My mother turned 83 in April. She takes medicine for cholesterol, high blood pressure, thyroid, and atrial fibrillation. These include beta blockers, blood thinners, and a host of others. She also takes an antidepressant, Celexa, medication to help her sleep (keeps changing) and a drug to slow down the course of senile dementia. She has inhalers for emphysema. She's a high-risk patient.
So when her colostomy began to prolapse - that is, turn itself inside out through the opening - Dr. Burke's first move was conservative: he did a rare but simple procedure to tack the outside of the colon to the belly wall. This had already been planned for July 5th, but after the damn thing began prolapsing frequently and she had to be admitted to the hospital, the procedure was done on June 23rd instead. I was expecting to take her home within a couple of days, but on the following Monday her cardiologist called and said, "You know she's going to need more surgery, right?" and absolutely floored me. After I gulped out a "No," he explained that the "safe" procedure had not worked and the colostomy was up to its old tricks again, and the only remaining option was major surgery to resect the colon.
He then told me that the aortic valve of her heart, which we'd known for a couple of years was too narrow, had closed quite a bit more just in the three months since her last echocardiogram. He suggested we have an angiogram done to see whether a balloon procedure called valvuloplasty (see aortic stenosis) could open it up. Without opening this valve, he said, she had little chance of surviving the major colon surgery she was now facing - the same surgery that was NOT done last October because of her heart condition.
So my brothers and I talked a lot to doctors and each other, and we decided to go ahead with this step, which was done on June 29th. It was a roaring success! The valve opening was doubled in size. Mom became spunky and animated; her breathing improved, and so did her memory; her confusion lessened; and she was funny. Although we knew the situation was still high-risk, we couldn't help but feel optimistic, seeing the changes in her from the balloon surgery.
My brother Bill came in from California on Sunday with his wife, and because I had Monday and Tuesday off for Independence Day, we ate almost all our meals in restaurants for the next few days. I had trouble getting to sleep Sunday and Monday nights, and had to get up and take more Seroquel each night, so Tuesday night, which was the night before Mom's major surgery was scheduled, I just went ahead and took 400 mg of Seroquel. I slept fine.
Wednesday July 5th was an intense day. We visited Mom in late morning and went along with her to the doors of the pre-op section. "Be nice to the doctors," said my brother Bob, and Mom said, "I will. I'll call him 'Lord,' and 'Sir'." Thus we went into the waiting room laughing - except for my youngest niece, who broke down. Once we had talked to the surgeon, who told us the operation would take probably a couple of hours, we went out for brunch. I surprised myself by being able to eat quite a bit - my stomach had done a wrench at the moment Mom was put onto the gurney from her hospital bed. After the meal, we went back to the hospital and waited. And waited. And waited. Finally Dr. Burke appeared and told us it had all gone well; the reason it had taken so long is that normally they staple the two ends of the resected colon together, but that had been impossible in this case so he'd had to sew everything together. He said she'd be intubated until some time tomorrow morning, but in fact, by the time my brothers went back over to see her in Intensive Care, the tube had already been removed because she was breathing so well. All good news!
There are still risks - pneumonia, blood clots, what have you - but everything is very encouraging.
And my meds have really held up well under all this stress. For example, although the quality of care Mom has received could not be better, there were several problems in communications during the last two weeks. Mom's first surgery was originally scheduled for 10:00 a.m. I called at 9:00 and was told they were getting ready to take her down, so I raced over only to find that no, the surgery was rescheduled for 1:30. I called at noon and was told it was rescheduled for 4:30. So I called at 3:15 and was then told she was just coming back from surgery.
There was the fact that no one told me, until the cardiologist called expecting me to know all about it, that the first surgery had failed and she was prolapsing again. And on the day of her heart surgery, I was given a pager and told that it would light up when Mom was out of surgery - but they forgot to page me.
I've kept my cool through all of it. Please gods nothing bad will happen that will really stress the meds.
