During my fifth week of participation in the Seroquel clinical study for bipolar depression, my mother became seriously ill. Each doctor had a different opinion, depending on his area of expertise - the gastroenterologist, the cardiologist, the surgeon - we were bombarded with information but none of it told us what to DO.
I guess if it had to happen, it's a good thing it happened while I was taking a medication that improved my mood and sleep.
I live with my mother, who is 82. Over the weekend of October 8-9, Mom complained of constipation and gas. The over-the-counter and homeopathic treatments we tried gave her no relief, so on Monday afternoon I took her to the doctor - who examined her swollen belly, diagnosed a bowel obstruction, and sent us straight to the emergency room.
What they found was that her colon had flopped over on itself and was twisted so that nothing could get through. They started her on intravenous Vitamin K to counteract the blood-thinning effects of Coumadin, which she takes for her heart condition. A gastroenterologist, Dr. Brand, explained the procedure he was going to attempt to correct what he called a sigmoid volvulus: a tube would be inserted up through the rectum into the large intestine and then inflated to "reduce" or untwist the fold. The danger was that perforation of the colon would occcur, requiring emergency surgery. For this reason, they had to give the Vitamin K some time to work. But they wouldn't wait too long - Mom's abdomen was already the size of a beach ball and very hard.
I went home long enough to have dinner and returned to the ER about 7:00 in the evening. Mom was much worse; they were giving her morphine but she was in a lot of pain. My brother Bob reached the hospital at 8:45, and we waited in Mom's cubicle until they kicked us out to start the procedure. Then we waited some more. About 10:30 pm a nurse came out and told us the procedure had been successful, and Mom would be admitted to the hospital for observation while her doctors decided what to do next.
The next few days were nightmarish. Mom, allowed no food and only occasional cracked ice for her dry mouth, cried from hunger - I guess intravenous nourishment doesn't fool the stomach. She had trouble remembering why she was even in the hospital, and demanded to go home. A CAT scan of the bowel turned up an orange-sized mass on one ovary that they first thought was cancer - though a day or two later they decided it was only a cyst and could be left alone.
My other brother Bill flew in from California Tuesday evening. Having him here was a great comfort - Bill is very clear-headed and determined and doesn't get muddled or distracted under pressure the way I do. And he was focused on just one thing: Mom's healthcare. Bob's day job is demanding, and while I was still not working full time because of meds hangover in the mornings, I had to be at work when possible - not least because I don't get paid when I'm absent.
On Wednesday everything seemed grim. Dr. Brand told us that Mom's bowel was almost certain to twist up again and again without surgery, because with age it had stretched and come loose from the abdominal wall. But her cardiologist said flatly that she was unlikely to survive surgery and if she did, she'd never get off a respirator, or would spend weeks and weeks in a nursing home that would end with a heart attack or fatal pneumonia. Mom continued miserable and spaced out. Our lawyer took a medical power of attorney to the hospital to make sure that Mom's signature would not be accepted as permission for any operation - I would have to sign.
The surgeon on the case, Dr. Burke, said the usual procedure was a colectomy - removing part of the colon and then sewing the ends together. This was the type of procedure the heart doctor said would kill her. Another option was a colostomy - so much less invasive and taking so much less time that it could be done under a partial anesthetic ... but it would leave her with an external appliance for feces for the rest of her life. What we wanted to know was, could they do a laparoscopic procedure (this is abdominal surgery done through a very small incision) and tack the colon to the abdominal wall again? This would be the least dangerous choice - if it was an option at all. Yet another doctor was called in; on his advice, the decision was made to wait a few days, giving time for the inflammation of the bowel to go down, and re-evaluate on Monday.
But on Friday morning, even though she'd had no food by mouth for four days, the colon twisted again.
