain in her back. By Thursday she decided that she needed to see a DR. She called, he said go to the emergency room. They knew the drill by now and decided to wait until morning. There's nothing worse than spending all night in the ER - why not start fresh in the morning? Looking back, I'm amazed she could endure the pain that long, but it was her decision.
I go in to the emergency room and while waiting for a wheelchair to bring her in, tell them her name and that her records should be on file, she was just in for the same thing. The ER clerk says, "Kidney failure? That's what it says here." I say, noooo, back pain. Barbed question marks start popping out of my head....what's going on???? Oh, and did I say her attending physician had to turn over her care to a new doctor because he had a medical problem of his own - prostate cancer? ...to be continued~