Saturday, November 13, 2010

Who needs sleep anyway?

A week ago yesterday W was lucid, actually making plans with me for the winter projects. Then he took a fall in the bathroom, landing on the edge of the tub with his ribs, re-breaking or at least cracking one rib. I gave him a light supper, a pain pill along with his normal PM meds, and told him to rest. That's all you can do with ribs these days - they used to tape them, but not anymore for years. BTDT - so off to bed he went.

The next day I let him sleep in, only waking him to take his AM meds (breakfast Skittles he calls them). Later I finally woke him because 1) if he sleeps all day he will keep me awake all night and 2) I needed to go over the plan for Sunday. That was my first clue of the trouble brewing.

I explained simply and clearly that I had been invited to go on a bus trip to NYC with my friend G who drives tour buses - there were extra seats so she was told by the group to feel free to invite a couple friends. I was her first call and after a few seconds of deliberation (clean the floor or take a day off?) I accepted ;-)  There was plenty of easy food and drink for him to take care of himself for one day.

The problem is 1) he somehow got the idea that he was also invited (NOT!), 2) he couldn't quite get it through his head that he was staying home, 3) I was only going as a guest, not a back-up driver, and 4) that he needed to rest, and so did I. Three hours later he finally was able to parrot back to me the gist of the plan, and seemed content to spend a quiet Sunday resting and watching TV, or sitting in the sun outside (it was scheduled to be a really nice day). OK, it had been unusually difficult for him to get that straight but I thought we were OK. Next morning I was up super early - we had to meet at her house just after 6 in order to get to the bus depot in time. He woke and glibly parroted the game plan for me, took his pills and was asleep again before I made it out the door.

Fast forward to my return home just after 9PM. He asks, with tragic puppy-dog eyes, where the car had been all day and was I OK? I hadn't run away and left him? ZERO recollection of our discussion - nil, nada, nothing! It was mind bending!

The next few days and nights were sheer torture. He slept most of the day except for occasionally calling for me in a panic thinking I had abandoned him 'again'. He could not hold a coherent conversation, or even a single coherent thought, and it was getting worse. Then he kept me awake most of the nights. A couple nights it was just constant bathroom trips, another night he got diarrhea of the mouth - couldn't STFU even when he tried, then last night he got stuck at the bathroom door. He became fascinated by the shoe rack hanging from the closet door and seemed to want to climb it. I had to physically manhandle him into the bathroom, where, as often happened, nothing happened - another false alarm. :-(

The bathroom and my head were in about the same state of disarray by this morning, and I called the VA ER for advice. After chatting with an RN telling her what I had been observing, then answering a bunch of her questions it was determined he needed to be seen ASAP. The possibility was there that he had also hit his had in that fall, or suffered a TIA or another stroke Friday night, which theories could only be confirmed or discarded with tests. She was inclined to blame interaction between his meds and his beer, but better safe than sorry. I confirmed that making the trip would not be a problem - I had called to be sure my concerns were justified, she concurred, and she called ahead to let them know we were on our way.

Much to my surprise and relief he gave no argument, willingly got dressed in the sweats I provided for a comfortable ride (2 hours each way) and off we went. He dozed part of the time, muttered to himself, or tried to engage me in conversation, but between the road noise and his fuzzy thinking that fell apart quickly.

The consensus was that the efficacy of the new med they had started him on to replace a nasty liquid one he had hated was being wiped out by his beer drinking. The drinking, however light, wasn't doing his brain any favors and was wreaking still more havoc on his poor abused liver. He had already begun to accept that he needed to stop again...'but not just yet'. Now the choice is gone. He either stops all alcohol completely and forever, or lose his brain AND liver. Further, as a necessary evil, he is back on the yucky liquid until the nasties are cleared out of his blood and he can think again. He was good about that too - a sure sign of how far his faculties have been eroded. Once he starts feeling better, I warned the staff, he will begin to get very cranky - he hates being in the hospital! The speed with which the mental dysfunction had set in apparently was more a function of his injured body trying to heal and being incapable of simultaneously coping with that and the warfare between the meds and beer than due to any sudden surge in his intake - which there hadn't been.

So now we wait. He will be spending at least two nights in hospital, since he needs time under observation. Also, the 'real' staff is off on weekends, and they want to have him seen properly on Monday. That means I get two nights of uninterrupted sleep! No being wakened by crashes as he thrashes his way from bed to bathroom a dozen times, no having the blankets ripped off as he rolls over, no getting my mind abraded by mindless babble for hours. Just peace and quiet in the knowledge that he is safe... and there are folks who are being paid to see to it that he makes those dozen trips back and forth to the john safely, or, more likely, he'll be forced to use the portable plastic urinal unless he feels a BM coming on. Knowing him as well as I do I feel sorry for them, but that is why they get paid, rather than doing it for love. Nice folks on this ward - I hope they survive...

Sleep - what a concept. I think I'll give it a try real soon....

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