Friday, October 28, 2005

Detective Work

The mystery began not with a dead body but with a scary wake-up call.
At 7:10 am Mom woke up yelling for help and vomiting the entire contents of her stomach.
Jona called me. Because I had gone to bed at 2 am, I was still sleeping when the cell phone rang. I lept out of bed and began to dress and rush down to Ocean View.
By 7:30 I arrived in her room and began the detective work. Jona had managed to clean her up and get her dressed. I knelt in front of Mom, looked at her, and held her hands, which were shaking uncontrollably.
Was she having an allergic reaction to food or medicine, as on June 14? That one nearly killed her.
Was she okay--just having a mildly upset stomach?
Was it a 24-hour flu, something going around Ocean View?
Was it the flu shot she had 36 hours earlier?
I remembered the pistachio nuts I had let her eat the night before, likely suspects for the allergic reaction theory. But then again she had also eaten a handful of orange and black M & M's I had put out in a dish for Halloween. Maybe it was just an upset stomach from eating too much sugar.
Jona reported that Maxine, the lead caregiver for the Reminiscence Neighborhood this morning, had come in to check on her, with Ogart, the caregiver to whom Mom was assigned. He rarely has to deal with her because she has "a private," Jona.
Maxine had taken her vitals: a blood pressure of 161/71, pulse of 56, and temperature of 97 degrees. They had concluded that this event did not warrant a trip to the ER.
Jona also reported that Mom had diarrhea. "Does this mean she is more sick or less sick?" I wondered.
When in doubt, I call everyone: my sister Emily; Suzann, the RN for Ocean View, who hadn't come in yet; Beth, the director of the Rem floor. I was about to call Dr. Susan C. to leave a message asking for advice when I ran into Ilona, a caregiver fixing breakfast in the kitchen.
"Oh yes," she said. "Ralph and Bob and Dorothy had this too, the next day after the flu shot."
It all made sense: these frail old people had been affected by the flu shot on Tuesday.
I went back to the room and talked a bit more with Mom and Jona. Emily had recommended 7-Up, toast, bananas, applesauce. Mom was refusing to eat anything. It didn't look good for even taking her meds this morning, so I talked with the medicine dispenser for the floor and we cancelled the big calcium pills and vitamins for the day. At lunch we would try her thyroid, and her Coumadin wasn't needed until 5 pm.
I went home at 9 am, and Mom got through the day pretty well with no more vomiting.
But in the evening a Monte Carlo Casino Night was scheduled: hors d'oevres, drinks, live music, and professionals with green felt tables to deal cards in games of chance. I wouldn't have gone, except that I had told Connie, Mom's evening caregiver, to come at 8 pm instead of 6 pm.
At 6:30 pm I put Mom's lipstick on and wheeled her down to the big party. She was feeling better and enjoyed the music and excitement at first.
She hadn't eaten all day, so I tried to put together a plate of crackers and some of the milder hor d'oeuvres. She tried both and said they made her feel sick, but she downed three chilled shrimp with no problem at all. I ate some of the hor d'oeuvres.
At the party, we consulted with another mother and daughter, who reported that her mother had vomited on Monday, prior to the flu shot. She had asked the staff whether others had been ill--was it a problem with something that came out of the kitchen?--and met with raised eyebrows. Apparently that was not a line of questioning one could safely pursue.
At 7:30 Mom was tired and insisted on returning to her room, so we left.
Connie arrived shortly thereafter, and I helped her with Mom's shower because Mom didn't feel good. I was half expecting her stomach to reject the shrimp at any minute. We discussed why the vomiting had occurred, and with the new evidence from the other daughter, I concluded that it must be a 24-hour flu going around. I left at 8 pm.
This afternoon, a day later, however, the truth emerged.
I was in the dining/kitchen area and asked Mom how she was feeling. She felt okay and had eaten normally today.
"She was vomiting yesterday," I mentioned to Marnie, the lead caregiver of the 2 - 10 pm shift.
"Yes, they all were," she said. "The cook was sick. He was vomiting earlier this week."
"Oh," I said.
Marnie's frankness stunned me. No coverup, nothing. I appreciated that.
Anyway, the whodunnit was solved. It was the cook and a flu that had already hit many of the residents.
By the way, I'm feeling sick to my stomach tonight, not eating dinner. I shouldn't have eaten those hors d'oeuvres--or did I get it from my mother?

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