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How low can her O2 sats get before she needs readmitted to the hospital? Mom was in the hospital for 6 days with bacterial pneumonia, and released to transitional care because she was very weak and unable to go home. She has been there about 5 days now. Friday I thought she had turned a corner for the better, but tonight Monday I went in to see her and she was burning up with fever, not very alert and although she knew where she was, she was wasn't making much sense when she talked. I've seen her like that when she was overmedicated and sick...kind of like she was time traveling in her mind. She said her O2 sats had been 57 this morning! She is normally on 3 litres and stays around 88-95. Considering the pneumonia, I would expect her sats to be on the low end of that right now, but 57 is downright dangerous. They cranked her up to 6 liters and left her there all day, and her sat was 86 tonight on that. I had to round up the charge nurse to see what was going on, and he got the respiratory nurse to come in and assess her. I'm worried that her sats will go down again...shouldn't they have taken her to the ER or at the very least called me if it was that low? I'm worried that she'll have organ failure and brain damage if it gets that low again and no one notices. At least in the hospital she's monitored continuously and an alarm goes off when it gets low. I just wish I knew how much to expect of this facility, because I can't be there 24/7, obviously. She's feeling so awful, aches all over and can barely move...can't even turn herself over to her other side in the bed without help, and it seems she's getting worse instead of better. What's the best way to support her right now? The nurses are very nice and attentive when I ask for something for her, but I worry about when I'm not there.

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amicable: Thinking of you ... hugs.
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Thanks so much Churchmouse. Yes, posted just today EST. Just knowing people know how I feel helps a lot. Hugs.
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I refused to go to rehab felt I was too ill for that zoo so I came home and sure enough I had to be admitted to a different hospital three days later.
Good wishes for your Mom Amicable Keep vigilant.
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amicable: Thank you so much. Oh, I am so glad to hear that your mom is rounding the bend towards recovery!
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Oh Amicable, that's so discouraging!!. Good thoughts coming mom's way!

In the hospital, is she being seen by pulmonology?
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When did you post, Amicable? It's 20:54 here = 3:34pm EST.

I'm sorry you're both going through this. Please keep updating, thinking of you even though it doesn't help :(
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Darn! Out of the rehab for one day, back in the hospital the next. Spent a week there and is back to rehab. Delayed getting her anxiety meds, and now she's running another fever. I know she feels like a hamster on a broken wheel....so do I.
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Just a comment on the use of vaporub on someone who's getting oxygen: if the vaporub contains petrolatum, it should NOT be used for someone on oxygen.
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llama, I'm so sorry you suffered that. Just wanted to update everyone...it seems there has been some recent turnover in the NH, and mom is thankfully recovering, and is coming home in a few days. We will have PT, OT and bathing help as well as nursing visits. She's weak, but very motivated to come home! I do have to say that for the most part the care has been very decent with that one concerning exception. Turns out they had fully qualified respiratory staff on hand, so they did the same things they would have done in the hospital to get her sats up, and without the disturbance of readmitting her. I appreciate everyone's input here! Meanwhile she's doing better, and since there's someone to look after her, hubby and I don't have to worry for the weekend and will take a short respite :) (take it when you can get it, right?!) Thanks again everyone for your advice and prayers!
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Babalou and churchmouse: I was about to rescind my post until I went over the op's message with a fine-toothed comb. While I am acutely aware of the germs in hospitals, this woman should have been called an ambulance and taken to the er stat! The daughter had to go looking for head/charge nurse...Good grief! They weren't even aware (and dare I say caring) that her mother was that ill! These facilities are sometimes a joke. My mother was in the nh in the family meeting was told "Maam, you're too well to stay here...The pt gave his 2 second montage and left." they got it dead wrong...Literally...In under 48 hrs my late mother suffered an ischemic stroke there, was transported to the er and deceased!
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Vapor vicks, rob her head & tummy works wonderfully on children and adult to bring fever down, lots of fluid specially lime juice, and rest .
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I second that, Babalou. I doubt if even pneumonia sees off quite as many very elderly people as hospital acquired infection, overstretched nursing staff, gung-ho interns and dementia all wrapped up together in one lethal bundle. Terrible things happen to little old ladies in hospital, especially demented little old ladies, none of it intentional. I was lucky enough to have a GP who always backed me up on 'get her out of there - stat!'

My former neighbour-over-the-road, aged 86, has no bone density to speak of, advanced heart disease and is a nightmare patient. But my God she has a will of iron. When she needed IV antibiotics for her infected hip replacement she still would not stay in hospital - she had the district nurses coming to her house three times a day to check the cannula and administer the next drip feed. Maybe they just went along with it to spare the hospital staff from having her on the ward! - but it does go to show it can be done.
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I have to disagree, LL. Hospitals are disorienting and germy places for the elderly. In general, i wanted my mom out of an acute bed and back in the nh asap. Now, as her dementia has progressed, we've gone to palliative care, whereby the nh treats the pneumonia, but we have a "do not transport" order for her. At this point, pneumonia is going to be a less painful death than dementia or chf.
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If it were MY mother, I would want her to stay in the hospital until fully cured. Pneumonia is a killer among the elderly.
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Your Mom needs oxygen to bring her levels up. My Mom had to be 95 or above constantly before the doctor took her off. If this is not a hospital, maybe she should be sent to one. P kills.
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So glad she's doing better, Amicable.
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Thanks to all, and no, she is not on hospice. She is in transitional care for 2 kinds of pneumonia. I suppose it came back up right away or they would have taken her. However, I'm told there's a full complement of respiratory professionals on staff as they have a respiratory care unit, so if they could handle it without a trip to the ER, I'd rather they did that. I was just upset because they didn't let me know it got that low...I really feel I should have been alerted. From my research, sat needs to be 92% to properly enter the blood cells, and below 85% is risk for organ damage....if not, please correct me. At any rate, she seems to be doing much better today. A new antibiotic, a simpatico roommate and visits from friends have helped!
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Mac, i don't believe Amicable's mom is on Hospice. And as far as I know, we only have mom' s say so on the 57%. I think it needs to be verified with staff.
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I am an acute care respiratory therapist and I wish I saw this posting earlier. If she is in hospice then there is no need to check sats. If she is a full code or intubation then a sat of 57 means she needs a non rebreather mask and a trip to the ED stat. But first a second sat should have been obtained by a second machine to see if it was an error. Did her nailbeds or her lips look blue? A sat of 57 may mean that her arterial oxygen levels are critically low in the 30s or 40s. The lowest tolerance for oxygen sats according to Medicaire is less than 88% for supplimental oxygen This includes hospitlaized patients who are on full codes
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Turned out she has a new pneumonia on top of the old one :( that's what happens when you can't get out of bed, I guess. I'm told she was more active yesterday, and she's getting a new antibiotic, so I'm hoping for the best.
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amicable: Hope your mum is OK. Hugs.
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Keep us posted - treats for the staff are always a good idea !
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Love-bombing the staff is an excellent strategy! Hope there's good news waiting for you.
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from my research, below 82%, the oxygen can't enter the blood cells. They did labs earlier today, CBC and CMP, so I'm headed in now to see how those results came out. Thanks everyone for the support! Hugs :)
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Thanks Babalou...She seems a little better. The nurse told me her fever may have been due to not passing bowels for 3 days...they administered an enema, and her fever's down today. I had no idea! They do have a hospital unit fully staffed with respiratory care people, so not sure it would have been a good idea to move her back to the hospital at this point anyway...it may have done more harm than good. I'm bringing donuts to the staff today to try to bribe them for better monitoring! LOL
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My mom, who was 92 at the time, had pneumonia a few months ago; she has CHF and a stable plueral effusion and has O2 available whenever she wants it. We had decided several months previously that we were no longer going to transport her to the hospital for anything, choosing Palliative Care (but not Hospice). She was on an antibiotic for 3 days with no change; NH saw that it wasn't working and put her on Levaquin (which is tough on old kidneys, but they put her on a saline drip as well to mitigate the effects). It worked; but my point is, that it took careful monitoring and a second round of antibiotics to pull my mom through.
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Follow your gut and get Mom back to the hospital. Do it today she needs more expert care.
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If you get a surprise reading of 57 the first thing to do is check it again, because there's a good chance the reading was wrong (though it depends on how they're measuring it, of course).

But clearly the main thing is that your mother is still unwell. I hope you find her improved at your next visit, please update.
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Amicable, how is your mom this morning?
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Is her own doctor following her care at the TCU ? If so then call his (her) office after hours if need be
Several years ago my mom was sent from hospital to TCU following a fall and was in renal failure due to dehydration and left unchecked over the weekend -TCU staff md is not anyone that I would choose or trust but more and more doctors don't visit facilities

Unfortunately you have to advocate on a near daily basis - it's draining physically and emotionally

Let us know how it goes
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