At Mom's doctor's appointment yesterday, he told us that her ammonia level (from last Friday) was 243. That's up from 188. That's up from 190. It's supposed to be under 95. She spoke gibberish and had an ammonia-migraine at 180 in the past.
Her symptoms have been getting worse. The memory loss was down to minutes. Her speech is very stunted - she breaths for every word and stutters. She gets frustrated because she can't think of how to say the word she knows she means. She described (sort of) a disconnect between brain and mouth. She hasn't been able to understand the simplest things, or take her meds right, or control her mood swings. She gets lost as soon as she walks 30 feet or turns a corner.
Her primary care doctor is a moron and I've thrown in the towel on him and his staff. His staff has always been disappointing, but this time, he lost my respect. I don't know why he won't do anything about this, so I can't possibly understand what I don't know. He has the power to put her in a hospital for treatment and won't use it. She doesn't understand what's going on, doesn't understand why she'd need to be in a hospital, doesn't understand that this could kill her very very soon, and doesn't understand the treatment she'd have to perform if she had stayed home (thus, she wouldn't have actually taken the medication to get better and would've slipped into a coma).
I had a crisis of morality. Of faith. I could not, in good conscious, drive her home with coma as her fate. I could not just pretend this was fine. I was nauseas with the idea of it, and the fear that she's so close to coma and that I knew I couldn't get her help in our area. I didn't know what to do. Our EMT's don't know what this is, don't know the signs, and don't have a baseline for her behavior to determine if it's "her normal" or not. I called her hepatologist's office, which was closed, but spoke to his colleague on call. He spoke with Mom. He told her to go to the hospital, and she told him how scary that was for her. She's terrified of hospitals, of the lack of pain medication, of the uncomfortable beds, and for some reason she strongly believes that things happen there that don't. I won't be descriptive, but it's stuff that happens if you're abducted by aliens; not hospital staff. I knew she wouldn't go unless I forced her, and I knew that once the doctors in the ER spoke with her or saw her, they'd keep her. No good doctor would let her walk out with ammonia that high and constant confusion.
So I drove to the hospital. She was crying and trying to convince the doctor on the phone that she would be fine at home or that they would do bad things to her in the hospital. And that she would miss her dogs. We've already been through all this; the bargaining ("I'll go if it gets worse"...but she never does), the threats ("if you make me go I'll never forgive you!"), the guilt trips ("you just want me to die, that's why you're taking me"). She is so afraid and so ill that she doesn't believe this can kill her, and today. So I drove.
And I texted our family friend, who's mother had this illness. She met us at the hospital and, for the majority of the time, was able to keep Mom calm. She pretty much bashed me the entire time ("no loving daughter would do this"), but at least she bashed me to someone else and didn't feel obligated to listen to it. And I wasn't alone, and neither was Mom. I am SO grateful that she was there!
We got there at 7 pm. They were drawing blood, ordering CT scans and x-rays, and trying to find her a room upstairs when I left at 7 this morning. I got home around 8, fed the zoo, and attempted to take a nap. Mom called me, demanding to know why I "stole her keys out of her purse". I got gas in her car on Tuesday, and the keys had been sitting on the bar the entire time, but she doesn't recall. She always thinks they are in her purse, even if nobody put them there. So I must've stolen them. I tried explaining this to her, but she didn't comprehend, and kept crying and screaming at me and demanding to know when I got into her purse to steal them. I'm up now, I'm packing a comfort bag for her, and I'll head out as soon as I eat something. It's been 14 hours since I've eaten. She still believes I did this for fun. I know she'll never understand or agree with it. I know she'll always think I took her to the hospital just to cause her pain. Even after they clear her system and get her levels back down, she'll still believe the delusions she's building now (she still thinks I kept her handcuffed to a hospital bed in our basement with my aunt....but we don't even have a basement and my aunt lives across the country, and I don't have handcuffs...she knows it was a hallucination caused by meds but she has never trusted me since). But I had to do something to help her. I know she doesn't want to die now, and this is what needed to be done to prevent that.
The doctors are doing what they can for her, and I'll try to update when I know more. Obviously that will entirely depend on the circumstances and where I am. I don't tend to blog at Mom's hospital bedside. Prayers and good vibes are welcome and I hope everybody had a better Halloween than we did.
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