I am writing concerning my mother Shirley Ann Mattina who received treatment over a 4 week period beginning August 14 and ending September 12, 2017 with her death. Shirley spent the majority of this time in the F3 wing of the Juravinki hospital.
Shirley had various ailments (Bladder Cancer, Diabetes, Failing Kidneys, and Heart disease). That is a rough combination for sure. Her life expectancy would naturally not be long, however she was well into her 84 year.
On August 14 my mother was admitted to the ER of Juravinski hospital.
Though administering a catheter is normal routine we had informed staff that no catheter should be administered to her as it always resulted in bleeding, but were convinced it was necessary so we went along. Bleeding commenced. Then when my brother and me were not in attendance a larger catheter was inserted over the screams of my mother who suffered extensive trauma. It was said this was done as they needed to ensure no clotting as saline solution needed to be administered. We emphasized that buy use of the catheter this may have caused some rupture, however we were repeatedly informed that it was most likely caused by baldder cancer. Much later CT Scan would prove that our suggestion that the bladder cancer was not the issue would be validated.
She was immediately tapped as needing palliative care within the first 3 days. At this stage she was fairly strong. The F3 Wing staff seemed determined that Mom was a palliative case and needed to go to St. Peters. We did understand that she had limited time and at some point if not from the bladder cancer, then kidney failure might be the defining problem. All her vitals at this stage, Blood pressure, oxygen, creatine levels, sugar were not out of the norm for her.
From there her hemoglobin levels plummeted, this was a result of previous blood loss. It was my brother who came in one day to discover that she was cool to the touch and she needed an urgent transfusion of blood to arrest the drop. She could have died that day. Why did it take my brother to notice this ?
Eventually her urine showed yellow over several days and we were hopeful, not for a full recovery but a chance to heal. The F3 doctors and staff had already seen her as not worth the effort as they always came back to palliative care making us feel that they would eventually vindicate that prognosis.
The staff of doctors and nurses was turning over so frequently that we were constantly filling in the history of what was going on from one day to the next. But no one was doing anything. All the doctors that came to see my mother were either residents or students of some nature. Rarely a specialist.
By the way the hemoglobin for my mom remained in the 90’s from some time after hovering in the 70’s previous to a requested transfusion from us. We were told that it would only go down again. It did not, because the bleeding had been stopped. But when my mom’s urine had been yellow for some time, frequent movement to reduce back pain caused the bleeding to reoccur.
She had now been in bed for over 2-3 weeks and her motor abilities were failing. We desperately requested physio and though sometimes someone showed up it was quick and no real attention provided. Often times no one came when they said they would. We tried doing exercises with ourselves. It took our urgent pleas to get her hoisted into a chair but we needed to hold head due to weakness in her limbs, but the chronic pain in her back from lying in the bed subsided, and she was relieved for only the one hour she was allowed in that chair.
The next blow was the loss of my mother’s use of her right side which the staff initially took to be a stroke. It turned out to be muscle atrophy from lying in bed so long. They gave her morphine to make her sleep which we did not want. We wanted her aware and active. This dulled her senses. They administered a second dose and then her Left arm became useless, quickly followed by inability to use her neck muscles and swallowing became an issue. She eventually could no longer swallow leading to starving of her muscles for nutrients. A CT Scan not only showed no stroke but as we expected ultra sounds showed that the bladder cancer had not changed, and not spreading.
Now with dead muscles, no ability to swallow we get high potassium readings. One nurse the day before my mother’s death chewed out 2 student doctors for not checking blood work sufficiently over the previous 4 days. We never during the month had the same team of people. They were always changing faces and miscommunication from one day to the next became an issue as we constantly had to fill in what had happened the day before to the new team.
They processed one bag of fluid through my mother on the night of September 11. The nurse on duty told me her potassium levels had gone from 6.7 to 5.7. A solution to improve urination was then hooked up. I changed shifts at the beside of mother with my brother and later in the morning of September 12 her potassium levels appeared to go up and they administered a second bag of fluid. The morning of September 12 my mother’s body could no longer process the additional fluid which anyone would have known with failing kidneys that this was too much. She began to drown in her fluid.
I arrived as they began to suction her lungs. Her body was bloated. I held her head as she breathed “Help Me…Help Me”, and we could do nothing.
Then for some reason I cannot to this minute fathom, they asked all of us to leave the room while they changed her gown from the liquid drool that spilled out of her. They actually said “It will cause a rash”. A rash was what the nurses were worried about when they knew she was going to die any minute. Unbelievable. We were in shock and complied not understanding what was about to happen. So we left her bedside in the F3 wing and waited outside. In 4 minutes the nurse callously comes from around the curtain and says “Sorry about that…she is gone”.
I detail all of this information as I want you to know that to the very end she was cognizant and sharp. Her last words to me before they walked us away was “I did the best I could”. But when you are stamped “Palliative” from the start, I guess the team had to be proven right. We were left feeling that here was just another 83 year old grandmother that was on the way out anyway. At no time did we feel any real compassion but a need to have her move on.
If there is anything that can be done to influence future conditions of patients in that ward please, please do so. For a lady pegged as needing palliative care in her first week at F3 wing, she survived a hemorrhage, a heart attack, work on her kidneys, and muscular atrophy. It took all that over 4 weeks before she finally succumbed to the treatment.
This story cannot end here. We can’t bring her back, but we can raise the red flag.