In the hospital - again

We returned home late Tuesday evening from our trip. Ron had been having some issues while we were gone and I was afraid that he was headed downhill. He fell twice in the hotel room, once in the street (when he hit a bump on the curb), and in the Denver airport. By the time we headed home, he was very swollen and his legs looked shiny because the skin was stretched so tightly. He, of course, did not think there was anything amiss with him at all. He thought I was nuts and just making things up.

The crew at the airport and on each of the planes could tell that Ron was having issues. I have to say that Frontier Airlines went above and beyond to take care of him and to make sure that we got to our destination safely. The flight crew on each flight (both going out and coming home) were very solicitous of Ron and did their very best to make sure he was well taken care of. We flew on a propeller plane from here to Denver and back. Those planes have steps and don't hook up to the tramway. Ron can't do steps so they had to hook a small ramp up to get him in and out of the plane. The crew getting him loaded and unloaded were very helpful, but I have to give big thanks to the crew from Denver to here. The gentleman who took Ron from our connecting flight absolutely saved my life. Ron had gone into the men's room and this guy stayed with me while we waited on him to come back out. A man came out a few minutes later and said, "There's a man on the floor in there" and I knew immediately that it was Ron. I had to crawl under the stall door to help him up. The transportation helper was right there with the wheel chair once I got Ron presentable and off the floor. I could not have done it without his help.

Once we got back to the gate, he told the crew there that they would need the ramp and that Ron would take a while to get loaded. We were second on the plane (after another wheelchair customer) and the flight attendant (Tom) was very caring in getting Ron seated, comfortable, and belted in. Each of the flight attendants on each flight helped me with our carry-on (I had Ron's BiPap machine and a rolling bag with his medications and other necessities). I emailed Frontier to let them know how much I appreciated their ground crew and flight crew assistance.

Before we had even taken off in Las Vegas, Ron looked at me and asked if we were home yet. On the shuttle ride from the hotel to the airport he asked me if it had been daylight or dark when we arrived in Las Vegas (it had been 9:30 in the morning on Friday). He fell asleep on the plane almost immediately and slept the entire way to Denver. Once we got to Denver he again asked if we were home and where was our baggage. He did manage to stay awake longer on the Denver to home flight, but it was much shorter.

Once we got home, it was obvious to Keith and me both that he was having some definite mental confusion. He didn't remember what day we went to Las Vegas (took him three tries) and could not remember what time of day we got there (never did get that right). He also could only remember that we had gone to Hoover Dam and only that because it was the last thing we'd done before we left. He couldn't name one other thing we'd done except in generalities (we went out on the street and saw some things). He did not remember that we had gone to the Pawn Stars pawn shop, that we had seen Criss Angel, or that we had seen the Titanic Exhibit. He asked me if I was going to take a picture of the chickens. I asked him what he was talking about and he insisted that I was going to take pictures of the Kentucky Fried Chickens to compare them with the baked chickens that the CSI crew was trying to find with the crazy people at the pawn shop. When Keith and I started laughing at him and telling him we hadn't talked about any cameras doing anything, he said I had set him up.

Keith and I told him that if he didn't let us take him to the ER that I was calling an ambulance. He agreed about 11:30 that we could go. He could see that we were not giving in so probably figured that was his best option. They did a CT scan, took a couple of x-rays of his chest, did an EKG, and some blood work. He was admitted about 3:30 so Keith and I went home to bed. He's got some swelling of his ventricles but not enough to indicate head trauma from his falls. He's also got elevated potassium which signifies that he was headed to kidney failure. Then, he's also not emptying his bladder all the way so they had to put in a Foley to compensate and restricted his fluid intake. The neurologists yesterday asked him how long he'd been in the hospital (he said two days) and what day it was (he said Saturday). They asked him to count backwards from 100 by 7; Ron got to 93 and could go no farther. Earlier, they had asked him to spell "world" which he did correctly. Then they asked him to spell it backwards, and he promptly said "b-a-c-k-w-a-r-d-s". He had a liver scan yesterday evening to check liver function but I don't know the results of that.

We got a solid "mild Parkinson's" diagnosis yesterday with a probable Vascular Dementia, and a "maybe" Normal Pressure Hydrocephalus (NPH). The NPH is indicated by the swelling of the ventricles but they don't think he has enough of the other symptoms. In looking at the list of symptoms online, I think he has more of those than he does for the Vascular Dementia. NPH symptoms include (from http://www.emedicinehealth.com/normal_pressure_hydrocephalus/page3_em.htm):

• Memory loss – check
  
• Speech problems – depends on the definition of "problem"
  
• Indifference and withdrawal – check; he doesn't really care about much of anything
  
• Changes in behavior or mood – not really
  
• Difficulties with reasoning, paying attention, or judgment – depends; sometimes
  

Walking problems, including:

• Unsteadiness – yes
  
• Leg weakness – yes; he has said how weak his legs feel
  
• Sudden falls – yes, I think so but he says maybe more balance related
  
• Shuffling steps – no; he waddles with a wide gait
  
• Difficulty taking the first step – not usually; sometimes he has trouble getting started but not often
  
• Getting stuck while walking – not really
  

Urinary symptoms:

• Inability to hold urine – not often; only a couple of times
  
• Inability to hold stool (less common) – he has two ways he goes: not at all or all of a sudden
  
• Frequent urination – no
  
• Urgency to urinate – no
  

Vascular Dementia symptoms include (from http://www.helpguide.org/elder/vascular_dementia.htm):

• Memory problems, forgetfulness – yes
  
• Dizziness – no
  
• Leg or arm weakness – yes
  
• Lack of concentration – not really
  
• Moving with rapid shuffling steps – sometimes
  
• Loss of bladder or bowel control – see above
  
• Slurred speech – no
  
• Language problems – no, unless you count not being able to think of the word he wants
  
• Abnormal behavior – hey, this is Ron we're talking about (grin)
  
• Wandering or getting lost in familiar surroundings – not really; sometimes confused as to where we are and where we're going (I drive)
  
• Laughing or crying inappropriately – no; cries at sad scenes in movies
  
• Difficulty following instructions – well, sometimes when he's confused
  
• Problems handling money – not really; got to have money first (LOL)
  

It is difficult to determine which of these is the correct diagnosis. Ron's mental awareness does vary depending on how his kidneys are functioning. Are they connected? Probably. Is it a kidney-caused problem? I don't know. I know that it is going to make things change once again for us. I'm not sure I'm totally up to the change or the requirements that it will put on me. I know that he worries that I will put him in a nursing home. That is not even on the horizon so I told him to not worry about it. A friend of ours came to visit him today and Ron said the same thing to him. Garry told him that he didn't believe that was anything I have considered, or would consider.

We shall see…