The good and the bad

I know I stopped breathing for a second as I stood over his body. From the way his neck bent, for a moment I was certain he was either dead or paralyzed. I was afraid to grab him and move him – terrified that would make the injury worse. For a second, Micah did not move or make a sound. That was the longest moment I have ever endured. I have to say, the relief washed over me when he started screaming and moving – my first thought was that he was alive and not paralyzed. Since he was already moving wildly, I decided to gently pick him up and hold him. I quickly realized he could move all of his limbs and turn his head. He had a bad scrape on his nose and a bit of a red mark on his forehead. We immediately called the doctor to figure out if we should go to the emergency room. Micah quickly showed us that he was able to walk and was behaving normally. When the doctor called back, she assessed the situation and told us that it was unlikely he needed to go to the emergency room and be put through xrays. We kept him up another couple of hours before putting him to bed, and I checked on him throughout the night, terrified something bad would happen to him overnight. The next morning, Wednesday, Micah appeared no worse for the wear. He had a big red triangle on his nose – the kind kids get with a skinned knee. He looked a lot like Raggedy Andy!! But, much to my surprise, he did not even seem sore. I hated letting him out of my sight for a moment, but he insisted on running all over the place.

A few hours later on Wednesday morning, I got another call, while we were meeting with an architect to discuss possible renovations to our house. Round 2, Bad Thing #1: My grandmother fell and was being rushed to the hospital. My mother told me that the fall did not sound like a big deal, and they were merely sending her to the hospital as a precaution. When my mother got to the hospital, however, she called again – apparently, they suspected that my grandmother had fractured her skull, and her temporal artery burst. After they stitched her up and took xrays, they confirmed the fractured skull. She then had a CT scan, which identified 3 major bleeds in her brain, including one major bleed in her brain stem. They briefly discussed surgery, but my grandmother is 97 years old and she suffers from dementia. Surgery is traumatic – if she survived it at all, it would definitively cause a loss of function. Because of the dementia and her age, she is not a candidate for physical therapy to recover that loss of function. So, any surgery (if she survived) would likely have made things worse. Add to that, my grandmother was taking a medicine called Plavix, which is a blood thinner. Because of the Plavix, she has a difficult time clotting (making surgery dangerous and the bleeds unlikely to stop on their own). While we stopped giving her the Plavix, it takes about 10 days to fully leave the system. Ultimately, the doctor suggested we not operate and transfer her to hospice care. They seemed to think she only had a few days to live, at most.

This was devastating news. While my grandmother is 97 and suffers from dementia, and while we’ve realized she could die at any time for quite a while now, we just never envisioned this scenario. Elliot and I spent most of the day at the hospital with my family during all of this. After a number of hours, we got my grandmother’s transfer to a nursing home for hospice care approved. When the ambulance arrived, my mother drove ahead so that she would be there waiting for my grandmother when she arrived at the nursing home. As we prepared her for transport, she became increasingly agitated. She managed to pull the bandage off of her head (which was there to try and control some of the bleeding). She started yelling at the EMTs and she was very upset. At the last minute, I decided to ride in the ambulance with her, to help keep her calm. My grandmother often does not recognize me, but yet, she seems to respond to me. Perhaps it is because I call her Grammy so she knows I am family, or perhaps somewhere buried in her mind I am still familiar to her. Either way, I thought she needed me with her, so I hopped in the ambulance.

Unfortunately, I did not think about my terrible morning sickness, or how it is exacerbated by motion. Nor did I think about the fact it was rush hour and we were traveling 10 miles away. It was a VERY long trip – but I only threw up one time. I felt awful for the EMT – you should have seen the look on his face when I calmly asked him if he had a container I could use for vomiting. We arrived at the nursing home, and both my grandmother and I settled down. It was amazing how alert she was, and she appeared not to feel any pain!

The next day, Thursday, was Micah’s 13 month birthday! Elliot was up and out at 4:00 am again to help get a team and supplies out to Haiti, so I was on my own that morning. I should have posted something joyous here to mark the event – but I was finding it hard to celebrate with such sadness surrounding us. Thursday was not a good day for my grandmother. She just slept all day, and barely responded to anything. We were getting mixed signals all day from the hospice providers – one minute they said she was doing well and this was likely just a reaction to the prior day, the next minute they felt her bleed was getting worse and were not sure she was capable of swallowing food and water, the next minute the doctor was telling us she was in a coma and we should pull all food and water. At 9:30 pm, my mother and I made a run out to see my grandmother again. We thought it might be the end. We got there … and my grandmother woke up and chatted with us. We were angry at the doctor for his misinformation, but it was a good visit, and once again, I am so thankful that I had the time to talk with her and tell her that I love her.

On Friday, while my mom visited my grandmother in the morning, she was quite alert and responsive. My mother insisted they do a swallow test to determine what she was capable of eating, and she passed. I went out to visit later in the day. We insisted that they give her food and drink to keep her comfortable for as long as she can take it. Saturday, my grandmother seemed to be holding steady. Sunday was another good day, although I was unable to visit her.

We had a very busy day on Sunday. Micah had a bad night and ended up sleeping until almost 10:00. As a result, he missed his morning nap, and was like the energizer bunny! I decided that it was not appropriate to take him to the nursing home – he is too restless and wants to get into everything, and I just did not think it was a good idea to have him fussing or crawling on the floor while I was trying to sit with my grandmother. In the afternoon, my mom came over for a few hours to spend time with Micah. Elliot and I took advantage of the time and went house hunting. I’ve mentioned before that we only have 2 bedrooms in our current house – so we have a space issue when Twoey arrives. We are torn between putting on an addition and moving, and we just cannot make a decision. I’ll save that discussion for another post. Anyway, we looked at houses for a few hours and realized that we still do not know what to do. We got home around 4:00, just in time for Elliot’s brother Steven and niece Melissa to arrive. She is a college student, and headed off to South Africa for a semester abroad! She was leaving from Dulles, so they drove down for the flight out on Monday afternoon. It was a nice, but brief, visit.

(NOTE – Round 2, Bad Thing #2 – Another earthquake hits Guatemala and El Salvador). On Monday, much to everyone’s shock, my grandmother was stabilizing. The doctors kept telling us that they could not believe she was breathing and not in a coma with the extent of her brain bleed. And yet…there she was, chatting. She was definitely sleepy and her dementia was still an issue, but she was quite responsive to us – more chatty than she has been in a while. They got her up and bathed her, and they even put her in a wheelchair for a bit. We had a long discussion on Monday about finances – insurance coverage, Medicare, hospice services, etc. Unfortunately, because the doctors were certain she would not survive more than a few days, we did not keep her in the hospital for 3 days, so she is not eligible for some of the Medicare benefits (which makes a few things a bit sticky for us). We are trying to work around this glitch, but we hope to be able to keep my grandmother where she is for as long as she is with us.

After I got home from visiting my grandmother, we took Melissa to the airport. We got her to the airport in plenty of time (despite the fact we were pulled over on the way out for an expired tag – long story, but the tag is actually NOT expired, but we cannot get the new sticker to put on my license plate). Ironically, we ran into our friend, Bill, at the airport. Elliot & I actually met at Bill’s Superbowl Party in 2005. We offered Bill a ride home. Steven left as soon as we got back home. Micah was being cranky and refused to nap – it was a LONG day.

Today, however, was not as good a day for my grandmother. She is back to being very sleepy. She responds to my mother (I was not able to go visit today), but she has not been responding to any of the nurses or caretakers. She has been choking more during meals, which is dangerous for her, so we have had to pull back on what she is eating. It remains to be seen if she is just exhausted because she overdid it yesterday, or if this is the beginning of the decline we have been expecting. I am planning to go see her again tomorrow.

Another selfish moment … I have a huge conference for work next week. All week – Monday through Saturday. This is the most important event for me all year, and if I miss it, I would lose my job. I’m terrified that something will change (or, to be blunt, that my grandmother will die) while I am away at my conference. How am I supposed to choose between being there to support my mother during a terrible time and my job? I hope I do not have to find out.

So…that is the good and the bad. Once again, I’m left asking – what is Bad Thing #3? I wish there did not have to be anything else to complete this chain. I hate that bad things seem to come in threes. And I hate that there is so much sadness tainting all the good right now.