"George"

Friday October 27th, 2006. 4:45 a.m.

My co-worker Mel and I were ending our shift. Tidying up the place, doing last minute chores. Mel, a cute little oriental girl, grabbed the trash and headed out the side door.

I was in the med room finishing up with charting, pills, just the same old routine.

A commotion in the lobby.

 Mel was speaking a mile a minute, loudly, with her strong accent the words I understood...GEORGE, COLD, and CAR.

As I walked toward the lobby my heart started beating faster. You know that feeling when something just isn't right.

I saw them as I turned the corner. Mel and George standing by the fireplace. Mel was still ranting. George was staring at her, frustrated and kept repeating.."I have to find my car."

"George" has severe Alzheimer's disease.

Mel's ranting, to him, was like having a radio station tuned in a little off. Some words come through but it is a jumbled mess. He was reading body language which probably looked like anger. To top his off, his incredible need to find his car, right then, was not being met.

I gathered my thoughts..opened my arms, put on my biggest smile...

"George!! I have been looking for you!!"

He smiled, reached his hand towards me, and said, "Honey, I have to find my car."

Ok George, I will help you.

Mel had found George in the parking lot of the facility when she went to take out the trash. I have no idea how long he had been out there. Once you leave the facility after 10 p.m., the doors are locked there is no way to get back in unless you press the doorbell and alert the staff. George would have never known to do that.

This could have been a tragedy, I know all too well as my Grandfather did the same thing years ago and was lost in the woods of northern Wisconsin overnight after leaving the facility he was in. He lived through the ordeal, but never walked again.

George is well. I talked to him gently. Using short, direct sentences that would not get jumbled. My body language was caring as I held his hand and listened. We even went back outside to check,  just one more time, for his car.

 

You can't argue or reason with Alzheimer's disease.

It's a losing battle.

You just have to care.

My Grandfather.

Lost the battle, and died of  complications related to Alzheimer's disease.

 

The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.

 -M.Scott Peck-

 

I go on each day, this quote is my life in a nutshell.

I am searching.

I don't know what it is. I sleep. I know everyone sleeps, I sleep from 12 to 15 hours a day. Even the most simple of tasks like grocery shopping or running errands exhausts me.

I don't feel sad. I wouldn't call it depression. My sleep, as my therapist and primary Dr. described it, is my way to "escape."

 

What am I escaping from? I don't have the answers.

 

My life is better than most, I have everything I need or want.

So I go on, this cycle of sleep, work, and my time on "The Stream."

I hope it will get better soon.

I hope I will get better soon.

 

The local news had a segment on the stolen bone last night.

Every time this resurfaces, the incredible story of people harvesting bones and tissue illegally from mortuaries...from people who died of things such as cancer,

I think of Brian (Hook) as he walks around with pieces of these bones in his neck, fusing, and becoming part of him.  He had his surgery in August of 2005.

There has been one confirmed case of Hepatitis C contracted from the bone in a man from Omaha.

 

How can things like this happen in this day and age, it is truly terrifying!

 

Parts of a story from the Washington Post dated January 28, 2006.

http://www.washingtonpost.com/wp-dyn/content/article/2006/01/27/AR2006012701569.html

NEW YORK -- Hundreds of very live Americans are walking around with pieces of the wrong dead people inside of them. A macabre scandal has spread from a body-harvesting lab in New Jersey to hospitals as far away as Florida, Nebraska and Texas as hundreds of people discover that they have received tissue and bone carved from looted corpses, not least the cadaver of Alistair Cooke, the late and erudite host of PBS's "Masterpiece Theatre."

 

The former dentist came to funeral homes, investigators say, and extracted bone, tendons and skin from corpses without the consent of relatives. Later, Biomedical Tissue Services shipped coolers full of tissue to hospitals for surgeries. A dead body can be worth tens of thousands of dollars when it is dissected for parts.

 

I know you're thinking..."CAN THIS BE REAL??" Sadly, it is.

 

The scandal raises questions about the safety and proper supervision of a billion-dollar-a-year industry that supplies skin and tissue for 1 million tissue transplants each year. But patients are most confounded by the skin-crawling fact that no one knows from whom the bone and tissue was harvested.

 

The Daily News broke the scandal in October, fingering several Brooklyn funeral home operators who had harvested patients without the permission of family members. In one case, reporters found that the English Brothers Funeral Home had forged consent and cause-of-death documents and allowed Biomedical Tissue Services to harvest the cancer-ridden body of Michael Bruno, a 75-year-old former cabbie.  

The New York City medical examiner's office in the past few months has exhumed three bodies from cemeteries in Brooklyn and Queens. Investigators discovered one female cadaver missing about half its body.

The New Jersey biomedical firm shipped large coolers filled with tissue to five suppliers across the nation. No one knows how many patients are affected.

But the examples uncovered so far are suggestive: Between early 2004 and September 2005, 60 surgical patients at Shore Memorial Hospital in Somers Point, N.J., received implants said to have originated with the corpse-snatching ring. Another 74 patients in Nebraska received stolen bone tissue during surgeries in the same period.

 

Brian found out he was a part of this thing with a phone call from his surgeon about 2 months after his surgery. He was tested for Hepatitis, AIDS, and several other things, so far everything has come up negative.

 

As we fill out the countless forms and paperwork that will someday be part of a lawsuit you have to wonder if there is any punishment suitable for such a crime.

 

Thanks for reading.

Joy

 

People are like stained-glass windows.

They sparkle and shine when the sun is out,

but when the darkness sets in,

their true beauty is revealed only if there is a light from within.

 -Elizabeth Kubler-Ross-

 

Going through old stuff.

My Nursing School Pinning Ceremony

Where's Alz?? (Hint: My feet NEVER touch the ground!!)

 

The past week I worked during the day, catching up on nursing things which I can't do in the middle of the night. It was nice to see everyone up and about. Talk with the staff. It was actually very enjoyable.

One of the tasks I was catching up on was doing Mini Mental Status Exams.

The MMSE is a brief, quantitative measure of cognitive status in adults. It can be used to screen for cognitive impairment, to estimate the severity of cognitive impairment at a given point in time, to follow the course of cognitive changes in an individual over time, and to document an individual’s response to treatment.

Cognitive-relating to or involving the act or process of knowing, including both awareness and judgement. Cognition is characterized by the following: attention, language/symbols, judgement, reasoning, memory, problem-solving.

The Mini Mental Exam

ORIENTATION

What is the: (year) (season) (date) (day) (month)

Where are we: (state) (county) (town) (facility) (floor)

REGISTRATION

Name three objects and have person repeat them back. (apple, table, penny)

ATTENTION AND CALCULATION

Count backwards from 100 by 7's.[ 93 86 79 72 65 ]

Or spell "world" backwards. [ D - L - R - O - W ]

 RECALL

Ask for the names of the three objects learned above (apple, table penny)

Identify a watch and a pencil.

Repeat the following: "No ifs, ands, or buts"

Follow a three-stage command:                                                                                              

"Take this paper in your [non-dominant] hand, fold it in half and put it on the floor".

Read to self and then do: "Close your eyes" is printed largely on a paper, they must read the message and close their eyes.

Write a sentence [subject, verb and makes sense]

Copy design 5 sided geometric figure; 2 pentagons interlocked.

The system of scoring is simple since it only involves adding correct answers given to the different items.

A maximal score is 30.

The overall score classifies the various levels of dementia:

Severe form of dementia = from 0 to 9 points

Moderate form of dementia = from 10 to 19 points

Mild form of dementia = from 20 to 24 points

A score higher than 27 is considered as normal.  

 A mild cognitive impairment or dementia is suspected if the score is equal or lower than 24 points.

 

The scores mean several things. It can give the doctor a clue as to whether the current treatment is still suitable, or if medications need to be adjusted. It tracks the disease process.

I usually do MMSE exams yearly, unless it's ordered to be done more frequently by their physician.

A sudden change in cognitive function can be as a result of an illness, a broken hip and surgery, pneumonia, even a urinary tract infection. Some will spring back after an illness, some will not.

The last 2 days were truly an eye opener. As I did my exams, I was amazed how some of my residents function even when their scores revealed they were suffering from severe dementia.

One resident scored a 4 on her MMSE and is still administering her own medications. (Since, the family has signed a waiver protecting the facility from liability, they insist on her continuing this activity.)

One resident is 95, a retired school teacher, found my test to be rather annoying and asked after every question...."Are there really people who don't know this stuff." She scored a 29.

One resident didn't know where she was or the date but could say the whole alphabet backwards. That was amazing. She scored a 20.

My last exam was heartbreaking. She struggled with every question I asked. People with mild to moderate dementia know there is something wrong. They search for words. They become frustrated and embarrassed. She was visibly uncomfortable and ashamed.

When it came time to write a proper sentence she wrote....

"I wish it were easier for me to answer your questions."

 I finished the exam, I went to the med room and cried.

 

 I'm back...I'm still alznurse929...I think they need me!!

 

Added Saturday

I finally took a picture of my beautiful mums....

 

 

The fall is so full of color.