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ER sloppiness could have killed my mother...or saved her.
Old 11-10-2013, 10:18 PM   #1
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ER sloppiness could have killed my mother...or saved her.

My mom is nearly 80 and is an asthmatic and a 60+ year smoker. Until this week, she has not been diagnosed with COPD but I'm sure she has had it for awhile. For the last three years since she has moved to our apartment complex, I have watched her compensate for not being able to get adequate oxygen. She has been in massive denial about the long term effects of smoking but she is very stubborn and had been very healthy (other than asthma) for a person her age.

I recently earned my Florida teaching certificate and I have been subbing in several subjects in middle schools. My certification is in Mathematics. I contracted a really bad crud from the students which I think I passed to my mom even though I tried to keep away from her while I was sick.

It turned very dangerous for her when she got bronchitis (as it turned out) and was having trouble getting adequately oxygenated. We went to the ER on Sunday where she received a breathing treatment, a steroid shot, and a Z-pack. She refused a chest X-ray for which the purpose was to determine if she had pneumonia (which she didn't have).

We went to see her primary care doctor Monday afternoon after she relented late in the day when she was feeling worse (worse than she told me or I could discern). Mom asked for a nebulizer which her PC prescribed. She has never done home treatments or taken oxygen at home. The nebulizer was delivered to her apartment late Tuesday afternoon. I had picked up the nebulizer medication Monday night but she waited to do a treatment until I arrived after subbing on Tuesday afternoon. There was no improvement after the neblizer treatment and she was in great distress. A second trip to the ER.

The catastrophe started when the ER recorded one of her medications as 200 mg a day instead of 200 mg three times per day. Unfortunately, this was her baseline medication to control her asthma and keep her breathing well on a good day.

Later I will give more details of our 5-day stay in the hospital (her in a bed, me in a chair) but I'm too tired right now. We are home now and she is at Day 6 without a cigarette. She has never before spoken of quitting but she did while in the hospital after 3 days.

The f*** up with her medication could have killed her but the upside was it kept her in the hospital 2-3 days longer away from cigarettes so maybe it saved her life if it convinced her to quit smoking. We are at Day 1 back home with her not smoking.
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Old 11-10-2013, 10:31 PM   #2
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I'm sorry to hear about the medical error, Buckeye. They are all too common. I wish your mother well. Be aware that 60 years of addiction and tissue damage may be irreparable. Time for you to get some well earned rest now.
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Old 11-10-2013, 10:47 PM   #3
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Originally Posted by Buckeye View Post
My mom is nearly 80 and is an asthmatic and a 60+ year smoker. Until this week, she has not been diagnosed with COPD but I'm sure she has had it for awhile. For the last three years since she has moved to our apartment complex, I have watched her compensate for not being able to get adequate oxygen. She has been in massive denial about the long term effects of smoking but she is very stubborn and had been very healthy (other than asthma) for a person her age.

I recently earned my Florida teaching certificate and I have been subbing in several subjects in middle schools. My certification is in Mathematics. I contracted a really bad crud from the students which I think I passed to my mom even though I tried to keep away from her while I was sick.

It turned very dangerous for her when she got bronchitis (as it turned out) and was having trouble getting adequately oxygenated. We went to the ER on Sunday where she received a breathing treatment, a steroid shot, and a Z-pack. She refused a chest X-ray for which the purpose was to determine if she had pneumonia (which she didn't have).

We went to see her primary care doctor Monday afternoon after she relented late in the day when she was feeling worse (worse than she told me or I could discern). Mom asked for a nebulizer which her PC prescribed. She has never done home treatments or taken oxygen at home. The nebulizer was delivered to her apartment late Tuesday afternoon. I had picked up the nebulizer medication Monday night but she waited to do a treatment until I arrived after subbing on Tuesday afternoon. There was no improvement after the neblizer treatment and she was in great distress. A second trip to the ER.

The catastrophe started when the ER recorded one of her medications as 200 mg a day instead of 200 mg three times per day. Unfortunately, this was her baseline medication to control her asthma and keep her breathing well on a good day.

Later I will give more details of our 5-day stay in the hospital (her in a bed, me in a chair) but I'm too tired right now. We are home now and she is at Day 6 without a cigarette. She has never before spoken of quitting but she did while in the hospital after 3 days.

The f*** up with her medication could have killed her but the upside was it kept her in the hospital 2-3 days longer away from cigarettes so maybe it saved her life if it convinced her to quit smoking. We are at Day 1 back home with her not smoking.
Well that's good news. 80 would be a great year to stop smoking.
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Old 11-11-2013, 06:53 AM   #4
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When I first saw the title of your post it really made me wonder what part of ER (early retirement) could have been sloppy...

Makes sense now. Hope she is feeling better. Looks like this episode really got her attention!
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Old 11-11-2013, 07:04 AM   #5
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When I first saw the title of your post it really made me wonder what part of ER (early retirement) could have been sloppy...

Makes sense now. Hope she is feeling better. Looks like this episode really got her attention!
+1 Good to hear she is on the mend and has got the wake up call. My 83 year old mother still smokes but is in good health despite her smoking and drinking. Go figure.
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Old 11-11-2013, 07:39 AM   #6
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I'm sorry to hear about the medical error, Buckeye. They are all too common. I wish your mother well. Be aware that 60 years of addiction and tissue damage may be irreparable. Time for you to get some well earned rest now.
Yes, there is damage that can't be undone. I think one of the saddest moments will be when she realizes what she has allowed cigarettes to steal from her and her family.

I have a lot of anger over her choosing cigarettes and an earlier death/disability over me and my sister. Our relationship is going to get interesting if she chooses to take up smoking again.
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Old 11-11-2013, 07:44 AM   #7
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I think your mother is fortunate to have both a loving and caring daughter and a health care advocate by her side,
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Old 11-11-2013, 07:48 AM   #8
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Yes, there is damage that can't be undone. I think one of the saddest moments will be when she realizes what she has allowed cigarettes to steal from her and her family.

I have a lot of anger over her choosing cigarettes and an earlier death/disability over me and my sister. Our relationship is going to get interesting if she chooses to take up smoking again.

Sorry to hear about the problems with the ER...


I would not hold my breath on her stopping smoking with this short time frame of not smoking... I have a BIL who has not smoked for up to 6 months and has always gone back to them.... With the many years of smoking, a few days is not going to change her... sorry to say...
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Old 11-11-2013, 07:49 AM   #9
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Buckeye, for what it is worth, a long time ago I gave up on trying to convince my Mom to quit smoking. While I wish she would, and we pleaded with her to for years I believe it is an addiction and the strain on our relationship would not be worth it.

While I hope you can get past your anger and simply enjoy whatever remaining time you have with your Mom, I can see where she as "quit" for 6 days now that if she were to start up again it would be particularly upsetting.
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Old 11-11-2013, 07:50 AM   #10
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Buckeye, for what it is worth, a long time ago I gave up on trying to convince my Mom to quit smoking. While I wish she would, and we pleaded with her to for years. but I believe it is an addiction and the strain on our relationship would not be worth it.
IMO, it may be appropriate to stop bugging her but never give up hope. My mom smoked for almost 60 years and just quit this spring, just short of her 78th birthday. In fact, she quit two months before she told me because she wanted to be sure she had kicked the habit for good first.
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Old 11-11-2013, 07:56 AM   #11
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Perhaps there is hope after all.
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Old 11-11-2013, 08:29 AM   #12
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for a good outcome.

Brings up a serious question.

What happens when the best intentions... wanting a loved one to quit dangerous behavior... results in hard feelings and disengagement?

What to do? Back off? Avoid the issue? Maintain your position and hope for results? Offer a reward for behavioral change?

No simple answers, but an issue that most of us have faced. Sadly, the best we could do was to accept "que sera,sera".
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Old 11-11-2013, 08:37 AM   #13
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Sorry to hear about the problems with the ER...


I would not hold my breath on her stopping smoking with this short time frame of not smoking... I have a BIL who has not smoked for up to 6 months and has always gone back to them.... With the many years of smoking, a few days is not going to change her... sorry to say...
Are making a breathing joke?

Yes, you are correct that the odds of her quitting on the first try are very slim. Her hospitalist nor any of the respiratory therapists think she will quit.

I have never asked her to quit smoking because I know how stubborn and independent she is and bugging her would probably have the opposite effect. I would just complain about how stinky the smoke was.

She has never said the words "quit smoking" as far as I know so I was floored when she brought it up after about 3 days in the hospital. Like I said, she is very stubborn and doesn't like to be told what to do. Her attitude now seems to be that the cigarettes are trying to control her so she is not going to allow them to do that. This subtle shift gives me hope that her natural stubbornness is now working in her favor instead of against with respect to quitting.
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Old 11-11-2013, 08:54 AM   #14
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You may be right that the hospital stay could serve as a big wake-up call. Most say that the 1st week of quitting is the hardest, so hope mom hangs in there!
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Old 11-11-2013, 09:35 AM   #15
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for a good outcome.

Brings up a serious question.

What happens when the best intentions... wanting a loved one to quit dangerous behavior... results in hard feelings and disengagement?

What to do? Back off? Avoid the issue? Maintain your position and hope for results? Offer a reward for behavioral change?

No simple answers, but an issue that most of us have faced. Sadly, the best we could do was to accept "que sera,sera".
My mother, also a lifetime smoker, "quit" at age 80 in preparation for major vascular surgery (her vascular disease was due to the smoking). Six weeks after surgery, Dad caught her sneaking cigarettes behind the garage, like a schoolgirl. What could one say? She was addicted, and the addiction was stronger than she.
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Old 11-11-2013, 09:45 AM   #16
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So sorry about your Mom and I hope she really does quit smoking .
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Old 11-11-2013, 09:49 AM   #17
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for a good outcome.

Brings up a serious question.

What happens when the best intentions... wanting a loved one to quit dangerous behavior... results in hard feelings and disengagement?

What to do? Back off? Avoid the issue? Maintain your position and hope for results? Offer a reward for behavioral change?

No simple answers, but an issue that most of us have faced. Sadly, the best we could do was to accept "que sera,sera".
I can really see how drug, alcohol and gambling addictions rip families apart. As unpleasant as it is, at least my mom's addiction is legal and relatively inexpensive.
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Old 11-11-2013, 10:07 AM   #18
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My mother, also a lifetime smoker, "quit" at age 80 in preparation for major vascular surgery (her vascular disease was due to the smoking). Six weeks after surgery, Dad caught her sneaking cigarettes behind the garage, like a schoolgirl. What could one say? She was addicted, and the addiction was stronger than she.
One of the respiratory therapists said lung cancer and other lung problems are a distant second to the damage cigarettes do to the cardiovascular system. Apparently, mom has been lucky in that respect. Her cardio system seems to be in good shape. An HDL of 90 probably helps protect her.

Mom's crutch is the e-cig I bought her at Costco about 3 weeks ago (okay, so I guess I was bugging her to quit ). She has a step 2 nicotine patch (I think due to her 104 pounds) on but she keeps the e-cig close. I haven't seen her puff on it but she feels better just having it around. There were 2 packs of cigarettes on her patio table and she asked me to put them in a drawer this morning because she didn't want to look at them. I will be staying with her full-time for at least a couple of days or until she throws me out. I am helping her do daily living tasks but we both know I'm the smoking police also.
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Old 11-11-2013, 10:36 AM   #19
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My FIL quit in his 60's after a lifetime of smoking. My Uncle quit in his 80s. It's funny what triggers folks to quit. I remember DF throwing his Salems (3 packs a day) out the car window on the way home from his DMs funeral. His step-father had said 'your DM never did like your smoking'. She never knew it but he quit that day.

Wishing your DM success, love her even if she doesn't make the break now.

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Old 11-11-2013, 10:45 AM   #20
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One of the respiratory therapists said lung cancer and other lung problems are a distant second to the damage cigarettes do to the cardiovascular system. Apparently, mom has been lucky in that respect. Her cardio system seems to be in good shape. An HDL of 90 probably helps protect her.
My mother did develop lung cancer, at age 90, at about the time her vascular graft was getting occluded. If the lung cancer had not killed her, she would have had a very painful course with amputation of her lower limbs.
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