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Ch.2- CODE BLUE: Flash Pulmonary Edema and ICU #Takotsubo #Narcan #America

Updated: Jun 3, 2021

Please join me as I begin to relive the nightmare of being in the hospital at the time my mother crashed and was a code blue due to suffering flash pulmonary edema, and that was just the beginning of what would be a devastating turn of events...

Chapter Two

Wednesday, September 4, 2019

The morning after the surgery we wake up to the surgeon checking her shoulder where he says everything looks good and we were set to leave by lunch, in my semi-state of consciousness, I quickly told him about the night we had regarding her foot swelling up so badly and the catheter, this was about 7:15 am. He didn't seem to think it was an issue I suppose because he left the room having not really addressed what I told him, then I fell back asleep. I had slept through the night and this was the first I had heard anything since they did the catheter on my mom around 10 pm. Once he leaves I sit up, straighten my back after sleeping heavily in the pullout chair that is bedside, then gathering myself I get up to check on my mom, she seems okay, considering she is exhausted and in pain, I expected it to be tough because she had a reverse total shoulder replacement. I, personally was trying to mentally prepare for the ride home knowing it would be a tough one but, we had prepared and were ready to take on this recovery period. Plus she has the nerve block in place and that somehow gave me comfort that transferring her would be doable. We wait.




Physical therapy came in the room early to work with her and we talked about her pain and they had her sit bedside and try to get up but she stood and sat barely and they said they would come back because they didn't make much progress. I mentioned the cough she had acquired since the surgery, they listened, agreed, and said they would tell the nurse. I was just happy to see she could stand. We were halfway there at that point and her discharge papers were on the way although nothing was signed so we sat and waited.



Around 10 am I was getting antsy so I walked around taking pictures of the long empty hallways, wasting time I left the room and went downstairs to the cafeteria to get a Dr.Pepper, but when I entered the cafeteria which is on the opposite side of the hospital from the outpatient wing, they informed me that they did not serve until 11 am. I was mad mainly because of Dr. Pepper but also because that was 15 minutes away. I contemplated leaving the hospital to go around the corner to the Whataburger or just going back to the room, but that would take about 5 minutes and I really wanted a drink so leaving seemed like too much effort so I waited downstairs in the lobby until it was open, got my drink and went back to the room.

While I was gone, physical therapy had come again to work with her and I missed them while waiting in the lobby "Oh well" I thought because she is being discharged soon and I will be her caretaker and pretty much knew what I needed to do, or we would learn as we went. We have done it before and we can do it again. I was naively confident and semi lackadaisical, basically ready to get back home.

Lunch arrived at noon so I came around her bed to cut up her vegetable medley since she was a one-armed bandit then walked back to my chair to sit. As she took a bite of food she immediately began searching for the nasal cannula for oxygen. It confused me a little, but I immediately began to help assist her in getting the O2 she felt she needed right then.

She isn’t an oxygen patient and has never had any respiratory issues in her life that required a need for oxygen and honestly, I do not know a lot about it but I put it on her and she continued to struggle for breath and began to motion to her neck, needing air. Saying to me in a laryngitic voice " I can't breathe" over and over motioning to her face and pressing the cannula further into her nostrils, as her eyes bore into me with a desperation I have never witnessed before.

I stood at the end of the hospital bed a helpless pile of flesh at this time trying to evaluate what I was witnessing and thought that maybe she was choking on the food. It seemed logical and I went to her and asked "Are you choking?" She then pulled the bite of food from her mouth and put it on the tray and continued with the raspy panic to beg me for help. I pushed the button on the side on the bed rail for assistance went into the hall where a nurse had just emerged from the room next to us and said "She can't breathe, she needs help." The nurse then said "I will get someone" and went down the hall to get my mothers' nurse, while I went back into the room and pressed the nurse station button on the remote for help. Standing there watching my mom die was not an option for me and I finally went running down the hall yelling for help, trying not to freak out.

Once I saw the nurse that I had first alerted to this issue and she was leaning on her elbows at the counter in front of the nurse's station. I loudly exclaimed "Is anyone going to help my mom?!" and as I approached the station that's when the first nurse said, "She's coming." but, I could clearly see she was on the phone and I let her know she lied to me with a look and a verbal "No she isn't, my mom can't breathe, WE NEED HELP!", so I immediately turned and looked for anyone else that was near. Found someone and ran back to the room to my mom who, at this point had turned blue and was not fighting or responding. She was succumbing.

The next thing I know she is a CODE BLUE, the alarms are ringing and people are clamoring to the room as fast as they can. I quickly moved mine and my mothers' things out of the way making room for them to get to my mom for help. They laid her back and began O2, at this point, I am kicked out of the room into the hallway. I know I have to call someone, but who? There were 7 people on a group text message waiting to hear from me and not about this, so I sent them all "Something is wrong" in a text and began calling one at a time.



I had no idea at this point what was happening and at that moment being stunned it is hard to acknowledge the actual gravity of the situation. Someone found me clearly panicked on the phone with my niece in the stairwell telling me she was having a PE (pulmonary edema) which I have no idea what that means. After about 5 minutes they have completed an EKG, X-ray, Bi-Pap @ 15 liters per minute, and a catheter. She was stabilized and they let me back in the room to see her. I snapped a picture to send to the family as they were all piling in cars and heading this way as fast as they could by this point.



Several Dr.’s at that time asked me about her heart and one doctor came to me with an EKG sheet talking to me about it looks like a heart attack, asking me about her past health, if she had a DNR, and what I wanted to do if this happened again. Finding myself not able to make a clear decision right then I am sure I said all the wrong things but the one thing I do remember telling the room full of doctors and staff is about the Anesthesiologist telling me she used Narcan to wake her and asked if that might be why this is happening. I told them all about her foot the night before and the mystery doctor that came in and did the cath on my mom and asked if she had heart issues. I also told them about that beep/moan thing I heard all night long on her monitor bedside. They leave the room except for one nurse that I told about pressing the buttons for help and she told me that a lot of the buttons on the beds didn't work and, in the future, if you have something like that happen I should rip the remote out of the wall and it starts a code blue call. Oh okay.



The phone was ringing off the hook because no one knew what was happening so I put my mom on the phone with her lifelong friend and her preacher. I didn't know what was going to happen next so I felt like a friend and a prayer couldn't hurt her and soon everyone was ready to transfer down to ICU so off we went.



As we get to the ICU it is chaos and they have her in this little room and it is now full of medical staff plugging her into all the bells and whistles. I tell a nurse I am running to the room to gather our personal items and I snapped a picture of the situation to send to the girls and took off, grabbed everything, made a few calls, cleaned up in the bathroom changing clothes, applying a little makeup and went back to the ICU family waiting room where the family began to flow in very concerned.

We were supposed to be home, not ICU and I was wanting some answers at that time. Also, I wanted very much to convey what I knew about the night before. They let us go into the ICU to visit and we were told she was stable and she has suffered a heart attack and flash pulmonary edema, they were doing an ultrasound and scheduled a cardio-cath for in the morning at 9 am.



Keith, her ICU nurse also told me that I could not take any more pictures and wanted to know if the supervisors have spoken to me about it. I told him no and he continued to chastise me about HIPAA. I agreed and left it at that. I was a little annoyed with him because don't scold me for wanting to make sure my family is informed. We have been doing it this way for a while and I have been sending videos for years to them of medical professionals speaking about my mom and dad without complaint and to be honest HIPAA protection is your deal not mine. Cover your paperwork up I guess but, this is my mom, and I think she is dying at this moment, so I am documenting. Go away, Keith.

I went to sit in the waiting area to talk to my family about what happened to mom and I had a theory as to why it happened. My theory was that the Narcan should have never been given to her and then the doctor forgot to put it in her record, so my mothers' course of treatment was altered, so was the path of our lives.

My family thought I was insane, being paranoid, overreacting, and basically not believing that could be the case. They were ready to chalk this up to her "being older" and "stuff like this happens". The problem I had with that was that I was there and I watched horrified as my mom crashed about 2 hours earlier. I knew what I knew and I guess I needed to talk to the doctors.

Keith her nurse came with a Cardio PA to speak with us about her condition and I had so many questions about what was going on, and it was at that point I realized by the careful answers they were giving that they knew there had been a mistake. Her surgeon ran in past us and tried to enter the ICU without speaking to us but I made Keith get him. He came over asking me what happened and I began to go down the sequence of events in my mind from the last 24 hours and he had the nerve to stop me and said "Can you get to the point?" all the while his knees are shaking so violently in his scrubs and he is obviously shaken and his pant legs are waving like flags in the wind. I said "This leads to the point" and I continued. I mentioned the Narcan and Keith acted like it was news to him but I could tell he was lying, by the way, he lowered his head and voice, shaking his head no, and acting like he didn't have a clue, also avoiding eye contact. Later I hear he told my niece it was "just a little bit of Narcan" using his fingers as a guide.

As I sat there in the ICU waiting area I saw my mothers' anesthesiologist leaving for the day out of the ICU exit just chatting away with a co-worker, I got up and snapped a picture of her.

The final word about mom that day from the doctors was, they were pretty positive she had blockages and would need to have stints placed, congestive heart failure, heart disease, yes, that must be the case. We were told they were performing a heart catheter in the morning and for tonight we should go home and rest, that she was in good care, so we all went home in shock and horror trying to compute what just happened.

I was traumatized and don't remember anything about this night to be honest but I know I slept after being so exhausted from the days' events and I knew I needed to write all of this down because everything was moving too fast and I was going to forget.

Tomorrow couldn't come soon enough and little did I know the life-threatening night my mom experienced in the ICU...

I feel the need to stop here for the day and will carry on with what is really the beginning of another 5 days in hell. Feeling the need to express my intent with this blog and let everyone know that I mean no harm to my family and am not doing this to hurt them in any way. I love my family more than anything and each one individually more-so I know they love me. I know me doing this so publicly might feel like an open wound and might make them nervous and worried about my poor sweet mother and her feelings regarding me saying all of this out loud with pictures.



My mom and I sit and talk about our experience in the hospital and with hindsight she agrees that this was not just your average oopsy. She survived this fiasco but as you will read it was not for anything but her own will to live and the support of her very protective family. She is aware I am reading and scanning her medical records in search of what actually happened in there. She allowed me to keep my Power of Attorney status after she was released. She trusts me on this and I have her blessings. Although people should know that my mother is a very private, modest, and proud woman that has lived a life of loyalty and commitment to her family with the utmost dignity so to say she isn't jumping up and down that I have to do this. I have to do this and yes it feels weird being so public. This place left me with no other option. There is a lesson to be learned here and there are a lot of people that are about to get schooled. This is for my family. This is for your family. This was not okay and it is as simple as that.





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