Sunday, February 20, 2011

And it's not even winter

(...but this is a silly summer!) Living with someone in the later stages of MS has its surprises, however sometimes the surprises aren't much fun, more's the pity. I've maintained for years a document to help others who may come in to care for Pam to get some idea of what normally happens. This recently had to be updated (yet again) because of the Dietician’s recommendation of four daily cans of PEG-fed food instead of the customary three.

To ease the difficulty of having an odd 2/3 can or 1/3 can sitting in the fridge as the day wore on, in order to deliver one and one third cans per feed, it was agreed between myself and our most frequent carer that starting the day with two full cans in the supply bag will obviate this difficulty, with reasonable care. After all, ‘one and a third’ cans per meal is OK on average, but if a push comes to a shove, Pam is known to have been able to take two cans at once without even noticing. Ah, but cutting one corner fouls another. When the pump was in play, bolus feeding was easily programmable, but with a gravity system this luxury doesn't exist. To deliver one and one third cans from a bag containing two cans worth takes some deliberation (regardless of the broadness of potential tolerance).

The truth is, just as it was with the pump and my subsequent errors with it thus forcing me to abandon it, it didn't take too long for a miss to occur in stopping the PEG feed at the correct moment and Pam being delivered (slightly) more food than she was supposed to have and as it turned out, this time, was quite uncomfortable with. I came home to find Pam dry-reaching and gagging, and for a while at least I thought the (rather minor 25ml) over-feed was the crazy cause. Well if indeed that was the case, it'd soon settle down in under an hour or so and that’d be that, so I thought.

Well Pam just got gradually worse. The over-feed (that insignificantly slight over-feed) happened Friday morning, but Pam was regurgitating almost continually not because of that, but because she'd evidently earlier caught a vomit-bug of some sort. The feed error was merely coincidental and unfortunate. Last night (Saturday night) as we were in our adjoining beds, Pam was definitely not normal. I feared she had aspirated some swallowed vomit which accounted in my mind for her rattly breathing. I turned on the light and watched her breathing - tummy rising and lowering, not her chest - and eventually announced I was going to phone for the ambulance. Pam didn't argue too much and in due course they were here. They quickly determined that Pam's temperature was sky high, as was her heart rate and promptly took her off to hospital.

Mildura Base Hospital is hard-pressed to cater for emergencies and yet the staff are calm and professional. They soon had Pam's nausea well and truly smothered with some wonderful mysterious substance, but as I type this in the early hours of Monday morning, Pam lies in a bed, as a hospital admitted patient, still in the ED Dept; such is the hard-pressedness of that which I wrote. (In spite of the time stamp, this update was published at 12:55am, Monday 21 Feb 2011 ADST)

Here I am once again adding to this - it's now Wednesday 23rd February and I, just this morning, loaded both the wheelchair and Pam's coming-home clothes into the car (van) with a half expectation of her hospital discharge being today. I had suggested to the medical staff earlier that if Pam needed more time to recouperate, could I invoke our private health cover and have her tranferred to Mildura Private Hospital? I was told that that was entirely up to Dr. Terry Cook, Pam's appointed treating specialist (Terry is a Physician and I've known him for decades). Regardless of this, it looks as though Pam comes home with me tomorrow.

What happened, I hear you ask? - well the cause of the vomit-bug is still a mystery as far as I am aware, but may have come from a bladder infection (a common event in view of Pam's supra-pubic catheter). Anyway, the vomiting eventually aspirated into Pam's left lung and caused an infection which would have become pneumonia if it hadn't been picked up when indeed it was. Pneumonia is life-threatening to otherwise completely healthy people, but I fear it would be fatal to Pam in her frail condition. Here's a picture of how she looked on Monday, still with an infection-induced fever...

(Isn't she beautiful though?)

Pam responded well to the antibiotic therepy and is now just waiting to feel strong enough to come home - Terry says,"Fair enough!"

(There are many postings for this blog - please check the Archive for those not displayed here.)

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