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Chronology of events:
Sunday, Apr.8/2001:
- Patrick is back home in Ottawa! James will be
back on Wednesday, Apr.11. We are taking some much needed R&R before the next run to Vcr. --
I will be updating more shortly... in the meantime, mom is not doing too well and we
all feel (including the hospital staff) that she is starting to lose ground. We can only hope that she is kept
comfortable and we take each day as it comes.
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- Mom does have access to a cordless phone on her ward and if you call, you might be
able to talk to her... Ask for Reine Meikle in Room 314 and tell them you are family... but be prepared for the staff to see if she is awake and able to talk... it may take a few minutes.
I'm sure she would like to hear from you. [1-604-244-5143 ]
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Did I tell you that mom has told a few of us that she wants to be around for her 81st birthday... May 27 ;-)
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Wednesday, Jan. 3/2001:
- Mom had not been feeling at all well during the week holiday I spent in Richmond, B.C.
Saturday, Jan. 27:
- Uncle Kurt and Aunt Jeanette Tiede, who were fortunately visiting mom in Richmond, took
her into local Richmond Hospital with severe chest pains, where she was then transferred by ambulance to the heart
unit at St.Paul's Hospital, downtown Vancouver. Tests confirmed a heart attack and a bypass operation was scheduled
for Monday, Feb.5.
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Wednesday, Jan. 31:
- The surgery was moved ahead to today, because of mom's poor condition. Quadruple bypass
was required and mom came out of the operation pretty well.
Wednesday, Feb. 7:
Amazingly to me, mom was sent home after six days. Cousin Bill Tiede was here to look after
mom, while I made arrangements to get to Richmond. She was able to walk around and had the assistance of a home
care nurse to change dressings.
Saturday, Feb. 10:
Mom has another attack, probably heart failure and is rushed by ambulance to the local Richmond
Hospital, which is only a nine minute walk behind her apartment building. The local cardiologist suggests that
the medication she was taking was too strong for her weak heart and prescribes something less strong. She remains
in the intensive care unit (ICU).
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Tuesday, Feb. 13:
- I arrive in Richmond. Mom continues to remain stable in ICU, but is weak. By week's end
her cardiologist is frustrated by mom's lack of progress and cannot determine why she is not responding to various
medications and treatment.
Friday, Feb. 16:
Mom is transferred by ambulance to the St.Paul's cardiac unit for an angiogram. The procedure
determines that only one of the four arteries replaced is working. The specialist, Dr.Ron Carere, feels that mom
is too weak for further treatment (angioplasty - using a balloon device to clear the arteries) and recommends return
to the Richmond Hospital for further recovery.
At 5:56 p.m., while waiting for
the ambulance transfer back, mom starts to go into cardiac arrest and a "Code
Blue" is called. However, as the cardiac team rushes to the floor, mom recovers
on her own, without losing consciousness. Believe me, what goes on is nothing like the hype that goes on in T.V.
shows.
A decision is made to keep mom at St.Paul's given her unstable condition.
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Tuesday, Feb. 20:
- Mom's condition has stabilized and she is transferred back to Richmond Hospital where
she will stay until she is strong enough for angioplasty. She is moved into the "step down" unit, halfway
between ICU and the recovering heart ward.
Friday, Feb. 23:
- This is mom's worse day so far she is at her weakest and is very lethargic. Her blood
pressure was so low that the doctor asked if we (mom and I) would be prepared to do everything possible to keep
mom alive should her heart stop. To add to the problems, mom is hardly eating and is dehydrating.
Further surgery is not an option. Angioplasty is too risky at this point. Certain medication
to stimulate the heart is also too risky as it would have the adverse effect of overworking the heart. So all that
remains if for mom to mom to try and take in more nourishment and get stronger.
Monday, Feb. 26:
- After three days, mom has rallied a bit but continues to eat only morsels. Her vital
signs, four that they monitor, ( heart rate, blood pressure, breathing and oxygen intake) are stable except that
her blood pressure continues to remain below normal. She is holding her own but her condition could go either way.
We are prepared for anything.
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Wednesday, Feb. 28/2001: Earthquake! 10:55 a.m.
- A large earthquake, measuring up to 6.8 in magnitude, hits the northwest Washington state
area and is felt all up and down the west coast. James and I are in mom's living room at the moment. The moving
building causes a sensation of vertigo and lasts long enough ( about 20 seconds) that we consider getting out of
the condo. The vertical blinds start to sway, a china cupboard door pops open, and an outdoor pool below the balcony
window shimmers with the rippling effect on top of the water. (Click here for more from the University of Washington Geophysics
Program.)
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- Mom seems to have gained a bit of strength since they moved her on to the cardiac recovery
ward. They are trying to get her up little by little, starting with sitting in a chair, but this procedure leaves
her very weak and she must rest for a long while after.
Cousin Bill Tiede has returned from Williams Lake for a few days and just got back from
the hospital. He has found mother to be a lot thinner from two weeks ago, but said that she ate a little more lunch
today, which is a good sign.
James is with her now. I have taken a break today, staying home nursing a cold that I
do not want to chance with a visit.
Friday, Mar. 2/2001; 6:00 a.m.:
- Mom appears to be gaining more strength but she still eats only tiny portions of her
meals and continues to breath with oxygen. I saw her cardiologist last evening, Dr. Gailey, who told me that if
they can get mom strong enough to walk around the ward corridors a couple of times, they will send her home to
continue her recovery.
Mom started the day Thursday in a somewhat confused and fearful manner, however her spirits
were good when I left her last night, and she was quite calm and O.K. with me leaving her early (6:15 p.m.) for
the rest of the night.
Sunday, Mar. 4/2001:
- Mom is improving, and can now have visitors, besides family. Many of her local friends
are dropping by and today, Doreen Foth, a long time friend and Air Canada flight attendant, just in for the day
from Winnipeg, stopped in for a short visit.
Mom's blood pressure has come up a bit, however she continues to tire easily and she is
sometimes confused. She tried to get out of bed during the night and fell to the floor. Luckily, she was not hurt.
Her heart is still only pumping at about 20 per cent, and she will have to gain more strength before she is allowed
to come home. When she does, she will need constant care for some time. The angioplasty procedure will only be
considered in about one month.
I expect to remain in Vancouver for as long as it takes... perhaps a month or more. Cousin
Bill Tiede headed back to Williams Lake for a few weeks, and Kurt and Jan Tiede (mom's sister) are returning to
Medicine Hat on Monday.
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Thursday, Mar. 8/2001:
- How the day seems to fly by and I wonder what we have accomplished. And how the scene
with mother changes too from day to day. In general she remains very weak and is still not eating much, although
James and I had her up walking about 20 steps this evening.
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- As of today, here's the new game plan from the cardiologist team of Gailey and Ornstein:
Mom will stay in the Richmond Hospital for at least one more week until a "viability
study" can be done at Vancouver General Hospital.
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- This is a nuclear exam to determine if the heart muscle is dead or only dormant (remembering
that it is only working at about 20 per cent capacity). If the muscle can be rejuvenated then an angioplasty (the
balloon thing) will be considered. If this is not feasible and the heart muscle cannot be revived, then mom will
be turned back over to her family doctor, Roy Brown, and future steps will be taken, such as home care, long term
care, nursing home, etc. So we are still hopeful.
If nothing else, mom will come out of the exam radio active so we will be able to save energy
on lights... ;-)
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- As for the early part of the week...
On Monday, cardiologist, Dr. Teddy Ornstein suggested that mom was not improving much, but
was stable enough and might as well be at home as at the hospital. We (family) were concerned about this possibility
because we did not feel at all equipped to be able to look after mom at home. She would require constant, some
medical attention and what to do in an emergency? In fact, the next day Tuesday, the nurses tried to walk her to
the bathroom and she collapsed in exhaustion.
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- By Wednesday, I had scheduled a meeting with Dr. Ornstein so I could express my concerns
about bringing mom home too early, and also trying to come up with a solution to get her eating. To my surprise,
Dr. Ornstein agreed that mom was indeed too weak to be allowed to come home. She further advised that mom will
stay in the Richmond Hospital for at least one more week until a "viability study" can be done.
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- And just when we were on a bit of a high from the new proposed treatment, James called
to tell me that during his noon day shift with mom, she started to have shortness of breath and chest pains. He
called the nurse and mom was put on oxygen once again... so like the earthquake that hit last week, we wondered...
is this "the big one?"
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Saturday, Mar.17/2001: St. Paddy's Day!
Well hallelujah, after about seven weeks -- Mom's
coming home on Monday! ...and there's lots to report. (Hard to believe that James and I have been out here for
almost five weeks :(
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- Mom's condition is still pretty weak. She did start getting up and walking for very short
distances this week, but had a few falls during the night shifts. Even after little activity she has to rest for
long periods from exhaustion. She will require 24/7 care so James and I will remain for at least another two-three
weeks to get her into a home routine, along with home/nursing assistance.
We will have to assess her progress and see if she is able to cope or if she will need
long-term nursing (residence?) care. In reality mom is still at risk and the best/only advice from the doctor is
if anything happens call 911 and get her back into the hospital.
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- There was some confusion last weekend about the location of the "viability study", the test for viable heart muscle... to check
the blood flow. We thought it would be done at Vancouver General Hospital, downtown, but turns out it was done
at the Richmond Hospital. This is only the third time it was done here... so it didn't inspire a whole lot of confidence...
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- Monday, Mar. 12/2001:
There was some delay in starting the test this morning because the radio-active isotope had
to be flown out from the east and it sat at Vancouver airport for some time before being delivered.
This nuclear exam requires an injection then two scans about three to four hours apart.
The results now are somewhat inconclusive, but it appears that mom's heart is so damaged that only about one-quarter
of it is functioning. It is not likely that anything else can be done, however the heart team has scheduled one
more test for March 27 -- an FDG scan which is similar and which apparently measures the heart cells for glucose
intake, etc. There is still a slim possibility of angioplasty.
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Wednesday, Mar.14/2001:
- Mom is still not eating much... so a gastro-something is called in and he (Dr. Marty
Fishman) orders an upper barium scan for today.
We are unaware that the day starts off badly for mother. An elderly patient across the
room dies at about 5:30 a.m. and the three other patients sharing the room are quite shaken. It sets mom's moods
from fear to anger to downright unpleasant by day's end.
The barium test goes well but indicates that mom's upper stomach muscle is loose, allowing
acids to back up, probably causing the nausea and even some of the pain she has been feeling.
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Friday, Mar.16/2001:
- A meeting scheduled for today with heart specialist Dr. Teddy Ornstein, the nursing supervisor
and two members of the social services (home care/nursing care), concludes that mom is medically stable (no recurring
heart failure) and that she should be discharged on Monday.
James and I know that the next few weeks will be challenging, so we are spending the weekend preparing the apartment
for accessibility. We have ordered a walker and a wheelchair and will spend the first few days of the week meeting
with the home care and nursing care experts to set up medication and physiotherapy schedules.
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Saturday, Mar.17/2001:
Tonight we are celebrating St. Patrick's day at a local Boston Pizza, but we have to
bring out own green colouring for the beer... and green olives for the pizza. Can you imagine? ...they only serve
black/ripe olives out here! And, Allan T., no bloody Keith's!
The evening is highlighted with the company of an old friend, Alan Scott and his 14-year-old
son Kengi. Al's wife Fumio is off in Japan, sadly, looking after her own ailing father who is going through the
same heart illness as mother. But the evening is brightened with our visit and with James' ever ubiquitous humour
and impressions. He/we are becoming quite well known at Boston and it has become our favoured hangout when time
permits.
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Monday, Mar.19/2001:
- After 37 days, mom is discharged from Richmond Hospital. Earlier in the morning I pick
up several pieces of equipment from the Red Cross, including a wheelchair and walker. Once she is settled in her
own home, I have her prescriptions filled... about 15 to 20 pills a day, costing about $185. Luckily this is mostly
covered by medical insurance.
James and I are not too happy about mom's release because we have been with her constantly
for five weeks and see her condition on a day to day basis. We really feel she should be hospitalized but know
that having her home may greatly improve her outlook and help her to gain her strength by being in familiar surroundings.
The first night gives us an indication of things to come and the work involved. Starting
at about 10 p.m. mom has to get up about once an hour. She has to do so with assistance. At around 1 a.m. she is
just able to make it back to the bed from the bathroom, a distance of about 15 feet. She is exhausted and gasping
for breath and it takes nearly 15 minutes to calm her by holding her upright on the edge of the bed. I am waiting
for pain (angina)to set in and the need for nitro or the possibility of calling an ambulance, but apart from a
fairly sleepless night, there are no further incidents.
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Tuesday, Mar.20/2001:
- A relatively quiet day as we three (mom, James and I) settle into the home routine of
meals, medication, mending and minding. The Richmond Health Services (RHS) community health nurse, Shaheen Sunderani
makes her first visit. Mom's blood pressure is a bit low but her pulse is strong and regular. Aunt Ida Sicotte
makes her daily phone call from Kimberley, B.C. and Cousin Judy Fredeen calls from Medicine Hat, Alberta.
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- Wednesday, Mar.21/2001: Ambulance
called! Not a good day...
- The day starts off reasonably well. Mom has had a quiet night and eats a bit of breakfast.
I beetle off to the red Cross again, this time to pick up a toilet support... one doesn't realize what it takes
to make a home disabled accessible and the hassles it takes to get assistance.
When I return, Michele Becker, RHS occupational therapist is there for her assessment
of mom's ambulatory needs. She takes one look at mother and tells James that mom is not well and should be in hospital.
Shortly afterwards, Cathy Gordon, RHS physio-therapist comes by to set up a schedule to assist mom in physical
exercise.
While the initial assessments are being done, mom begins to have difficulty breathing
and is experiencing chest pains. She is given a spray of nitroglycerine under her tongue. She then has to use the
washroom but cannot make it back to her bed and is being held up an comforted in a sitting position on a makeup
salon stool. Based on the cardiologists instructions, the prescribed doses and frequency of nitroglycerine are
administered, but do not seem to help... mom's condition worsens.
I decide it is time to call for an ambulance... my first time for a 911 call.
- The Richmond Fire Department rescue squad arrives first... three members.
- The BC Ambulance Service arrives with two crews of two and three persons, respectively.
- So with James and I and the two RHS workers, we now have 12 people trying to slide past
each other throughout the apartment.
(Where's the camera, when you need it!)
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- When the ambulance stretcher is brought in, it is too wide to fit into where mom is located
so she is transferred onto the gurney in the bedroom/hallway entrance then moved into the main apartment hallway
where she is given oxygen and her vital signs are monitored by a portable unit. The information is relayed to the
emergency room doctor via cell phone and the ambulance attendant asks for permission to start an intravenous and
start some medication(?).
- The hallway is blocked by the stretcher and about six ambulance and rescue personnel.
Some of the tenants must go around by taking the end of hall stairs... and while this emergent activity is going
before us a neighbour and distant relative comes down from three floors above and matter-of-factly gives us a fresh
loaf of of home-baked bread, just as if we were exchanging the morning paper at the breakfast table. "Thanks,
but I think she'd rather have the oxygen," I said.
It's an eight minute walk to the hospital. James and I meet the ambulance there. It will
take some time to process the paper work and get mom settled. She is doing O.K. especially with the oxygen, so
we go across the street to an Irish pub (The Foggy Dew) for lunch.
After a few short visits with mom, we leave her to rest for most of the day and await
more information from the emergency staff. In the interim we get a few phone calls:
- Monique, from Ottawa
- Uncle Phil Poulin from Belleville, Ontario
- Aunt Jan Tiede from Medicine Hat, Ab
- Aunt Ida Sicotte from Kimberley, B.C.
- Cousin Bill Tiede, from his son Curtis' in Saskatoon, Sask.
We are hoping that mother will remain in the hospital, but incredibly we are called at 9:05
p.m. "Your mother has been discharged, come and pick her up."
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Thursday, Mar.22/2001: Another tough day for mom...
- Mom has a restful, uneventful night at home and because she is feeling better we decide
to keep our appointment at the Vancouver General Hospital (VGH), where a special Fluoro-2-Deoxy-D-Glucose (FDG)
spect imaging test will be conducted... it is an "evaluation of patients with prior myocardial infarction"
(heart failure)... basically a radioactive, before and after scan, to measure the the intake of glucose into the
heart cells, to determine the damage of the heart muscle and to see if enough cells are alive in order to try and
rejuvenate the heart through angioplasty.
We already know that close to 75 per cent of mom's heart is not working and that it is
only pumping at around 20 per cent of capacity.
This test, we learn is not approved in Canada and is only done at the VGH, on an "experimental
basis". It has been going on for about three years and has had a very high success rate in determining heart
viability and getting patients back up to par.
We are concerned about having to drive mom the 45 minutes, but the test is important and
hard to book, and she appears psyched for the day. We arrive at 10:45 a.m. and after preliminary work, attempts
are made to insert two IVs into either arm. Mom's veins are virtually collapsed from all the previous times over
the past many weeks, and it takes special efforts to get them in. Eventually, a radioactive sugar (FDG) in injected
into the vein and a 45 minute waiting period before the first SPECT (?) scan.
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At 1 p.m. the scanning starts. The technique is quite simple but the hardest part is for
mom to hold her arms over her head for the 40 minutes it takes to complete the scan. At the same time, one of the
IVs fails so to keep up with the multi sugar-glucose readings that have to be taken through blood samples, mom's
little finger tips are pricked about 40 or 50 times throughout the afternoon.
3:40 p.m. - the second, comparison scan is started and again mom has to keep her arms
raised. With about 20 minutes to go, mom is starting to get very antsy and tired. James and I are called in to
the SPECT room to help mom... hold her arms and talk her through the last grueling minutes.
The staff here are admirable, especially coordinator nurse Cheryl Davies, nurse Craig
and technician Suhki
- 4:30 p.m. - We finally leave the hospital and naturally run into Vancouver going-home
rush hour traffic. Mom manages the trip home O.K. and to supplement the need to replenish her blood sugar supply
with something sweet, mom asks for her favourite... a hot fudge sundae!
As James is about to wheel mom up to her apartment, a lovely, young dark haired woman
with a tanned face comes up to ask for directions... but that is another story (which I will relate shortly). Mereille
is from Colombia... only three weeks in Canada... only six months married, and from a country where her father,
brother and uncle have all been killed by guerilla fighters.
Mom gets her hot fudge treat and is soon drifting off to sleep after a fatiguing endurance
testing day.
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Friday, Mar.23/2001: are we losing mother?
Mom passes a good night notwithstanding the awful day behind her. I return to the Red Cross to pick up a commode
as she is often too feeble to make it to the washroom. When I return, she is feeling nauseous and is experiencing
a burning pain when passing water.
I call Dr. Gailey to report on mom's condition. The good doctor will prescribe an anti-biotic
and also requests I pick up a plastic sample bottle for a specimen.
By 2 p.m. mom starts to look very bad. Her eyes are colourless and glazed over, her skin
has an unnatural pallor and she is drifting in and out of sleep. Her breathing is troubled and difficult and James
and I wonder if we are losing her.
I drive to Dr. Gailey's office. She herself is sick with a cold/flu bug and can hardly
talk. I brief her on mom's condition and besides the anti-biotic, she also prescribes a portion of liquid morphine
to help relieve the symptoms of pain for breathing. (Don't think a narcotic is easy to get in Vancouver!)
She also contacts the RHS and requests that a nurse come to look in on mother. Shaheen,
whom we know from before, comes by about 4 p.m.. Mom's signs are stabilizing. I spend the next several hours picking
up dropping off prescriptions, sample bottles, etc.
There is a problem with the way the morphine request is written, but thanks to the extra
effort put in by the Zellers pharmacists, Jeff Chan and Rebecca Leung (friends of mom), after about an hour of
trying, they locate Dr. Gailey to confirm the dosage and type.
I am whipped by this time, but James has a great supper waiting... smoked salmon, in a
bed of tomato and vegetable sauce rice. And... mom is doing better.
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Thursday, Mar.29/2001:
- Can't believe it has been almost two weeks since our last Web page update. I have sent
the odd e-mail note to family members but so much has happened since mom came home on Monday, March 19.
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- It has been a rough ten days. Mom did not at all fare well at home. Between two trips back to emergency by 911 ambulance, several anxious episodes
at home, and an excruciating day of testing at Vancouver General Hospital on Thursday, March 22, mom is back in
Richmond Hospital.
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- She is in the palliative care ward, but before anyone gets concerned, it may not be as
bad as it looks. I have started updating the week in chrono order, but after another long day (up since 4:30 a.m.)
I am stopping for the evening and will add more when I can.
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