Thursday January 24^th, 2019

Maddie is cutting mom’s hair today at the salon. Its been snowing, and downtown is a mess. The streets are narrow with ice bumps and ice pot holes. I can’t find a parking spot beside or across from the salon but I think that someone is leaving further down the street, nope, they are going into the spot, so I make my way around the corner and find one. Should I park here or make my way around the block, to give it another go? I don’t want mom to have to walk too far, maybe I should just drop her off at the door. No, its not to far, we will take our time and make our way down the street.

I soon realize this is a mistake. The roads and sidewalks are terrible to walk on. Bumpy, narrow, and slippery. I’m afraid both of us will fly up in the air. We laugh a little about that. In my head, I hear the little old lady music that used to be on the Warner Brothers cartoons when the little old lady showed up usually on a Foghorn Leghorn episode. As we slowly make our way to the salon without breaking anything, something feels different today, more polarized, I feel more present somehow. Time feels slower, more precise.

We arrive at the salon and everyone there is so thrilled to see mom. Maddie gives her a big hug, Kearn makes her feel so welcome. She gets her hair did and is so happy. We’ve planned to go to meet up with Derek at Nordstrom today, hopefully catching him at his lunch hour, perhaps getting a bite together.

I get mom to wait at the salon while I make my way back to the car and bring it around to pick her up at the door. We are now on our way to Nordstrom at the Rideau Centre. Upon arriving, I figure we can park in the underground, find a spot pretty easily by the door, but soon realize I am on one of the lowest levels and that we will have to walk up quite a few stairs. Mom won’t hear of the elevator, she hates them, but says she will walk up. I don’t know about this and suggest that we re-park the car, but she won’t hear of it. I insist if that’s the case, we will walk up slowly and pause for a moment on each of the 3 landings. As we make our way up the stairs and then up the escalator to the second floor, we land in the beauty department at Nordstrom. As we walk into the department we are greeted by one of my son’s co-workers, Tina, at the same time my mother has a huge dizzy spell that almost knocks her off her feet. Strangely, walking beside her I can physically feel her dizzy spell as well. I grab her arms to prevent her from falling and with the help of Tina, we get her into a chair. Thinking she hadn’t eaten enough, as it’s always a challenge to get her to eat a decent-sized meal, it’s the same thing every time, “Oh, that’s way to much food Beverly.” “Honestly, it’s not enough to feed a budgie”, I would say. Surprisingly in only a few moments, she seems fine. While she is sitting and chatting with Tina, I call Derek, as he on his lunch already and upon explaining what happened to him, he heads back to the department. When he arrives he says, “For goodness sakes gram, are you ok? I’m only gone for a minute and you’re causing a sensation in the Beauty Department. ” We decide that it’s best to head home, so we take her back down to the car in the elevator, much to her dismay, and head home.

On the way back and when we arrive home, she says she feels fine and honestly, all seems ok. We have dinner, there is no more dizziness, we watch some Netflicks and being the night owl she is, she is in bed by midnight. I figure that I’ll call the doctors office on Monday to have them check her out.

Friday January 25^th, 2019

Friday is a like a day like any other, mom putters early in the morning and goes back to bed for more sleep. The afternoon is uneventful, as is the early evening, as we just spend time together. We go for a walk with the dog, make lunch, make dinner, do some outside work. We watch a movie, The Book Club, in the evening and at around 10ish mom says she wants to go to bed.

Since yesterday there has been no sign of another dizzy spell or any other symptoms of any kind. She gets herself ready for bed and closes her door for the night. About an hour or so later, I hear her coughing a bit and decide to check on her. She says she feels that her breathing is labored, but “she’s ok” she says. As she breathes I hear a sound, a deep gurgling sound. No, this is not right, there is definitely something wrong and a bit of panic sets in.

Calling for an ambulance might take a while, as we live in the country on the outskirts of Ottawa, about 40 minutes from the Queensway Carleton Hospital. So we decide to get her dressed, get her into the car and make are way to the hospital ourselves. As we make are way into the city, it is slowly getting worse.

We arrive at the hospital in Ottawa just short of 11pm, grab a wheel chair and make our way into the building. After explaining what has going on, they take her in immediately to the initial screening area, where more information is collected and vitals are taken. Within minutes she is then taken to a bed in emergency with Erika, as I fill out the rest of the paperwork. This is not a good sign.

The nurses immediately get to work to figure out what’s up. Within an hour, they tell us they believe she has what they would call “a big heart attack. One 100% blocked artery, 2 blocked at roughly 80% and a leaky valve. This was congestive heart failure, the gurgling I was hearing as she breathed was fluid in her lungs. It sounded like she was drowning.

Mom is now set up on the machinery necessary to drain the fluid off of her lungs, while the nurses and doctors get her ready to transport her to the Heart Institute where she would immediately be taken to the OR for surgery.

Over these hours, we make calls to let my husband, kids, and close family know what has happened. As it is late at night, the nurses in the ER rustle up some sandwiches from the kitchen for us. They are all so kind. We take turns sitting with mom, taking bathroom breaks, and sitting trying to get our brains caught up with what has happened in such a short time.

The transport arrives, with two lovely young fellas who will be driving mom to The Heart Institute. They tell us to follow them to the hospital and where to meet them. As it was late, we would have to get there at about the same time as they do, to enter the private entrance for ambulance drop-offs. Mom wants Erika and I to come in the ambulance with her, but the ENT’s said that it would be best if we followed them. Jokingly I said to mom, “you will be fine mom, you’re in great hands with these two. Just get them to put on some tunes in the truck on your way there.” One of the drivers said, “No worries Mrs. Brammer, but if you want to listen to country, we are going to have to have a talk”. We all had a bit of a laugh and she was ok with that. Off she went and so did we.

It’s 1 am now and we’ve missed them at the ambulance door and have to park behind the building and make our way around the front. It’s January, we’re freezing, it’s a massive campus, we’re carrying all her stuff, the walk seems endless, it’s really icy and we’re working on adrenaline, so I say to Erika, “we might need a couple of wheelchairs for the two of us by the time we make it around to the front.”

Inquiring at the counter, they send us to the Heart Institute where a Surgical Co-ordinator Nurse was waiting for us. As she explains what was going to happen, people start arriving through the front entrance, men, women, younger, older, backpacks, hoodies. I ask who they are, she explains that they are the team that will be operating to insert a stent to open the blocked artery.

This nurse was amazing. She sat with us for about an hour, then checking in with us regularly over the next hour. She comforted us as we cried, encouraged us to ask questions and did everything to calm and reassure us that mom was in good hands and she was. Prior to operating, the Cardiologist came out to introduce himself, meet with us and also explain what he would be doing. He was tall, handsome with beautiful long hair and his name was Dr. Dick. Mom would approve.

Not in my wildest dreams did it ever occur to me that my mother was having a heart attack. Nor did I expect that between the time that we left the house, arrive at one hospital, be diagnosed, transferred to the Heart Institute for surgery to have a stent installed, all in the space of 4 hours. Incredible.

My mother was 88 years old when this happened. She had a c-section giving birth to me, stitches once, and cataract surgery at 85. I went with her to Etobicoke General Hospital, when she went for eye surgery. While we were waiting to go in, the surgeon and the anesthesiologist were standing across the room staring at her. She didn’t notice, but I did and said “What?”. They both looked at me and looked at her and said, “She’s remarkable”. That she was for sure. She had only one medication for blood pressure that she was prescribed at age 80. An active person, over the years she walked about 4 miles a day, went to the Seniors Centre several times a week, to meet up for lunch with friends, take a yoga class, do furniture refinishing, line dancing, a computer class, and aerobics. She had never been seriously ill in her life.

So here we were, my daughter, Erika and I sitting there in the middle of the night waiting to hear news. Was she going to die? She couldn’t die, not now, not ever.

About an hour passed and the nurse came to us to let us know that the surgery was done. Dr. Dick soon followed to let us know that a stent had been put in and he was pleased with how everything went, but there were a few other issues with the heart that would need to be addressed at a later time. I broke down at this point, feeling so grateful, so overwhelmed, so thankful that he had done this for my mom. I asked him if I could give him a hug and he said, “of course.”

Mom was now in a private room for patients just out of surgery, 2^nd floor, the beginning of the journey of recovery for heart patients of her type. The nurses here are exceptional, they are kind, compassionate, and are the clear heads amidst the fog that surrounds the families and patients that are in their care. She had a thoracic catheter to basically siphon off any residual fluid from her lungs and is a little disoriented, but that is to be expected. The Nursing Coordinator tells us that she will remain in this unit until they are sure that things are stable. We visit for about an hour and then the nurse insists we head home for some much-needed rest and to come back in the morning.

It’s now about 6am as we make our way home. We don’t speak much in the car, we are both emotionally exhausted and in shock. Both of us just fall into bed.

The next day I make my way into the hospital, mom is coherent, strangely calm but baffled by what has happened, in her mind, she has always done all the right things, walked, exercised, and never been sick. Dr. Dick says to my mom, “Anne, many of my patients are athletes.”

We are now inundated by a variety of specialists, geriatric social workers of various kinds, nutritionists, nurses, and doctors. Everyone is wonderful, but quite frankly, it’s a lot. If I have one piece of advice to give families that have a loved one in the hospital, particularly if it is a sudden event if at all possible, take someone with you that is a little more removed from the situation emotionally. Someone who can bring you food, liquids and serve to hold space for you in this difficult situation, so you can be present for the person who has taken ill and interact with the medical staff to support the best interests of your person.

They continue to drain her lungs, monitor her recovery and she is improving everyday. One day a nurse mentions to us that they have noticed that mom has periods of confusion, disorientation and often repeats herself. She says that it is common for people of any age that have a heart attack to experience this, due to the shock and trauma associated with such a huge event. Almost like dementia symptoms, in most cases, it disappears but in some people, such an event can bring forward something that’s already present.

A week later mom is moved to a room on the 5th floor of the Heart Institute. This is the home stretch area for patients. This is where a patient’s medical team determines if a patient can go home, teach them about their condition and determine what if any home support is needed and if so, what kind. Mom continues to get better, but still gets disoriented and it is difficult for her to retain information, so I am delegated to take the training on her behalf. Yikes!

Her memory and anxiety levels still cause me a great deal of concern. On one occasion, she is moved to a different room on the 5th floor. When I arrive, whe is very upset at the fact that the side table in on the other side of the bed from last room. This is the second time the room layout has caused a great deal of distress for her. The first was at the Queensway Carleton Hospital when the room she was in was not square, it was angeled and she was so distressed about it.

I begin to realize that we are going to need help, if she is to come and be given the kind of care that is important to me. My family is outstanding, we all took turns sitting with her, navigating the care, relaying information to her, and helping her to understand what was going on, but we needed more help when the time came to come home. What we needed was someone neutral, to help us give her the care that she needed, to take over, so that we could rejuvenate ourselves. Ultimately, as an only child, I was responsible to regularly consult with my mom and then serve as the go-between hospital staff and her, and at the end of the day have some hard conversations and make some hard decisions that were in her best interest. That is a huge responsibility, that I gladly accepted, but it is draining.

Fortunately, from the time my mom entered hospital, everyday the first question out of the mouths of social workers, nurses and doctors was, “how are you?” Followed by marching orders for self care. I too, felt very well cared for. Truth is, you are at the hospital long days, even when it is your intention to only stay a few hours but inevitably the doctor is late and a family member is unable to come to take over. On this day, it was my plan was to arrive around 9 am and head home for an early night, hopefully around 3. Nope, that didn’t happen. It was 9 pm when I left the building.

As I walked to the parking lot I realized that there was no one to give me the keys to my car. They have a kind of valet service at the hospital so they can double park vehicles. I went back into the building and asked a lovely volunteer what to do. He told me they move the key rack over to the underground parking at 7pm. I’d have to walk a block or so to the underground. At this point, I dropped my bag on the floor and started to cry, at the same time saying, “I can’t do anymore today.” The poor man, bless his heart, said not to worry, “I’ll get someone to run them over to you.” To be clear, I’ve never done that in my life, but I was tired, really tired.

My advice, do your best to not let it go that far and if you are too tired, have someone who is good at reminding you, in person, by text, or phone. Be aware of your limits, someone that will hand you a drink and a sandwich, And, always factor in, that there is often something that comes up with others, so it’s up to you to be prepared. Many of us, including myself, forget to ask for help, someone to take over, but it’s important that you do because the more tired you are, haven’t eaten or taken a break, it is difficult to cope, let alone be there for someone in a positive capacity or make any important decisions.

The issue of mom’s memory has been brought up again, so I’ve asked her doctor if while she is still in hospital, would be possible to do a geriatric assessment. Although it means about a week longer stay for her, it might clarify more of her current condition, allow me to catch up on some much needed rest and prepare for her arrival home. I feel that this is the right thing to do for everyone’s sake. She agrees.

I tell mom that we are moving to a different room today, the last few days of stay until she can come home. She is pleased about the thought of coming home but would like that to be today. I tell her that her doctor wants to make sure that she is well enough to do so and that the doctor also wants me to get caught up on my sleep. She’s totally on board with that because she’s always telling me I do too much for her. This time I’ll listen and accept the help.

We make our way from the Heart Institute walking to the Geriatric floor at the Civic Hospital. Mom is in a wheelchair with a nurse and me loaded to the nines with all of mom’s flowers and gear. Upon arriving at her new room she is unhappy that she has two other roommates, insisting that dad’s coverage, which he paid into for years, was for a semi-private room.

A few days later, she finally settles in and begins to enjoy the company of her roommates. The week is relatively uneventful as they continue to observe and report in.