I am sitting at my mother's house tonight, alone. It seems too quiet here, without her relaxing across from me in her recliner, dozing, while I type. In the eighteen years I have been visiting her at this Columbus, Georgia apartment, I have never spent a night in it without her present. Even the past two days, when she hasn't been aware who I am, I could look across at her and remember times past. Now I just feel so bereft.
Today, she slept until I woke her at 11AM. She has stopped reading the morning paper or having coffee, two habits that have been part of her life as long as I have. It took me an entire two hours to get her up and moving to make her appointment at Dr. Fussell's office, her board certified gerontologist. She was so short of breath, even the slightest movement exhausted her and required that she stop and rest. Getting her out the door and into my friend's truck left us both gasping and the situation repeated itself once we got to the doctor's office. The nurse then attempted to do a geriatric assessment, asking numerous questions. My mother did not know who she was, where she was, what state she was in, the year, and, of course, she still had no idea who had been harrassing her for the last couple of hours. The nurse mercifully gave up on the rest of the questions.
Once the medical assessment got under way, we began to get some answers. Her pulse was 173 and the two nurses were unable to get a blood pressure reading. Her oxygen was extremely low and she was short of breath and very dehydrated. After she was seen by Dr. Fussell, he said she had to be admitted to the hospital for atrial fibrillation and congestive heart failure. He felt she had probaby had a stroke, secondary to the atrial fibrillation. According to the American Heart Association, "Atrial fibrillation is a disorder found in about 2.2 million Americans. During atrial fibrillation, the heart's two small upper chambers (the atria) quiver instead of beating effectively. Blood isn't pumped completely out of them, so it may pool and clot. If a piece of a blood clot in the atria leaves the heart and becomes lodged in an artery in the brain, a stroke results. About 15 percent of strokes occur in people with atrial fibrillation. The likelihood of developing atrial fibrillation increases with age. Three to five percent of people over 65 have atrial fibrillation. Several approaches are used to treat and prevent abnormal beating: Medications are used to slow down rapid heart rate associated with AF. These treatments may include drugs such as digoxin, beta blockers (atenolol, metoprolol, propranolol), amiodarone, disopyramide, calcium antagonists (verapamil, diltiazam), sotalol, flecainide, procainamide, quinidine, propafenone, etc. Drugs are also used to help reduce stroke risk in people with AF. Anticoagulant and antiplatelet medications thin the blood and make it less prone to clotting. Warfarin is the anticoagulant now used for this purpose, and aspirin is the antiplatelet drug most often used. Long-term use of warfarin in patients with AF and other stroke risk factors can reduce stroke by 68 percent."
My mom is now at St. Francis Hospital in Columbus, Georgia, the same place where I worked as a candy striper fifty years ago. I also spent three months there as a young medical-surgical R. N. when my infant son and I stayed at my mom's while my husband was at the Air Force's Squadron Officer's School in Montgomery, Alabama eighty miles from Columbus. Of course, nothing is the same as it was then, other than their stellar reputation which has only grown. Today, it is also Columbus' first and only Primary Stroke Care Center, accredited by the Joint Commission ( which really means something to us nurse types who always sweated through those inspections at our hospitals! ). As soon as my mother got into bed, she seemed to relax and barely moved when her excellent nurse started her I.V. I feel certain that, right now, my mother could not be in better hands. I hope she is having a good night's sleep and that her heart, with the help of pharmaceuticals, will return to a normal sinus rhythm, and do the job it is supposed to do. Perhaps, then, at least, she will be more aware of her surroundings and will be able to recognize the people who love her.