Patricia Scannell Cragen
My mother was diagnosed with Parkinson’s many years ago. My father’s sudden and unexpected death broke her heart and turned her world upside down. Her Parkinson’s has advanced rather aggressively and she has suffered two devastating falls with injuries. Subsequent hospitalizations were followed in acute inpatient rehab.
Making slow progress, she complained of new-onset pain: severe, localized on one side of her face. Differential diagnosis: trigeminal neuralgia. She was seen by a neurologist the next day. Noting that the right side of her face progressed to swelling with redness, point tenderness, trigeminal neuralgia was ruled out. Infectious disease was consulted. The physician had made rounds earlier in the day. No longer in the hospital, he was told the consult was not urgent and could wait until the next day.
The next 12 hours proved near fatal as my mother developed fever, diminished level of consciousness, difficulty swallowing. She could no longer tolerate liquids, oral meds, or participate in physical therapy. On several occasions I expressed grave concern and asked the nurse to call a physician to see her…time and time again, no one came. Exhausted, frustrated, and scared, I left the hospital for a while…thinking maybe I just needed a break…the bedside vigil had simply become overwhelming.
I returned a couple hours later. With pain medication on board, my mother was resting. Again, I expressed concern and then I left for the night. Unbelievably, I went home, laid my head on the pillow, and slept for several hours. Not to miss the physician’s visit, I returned to the hospital early the next morning. Her condition had worsened. As the physician stood at her bedside noting point-tenderness over her cheek bone, I asked if anyone had looked in her mouth and he responded, “No.” I turned my phone’s flashlight on, looked in her mouth…top right…foul, purulent, blackened material, redness and swelling…BINGO…I had found the probable cause of her deterioration. (Sepsis and Dental Health)
At this point I suddenly became her nurse-daughter. Demanding action, she quickly had an IV line placed, fluids and antibiotics started, CT scan done, and transferred off the rehab unit back to the hospital. Soon after, CT results confirmed swelling that compromised her airway and she was admitted to the ICU…STAT. A consult to ENT followed was followed by consult to an oral surgeon. Findings: root of tooth/teeth fractured in the fall one month prior, teeth abscessed, cellulitis confirmed (and while no one spoke of it, I would predict that the area had become gangrenous).
After 24 hours of treatment and continued deterioration, we had her anointed by a priest. The next day two teeth were extracted. Through the grace of God, she managed to survive, progressed, and was moved to a rehab facility for several months.
I am a daughter (wrapped up in emotion) and I am a critical care nurse (on the sepsis team). I cannot believe I went home that night and laid my head down to sleep. The alternative was to stay and “make-a-scene.” Oh how I wish I had. Insistent on follow-up with the healthcare team. my only request was that they talk about sepsis, develop a sense of urgency in the face of deterioration, numerous expressions of concern, and pleas from the family for further medical evaluation.
I want to thank her roommate on the rehab unit for sharing with me that she was glad I came when I did, sharing that my mom had nothing to eat/drink during the night and had not used the restroom. I want to thank and applaud everyone who is working to make a difference in the name of sepsis awareness.
Most often, no one knows patients better than their family. Why, why, why do we hesitate to speak up? Why don’t we listen to repeated concerns and pleas for help? This can no longer be tolerated in America’s hospital systems. Educate your self, your staff, and “make-a-scene” if you have to.
I love you mom.
Source: by Theresa Cragen Draher (Patricia's daughter)