OldBroad is having surgery on Monday 4/6

Geez, Diana! Hope you did get a good night's sleep! Seems like the 'tough' genes are alive and kicking in your family! Glad your sister and mom are doing well and I hope they both settle into a smooth healing phase now.
 
wow, what a night. glad your Mom got the surgery she needed and hope to hear a good update soon.
 
I was just quickly catching up after a busy post-vacation week and came across this thread late.

First, @OldBroad congratulations on a successful surgery and welcome to a healthier you! Please make sure to stay hydrated!

I'm so sorry for you, @DianaCox and your families as what has happened with your mother must be incredibly worrisome and it is so hard to see people that you love suffer. I'm glad she is breathing independently and the surgical outcome was positive. I hope the rest of her recovery goes well and that she is comfortable.

Hang in there! It can only get better from here!
 
Oh my goodnes Diana, I did not get a chance to read this yet. I will hope and pray for your Moms recovery and wish you and your family my best wishes.Sis too...
 
Well, here I am. Not too much pain (thanks to meds and On-Q). Starting full liquids today. My mom's situation is on my mind, but I feel helpless to do anything to help. I'm really lucky that Diana is so knowledgeable and pro-active with Mom's health care team. I don't know what I would have done without her.

Rachael
 
I'm glad they got Mom into surgery before she perforated. That would have been an absolute disaster in someone as old and frail as she. And tough old bird indeed!
Open surgery isn't the end of the world and it sounds like there was no safe way to avoid it. She isn't going to be able to eat or drink for awhile, so make sure her nutritional status is assessed and that she gets TPN or PPN if she needs it as a short term measure.
Now get some rest yourself!
 
I have spoken to the ICU nurse and Mom's PACE doctor - she is still doing quite well. She is mentally still fuzzy on why she is in the ICU - she remembers that she was having pain, that she was at Manor Care after being in the hospital last week, but she can't retain the fact that she had surgery - the morphine must be doing its thing! They are dealing with some tachycardia (she has A-fib, plus her pain isn't 100% under control), but her other vitals are good, including BP, blood sugars and she is not needing oxygen.

I asked the doctor today how much Mom weighed - she had mentioned that she had been losing weight. The doctor responded "211 lbs" - and quickly added "but she's pumped full of fluids!" I responded that she had not been that small since her 30s, when she did an amphetamine (legal) starvation diet. It also was noted that she had lost over 25 lbs since December. While this is excellent for her diabetes, it probably also means she is not well nourished either - I'm going to mention drawing nutritional labs and administering TPN if needed. She needs a lot of protein to heal, in particular, especially with the diabetes and wound healing issues.

When I saw her a year ago, she was closer to 300 lbs. She has a great deal of redundant skin from weighing about 100 lbs more, and some lymphedema. Under all of that, if she weighs 211 now, she probably "really" weighs (bone, muscle, viscera) more like 150-160. Which means not a lot of reserves for someone who was 5'11" as a younger adult.
 
@OldBroad Glad to see you posting...now go sip, sip, sip, walk around the dining room table a few times, sip, sip sip, rest and repeat!

@DianaCox about a year before I was actually diagnosed with diabetes, I lost weight too...about 40 lbs. Turns out the reason is my body was literally starving. And while extreme thirst, frequent urination, etc are the more common symptoms, weight loss DOES happen. My A1C at diagnosis was running around 10. Fasting was in the mid to high 200's.

One would think losing weight is good for diabetes but it CAN be a signal that your system is truly messed up. http://www.endocrineweb.com/conditions/type-2-diabetes/type-2-diabetes-symptoms
 
OK, it has been quite a night and day for me, my sister and Mom.

FIRST: OldBroad is home already (sheesh - only two nights - and here I was telling her to not expect to do as well as *I* did, because I was SO much (7+ years) younger when I had my DS, more in shape, and my BMI was "only" 49 when I had my DS - and she's showing me up pretty badly already.

Mom became progressively more ill overnight. By the morning, it was clear she needed surgery - and she is in very poor health to start with. But her white count was increasing, as well as lactic acid, which indicated her bowel was dying, and we had no choice. Mom was out of it, so the doctors were calling me - I managed to get OldBroad in on the call with the surgeon, and we discussed Mom's wishes, and what they could find and what the could/would do. It was horrible. They didn't know what the cause of the obstruction was, and it could have even been (due to her diabetes) ischemia caused by a blood clot in the main artery serving her guts, and that would pretty much be it for her. Mom turned 83 last week - she is quite frail, considering that she has been MO or SMO or SSMO most of her life - at some points in time, nearly if not more than 400 lbs. (She was also 5'11" in her prime - I am the family midget at 5'5".) Because of her obesity, she has been living for years with type 2 diabetes, congestive heart failure, hypertension, hypercholesterolemia, cellulitis, and severe joint degeneration, as well as macular degeneration. (Yes, she was my dire warning that got me to the DS 12 years ago.)

But she's a tough old bird. After a desperate outreach to Dr. Elariny to tell him what was going on, and that I was worried the HMO my mother is getting her Medicare through was not going to have an in-network laparoscopic surgeon up to the task of doing surgery on our desperately ill mom, Dr.E reassured us that their surgeon was in fact excellent. So we agreed to give consent to the surgery, including intubation and colostomy if needed.

One glitch leading up to surgery (my sister might be reading this here for the first time, because I didn't tell her): there was some confusion regarding various messages left for the surgeon earlier in the morning, and he ended up calling me THREE TIMES after we gave our consent, including just before going into the OR to take care of her - he snipped at me that there was a message saying we had reconsidered (there was not!), and the OR nurse would not allow surgery to proceed until it was worked out - he started out by telling me with urgent annoyance that during the delay, Mom had started going downhill rapidly, and it was URGENT to get her into surgery right away - I was like - GET YOUR ASS IN THERE! And then repeated it for the OR nurse (who was just doing her job, of course).

Mom pulled through the surgery. She indeed had necrotic small bowel that required resection, which had been trapped in scar tissue/adhesions from prior surgeries (including a ventral hernia repair with mesh in 2007). But it was "only" six inches, and it had not perforated - on the other hand, there was so much scar tissue and mesh complicating the field, the surgeon had to convert to open. She has a new 6" incision, through the mesh.

The doctor initially told me she was sent to ICU on a ventilator, and probably would be on it until later tonight or tomorrow - OB and I had discussed that this was OK, and in fact Mom's PCP confirmed prior to the surgery that he had discussed with her (which she was still lucid and not in pain last Saturday) whether the DNR could be held in abeyance if she had to have surgery, and she had agreed.

Later this evening, I called ICU to see how she was doing, and was surprised to hear she had already been extubated, and was resting comfortably with morphine and NO oxygen! The ICU nurse said she was doing really well. Perhaps, when she recuperates, she will be better than she has been for a long time, as the source of her belly pain should be gone.

What a wild, emotional day. I will note without further comment for now that my adult daughter and my husband's adult daughter chose yesterday to have major crises as well that had to be dealt with. And I had multiple work issues to deal with today. I think this is going to require a glass of port before bed to wind down before bed, even though I only had about 3 hours of broken up sleep last night.

I think I would have two glasses of port...hell, maybe the whole bottle! So glad your mothers surgery went well and that @OldBroad is home and doing well.
When it rains it pours they say!
 
Omg Diana I can't believe everything happened all at once. Thank God you are strong enough to be there for everyone. Diana your sister is, Old broad, just how would I know someone who is spunky enough and picks a name like that would be related to you? Lol. Hoping your situation calms down soon!
 

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