Wednesday we drove out to my aunt’s farm. It was an overcast day, and Ma told me to take a jumper. I don’t get to the farm much, so I thought, maybe it’s cooler out there. I was hot in shorts and a tank top. Ma had long pants and a jumper on.
We arrived bearing some fairly solid iced finger buns which had been in the fridge at least six days, and the remnants of a barbecued chicken which had been uncovered in the fridge for at least four. Did I mention Ma was recovering from Salmonella? Thanks to the wonders of text messaging, my aunt was forewarned and thus armed with a fresh chicken roasting in the oven. The old one quietly disappeared.
We ate, I hung out with my cousin, we watched some coverage of the floods, we left. Ma looked peaky. She napped in the car. Overnight I could hear her coughing.
Thursday morning, back to the doctor, No, Doctor, I feel much better. My stools are normal. I feel fine. What about that arthritis in your finger, Ma? It came up overnight. It was red and swollen. No, no, that’s just my arthritis. But I will get my pills in a bubble pack after all. Hurrah! We’d been applying subtle pressure on this for a year. Off to the chemist with all the scripts. Walking up the ramp to the chemist she was breathless and we took it very very slowly. Come back and get them at three? Sure.
Lunch was scheduled with my mother. I thought Ma looked overtired. She insisted she was fine. I insisted it would not be rude of her to stay at home. That I would be fine on my own. She refused.
She ate a bit of soup. We stopped back at the chemist on the way home and picked up the bubble packed pills. We got home. I went to do some washing. She put on a coat and started peeling vegetables.
A coat?
My uncle fetched the thermometer. 38.9°. I grabbed us a bag of clothes and we headed for Emergency. Her first set of rigors started in the car.
The triage interview happened fast and then we sat in the waiting room. When the hallucinations started, we went straight through.
Fluid resus. IV antibiotics, complicated by allergies. I sat with her all night while her blood pressure swirled, her heart raced, and her body convulsed with rigors. She kept trying to send me home. I held her hand through the wild-eyed terrifying half hour that we all thought would kill her. I talked her through the hallucinations and the strange surrounds and the man who was screaming all the foul words down the hall. I talked to the Med Reg and to ICU. I held her hand through her “final indignity” of insertion of the urinary catheter, keeping her eyes on mine while we talked about the beach and old holidays. I bossed her around for the first time: We are not having this conversation; I am not going home until you are on a ward.
She stabilized, more or less, so they sent her to a ward rather than ICU. I went home and cancelled my flight and called my dad and my aunt. When my uncle woke up, he asked what I thought would have happened if we hadn’t been staying.
What would have happened? She would have put on another coat, and gone for a lie-down, and covered herself with all the blankets she could find. And when those rigors hit her and she was wild-eyed and thinking she would die, with her failing heart desperately trying to keep her brain alive, if she thought to call for help she’d have not been able to dial the numbers. There would have been no one to hold her hand. And that would have been how it ended.
Septic arthritis in the finger. Incontinence pads in the bedroom. Increased work of breathing. Intermittent fevers. Thermal flaming underwear. Intermittent confusion, query delirium. Those are the things I missed, even though I saw (most of) them.
The answer, med nerds, is severe sepsis. The bug was e.coli, origin UTI. It’s a damn scary thing to see in your 87-year-old grandma. Especially when she says she’s fine.
Free Air 