Sunday, December 11, 2005

Miracles Do Happen

This past Monday, my mother had a heart attack. Long-time readers of NITA will remember that she is wheel-chair-bound after a major stroke in 1999, and was already fading. She was admitted to the ICU and faltered all through Tuesday and Wednesday. On Thursday morning, her doctor told my father to start calling the family, because she probably would not live through the day, and certainly not through the night.

When I got there Thursday morning, her blood pressure was wavering around 65 over 45. A Bi-PAP machine with supplemental oxygen was helping her breathe, but she was still gasping and struggling. At this point, we ran up against the hardest decisions we had ever faced. Mama left strict Do Not Rescucitate and no artificial life support orders. It was up to us to decide what that meant. A ventilator was definitely out, but what about the Bi-PAP? It was not forcing her to breathe, just giving an assist. Should we let them try dopamine to bring her blood pressure up? That is strictly a crisis-intervention measure for her, given the state of her circulatory system. Tough time, tough decisions. We decided to leave the Bi-PAP on and try the dopamine. Were we right? Who can tell. We did what we thought best.

A potential side-effect of dopamine is tachycardia, or accelerated heart beat. Unfortunately, we did not know this until Mama's heart rate went up to almost 150 beats per minute. For someone already weak and with a damaged heart, this was definitely a really bad turn of events. The ICU nurses kept adjusting dosages and got her heart rate down and blood pressure up, but she was in definite respiratory distress.

By 11 o'clock Thursday night, Mama's condition had actually stabilized. Her breathing was better, and her heart rate and blood pressure stayed at something at least resembling normal levels. The fact that she lived through the night was amazing in and of itself. The fact that she regained consciousness Friday morning and was able to respond to questions with head shakes or nods is nothing short of a miracle. I don't know what to think about her continuing improvement since then. Some things cannot be explained by science.

Anyone who witnesses the power of the human spirit cannot come away unchanged. To see a person challenge all odds and beat them, to see a person stand face to face with Death, spit in it's face, and dare it to do something about it, is one of life's most inspirational and wonder-ful moments. Anything is possible. Miracles actually happen. Almost any doctor or nurse can tell you about impossible things that happened, and people that lived in spite of, or perhaps to spite, their condition.

What happens from here, we don't know. She will probably go to the Medical Center of middle Georgia tomorrow for a heart catheterization so the doctor can evaluate the damage and start to make treatment plans. Right now, all I can do is walk in awe and wonder.


At 4:48 PM, Blogger Melly said...

Carter, I don't know what have drawn me to you again today, but I visited you in the morning, and now for some reason came back and found your new post.

I know that miracles happen and I cannot imagine what it must have been like to make the decisions you have, but I'm so happy to have read this post and I wish all the best to you, your family and especially to your mother.

(Can you tell from my writing that I'm excited just from reading your post? :)

Thanks for sharing.

At 6:27 PM, Blogger Jean said...

First, Carter, I'm glad you have good news to report at this time, and I hope things continue to go well for your mother.

Second, you decribe the situation that worries me most about my own instructions to my family about how to proceed with my care when I am unable to decide for myself. I have asked them not to keep me alive on a machine or take extra-ordinary measures, but how should they proceed in the situation you just had to struggle with? I trust my family (I've assigned responsibility for that decision to my husband and my mother, a geriatric nurse) will be able to wade through the decisions as well as you have in this instance.

At 10:26 PM, Blogger Carter said...

Thanks Melly. All good thoughts and prayers gratefully accepted.

Jean, you have to trust your family to do the right thing. Just make sure you have a Living Will on file at the local hospital and everybody has a copy. The best thing you can do is discuss it. What we discovered about this situation is that the complicating factors are the unwillingness to let go and quality of life. It's really tough to balance all those things under pressure. Knowing what Mama wants is the deciding factor. Doing it is what's hard. I'm damned glad it didn't come down to enforcing the DNR order. It would take me a long time to get over that.

At 4:50 PM, Blogger Jean said...

I've done all that. Local hospital translates to military medical records for me, but it works the same. In my case, nobody is likely to be physically there, making it both harder and easier. I'm in AL, subject to deployment anywhere; hubby is in TX, and Mom is in WI. But I've done the best I can.


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