After our failed attempt at a visit with the pacemaker clinic, Mom just had a rough week. She complained the next morning of feeling 'disoriented,' although what that means when one already has dementia I really have no idea. She was acting off, somehow, and was forgetting basic like toileting. I changed bedsheets, nightgowns, socks, and floor mats. I checked in a little more often, was really compliant with daily weights and blood sugars and encouraging healthy diet. I thought maybe the pain in her knees from the near-miss fall on Tuesday was slowing her down so I added Tylenol to her daily medications. Maybe the upcoming full moon was throwing her off.
On the way home from work Friday, while waiting (behind a police car!) at the ATM, my cell rang. I almost didn't answer - POLICE! - but I snuck it onto speaker. It was hubby.
"Em found your Mom on the floor a few minutes ago. She must have fallen. We can't get her up. Should we call 911?"
I love that man, I do. But, seriously, you do not need my permission to call the Boys in Blue. By all means, give 'em a call. (They were rude to him. Apparently the dispatcher didn't think that an old lady on the floor was an emergency. I told him he'd've gotten more respect if he'd thought to mention that she was unconscious when they found her. It's all in the details.)
I arrived home just a few moments ahead of EMS. Mom was incoherent, in pain, and freezing. To the best of her (admittedly poor) recollection she'd fallen shortly after I'd left for work at 8 AM. It was now nearly 6 PM.
Off to the ER we went (it's 0.4 miles according to the ambulance mileage record. We should just build a ramp and coast there). She was diagnosed with a UTI and admitted.
Old ladies. They don't get normal UTI symptoms, like cramping an painful peeing and fever. They get weak and confused and they fall down. Sigh.
The problem with lying on the floor for 8+ hours is that it causes decreased circulation to the muscles, which causes muscle damage. Damaged muscles sort of dissolve into something called myoglobin, which leaves the body via the kidneys. And the kidneys HATE that stuff, so they frequently fail following this kind of event, so it's normal for patients to be admitted and super-hydrated. Of course, if the patient has congestive heart failure, super-hydration is not the best idea on earth either - our typical tightrope walk with Mom.
Because every part of her body hurt, the ER scanned her. Brain - no change, no new strokes. Belly - no injured internal organs. Bones - healed 9th rib fractures on both sides (?!?) but nothing new. Chest x-ray - no pneumonia, mild heart failure, like always. But on the chest CT.....
There's a mass in the lung, well over an inch big. It doesn't show on the last two chest x-rays because it's parked behind the aorta. It's up high, likely not easily reachable for biopsy, but there isn't much doubt that it's lung cancer.
Her kidneys won't tolerate the dye needed for a PET/CT to evaluate for metastatic lesions, I don't think. She's a crappy surgical candidate - anesthesia didn't want to take a lesion off her face last year under mild sedation. No way they are going to want to put her under.
I told her about it tonight. I laid it out, kept it as simple as I could, answered the same three questions four times. And in the end she took the Scarlett O'Hara approach and said, "Well, there's no point in being sad about that NOW. I can be sad about that LATER." I'm willing to bet she won't remember it tomorrow, and hey, nothing wrong with that.
Wish I could say the same.