* Congestive Heart Failure

Written 08/11/2006 – 09/10/2006

Mom checked herself into the hospital again because of extreme weakness and trouble breathing. It turns out her blood oxygen level was dangerously low.

Here I have included updates to my family and friends so that you might understand the roller coaster ride that care givers experience. Hopefully my account will help others to cope and support each other:

Hi All,
Mom was moved to a room on the Physical Therapy floor and started some treatments this afternoon. Basically, they got her on her feet and walking a few steps with a walker, and teaching her how to breath correctly to keep her oxygen level up.
In dealing with all the issues of cancer and COPD, the third disease that she’s had for years has been ignored, that is heart disease. The doctor feels that Mom could be dealing with some heart failure along with everything else. Congestive Heart Failure is not something that I have researched until last night and did not know that it could very well be the cause of her current problems. I thought it strictly affected the heart when in fact it can cause congested lungs, swollen ankles, fatigue, weakness, confusion, a feeling of fullness, loss of appetite, all of which Mom has been experiencing the last few weeks and more so now.
Unless Mom makes some miraculous improvement (she’s surprised us before) the doctor does not anticipate her leaving the hospital without a lot of home care or a nursing home. The doctor has NOT stated this to Mom and neither have I, so DO NOT bring it up in a phone conversation. The doctor does not want to dump too much on her at this stage and just wants to try and get her stronger. I have not talked to the doctor today, but yesterday he was still leaning toward the infection getting her down and only mentioned heart failure as an aside. He feels that if the infection can be cleared up she’ll be able to regain some strength.
So, that’s it for now.
Emily


Hi All,
So, here’s the latest on Mom… Monday afternoon the doctor was talking about possibly moving Mom to a nursing home where he anticipated that she may last a month.
On Tuesday, Mom was then moved to the Physical Therapy floor to see if she could regain some of her strength.
On Wednesday, she seemed to sound stronger and feel a little better, but Emily told me that the nurses wanted to make sure that the family understood the dire condition that Mom was in.
This morning about 10am I talked to the doctor and he was talking about putting Mom back on Hospice, moving her to the hospice floor, and just trying to make her as comfortable as possible. In the course of the conversation he stated that he felt she only had a few days to live. I asked him to clarify his statement since only Monday he had given her a month. He stated that the physical therapists were very concerned that Mom’s oxygen level would drop drastically at the least effort, like just sitting up in a chair. I left work and got to the hospital around 11am. I had just missed the doctor but he had written in her chart to continue physical therapy and a normal diet. To add to the confusion, Mom had both an upper and lower GI done this morning – doesn’t sound like comfort care to me. In addition, Mom devoured her lunch, and looked and sounded better than I’ve seen her in weeks. I got a phone message from the doctor about 1:30pm stating that Mom was eating better, breathing better, feeling better, and moving around better. He said he would talk to me again in a couple of days.
Go figure… Is this Mom doing better just before the end? Possibly. Is this Mom showing us what she’s made of and fighting to get better? Very likely, she has surprised us in the past. Is this a doctor’s hour by hour best guess? Most definitely.
So, now you are as bewildered as I am. Should you come? When should you come? I have no idea. You have to follow your own heart on this one.
Emily


Hi All,
So, it was the doctor’s best guess at the time. I got a message update and then talked to the doctor directly this afternoon. The doctor stated that Mom was doing better yesterday and much better today. He's thinking that she had a very bad day on Wednesday but is now about the same as when she came into the hospital. He is no longer pushing Hospice and morphine, and is back to watching her progress. He said that he might have overreacted yesterday morning since Mom had such a bad day on Wednesday. He plans to leave her were she's at for now and continue the physical therapy to get Mom stronger. She is on an extended stay floor and can be there for 20 days. He does not anticipate her being there that long and is back to his original plan of getting her to where she can go back to her apartment with home help. All good news...
Emily


And then one last email to a friend:

Well, I’ve put this off long enough and I still can’t bring myself to call you, so this will have to do for now.
My Mamma died last Sunday, September 3, 2006. She was in the hospital for two weeks fighting an infection and suffering some heart failure. The doctor “said” that he had both under control. Personally, I think that Mom had been experiencing heart failure for at least a month. Anyway, she went from the hospital into a nursing home for a little over a week but was not gaining any strength back.
My brother had been scheduled to visit Memorial Day weekend and arrived on Saturday morning. My middle sister had been here for about two weeks, and my oldest sister arrived on Thursday before the weekend. So, all of Mom’s kids were here to visit on Saturday. We all had a feeling she was not going to be with us much longer and we each said goodbye in our own way. Sunday morning Mom got out of bed and her heart just gave up. It’s like she said, “I’ve seen you all one more time, now I’m out of here, I’ll see you later”. Official cause of death is Respiratory Failure as a consequence of lung cancer and COPD but I think it was the heart disease that actually took her.