Ch. 1- Takotsubo Stunned Medical Pros Into Denial: A Daughters' Story #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...
Tuesday, Sept 3, 2019
Today I woke up at 6 am after a sleepless night worrying about my mother and the next few weeks we had ahead of us, as I had committed to helping her through a reverse shoulder replacement surgery, and the time it takes to recover successfully from a joint replacement. I had cleaned my home to the max and packed a bag. I was going back home after this night to stay at our family home during this recovery time and it was long overdue. Her shoulder is completely separated, she has bone spurs and arthritis has taken its toll, not allowing her to move it. She has to spend every second protecting it and writhing in pain, daily depending on pain medicine to bring any relief and as of late, nothing was touching the pain so she was depending on immobilization. That doesn't work, by the way, if you were wondering. I don't think she slept a wink last night either. This surgery is to bring her a better quality of life and range of motion.
We arrived at 10 am to register my 75-year-old mother for surgery and everything went normal from registration to pre-op. She is getting a nerve block placed before the surgery so when she comes out she will not feel the pain of the surgery. Thank God! That buys me 3 days of working with her and getting her used to not having an arm she can use, before the pain of the replacement hits. That is amazing! I love nerve blocks, and boy howdy she needs it. I was just grateful she would have it for the ride home. I mean, after all, it is just the two of us and the car we have is very bumpy. This was going to be a good thing.
Feeling confident she was in good hands, I left the pre-op area when the anesthesiologist came in to put the block in place. I put a few things in the car and when I came back she was heading back for surgery. We said our goodbyes, I touched her forehead and they wheeled her into surgery, which began at 12:34 pm.
I was the only one in my family at the hospital that day with my mom because it was an outpatient procedure that she was scheduled to spend one night. I don't know how that works but that is how it was stated to us. Outpatient overnight. Got it. I spent the 2 hours it took to do the surgery just hanging around the place, checking out the cafeteria which I noticed right away we were in a much smaller facility based on its size and hours of operation but we weren't going to be there long anyway, so whatever. Right? I have been the designated daughter for hospital stays with my parents for almost all of my life. Cafeterias are a big deal.
Her surgeon came out into the outpatient waiting area around 2:20 to let me know that the surgery had gone better than planned and they were in and out with zero difficulties. She now had a room number and I went there to await her arrival. He said it would be about 45 minutes so I gathered our things and headed up to the room to wait for her.
Sitting there for a little bit, I fell asleep in the quiet room after an otherwise exhausting 36 hours. I think I might have slept sitting up in the chair for over an hour and when I woke up, she was not there yet so I texted the family to let them know the situation in order to get some feedback.
Nobody panicked and after a few minutes of scrolling through my phone, being I was bleary-eyed from the mid-day nap, I went out of the room and into the bathroom in the hallway to clean my face, then walk to the nurse's station to inquire about her late arrival. It was almost 4:30 and I was getting worried by time, I had a bad feeling.
As I exited the restroom I see a gurney in the hallway that wasn't there before and it was her, just chilling in the hallway by herself. So I walked around her and snapped a picture to send to the crew letting them know she was in her room. Two women walked out of her room right after and one asked me if I was with her and I replied with "I am her daughter" she laughed and made a joke about how she thought someone had moved into the room because our things were in there already and I had my computer and stuff set up for my evening with mom at the hospital.
They roll her into the room and I comment that she is pretty "out of it" and the Anesthesiologist Korie Vakey, the same lady that put her nerve block in, said "Yes, she was a hard wake, we had to give her Narcan" and I said " Narcan? Like the stuff they give people that overdose on heroin?" She said "Yes" and I joked that I was going to kid my mom about that when she woke up. Dr. Vakey carried on with her orders to the nurse about what to watch out for on her face, like twitching and facial slag. We shouldn't worry but she expected her to be much more awake. That was when I told her that neither of us had slept the night before. Dr. Vakey breathed a sigh of relief saying "That makes me feel so much better, I was beginning to worry but that makes sense" She began to rave about the line of communication they had at the hospital and that was what they were doing was following the chain and that my mother should expect the best care of her life here at The Med. She was very enthusiastic and convincing. The nurse was getting my mom situated in her bed, plugging her in, and trying to communicate with my mom by her bedside, Dr. Vakey told the nurse that she had not yet documented that dose of Narcan so she would not see it on her chart yet, but she was heading down to finish up her paperwork for the day. The nurse replied with " My shift is almost over" and moved on to another topic about her I.V. bag and letting the saline run since we already paid for it. Dr. Vakey told me to shake her every 15 minutes and feed her ice chips, I agreed to do so, and off went Dr. Vakey and the nurse never to be seen again.
I immediately turned my attention to my mom going to her bedside to see if I could get her to stir. She would not wake up for more than an acknowledgment that I was shaking her and having to feed one little piece of ice in between her lips at a time. She rejected it. I decided I would just sit bedside and keep an eye on her. She was so tired and really did need to rest so I sat there for about an hour before getting up to look at her again and try to wake her. It was super quiet in the room other than the sounds of her oxygen and blood pressure cuff. I went over to her monitor and was taking a picture of her sats to send to the group and as I was trying to center the monitor within my screen I snapped a pic, decided to try another and that is when I saw the heart rate number 221 flash on the screen and at that time a beep went off, and my mother sighed. I felt a wave of guilt come over me, thinking maybe I shouldn't be taking pictures so much just because I was bored and sat back down sending the group the first pic I took and relaxed back into the chair, assuming this monitor was somehow connected to the nurse's station for monitoring.
Once the night nurse made her rounds mom finally woke up and was saying that her foot hurt so bad, I got up excited to see she was awake and talking, pulled the covers to expose her leg which had the surgical hose, hospital bootie, blood pressure cuff and an alternating air pump sleeve for clot prevention. The nurse was upset that both were still going and pulled the clot reducing sleeve and I pulled off the hospital bootie only to reveal that it was acting as a tourniquet and her foot was completely swollen with about an inch indention where the sock band had been. I voiced concern and also told her about the monitor beeping and the 220 number at that time. She got her bedding cleaned up and tossed an iv bag that was never administered that the original nurse said she was going to let run since we paid for it. It never ran. She attached the new bag and administered her medication and the night went on from there without issue other than she couldn't seem to be able to pee. She tried a bedpan with no success and was asking if someone could do a catheter to relieve the pressure. The nurse was not really wanting to do this but after a second complaint she found a doctor on the floor and they both entered the room while I was sleeping on the cot next to her, sat on either side of the bed with my mom and the doctor was walking the nurse through the procedure. I only know this because I heard the young nurse apologize to the doctor about having to call her to help. I was in and out of sleep mostly to give my mother some privacy as she was exposed and that's that, but they woke me up to ask me if she had a history of heart problems and I turned to look at the doctor and said "No, she doesn't have heart issues, we are here for the shoulder." That was it, they finished and left, the next thing I remember is her surgeon coming in very early the next morning on his rounds checking her incision. It was at that moment I told him about what had happened to her foot and mentioned the Narcan to him as well. He was not alarmed, said her blood work looked good and she could go home...That was at 7am
I am going to stop here for today and will continue on another day's blog. This is a long story and will have to be broken up into several posts for me to tell it clearly. If for no other reason than for my own personal understanding. Thank you if you are here with me as I cross uncomfortable boundaries into a situation nobody wants to be put in. I will gladly lead the charge for my mother in this situation and you will understand as I go along.