Saturday, July 31, 2004
Updates from recent e's to a friend.
I haven't had any time to update here, although some of you who read this should know what has taken place over my journal absence. I did, however, cover all the events of yesterday in e's to a friend with whom I keep up a correspondence that may as well be considered journaling. I'm appending the pertinent sections of those e's below.
7/30/04 - 0301
Oh, MFASRF...what a week it's been. When did I write that last e? Let me check...the 25th and today is, damn, let's see, Sunday was...ahhh...okay, I wrote it late Sunday night. Well, since then I've figured out that my mother probably had another mini-stroke although I'm not sure when. It's hard to calculate with mini-strokes because nothing happens for awhile then little things start to happen. Anyway, although none of the stuff I said in my previous e is untrue or misperceived. I've finally figured out by observation and questioning that the pronounced weakness is affecting her right side, which was already challenged by the previous mini-stroke. Everything else still applies. She managed to recover before, as much as possible, because she was more active when she had the last one: Active enough that I never realized she'd had one, nor did her Mesa PCP until he medicated her into a blood pressure crash in the fall of 2002, she ended up in the hospital, a routine brain scan was done and the doctor who ordered the brain scan discovered its tracks. I'm not sure why she had this recent one. Could be because her PCP took her off her daily aspirin in order to combat the possibility that her anemia was being caused by internal bleeding. I put her back on a couple of natural anti-coagulants in higher doses than she'd previously been taking: Vitamin E and garlic (which I'd removed because they are anti-coagulants) maybe 3 weeks ago. Soon after I doubled her usual supplemental doses because her blood rouleauxed in her last blood draw (that means that her red blood cells splayed out like a bunch of lined up, knocked over dominoes, which indicates sticky blood). Her rouleaux factor was very low, so low that MCS said it could have been caused by a dry slide, but I didn't want to take any chances. I think she mini-stroked, anyway. However, that doesn't really change anything.
This one wouldn't be affecting her as badly as it is if she hadn't refused to move. She's lucky if she can stand from a sitting position and walk up and down the two stairs leading into/outof (should be a conjoined preposition) our sunken living room. There's nothing that can be done medically except therapy. Mini-strokes are almost never discovered until it's too late to apply those wonder drugs to them. So, yesterday I realized we'll have to use the wheelchair in the house for awhile. Today, our first day using it all day, I figured, well, she's my captive now so she goes with me where ever I go and she'll probably enjoy it, since she'll be sitting on her ass. She did. Except that, once again, all the standing up and moving an aided step or two from bed to wheelchair to toilet to wheelchair to table to wheelchair to steps to wheelchair to rocker to wheelchair to steps to wheelchair to car to wheelchair...well, you get the idea, exhausted her legs. Unfortunately, she felt so good that it also gave her a false sense of confidence. She decided, after we returned and I told her I was going to confine her to level ground for the rest of the day, while I was in the bathroom, that she could damn well walk from the dinette down the steps to the rocker if she felt like it. She almost made it, collapsing maybe a foot from her rocker. When I returned from the bathroom I saw her, surveyed her for damage and picked her up again. But this time my muscles were so tired and overworked from the last several days (they haven't yet incorporated all the new things they're doing) that I'm now fucking sore all over.
So, you know, leave it to me, I cried out of exhaustion, then I got angry. Not really bad. My mother thought I was joking. I decided she needs a skilled nursing facility for a short period of time. I spent the evening researching that possibility through her Medicare/TriCare for Life insurance. That one requires a three day stay in a hospital to qualify. Like I'm going do that to her again. I'm having trouble researching her commercial policy. I called and they observe ET business hours so I've got to call tomorrow. I'm not expecting good news. Call me a cynic, but I've learned too many fucked-health-care system lessons in the last several years to be anything but.
I am pleased, oddly, to hear from you that there is such a thing as working out to the point of vomiting. I was assuming a few other possibilities besides the ones I mentioned, including her anemia, which I know scored a temporary low during her urinary tract infection...unfortunately, her infection was not cured by the three day course of Cipro XR and we were back at the urgent care clinic day before yesterday because she was once again bleeding from the urinary tract. She's now on a milder, longer course of Levaquin which is working well, I think. However, her weakness and her challenged immune system have convinced me that I should probably start looking, once again, for a doctor up here. I just haven't had the time. Most of the time now I'm focused on what my mother is doing or aiding her in doing something. It's so weird. I have now achieved a peculiar state of "I care/I don't care" which, come to think of it, may very well be a type of Buddhist detachment. Odd that this is happening to me. I'm not exactly the best candidate for detachment.
Well, I'd better get back to bed. I'm sleeping in my mother's room in case she forgets she can't stand on her own and tries, in the depths of sleep, to go to the bathroom. I was "too tired to sleep" tonight, which, now, I'm glad I was. When I happened upon your e, much earlier I figured I wouldn't get around to answering it for awhile, measured in days. But, lucky me, I just fucking couldn't get to sleep!
7/30/04 - 1205
This morning, at 0515 I sat bolt upright on my futon. My mother was sitting on the floor staring at me. I asked her what had happened. First she said she'd rolled out of bed. Then she wasn't sure, but that's not the point. Once again I checked her and everything seemed fine I arranged her, picked her up off the floor with great difficulty considering that my body has had an unaccustomed beating in the last few days. As usual, she was not working with me but I got her into bed, her legs collapsing underneath her as we went.
I'd had it. I said, "Mom, I'm calling the paramedics. Something's seriously wrong and you're going into the ER." She protested like the devil but the paramedics arrived within minutes. I explained what happened, etc., and while three of them (one of them was one of the guy's sons who had on a T shirt, just like his dad's in every respect except it said, "My Dad is a Paramedic", it was very cool and I said so; the father grinned, the son continued very seriously into the house, carrying a piece of equipment...it was an unexpected highlight, but, that's not the point) gathered in her room to pick her up out of bed one of the men took me into the master bedroom to take a short history, med rundown and my version of what happened. He correctly guessed that my mother is senile.
So he finished the history taking and I turned to see my mother sitting up in the cot. One of the into-the-cot guys said, "What's wrong with your mother?"
I told him she had fallen out of bed and couldn't get up and that even when I lifted her her legs collapsed underneath her.
"She walked from her bed to the cot," he said.
I was stunned. "Unaided?" I asked.
"No, he said, "I held her right hand for support but she did real well."
So, here I sit, head shaking, eyes closed, literally beside myself, very, very tired, (so I'm going to take a nap, in her room, of course), understanding something very important and very troubling about my mother's relationship with me, pretty much understanding what needs to be done, she needs to be living with another one of my sisters now, I think, pretty much aware that this probably won't happen because they have reasons why it can't, all involving her extremely high maintenance, all of which are legitimate, and, well, fuck, I guess I'll take a nap and think about it later.
I did tell her, and have been telling her ever since we left the hospital, that every time she collapses now I'm calling the paramedics and she's going to the ER. I don't know whether that will make a difference. I also told her that she needs to perform for me just like she performed for the paramedics. That seemed to make an impression but I have no idea if the impression will last.
Sometimes, MFASRF, sometimes...I don't know how to finish, I'm not sure how to put into words what I'm thinking. Just sometimes...
7/30/04 - 1710
So, I realized, in my bleary-eyed update this morning...
...I forgot to let you know how my mother is. No different than when she left for the hospital. They didn't do much looking because she statted out fine. Even my mention of the possible mini-stroke didn't bring out the machines. We went home with some references for physical therapists (some of which I already know) and a number for a local physicians' referral service. I also talked to her attending physician about the problems of finding a physician in Prescott, including my problems with the physician we previously retained. I asked him point blank if the problem was, as it seemed to me, that there were too many patients and too few doctors.
"Yes," he said. "It's a seller's market."
I also asked him if he was taking new patients.
"Yes," he said, but not anyone on Medicare (he laughed nervously), then he launched into a long but interesting monologue about the problems with Medicare and commercial insurance companies in a rural area from a doctor's point of view. I also mentioned to him that I am a very assertive caregiver when it comes to my mother's medical care and at least one local doctor, whom I mentioned by name, has a problem with this and sent us a registered letter dismissing us from her service because of my assertiveness.
"She isn't the only one," he said, not naming names. "I've heard that complaint about other physicians in the area."
I'm still not completely recovered. I think this day is going to be a wash for me. I slept for about 2 hours. The Little Girl awoke me then took my position on the futon. I decided, well, I've got bills to pay, may as well do that. I'm letting Mom nap as long as she wants. As is usual in the hospital, regardless of my warnings, they put her on her back, kept returning her to her back whenever she or I repositioned her and she got sick and vomited...something to do with the way the curvature of her spine works or doesn't work.
So, it's weird, because maybe a week ago I ruminated in my online journal about taking care of my mother that one of the things that gets me through is a strange little fantasy about being alone on an island with her. If you're curious about the fantasy, here's a direct link to it (with target): I have an often indulged fantasy....
Anyway, whether or not you read it, in my sleep deprived, wondering-if-I'm-mother-toxic way, I'm thinking, it isn't just a fantasy. It's my reality, now. The reason I fantasize about it, I figure, is to try to create some of that "distance with clarity" that might help me handle what I'm doing and what I have to negotiate to do it. That's the theory, anyway. It's not working today, of course, because I'm not fantasizing about it, I'm believing I'm there.
Didn't mean to bother you again, and it's not that I'm feeling any recrimination about my self-involved e of earlier. But I thought you'd want to know how my mother is and what happened at the ER since I know you have an interest in her.
Well, back to dinner. I'm making something that should stay down and taste wonderful, a chicken with rice soup using my own homemade broth as a base, with sweet basil, lemon, celery and onion. I wasn't going to awaken her, but she went down at noon and it's five so I think I'll gently bring her to. I think it will be relatively easy. After a cup of very strong coffee I think I can handle anything again, for at least a couple of hours. Anyway, Driving Miss Daisy is on tonight and my mother can't get enough of that movie, so that should keep her up for awhile. --Gail
7/30/04 - 0301
Oh, MFASRF...what a week it's been. When did I write that last e? Let me check...the 25th and today is, damn, let's see, Sunday was...ahhh...okay, I wrote it late Sunday night. Well, since then I've figured out that my mother probably had another mini-stroke although I'm not sure when. It's hard to calculate with mini-strokes because nothing happens for awhile then little things start to happen. Anyway, although none of the stuff I said in my previous e is untrue or misperceived. I've finally figured out by observation and questioning that the pronounced weakness is affecting her right side, which was already challenged by the previous mini-stroke. Everything else still applies. She managed to recover before, as much as possible, because she was more active when she had the last one: Active enough that I never realized she'd had one, nor did her Mesa PCP until he medicated her into a blood pressure crash in the fall of 2002, she ended up in the hospital, a routine brain scan was done and the doctor who ordered the brain scan discovered its tracks. I'm not sure why she had this recent one. Could be because her PCP took her off her daily aspirin in order to combat the possibility that her anemia was being caused by internal bleeding. I put her back on a couple of natural anti-coagulants in higher doses than she'd previously been taking: Vitamin E and garlic (which I'd removed because they are anti-coagulants) maybe 3 weeks ago. Soon after I doubled her usual supplemental doses because her blood rouleauxed in her last blood draw (that means that her red blood cells splayed out like a bunch of lined up, knocked over dominoes, which indicates sticky blood). Her rouleaux factor was very low, so low that MCS said it could have been caused by a dry slide, but I didn't want to take any chances. I think she mini-stroked, anyway. However, that doesn't really change anything.
This one wouldn't be affecting her as badly as it is if she hadn't refused to move. She's lucky if she can stand from a sitting position and walk up and down the two stairs leading into/outof (should be a conjoined preposition) our sunken living room. There's nothing that can be done medically except therapy. Mini-strokes are almost never discovered until it's too late to apply those wonder drugs to them. So, yesterday I realized we'll have to use the wheelchair in the house for awhile. Today, our first day using it all day, I figured, well, she's my captive now so she goes with me where ever I go and she'll probably enjoy it, since she'll be sitting on her ass. She did. Except that, once again, all the standing up and moving an aided step or two from bed to wheelchair to toilet to wheelchair to table to wheelchair to steps to wheelchair to rocker to wheelchair to steps to wheelchair to car to wheelchair...well, you get the idea, exhausted her legs. Unfortunately, she felt so good that it also gave her a false sense of confidence. She decided, after we returned and I told her I was going to confine her to level ground for the rest of the day, while I was in the bathroom, that she could damn well walk from the dinette down the steps to the rocker if she felt like it. She almost made it, collapsing maybe a foot from her rocker. When I returned from the bathroom I saw her, surveyed her for damage and picked her up again. But this time my muscles were so tired and overworked from the last several days (they haven't yet incorporated all the new things they're doing) that I'm now fucking sore all over.
So, you know, leave it to me, I cried out of exhaustion, then I got angry. Not really bad. My mother thought I was joking. I decided she needs a skilled nursing facility for a short period of time. I spent the evening researching that possibility through her Medicare/TriCare for Life insurance. That one requires a three day stay in a hospital to qualify. Like I'm going do that to her again. I'm having trouble researching her commercial policy. I called and they observe ET business hours so I've got to call tomorrow. I'm not expecting good news. Call me a cynic, but I've learned too many fucked-health-care system lessons in the last several years to be anything but.
I am pleased, oddly, to hear from you that there is such a thing as working out to the point of vomiting. I was assuming a few other possibilities besides the ones I mentioned, including her anemia, which I know scored a temporary low during her urinary tract infection...unfortunately, her infection was not cured by the three day course of Cipro XR and we were back at the urgent care clinic day before yesterday because she was once again bleeding from the urinary tract. She's now on a milder, longer course of Levaquin which is working well, I think. However, her weakness and her challenged immune system have convinced me that I should probably start looking, once again, for a doctor up here. I just haven't had the time. Most of the time now I'm focused on what my mother is doing or aiding her in doing something. It's so weird. I have now achieved a peculiar state of "I care/I don't care" which, come to think of it, may very well be a type of Buddhist detachment. Odd that this is happening to me. I'm not exactly the best candidate for detachment.
Well, I'd better get back to bed. I'm sleeping in my mother's room in case she forgets she can't stand on her own and tries, in the depths of sleep, to go to the bathroom. I was "too tired to sleep" tonight, which, now, I'm glad I was. When I happened upon your e, much earlier I figured I wouldn't get around to answering it for awhile, measured in days. But, lucky me, I just fucking couldn't get to sleep!
7/30/04 - 1205
This morning, at 0515 I sat bolt upright on my futon. My mother was sitting on the floor staring at me. I asked her what had happened. First she said she'd rolled out of bed. Then she wasn't sure, but that's not the point. Once again I checked her and everything seemed fine I arranged her, picked her up off the floor with great difficulty considering that my body has had an unaccustomed beating in the last few days. As usual, she was not working with me but I got her into bed, her legs collapsing underneath her as we went.
I'd had it. I said, "Mom, I'm calling the paramedics. Something's seriously wrong and you're going into the ER." She protested like the devil but the paramedics arrived within minutes. I explained what happened, etc., and while three of them (one of them was one of the guy's sons who had on a T shirt, just like his dad's in every respect except it said, "My Dad is a Paramedic", it was very cool and I said so; the father grinned, the son continued very seriously into the house, carrying a piece of equipment...it was an unexpected highlight, but, that's not the point) gathered in her room to pick her up out of bed one of the men took me into the master bedroom to take a short history, med rundown and my version of what happened. He correctly guessed that my mother is senile.
So he finished the history taking and I turned to see my mother sitting up in the cot. One of the into-the-cot guys said, "What's wrong with your mother?"
I told him she had fallen out of bed and couldn't get up and that even when I lifted her her legs collapsed underneath her.
"She walked from her bed to the cot," he said.
I was stunned. "Unaided?" I asked.
"No, he said, "I held her right hand for support but she did real well."
So, here I sit, head shaking, eyes closed, literally beside myself, very, very tired, (so I'm going to take a nap, in her room, of course), understanding something very important and very troubling about my mother's relationship with me, pretty much understanding what needs to be done, she needs to be living with another one of my sisters now, I think, pretty much aware that this probably won't happen because they have reasons why it can't, all involving her extremely high maintenance, all of which are legitimate, and, well, fuck, I guess I'll take a nap and think about it later.
I did tell her, and have been telling her ever since we left the hospital, that every time she collapses now I'm calling the paramedics and she's going to the ER. I don't know whether that will make a difference. I also told her that she needs to perform for me just like she performed for the paramedics. That seemed to make an impression but I have no idea if the impression will last.
Sometimes, MFASRF, sometimes...I don't know how to finish, I'm not sure how to put into words what I'm thinking. Just sometimes...
7/30/04 - 1710
So, I realized, in my bleary-eyed update this morning...
...I forgot to let you know how my mother is. No different than when she left for the hospital. They didn't do much looking because she statted out fine. Even my mention of the possible mini-stroke didn't bring out the machines. We went home with some references for physical therapists (some of which I already know) and a number for a local physicians' referral service. I also talked to her attending physician about the problems of finding a physician in Prescott, including my problems with the physician we previously retained. I asked him point blank if the problem was, as it seemed to me, that there were too many patients and too few doctors.
"Yes," he said. "It's a seller's market."
I also asked him if he was taking new patients.
"Yes," he said, but not anyone on Medicare (he laughed nervously), then he launched into a long but interesting monologue about the problems with Medicare and commercial insurance companies in a rural area from a doctor's point of view. I also mentioned to him that I am a very assertive caregiver when it comes to my mother's medical care and at least one local doctor, whom I mentioned by name, has a problem with this and sent us a registered letter dismissing us from her service because of my assertiveness.
"She isn't the only one," he said, not naming names. "I've heard that complaint about other physicians in the area."
I'm still not completely recovered. I think this day is going to be a wash for me. I slept for about 2 hours. The Little Girl awoke me then took my position on the futon. I decided, well, I've got bills to pay, may as well do that. I'm letting Mom nap as long as she wants. As is usual in the hospital, regardless of my warnings, they put her on her back, kept returning her to her back whenever she or I repositioned her and she got sick and vomited...something to do with the way the curvature of her spine works or doesn't work.
So, it's weird, because maybe a week ago I ruminated in my online journal about taking care of my mother that one of the things that gets me through is a strange little fantasy about being alone on an island with her. If you're curious about the fantasy, here's a direct link to it (with target): I have an often indulged fantasy....
Anyway, whether or not you read it, in my sleep deprived, wondering-if-I'm-mother-toxic way, I'm thinking, it isn't just a fantasy. It's my reality, now. The reason I fantasize about it, I figure, is to try to create some of that "distance with clarity" that might help me handle what I'm doing and what I have to negotiate to do it. That's the theory, anyway. It's not working today, of course, because I'm not fantasizing about it, I'm believing I'm there.
Didn't mean to bother you again, and it's not that I'm feeling any recrimination about my self-involved e of earlier. But I thought you'd want to know how my mother is and what happened at the ER since I know you have an interest in her.
Well, back to dinner. I'm making something that should stay down and taste wonderful, a chicken with rice soup using my own homemade broth as a base, with sweet basil, lemon, celery and onion. I wasn't going to awaken her, but she went down at noon and it's five so I think I'll gently bring her to. I think it will be relatively easy. After a cup of very strong coffee I think I can handle anything again, for at least a couple of hours. Anyway, Driving Miss Daisy is on tonight and my mother can't get enough of that movie, so that should keep her up for awhile. --Gail
