Scrubs in the Trenches

Ode to Grandma: SHOCK THEM ALL!!!

Isaac BenJamIn Season 3 Episode 3

This is the story of my Grandmother, Thelma Louise Smith, and how her Ending snuck up on me and my family.  In the previous episode I told you about her husband and how he hung around in a land I call Pillgatory so now I'd like to share how I was able to help coordinate getting her out of the hospital so she could pass peacefully as possible at her home surrounded by loved ones.  

Louise was a librarian and was definitely my "fun" grandparent.  She helped formed my sense of humor and took me on cross country motorhome trips.  She was a church going Methodist that loved her some X-Files and wasn't afraid to say what was on her mind.

She got a bad cold during February of 2022 and developed into pneumonia that landed her intubated in the hospital.  She was a DNR and had some words to say when she was extubated but was glad to not be dead at the same time.  

She began to decline again and I felt the need to go to the hospital to assess the situation with my own ICU eyes.  I then tell how I was able to suggest the proper non invasive treatment to tank her up enough to allow her to make it safely home to be set up on Home Hospice.

It wasn't easy but I poured every ounce of medical knowledge and called on the advice of other medical professionals to formulate a plan to do what was right by my Grandmother!

Also listen to the post credit scene to hear about how my grandmother wanted me to dose her and Papa up with so much morphine that they could go in each others arms like in The Notebook...  Spoiler Alert, I Didn't... 


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Ode to Grandma:  Shock Them All

On the last episode, I was able to tell you a little bit about my papa and his ending. Well on today's episode, I'm gonna tell you about his wife Thelma Louise no seriously that was her name.  And the ironic thing about her ending is that less than six weeks earlier I was called to her house about Papa being put on hospice. Nobody was expecting her to go on and check on out so soon.  She was overweight and had mild diabetes, but  she got around just fine with her tree trunk ankles and her mind was sharp as ever.

Grandma was never afraid to tell people what she thought, even if it was directly about them to their face.  One time my sister brought over her boyfriend, and Thelma went on to say you know that boy, Connrad last time he was over here he took his shoes off and he had some stinky ass feet.   Needless to say he kept on his shoes on this time over…

She was always a good churchgoing Methodist when I was growing up, but she never was afraid to say the aliens are possible or. Show me the movie, naked gun, because she thought it was HILarious.  She would beat me at streetfighter by button mashing, and she made me and my cousin watch Deliverance… still don't quite understand what that bit of Culturing was about. 

She spent most of her career being a librarian, and I would consider her a free thinker. She was never afraid to question the main narrative. It was honestly quite a lot of fun to be around.  She took me to the Grand Canyon, and then to Vegas and dropped me off at Circus Circus or her and Papa did a little Gambling.

She was definitely my cool grandma and really open my mind to things like Calvin and Hobbes and the Farside.  So whenever I had just worked, I don't know how many 12 hour shifts in a row and had been trying to understand My grandmother’s situation for the past three days by phone I knew I finally had to drive down to the hospital to see her with my own eyes.  

Apparently, she had a real bad bronchitis, and had been taking her hydrocodone with makers, mark for a few days for her cough you know doing a little hottie toddy. And before she knew it, her CO2 had climbed, and she was intubated, even though she was a DNR. Understandably her children had her intubated as a DNR because it happened to her so rapidly and the doctors assured that this was a temporary problem. Fix the pneumonia get her off the vent and she's back to being grandma who at the time was 86 I believe well when they extubated her she woke up and said why the hell y'all do that I'm a DNR. And after she was over being pissed off for going againsther wishes she was grateful that she was still with her friends and family. 

But within a couple days her CO2 he climbed again and they had put her on BiPAP machine. She made it clear that if she couldn't be fixed by BiPAP or less, she did not want to be reintubated.  My mom had sent some pictures of the pressure readings from the bottom of Pat machine that she was on, and with the assistance and expertise of an experience respiratory therapist. She helped me understand what my grandmother exactly needed from the BiPAP machine to blow off her CO2. So when I showed up to my grandmother's room and they were still Covid restrictions and limitation of how many people could come in, I caught that young one year experience traveling nurse very offguard.

I didn't mean to come in so hot, but I made it clear that I needed to get in touch somebody that knew that I understood exactly what my grandmother needed. She needed more pressure support, and my grandmother was a big woman, so what they were we're trying to give her was severely inadequate, basically just blowing her face with air, almost like a prop.  The PA tried to scare me with nonsense about how too much pressure I could pop my grandmother's lung and I basically double dog dare him to try and do it the Peep suggestion that I was recommending which was never close to the amount that would pop a lung, but it would help her blow off enough CO2 to be conscious enough in the morning to have a conversation with us.

So I go to my parents house after midnight to get a little rest and awake and in the morning with my mother and aunt freaking out because grandma's unconscious after being conscious momentarily.  My dad was trying to rush me out of the house but I told him she ate them before I get there and I got a poop. So I did my morning poop and Joe to the hospital. It's kind of crazy how it worked out but as soon as I walked in the room, my grandmother lifted her head and pretty sure she said hey Isaac, my aunt and mom just looked at each other like what the fuck.  

At this point, I get to have my first conversation with grandma since she was hospitalized, and she looked out the window and said I never thought I was gonna die in here referring to the hospital. And downgraded to nasal cannula in her nose I was able to look into your eyes and tell her you don't have to if you don't want to.  My same aunt in the previous story that was the vice president of nursing at the hospital my papa went to what is the power of attorney and had ultimate say of what happened to grandma.  Since we were able to get her conscious enough to be able to tell us, her exact wants and needs we able to set up home hospice where she remain for almost 48 hours sipping on morphine and popping Ativan watching the new dune surrounded by family and loved ones.

It was kind of surreal getting to leave the hospital with her. I pretty much dropped. My life drove two hours back to the town where I grew up. I need anything everything within my power to bring back my grandmother from the jaws of death. I kind of got weird looks from some of the staff because I think they had already left Thelma Louise for dead.  But her primary nurse that discharged me really respected the way I fought for my grandma. I helped turn her as he had to wipe her bottom after a BM and assisted another nurse as they inserted a Foley for comfort before rolling out the door. And I'm not sure, but a look like a know it all secretary gave me a cross eye for some reason. But I did it. I got grandma out of there.

Now driving up behind the ambulance rolling up to her house or something out of like a movie. Have you seen the movie big fish? It's like everybody was there. So many friends and family were there and as she was being let out by the two paramedics, she began to flirt with them.  She may have even kissed one of them She was the best.

The next day, she was still sharp and coherent, and gathered every family in one at a time, basically to give us the business one last time. When she called my family and she reminded us that we were stickers and about that she meant that we stick together. And she did it eventually look at my wife and told her since we had four boys at this point to shock them all and give the world a baby girl.

After all was said and done my aunts and uncle's expressed much gratitude and appreciation for my part in bringing grandma home. Without my ability to use my knowledge and essentially mastermind with a cousin CRNA and an experienced respiratory therapist, the medical system would have just let my grandma ROT in the hospital with a BiPAP blowing air on her cheeks.  Even though she had two nurse daughters they couldn’t see that the settings were wrong because the system is that complicated.  

This is exactly where I want to help families I want people to really understand advance, directives, DNR, DNI,  and everything in between.  So join me next time when I tell the story of Mawmaw and her slippery slope of a dementia slide.

Where are MY Manners… I ALMOST forgot to spill the Pilly details about how my Grandma wanted me to Murder her and My Grandfather…

So it's still kind of a blur, but I spent the night with one of my cousins who is also a nurse either the night my grandmother got home from the hospital or the following night.  Since Papa was already on hospice, liquid morphine was in the house, unused it this point, but it was there.  So I had jokingly said to grandmother,  how neat would it be if they could basically Romeo and Juliet each other.  Since she was a librarian and loved the story of Romeo and Juliet, she completely ran with it.  She just wouldn’t drop it, I MEAN LIKE SERIOUSLY GRANDMA… NO MEANS NO!!!

She then took the liberty tell cousins of mine that I was going to give her and Papa enough morphine to send them both to the moon on a Rainbow Road riding Unicorns ALL the WAY…  I had to assure my cousins and their spouses that I would not in fact be murdering my grandmother and grandfather that evening.  But you know it is worth at least talking about in a Country that still technically even if begrudgingly to the techies, still has the 1st amendment right for Freedom of Speech…. What should I have done in that situation?  

I honestly don’t know the Right answer in this situation with hind sight… If I would have listened to my Grandmother it would have allowed them to go in each other’s arms all Notebook Style I would have literally saved my Papa years of confusion and suffering and allowed him to die at his house as he desired… But since I didn’t, he slipped off into Pillgatory and drifted in that desert