I am thrilled to share some good news that mom will likely be ready for discharge back to our home tomorrow!!  Woohoo!!  Thank you all for your support, encouragement, prayers, positive thoughts, and well wishes.  The power of prayer from such a wonderful circle of friends, family, and community is truly amazing.  Thank you!!

While it is great to share this good news, the past 48 hours have been extremely challenging for mom, to say the least.  Yesterday can be summed up with the title, Deb and the Terrible, Horrible, No Good, Very Bad Day.  It truly was.  In fact, it was probably worse than the day before when this whole episode began.  Mom's pain from the pulmonary embolisms was absolutely unbearable yesterday and it took about four hours while I was there before she began to experience any real relief.  To add insult to injury, mom struggled with vomiting/dry-heaving which further intensified the pain she was already experiencing.  It was as if I were watching someone get repeatedly beaten up while puking on an endless tilt-a-whirl ride...urgh!  The upside is that by early afternoon mom was able to sleep and get some much-needed rest.

Despite yesterday being such a terrible, horrible, no good, very bad day, mom is receiving excellent care from the doctors and nurses.  As a daughter watching her mom experience so much pain and suffering, it was comforting to feel and know my mom was being so well taken care of.  What little I could do, I was glad to be there to provide her with love and support so that she was not alone.  I am so incredibly thankful for the entire medical team at Fairview Ridges who have been managing my mom's care--it has been absolutely the best care and best experience one could hope for under these circumstances.  

Here are a few things we learned yesterday that we didn't know the day before:

• A Doppler ultrasound confirmed that the pulmonary embolisms in mom's lungs were caused by a DVT, or blood clot, in her right leg (the one with the broken knee). 
  • Mom's DVT was a sizeable clot that formed in the upper part of her right leg despite being on Lovenox for two weeks after her shoulder surgery and baby aspirin after her knee surgery.  The good news is that this DVT was the only one in either of her legs.  The hospitalist said that some people have DVTs that are present the entire length of one's leg...so we are grateful that mom's DVT was not any larger and that there were no other DVTs.
• Two troponin blood tests were negative and confirmed that mom's pain that began radiating into her sternum (and mouth/teeth at one point) was not a heart attack.
  • Not sure that I mentioned this in my previous post, but mom started experiencing chest pain shortly after she arrived at her hospital room.  This was a key reason for the physicians wanting to monitor her heart's sinus rhythms via telemetry.  This pain was from the blood clots.
  • We learned today from the hospitalist that a section of mom's CT scan showed evidence of a sizeable lung infarction in her right lung.  Basically, this means part of the lung tissue died due to the pulmonary embolism cutting off blood supply to an artery in her lung.  The hospitalist said this condition is extremely painful and is another contributing factor to her pain radiating into her sternum area.
• An Echocardiogram confirmed that mom's right ventricle of her heart is pumping blood as it should and did not show a weakening of her heart muscle. 
  • This is a very common test administered following admission for pulmonary embolisms to assess how well one's heart is functioning.  The doctor did note that mom's heart is working a little harder than normal; however, he also stated this can be attributed to her body responding to and working to heal the blood clots, as pulmonary embolisms cause pressures in the right side of one's heart to increase.  
• Mom's blood INR reached the appropriate therapeutic level, so the Heparin IV was discontinued yesterday.
  • Mom was switched to oral anticoagulation medicine yesterday afternoon.  In other words, she is now taking blood thinner pills and will be on this medication for at least three months to six months.

Here are today's goals ahead of mom's probable discharge home tomorrow:

• Discontinue IV pain medication and manage pain with oral medication
  • Yesterday the oral narcotic pain medication couldn't make a dent in alleviating mom's pain, so we are crossing our fingers that she has more success with it today.
• Improve deep breathing to prevent pneumonia
  • The lower lobes of mom's lungs are a little crackly, which is evidence of some atelectasis, or a sign that her lungs are not fully inflating.  The technical term the hospitalist used was "squishy."  Mom has been using her incentive spirometer more today now that her pain is better controlled, as this device will help her increase her lung capacity.  Mom is very motivated to stay on top of this.
• Physical Therapy consultation to ensure strong enough to resume pivot transfers at home
  • Mom has essentially been lying in bed for the past 48+ hours without any physical activity.  After talking with the hospitalist this morning, he agreed that it would be wise to order a physical therapy consultation to evaluate mom's mobility to ensure she can replicate the pivot transfers she needs to be able to do at home.  Even though it's only been 48 hours, I do not want to underestimate the toll these pulmonary embolisms have had on her strength and balance, so I am grateful physical therapy will be working with her today.

"Thank you" hardly seems enough to describe the depths of my mom's and our family's gratitude, so please know that the continued love and support you've been sending our way...it truly means the world to us.

Best,
Alissa