Saturday, June 5, 2004
I used cigarettes as medicine tonight.
In a nutshell: My mother's blood pressure has been running alarmingly low for several days even before she took to bed and I threw up my hands and let her sleep almost as much as she wanted for a few days. I've been meticulous about feeding her foods high in sodium. I've been making sure she gets enough oxygen (as much as she'll take, anyway, and the only time she'll use it is when she's sleeping or out and about) and enough fluids. I've probably been overdosing her with fluids, in fact, although standard practice medical science says that there's no such thing as too much fluid; trust me, there is, and not as a result of renal failure. Yesterday her feet began swelling. I managed to control it throughout the part of the day she was up. This morning they looked much better but by this afternoon they were swelling again. So I've been taking her blood pressure under all kinds of circumstances: When she awakens; after a breathing treatment; after she eats; after she smokes. It has remained very low throughout the day. She has also been quite bleary when awake (for a variety of reasons, not the least of which is her desire to sleep a lot and me letting her) and forgetting to smoke. It seemed like a relief that she was forgetting to smoke except that, while scouring my brain for ways to raise her blood pressure to normal levels I realized that smoking might do the trick. So this afternoon I encouraged her to smoke. Transported her cigarettes for her when she traveled from one place to another and forgot them. Normally I count on her forgetting to smoke to decrease her fouled air intake. Today I became her Cigarette Girl.
It didn't work. The only treatment that seemed to work to raise her blood pressure was giving her Siberian Ginseng, which I haven't been administering for awhile because, under normal circumstances, it raises her blood pressure too high. I gave her one dose and within a few hours her diastolic shot from the high forties to the low 70's, perfect. Her systolic went from the low 80's to the mid 150's. That, of course, is a bit high. Since her feet were still swollen, although not continuing to swell, I decided to give her a quarter of a furosemide, 10 mg. I'm hoping it will pull the water off her feet and pull her systolic back down without provoking a blood pressure crash. I warned her that if she thinks she sheds "too much" on a regular basis, wait until tonight. I expect she'll be sleeping in a puddle in the morning. But, that's okay. The amount of watershed makes no difference to our morning routine, anymore.
When and how did this particular health dip start? Two weeks ago yesterday, when MCS was visiting, she changed the position of the pillows in my mother's rocking chair. Having had back trouble herself, she was concerned that Mom wasn't sitting correctly. An honest observation and an honest correction, but a mistake, nonetheless. Saturday, Mom began experiencing sharp, debilitating pain in her upper back. Sunday I realized that the changed position of the cushions in her rocking chair had caused her upper back to misalign. I did what I could to relieve the pain: Strong doses of acetaminophen. I discovered on Monday that I wasn't going to be able to procure hands-on professional help until she saw her therapist the following Friday so, under expert guidance, I attempted to gently realign her back. The three separate adjustments I made did help but didn't completely relieve the condition. In addition, she was in so much discomfort that she vomited three times in the middle of the night that week. Luckily, I am so attuned to her now that even though the vomiting happened when we were both was asleep I heard her and immediately came to her aid.
On Friday her therapist was able to completely realign her back. This week, though, she's been recovering from the muscle soreness caused by the misalignment episode so I've cut her some slack. It seems I may have cut her a bit too much slack and now we're having problems with extremely low blood pressure and feet swelling. Her blood sugar is remaining fairly well under control. In order to get her to eat (which is difficult when she's sleeping a lot), I've been making her favorite foods. I've only been able to get in two meals a day and she's been foregoing snacks in favor of naps so there have been days when administering her blood sugar medication has been iffy and her numbers have shot up, here and there, but that's been easy negotiate.
I've been terminally exhausted throughout this entire period. I've had some rather disturbing revelations, as well, regarding:
Now I am finding myself in the position of correcting the mistakes that well-intentioned loved ones make with my mother. I can blame the medical establishment, I can call them to account for their mistakes. I can't do this with loved ones. I make mistakes, too. The difference in the mistakes I make versus those made by loved ones who know my mother through occasional visits and phone calls is that at least I have several years of intense observation of, research on and thought about my mother. When I make a mistake I do it with close consideration not only of my own experience but of my mother's experience. Thus I am usually able to discover the mistake almost immediately and begin the correction before any damage is done or any long term suffering occurs. No one else who loves my mother has this luxury. Of course, this time, with this incident, I also made a mistake: The mistake of trusting someone else's experience over my mother's. The circumstances evolved out of genuine love and concern for my mother's welfare and are completely understandable and forgivable. And, I will not make that mistake again.
There's more I've considered over the last two weeks, much more, but I'm tired and need some sleep before arising early to see if we've managed to allay the swelling in my mother's feet.
Later.
It didn't work. The only treatment that seemed to work to raise her blood pressure was giving her Siberian Ginseng, which I haven't been administering for awhile because, under normal circumstances, it raises her blood pressure too high. I gave her one dose and within a few hours her diastolic shot from the high forties to the low 70's, perfect. Her systolic went from the low 80's to the mid 150's. That, of course, is a bit high. Since her feet were still swollen, although not continuing to swell, I decided to give her a quarter of a furosemide, 10 mg. I'm hoping it will pull the water off her feet and pull her systolic back down without provoking a blood pressure crash. I warned her that if she thinks she sheds "too much" on a regular basis, wait until tonight. I expect she'll be sleeping in a puddle in the morning. But, that's okay. The amount of watershed makes no difference to our morning routine, anymore.
When and how did this particular health dip start? Two weeks ago yesterday, when MCS was visiting, she changed the position of the pillows in my mother's rocking chair. Having had back trouble herself, she was concerned that Mom wasn't sitting correctly. An honest observation and an honest correction, but a mistake, nonetheless. Saturday, Mom began experiencing sharp, debilitating pain in her upper back. Sunday I realized that the changed position of the cushions in her rocking chair had caused her upper back to misalign. I did what I could to relieve the pain: Strong doses of acetaminophen. I discovered on Monday that I wasn't going to be able to procure hands-on professional help until she saw her therapist the following Friday so, under expert guidance, I attempted to gently realign her back. The three separate adjustments I made did help but didn't completely relieve the condition. In addition, she was in so much discomfort that she vomited three times in the middle of the night that week. Luckily, I am so attuned to her now that even though the vomiting happened when we were both was asleep I heard her and immediately came to her aid.
On Friday her therapist was able to completely realign her back. This week, though, she's been recovering from the muscle soreness caused by the misalignment episode so I've cut her some slack. It seems I may have cut her a bit too much slack and now we're having problems with extremely low blood pressure and feet swelling. Her blood sugar is remaining fairly well under control. In order to get her to eat (which is difficult when she's sleeping a lot), I've been making her favorite foods. I've only been able to get in two meals a day and she's been foregoing snacks in favor of naps so there have been days when administering her blood sugar medication has been iffy and her numbers have shot up, here and there, but that's been easy negotiate.
I've been terminally exhausted throughout this entire period. I've had some rather disturbing revelations, as well, regarding:
- The unfortunate and unintentional treachery of well-intentioned visits;
- Despite the fact that we need a physician for test orders and prescription medicines, I am now my mother's Primary Care Physician and have been operating more successfully as such than any degreed physician she's had in the last several years;
- "Medicine" can be almost anything, including cigarettes.
Now I am finding myself in the position of correcting the mistakes that well-intentioned loved ones make with my mother. I can blame the medical establishment, I can call them to account for their mistakes. I can't do this with loved ones. I make mistakes, too. The difference in the mistakes I make versus those made by loved ones who know my mother through occasional visits and phone calls is that at least I have several years of intense observation of, research on and thought about my mother. When I make a mistake I do it with close consideration not only of my own experience but of my mother's experience. Thus I am usually able to discover the mistake almost immediately and begin the correction before any damage is done or any long term suffering occurs. No one else who loves my mother has this luxury. Of course, this time, with this incident, I also made a mistake: The mistake of trusting someone else's experience over my mother's. The circumstances evolved out of genuine love and concern for my mother's welfare and are completely understandable and forgivable. And, I will not make that mistake again.
There's more I've considered over the last two weeks, much more, but I'm tired and need some sleep before arising early to see if we've managed to allay the swelling in my mother's feet.
Later.
