7-21-2022 Another bad time for Linda

(Tricia)

I should know by now that Linda's condition rarely stays good for long. As Marilyn mentioned, Linda's C.diff returned yet again Monday morning. We jumped on it with antibiotics (vancomycin), along with antidiarrheal and electrolyte drinks, as soon as we knew it had returned, but she was weakened almost immediately by dehydration.

And just as the meds started pushing the C.diff back, we had a seemingly small incident with chicken noodle soup that has turned out to be not-so-small at all. When Linda was in the hospital, the nurses and doctors were incredibly concerned about Linda's ability to swallow. They were afraid that she would accidentally get food or drink down the wrong pipe and into the lungs: aspiration. If you recall, they put her on "no food, no drink" protocols when they were concerned that she was having trouble swallowing. At the time, I thought they were being overly cautious, and Linda wanted to something to drink so badly. 

Well, that danger has now come to pass. When she was eating soup Tuesday night, some went down the wrong way, and it is now in her lungs. She is coughing, but it's not coming up, and there is an audible gurgle when she breathes. Aspiration is not good...at all. It can lead to aspiration pneumonia, and there's really not much to do for that except treat with something we have become far too familiar with--antibiotics--and hope it otherwise clears on its own.

The private duty nurse who is helping care for Linda is giving her Mucinex every four hours in the hope that it will trigger Linda to cough to clear her lungs. But if that doesn't work, I have been told by both the private duty nurse and hospice nurse that things can get bad quickly.

Right now, Linda is not doing well mentally--she is talking, but not making a lot of sense. And she is not eating well. I was so worried about the C.diff, but it very well might be the aspiration that we should have worried about the most. 

All this just before I finally had an appointment set for Linda with a primary care physician this Saturday (yes, he sees patients on Saturday!). It would have been her first time out of the house in three months, and I was so hoping to get her to someone who could help oversee her overall care, advise us on next steps, and even order some in-home physical therapy to keep Linda moving. Before the C.diff hit, she was doing so well that we were confident not only that she could make the trip to the doctor's and would be ready for some PT, but that she would soon be discharged from hospice.  

But at this point, I'm not sure she will be up for making that appointment--or leaving hospice. As usual, something intervenes just before we can get her to a point of taking a next step forward. The fact that, this time, that something was caused by chicken soup (of all things) is just surreal.

As you probably can tell, I'm incredibly disheartened. Linda is doing better than she was on Monday and Tuesday, but the aspiration is of extreme concern. All we can do is watch and wait and hope for the best. We should know more by tomorrow which way this is going to go.

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