Another Source of Infection (with Fever)

Mom remained in the hospital on this day in 2014, as she still had a fever. We thought, initially, that her cellulitis contributed to her fever. But, her medical history since her diagnosis indicated that, perhaps, she required a new stent in her bile duct for bile removal, and that "guess" was correct.They changed her stent while she remained in bed, with hopes that she would return home within a few days. This was on a Thursday, so if she wasn't released by Friday or Saturday, we'd have to wait until Monday as the hospital didn't release patients on Sundays.

I noted in a Facebook post that mom was "a little loopy" over the past 24 hours. I learned over time that when mom developed a fever, she became totally irrational and mean. Dad couldn't handle it, but I had some practice, as that's how she would treat me when I was a child when dad wasn't around. If you have questions about why I would help mom in the last stages of her life in light of this information, it was because I did it for dad. When mom ran a fever, he froze like a deer in headlights in the face of her behavior.

Crash and Burning Up

Today in 2014, my mother was still in the hospital. We were hoping to take her home that day and get her set up with hospice, but after all she went through yesterday she was depressed. She had crashed.

It didn't help that she had developed a fever, probably from the cellulitis infection. On top of it all, she was refusing to eat.

I could tell I was angry, as that's the only inkling I had of what happened that day. Otherwise, I might have been more forthcoming about mom's condition. Looking back, I know I would have had the same feelings she had, but I knew then and I know now that half of what she was going through she brought on herself. She never was a person to give in gracefully to people trying to help her.

Even today, I become angry with her foolishness when I remember her behaviors, but I also have had enough therapy to know that she was who she was, and it was her life. No matter what I would hope for, she would make sure it wouldn't happen. That was the most difficult side of her competitiveness with me that I endured.

Photo: Canva.

Hospital, Hospitalist, and Hospice

Today in 2014 was a long and stressful day, with our hopes of mom returning home from the hospital shattered by the hospitalist. All of mom's specialists had released her, and dad and I were hoping to pick mom up about noon. But then we heard from the hospitalist. He took one look at mom's legs and refused to sign her release. She had developed cellulitis, and a return home without treatment would have spelled disaster.

I had mentioned the other day about how I was trained by mom's home health care on how to massage mom's legs, ankles, and feet to help relieve some of the fluid build-up pressure. Not only did this practice help relieve some of her discomfort, but I could also look for open sores, scratches, or other issues that would allow bacteria to enter and cause an infection. When this happens, cellulitis can develop. Left untreated, the infection can spread to the lymph nodes and bloodstream and rapidly become life-threatening.

Mom didn't allow me to massage her legs in the hospital, and that refusal turned into more days in a bed away from home. Her weak immune system and arterial issues, along with pressure of fluid build-up against her skin had taken its toll, and now she had an infection that was very dangerous, as in her condition cellulitis could lead to septic shock. What was difficult to hear was that now that she had that condition, it could occur again often and very quickly without keeping watch over her legs.

The image shown here is not of my other's condition (in fact, it looks like ringworm), but her cellulitis patches looked just like this--something that might be easily overlooked. I carry so much gratitude for the hospitalist who saw several of these patches and knew it for what it was. That cream was also in mom's future, as I was later designated as mom's "cellulitis watch", and I applied the cream to her wounds as well as massaged her legs and cut her tonails and did a number of other chores that helped her keep infections at bay.

After meeting with the hospitalist, we also agreed that, perhaps, mom needed to sign up for hospice. Of course, that didn't sit well with mom, either, as it was one more step toward acknowledging that she had a terminal illness. I remember meeting in the hallway with dad, the hospitalist, and a specialist who was called in to look at mom's legs. We decided the best way to handle the situation was to tell mom that dad and I couldn't administer the intravenous antibiotic mom required to treat her cellulitis. The nurses from hospice could, however.

The people we met from hospice (Centra) were wonderful. They helped mom to understand they would be better than her current visits from Home Health Care, because they had staff who could work with her port (which was installed in 2013 before her first chemo treatments), as well as the antibiotics. If she chose hospice, the hospitalist added, she could return home in one or two days as opposed to another week in the hospital bed.

I can see that whole scene clearly even today. With everyone surrounding her bed and taking turns talking to her, it reminded me of an intervention...and it was, truly. We only wanted what was best for mom, and I think she got that message. I wrote that she was in good spirits at the end. Dad and I were less optimistic. Events were cascading, and it made us feel as though the end was very near.

Fortunately, we were wrong.

The oncologist and the cardiologist agreed that chemo wasn't an option at the moment, as those treatments aggravated her heart. We could only guess at what those treatments were doing to her one kidney. While a few friends and even her oncologist were concerned that gaining hospice meant losing chemo treatments down the road if her health improved somewhat, their fears were unfounded. As hospice explained, the chemo would be for palliative care, not for a cure.

That was another harsh reality.

Through it all, mom held up. When we left the hospital, she had a smile on her face. The only hint as to how she really felt was when she asked that we refer to hospice as "dad's help." That way, the use of palliative care wouldn't seem so hopeless for her.

Catching Up With Myself

I didn't see any journal entries or other information about my mother for this week in 2013 or 2014 until this morning when I delved deeper into items I saved in various folders. I found a couple notes that I want to post here so I don't forget them when it comes time to edit this whole shebang.

On January 4th, 2014, I had a sneezing cold, so I couldln't visit mom in the hospital. I think I caught the cold when we were admitting her, so staying away probably was more for my benefit than hers. I did mention that I had masks, which was an unusual thing to have before 2020.

Also on that date I was more specific as to my mother's definition of pain. I wrote, "It appears "pain" is long-term constant hurting. "Hurting" is temporary until it becomes "pain." So when my mother's doctors asked her if she was in pain, she always responded in the negative. No one bothered to ask her if she was hurting.

I said it before, and I'll say it again. My mother could be difficult. When I learned the difference between the two words for her, it made it easier for the doctors to understand. When they would ask my mother if she was in pain and she would say no, I'd look at the doctor and say, "Now, ask her if she's hurting." My interjection would anger my mother, but it helped her in the long run.

Another thing that didn't help mom was the lack of communication among her specialists. At that time, we didn't have "MyChart" or any other way to deal with multiple specialists viewing what other specialists had discovered. I was my mother's advocate, and I would inform each specialist about my mother's health history between her visits to the oncologist, the cardiologist, and the nephrologist.

Being my mother's advocate was a lesson in many things, but the main thing I learned was to love myself first. If I didn't feel loved, then I couldn't deal with my mother. She disliked having to depend upon me, too, but she did.