An Update on Alma

For those of you who may not know, Alma was hospitalized Sunday evening for what we thought was an upper respiratory infection. But, since she is a kidney transplant patient, the ER doctor did not feel comfortable sending her home, so she was admitted.

Today was not a good day on several fronts. First, with Alma. She had absolutely no motor skills, could not pick up hands or legs, could not control her mouth to form words, her tongue like a thick piece of meat in her mouth, instead of an instrument for sound. She was extremely frustrated. Because she was having an ultrasound, she had no liquids overnight, but did not have any iv fluids, either! I found that unbelievable. Ice chips only.

When she left for the ultrasound, I left to go to the doctor, and Toni Redd Dyson was going to be there when she got back. I planned to go to the doctor, get medications, and go home and rest. Alma returned from the ultrasound, and was raising Cain because her blood sugar was in the 400’s, and they were not giving her nearly enough insulin to bring it down. Mind you, she couldn’t talk, couldn’t lift and hands or feet, but could make her point, nonetheless. So I came back to the hospital, without any rest, but with medication, and we began working this out.

The endocrinologist sent her to ICU for an insulin drip, but it took almost two hours for the transfer to take place. So two hours of extremely high and untreated blood sugar. To be fair, they had given her a few units of insulin, but not nearly enough to bring down 500 to 110. After she got to ICU, after two more hours of insulin by drip, it was only down to 330.

They also ordered an MRI for her, which finally took place about 6pm. They were checking for the possibility of a stroke. There is no way to measure the depth of Alma’s hatred for MRI machines. It’s not really hatred; it’s loathing. Is there a stronger word? Probably, but I can’t find it right now. Anyway, you get the idea. When the nurse told her, she distinctly rolled her eyes. The nurse just looked at me, and I said, “She rolled her eyes at you. She understands, even if she can’t say anything.”

I told the nurse they needed to give her a sedative before putting her in there, but the doctor hadn’t ordered it, so no sedative. When she wheeled her back into the room, Alma was sound asleep, and the nurse was laughing. She said Alma squirmed through the entire MRI, crying out for help. She had to go in and try to calm her down. Then, when they wheeled her out to bring her back to the room, she went fast alseep, and was still, of course.

They also had to put a foley catheter in. That was another eye roll from Alma. She may not be able to speak, but she still communicates!

We were very worried when the nurse tried to ask her some questions to see how confused she was. They have a word for this, but I can’t think of what it is. She asked her name, which she answered, very thick speech, but understandable, all the same. Then she asked her birth date. Alma fell asleep in that question, but when prompted again she said 1948, but could not come up with the month and year. Then she asked her what year it was. I think the way she worded it confused Alma, who answered again 1948. So, I said, “What year is this now?” She jerked her head over, glaring at me, and quite plainly said, “1948!”

About that time, the nephrologist came in, smiling, and said, “Let me try. Alma stick your tongue out at me,” Which she did quite willingingly. Then he asked her to close her eyes tightly, which she did. He said, “She’s fine. No deficits.”

He had been looking over her charts for a couple of hours, then came down to talk to us. He said, “I can tell you what’s wrong.” We just looked at him. He continued, “She’s dehydrated. They have given her no fluids since she got here Sunday evening, and she has progressly gotten worse, hasn’t she?” Toni and I looked at each other, and nodded. He then listened to her heart, and said, “She has a good strong heart.” He turned to the nurse, giving orders to push fluids all night. He said, “I really believe that will take care of the lethargy, the confusion and the weakness. Once she gets fluids, the kidney will begin to function normally again (maybe a little worse), but within normal range, and the liver will follow suit. She still has to have a foley, though, so we can measure output better.” I think I saw Alma stick her tongue out again.

We have been struggling all day, so worried that the worst would be coming true. I’ve spent most of the day on the verge of tears, probably due to my own exhaustion. I’ve been awake since Sunday morning, and it’s now Tuesday evening.

Now, there is still the gall bladder issue to deal with, which is the culprit that acerbated the infection which probably did begin with the upper respiratory infection. They will do an exploratory scope tomorrow to take a closer look at the gall bladder and surrounding organs. I’ll try to update then.