Mom & Me Two Archive

    Here are my choices, all of which are linked to their sub-posts below:

1. I was wrong. Mom needs to stay at the SNF some days longer than I thought.
2. The facility is dragging their feet on trusting my medical knowledge of my mother.
3. I am no longer harboring silent guilt for seeing her every other day. Today killed that.
4. MCS's relating of her recent sigmoidoscopy finally convinced me that am I am right: No more scoping of my mother.
5. I'm waiting for some software updates to download so this is a good time to post.
6. My mother's sense of taste has returned to the point where her favorite flavor of V-8 juice was almost too much for her today.

    Take your pick. Downloading is going to take awhile, so I might be able to write on all of them. Follow along by number:

1. Today I decided to take my mother for another walk in the facility. Instead of wheeling her I decided to let her wheel herself, since the facility's insurance forbids me from yet supervising her through upright walking and I'd seen her doing this wheel-walk as part of her physical therapy on Tuesday. I'm sure you've seen it. The wheeler gives herself intermittent, needed spurts of movement with her hands attending to the wheels while she walks herself on a surface with her feet pushing off the floor as though she was walking upright. We headed toward the living room to fill her popcorn bowl from the facility's machine. She made it about 2/3's of the way then begged fatigue. I pushed her into the living room and back down the perpendicular hall. When we reached the turn I let her go on her own back to her room.
       Although it seemed to me during her therapy sessions that she'd had much more stamina and much better skill at this I decided that perhaps I hadn't studied her well enough, hadn't paid attention to the "right" cues and that she had done her best for me today.
       Later, one of the CNAs who is very familiar with both of us, individually and as a "couple", came in to query about Mom's bowel movements and joked with her, "I saw you fooling your daughter today in the hall acting like you didn't know what you were doing in that chair, fooling her into pushing you half the way to the popcorn machine and back."
       My mother grinned, sly sure of herself, forgetting, I think, that I was in the room on the other side of her bed. "Don't give my secret away, now," she scolded.
       The CNA winked at me. I thanked her profusely for finding a way to let me in on my mother's scam and at the same time "conspire" with my mother in her deception in order to keep her trust.
       She gave me a "just thought you ought to know" look, indicated to me that is it wise for me to know and to continue to keep in mind that my mother doesn't, for some reason, like or think it's necessary to perform for me and it is important for me to continue to look for numerous ways around her intransigence.
       "You know," I said, "I thought I'd noticed that she was performing much better for the therapist than for me today, but she was so convincing."
       The CNA, who had a merry approach to this whole episode, laughed. "You need to become as tricky with her as she is with you when you take her home."
       Suddenly I realized I was wrong last night, overwrought with missing the suddenly-no-longer-ubiquitous in my life. As long as she is instantly willing to not perform for me by pretending to weakness and lack of skill she needs to be in this facility to take advantage of the desire to please and show off that the professional therapists evoke from her. Not that an out-patient therapist, which I intend to procure when she is released, would not evoke the same enthusiasm and cooperation. But, an out-patient therapist is likely to see her twice a week, if we're lucky; more than likely, once a week and then counsel us to exercise at home. Right. We've gone through this before. Her health is ripening to the point where she has the needed stamina to perform, daily and vigorously (relative to her abilities), for outsiders. It seems to me we should take advantage of this opportunity while we can.
       It was with this attitude that I approached the nursing staff asking exactly what the SNF's goals were for her and how long they expected her to be pursuing these as a resident at the facility.
       "We think she is capable of strengthening to the point that the likelihood of her falling would be very low when she walks around at home and in her community. This is what we're working toward. When we discussed her on Tuesday we figured we may be able to accomplish this in a two week visit, including the time she'd already put in."
       Interesting choice of words "time...put in", I thought. I like this attitude. It is a boot camp attitude.
       A part of me was reluctant to break this news to my mother since I'd been talking to her earlier in the day, before I gave her the opportunity to con me, about how "a week and a few days", one of the Charge Nurse's pronouncements after careful evaluation of her condition when she was admitted, including an extensive physical examination, was almost up and maybe she'd be released around Monday of next week. We'd both panted at this possibility. When I broke the news to her of possibly another week with release maybe next Friday or so it was after she'd not only conned me but I'd been let in on the con. Because I knew she would not only understand the truth but it would make an impression on her, when I told her I also mentioned that if she went home earlier than this short term stay allowed she'd not be taking advantage of the extra physical strength and skill she'd recover from being allowed to show off for therapists. I reminded her of how, even after almost a week at the facility, she still insisted on cutting back her performance for me and it would be a shame if she didn't achieve as full recovery as possible in the time Medicare/TriCare allow her simply because she knew how easy it was to pull one over on me.
       She looked startled, rather like a kid having been caught red handed. "I suppose you're right," she conceded.
       I will continue to remind her sumptuously throughout every day I'm there and with every phone call I make to her that this is short, short term and a magnificent opportunity; that it is her job; that it is boot camp for a more satisfying continuation of our life together. I'm also not shy about reminding her, often and very explicitly, how much I miss her when I'm at home, how much The Little Girl misses her, how I think about her sitting in her room at the facility and me sitting in our living room and probably 'watching' the same TV show in the background but not really paying attention to it, her doing her crosswords, me probably on the internet entering "stats", writing about her or her and me, and it makes me very sad. I want her to be reminded often of the extent of her importance not only to me but to her pets and to the identity of her home. She has a tendency to sometimes think she is not important, a hold over from generational messages. I want to make sure this thought habit is contended as often as possible.
       So I'm preparing for another week of commuting, planning business in both places and carrying it out, paying a few more bills, and last because it is the most important, making sure my mother considers this SNF stay as a radical turn in but still a continuation of our life together, a significant blip, but a blip, nonetheless.
       Funny how crises have a way of reminding one of just how much more one can gracefully take than one thought...how much further one can go...and how much one lusts after the thought of going there.
2. Blood for another CBC/BMP was drawn early this morning about the time I was thinking, "Oh, okay, the alarm just went off, I can sleep for a few more minutes." The results of the CBC were at the nurses station a bit before noon. The BMP wasn't available, yet. Her hemoglobin was 9.4, the same as it was on the 9th. Three of the ranges, Red Blood Cells, Hemoglobin and Hematocrit, were lowered to ranges I prefer to use with her, which was nice. Her results, though, had barely budged. Immediately I thought, they didn't take me seriously on the Niferex.
       I brought the results and a reminder of the Tuesday discussion of my mother's recurrent anemia to the Nursing Supervisor's attention and asked to see if the Niferex-150 was being given, as, I said, if it had been started on Tuesday her hemoglobin would have been up at least a couple 10ths of a point, probably more. The chart indicated that it had been first administered this morning. I didn't ask why. I knew why. They needed to make sure my analysis of the situation could be trusted, so they did it their way by consulting a blood test first.
       I hope these episodes of me not being trusted or listened to about my mother remain mostly benign experiences for her; barely noticed, not pondered. I'm sure there will be more.
       As it turns out although my mother thought she remembered drinking V-8 juice yesterday the evidence revealed that she hadn't. An overheard conversation between her and a CNA revealed that she had eaten a good amount of popcorn yesterday. So, I'm not being taken seriously on this issue, either. Well, they are the ones who will have to clean up.
       I was pleased to note, however, that they did heed my passed on advice from a couple of doctors that she not be administered anything to control her blood sugar other than 10 mg glipizide X 2 unless she shot over 200. I think the only reason this was instituted was that the medical director agreed that he doesn't like metformin for his elderly patients. In essence he wasn't recognizing my authority in such matters. I take what favors I can get, though, for whatever reason they are offered.
3. Knowing that she is still in high performing mode for the therapists at the facility and still in low performing mode for me, I am encouraged that visiting her only every other day is the right thing to do, despite how hard it is on both her and me seeing her experience loneliness and knowing it is not an easy emotion for her to deal with, knowing it is not just her body that is getting somewhat stressful therapy. If I was ever feeling any guilt over my schedule, and I think I was, the guilt is gone.
4. Without going into excrutiating and distasteful detail, MCS had a routine, "over 55" sigmoidoscopy a few weeks ago. She described what it felt like, underlining her perception that it was "extremely" uncomfortable, enough so that she involuntarily "moaned". She confirmed that there were, indeed, many times when her ability to cooperate with the internist who performed the procedure was crucial. My own bowels cringed at what the colonoscopy must have seemed like to Mom, how uncomfortable it must have been and how handy that her horrible short term memory allows her to dismiss it as though it had not happened. I am now convinced that Mom's internist was absolutely right (and absolutely surprised, as well) that Mom's colonoscopy was "torture" for her and that Mom should not ever be scoped again, certainly she would never consider scoping Mom again.
5. I'm still downloading software updates. There was a mess of 'em.
6. Deciding to make sure that she had at least some V-8 juice once every other day, if that is all she's going to get, today I poured her a cup of her favorite flavor, Picante Mild, to drink with lunch. If you are a fairly regular reader of this presentation or you just happen to know my mother well you know that she has, over the last several years, exhibited a decided preference for spicy, the hotter the better. She has been known to happily eat jalapenos out of the jar. She loves straight horseradish and will sometimes forget she has a pile of it on her plate as a condiment and simply eat it with her fork like cottage cheese then become indignant when I remind her of its original purpose. She has considered the spicy V-8 juice "good", but has, in the past, not been sure whether it was hot or not. Today, the "picante" singed her tongue, much to both her and my surprise and my delight. She will, I think, continue to enjoy the flavor of most spicy stuff so I'll see if I can't cook with hot spice in a way that pulls out some of the heat but leaves the flavor. It will also be refreshing to cook with more subtle flavors. The only problem her recovering taste presents is that she also noticed today how bland the facility food is.
       "I told you, Mom, on Sunday when I had one of their 'Sunday Dinners'. It's very bland. Filling, if you aren't offended by the idea of eating it, but bland. And, what is it with all these potato side dishes?"
       "I've never cared much for potatoes," she confirmed.
       "Well," I reminded her, "you used to always order a baked potato with sour cream, chives and lots of butter when we went out as a family when I was a kid."
       "Do you see any sour cream, chives and butter to speak of here?"
       I laughed in agreement.
       Today the potato side was a couple of broiled (or something like that) red potatoes with skin which probably would have been good if they'd been marinated in ranch dressing mix or even a combination of herbs and salt, dipped in olive oil and rolled in the spice mix before "broiling". How hard and how expensive could this taste-ensuring procedure be?
       She isn't a gravy person either, but "your father always wanted gravy," so she made a flour "gravy" only he would eat, usually a beige mush with suspicious lumps and bits of dripping meat. Thus, she and I never developed a taste for gravy.
       I bring her stuff here and there but so far she's declined my offer to get her a fast food something. With her improving sense of taste, she may be taking me up on my offer, soon.

    Well, software is still downloading and I'm getting tired. I think I might pause the process and go to bed. No alarms in the morning. That'll be nice.
    Later.