"Her Health is the Biggest Gift"

I sat at the edge of my mother's bed, eagerly awaiting the discharge papers. As the nurses came by, sometimes in groups, to say farewell, I asked them how we could express our gratitude for their love, tireless work and benevolence. "Seeing her healthy and leave the hospital is the biggest gift" said one of the nurses. I almost choked up and hugged each of them before they left mom's room. My mother, with limited mobility, expressed her thanks with a smile and an air kiss.

The purpose of this blogpost is to share some learnings and reflections from behind the acute care lines so that it may serve as some inspiration to others facing serious illness. I share it as a son with an ailing mother on the brink and not a medical expert. When I share something like this it's because I hope it will serve with some value and utility to others.

When crisis hits you this hard and fast, it forces you to do a lot of thinking, reflecting and processing -- from the mundane and tactical to the ontological, existential and philosophical.

No blogpost on this topic would be worthy without first expressing profound gratitude to the men and women who work in acute and critical care. Having now lived within the walls of a hospital ward for 2.5 weeks, I have developed a fuller appreciation for just how demanding the job is. Nurses, in particular, are heroes and deserve our highest praise and admiration -- we must stand them on whatever pedestal we can afford as society.

A Preventable Crisis

Roughly two years ago, at the age of 79, my mother had a knee replaced, during which she contracted a UTI. It troubled her for months, so much so that she revealed to me many months later that she was falling into deep despair and depression as she thought she may be living with it for the rest of her life.

The UTI resolved after several months, and my robust mother was back to living vigorously. Below is a picture of her one-year post knee replacement touring the Mayan ruins with me in Tulum. Mom walked nearly one hour in 30 Celsius weather to get to the ruins. Admittedly I had to commandeer a wheelchair to take her back to the car but nonetheless the walk there in scorching heat was no small feat for an 80-year-old on a replaced knee.

I've come to learn that UTI is the second-most common infection in elderly women, and the most common cause of infection in hospitalized elderly women or those in long-term care. I've also come to learn that UTIs can be fatal, as was almost the case with my mother.

Roughly three weeks ago, my mother had a tooth pulled. It led to another UTI. This time, she was afflicted with a severe, unrelenting and persistent fever that saw her become weaker and weaker and more and more impaired cognitively. Emergency room visits and a heavy dose of antibiotics had no effect. Mom had to be hospitalized.

"I'm very worried, this is bad" my brother messaged in a newly created WhatsApp group "mom's health". The above was the first picture sent. It was jarring for all of us.

My mother proceeded to decline, falling into severe delirium and disconnection from all things. She didn't recognize us, she didn't know where she was, and at night in a state of psychosis she got up and fell, injuring herself quite badly. She had to be restrained by five nurses and tied down to the bed, which was about as difficult a thing to experience for a family member as one could imagine. For three days my delirious mother didn't eat or sleep. By the end she looked as if she were paper thin, a "painting on the hospital bed" as I have told others. It was very dire and bleak.

It was in a moment of incredible weakness for me where I went deep inside to search for answers and some inspiration on how to mentally resolve what we were dealing with. This was a post I shared with family members during this time:

In the silent depths of cosmic night, Where galaxies dance in shimmering light, We find the truth that binds us tight, For we are all born of starlight.

From distant realms where giants roam, In fiery furnaces, they find their home, Particles forged in celestial loam, Scattered across the vast unknown.

In every atom, a cosmic tale, Echoes of stars that once set sail, Through time and space, they prevail, A symphony of dust, a celestial trail.

In each beating heart, a stellar spark, A reminder of the heavens, deep and dark, We're woven into the fabric, stark, Bound by the light, in which we embark.

So let us embrace this cosmic bond, With reverence for the stars beyond, For in the universe, we correspond, Forever connected, star dust spawned.?

We knew that if my mother had any chance, it would be through nourishment, sleep, exercise and love. So, we went to work, 24-hour shifts alternating between us four brothers and my niece. We had her sedated and held her hand through the night.

We played my mother her favorite songs, showed her old pictures from albums, we held her hand and touched her constantly. Anything that would engage her cognitively and conjure the strength and will to fight.

On her 81st birthday, mom decided to show us that she wasn't ready to leave us just yet. She gave her first glimpse of recognizing us with minor lucidity returning.

With continued nourishment, exercise, sleep and love, my mother continued to make remarkable progress. Within a few days, speech had returned. She was guzzling her mend and slowing beginning to get vertical and to stand with aid.

We began to push her PT further, making her walk without her walker. I took her downstairs to the cafe to sit and soak up the sun. My fiancé joined me whenever she could and offered her long hugs. Slowly mom began to do rounds of the ward on her own, gaining confidence with each step.

Yesterday my mother was discharged from the hospital. Below is a picture of the two of us leaving. Just a week prior she was in deep peril, and we were genuinely worried that we could lose her.

This time spent in acute care, and time alone in anguish with my thoughts has given me a number of lessons, some of which I'd like to share.

Surgery is a big trauma and can significantly compromise the elderly: any surgery, even a tooth extraction, can lead to significant problems for the elderly if not managed well. It's a major trauma placing significant demands on the body. A patient needs to be well nourished and follow all of the necessary safety protocols to avoid risks. My mothers' situation was entirely preventable had she been on the right readiness and recovery protocols with surveillance, monitoring and support during her joint replacement and her tooth extraction. Readiness and recovery precision care and monitoring are entirely possible with new technologies and should be mandated for all elderly patients.

Muscle wasting happens fast but can be mitigated: within a week of being in a hospital bed, my mother was unrecognizable. I don't know any other way to describe it other than she looked like head with a flat body, like a painting with some minor contours. The more muscle that is preserved, the easier it becomes to recover and begin physical therapy and rehabilitation. Had the hospital immediately given her the appropriate amino acids and nutrients such as HMB, the muscle wasting would have been significantly reduced and her time to recovery significantly accelerated. My mother still feels weak, undoubtedly because of the amount of muscle that quickly wasted but her strength is returning quickly due to the nutrition and exercise program we have her on.

Social support is vital: my mother is lucky that she has lots of family that were able to be there with her to support her and provide her love. But the need for support doesn't stop within the walls of the hospital. Fear persists after a major trauma and just having someone to be able to reach out to and speak with for guidance and support provides tremendous peace of mind. There have been plenty of studies published on the value of social support in driving good outcomes. Far too many don't have any social support, and this is eminently addressable through solutions available today such as Upgraid.

Everyone's time comes but this wasn't my mother's time. Regrettably, this situation was entirely preventable and should never have occurred. Basic surgical readiness, nourishment and safety protocols to prevent UTI would have saved the healthcare system in Canada hundreds of thousands of dollars and all of us immense suffering.

Given the right conditions the body has a remarkable ability to heal. Nutrition, activity, sleep and love - the alchemy of healing. It's what healed my mother and it's what I believe will help you or your loved one to heal. We can change the paradigm of healing from the passive one that is too often followed to a much more active one.