Kathleen A. Gagne

Kathie Gagne died 4,756 days ago.

June 4th, 2012 @ 9:24 am

An email to my sister:

I talked to a nurse named Terri this morning at Halifax. There is a new nurse assigned to her basically every 48 hours, so every other day I need to spend fifteen or twenty minutes explaining the last 63 years to someone new.
She was just starting physical therapy when I called; they’re doing that every day.
Right now the issue is that she is not swallowing her food. Apparently it is common after being intubated to not swallow for a little while because it’s very painful on your throat, so they aren’t particularly worried about this. They said most people start swallowing within a few days of being extubated (when they *remove* the tube) but it’s not totally weird for this to last a week or more. And of course with mom it makes sense that anything would be on the extreme side. So she still has a feeding tube.
Terri said that she was responding to her — one-word answers, but still something is better than nothing — this morning, which is good.
That’s about all I could tell you right now.

She replied to me at 2:10 pm with the following:

Thanks. Any sort of update is good. People keep asking me how she is doing, and I feel like I don’t even know what to say to that. This sucks. I want to talk to her.

Paprika ¹ is in a new home on a trial basis through Pawsibilities. Hopefully, she gets along with the other pets and the husband. Funny, but it has been breaking my heart thinking about Paprika. I think it just makes me think about Mom and how she would feel about giving her away. Not to mention the stupid cat made me bond with her while I was there. I hope this home works out.

I got a bill in the mail from Grace Manor. Apparently, we owe them $1014 for the first few days of May when Mom’s furniture was still in the room. I guess it is in the contract. Sucks, but I will send it to them. I guess it helps keep Mom’s funds under $2000 since her Social Security hasn’t been used in 2 months.

No word from Chamberlin Edmonds yet. I called twice today, but the gal I have been talking to has not been there. I will let you know. […]

¹ Paprika was the last pet my mom owned, a very fluffy cat.

Nothing Is Surprising

May 30th, 2012 @ 11:38 pm

My sister sent me this email in response to the news about the possibly unsterilized endoscope:

No, David, I had not heard about the endoscope. I don’t even know what to say about that. At this point, I don’t think I would be surprised if they told us that a moose ran into Mom’s room and butted her in the head. She “forgot”? How does that EVEN happen?

Please let me know when they move her and to where. I will update [name redacted] and [name redacted] on at least the room change.

Are they going to attempt any physical therapy with her while she is there? Have they checked to see how her pelvis is healing?

Has the doctor talked to you at all about Mom needing to be in any sort of specialized clinic after she is discharged or just another skilled nursing facility?

Intestinal Issues Persist

May 30th, 2012 @ 2:15 pm

I received a call from Dr. Bratu at Halifax Hospital. He said that he had prescribed mom some medication for inflammation of her bowels and colon, and that he wants to perform a thorough colonoscopy as soon as possible (maybe early next week).

Intensive Care

May 30th, 2012 @ 1:45 pm

Someone gave me the email address for Deborah Reid, the Nurse Manager for ICU at Halifax Hospital.
(I never sent her an email.)

Another Colonoscopy

May 30th, 2012 @ 10:18 am

I just sent the following email to my sister:

Hey [name redacted],

Nurse Patty — the same one who was there yesterday (Tuesday, May 29) — called me at 4:45 this morning to tell me that there was blood in mom’s stool. She called so they could get my permission to perform another colonoscopy. I approved the colonoscopy (which requires anesthesia) and a blood transfusion (if needed). She said they were going to do it as soon as possible and she would let me know the results. She said that it is likely an ulcer that they can simply cauterize, but they want to make sure it’s nothing more dramatic than that.

She also said that the results of the HIV test were negative (good) and that they should have the results of the HepC test today.

When I talk to her again I will double-check on the status of her pelvis. I know that they have had a physical therapist working with her to make sure her muscles don’t atrophy and to prevent any stiffness and / or bed sores, but she is not walking or anything like that.

No doctor has said anything to me about a specialized clinic or anything else concerning her getting discharged yet.

David Vincent Gagne

Status Update

May 29th, 2012 @ 2:45 pm

I just sent the following email:

[name redacted],

I’m copying [name redacted] on this since I haven’t had a chance to update her on my call with the hospital this morning yet, too. I’ll leave it up to [her] to update [name redacted] and / or [name redacted] if she wants.

The nurse told me that she was basically crying and making “silent screams” all day yesterday (Monday), so the neurologist started her on Zoloft and Namenda. I flipped out, because I specifically told them I didn’t want them putting her on any drugs at all without talking to me and they had said that they would respect that, and they clearly didn’t.

This was nurse Patty, a new nurse and the fourth or fifth one she’s had since the 16th when she was admitted. I told her the whole back story, like I do every time I talk to someone new.

The nurse was very understanding about my frustration. She said that she spent two years basically living in a hospital with her 3yo daughter who had lung cancer and died, and that was why she became a nurse. So that was awful.

She let me speak to Dr. Escander again, and he said that they ran all the tests on vitamins and hormones and everything seems fine. She’s not deficient in B-12 or any of that stuff, and her thyroid seems fine. He said that he had another doctor review her CT scans and nobody thinks she has ever had a stroke or any brain damage, so he doesn’t know why Dr. Caliendo told us that in December.

She got the neurologist to call me and I told him the whole “story of my mom”, which I can now deliver in full in less than fifteen minutes. He reviewed the eight or nine CT scans they have on file of her and confirmed that she has never had a stroke and that there is no evidence of any brain damage, and that I was probably right to ask them to lay off all the psycho pharmaceuticals for a while, so he stopped the Zoloft and the Namenda. (Namenda, by the way, he told me has no real proven benefits but “it can’t hurt”, so they just give that to everyone. Ridiculous.)

He said that he would try to get her a psych consultation, but that she was basically just not talking to anyone or responding at all. She’s not unresponsive; she just ignores people. He also said that he doesn’t think she has dementia, but that it looks like she has severe anxiety and depression. But he said he thought it was a good idea to lay off the antidepressants for a little while to clear out her system.

She’s supposed to be moved out of the intensive care unit today or tomorrow; she’s fully off the respirator and physically she’s doing very well.

They’re not talking about discharging her yet; they seem to be a little anxious about the whole “forgot to sterilize the endoscope” issue so they want to — gasp! — maybe find out what’s wrong with her before discharging her this time.

[name redacted],
I can’t remember if I talked to you since Friday or told you about it. They performed a colonoscopy on the 23rd and on the 25th I got a call from the gastroenterologist, Dr. Nasr, who said they were really sorry and they didn’t want to scare us, but the nurse “forgot” to autoclave (sterilize) the scope they used. So they are running tests on mom to make sure she didn’t contract Hepatitis C or HIV from the previous patient(s) that might have used the same equipment. They know for a fact that the patient who was “scoped” immediately prior to mom does not have HepC or HIV, but they “just want to be careful”. They said they would let me know the results of the tests today or tomorrow.

David Vincent Gagne

No Bed Holds?

May 28th, 2012 @ 12:43 am

I just received this email from my sister:

Hi, David.

So, I talked to Jessica at Coastal.  Their beds are full, and I will need to find yet another facility that will be able to meet Mom's needs, whatever they may be by the time she is able to leave AND that will also take Mom as a "Medicaid Pending".  I have to mail the last 3 months of bank statements for all of Mom's accounts to Chamberlin Edmonds so they can now take over the Medicaid process. Coastal had not really started moving on it since she had only been there a few days.  Also, you will be getting a refund check for the money you put in for her transportation. ¹  I should get a partial refund from the money I paid towards her PT, etc.  We need to give Coastal a heads up as to who is going to pick up Mom's things and when, I guess so they can have someone there to get it out of storage.  Basically, she said they don't do bed holds.

¹ While I was at the facility, I gave them $100.00 to put in an account for my mom. Mom needed to leave the facility to get an X-ray performed on her pelvis and they asked me if it was okay to put her on a bus because she didn’t have the $5.00 needed to pay for the private transportation Coastal provides. I said that it was absurd and insulting that they wanted to put her on a bus for want of five dollars, and wrote them a check.

News from Dr. Escander

May 24th, 2012 @ 3:12 pm

I finally was able to talk to an actual doctor this morning about mom and the news is good.

I talked to Dr. Escander — not sure about the spelling there — and he was very nice and extremely helpful and kind.

Here are the notes that I took from our conversation:

He said that mom was still on a ventilator to assist her breathing and that she was being treated primarily for pneumonia right now. He thinks that the pneumonia is probably what contributed the most to her UTI and the subsequent sepsis. (This is interesting to me because I distinctly heard one of the nurses at Coastal Rehab talking to mom’s roommate, [name redacted], about needing to take medicine for her pneumonia, and I remember wondering if she was contagious.)

He confirmed that they performed a colonoscopy on her yesterday (May 23rd) and that she had colitis, but that it was not serious, was most probably caused by the lack of bowel movements prior to being admitted, and was being treated with mild antibiotics and mostly gone.

He noted that they were trying to wean her off of the ventilator a little each day, and that this morning when they reduced her sedatives while turning off (but not removing) the ventilator, she opened her eyes and was alert and responsive. She is still very weak, though, and of course she sort of freaked out, so they resumed the sedatives and returned her back to the ventilator. They are extending each day the amount of time they leave the ventilator “off” until she can breathe normally on her own.

Dr. Escander said that yesterday her blood pressure was elevated slightly so they administered a bit higher dosage of the blood pressure medication and she responded well to that; her blood pressure is back to normal and they’ve returned her to the normal dosage.

She is being fed intravenously right now; her potassium was low so they are supplementing that.

Her red blood cells are stable (whatever that means) and she has no fever or anything; there is no longer any infection in her blood or urine.

He said she was, “on the right track,” and he confirmed that there was no evidence at all that she had ever had a stroke; her brain appears perfectly fine physically.

I explained to him the whole story of the last six months, and told him about Nana dying at Indigo Manor and about the other details of mom’s history, and he said that he thought it was very irresponsible of Dr. Caliendo to diagnose mom with dementia without doing a bunch of tests. Dr. Escander thinks that what I have been saying all along is probably more likely the case: That mom has severe psychological issues and suffers from extreme anxiety and depression which definitely requires therapy and may require psychiatric medication, but that she most likely does not have any sort of incurable “dementia”.

He also said that poor diet and / or a bunch of problems with hormones or vitamins frequently present as dementia, and he ordered blood tests to check for all of these possible causes for her change in personality and cognitive functions. He also ordered a neuropsychological evaluation.

So … Although it’s not exactly “jump for joy” sort of news, it was very, very good to hear Dr. Escander’s thoughts and to know that he is going to try to determine “WHAT HAPPENED” instead of simply considering this a “done deal”.

News

May 22nd, 2012 @ 10:01 am

My mom’s friend from her church visited her at Halifax Hospital today. She left me a voice mail, which I’ve transcribed here:

“Hey David, it’s [name redacted]. I’m sorry I missed your call yesterday; I didn’t even hear the phone ring. I’ll probably send you a text. I just finished visiting your mom on my lunch hour. She seems to be doing good. They are taking her off of … or stepping her down from her full-out sedation and trying to … to wake her up so they’ll step that down and … apparently I visited and they had already done her colonoscopy this morning and she seems to be doing better … or … She looks good, color’s good. So. Y’know I don’t know how long she’s gonna be there but things seem to be doing okay. I guess her UTI’s getting better; things are proceeding as they should I guess. I will talk to you later. Bye.”

^* Today is my little sister’s birthday.

An Update

May 17th, 2012 @ 8:35 am

I just sent the following email to my sister:

[name redacted],

I just talked to Christy, the morning shift nurse on mom’s floor. She said that there were no significant changes during the night, but that mom seems to be responding well to the antibiotics; her body temperature (which had been dangerously low) has returned to normal and her body appears to be regulating its temperature well on its own now.

She’s still on a ventilator (with a breathing tube) so they are keeping her pretty well sedated on morphine because they don’t want her to wake up and freak out because of that. (Apparently that’s pretty common.)

They’ve also stopped administering ALL of the anti-psychosis / anti-dementia / anti-memory-loss drugs (e.g. Namenda, Risperidone, Ativan, Aricept, Haldol) while she is in the intensive care unit, which is another reason they’re keeping her knocked out for now.

I’ve given a thorough history of mom’s last six months to both of the primary nurses on that floor — Christy and Natalia — and am waiting to hear from the physician this afternoon. Both of them seemed to agree with me on the chance that the continuing and ever-changing dosages and schedules of the potpourri of psycho pharmaceuticals could potentially be causing problems with her liver or kidneys which is why she keeps getting urinary tract infections; or it could be completely unrelated. But either way it’s probably best to “start fresh” and we’ll learn more when she’s moved out of the ICU.

She’s in room 519 on the fifth floor of the Fountain Building at 303 N Clyde Morris Blvd, 32114. I sent her a letter with some photos of [name redacted], although I have no idea if she’ll be in that same room by even the end of the day today.

You can call 386-254-4150 with PIN [redacted] for information, but (since you can’t actually talk to mom anyway) for now it’s probably best if I’m the only one talking to them and I’ll keep you updated. I’m just relaying all this information in case I get hit by a bus or something.

I called [name redacted] and updated him this morning. He said he may try to visit her this afternoon, even though I strongly suggested that it would be pointless because she’s unconscious.

I love you and will keep you posted.

David Vincent Gagne