I have not flown an airplane since August of last year. As you might have noticed, I also haven’t posted much lately. It is time to let my readers, if I still have any, know what has been going on.
Georgia’s health has been going downhill for at least the last 3 years. It was getting harder and harder for her to walk. In the last several months, it became difficult for her to even stand up. She complained of muscle weakness, stiffness, and dizziness. Our doctor first blamed it on arthritis then later found that her blood pressure dropped significantly when she stood so he thought that was causing her dizziness. By the time we went to AirVenture 2008, she had to rent a mobility scooter to get around the grounds.
In December of 2008, she broke her foot and had to have a plate and three screws put in. That made walking even harder for her. After that, she bought a TravelScoot so she could have some mobility on our trips. That worked out well for AirVenture last year and for the last couple cruises we took. But, even as the foot healed, her movement became even more restricted. By early fall of last year, it was bad enough that she stopped driving. It was getting hard for her to even get out of bed and she was sleeping a lot. I was coming straight home from work every day so I could help her.
On Christmas day of 2009, Georgia fell twice. She just couldn’t seem to keep her balance without help. Her hands and arms were shaking too. We called the doctor the next day and got in to see him a couple days later. He still thought her balance problem was from the low blood pressure when she stood and he blamed the sleepiness and shaking on depression. This time he referred her to a psychiatrist.
The psychiatrist we visited prescribed Cymbalta for the depression and suggested she start seeing a psychologist for therapy. The next couple months were terrible as, despite the drug and therapy, Georgia continued to get worse. By March, she was sleeping up to 18 hours a day and her usually sharp mind was failing her. As a long time accountant, she had always handled our family finances. Now I had to take over that chore since she could not do even simple numerical calculations.
Finally, her psychiatrist decided there might be some physical reason for what was going on and sent her to see a neurologist. Within minutes of seeing Georgia she diagnosed her has having Parkinsonism, probably caused or accelerated by long term use of the medication Reglan. Georgia had been taking it for ten years because of gastrointestinal problems. The doctor told her to stop taking the Reglan right away. She also wanted us to scheduled an MRI just in case there was something else effecting her brain.
In hindsight, the indications of Parkinson’s had been developing for a long time. They came on so gradually at first though that each one was mistaken for something else. It took a new doctor who saw all of the symptoms at once to come up with the right diagnosis. We left the office feeling relieved that someone had, at last, identified a cause for all the problems Georgia had been experiencing. At the same time though, she was afraid of what the future would be like for her. As it turned out, the next week really scared both of us.
Instead of getting better now that she was not taking Reglan, Georgia went into a rapid decline over the next week. We has seen the neurologist on Thursday. On Friday I called to schedule the MRI but I was told she would need some blood tests first. The neurologists office was closed so we couldn’t ask them to order the tests until Monday. The office called back on Tuesday to confirm the tests were ordered. Georgia would have to fast ahead of the test so we planned to get them done Wednesday morning. But, when the morning came, she said she was feeling very ill and wanted to put the tests off until Saturday when she had an appointment with her psychologist. We would do both in one trip.
By Wednesday night, Georgia was finding it almost impossible to get up by herself. I suggested she might need some home nursing help during the day while I was at work but she was reluctant. Her condition continued to worsen. When I got home Friday afternoon, she had to have me pull her up to even sit and could not stand or walk without my help. I helped her get up and walk to the bathroom but as soon as I relaxed my hold, she crumpled to the floor. One leg was stuck out in front of her and she could not bend it to get her feet under under her. She also seemed to have very little awareness of what was going on. I told her I was going to call 911 and that I wanted her to go to the hospital. She nodded but I’m not sure she understood.
When the paramedics arrived, they asked Georgia if she wanted to go to the hospital or just have them help her back to bed. I told them she needed to go but they wouldn’t listen to me. One of them told me Georgia had to tell them herself. First she said she just wanted help to get up but, when they got her on her feet and she couldn’t stand without their support, she agreed to go.
We spent the next several hours in the emergency room where they did a CT scan, an EEG, X-Rays and blood work. They decided she hadn’t had a stroke and wanted to send her home. Fortunately, our regular doctor ordered her held for 24 hour observation and an MRI. So, Georgia was admitted to the hospital on March 19.
Saturday morning, the doctor called me at home about 7:30AM. He said they would do the MRI right away and that he was ordering Parkinson’s medication for Georgia. He also told me she was totally out of it mentally and didn’t know where she was.
When I arrived, Georgia knew who I was but she thought we were in a hotel and that I was going to leave her there with strangers while I went to Canada. She cried most of the day Despite what the emergency room doctor said, the nurse on duty was sure she’d had a stroke. She got her first dose of Levodopa in the afternoon but she stayed pretty much the same. I stayed there with her all day and until she went to sleep that night.
Sunday morning I got to the hospital very early so I would be there when the doctor came in. Georgia was awake but didn’t acknowledge me at all. The doctor came in about 7:00 and also didn’t get any response from her, except when he asked if she knew where she was.
She said, “Home.”
He told me that the MRI did not show any sign of a stroke so he was confident that she just needed a little time on the l-Dopa. Then, as he was about to go out the door, Georgia suddenly looked over at him and said:
“I just remembered that I am in the hospital.”
From that point on, she was alert and completely aware of her surroundings. Her speech was very slurred but she seemed to be mentally fine. Except for numbers that is. She was not able to add even single digit numbers and could not count backwards or tell time.
Monday and Tuesday showed big improvement. By lunch time Tuesday she could sit up by herself but still couldn’t stand or walk. Despite that, and ignoring her doctor’s request that she stay in the hospital a few more days, by Tuesday evening the hospital board decided to discharge her and move her to a rehabilitation facility. So, at 7:30 PM on March 23rd, Georgia left the hospital in an ambulance and was transported a mile down the street to the nursing and rehab center.
Over the next four and a half weeks, she got physical, occupational and speech therapy every day. She can now get out of bed unassisted, walk with a walker and go up and down stairs with help. Here speech is back to normal and her number skills are almost there. In the last two weeks, her neurologist gradually switched her from the l-Dopa to a long term maintenance drug called Mirapex.
On Friday, April 23rd, Georgia was discharged from the rehab center and is back home. She can get around the house with the walker and has a wheelchair for when we are out. She will need home health care and physical therapy for some time but, she is far better than she was a month ago and will continue to improve. We still don’t know if she will be completely free of symptoms or if the Parkinson’s will always be a factor. Her neurologist wants her to stay on the Mirapex for six months to be sure all the Reglan is out of her system. Then, if she doesn’t show any symptoms, she will gradually take her off the Parkinson’s medication. If she stays symptom free, we will know that the Reglan was the cause. If she still shows symptoms, that will indicate she had underlying Parkinsonism all along and the Reglan just unmasked it. Either way, now that we know what we are dealing with, the disease can be controlled.