Another long, up and down day. We got to the hospital this morning and it was quite frightening -- my grandma was very agitated, trying to pull out her IV and get out of bed, insisting that the people in the surgical step-down unit where she'd been for the night were trying to hurt her, and they were evil, evil villains, we can't trust them, we have to leave or they will tie us up and torture us as well, and how can we stay there, and she has to leave, and we all must escape before it's too late and they kill us. We assumed part of it was she was utterly exhausted -- unable to even really open her eyes -- we were worried for a little while that somehow her sight had suddenly been affected, but then she opened her eyes for a moment, and said she was tired and closed them, so it was just the exhaustion. But despite the exhaustion, she was very, very hard to calm down. Partly because they'd restrained her after she tried to pull out the IV and she quite understandably didn't like the restraints, and they made her feel like a prisoner. But we got them to move her out of the bed to a chair, and take off the restraints, and she trusted me and my mom when we reassured her that she's safe and doing well and she'll be okay, and so I held her hand and she fell asleep... and then right when she fell asleep, they wanted to move her to another room, so they put her back in the bed and, somehow she stayed pretty much asleep through the room transfer and for the next few hours. So we figured things had stabilized when we left the hospital at around 4:30.
Until we got a call at around 7:30 from my uncle -- he's the first one they're supposed to call with any sort of emergency situation, he works as a biologist in a hospital, and my aunt's a doctor, so they're more equipped to deal with some of this stuff -- who'd gotten a call from the hospital psychiatrist saying my grandma was very agitated and we needed to get to the hospital and calm her down. So we rushed down there, not really knowing what to expect -- I feared that she was inadvertently harming herself, pulling out the IV, trying to get up, really physically acting crazy -- and was relieved that she was sitting in a chair eating the tuna salad they'd given her for dinner. But she was certainly agitated, she was very relieved to see us, and had the same sort of delusions as earlier in the day -- these people looked like human beings but they were really monsters, they're her enemies, she feared that she was being taken somewhere and we'd never find her and she'd never see her family again. And that everyone around her was an enemy and there were all of these people coming in and poking her and squeezing her arms and legs. We tried to explain to her that she's just in the hospital, and these are just the doctors and nurses, and everyone's trying to make here better. But she was insisting that they can't be trying to make her better, because they are so unfriendly, and she tries to be nice to them but they are not nice back to her. And we explained that that's certainly possible -- the doctors and nurses might in fact not be terribly friendly, and if she's not thinking clearly, I'm sure the blood pressure cuff and the blood draws and moving her in and out of bed would feel like they're trying to hurt her, but, no, she needs to realize her brain is just playing tricks on her and it's a hospital and she'll be okay. But the psychiatrist wasn't really making things any better. I passed him on the way to her room and he said I should go right to her room. Where she was pretty calm, although definitely not completely in tune with reality. Then two minutes later the psychiatrist runs in, looks around, and screams, "Where's the grandson? I thought I saw the grandson!" So I waved my hand and said I was right there. And he was a little confused, said he didn't see me. Then he goes over to my grandma and asks if she remembers meeting him, and telling us that we don't know what it's like, when we're here she's fine but as soon as we leave she's going to be crazy again. Wasn't sure I thought the psychiatrist throwing around the word "crazy" seemed quite right. And she asked me who exactly this doctor was, and I started to say he's the psychiatrist, but he yelled "No, don't tell her that!" And I sort of found myself starting to wonder who the craziest one in the room really was. And hoping it wasn't me. He was insisting that we can't stay with her all night because it's a female-only room and that would be a violation. But we weren't asking to do that. He then went back to the nurses station and for some reason called my mom, who had stayed at home, and said he was the doctor and we can't stay with her all night. Which, again, we didn't ask if we could, and what good was calling her when my stepdad and I were right there in the room. I mean, I don't think he was actually a lunatic, but he seemed much more agitated than I'd want the psychiatrist to be, and while my grandma clearly wasn't in touch with reality, he didn't seem to be helping. He then told the nurse he was leaving and if they need help, call the house doctor, not him. And he left. Bizarre.
We actually had met the psychiatrist yesterday when he came to do a consult because of my grandma's talk of death and her life being over, on Wednesday. But she was in surgery at the time, so he talked to my uncle and me instead. But he hadn't seemed to have read her chart and wasn't real clear on what was going on. He asked us how long she's been talking about suicide, which she hadn't been at all. And at least once made some comment about how we don't know what her situation will be after "some of her symptoms pass away," which I thought was a bizarre and head-scratching way to word that in these kinds of situations. He seemed like a doctor from the 1800s, sort of. He's probably about 80 years old, was wearing a brown three-piece suit, has a shock of white hair, and I could see him being very comfortable in an episode of Little House on the Prairie. When we mentioned her specific language loss -- anomic aphasia -- he waved it off and said we can't use the medical terms like that, he doesn't know those words. Okay, but he's a *doctor*, no? Anyway, he didn't inspire much confidence either yesterday or tonight. Although I suppose he's probably a very nice man and the stress of the situation, on my end, is making me expect more than I should and seeing him as less competent than he quite possibly is.
In any case, we calmed my grandma down, explained to her again that she's in a hospital and the doctors and nurses are not her enemies, and she's getting better and her brain is playing tricks on her and she'll be okay. And she, intellectually at least, seemed to get it. She said she was relieved to see us because she was worried "they" had taken us away, but she couldn't really explain who "they" were. And we pointed out that there's a TV in the room, and a window, and her roommate is very nice, and that all seems consistent with safe, good hospital, not crazy insane prison camp, and she got that pretty well. My uncle was able to arrange for a one-on-one private nurse to sit with her tonight, so we introduced her, told her she's very nice, she'll take good care of her, and as long as she's here, my grandma shouldn't worry, she'll be safe, and we'll be back in the morning. And she seemed to really start to get that her mind was tricking her and we wouldn't leave her in any sort of harmful situation and she'd be okay.
And then I discovered some magical food on her tray. I asked her if she wanted some of the canned pears and she said she did, so I gave her some pears and she ate a few bites and said, "Oh, gosh, I might have been wrong. Because if they're giving me food that's this delicious, I suppose they can't really be my enemies." I think that's probably the nicest thing anyone's ever said about canned pears! And then a few more mouthfuls and she said, "You know, I feel alive again. I really feel alive again. Is there more of that fruit?" And we gave her more. Magic, these pears must be. Magic.
The weird thing is that aside from this very terrible and frightening delusion about everyone out to get her, she's pretty lucid and with it. Knows everyone's name and completely understood when we were telling her about my mom getting some good follow-up test results from her kidney thing from last week, and was able to talk on the phone to my uncle without difficulty -- her language is really making a terrific comeback, the day-to-day progress pretty tremendous and gives me hope that she can get back to normal function with her speech, and not have any noticeable problems at all. But it's awfully scary to have to explain to someone you love that they need to trust you and that they're safe and there are not people trying to kill her.
We expect it's all from the medication from surgery or post, but we're also wondering if she might have had some sort of frightening dream during the surgery that she's confusing with reality. Because when I saw her right after surgery -- and I didn't think anything of it at the time -- what she said was, "Were you in there doing all the stuff to me? I know you're my grandson, were you doing all that in there?" And I said no, I wasn't doing anything but she'd be okay. I'm actually wondering a bit if the sedatives possibly didn't quite keep her totally out of it during the procedure and she was aware of some of it, and these bad people doing bad stuff to her was how she interpreted the surgery itself, without knowing what was going on, and she somehow internalized that as some sort of experiment on her and now quite understandably believes that everything these people do is to try and hurt her.
In any case, hopefully this will all subside after a good night's sleep, and besides the delusion she seems to be doing great -- good speech, and she's eating well.
(Incidentally, I really appreciate all the blog comments and e-mails I've gotten -- I'm writing this mostly just to get it out of my own head, but the well wishes have helped, and I've shared them with my family and will share them with my grandma once she's better...)