Simple Ideas

Momus Updatus

Blogging | September 20, 2012

So we are a week or so into the latest ICU experience with my Mom. We had the “family call” with the medical team last Thursday. That was an ear opener for my brother George who to that point had been getting second hand news from my sister that indicated everything was improving day by day. My brother was in the post ICU phase mentally, trying to figure out where to go from here.

But once we got direct access to the medical team and the brothers were able to ask questions, it became clear what the real situation was. By way of an analogy, here is the deal. You take your car into the shop with a blown engine. The mechanic can’t get the engine fixed, but while he is not fixing the engine, he fixes the headlights, the shocks and get the car detailed for you. In truth, the car is “better” every day. But the central problem is not improving. That was the gist of the call.

The problem started with a broken ankle. How did the ankle break? Good question, but only one viable answer. The only time Mom attempts to walk is to the bathroom or to the doctors. So it was one or the other. She has a huge amount of weight bearing on not the best of joints. Snap. So she went in to have it fixed. Bad break requiring surgery. Surgery involved morphine. Morphine put her into respiratory failure. Then her kidneys shut down. Fluid filled her lungs. With zero kidney function, no fluids were leaving. This was not a sustainable proposition.

With all this going on, the only option was to put her on a ventilator. The problem with that is, you only get about 2 weeks until the complications of the ventilator kick in and those add to the laundry list of problems the medical team is dealing with. So once it became apparent to me the key problem was the fluid in the lungs, I realized there was no point having any other discussions about “the path forward”. If the lungs don’t clear, there is no path forward. That took about 5 minutes. I tend to get to the point. That can be annoying to people who make a life out of ignoring the point and focusing on the blurry stuff in the background. Which is where my sister comes in.

“Ok, I’d like to ask a pertinent question now.”

Really? There were no pertinent questions left, they fix the fluids in the lungs in a week or this is all doom and gloom. But we give our sister the floor.

“One of her siblings is concerned about a possible blood clot from the broken ankle…”

Really? This actually wasn’t a completely stupid question, but it was so far down the list that prefacing that with pertinent was about as pretentious as describing what I’m sure was Aunt Jean as a “sibling”.

The medical team explained that they are aware of the clot potential and have a management plan in place for that.

That whole interlude was a prime example of just what the problem is. This sister’s ability to ignore the 300 pound gorilla and focus on the 30 pound monkey. My mom does live with this sister. My Mom is on oxygen 24/7. My sister smokes in the house. My Mom’s primary health issue is that she is probably 2 to 2.5 times what her body weight should be. But let’s pretend that smoking around a person in respiratory distress is not a problem. And that avoiding the whole diet question is a good idea because how could that possibly be pertinent?

So there you have the update this week.

Well not quite. There is more. Or less. Mostly less. Since the group call where it became obvious that my sister was either feeding good news and skipping the bad, or just totally ignorant of the bad, the flow of information has dropped to zero. Now we have to insert agents into the rooms to get past the information hoarder. My niece visited on Sunday and we did get a visual update. But zero information on the medical condition. We didn’t send our best agent.

But there is now a signed document on the door that says the only person who gets medical information about the patient is my sister. Not cool. Way not cool. But it is what it is. There were four brother’s on the call. Virginia, Georgia, Nevada and California were our call in locations. We all exited the ghetto life. But our mom and sisters are still there. The apartment they live in now is, thankfully, not ghetto. But the mentality has never left the ghettos we grew up in.

In truth, my sister and her son have been the people that allowed my mom to live at “home” and be with her two dogs. From a mental health standpoint, that is huge. Mom is always in good spirits at home. But the fact that Mom is more than they can take care of is another of those 300 pound gorillas that people just want to ignore. True, Mom would not like being on a restricted diet and losing half her body weight. But in a 24/7 care facility, I think they would be apt to address that issue and actually give her a chance to regain some functionality. Rather than this continual decay and periodic bouts with the ICU.

The whole issue is this. It is “management by ignoring the problem”. That is exactly how ghetto’s get to be ghettos. Buildings don’t get maintenance. Over time they decay and rot. The streets are not maintained. The traffic lights don’t work. Dysfunction becomes so much a part of life, that you get to where the only things that seem pertinent are the trivia. You ignore the real issues because…that’s just how it is.

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