Mom had gotten pneumonia november 11,i had called 911 after she started to hallucinate and act strangely..she was alert, and aware, although confused at times.. - then co2 levels rose drastically the next morning and she was admitted to hospital.. and was intubated..she was alert after this, she couldn't speak - but mouthed words... she had difficulty being weaned off of the tube in her mouth - her levels rose again.so they needed to perform tracheostomy..she was sedated several times..they said they were afraid she would remove tube... and then after vent operation, they had to surgically put feeding peg tube in her stomach so that she could eat, and also be transferred from hospital....so 2 operations in the space of 5 days.. and antibiotics to knock out the infection...the hospital could do no more for her.. this was one month after arriving in hospital.. she became lethargic at times, and then woke up right before she was transferred to Nursing Home/Rehab..again she was given something to sedate her for transport.. she has been in a very deep sleep ever since then.. she arrived at NH dec. 11, and woke up only once to my knowledge where she actually spoke some words, and acted as if she knew who i was and that i was there..basically acted like she was there.. not out of it.. that was on the 8th right before going to NH..since then, only recently she opens her eyes..i believe she tries to wake up.. but can't for whatever reason.. maybe she is exhausted, or she is in the healing process.. but only the last few days i have seen any improvement in her consciousness at all.. yesterday she didn't open her eyes ( and once or twice turned her head at the sound of my voice) - but she started to move her lips and smack them..not awake..but looking more like she is really sleeping.. not in a semi unconscious state.. is this normal? does the ventilator have this effect on people? she is 84.. has emphysema..stopped smoking 12 years ago.. but her lungs could not get strong ernough to breath on her own.. hence the vent, and the NH.. i'm hoping she will wake up.. the only thing wrong with her is that she can't breathe on her own..why won't she wake up?? does anyone have any similar situations or advice?? i am her only daughter. i don't know what to do.. i have to start making some long term decisions and i don't know where to begin...
Was the water from a pleural effusion? Is she a diabetic? Type I or II?
I'm not a medical person so I'm just asking from experience, but it does sound as though her body is still undergoing some extreme and complicated challenges for recovery.
In my personal experience, I've only seen one person in a similar state, and that's my father. He was medically induced into a coma and remained so for about 2 weeks until the ratio of inhalation and exhalation of air was normalized. He did have a difficult time coming out of the coma. He was 85 at that time.
I would think that with all your mother has gone through, her body may just not be ready and she's still sleeping b/c she needs to be. That sounds like a very nonmedical conclusion, but sometimes the issues are more along that line than something more complex.
What happened in Cancun that brought on this emergency?
BTW, knowing the SE Michigan medical facilities fairly well, if she's at DMC Receiving, she's at a good hospital. Inconvenient and in a bad area, but my father was treated there for a traumatic finger amputation. I had some problems with a few nurses, so if you do, go to the charge nurse immediately, or ask to see and confer with a hospital administrator.
Could you explain this: "I noticed 5 years ago, 1-year ago.. " Did this happen 5 years ago and 1 year ago as well? If so, what were the causes, and the outcome?
I think the fact that she's responding by wrinkling her nose or opening her eyes is a really positive sign!
Is she by any change on a monitor that measure brain activity? I watched this when my father was in a coma. I talked to him, played music on a portable CD player, and watched to see if his brain functions increased. I also sang some of his favorite church hymns.
He responded; his brain function increased. And the infectious disease doctor as well as a nurse confirmed. They recognized that he was responding to music, even while in a coma.
You might try that, playing music for her.
I fought their prejudice and willingness to just give up on an 85 year old man. It wasn't the first time I challenged the "quitter attitude." Eventually, 7 months later, Dad came home, after being decannulated and having speech therapy. A few months later he passed a swallowing test and began eating real food.
He'll shortly celebrate his 98th birthday. He still walks and causes me great anxiety when he's out walking in this heat.
I read all I could on his situation and asked doctors and nurses a lot of questions. By the time he came home, I had two 3 ring binders filled with medical information downloaded from online.
Your mother may be sleeping b/c that's what her body needs, or b/c of a combination of meds, etc. Even after Dad came out of the coma, he slept a lot, especially when he was hemorraging internally.
So, don't give up; hang in there! Learn as much as you can about all the complicated and interactive situations and ask as many questions as you feel necessary.
And just keep holding your mother's hand when you visit her. Although we don't really know how much she's sensing now, I do believe that the power of touch can communicate words that can't be heard.
She can't be removed from the ventilator until certain medical conditions are met, specifically, she has to be able to breathe on her own. And apparently that isn't happening right now, b/c of her carbon dioxide level. So they can't "unsedate her and take her off the vent".
This is too complex a situation for anyone here to diagnose. There are some medical people, but primarily this is a forum of caregivers. And w/o more information on SAT rates, CO2 level, etc., no one can really second guess the doctors. The medical people could probably offer more insight into the situation to make it more understandable though.
In the meantime, perhaps you could try to make her more comfortable and relaxed, just by sitting with her, holding her hand, talking soothingly.
When my father was intubated and in a chemically induced coma, I brought a small portable CD and played his favorite songs for him. I watched the meters monitoring his various levels; I can't remember the name of the instruments these 13 years later. But some of the ICU nurses watched the change when I played the music, and they agreed he was responding.
Music does have soothing capabilities; perhaps it might help your mother until the medical issues are stabilized.
Have you had any really serious discussions with the doctors to address your concerns? That's the first thing I would do to understand more the methods they're using to treat her.
I am so sorry for your loss and for the hard time you went through with your mom. your advice to lisamichelle is right on. Make peace with mom, even though she is unconscious. Let her know how much you love her, let her know you are doing your best to look out for her.
It was time.
I agree wholeheartedly that quality of life is the most important thing. Make peace with her, even if she is unconscious.
I just found out they were giving my mom an anti-anxiety med 24-7 at her ALF. I would come to see her, she looked like she was near death. They said "she's only on a very tiny dose". They told me "it leaves the body in fewer than 6 hours".
All untrue.
If they are giving her benzodiazepines, it is VERY DANGEROUS for you. This class includes drugs like Xanax (alprazolam), Ativan (lorazepam), Klonopin (clonazepam), Valium (diazepam). This class includes the drug known as "date-rape" (Rohypnol). Others are ProSom (estazolam), Dalmone (flurazepam), Restoril (temazepam) and Halcion (triazolam).
Many of these drugs are actually very dangerous for elders;
They gave it to my mom every 8 hours, but Ativan has a 10- to 18-hour clearance time (longer in older people)! She was overlapping and overdosing and it was making everyone think she was dying.
Good luck to you.
This is a very real issue that gets overlooked or not even considered as the cause for the semi sleep state. For individuals who live alone, often they don't know they even have apnea so it's not indicated on their health history.
Sedation apnea is different than a coma.
There is a whole protocol to dealing with sedation apnea management and most health care providers really aren't familiar with it. Good luck and let us know what evolves. Love a mystery.
Obviously, I don't know about your mom's outlook for any meaningful recovery but, from my experience, the people at the health care facilities who DO know her prognosis, won't take it into account when deciding whether to order tests, procedures, life-support, etc... Mercy is a quality that's hard for the elderly to find in healthcare these days. Doctors used to take responsibility for guiding a family through end-of-life decisions; offering their insight and experience to help us make choices about our loved ones. Not so anymore. As patients, we are simply a collection of conditions.
This is a painful time for you. Find one of your mom's doctors who will speak candidly with you about her prospects for recovery.