Saturday, April 24, 2004

 

"You don't have to make the bed for me."

    Yes. I do. About a third of our days, I "have" to make it twice. I've got the routine down to the point where, overall, stripping, disinfecting/cleaning and making her bed takes very little time or effort. A few days ago my mother, for some curious reason into which I didn't pry, followed me into the bedroom and told me she was going to time how long it took me to make her bed.
    I grinned. "I'll bet it takes me less than a minute without rushing."
    "54 seconds," was the tally. That included using the one sheet we have that's the decades old, slightly smaller single sheet size and resists latching itself under the corners of beds younger than a decade.
    It's funny because I understand my mother's protests. I'll sleep well on anything, anywhere, if I'm really tired. My bedding certainly doesn't get changed and washed every day and that's fine with me. I know, though, how sensuously delicious it is to snuggle into a clean, made bed, and this is one of the mundane pleasures that I can offer my mother, aside from the fact that, in her case, it is hygienically important to change and wash all her bedding, including the comforter and, at least twice a week, the pillow.
    My mother doesn't seem to respond to the "big" pleasures, anymore: Things like watching a movie in a theater, attending a concert or a play, trade shows for the public, visiting an arboretum or a zoo, even eating in a restaurant, which continues to appear on her "big pleasures" list can sometimes be dicey, now. If the sound level plays havoc with her hearing, if the restaurant is too full or too empty, it there are too many or too few kids, if the portions are too big or too small, if the lighting is "romantic" (which is to say, softened toward the dullness in which physical imperfections are hard to distinguish), if our waitperson appears to have his/her eye on other tables while waiting on us, she loses her appetite and decides "it's about time to get home". A couple of years ago it was almost impossible to get her out of a restaurant, even a bad restaurant. Now when we go out to eat it's anybody's guess whether she'll enjoy herself.

    Yesterday was a strange day for me. Fairly active for Mom, although she, again, refused, this time vociferously, my suggestions of things to do outside of the house, even accompanying me on a few errands. She balked at my good-natured attempts at "forcing" her to get out. So I saved the errands until she decided to take a nap late in the afternoon after we'd played Sorry and she'd soundly beaten me, after we'd watched Cheaper by the Dozen [a bit more on this movie further down], after she'd helped me fold clothes, after we'd sat at the dining room table and rediscussed the Mother's Day menu.
    Although the day had so far been what I would objectively consider successful, I was in a hell of a mood when I headed out on errands. I plodded through the errands as though I knew death was waiting for me at the end. Mom had asked me to see if there was anything "new" at the video store that might be interesting to watch. Although there were several new releases I couldn't find anything that I thought my mother or I would consider worth watching. At Mom's request I'd picked up "one of those chicken pot pies that looks so good" at Costco. I noticed that they require 1.5 hours baking time and figured that was going to create a problem. While I handled the packaged pie I considered putting it back and lying that Costco was out of chicken pot pies but I was in such a terrible mood that I relished the possibility of announcing, to what I was sure would be my mother's dismay, that dinner was going to be awhile. When I arrived home I was only able to summon energy in short, frustrating bursts which strung unloading the car out so long that the continual opening and closing of the front door awoke and concerned my mother.
    While my mother stood in the door watching me haul a box of paper underwear out of the car as though the absorbent fibers were laced with lead she said, "Your breakfast is still on the counter. Have you eaten anything today?"
    Suddenly I realized, no, I hadn't eaten a thing. I couldn't remember why but, somehow, in the midst of preparing two meals for my mother before she napped and one for myself and working unsuccessfully to get her out I had neglected to eat anything. I'd taken my Black Cohosh and other supplements with my morning coffee but I hadn't eaten anything. No wonder.
    Last night I resolved that even if it increases my chore load, which it surely will since I awaken much earlier and retire much later than my mother, I would eat at least 3 times a day. This will mean eating breakfast a few hours before my mother is breakfasting, or even awake. This will mean that, likely, the only meal we'll eat together will be dinner, although I will still be at the table or next to her or in the living room, making conversation for all my mother's meals. This will mean that, day after day, I will be explaining, at least twice, why it is she's eating and I'm not. When I'm feeling physically good and emotionally tightly knit, though, I can answer the same question over and over and over as though it's a new question, and internally reason and externally display that it is, indeed, a new question since it's being asked in a new moment. I can make 5 meals a day. I can do everything that's necessary, many things that aren't, and do them all with a tangy twist. All I have to do is remember to eat regularly. It's true. Sometimes the solution is a lot simpler than the problem.
    Lastly, this morning, when she awoke and we conversed her out of bed, she mentioned with a satisfied smile that she had been thinking about the movie Cheaper by the Dozen. I was pleasantly surprised (although I didn't mention it). She still insists, whenever we watch Finding Nemo that it's her first time viewing that movie. Her ability to remember Cheaper by the Dozen, though, indicates to me that it isn't always her memory that's the problem, it's her interest. You'd think I would have figured this out a long time ago, but, well, as my mother would say, "I'm a little slow, just go around me."
    She's up from what turned out to be a 45 minute nap today. I just talked to her about how, with her being up so much more, now, we need to cooperate on getting her out. I explained how easy it is for me to give up in the face of her intransigence to movement and all the reasons why this is so (even the illegitimate ones) and that, "It's time to get you out, again, Mom, even if you don't want to go. Look," I continued, "I'm the kind of person who would be perfectly happy not conversing with anyone for months at a time and have been; I'm the kind of person who doesn't mind looking at the same four walls day after day because I am good at embellishing those walls with the contents of my mind. But, Mom, you're more social than me [not hugely social, on a total population continuum, but much more social than me]. You need to see, regularly, that there are other people in the world. You need to see them move, hear them speak, you need to be out in the day, and you need to do this much more than I do. So, I think it's time, Mom."
    "Yes, I think you're right. It's time."
    Whether she was simply agreeing with me so that I'd let her eat her tuna sandwich in peace remains to be seen. But, well, here we go again. "Shoulders back. Eyes forward. Look at what's around you, Mom, and move toward it. Motivation is the best teacher of movement."
    Another quick errand to run. Later.

Thursday, April 22, 2004

 

Ooh...this morning. I'm wincing.

    Not a good morning, courtesy of me. Mom and I awoke at the same time due to me not actually retiring 'last night' until close to 0200 and she retiring at 2030. At 0700 we were both awake. I heard her coughing. She heard me flushing my toilet.
    "Gail, did you just get up?!?"
    "Mom, are you already up?!? I mean, are you planning on getting to your feet?" By the time I'd finished this query I'd arrived at her bedroom door. She was on her belly, resting on her elbows, looking at me wide-eyed. I'm sure I looked bleary eyed. I was certainly unpleasantly surprised and probably not masking it very well.
    I need a couple of hours to myself in the morning preceding the slam bang intensity of the care she receives when she awakens and arises; at the very least one and a half hours, which is what I schedule in by using an alarm clock to awaken me if I have to get Mom up really early, like 0600 or 0700. Even if I need to get her up at 0500 I'll set the alarm for 0330 no matter how late I retire. I need to begin my day long before her day begins. This allows me to be present to myself so that I can be present for her without drifting back into myself (which can happen, anyway, if I'm funking). I need to anticipate myself before I anticipate her. In an emergency I can perform an autonomic, background self-anticipation and have, with great success, but on a normal morning, even a very active normal morning, if I don't stretch out into the day without anyone hampering me I tend to bind myself against others rather than reaching out to them.
    When I saw her looking as though she was ready to begin her day I was devastated. I was foggy anyway, I was feeling a bit out of sorts and realized while peeing that I'd forgotten to take Black Cohosh last night so I was in a hurry to make coffee, down pills, roll around on the floor to loosen up, bring up the garbage cans, water the roses and mourn the walk I wouldn't be taking because I retired late and awoke late.
    When I realized I was going to be ushering Mom through her morning I physically balked at her door. I mumbled something that I hoped sounded like, "Are you getting up up? I mean, breakfast and everything."
    "Are you eating something?" she asked.
    "No. It's just the first thing I said this morning. Are you ready to get up and bathe and eat breakfast?"
    She looked suspicious and sounded a little indignant. "Yes, I think so."
    My mind spun and my heart sank into the vortex. "Oh. OK. Well, nothing's set up. Stay in bed for a few minutes. I'd better take your blood sugar. It'll be a couple of minutes before everything's ready. You can lie there and contemplate getting up."
    "Oh, don't worry about any of that. I'll just get up."
    "No! Mom!" I was fairly shouting my desperation. "Please! You'll get pee all over the place! If you're going to get up let's do this right." I was close to crying.
    Mom looked at me quizzically. "Are you all right?!?"
    I stopped. And sighed. "Yes. It's just that I just got up. I usually have a couple of hours to work into all the stuff I do when you get up. This morning, I'm not even sure where I am yet and you're ready to get up. I haven't even had coffee."
    "Oh. Well, you don't have to do all that for me."
    Close to tears again. God damn it, I need my pills! "Yes, Mom, I do. And it's not just for you. It's for me. If we don't go through this morning routine of cleaning you and your bed first thing it's not healthy and there's a lot more cleanup to do later. Look. If you want to get technical, I do it for me more than for you. I'm just not quite ready for you yet." Appealing to her sense of self interest by stressing one's own self-interest usually works on Mom.
    I walked out of the bedroom, not wanting to face whatever expression was forming on her face. The extenuating circumstance is this: She doesn't remember from day to day the meticulous, extended routine that brings her forward into the day. She doesn't remember it because she neither directs it nor performs most of the movements involved in the routine. She does not, usually, even initiate starting or timing the routine.
    In a few minutes I was back. I'd gathered the blood sugar measuring stuff, thrown the four washcloths and towels we use into the bathroom toward their approximate optimum marks. I slapped the bacon in the skillet and started the electric water boiler. I'd also calculated how I could extend the set-up part of the routine by a few more minutes so I could quickly harmonize with The Tenor of the Day and feel remotely like myself. By this time, though, Mom's head was back on her pillow, dozing.
    "Give me an arm. Any arm," I said. Her right arm lolled over the edge of the bed. Her eyes remained at half mast. I took her blood sugar. A background screech began. "Hold on," I said, and dashed to the kitchen to unplug the water pot.
    When I returned her eyes were fully closed. Her body was completely slack. "Mom," I whispered, leaning over her, "are you getting up?"
    She batted her eyes sleepily. "No," she said, "It's too early. I looked at the time."
    I won't know, I suppose, whether I influenced her decision to abandon the surge of energy she was feeling or whether she, indeed, has an internal rule that, exceptional circumstances not withstanding, 0700 is an indecently early hour for activity of any kind other than sub- and unconscious.
    I am uncomfortable with what happened this morning, but I'm not feeling guilty. I slurped at the extra time I was granted as though it were shaved ice with extra cherry syrup. I needed it. I did not let the discomfort of my disgruntled sway over both my mother's and my mornings get in the way of taking advantage of the time I was granted.
    She rose again just before 1000. By that time we were both ready for her morning to begin. Although she seemed lively enough at breakfast, after breakfast she refused all my out and in activity offers and finally interrupted my attempts to fill in the day by telling me, "I just want to sit and stare."
    I understood, asked after any pain or stiffness she might be having, to which she replied in the negative. I wandered about the house finishing up some chores, starting others. She read a bit in her book, drank all the fluids offered her, did, indeed, stare out the window and noticed, with great pleasure, the leaves on "her" rose, the Passionate. She didn't want to view it from the first row, though.
    I just tucked her back in bed. "Just let me sleep, today," she requested.
    "Fine," I said. "We've got a movie to watch this evening, or your forensics shows might be on, tonight."
    "Maybe both," she said.
    Ah, good. She's thinking in terms of waking up, staying up for awhile. Good sign. As additional confirmation, because she seems so tired and it's hard, every day after FT, for me to believe that it is simply her body rest-incorporating the work into her system, I responded, "Do me a favor. I don't care if you die in your sleep, but not today. I've got plans."
    She grinned, almost devilishly. "Not today. I won't."
    I swear, the reason she can be a scamp about death, and allow me to participate, as well, is because she doesn't believe in it. Which, if you think about it, makes sense. Since it is an event in which one doesn't need to believe, why waste time and mood approaching it from the standpoint of belief?

    I've been noticing lately how quickly the angle of the sun on the floor through our front pseudo-cathedral windows changes. One day I have to move something heat-sensitive out of its path. The next day I don't. The cats follow the sun across the carpet in approximately 10 minute increments. They finally give up in disgust and find a warm place for burrowing into an uninterrupted nap.
    This spring, because it is so evident in this house, Mom is noticing the changes of light from one season to the next. Lately, as the sun moves further north, for a half hour prior to sunset our living room carpet is glitter-dappled by the sunlight shining through the pyracantha leaves sheltering our west facing pseudo-floor-to-ceiling window. The light play is so animated that we stop whatever we're doing, watch it and comment on it as though it is one in a serial of Fantasia. A few days ago Mom said, "You just don't see this in Mesa."
    "No, you don't," I agreed.
    Later.

Wednesday, April 21, 2004

 

It is my great pleasure to relax, here, this evening...

...contemplate this past-pleasurable day, shake my head, smile...it was an FT appointment day.
    I am so pleased the FT allows me to sit in on treatments. I noticed today that as I sit tailor fashion on a magnificently comfortable deep sage green upholstered love seat and watch her work on parts of my mother's body I move and stretch myself in sympathy. I wasn't aware I was doing this until today. The FT slips her arms under my mother's back and gently realigns her spine and I stretch and settle my spine in the same direction. She coaxes my mother's shoulders back into alignment and I jiggle and drop my shoulders. She aligns my mother's pelvis and I wiggle my hips against the cushions. She rolls my mother's feet back and forth and I instinctively extend my leg and roll my foot back and forth to 'crack' it. She triggers my mother's neck and I flex mine. When I realized I was doing this I mentioned it to the FT. She took little note of it so I guess it's not a disturbance to her time with my mother. I took confidence in this consideration and built on it: That maybe what I was doing not only helped me but my mother; that is, everyone in the room capable of being conscious of my mother, including me, and working within the manipulation of energy helped her. That's my 'narrative', anyway.
    Again today while the therapist was working a particular area of my mother's back, relaxing and realigning it, my mother was engulfed by a wave of nausea. The FT always rushes to reassure me and my mother when this happens, which I appreciate, as it betrays one of the skills that makes her so effective at what she does. But, I understand exactly the reaction my mother is having, especially since I know exactly what area the FT works on that causes this reaction, what she is doing, and that what she is doing is working "...as it should." To clarify everything, especially for my sisters, it is the acutest point on her upper back that is the apex of her upper spinal hump. The FT showed me, exploratorily, this area. Not only does her spine hump 'unnaturally', it also curves slightly to the right. What the FT is doing is reeducating the various organic structures in this area in order to release the pressure that this structure is causing. Eventually the manipulation should help correct the anomaly. When the FT stimulates this area the physical stress is released in waves, literally, and it is not uncommon for the body to react to both sudden releases and sudden build-ups of stress (when, for instance, your knee pops out) by expressing its surprise in a wave of nausea.
    Today, though, Mom didn't vomit. The session dwindled to an amiable end after we retrieved Mom into a sitting position. The FT and I teased Mom about going to any lengths to get out of a trip to Costco today, with which I'd been "threatening" (her word) her since this morning.
    I had related to the FT earlier about Mom being buffeted by the wind over the weekend: How it angered her and scared her simultaneously and how the event underscored for me that she certainly needs continued balance therapy. I also told her of an exercise I'd devised after thinking about movements we could practice to help improve her balance. It occurred to me that if I stand Mom up sideways to a wall, and I stand to the other side of her and lean against her gently while she adjusts and pushes against me, using the wall or me as support if she should falter, that this might help her body regain its confidence in its ability to move without landing itself on its back again. I didn't want to initiate the exercise, though, until I described it to the FT and she okayed it.
    Indeed, the FT told me that this was a well recognized method of helping people regain a usable sense of balance but that my technique is at this point, "too advanced" for my mother. She showed me through practice how to set up a similar situation with Mom sitting on the couch and me pushing against her and telling her not to let me push her over. The 'trainer' can 'challenge' the body from several positions including diagonally and from above and below (describing the direction of the force applied) and from the front and back. As she practiced these exercises with Mom, she pointed out that Mom displays a significant lag of about 2 seconds when responding to force of any type, which is very typical of someone who's recently lost a challenge to their ability to stand upright. From the peanut gallery it appears as though her body is thinking, "Okay, if I do this, will I succeed, or would it be less harmful for me to give into the force? Which will hurt me the least?"
    After the appointment Mom ate a light lunch. She was alert, feeling good, looking so ruddy I decided she doesn't need any more iron pills until she begins to look a little white around the edges, again. I was anxious to get on with the trip to Costco and she was intent on meandering through lunch. She noticed my agitation and told me to go on. I told her that I was concerned that she would lie down and not put on the oxygen, which she needs. She looked at me as if to say, "You have no idea with whom you're dealing." So I proposed a bargain. I laid out the cannula on her pillow, placed her pillow crosswise on her bed so she couldn't miss the juxtaposition, placed a large note underneath the cannula directing her to put it on, turned on the concentrator before I left, had her read the note aloud to me so she'd remember it was waiting for her and told her that if this experiment was successful I would be very encouraged and certainly inclined to pull my nose a bit further out of her ass.
    She passed with flying colors. When I returned home an hour and a half later she was snugged in bed with the cannula firmly across her face.
    I had told her I would let her sleep as long as she wanted until I started to worry. She awoke of her own accord a few minutes before 1700. I had bought a book for her at Costco that I thought she would find interesting and left it on the table in front of her chair in the dinette. The book, Founding Mothers by Cokie Roberts, was a hit. She settled down and began to read, something that's only been happening again recently. I was so pleased at her reaction to the book and so relieved that she was rediscovering her ability to entertain herself with life that I relaxed more than I have in several days. I lounged on the sofa, decided to "close my eyes for a few minutes", threw a chenille spread over me, immediately magnetized one of our cats into collapsing on my legs for a nap, and the next thing I knew it was 1830. Mom was still at the table deep into the book. She'd drunk a couple of cups of her 'coffee', apparently refilled and warmed in the microwave, something she hasn't had the concentration to do correctly for awhile.
    She stuck with the book while I prepared Cobb salads for dinner. She ate and drank and read and occasionally quoted passages from the book to me. After dinner, I headed into the living room to continue a paper sorting/shredding project I began April 15.
    An hour or so before she retired I caught her slouching all over herself and the table as she read. I pointed this out to her, reminded her that she was compromising her back and that it was posture like this that got her into trouble in the first place. I continued, "You know Mom," I said, "I don't want you to injure your back again..."
    She cut me off, thinking she knew where I was going, "No, I know. Neither do I."
    "No Mom," I corrected. "I don't want you to injure your back again because the last five and a half months of the level of care this injury has required has been hell for me. I would do it again if necessary but it's been so intense that I'm going to do everything in my power to make sure it doesn't happen again. This isn't for you, it's for me."
    She took a minute to absorb this but within that minute the expression on her face transformed into, "Oh, yeah, I see what you mean." For the rest of the evening she sat properly, supporting her lower back with her pelvic girdle, supporting her upper back with the chair back.
    As the evening has unfolded it has begun to occur to me that I may, once again, feel free to allow each of us to have our own unattended time with which to do whatever we want, as in the past. I didn't think I'd be seeing that possibility again throughout the rest of Mom's life.
    Earlier today while driving back from Costco it occurred to me that one of the grave disservices we do The Ancient Ones is that, in the broad sense, we expect too little of them. While it is true that it is hard to ignore failing health, failing strength and failing memories, it should be equally hard to ignore indomitable wills and the ability to surprise expectations, even one's own. I have a tendency to prepare ahead of time for the loss of loved ones. It's a handy tool; it educates one in grief before one needs that education. But, I think, it also causes me to surge toward and step back from my mother at inappropriate times. I do not think her ability to recover would surprise me so much if I didn't also harbor the assumption that she is "too old" to heal completely from anything. If I was not capable of being so surprised at the strong continuance of her native regenerative capabilities, I might, in some way, be more readily available to recognize and encourage any healing she might be accomplishing at any time. I know, as well, that I am still scared of trusting her ability to know how important sleep is to her personal recovery profile. I also forget how sensitive she is to suggestion, as evidenced by the fact that it was she who cut her daily pound or two of Hershey's Almond Kisses to nothing, not me.
    I've zeroed in on specifically what "dipping into the negative" I was doing to which I was dangerously vulnerable, enough to screw up my ability to address issues and relieve blocked movement patterns. I remembered it early this morning. I remembered this weekend writing out in this journal my occasional Very Tired Fantasy of Mom and I being taken out at the same time. I did spend a certain amount of time this weekend longing for some permanent relief from, well, just everything and from anywhere, I guess, and it translated into me recalling this occasional fantasy. I usually don't 'worry' about fleeting emotional vacations like this because it is their power to relieve internal stress without provoking action that allows them to be so handy for me. Perhaps the acupuncturist sensed that, right now, my ability to heal is at a very low ebb (it is) and it would be best not to challenge it with my peculiar reverse-psychology adaptations that entertain me enough to push me right out of a depressive phase. I've never used the tactic of temporary suppression in healing but I have no objections to it,so I'm trying it. Suppression isn't as difficult as I thought.
    Hmmmm. Tomorrow's Thursday. I need to begin calculating and preparing for MCS&BIL's visit. Still working on an impromptu Meeting of the Hudson Mothers. Not sure it will materialize but I'm hopeful.
    I didn't make it to the book club meeting last night. I was honest with my Very Dear Prescott Friend about why I wasn't coming. She was disappointed but understanding. It was during this conversation when I was prompted, by her, to reconsider outside day help. I am very lucky in my friends. I needed to verbalize this in order to catalyze it and she gave me the opportunity. Today I even did some preliminary research and discovered that the woman in whom I'm interested as a part time relief caretaker will probably not be available for a couple of weeks, which is okay. With MCS&BIL's visit coming up we've got enough confusion and hilarity scheduled for the next few weeks.
    Mmmm...I'm pleasantly tired. Think I'll take advantage of the feeling.
    Later.

 

Today, I am, finally, no longer fighting...

...my low energy level. It's been this way for about 5 days. I've been doing things anyway but my muscles, even though they are strong and healthy, have been resisting, creating an annoying ache here, making me pull back from something by shooting a pain there.
    When I awaken Mom at 0800 we'll be preparing her for FT. The Pre-Therapy Routine is autonomic now, including her hair, and my body doesn't seem to feel quite as restrictive as it did last night. I was going to do her hair yesterday but the day filled up quickly. At night I felt as though I could barely lift my arms so decided to put off the hair until this morning. I put off everything until this morning including taking out the garbage, setting up the dishwasher, rewinding the drier for its third run and, bizarre, this is how tired I was, putting off peeing until morning. I remember, as I walked down the hall, calculating the amount of muscular effort it would take to pee before stripping and falling into bed and deciding, hell, my bladder's strong, I'll just let it wake me up in the morning. It did.
    I hear a cough, now. Good sign. I just looked in on her and she was sleeping peacefully, breathing evenly and deeply, so I'll not go in again until 0800 unless she emerges on her own. Although she hasn't been as physically active as I'd like and her excuses for not going out have sometimes been poor, there is one area in which she has been showing increments of improvement: Brain power. Over the last three to four weeks it's been as though her brain is choosing to become more conscious of itself. My mother is becoming more aware of her environment; remembering and anticipating plans. Lately she's been resurrecting habits that she hasn't incorporated into her behavior or her day for almost four years, since her health became rickety. Playing Solitaire. Reading books. Considering books at the paperback displays in groceries. Being attracted to sugar in the store. Chain smoking (unfortunately, although she's still well below smoking a whole pack a day because she's been spending so much time "resting"). Taking an interest when I'm baking or cooking. At the last book club meeting she strained to hear the conversation. Afterwards she asked me about the book we were discussing which I hadn't read. Although battling her inertia has been particularly challenging lately for me she is becoming stronger and healing, anyway. Sleep is, again, becoming optimally recuperative for her.
    I'm very pleased that her initiative is improving while mine seems to be dwindling. My acupuncturist, without me mentioning all this, called it "dipping into the negative" which, apparently, I hadn't been doing during the period encompassed by my appointments up until now. Or if I had, and I tend to think I had, I was invulnerable to harm, which is what I expect of myself. The acupuncturist went out of her way to mention yesterday, though, that I should probably "set that aside" for awhile. As soon as she expressed herself on this matter it made sense to me. During the needling of the first part of my treatment I allowed myself to do this. I won't miss anything, I realized. All that negative stuff will still be there holding all its fascination when I "get back".
    I think it's becoming critical that I find some trustworthy, confidence inspiring day help at this point. I think one of my mother's supplemental policies covers in home day care without requiring skilled nursing care. I have my eye on someone but, damn, I need to generate enough energy to task myself up to hiring her.
    I had to force myself to report in here this morning. Lifting my arms to the keyboard seemed like so much effort and possibly painful, besides.
    During this period I imagine pain as a quantitative substance rather than a neuromuscular reaction. I imagine it salted throughout my body. I imagine that during this period I am, through a very specific but sublinguistic procedure, clearing the pathways to my joints, which I imagine to be the areas of least resistance to the release of pain, relaxation and the substance of the pain filtering out of my body. My joints cramp and ache while it's happening but once it's over I expect to feel much more, well, mobile and energetic. It's funny, it isn't actually as though I feel I have no energy, it's that I feel it in quivering blocks stored somewhere in the last few months, waiting to be released. I'm not sure why I stored it away but I'm working on the release, right now.
    So I wrote in this journal.
    Later.

Tuesday, April 20, 2004

 

Last night, while watching...

...Cell Dogs: Kit Carson on Animal Planet, a good three hours after she'd eaten dinner she suddenly upchucked the dregs of it while sitting in her rocking chair. She was trying to catch it with tissues. At first I thought she was coughing up phlegm although I thought this odd because she hadn't been congested for a few days. Then, from the sound of what she was doing, I realized it wasn't coughing. I secured a bowl, a warm moist washcloth and coached her to lean over the bowl (even after I brought the bowl and the washcloth, her automatic reaction was to vomit into her hand). In two episodes about a half hour apart, she cleaned out what was left in her stomach. She felt "fine" both before and after the episodes. I fed her some Milk of Magnesia, the antacid dose, not the laxative dose, even though she insisted she didn't need it. No, she did not vomit up any blood. I checked.
    I'm not sure what caused the episodes. We had Quick Beef Stroganoff, a concoction I make for her when I want to elevate her sodium levels so that she'll retain more water. She's been dehydrating quickly over the last few days and we've been eating fairly healthy, too. As well, those pumpkin muffins promote regularity (to put it mildly). We have this recipe, oh, I'd say about once every two to three weeks. Neither of us ate any of the elk stuff so that wasn't it. I can't think of anything unusual we've eaten.
    This morning she awoke a little before 0800. She had to eliminate. I consider it a plus that her body signaled her to Rise and Obey. She insisted she was feeling fine but, "awfully tired" and that she was going back to bed. She had already experienced a typical watershed so this morning I discovered the "instant" way to disinfect and dry the plastic sheet on her bed: Glass Cleaner. Although I continue to smell its relentless cleanliness out here over an hour later, it does the trick in a pinch.
    Last night we watched Cheaper by the Dozen, the new one. I knew she'd love this movie. She has always said that she has wished that she and Dad could have had "dozens" of kids. It brought back a lot of energizing memories for her. Throughout the movie she'd say, "Now, your father and I did that..." or, "that's what your father and I thought," and I'd stop the movie and we'd talk about our family, how we were created, how we operated as individuals in a unit and as a unit of individuals. When the movie was over she was not ready for it to end. This one's a keeper; I'll be buying a copy of it.
    During the afternoon (yes, yesterday was a low key movie day...it kept Mom up and moving, except for a short nap soon after breakfast, after she had beaten me in 3 rounds of Sorry) we also watched House of Sand and Fog. I expected a somber movie and I wasn't sure how Mom would react. She has to be in the mood for a "serious movie". She was riveted and I was blown away. Later, when we were talking about the movie I realized she didn't register that the Iranian couple committed suicide after their son died. She thought they were, with the victim of the county, in an artistic repose of grief. She was very taken by the belief structure behind much of what was said within the Irani family, mentioning that, "We should see if we can find a book to read on Islam."
    Her body may be weak and she may not yet have enough confidence to completely rely on it (perhaps at her point in life confidence in one's body is a precious commodity or the confidence one has is that it will fail) but her attention to her environment continues to gratify me.
    I have an acupuncture treatment, today. A book club meeting is also scheduled which means doing Mom's hair, to which I'm looking forward. It's a relaxing time for both of us. Petting a relative is probably as soothing and beneficial as petting a pet. I wonder if any studies have been done on this. I don't want to go to the book club meeting tonight, though, primarily because I just don't feel like gearing the entire day toward preparing to take my mother there, especially the psychological part. Most of the time it's worth it but today I'm tired and suffering a little, acupuncturally speaking, and I'd like to be able to kick back when I return from my appointment. I can kick back with Mom but I can't kick back at the book club. I don't know what I'll decide. Depends on how the day develops.
    Later.

Monday, April 19, 2004

 

So far, I've read...

...three of the articles in this week's issue of the NY Times [Sunday] Magazine focusing on health care. I'm sure before the week is out I'll have read all but one of the articles, the journal on a mother and daughter's journey through cancer "together". I've found the most interesting article to be the one I just finished, The Writing Cure. The link above, by the way, will probably only be good for a week. Once the stories hit the archives you have to pay to access them. Oh. Okay. In order to access the article you have to be registered with NYT. It's free but just so you know, in case you're sensitive about subscribing to online services. Otherwise, your local book store or grocery or cafè may still have copies of the Sunday edition for sale, magazine included.
    The article discusses the perceived lack of compassion and empathy in physicians as critical to their ability to heal and explores ways to approach this by training physicians to be more sensitive to narrative. About halfway through the article an oncologist-hematologist, who has become a leader in one school of narrative medical practice, mentions that, and I quote, "the last thing he wants is his patients '...going to alternative practitioners for healing and me for chemotherapy.'" This is exactly the position in which I was put with Mom's former Prescott PCP, the one who dismissed my mother as a patient because of, well, me and my "damned meddling". There was nothing at all remotely healing about this physician's three encounters with my mother but F[ormer]P[rescott]PCP did operate as a valuable resource for some prescription refills and necessary blood tests. As well, by intimidation but still of worth to me, FPPCP initiated a series of tests that ultimately proved to me my own competence as a healer and the value of healing resources of the alternative health treatment community.
    While I can see that if the above mentioned PCP had been trained into an autonomic use of narrative FPPCP would have been more useful to Mom as a healer, I think, the main problem was a pronounced personality clash between this person and me which revealed itself slowly. This is not an excuse, merely an observation.
    I have noticed that alternative healers always make an interesting use of narrative as they heal. Usually it's off the cuff, to the point and open ended so that the patient can take charge of the end of the story, so to speak. Once, no, twice, I've seen an alternative healer get the story wrong (the same healer, two different stories) but she was still an effective healer for my mother. By being observant of this ahead of time, when I decided to consider treatment for myself through an alternative healer, in order to choose the healer best matched to me I was able to 'scan' the narrative data I'd stored on both healers and determine that one of them would be inappropriate for me.
    I'm not sure that the three of us, Mom, FPPCP and me, ever got to the level of narrative. I don't know if it would have helped in treatment in this case. The character blocks between FPPCP and me became obvious fairly quickly. Whether there were any character blocks between Mom and FPPCP was never determined. In this case, unfortunately, the mutual inappropriateness of the relationship between FPPCP and me was much too heated to allow either of us to focus much on my mother, when she was in the office.
    As my mother's medical advocate though, and at this stage her necessary medical advocate, in most cases (except within the alternative healing community; hmmmm...) if I don't get along with a healer then the healer is inappropriate for my mother.
    The article also mentions something about productive, satisfying 10 to 15 minute appointments conducted by one of the physicians who is also the leader of the currently popular version of the medical narrative movement. When I was looking for explanations for why it appeared that my relationship with Mom's FPPCP was going to be completely unproductive I realized that the "shortness" of the standard medical appointment 'now-a-days' has not been a problem for me. I routinely find it easy to make sure a 10 to 15 minute appointment is productive and all physicians have been appreciative and cooperative in my efforts. I also don't find newness to practicing medicine a problem. In the case of her Mesa PCP I find it refreshing. When he's not stressed by his schedule (and I give him leeway for adjustment) he is more than willing to consider alternative "narratives" for my mother's health problems as well as alternative treatments. He has a tenacious faith in non-alternative medicine but he also has a deep-seated need to be a healer and hasn't yet become disillusioned. Maybe the difference between him and Mom's FPPCP is that he chose the right initial practice and the right initial colleagues.
    Anyway, I recommend the series of articles. The article by Hillary Rodham Clinton is, well, elegantly and politically statistical. The article about Primary Care provides back-up material to the other two I've so far read.
    We watched Lawrence of Arabia last night. Although she determinedly declined my several offers and bribes to get her to do some light shopping with me she did not sleep overly much, was up and alert a lot and when I gave her a leg rub it energized her and she stayed up an additional hour and a half.
    It's windy and cloudy, today. Despite the current prediction on the weather channel for a clear, sunny day, I don't see it. They are predicting a high in the low 60's. I don't think we're yet pushing 50 up here. I doubt that I'll be able to get her out which, I think, is okay. I've already heard a weak reconnaissance cough so my guess is that she'll be up in about an hour. I'll build out the house now in preparation.
    Today is a Monday. Aiyee!
    Later.

Sunday, April 18, 2004

 

Every so often I become fixated on a supplement...

...or aspect of Mom's home health care and decide to do a little side study to see if my choices are continuing to be supported by current research. The areas of fixation are always circumstantial. This morning I decided to look up iron supplements again, since I've been focusing on finding sources of iron that are natural and more easily absorbed...thus the unsuccessful attempt to work wild, hoofed game into our diet.
    This morning I remembered that I had learned of a new source of iron the last time I talked to our 86 year old yard man in Mesa in March of this year. Despite his natural health profile including quite a bit more exercise and discluding Type 2 diabetes, their diets are about the same now and he smokes probably about as much as my mother (although our yard man is not on supplemental oxygen, thus I must assume, he does not suffer from COPD). He, too, has recurrent iron deficiency anemia, was colonoscoped for it, nothing was found except a bunch of benign polyps which were removed, his PCP decided against an endoscopy. "Said I wouldn't appreciate it for a long time to come and chances are the problem isn't intestinal bleeding, anyway," he told me. So, his doctor treats him with Niferex by prescription. It is also an over-the-counter medication.
    Both the generic form of Niferex, iron polysaccharide, and the form of iron I'm using, iron protein succinylate address the problem of iron overdose turning to free-radical rust (literally) in the body and screwing up other vital organs. So far it seems that the research results on iron protein succinylate seem to be favoring its use over iron polysaccharide.
    I learned some new information today while I was scrounging search results about iron deficiency anemia and iron supplementation and standardized "healthy" levels of iron and ferritin, at a page in a site called The Life Extension Manual. Scroll down the page a bit to the section entitled Iron. I know, from experience, that, although this tract is dated 2002, doctors are still recommending ferrous sulfate. When they aren't, they aren't automatically suggesting anything else. However, I now know as well why my mother's Mesa physician didn't freak over her iron and ferritin levels until they got really out of range on the low side.
    Change of subject: Yesterday morning, after awakening but before arising, my mother mentioned that, lately, when she awakens, although she knows where she is, it is as though she is somewhere else.
    "Is it pleasant?" I asked.
    "Oh, yes."
    "Familiar?"
    "Well, I'm not sure..."
    "Is it Mechanicsville?" A few evenings ago she once again in memory placed Mechanicsville, Iowa, as only an hour or two drive from Prescott, Arizona, and decided we should visit "tomorrow".
    She looked at me steadily, up for our usual interview attempt to jog her memory. "No."
    "Mesa, then?"
    "No."
    "Are you with people? Who?"
    She was frowning now. "Hmmm...I can't remember..."
    Quickly, before everything disappears, the critical question, "When you realize you're here, are you sorry? Do you wish you were at another place?"
    She searched her fading database on this subject. "No. Not at all."
    Could it be you've been visiting heaven lately, I silently wonder. Take note: When I use the word "heaven" I'm referring to my mother's beliefs about death and afterlife. She definitely believes in a "heaven" although she believes in no more of a hell than what we have here, for anyone, regardless of what they've done. She believes in consciousness after death, a rest, a chance to catch up with loved ones, a secure knowing, for awhile, that everything is, indeed "unfolding as it should", and then on to the next project. I wonder if she's been sneaking previews lately.
    "Does it feel like home?" I ask her.
    "What?" she demands.
    The moment is gone. I begin removing her soaked top covers.
    "You were with me," she blurts from memory.
    "Oh! Good!"
    I recall my occasional strange wish, usually contemplated when I'm close to mental exhaustion from business dealings (including medical business) on behalf of my mother's (and my) life, that we die together: In a flash; maybe a semi jack knives on the highway between Black Canyon City and Sunset Point and we get caught in the tailspin and are flipped over into the canyon; maybe something absurd happens, like we're robbed and murdered or a small asteroid or a stray bomb falls on our house. Sometimes I think, yeah, I'd like to go with my mother, just to see what happens to her. I won't be missing anything, here. Yeah, why not?
    She brings me back to my mother's fading phasing. "Yes. Good," I acknowledge. I know my mother is not referring to the same outcome as me. I know she isn't thinking that she's sampling the possibilities of an afterlife now that she's so close to it. Hell, I'm not sure she even believes in death yet, let alone an afterlife. She spent so much of her life separated from loved ones, as have I, that I think she considers death just another sort of enforced absence: Someone's husband got a job on the other side of the world; someone else bought an inn two states away with the realized intention of investing some decades in it; someone else decides to join the Navy; someone else makes several successful moves up and east in a career; someone else vows to remain outside of the continental U.S. as long as possible. Death doesn't necessarily separate people longer than certain of life's circumstances.
    It is from my parents' example that I learned to celebrate loved ones leaving the nest or friends leaving the community to adventure in the world. Leaving was always an adventure. It's from them, I am sure, I learned that it is impossible to miss someone when you or they are embracing growth and change. It is from them I learned that relationships do not die with distance, they reach into the expanding atmosphere and thrive. It is not that we never said good-bye to one another. It's that we took it literally: "Good Luck on the Bye!" with an added, "Maybe we'll come visit!" In fact, when MFS decided not to remove her sons from their Jacksonville home for a second tour in England, this time on the southeastern coast and since she was retired she didn't have to, my mother's initial response was disappointment that she wasn't going to get a chance to visit England again.
    In our family, being somewhere else while clearly "here" can be a profound experience. Then again, it can simply be a matter of having an excuse to travel.
    The wind has settled today. I haven't heard any reconnaissance coughing, yet. I'm going to let her sleep a bit but no later than 1100. Maybe I can think of an excuse to get her out today.
    Later.

All material copyright at time of posting by Gail Rae Hudson

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