Reboot

I am thrilled to report that Mom will NOT have to have the VP Shunt replaced at this time.

The Neurosurgeon successfully reprogrammed the shunt yesterday using a different machine and said that he doesn't need to see her again for another month. He set the program so that it would not drain a lot of fluid, and will slowly (over a period of months) increase the amount of fluid being drained again. Although, not to the level it had reset itself to...the reason which still remains a mystery; as does the reason his machine was unable to reprogram the shunt the first three times he tried. He said he would contact the manufacturer of the machine to ensure it was working properly. Obviously, if his machine checks out, this could still mean there is a problem with Mom's shunt. If his machine needs recalibration, then Mom's shunt is probably ok. Only time will tell.

Ok...that's a lot of medical babble, but it's good news.

During the visit, Mom was insistent that there is nothing medically wrong with her. She did acknowledge having a fall...on her Patio at home, about "a week ago". (The fall she remembers occurred last "Fall"). Initially, I told her that isn't where she fell, but when she called me a liar and got upset, I let it go. She thinks that it's "Spring" and time to get her tomato's planted.
I asked if she'd visited the vegetable garden at AC, and she said yes, but it isn't "her" garden. After I gave her the medication the staff sent with me, we went for the CT Scan, and I noticed a chip on her glasses. When I told her about it, and said I should make an eye appointment for her, she said, "You are so good to me." I was worried about how she would act when I returned her to AC, but she got out of the car without problem and said, "I hoped you were taking me home. "
My Mother-in-Law visited her a short time later and said that she had a nice visit with her. She reported that Mom said the Doctor gave her a "clean bill of health".

The staff at AC reports that she is becoming agitated more frequently the longer she has been there (approximately 2 weeks if you subtract the days she spent in the hospital because of her fall). I feel confident that this will pass in time, though it may take awhile. Hopefully, her medications can be adjusted give her some relief from her obsessive thoughts. I pray for their patience.

Overall, I'm pleased with the day, and that's all I can ask for.

Déjà Vu All Over Again

It seems that the VP Shunt that is draining the fluid from Mom's brain has malfunctioned and she will have to have it replaced. It is draining twice as much fluid as it is supposed to, and it is not responding to reprogramming. The Doc's have attempted to reprogram it three times, and each time it has reset itself.

The last time we know that everything was in good working order was on 8/24 when Mom had a routine CT Scan. She had the anxiety attack on 8/27 and remained agitated for weeks. So it seems likely that she hit her head while home alone, damaged the shunt and caused the subdural hematoma's that were evident on the emergency CT scans last week sometime between 8/24 and the end of August when she was hospitalized.

The bottom line is that the VP Shunt will have to be replaced. Surgery is pending for later this week, probably Thursday or Friday. I am waiting for the Surgeon to call back after making the arrangements.

So here we go again.

EDIT 9/22: The surgeon called and wants to do ONE more test to try to get the Shunt working again before going into surgery. Says they've never seen a Shunt do this before and they just want to be certain.

The good news is that my son & I had a wonderful visit with Mom on Saturday morning. She was calm and relaxed. The Nurse told me that she was even laughing earlier in the morning. We were able to talk about the sunshine outside, college football games, my son's activities, we took pictures and just relaxed together for awhile. While she did ask about the cats and going home, she was not agitated, repetitive and insistent about the topic as in previous encounters. Although a small victory, it sure felt good after so many hard battles in the previous three weeks.

Free Fallin'

Mom fell and suffered an acute subdural hematoma. There is also swelling at the front of her brain and a couple of other subdural hematoma's that appear to be a couple of weeks old. This seems to coincide with the onset of her increased agitated state. All very scary.

While in the Emergency room Mom experienced aphasia and was unable to communicate with or understand what was being said to her. I'm sure this was very scary and confusing for her, it certainly was for me. On the other hand, she didn't seem to have much awareness of being in the hospital and only seemed interested in going home. She kept taking the heart monitors, blood pressure cuff and even her hospital gown off and trying to get out of the bed to leave. Eventually, she had to be medicated to calm her down, but would try to fight through it after an hour or so. She definitely has a strong will.

I am not aware of any falls prior to her anxiety attack on 8/27, but she obviously hit her head twice - hard enough to cause significant injury. I do know that she hit her forehead on a shelf in the bathroom at the Psych Hospital on 8/31 because the staff called me and told me. It left a nickle size bruise that I saw when I visited her on 9/1.

The Neurosurgeon ordered another CT scan the morning after her fall. He adjusted the VP shunt back to where it was immediately after it was placed at surgery, then he will slowly readjust it again.

The day after her the fall she was calm in the morning and seemed to understand she was in the hospital, but became highly agitated in the afternoon and had to be restrained. She no longer understood she was in the hospital. Two days later, she was calm again, but doesn't have awareness of being in a medical hospital. I can't imagine how difficult it must be to try to determine any progress from this type of head injury when the patient is suffers from Alzheimer's and is often unable to tell you how old she is, what year it is and the like.

She is unable to look at me without begging me to take her home, and doesn't seem to be able to have any other conversation with me. :(

This turn of events does help to piece together all the changes in Mom's behavior over the past weeks. But what does it mean for the future? Will she heal, will her agitation abate over time? Will she need a wheelchair or walker - will she accept one?
The things I'm reading about this condition are very frightening.

In My Room

Today Mom was released from the Hospital and transferred to an Alzheimer's Care Facility. She met with the Director and Nurse from the facility at the Hospital this morning but was unable to recall the incident that had resulted in her placement in the Hospital...other than "her daughter put her there". As I've previously noted, that behavior is so far out of character for her, she probably can't even conceive it. Also of note is that she was so highly emotional at the time that it was probably never processed...even temporarily. She cannot fathom that she would or could commit such an action. And she couldn't, if it weren't for the illness that has invaded her mind.

But I digress. Today Mom has a new home, with a private room that has a nice view of a large courtyard in which she can walk or sit, and pictures of her family nearby. She will soon have a TV in her room, and personal items that she can enjoy which will hopefully help her feel comfortable and eventually at peace. I know it will take some time for her to become accustomed to her new surroundings, but I am satisfied that she is safe, she will take her medications, and she will eat properly.

Her Sister from Arkansas came to see her through the transition and my Son was also able to visit as she was checked in. However, after this initial transfer, we will not see her for a couple of weeks so that she can learn and become familiar with her new surroundings and the people who will be assisting her on a daily basis. From my initial impressions, they are wonderful people, who are committed to ensuring that the individuals they care for are treated with respect. Slowly we will visit and eventually it is our goal to be able to take her away from the facility for dinner, medical appointments or other special activities.

While this has been the hardest thing I have ever done in my life, I know it is the right thing. Mom told me that I would have to answer to God for what I have done, and I quietly answered her that "yes...I will." I only wish she could understand that He already knows I'm acting with love in my heart.

Caught in a Trap

My Aunt & Uncle from Illinois visited Mom at the Hospital yesterday. It was another difficult visit. They reported that they barely recognized her, having changed so much since the last time they had seen her in Mexico in January. She's lost 25 pounds since then. They also reported symptoms of extreme anxiety, such as persistent hand rubbing during their conversation. Something I've also noted.

She was happy to see them, and repeatedly told them how much she loved me and my son. She pleaded with them to ask me to take her home and be with her cats, insisting that I have the "power" to come and get her; but W&S told her that it is the Doctor that will determine when she is released. She asked to speak with her Grandson on the telephone (which can be arranged). Sadly, she didn't remember that I had been to visit her in the hospital.

W&S reported that she was wearing the fleece pants that I brought her, but is still wearing one of the hospital shirts. One of the Aides came to take her for a shower when they left.

I know it was hard for W&S to see Mom, not only in a Psychiatric hospital, but in her current emotional and physical condition. It's been heartbreaking and startling to watch her decline these past months and weeks.

I am still concerned that she is experiencing so much anxiety and feel that this needs to be addressed further before she is released from the hospital. My prayers are that she is able to find some peace of mind, relax and find some enjoyment in her days. I know that she's currently still in great distress.

I took W&S to visit the Alzheimer's Facility that I have arranged for Mom to live in after she leaves the hospital. They seemed pleased with the choice. We visited with the Director for a bit. Hopefully, we will be able to move her there very soon.

Pacing the Cage

I visited Mom in the Hospital last evening for the first time since she was placed on medication to help her with her anxiety/agitation (2 evenings prior). My previous visit (before medication) had not gone well at all, so with professional advice, I decided to wait until she had been placed on medication before visiting again. (Easier said than done, since her "anger/acting out" is directed specifically toward me as her primary caretaker and isn't really displayed on the Unit, but that's another story.)

At the beginning she hugged me, was weepy and held my hand. We told each other we loved one another. She was definitely happy to see me. (Yay!)

But ultimately the conversation turned to why had I locked her up, that I had the power to get her out (pleading with me to take her home), and that there isn't anything wrong with her. She denied any responsibility for the behavior that caused her to be there...and I've decided not to remind her of it since I don't really see how it can be beneficial. It only serves to upset her further. (In the moment) :(

I got the Nurse to supervise because I wanted her to listen in.

I explained to Mom that the Doctor would determine when she would be released and I only want to ensure her safety but she wouldn't listen. She stated that she hasn't seen any Doctor(s), and that the only Doctor she has is the Doctor she's been seeing for many years and the last time she saw him was "a couple of weeks ago" (which is fairly close - especially since we've been seeing him once a month for a long time).

She denied any problem with her memory and said I was making that up. It got very circular & repetitive very fast, and she became angry/frustrated and laughed at me stating that I enjoy keeping her locked up.

The Nurse supported what I was saying but Mom didn't (or couldn't?) listen and persisted with her point of view. I knew the visit wasn't going to go anywhere positive from there so I ended it and left. The Nurse walked me out and was very supportive stating that Mom didn't recognize her from day to day either.

It's just so hard that she doesn't understand and refuses (or is unable) to accept that she has memory problems.

She has a very strong will that has always served her well in achieving things in life...except for now. Alzheimer's is one challenge she can't overcome simply by sheer force of will.