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My husband and I were headed down the back roads to Crazyville following a week of unending phone calls at all times of the day and night from a woman, unrecognizable at times, who repeatedly told me she was my mother and secret calls from my father, a man with a booming voice that filled a room, now speaking in whispers, broken, tired and scared.  It was Saturday, September 15, 2007, eight days following their appointment with their family doctor.

I was exhausted and we still had over 30 miles before we would arrive.  I dreaded the moment we would walk in that house.  She had broken me.  Every hour was filled with drama.  As soon as I would hang up, Mom would call again pleading one moment, screaming the next claiming Dad was stealing her pills, accusing us of colluding to keep her from her nightly drink, her medications and swearing on her life that dad was abusing her by pretending to give her the pills as posted on the pill chart but in actuality was stealing them for himself.  She had placed numerous calls daily to her family doctor begging for help.  Dad had spoken to the doctor and was completely lost.  His world was collapsing in on him and he had little strength to continue.  We were coming as reinforcements–to help him–to help her.

My cell phone rang and my hands shook as I answered—caller ID confirmed it was coming from my parents’ home.  Dad’s voice cracked as he responded to my “hello.”  “They just took your mom and honey, she wasn’t breathing.  I think she had a stroke.  I think your momma is gone.”  Stop.  Think.  Ask the right questions.

“Dad, who took mom?”

“The ambulance.  I was in the garage and when I came into the house, she was lying on the ground and she wasn’t breathing.  I think she fell out of the chair and her neck was bent and she may have hit her head on the corner of the wall.  Her arm was still attached to the table.  I can’t drive, can you pick me up?  Where are you?”

“We are about 25 minutes away Dad.  We will come and get you.  Where did they take her?  What did the paramedics say?”

“They said that they got her to take a breath and put oxygen on her and told me they would be taking her to St. Mary’s ER.”

“Be ready, Dad.  We will be there as soon as we can.”

I found it difficult to find my voice.  It was coming out of my mouth but I didn’t recognize it.  Adrenaline pouring into my bloodstream so quickly that I could feel my eyelashes on my cheeks when I blinked and wondered if I had just lost my mother.  My husband started to pass an 18 wheeler on this back-road two lane highway and I shouted for him to get back in his own lane.  “Pearblossom Highway is called ‘Death Alley’ for a reason,” I shrieked.  By damned, I was going to get to my father and safely take him to the hospital.  I honestly felt in my soul that he would die if we didn’t show up to help him.

We pulled into their driveway and he met us at the door.  I ran past him to use the facilities and told him to go on out to the car and I would lock up and put their dog inside.  We were back on the road to the hospital within 3 minutes of our arrival.  Dad repeated the story we had heard but filled in a few details.  She had peed herself and he had cleaned it up before the ambulance arrived because he didn’t want her to be embarrassed.  Dad had gathered all of her medications and had given them to the ambulance driver.  I swallowed all emotional responses and went on auto-pilot.  I questioned him on every minute detail from the time they awoke to the time the ambulance pulled out of the driveway.  I knew that when we arrived, if she was still alive, my job was just beginning.

We poured through the ER doors and I headed to find my mother.  They told me that she was talking and was in bed 3.  It was just past the admission desk and it was empty—no bed, only a table with a bag of pills.  Another nurse indicated that she had been taken for testing and would return.  We could wait outside.  I declined her suggestion, sent Dad and my husband out to the waiting area and I sat down in a chair near the spot where her bed had been.  And then she appeared, sitting upright in a bed talking with the attendants.  She was beautiful and laughing.  She spotted me and turned and told the technician, “That’s my daughter, Debi.”  And turning to me she asked, “What are you doing here?”  She seemed at peace with her world.  No rantings, just concern etched on her face for me.  I must have looked like hell, because she became immediately concerned about me.  Then she asked about Dad and my husband.  It was so surreal.

A young doctor approached the bed and I introduced myself.  He then told me that he had no idea what had happened, “perhaps she hit her head,” but she did not have a stroke.  She did, however, have a dislocated shoulder and they would be putting it back into place but wanted to observe her for awhile.  He then said we could take her own in a few hours.  He left.  I immediately went to the waiting room, informed Dad and my husband of the miracle and headed back in with both of them.  The roller coaster of emotions Dad had been on led me to suggest that my husband take him back to the waiting room and I would monitor mom in the confined area of the ER.  She had no memory of any events except she continued to say she thought it was evening and she could see herself being taken out of their home on a gurney.  The nurse came and took a history and as I gathered her bag of pills, it was apparent that someone had ‘lifted’ the Vicodin.  They had recorded the Vicodin coming in with her, but it was no where to be found.  I wasn’t surprised but it bothered me.

I sat and found myself speaking to my mom.  Not the woman that had called dozens of times during the past week, but Mom.  She was smiling….she was beautiful….she was alive.  After we had been there for about an hour, she started to turn her head and her eyes rolled back, her teeth clinched and her facial muscles became taunt changing the actual structure of her face.  Her left arm was holding the rails of the bed and she started flopping and twisting. I knew she was having a seizure and screamed for help.  Two assistants wandered over as I watched my mom’s lips turning blue.  They continued talking about what they were going to do later that evening and one shook mom’s toe.  She continued to flail as the seizure continued to overtake her.  I screamed at the two imbeciles to get a doctor.  “NOW!” I shouted.  The doctor  heard me and came over on his own.

He asked me a number of questions about her seizure history (none) and what I had observed.  I told him I observed her not breathing and she still hadn’t taken a breath–a few minutes seemed like hours. He called her name.  He shook her.  He used his knuckles on her chest and then he hit her and she took a breath.  She was back but out of it.  He then quickly explained that she had suffered a “tonic-clonic” seizure (one we would have referred to as grand mal) and that she was “postictal” (the state of disorientation following a seizure of this kind) and he wanted to try to set her dislocated shoulder while she was basically unaware of what was happening around her.  He attempted to set the arm and broke it.  I heard the snap and he indicated that this was “bad,” and then left to order another x-ray.  As she came around, the pain was enormous.  They sedated her with morphine and an anti-seizure medication.  Instead of sending her home as originally indicated, he informed me that he was looking for a doctor to admit her for observation given the seizure and shoulder issues.

Mom was admitted late Saturday afternoon.  She was completely out of it and all of us looked like we had been through the ‘wringer’ as mom would have said had she been conscious.  But she wasn’t.  We took Dad home and went back early in the a.m.   We were told she had a peaceful evening but she was still so sedated she hadn’t spoken to anyone.  Dad spoke with her orthopedist who arrived as soon as I had left her bedside for my only 15 minute break of the day.  I saw him talking to dad and examining mom from afar.  She was unconscious but he proclaimed that her shoulder looked good and the break was a chip that would float around and eventually attach itself–most importantly, it was “nothing to worry about.  I see nothing that would indicate that she needs any surgery or physical therapy.”

He left and my husband came and took my father to lunch.  I was alone with mom when a woman in blue jeans accompanied by two young boys entered the room.  She had long hair and it was pulled back in a pony-tail.  I figured she had the wrong room.  She went up and started talking to my mother (mom was still unconscious) and the children stood at the foot of the bed looking on.  I asked if I could help her.  She glanced up from her black notebook and informed me in a very unfriendly manner, that she was Dr. McKinney and that Christine was her patient.

If sparks can fly between two people, we just set the room on fire.  I testily told her I was Christine’s daughter, the daughter who had spoken with her on the phone on September 7, 2007.  I then told her she could stop talking to my mother because they had her so sedated she couldn’t speak.  I was terribly offended by the children in the room although I didn’t verbally express it, my body language was a ‘tell.’  Who were they?  They were NOT family.  I mentioned that they might be more comfortable outside and she explained that HER patients liked when her sons visited.  But then she turned and told them to wait in the hall.

I told her what had happened from the time dad called to the visit a while ago by the orthopedist.  She told me she would be adjusting mom’s medications, ordering an attendant to sit with her at night (in case she was ‘sun-downing’ or agitated as she had been prior to the stroke-that wasn’t), and that she had ordered an anti-psychotic for her the night before and thought that might be the reason for her current condition.  She couldn’t explain the seizure I had witnessed, the initial stroke-that wasn’t, but indicated that she had contacted mom’s neurologist and that I should speak with him.  She stated that she was mystified but he should be able to help us fully understand her mental condition.  She told me that Dr. Chow was an excellent orthopedist and that mom was in good hands.

Throughout the next two days, Mom’s arm was taken in and out of its brace by the nursing staff and aides for just about every reason except allowing her to use the restroom.  They told her to “pee yourself.  You are wearing a diaper, just pee!!”  This caused not only terrible consternation to mom but later, became a major issue, like when potty-training a child.   As a nurse told me later, once you give them permission, it is hard to take it away.  I questioned the removal of her brace and they indicated that the orthopedist had not placed any restrictions on the removal and would have, had it been of any import.  Mom’s mental state deteriorated more each day.  She was angry and shouted at everyone.  She looked and acted witch-like, her voice shrill and her anger palpable.  Her roommates were all moved after short periods of time because of her incessant rantings.  I was thrilled to meet her neurologist on the evening of her second day and was told that he was sending her home and she would remain on anti-psychotics and many of her past drugs, would need oxygen, would need to quit smoking and was currently on a nicotine patch, had ordered an EEG and would speak to me about the results at our first post-hospitalization office visit.  I thought he said he was “going to the opera.”  It may have been the outfit.  He flew in dressed like a character out of a Lon Chaney movie—with a tuxedo and cape like outfit—and flew out.

The EEG turned into a nightmare, taking twice as long, because of mom’s agitation and inability to stop talking.  The nursing staff seemed relieved that she was being discharged.  I questioned whether she was ready for discharge citing her personality changes.  They indicated “doctor’s orders.”   She screamed for pain medication claiming she had pain “everywhere” but I was informed that they could not administer any on the day of release.  Instead, I would be getting her prescriptions.  She screamed for hours of the pain.  She spit on aides that tried to touch her and her eyes were no longer focused and she acted like a caged animal that was trying to escape. They told me that it was her ‘mind.’  She was suffering some break with reality.  Everyone that entered her room for the first time would utter:  “Is she always like this?”  “NO!”  I repeatedly told everyone that this “wasn’t my mother.”  It landed on deaf ears.  I was repeatedly told her pain was in “her head.”  They would check her chart and tell me she was on anti-psychotics and that this might help.  Maybe.

The discharge nurse was attending a meeting so another named ‘Rainbow’ discharged mom.  Mom screamed of her pain all the way to our car.  It was just Dad and Mom and me.  I had driven my husband home and returned the night before.  Mom’s last words to the nurse’s aide were, “If you send me home, I will die.”  The nurse’s aide began to cry and asked me if it was just Dad and I to take care of her.  I shook my head in the affirmative and she asked God to take care of us.

A home-visitation nurse came to the house but after looking around and taking a history, left without doing much else.  Others came and went, sometimes taking her vitals, sometimes not and some to explain equipment that was being dropped off.  A woman would come by once or twice a week and offer Mom a bath.  Mom would rant that she didn’t need a bath and dad wasn’t really keen on this slightly disheveled woman who wore a “Gilligan’s hat”  either.  Her husband would sit in the car.  It was weird, creepy and everyone was on edge.

Dad looked like something the dog dug up.  He had aged years in a matter of weeks.  Mom could no longer smoke as she was on oxygen and would rage at him that she smelled cigarettes on him and wanted one.  After smoking for 60 plus years, my father went cold turkey and borrowing some of her nicotine patches, handed over several cartons for us to ‘donate.’  “Those cost more than gold.  Don’t you dare throw them away,” Dad told my husband.  My husband gave them to our “bum-friend Dave” that loved the Lakers and lived in an alley near our local post office.  He smoked some–and used the rest to barter for cheap liquor and food.  We told dad and he smiled—first time in a month.

The next 3 weeks consisted of around the clock care by dad and I (with a four day visit by my sister who never returned and made it clear that this was simply too much for her to deal with) that can only be described as a trip into the bowels of Hell.  I explained during a deposition that my mother had fallen into Alice’s rabbit hole and came up in another place.  The house was never quiet.  The alarm monitoring the oxygen was continually going off as she refused to wear the nose cannula and would toss the 50 foot of cord aside as she made her way down the hall with her walker.  Mom was either moaning, ranting, raging or begging us to kill her and get “it over with.”  One afternoon, when she had screamed herself to exhaustion, she laid on her bed and fell asleep.  I quietly laid down on the other side of the bed staring at her face.  It was beautiful and so peaceful.  Less than an hour later, she open her eyes and softly spoke my name.  “Debi….where’s your dad?”  “He’s in the living room taking a nap, Mom.”  She was so calm.  “Sweetie, I had the weirdest dream.  I dreamed that my arm was way across the bed and the only thing holding it onto my body was my skin.”  And then she smiled.  A tired, sweet smile.  “It’s okay Momma, it was only a dream.”  Then she attempted to sit up and whatever peace was ours for an hour, was gone.  She fell back into the rabbit hole.

One theme that she never let go was the repeated cries that we were trying to kill her.  She would throw things with her left arm and the most distressing character change was that she no longer had any filters.  We took her to repeated doctors’ visits where she lashed out and insulted people about their weight, their smells, their nationality, their clothes—anything and everything that popped into her head, came out of her mouth.  I had never heard my mother in my entire life speak an unkind word to another.  Now this was her ‘new normal.’  We went to her family doctor on two occasions and the doctor came to the car to examine her as mom was unable or refused to get out of the car claiming she was in too much pain.  Her neurologist informed us that she had epilepsy.

On October 4, 2007, her orthopedist, after keeping us waiting two hours, sent us away to obtain x-rays and told me to tie a dish cloth or a piece of gauze around her arm and neck as she was now refusing to wear the brace.  She begged him for pain medication.  He told her she had enough pain medication. She had covered her body in little white patches that she placed all over, including her genitals.  They looked to be the patches that one gets over-the-counter for sprains.  She hovered in a corner and begged.  I told him we would get the x-ray and be right back.  He stopped me in my tracks with his response.

He told me he was too busy to review the x-rays and would see her next week before he was scheduled to leave on vacation.  He had a lobby full of sweaty teens with broken bones and the waiting room was 100 plus degrees because his air conditioner had broken.  Everyone was edgy but the mothers in the room looked at me with pity and several spoke as dad left to take  mom to the car.  They told me to go immediately and get the x-ray–that the place would be empty (and it was) and they all had stories about relatives with mental illnesses.

I took mom for the x-ray, received a CD and returned to their home.  From that time until the time I drove her to a mental institution was a blur.  I wrote letters begging for her neurologist and family doctor to help.  I called everyone in the Valley to help.  I told them what I was told.  “She had lost herself.”  “She was mentally ill” and then I told each person that I spoke with that my mother had disappeared into this shell that was now peeing in coffee cans in the living room.

“She will never live on her own again.”

“Your mom needs around the clock care.”

She has entered a new phase of Alzheimer’s and the mother you knew is gone.”

“You aren’t equipped to take care of her.”

“She needs a lock-down facility.” “She needs a lock-down facility.”  “She needs a lock-down facility.”

“Dad, we need to talk.  Momma isn’t ‘coming back.’  I know you promised each other that you’d never put the other in a ‘nut house,’ but she’s no longer the person you made that promise to.  No, Papa, we can’t take Mollie.  She’s too big and she needs medications and she needs a big yard and lots of time–and we have none of that to give her.  I will find a no-kill shelter, a farm, someone who can take good care of her.  We need to take care of momma.  We need to sell your house.  You don’t have long-term care insurance and Medicare doesn’t cover this.  I’ll call a realtor.  What a god-awful time to be selling–we’ll be lucky if we can sell it at all.  Don’t worry dad, we’ll take a second on our house.  You can move in with us—it’s all about Momma, now.”

After calling dozens of people on Monday and Tuesday, October 8th and 9th, 2007, I was thrown a lifeline by the Encino-Tarzana psychiatric hospital with a lock-down mental ward.  I was told to bring her in—they would send an ambulance if needed–that she was now a danger to herself and others, including dad and me.  She had also hidden a handgun.  God help us.

The admission was horrific—they took her screaming down the hall—“Don’t do this to me,” all the while claiming she wasn’t crazy.  I drove dad immediately back to Crazyville as we had left their large dog locked in the house.  By the time we arrived my phone was ringing and it was an orthopedic doctor that had been retained by her admitting neuro-psychiatrist.  He indicated that upon Mom’s initial exam, the psychiatrist had immediately noticed that her arm was out of socket.  He indicated that he, personally, could visually see the deformity and her TB x-ray prominently showed the dislocation.

I told him of our visit the prior week with Dr. Chow and asked if she had been attacked by any of the locked down patients.  He said he had no knowledge of any attack but that her arm would need immediate surgery and that successful healing would depend on when it had slipped out of joint.  I told him I had brought the CD of her x-rays taken at her last visit with the orthopedist on the 4th and had left it with the intake personnel during her admission.  He called me back after his review of the x-rays.  He said he had “bad news.”  Mom’s arm had never been set.  It had floated and attached itself to her clavicle and that there was terrible damage to her ligaments, tendons and muscles.  He didn’t sound like he had much hope for saving her arm, but minimally, he was willing to try and he was scheduling surgery for the earliest possible time.

“Dad.  Mom needs surgery.  Now.”

“This isn’t good, is it, baby?”

“No Dad, it isn’t.  Get Mollie, her cage, her food, her medications.  Get your medications, clothes and don’t forget your hearing aids, batteries and C-Pap machine.”  We are headed home.  Momma needs us.  The surgeon will be meeting with us tonight.”

PART IV to be continued.

[The x-ray was taken on October 4, 2007, 11 minutes after leaving Dr. Stephen Chow’s office following mother’s ‘exam.’  It is clear, even to a layman, that the shoulder is dislocated and a large piece of bone is broken off and is floating in the area.  While we were unable to view this initially as it required a special viewer for the CD we were given, a report was sent to Dr. Chow by the radiologist shortly after these x-rays were taken.  Dr. Stephen Chow declared in his deposition that he did not see the report but did indicate that he suspected her arm was dislocated at the time he sent her home and rescheduled her appointment for the following week.]

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