June 4

Last year June 4 was a Saturday. It was my seventh day in Morgantown, WV, and my mother's tenth day post-op. She was still in the surgical ICU. My brother left for home the evening of the day I arrived because he had only packed for two nights (he was there four) and he needed to check in at work. I would update him daily.

The morning of the day I arrived the doctors decided my mom needed breathing support because she was exhausted; she was put on a ventilator in CPAC mode. She was breathing "over it," fully conscious, with the expectation that her lungs would benefit from the support and her oxygen level would improve. The respiratory technician regularly checked on her, and we had daily conversations about mom's progress and what needed to happen for the vent to be removed. They gave her a breathing test each morning and that determined the treatment each day. Every morning at doctors' rounds I heard, "She couldn't pass the breathing test; one more day on the vent." 

So my mom perfected communication without talking - hand signals, eye movements, tracing letters on her sheet, and shrugging her shoulders. I asked the staff about a white board, and on Wednesday the respiratory tech found one. Mom and I "chatted" about all kinds of things. I asked her where she wanted to be after the hospital, and she wanted to be near my brother. I was hoping that would be her first choice. He had been a major support for years, a steady presence and trusted advisor. Wednesday was a good day.

Thursday morning I arrived to find her sleeping. She was too tired for the breathing test. Her hip was not healing, and her heart rate and oxygen level could not be regulated. Mom slept off and on all day. I texted my brother and advised him to come on the weekend. Friday was much the same as Thursday, and my brother arrived Friday afternoon.

Considering the way the week had gone, I was stunned when I arrived at the hospital Saturday morning to see my mom sitting up in bed and talking. While it was wonderful to hear her voice, I wondered why the change. The doctors had removed the ventilator and put her on high-flow oxygen. I could not get a straight answer from the doctors as to why the decision had been made. They would not say she passed the breathing test. She could still not have anything by mouth, hooked up to tubes for anything she took in. Her condition seemed to be the same.

My brother and I had a long conversation about what the change could mean. He wanted her to stay on the vent until things improved; I explained that the vent was not a long-term solution. He wondered if they would put her back on if her condition got worse. I said I didn't think so, but he could ask the doctors.

My notes on the day are clinical, facts about her condition and who I talked to. I didn't write anything down about what I was thinking because my thought was that this day was a turning point. My worst fear was that it wasn't in the direction we had all hoped for.