Mom in Hospital 11/22/2006

Thursday, Thanksgiving Day, November 23, 2006

Dear friends and family,

Two days have gone by without writing an update on mom. I apologize. Tuesday and sometimes Wednesday are both long days for me. But Jack went to see mom Tuesday afternoon and I went Wednesday afternoon.

Shana was mom's nurse Tuesday afternoon when Jack got there. Midgie is a little antsy and uncomfortable from pain and sedative medications being withdrawn over the last few days. Jack said the physical therapist came while he was there but only stayed a short time. I can interject a comment here after talking with Dr. Kahn Wednesday. The therapist are now to have only short sessions with her and trying to achieve her maximum range of motion in her limbs but not to the
point of making her sore. She can have tylenol and she is given this regularly and when needed.
Mom was not eating and or very little and we are addressing this and whether the CPA's are helping her with her meals. Jack called Tuesday night and gave Karen the update on mom.

I had planned to go early Wednesday and possibly visit some skilled nursing facilities but my job took me to Selma, not getting back to Bham until after lunch. I got there about 2:00pm and stayed until after 4:30pm and got to see Dr. Kahn. Katie was her nurse today and she told me overall mom was having a good day. She again had physical therapy, followed by a bath and a shampoo which her CPA said she enjoyed the warm cloth and warm rinse of her hair. I do not remember Wednesday's CPA but she has had mom several days and she is so loving and attentive and caring. The same goes for the RN's especially Katie, Shana, and even Michael, who having caring helped me (and Jack) with mom at every turn.

Mom was antsy and nervous but not in any pain! She settled down as I sat and talked to her about how well she was doing and Jeff and Jack have got you in their care, and we are taking care of everything. I ask her specific questions about how she felt, headache, leg ache, back ache, arm ache, and all came back with a NO. Katie apologized for torturing mom some today as the doctor needed blood drawn and she had tried twice in vain. She did not want mom stuck again so Dr. Kahn had been called and he was on his way.

Dr. Kahn, Katie and I got mom still and calm and i held her hand while Dr. Kahn inserted a needle vertically beneath his index finger on mom's wrist. Within no time, Katie had her three vials of samples. I talked to Dr. Kahn for a time afterwards and he feels mom might be well enough to move to a skilled nursing facility probably next Monday or Tuesday. He said her lungs are clean and much depends on the blood sample results.

When I left mom about 4:30pm, they had given her some tylenol. She was calmer and napping some so I told her bye, kissed her forehead and exited. I wish I could tell you better or more different news but her progress has been and most probably will be slow. How quickly she responds to rehab and can we do this comfortably is our primary condern. I talked to Bobbie this am and we are all pretty much on the same page with mom to now be as comfortable as possible and let's see if she can bounce back after an almost 4 week bout with pneumonia. Keep her in your prayers and I will try to do better in posting news....Sons Jeff and Jack

Nursing Home Rehab Search

Sunday November 19, 2006

Dear friends and loving family,

You have read my recounts of our mother, sister, grandmother, aunt, and most of all, the kind loving person to all she meets. Mom is still that persona! No matter how ill she may be, or how bad she may feel, she still wants you to know she love you and wants to know how you are? Is that not wonderful!

She has been in the hospital, Tuesday 11/21/2006 at 3:00am will be 3 weeks. That is 21 days in bed, 21 days with her infectious pneumonia and a minimum of visitors. This was our choice as mom's, knowing she would not want to expose you to something that would make you so very sick. Is that not the Midgie we all know and love? Jack and/or I am there everyday and calls to her nurses each day keep us up todate as to her welfare.

Saturday, Jack went to the hospital and mom was still about the same. But her temperature was up, about 100 degrees and they are treating this. We really thought we had the pneumonia on the ropes but this is still a factor. The feeding tube is keeping her caloric needs met for the most part, but this reduces her appetite and she is now reluctant to take any nurishment by mouth. Jack tried in vain, and I called later and the pm RN told me the same.

Karen and I spent the biggest part of Saturday morning visiting nursing/rehabilition centers here in and around this side of the mountain. We began at Shelby Ridge in Alabaster, off 31S, behind Shelby Baptist Hospital. We quickly learned that the marketing personel and administrative people we might have questions for are off on weekends. We did get to look at Shelby Ridge but did not get shown around but did talk to a couple leaving who have an 84 year old aunt in the rehab section. Bottom line, the retired nurse, rated this slighter higher than average, food just average, but commented this would be everywhere as that is her aunt main complaint. It is a fairly new facility, appears clean and the halls looked similar to Ashton Gables. Rebab is adequate working with her but she said "I am here everyday!" Nursing homes/rehabs, how much is done when we ARE NOT THERE?

We then went to Laurelton Nursing/Rehab on Hiway 95 in Alabaster. Both of these first mentioned facilities are about 9 miles from Ashton Gables. To get to this facility, look for highway 52 intersecting 31S in Alabaster, go about one mile to highway 95, turn left and Laureltons (formerly Briarcliff) is about 2 miles on the left. A nursing supervisor showed us all over Laureltons and it is big. It is an older nursing facility under new ownership and much inside is being updated as we speak. It offers all mom might need, but much like Meadowood, semi-private rooms in much of the facility. It offers some private rooms, depending on the patients needs. It has a dementia section where all the patients are brought into a common area (much like Meadowood) so they can observe and see to their needs and safety. Some of the rooms were small, and maybe room for one or two chairs but that is all. The bathrooms were clean but older. She gave us a good tour and held nothing back so we would not get any surprises should we move mom there.

The last facility we looked at was off data drive next to Telco where Laurie works. This is a Beverly facility as is Meadowood. We did get to tour by a nurse, an the halls were wide and appear clean but like the others, no carpet like at Ashton Gables. The rooms we saw were smaller than Ashton Gables and again more like a hospital atmosphere. We visited the eating and rehab area and were introduced to the activities director working with patients much like mom was at Ashton Gables. This facility is the closest of the 3 we visited! It is fairly new like Shelby Ridge. We did not talk to an objective person but this facility appears adequate for mom at first glance.

Sunday afternoon, Jack and Vicki called from Brookwood and mom is still not eating per the nursing assistant. I talked to Susan, mom's RN today, and she said mom was sleepy or sleeping and refusing to eat breakfast and Jack said lunch was there while he was talking to me and mom again was combative, refusing at every turn. Jack and Vicki are talking to the RN, RNA, and anyone else who can give us information on mom and give us an update as we speak. I'll pause and write more after Jack calls back!

I called Jack and they had just left the hospital. Mom is like I have said and again refusing to eat. They talked to Susan and she said mom is scheduled for PT on Monday and I have an appointment with mom's case worker early Monday morning at Brookwood. I plan to visit at least 2 (hopefully 4) other nursing/rehab facilities in Trussville, Bessemer, back to Alabaster and one in Hoover on 31S. We too have to make plans to get mom's things out of Ashton Gables targeting this next Saturday. If Karen and I can work it out, we plan to go to AG and pack up some things of mom's to make the move as easily as possible when it happens. Keep mom and all of her doctors and caregivers in your prayers.....Love from the Nutter/Northcutt families/Jeff

Midgie's OK, PEG Line Operation

November 13, 2006

Dear friends and family,

It is up at 4:30…well I tried to do 4:30am but my body said 5:00! Coffee, feed the cat, get shower, shave, partially dressed, get coffee, pet cat, find socks, get dressed, find light weight jacket, load up small laptop, get books, head out toward Brookwood Hospital. I got there right at 6:30, and they had already taken mom to surgery. Sorry, made coffee for Karen, left her a note in the bathroom and try to remember to call her and get her up!

Get there before she left, well I tied. I saw Michael, her RN but did not see the night nurse as they were already making shift changes and no one seemed to know exactly when she left? But I get info from Christy Harris that I need to talk to surgery and the lab and verbally again consent to this procedure for our Midgie. Christy soon brings me a copy to sign to make it official.

Mom came through things OK but sleepy big time. I brought my laptop to do some Zeigler work and thought I would answer a few questions about mom now. She is on two new heart medications Digoxin and Altrace, both to help her cardiac output. Currently the nurse practitioner said her heart is currently at 35% and 55% is normal and this she feels mom will attain when she wakes up from this operation.

The peg tube in her side will assist in making sure her medication and nutrition are sufficient to maintain and even gain some weight back. The physical therapist came in but again mom was too sleepy to do much good this am, so she said she would come back this afternoon. Michael is her nurse today and I saw Shana again from Sunday.
Both nurses are good with mom and attentive to her needs.

I wonder how long she is suppose to sleep after this surgery? The surgery was about 8:00am or so, and she came back from recovery at 9:45am. It is now 1:35pm and she is snoring away. I was hoping to be able to tell you she was alert and eating and making conversation but each time I try, I get put off. But I am not almost 92 years old! As long as it does not hurt her recovery, enjoy the nap mom. I will wing it filling in the blanks later.

Doctors of record.
Dr. Kahn is her GP or hospitalist here at Brookwood
Dr. Chapman is her cardiologist I have met.
Dr. Shaver was the internist and/or surgeon that did mom’s peg tube today.
Dr. Elliot is the cardiologist that saw her this past weekend.
Dr. Cohen is another cardiologist in this same group
Dr Goyal is another cardiologist in this same group.

I ate lunch at 12:45pm and mom is still sleeping. Michael and I tried to temp her with ice cream, but no such luck. Jack called about 2:30 and he was there by 3:00pm. We both tried several times to rouse mom but she would slip back into sleep without blinking an eye. The three of us talked and really believe she is still sleeping off the anesthesia and it may be tonight before she really wakes up. Mike would be there until 7:00pm and he would pass all our observations off to the 7:00pm to 7:00am nurse, I now know is Christy.

Jack and I told them to call either of us if we were needed and either or both would come back ASAP. He suggested calling the nurses station after 8:00pm giving mom a few more hours to get over this. I called at 8:10 and Jack called at 8:15! Christy got a double dose of the Nutter Brothers checking on her and Jack’s report was better than mine as Christy got mom roused up enough to tell her that her son’s were calling about her and wanted to know how she was.

Mom said (yawning) “But where are they?” Don’t go there! She tried to explain to mother she had been asleep 10 to 12 hours and I had spent the day and Jack was there also. Christy said she is now waking up and hopefully she can get a snack in with her medications for the night. It was a long day and this boy (as is Jack) heading for bed. Both of us have full days tomorrow and Jack said he will check on her tomorrow afternoon and I will probably just get to call.

Thanks for all the prayers and Jack, thank Kay from St. Marks who came by earlier in the day. She visited mom at Ashton Gables and here and has a thanks from all the Nutter/Northcutt family. Keep the cards, letters, and prayers coming in. I have 4 cards from friends and from 1st Presbyterian to deliver on my next visit. News at 11:00pm!
Love to all,
Sons Jeff and Jack

Midgie's Peg Surgery OK

November 13, 2006

Dear friends and family,

It is up at 4:30…well I tried to do 4:30am but my body said 5:00! Coffee, feed the cat, get shower, shave, partially dressed, get coffee, pet cat, find socks, get dressed, find light weight jacket, load up small laptop, get books, head out toward Brookwood Hospital. I got there right at 6:30, and they had already taken mom to surgery. Sorry, made coffee for Karen, left her a note in the bathroom and try to remember to call her and get her up!

Get there before she left, well I tied. I saw Michael, her RN but did not see the night nurse as they were already making shift changes and no one seemed to know exactly when she left? But I get info from Christy Harris that I need to talk to surgery and the lab and verbally again consent to this procedure for our Midgie. Christy soon brings me a copy to sign to make it official.

Mom came through things OK but sleepy big time. I brought my laptop to do some Zeigler work and thought I would answer a few questions about mom now. She is on two new heart medications Digoxin and Altrace, both to help her cardiac output. Currently the nurse practitioner said her heart is currently at 35% and 55% is normal and this she feels mom will attain when she wakes up from this operation.

The peg tube in her side will assist in making sure her medication and nutrition are sufficient to maintain and even gain some weight back. The physical therapist came in but again mom was too sleepy to do much good this am, so she said she would come back this afternoon. Michael is her nurse today and I saw Shana again from Sunday.
Both nurses are good with mom and attentive to her needs.

I wonder how long she is suppose to sleep after this surgery? The surgery was about 8:00am or so, and she came back from recovery at 9:45am. It is now 1:35pm and she is snoring away. I was hoping to be able to tell you she was alert and eating and making conversation but each time I try, I get put off. But I am not almost 92 years old! As long as it does not hurt her recovery, enjoy the nap mom. I will wing it filling in the blanks later.

Doctors of record.
Dr. Kahn is her GP or hospitalist here at Brookwood
Dr. Chapman is her cardiologist I have met.
Dr. Shaver was the internist and/or surgeon that did mom’s peg tube today.
Dr. Elliot is the cardiologist that saw her this past weekend.
Dr. Cohen is another cardiologist in this same group
Dr Goyal is another cardiologist in this same group.

I ate lunch at 12:45pm and mom is still sleeping. Michael and I tried to temp her with ice cream, but no such luck. Jack called about 2:30 and he was there by 3:00pm. We both tried several times to rouse mom but she would slip back into sleep without blinking an eye. The three of us talked and really believe she is still sleeping off the anesthesia and it may be tonight before she really wakes up. Mike would be there until 7:00pm and he would pass all our observations off to the 7:00pm to 7:00am nurse, I now know is Christy.

Jack and I told them to call either of us if we were needed and either or both would come back ASAP. He suggested calling the nurses station after 8:00pm giving mom a few more hours to get over this. I called at 8:10 and Jack called at 8:15! Christy got a double dose of the Nutter Brothers checking on her and Jack’s report was better than mine as Christy got mom roused up enough to tell her that her son’s were calling about her and wanted to know how she was.

Mom said (yawning) “But where are they?” Don’t go there! She tried to explain to mother she had been asleep 10 to 12 hours and I had spent the day and Jack was there also. Christy said she is now waking up and hopefully she can get a snack in with her medications for the night. It was a long day and this boy (as is Jack) heading for bed. Both of us have full days tomorrow and Jack said he will check on her tomorrow afternoon and I will probably just get to call.

Thanks for all the prayers and Jack, thank Kay from St. Marks who came by earlier in the day. She visited mom at Ashton Gables and here and has a thanks from all the Nutter/Northcutt family. Keep the cards, letters, and prayers coming in. I have 4 cards from friends and from 1st Presbyterian to deliver on my next visit. News at 11:00pm!
Love to all,
Sons Jeff and Jack

Midgie at Brookwood Hospital, B'ham, AL

http://www.christie.nhs.uk/patientinfo/booklets/TextBooklets
/picc/picc.htm
************Original Message***********
November 6, 2006: 9:45pm

Dear friends and family,

Midgie is OK! But I am sitting in my living room trying to put into words 7
hours in Brookwood hospital. Someone said be brief, be brief Jeff. So let's
cut to the chase and start with the end.

Mom is now is a private room in the same unit. Her room is now #103. They
came and told me as soon as I got there that the lab test revealed a resistant
type bug that does not or has not responded to the medications they have given
her. And this is contagious! The culture came back "MRSA" which means they have to use more higher powers Rx to kill this pneumonia bug she has.

Her private room is now next to the nurses station and away from most of the
other residents. I also was told mom would need a PICC (Peipherial Intravenous
Central Catheter) line and they needed my signature to do this surgical
procedure. So I helped mom with lunch and dinner and she ate about 20% of her
lunch but almost 1/2 her dinner. They told me the procedure would be about 2:
30pm and I felt mom would be far more comfortable with me there. 5:00pm and no
procedure.

Shortly after mom finished dinner, the RN came and told me the techs were on the
way to put in the PICC line. Two young ladies came and I asked if they wanted
and/or needed me to stay. Once I explained mom situation, they encouraged me
to stay and help keeping her calm and to help make her understand what was
happening. I did!

Two hours later, mom now has a PICC line in her left arm. What was supposed to
take <1 hour took almost 2 hours. The difficulty was moms neck is narrow and
she has had neck/back surgeries that make rotation of her head and neck
somewhat restricted. They could get in the line in so far then it would stop
or not make the downward turn into the vein next to the heart. This is line is
necessary as the IV mom needs now would 'burn up' a vein in her arrm or hand
everyday and this makes resticking her to give her medication or fluids
unnecessary.

It was a long and trying day for mom but she came through with flying colors.
I guess one thing about dementia, she does not or will not remember this, but I
will. They ask me if I was squeamish or if the sign of blood bothered me? I
am a guy and do you think I am going to tell them YES.

Mom was fairly comfortable when I left shortly after 7:00 tonight. I told her
either I or Jack would be back tomorrow so she kissed me on the cheek and told
me good night. Randy Kesler (1st Pres., Bessemer) was there shortly after I got
there at noon and we had prayer together with mom. Thanks Randy!

I know I have left out a lot of things out but this has been a trying day. Keep
mom in your prayers and I will try to keep each abreast of any changes. Love
you all, and had so many email replies tonight. Mom may not really appreciate
them but we (I) do! Love,,,Son Jeff