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On Wednesday August 30th, mom had surgery to replace her badly diseased, non-functioning heart valve. There was a 1% chance that her heart wouldn't pace again on its own, and a 5% chance of a debilitating stroke. It was a necessary procedure for her. Without it, life expectancy was 6 months or less. During the procedure, it became clear that her heart would not pace on its own, at least initially. Surgeons installed a temporary pacemaker to alleviate the problem. All appeared to have gone well. The surgeons told me that they would leave the temporary pacemaker in place for 24 hours and try adjusting it to see if the electrical conduction in her heart would take over. If not, they would install a permanent pacemaker; a very low risk procedure. All seemed well.
She was held in recovery to be monitored as she woke from sedation. Once she was brought to the cardiac unit, we were able to see her. She looked good, but soon it became apparent that her ability to speak was very limited. Nurses thought that her mouth was just dry, so they gave her water. She was unable to swallow. I gave her a pen and paper. She could write a few words. The hope was that it was just from sedation. As a precautionary measure, they took mom down for a CT and a carotid ultrasound. Those tests were clear; no stroke. They could not take her for an MRI, because she had a temporary pacemaker. The metal could not go in to the machine. It had been a long day; they told me to go home and get some rest.
When I returned on Thursday morning, additional symptoms had surfaced. She now had a right side droop, could not speak at all, and was unable to write. She knew what she wanted to say; she couldn't find words or sound. We both cried. Late Thursday, the speech language pathologist administered a swallow eval. Mom failed. She was unable to eat or take critical medications. The doctors and nurses sifted through her complex health to identify alternative options. It is now believed that it may have still been occurring, even after she was brought to her room from recovery. The damage and bleeding in the brain were still in process. The doctor apologized. 'This is devastating,' he said. It was one of the risks; we knew that; and mom was afraid.
By Thursday, mom's heart did begin to pace on its own. She would not need the permanent pacemaker, and the new valve was working.
Friday would bring many activities, evaluations, and brainstorming. Mom was exhausted. The speech language pathologist returned to administer another swallow eval. Mom improved a little. I think it was also helpful that the evaluation was done in the morning when mom was a little fresher. She was put on a soft diet to try it out. She took 2 bites and pushed it away. :-( She was able to walk with her walker. The pacer wires were removed, and gradually, other hardware (IVs, etc.), as well. I met with the social worker. We determined that mom would go to a rehab facility this Sunday (9/3). There was no progress in her ability to speak.
An MRI is ordered and will happen today (Saturday). It will not change the way they treat, but it will identify the extent of the stroke and specifically where it took place. They will also be doing a chest Xray. If you know mom, you know that she has progressive lung disease that she has had since she was a little girl. There are concerns that her lack of strength and mobility have left her unable to clear her lungs of congestion, leading to pneumonia. The nurse told me that they administered suction Friday night.
The shock is beginning to wear off. It is life-changing and difficult to watch. Mom is very aware of what has/is happening. To me, that makes this season more difficult. She has always been extraordinarily strong and courageous. The focus now is adjusting to new normal and providing support/resources. There will be improvement; the extent of which, we do not know. She is in good hands.
While we are asking for no visitors to the hospital, once she gets to the rehab facility and gets a bit more rested, she could use any and all encouragement. I also would ask that people pray as you feel led. I think of asking for peace and rest for mom, regardless of outcomes. She is loved by many, and we are grateful.