Saturday, July 17, 2004
This post is about me, not my mother...
...nor about the my-mother-in-me part of me. It's a curious anecdote, though, so I decided to insert it.
I went to Costco today to pick up an ear thermometer for my mother. I found something much better, a temporal artery thermometer (a very cool instrument). I was using my iPod during the excursion. At the register as I was removing the headphones the left wire tangled in my earrings. As I struggled to free my earrings from the wire the cashier winced in sympathy and said, "Oh, that's one of those newfangled headset telephones, isn't it?"
"God, no," I said, in my normally resonant voice. "I'm not one of those cell phone people. I don't want to be that available to others. If people can't get me at home, too damn bad."
Almost before I finished, the customer behind me applauded. Within seconds, several other people in my line and the line next to me were clapping.
I was startled. I thought I was the lone cell phone holdout in the universe but I guess not. Makes me feel a little bit more at home in this life.
In a somewhat related incident, when I awoke my mother from her nap (during which I purchased the thermometer) I told her I had a surprise, produced the thermometer and proceeded to slide it across her forehead and exhibit her temperature. Surprises are always a good way to awaken her and get her out of bed. This one was exactly what the daughter ordered. She was amazed, insisted on examining the instrument and taking my temperature.
A few minutes later, while we were in the bathroom setting her up for the activity of being awake, I mentioned to her that since I began living with her every time I bring home a new piece of technology I always, always contemplate that when she was a teenager each of these instruments was beyond her imagination.
"That's true," she said.
"Does all this stuff surprise you or shock you?"
She gave me a deeply knowing, slightly accusatory look. "No," she declared. "Remember, I had a microwave, a home computer and a VCR long before you."
"That's true," I said, laughing. "I guess, compared to you, I'm a Luddite!"
"What's that?"
I explained and she said, "Well, you're coming along. I'm a good influence on you."
Gotta love that woman!
Well, I guess this post was about my mother. Figures, doesn't it. This, I think, is a good, offhand definition of what I mean by "surrender". In my life right now everything, in one way or another, brings me back to my mother. I'm lucky I was spit out of the womb of a woman with whom I feel grateful that this is the nature (sometimes more apparent than others) of mother/child relationships.
I went to Costco today to pick up an ear thermometer for my mother. I found something much better, a temporal artery thermometer (a very cool instrument). I was using my iPod during the excursion. At the register as I was removing the headphones the left wire tangled in my earrings. As I struggled to free my earrings from the wire the cashier winced in sympathy and said, "Oh, that's one of those newfangled headset telephones, isn't it?"
"God, no," I said, in my normally resonant voice. "I'm not one of those cell phone people. I don't want to be that available to others. If people can't get me at home, too damn bad."
Almost before I finished, the customer behind me applauded. Within seconds, several other people in my line and the line next to me were clapping.
I was startled. I thought I was the lone cell phone holdout in the universe but I guess not. Makes me feel a little bit more at home in this life.
In a somewhat related incident, when I awoke my mother from her nap (during which I purchased the thermometer) I told her I had a surprise, produced the thermometer and proceeded to slide it across her forehead and exhibit her temperature. Surprises are always a good way to awaken her and get her out of bed. This one was exactly what the daughter ordered. She was amazed, insisted on examining the instrument and taking my temperature.
A few minutes later, while we were in the bathroom setting her up for the activity of being awake, I mentioned to her that since I began living with her every time I bring home a new piece of technology I always, always contemplate that when she was a teenager each of these instruments was beyond her imagination.
"That's true," she said.
"Does all this stuff surprise you or shock you?"
She gave me a deeply knowing, slightly accusatory look. "No," she declared. "Remember, I had a microwave, a home computer and a VCR long before you."
"That's true," I said, laughing. "I guess, compared to you, I'm a Luddite!"
"What's that?"
I explained and she said, "Well, you're coming along. I'm a good influence on you."
Gotta love that woman!
Well, I guess this post was about my mother. Figures, doesn't it. This, I think, is a good, offhand definition of what I mean by "surrender". In my life right now everything, in one way or another, brings me back to my mother. I'm lucky I was spit out of the womb of a woman with whom I feel grateful that this is the nature (sometimes more apparent than others) of mother/child relationships.
My careful attack on Mom's blood sugar meds...
...has gone to hell since Thursday's introduction of Cipro XL. Today is her last dose and I'm hoping I'll be able to continue working to control her blood sugar on fewer meds after tomorrow. I did my typical research and found warnings all over the place that type 2 diabetics on oral medication "may experience changes in blood sugar" when taking antibiotics, steriodal preparations and some other things. The most common change reported is low blood sugar, but my mother's etiology is that when she takes powerful antibiotics her blood sugar rises, and this is what it's been doing. Yesterday I gave in and administered metformin to counteract her high notes.
The Cipro seems to be doing the job very quickly. I'm pleased about this. She is having pronounced swings between high and low energy which affected our plans, yesterday. At one point she was adamant about accompanying me to the grocery. By the time we did her hair (the full meal deal) and dressed her, her energy had bottomed out. She didn't want to take a nap, which surprised me, but she didn't want to go to the store either. I decided not to badger her. I can tell, from her blood pressure readings, that her body is vigorously fighting her urinary tract infection. She elected to watch The Lion King while I shopped. I expected to find her laid out on the couch when I returned but she was up and glued to the set.
Throughout the day she'd consider napping then a quarter to a half hour later she'd decide she wasn't tired. Finally, around 1800 she headed in for a nap before dinner, telling me she was "bushed" and to be sure and awaken her at 2000, as she didn't expect she'd be able to abort the nap on her own. About an hour after retiring she was back in the living room under her own steam wanting to help me pick through raspberries for a sauce I'm making today.
Regarding how she contracted E. coli: I've given this some thought. My best guess is that it's from the mini-accidents she was having for a couple of weeks after beginning the mega-iron regimen. The maxi-accidents are easy to detect and clean up immediately, but she had two episodes of expelling small turds that neither she nor I detected until she went to the bathroom to urinate and I checked her underwear before changing it out, as I always do. After two of those happened I initiated a regimen (which she didn't appreciate, although she went along with it) of checking her underwear every hour or so to make sure nothing went undetected. As well, although I am meticulous when I clean her, paying minute attention to her uro-genital-anal area, whether it be when we're bathing her or cleaning up after an accident, it's entirely possible that I missed a spec here and there which could have traveled into her urinary tract. Her wiping habits after a non-accidental bowel movement are not a problem and she is an energetic, thorough hand washer, but, you know, when accidents are occur sometimes all these precautions are not enough, especially on someone with an old immune system.
Although it was a bit difficult to collect stats on Friday, I've got a back-up to record over on Mom's Daily Tests and Meds to which I intend to apply myself sometime today.
In the way of commentary, our experience with the urgent care nurses and doctor was not any different than our usual experiences. Although I specifically asked for complete information from both the doctor and nurse on the Cipro she was prescribed, the only information I was offered was that she should take it "with food". Once I got home and did a little research I discovered that it works best two hours before or after a meal, fluid intake is a priority, I could expect her blood sugar to go crazy and her blood sugar meds would probably not work as well as normal.
One highlight of our visit, though, for which I was grateful is that I was able to discuss with this physician my recent discovery that almost all type 2 diabetic medications and many blood pressure medications, especially those which are diuretic, are derivatives of sulfa. When my mother was in the Navy sulfa drugs were tested on her and she was determined to be allergic. The physician we had was an older man who had also been in the military during the Korean police action and had much experience with sulfa, then and now. He told me that although sulfa preparations are quite a bit different now than they were then, "cross reactions" do occur, in the sense that those who were allergic to the older sulfa drugs can have a variety of reactions to current sulfa based medications, sometimes noticeable but often undetectable unless "special tests" are done. Over all, he said, this doesn't necessarily mean that the drugs aren't effective, but it could mean that "other bodily functions could be affected". I find this interesting in light of my mother's acupuncturist's discovery, when I asked her to check Mom out for reactions to metformin, that Mom's body was reacting to it as though it was an "allergen". I've decided, when I start acupuncture treatments on Mom again, which should be within a week or so, to give the acupuncturist a list of all Mom's medications, whether I've discovered that they are sulfa-based or not, and have her diagnose Mom for reactions and treat her, if necessary, to dispel those reactions. In addition I think I'll also have her do an overall sulfa diagnose-treat regimen. I'm hoping this will help Mom's body use the medications more effectively when they are necessary without running the risk of triggering what is now her recurrent iron deficiency anemia.
I'm doing some backdraft thought regarding my inability to understand that Mom's low energy level and apparent and sudden onslaught of weakness, beginning a couple of week's ago, was due to the development of a particularly virulent infection. I even recall mentioning here or perhaps to MCS at one point a few more than a few days ago that her urine appeared to be a bit cloudy one morning. My reaction, though, was to increase her garlic consumption and, hmmm, something else, I can't remember right now. When you're dealing with an Ancient One the learning curve never ends. My lesson this time involves realizing that although sometimes it is legitimate to attribute her lethargy to over sleeping and lack of movement it would be wise if this is not my first assumption. It's hard to tell with the old but I need to be more observant and less assumptive when it comes to her energy levels.
I found it necessary to apologize to her for my insistence on trying to up her energy level by insisting that she awaken earlier, "whupping" her out of bed when she was dragging and firmly guiding her toward movement. My initiative in trying to change her lethargy index over the last few weeks has actually taken hold in her memory and over the last few days she's been wary about her own interpretations of her dynamically convolutive energy swings. This has caused her some confusion in regards to whether or not she should nap or retire for the night. When I realized this I immediately explained to her, several times yesterday, every time she tried to use my almost two week's full of advice in order to keep herself from feeling lethargic, that I was in error this time making and stating the assumption that her low energy level was due to over sleep and lack of movement (and, I remember cautionarily adding, self-perpetuating if these cycles weren't broken). I told her I was very, very sorry that I let her down and that I was in the process of learning my lessons about what to consider when her energy level drops and stays low for a period of days. I told her that my first assumptions and advice were not incorrect across the board but in this case I was definitely out of line and should have been much more careful in my analysis. Luckily, my blinders did no harm this time but they did delay treatment of a critical infection and this is something I have to keep in mind now. It's definitely not easy being green.
As a reminder to myself, I want to more fully discuss my surrender; it's a complicated issue and I don't want people to think that I am advocating surrender in all cases, at all times, across the board for all caregivers whether the care is being taken of children, the infirm or the elderly. In fact, one of my all time favorite pop songs is Corey Hart's Never Surrender from the 80's, I think. I've found in this experience with my mother, though, that my personal surrender to her, which is probably better stated by saying that it is a process of constantly reminding myself to attempt to walk in her shoes with every step she takes, is of great benefit to me in helping me to be aware of not only how to treat her, but when to give in to her, when not to give in to her and how to conduct myself with her when I need her to give in to a treatment, regimen or request in which she is clearly not interested. One of my primary strategies is to always give her all the background from which I'm working, whether she remembers it or not, repeat this information as often as necessary and respect the fact that, although her short term memory is a sieve, her in-the-moment ability to understand and analyze is not. As well, her long term memory and her ability to rummage through her cerebral storage, which contains decades of data, is reliable and quick on the draw.
An update:
...later.
The Cipro seems to be doing the job very quickly. I'm pleased about this. She is having pronounced swings between high and low energy which affected our plans, yesterday. At one point she was adamant about accompanying me to the grocery. By the time we did her hair (the full meal deal) and dressed her, her energy had bottomed out. She didn't want to take a nap, which surprised me, but she didn't want to go to the store either. I decided not to badger her. I can tell, from her blood pressure readings, that her body is vigorously fighting her urinary tract infection. She elected to watch The Lion King while I shopped. I expected to find her laid out on the couch when I returned but she was up and glued to the set.
Throughout the day she'd consider napping then a quarter to a half hour later she'd decide she wasn't tired. Finally, around 1800 she headed in for a nap before dinner, telling me she was "bushed" and to be sure and awaken her at 2000, as she didn't expect she'd be able to abort the nap on her own. About an hour after retiring she was back in the living room under her own steam wanting to help me pick through raspberries for a sauce I'm making today.
Regarding how she contracted E. coli: I've given this some thought. My best guess is that it's from the mini-accidents she was having for a couple of weeks after beginning the mega-iron regimen. The maxi-accidents are easy to detect and clean up immediately, but she had two episodes of expelling small turds that neither she nor I detected until she went to the bathroom to urinate and I checked her underwear before changing it out, as I always do. After two of those happened I initiated a regimen (which she didn't appreciate, although she went along with it) of checking her underwear every hour or so to make sure nothing went undetected. As well, although I am meticulous when I clean her, paying minute attention to her uro-genital-anal area, whether it be when we're bathing her or cleaning up after an accident, it's entirely possible that I missed a spec here and there which could have traveled into her urinary tract. Her wiping habits after a non-accidental bowel movement are not a problem and she is an energetic, thorough hand washer, but, you know, when accidents are occur sometimes all these precautions are not enough, especially on someone with an old immune system.
Although it was a bit difficult to collect stats on Friday, I've got a back-up to record over on Mom's Daily Tests and Meds to which I intend to apply myself sometime today.
In the way of commentary, our experience with the urgent care nurses and doctor was not any different than our usual experiences. Although I specifically asked for complete information from both the doctor and nurse on the Cipro she was prescribed, the only information I was offered was that she should take it "with food". Once I got home and did a little research I discovered that it works best two hours before or after a meal, fluid intake is a priority, I could expect her blood sugar to go crazy and her blood sugar meds would probably not work as well as normal.
One highlight of our visit, though, for which I was grateful is that I was able to discuss with this physician my recent discovery that almost all type 2 diabetic medications and many blood pressure medications, especially those which are diuretic, are derivatives of sulfa. When my mother was in the Navy sulfa drugs were tested on her and she was determined to be allergic. The physician we had was an older man who had also been in the military during the Korean police action and had much experience with sulfa, then and now. He told me that although sulfa preparations are quite a bit different now than they were then, "cross reactions" do occur, in the sense that those who were allergic to the older sulfa drugs can have a variety of reactions to current sulfa based medications, sometimes noticeable but often undetectable unless "special tests" are done. Over all, he said, this doesn't necessarily mean that the drugs aren't effective, but it could mean that "other bodily functions could be affected". I find this interesting in light of my mother's acupuncturist's discovery, when I asked her to check Mom out for reactions to metformin, that Mom's body was reacting to it as though it was an "allergen". I've decided, when I start acupuncture treatments on Mom again, which should be within a week or so, to give the acupuncturist a list of all Mom's medications, whether I've discovered that they are sulfa-based or not, and have her diagnose Mom for reactions and treat her, if necessary, to dispel those reactions. In addition I think I'll also have her do an overall sulfa diagnose-treat regimen. I'm hoping this will help Mom's body use the medications more effectively when they are necessary without running the risk of triggering what is now her recurrent iron deficiency anemia.
I'm doing some backdraft thought regarding my inability to understand that Mom's low energy level and apparent and sudden onslaught of weakness, beginning a couple of week's ago, was due to the development of a particularly virulent infection. I even recall mentioning here or perhaps to MCS at one point a few more than a few days ago that her urine appeared to be a bit cloudy one morning. My reaction, though, was to increase her garlic consumption and, hmmm, something else, I can't remember right now. When you're dealing with an Ancient One the learning curve never ends. My lesson this time involves realizing that although sometimes it is legitimate to attribute her lethargy to over sleeping and lack of movement it would be wise if this is not my first assumption. It's hard to tell with the old but I need to be more observant and less assumptive when it comes to her energy levels.
I found it necessary to apologize to her for my insistence on trying to up her energy level by insisting that she awaken earlier, "whupping" her out of bed when she was dragging and firmly guiding her toward movement. My initiative in trying to change her lethargy index over the last few weeks has actually taken hold in her memory and over the last few days she's been wary about her own interpretations of her dynamically convolutive energy swings. This has caused her some confusion in regards to whether or not she should nap or retire for the night. When I realized this I immediately explained to her, several times yesterday, every time she tried to use my almost two week's full of advice in order to keep herself from feeling lethargic, that I was in error this time making and stating the assumption that her low energy level was due to over sleep and lack of movement (and, I remember cautionarily adding, self-perpetuating if these cycles weren't broken). I told her I was very, very sorry that I let her down and that I was in the process of learning my lessons about what to consider when her energy level drops and stays low for a period of days. I told her that my first assumptions and advice were not incorrect across the board but in this case I was definitely out of line and should have been much more careful in my analysis. Luckily, my blinders did no harm this time but they did delay treatment of a critical infection and this is something I have to keep in mind now. It's definitely not easy being green.
As a reminder to myself, I want to more fully discuss my surrender; it's a complicated issue and I don't want people to think that I am advocating surrender in all cases, at all times, across the board for all caregivers whether the care is being taken of children, the infirm or the elderly. In fact, one of my all time favorite pop songs is Corey Hart's Never Surrender from the 80's, I think. I've found in this experience with my mother, though, that my personal surrender to her, which is probably better stated by saying that it is a process of constantly reminding myself to attempt to walk in her shoes with every step she takes, is of great benefit to me in helping me to be aware of not only how to treat her, but when to give in to her, when not to give in to her and how to conduct myself with her when I need her to give in to a treatment, regimen or request in which she is clearly not interested. One of my primary strategies is to always give her all the background from which I'm working, whether she remembers it or not, repeat this information as often as necessary and respect the fact that, although her short term memory is a sieve, her in-the-moment ability to understand and analyze is not. As well, her long term memory and her ability to rummage through her cerebral storage, which contains decades of data, is reliable and quick on the draw.
An update:
- I was wrong about Hidden Valley Ranch dressing. The original buttermilk recipe, which is what we use (although I mix it differently than the package directions), does not contain sweeteners and is essentially the same as the 1996 mixture.
...later.
Friday, July 16, 2004
Quickly, before the next thunderstorm hits:
You'll notice a dearth of stats at Mom's Daily Tests and Meds for yesterday, today, and a dearth of posts since the day before yesterday. Yesterday after Mom arose while we were bathing her I noticed a slight pinkish tinge to her urine. At the direction of her PCP in Mesa I took her to the nearest urgent care facility in Prescott Valley. By the time a urine sample was collected her urine was the color of cranberry juice.
Her problem? A urinary tract infection. Although the culture won't be "ready" until early next week, the preliminary analysis indicated E. coli. She is on an aggressive three day course of Cipro XL 500 mg. Already this morning her urine has almost returned to normal. Her blood pressure is still a touch high (for her), but I'm administering lisinopril 2.5 mg on her prescribed schedule. As the infection subsides her stats should return to normal.
I expected her blood sugar to run riot yesterday. We were at the urgent care facility all afternoon, which I hadn't expected. She missed lunch. I had none of her medications with me. In order to quell her hunger I gave her some wintergreen Altoids. When we left, some time after 1700, she was ravenous, so we stopped and picked up hamburgers, onion rings and fries. I wasn't able to administer her evening glipizide a half hour before she ate for obvious reasons so I gave it to her with dinner and with two ounces of aloe vera gel juice. Surprisingly, this morning, her blood glucose was only 136 so I have no complaints.
She's feeling so much better today that I'm going to do her hair, take her to the grocery with me and see if we can't get the papers notarized that I've been putting off all week because I haven't been able to get her moving. Now I know why. There's more to tell, so I'll write more much...
...later.
Her problem? A urinary tract infection. Although the culture won't be "ready" until early next week, the preliminary analysis indicated E. coli. She is on an aggressive three day course of Cipro XL 500 mg. Already this morning her urine has almost returned to normal. Her blood pressure is still a touch high (for her), but I'm administering lisinopril 2.5 mg on her prescribed schedule. As the infection subsides her stats should return to normal.
I expected her blood sugar to run riot yesterday. We were at the urgent care facility all afternoon, which I hadn't expected. She missed lunch. I had none of her medications with me. In order to quell her hunger I gave her some wintergreen Altoids. When we left, some time after 1700, she was ravenous, so we stopped and picked up hamburgers, onion rings and fries. I wasn't able to administer her evening glipizide a half hour before she ate for obvious reasons so I gave it to her with dinner and with two ounces of aloe vera gel juice. Surprisingly, this morning, her blood glucose was only 136 so I have no complaints.
She's feeling so much better today that I'm going to do her hair, take her to the grocery with me and see if we can't get the papers notarized that I've been putting off all week because I haven't been able to get her moving. Now I know why. There's more to tell, so I'll write more much...
...later.
Thursday, July 15, 2004
How Loooow Can I Goooo?
It appears as though I discovered the answer to that question tonight [see Tonight's Dinner Stats; this link will take you directly to the specific post]. Perhaps you will recall that at lunch today I administered no type 2 diabetic medications to my mother, only supplements, including 1/4 tsp cinnamon and 2 oz aloe vera gel juice. As well, she had exactly the same lunch today as yesterday and a breakfast with less sugar in it than yesterday. A half hour before dinner tonight, her blood glucose tested at 158; actually, somewhat lower than I was expecting but definitely higher than I'd hoped. Considering what I learned yesterday regarding adding another 10 mg of glipizide at lunch to her medication regimen, I think I am very close to hitting on the correct way to medicate her for her type 2 diabetes without using metformin.
Keeping in mind that she received 1 dose of 225 mg of metformin at breakfast yesterday, I've decided that tomorrow I will administer 10 mg glipizide 1/2 hour previous to all three of her meals and use the aloe vera supplement at both breakfast and dinner, to be administered with her glipizide. I'm hoping this will work. I'm going to start with 1 oz at breakfast and 1 oz at dinner; this is the recommended dose. However, since I don't know whether I'm giving her 80% aloe vera gel juice and I can't tell from today's experiment whether the aloe vera gel juice worked (it may have...she may have been quite a bit higher if I hadn't given it to her) tomorrow should fill in some of my knowledge gaps.
Although she has been dragging most of the day today and was very reluctant to arise from her nap this afternoon, she's quite lively tonight, except for a congested cough. She ate a good dinner, has been drinking fluids pretty well and is leafing through The Joy of Cooking marking recipes that pique her interest with playing cards, such as (she's so funny and so predictable) waffles, pancakes and French toast; a page with a variety of chocolate shortbreads; a page on the decorative art of powdered sugar dusting...you can take the sugar out of the woman but you can't take the woman out of the sugar, I guess.
Earlier this evening we had what is a continuing discussion addressing her fear of developing Alzheimer's. Forgive me if I've written on this before. It seems as though I may have recently but I performed several searches and couldn't seem to find anything. When we discuss this it is because Mom brings it up and uses the following sentence toward the beginning of these discussions, "Mother [her mother] had Alzheimer's, you know."
Actually, since the family did not ask for an autopsy this is not known, although because of her mother's behavior in her last years (I'm thinking between 5 and 10 years, but I may be off on the long side) the chances are fair to good that her senility was Alzheimer's. Whether or not it was, she traveled into advanced dementia and probably died of this. Many of her senile behaviors were specific to Alzheimer's also not exclusive to it. In the beginning she hid things and she wandered. As her senility advanced she hallucinated and had an urgent need to "go" somewhere, a where she could never define. She not only lost touch with her friends and loved ones but with herself. During her final days, which she spent in a nursing home, she curled into a fetal position. By the time she was my mother's age, she had begun to exhibit the first of these behaviors with abandon.
My mother's sister also traveled into moderately advanced senility. The family referred to her senility as Alzheimer's but I don't think it was. Her senility developed very quickly and at the beginning was pronounced by at least one of her physicians as stemming from malnutrition due to advanced alcoholism. She did, at times, exhibit a need to "go" somewhere, but the most significant characteristics of her senility were constant, severe fogginess and a lack of ability to do anything for herself. There were certain aspects of her character that she did not lose and which she exhibited often. As well, she paused at a certain point and never went further.
Tonight, when my mother, once again, voiced her fear, we talked about all these aspects of senility in her family. I also reminded her that she takes after her father's side of the family.
"That's true," she agreed.
"Grandpa certainly became forgetful, and he lost interest in life close to his death, but he did not lose himself, nor did he lose the ability to remember those who were significant in his life and who he'd encountered many times throughout his life."
"I know," she said.
"Grandpa also never stopped telling stories about the past."
She glanced at me sardonically. "Are you suggesting something?"
We both laughed. I reminded her that she doesn't tell nearly as many stories as Grandpa did, nor does she repeat them nearly as often, but she has her moments.
So she'd know that I wasn't trying to josh her into a false sense of security, I reminded her that she's occasionally mistaken me for her mother, students of hers from scores of years ago or treasured friends.
"I have!?!" she said. "Does it bother you?"
"Not at all! You always mistake me for someone you love a lot, and that pleases me."
She grinned. "Well, good!"
"I'll start to worry when you mistake me for someone you hate."
"I don't think that'll happen," she said thoughtfully. "I can only remember one person I've hated, and that was a man. Have I ever mistaken you for a man?"
"No," I assured her. "You haven't."
"Well, it bothers me that there is so much I can't remember."
"That's why I'm here," I told her, something I say to her often when she needs reassurance. "I remember the things you need to remember, and, if I don't remember it it's probably not important."
Once again, she displayed that wily grin. "Probably, eh? How many things have you forgotten that you shouldn't've?"
"It's probably a good thing that neither of us knows the answer to that question," I said.
She cast a wizened glance my way. "I'm sure you're right about that."
She went to bed about 45 minutes ago. We had a very good evening. I told her this as I settled her into bed. "I was worried earlier today but you seem to be feeling much better than you were before you took your nap."
"You don't need to worry," she said. "We're just fine."
Through it all, through every step of the way, whether I'm feeling optimistic or pessimistic about what's going on, underneath it all, I agree with her.
Now it's my turn. The second drying cycle just ended. Time for me to go to bed.
Later.
Keeping in mind that she received 1 dose of 225 mg of metformin at breakfast yesterday, I've decided that tomorrow I will administer 10 mg glipizide 1/2 hour previous to all three of her meals and use the aloe vera supplement at both breakfast and dinner, to be administered with her glipizide. I'm hoping this will work. I'm going to start with 1 oz at breakfast and 1 oz at dinner; this is the recommended dose. However, since I don't know whether I'm giving her 80% aloe vera gel juice and I can't tell from today's experiment whether the aloe vera gel juice worked (it may have...she may have been quite a bit higher if I hadn't given it to her) tomorrow should fill in some of my knowledge gaps.
Although she has been dragging most of the day today and was very reluctant to arise from her nap this afternoon, she's quite lively tonight, except for a congested cough. She ate a good dinner, has been drinking fluids pretty well and is leafing through The Joy of Cooking marking recipes that pique her interest with playing cards, such as (she's so funny and so predictable) waffles, pancakes and French toast; a page with a variety of chocolate shortbreads; a page on the decorative art of powdered sugar dusting...you can take the sugar out of the woman but you can't take the woman out of the sugar, I guess.
Earlier this evening we had what is a continuing discussion addressing her fear of developing Alzheimer's. Forgive me if I've written on this before. It seems as though I may have recently but I performed several searches and couldn't seem to find anything. When we discuss this it is because Mom brings it up and uses the following sentence toward the beginning of these discussions, "Mother [her mother] had Alzheimer's, you know."
Actually, since the family did not ask for an autopsy this is not known, although because of her mother's behavior in her last years (I'm thinking between 5 and 10 years, but I may be off on the long side) the chances are fair to good that her senility was Alzheimer's. Whether or not it was, she traveled into advanced dementia and probably died of this. Many of her senile behaviors were specific to Alzheimer's also not exclusive to it. In the beginning she hid things and she wandered. As her senility advanced she hallucinated and had an urgent need to "go" somewhere, a where she could never define. She not only lost touch with her friends and loved ones but with herself. During her final days, which she spent in a nursing home, she curled into a fetal position. By the time she was my mother's age, she had begun to exhibit the first of these behaviors with abandon.
My mother's sister also traveled into moderately advanced senility. The family referred to her senility as Alzheimer's but I don't think it was. Her senility developed very quickly and at the beginning was pronounced by at least one of her physicians as stemming from malnutrition due to advanced alcoholism. She did, at times, exhibit a need to "go" somewhere, but the most significant characteristics of her senility were constant, severe fogginess and a lack of ability to do anything for herself. There were certain aspects of her character that she did not lose and which she exhibited often. As well, she paused at a certain point and never went further.
Tonight, when my mother, once again, voiced her fear, we talked about all these aspects of senility in her family. I also reminded her that she takes after her father's side of the family.
"That's true," she agreed.
"Grandpa certainly became forgetful, and he lost interest in life close to his death, but he did not lose himself, nor did he lose the ability to remember those who were significant in his life and who he'd encountered many times throughout his life."
"I know," she said.
"Grandpa also never stopped telling stories about the past."
She glanced at me sardonically. "Are you suggesting something?"
We both laughed. I reminded her that she doesn't tell nearly as many stories as Grandpa did, nor does she repeat them nearly as often, but she has her moments.
So she'd know that I wasn't trying to josh her into a false sense of security, I reminded her that she's occasionally mistaken me for her mother, students of hers from scores of years ago or treasured friends.
"I have!?!" she said. "Does it bother you?"
"Not at all! You always mistake me for someone you love a lot, and that pleases me."
She grinned. "Well, good!"
"I'll start to worry when you mistake me for someone you hate."
"I don't think that'll happen," she said thoughtfully. "I can only remember one person I've hated, and that was a man. Have I ever mistaken you for a man?"
"No," I assured her. "You haven't."
"Well, it bothers me that there is so much I can't remember."
"That's why I'm here," I told her, something I say to her often when she needs reassurance. "I remember the things you need to remember, and, if I don't remember it it's probably not important."
Once again, she displayed that wily grin. "Probably, eh? How many things have you forgotten that you shouldn't've?"
"It's probably a good thing that neither of us knows the answer to that question," I said.
She cast a wizened glance my way. "I'm sure you're right about that."
She went to bed about 45 minutes ago. We had a very good evening. I told her this as I settled her into bed. "I was worried earlier today but you seem to be feeling much better than you were before you took your nap."
"You don't need to worry," she said. "We're just fine."
Through it all, through every step of the way, whether I'm feeling optimistic or pessimistic about what's going on, underneath it all, I agree with her.
Now it's my turn. The second drying cycle just ended. Time for me to go to bed.
Later.
Wednesday, July 14, 2004
Get back Lo-ret-ta...
...and take your blood glucose with you! Whew! Her lunch number was 100 [link provided for those of you who want to check all her stats], after no metformin at breakfast. Before lunch I was able to find aloe vera juice. Unfortunately, I don't know if it is 80% aloe vera gel. The brand Costco carries says that in a 2 oz serving there is 60 ml of aloe vera gel, however, two fluid ounces is 60 ml (almost, anyway), and the back of the bottle lists some additions to the juice, including water, so I hope that at least 80% of a two ounce serving is aloe vera gel. At any rate, instead of breaking the 2 oz up, I gave it to her all at once at lunch instead of giving her any of her normal diabetic medication. I did, however, also administer 1/4 tsp. of cinnamon.
Needless to say, I am breathless to discover what her blood glucose measurement will be tonight before dinner. Considering when we ate lunch, we'll probably be eating dinner around 2130. I'll decide, at that time, whether to administer glipizide. I expect that I will but we'll see. I'm prepared for anything, including the possibility that her blood glucose will jump through the roof. If it does, I'll reconnoiter her medicine and the timing of it.
At the moment, though, the only real health problem I'm worried about is her knees. I'm trying to be patient. The knee weakness probably is a result of some strenuous over-walking a little over a week ago. As MPS says, I have to remember that she's almost 87 and "she's not Olympic material anymore." As well, movement hasn't been something in which she's been specializing lately. She did pretty well walkering in the driveway yesterday, considering, but today she gave out in the middle of one lap and could barely make it back to the door. I go back and forth between sympathizing with her and trying to motivate her, sometimes like a beloved coach and sometimes like a hated drill sergeant, whatever I think will work at the time. Today neither worked. As well, I think she may have a bit of a cold, which doesn't help. She's napping now, which is something she hasn't done for some days.
Our business has been pushed back a day at her request, which is okay. Just as I was heading into her room to wake her up at 0900, I got a call about that particular piece of business, which lasted 40 minutes. As it turns out, doing what we need to do up here, which involves some paperwork, can wait for a day.
I'm glad Mom feels comfortable being Ancient around me. The further I accompany her along The Road of The Ancients, though, the more I think I don't want to live to qualify for Ancient One status. I would say she's brave and courageous but I know better. She simply hasn't yet decided that she no longer wants to be alive. Old people can talk all they want about how old age isn't for sissies but, most people who live long enough to be ancient move into old age whether or not they're sissies. I'm lucky, from a caregiver's perspective, that my mother isn't a sissy, but I can tell you, lots of sissies become ancient. Old age doesn't play favorites. Perhaps the most important favor we can do for those who live into old age is to stop glamorizing it and those of us who remain alive long enough to become old. It's full of both compensations and drawbacks, just like any other age, and even those compensations and drawbacks depend on the particular Ancient One.
Later.
Needless to say, I am breathless to discover what her blood glucose measurement will be tonight before dinner. Considering when we ate lunch, we'll probably be eating dinner around 2130. I'll decide, at that time, whether to administer glipizide. I expect that I will but we'll see. I'm prepared for anything, including the possibility that her blood glucose will jump through the roof. If it does, I'll reconnoiter her medicine and the timing of it.
At the moment, though, the only real health problem I'm worried about is her knees. I'm trying to be patient. The knee weakness probably is a result of some strenuous over-walking a little over a week ago. As MPS says, I have to remember that she's almost 87 and "she's not Olympic material anymore." As well, movement hasn't been something in which she's been specializing lately. She did pretty well walkering in the driveway yesterday, considering, but today she gave out in the middle of one lap and could barely make it back to the door. I go back and forth between sympathizing with her and trying to motivate her, sometimes like a beloved coach and sometimes like a hated drill sergeant, whatever I think will work at the time. Today neither worked. As well, I think she may have a bit of a cold, which doesn't help. She's napping now, which is something she hasn't done for some days.
Our business has been pushed back a day at her request, which is okay. Just as I was heading into her room to wake her up at 0900, I got a call about that particular piece of business, which lasted 40 minutes. As it turns out, doing what we need to do up here, which involves some paperwork, can wait for a day.
I'm glad Mom feels comfortable being Ancient around me. The further I accompany her along The Road of The Ancients, though, the more I think I don't want to live to qualify for Ancient One status. I would say she's brave and courageous but I know better. She simply hasn't yet decided that she no longer wants to be alive. Old people can talk all they want about how old age isn't for sissies but, most people who live long enough to be ancient move into old age whether or not they're sissies. I'm lucky, from a caregiver's perspective, that my mother isn't a sissy, but I can tell you, lots of sissies become ancient. Old age doesn't play favorites. Perhaps the most important favor we can do for those who live into old age is to stop glamorizing it and those of us who remain alive long enough to become old. It's full of both compensations and drawbacks, just like any other age, and even those compensations and drawbacks depend on the particular Ancient One.
Later.
Tonight I've decided to discuss...
...July 13th's dinner stats here.
At lunch I gave her glipizide instead of metformin to see how it would affect her blood glucose. As a precaution I measured her blood glucose level a few hours after lunch. I was concerned that she might run low and I'd need to feed her. If you've been following the meal stats (and, I'm pretty sure you haven't been, regardless of who you are, because almost no one visits there), you know that between lunch and dinner her blood glucose measured 140. I came to the hasty conclusion that the conventional research, stating that anything over 20 mg glipizide per day seems to have no effect, was reliable. I expected her blood glucose to be even higher at dinner. Instead, it came in at 90, a nice, normal range number.
Three years ago when we were finding it difficult to control her blood glucose with prescribed medications and I was struggling with her to eat healthier and exercise a little, during the periods when we seemed to be having some success I devised a habit, on my own, of testing her blood glucose several times a day. This practice caused me a great deal of anxiety. On the days when it seemed as though there was every reason for her blood glucose to be normal all day long it was only normal when I took her readings before the meals she ate. Between meals it would regularly soar, sometimes as high as the 160s. At our next visit I reported this to her PCP (the same one she retains, now). Although he didn't explain the zig-zagging to me specifically he told me not to worry to stop taking her blood glucose all the time and that, if at the next blood draw her Hemoglobin A1c came in normal everything was fine. It did. Thus, I realized that the etiology of type 2 diabetes, at least in my mother's case, is that, at this time in non-alternative medical practice, it is almost impossible to bring her type 2 diabetic blood glucose under control to where it tests at or close to normal no matter when a sample is taken. When I saw the normal reading this evening I realized that her blood glucose is probably now performing exactly in this manner and has probably been doing this the entire time that we've had it under excellent control. I am thinking, now, that the glipizide at lunch did work as I was hoping it would. I might be able to control her blood glucose, now that she is eating healthily and I am occasionally able to either excite her or badger her into movement, with glipizide alone. I'm still planning on supplementing her treatment for type 2 diabetic blood glucose instability with aloe vera gel. I'm hoping the addition of this will normalize her blood glucose through most of the day instead of allowing wildly out of normal range peaks between meals (and probably at night when she sleeps). At any rate, as long as her Hemoglobin A1c (which will be tested on July 23rd) remains normal and her kidneys continue to function normally, as they have throughout these last four years (except for the times when she is severely anemic, and then, actually, her kidneys are functioning normally as they reflect her severely anemic state), I'm not going to worry too much about the peaks, although I will worry, a bit, about possible valleys and will probably, throughout the next few weeks, take a few extra readings here and there to see if she's dropping too low in order to adjust medications and supplements and bring her back up with food, if necessary.
I have a few more aspects I want to mention, but I think I'll wait until morning. We have some business to which we need to attend and I need to regress Mom's awake time to 0900, so I'll be setting my alarm for an early rising and need to get to bed, now.
Later.
At lunch I gave her glipizide instead of metformin to see how it would affect her blood glucose. As a precaution I measured her blood glucose level a few hours after lunch. I was concerned that she might run low and I'd need to feed her. If you've been following the meal stats (and, I'm pretty sure you haven't been, regardless of who you are, because almost no one visits there), you know that between lunch and dinner her blood glucose measured 140. I came to the hasty conclusion that the conventional research, stating that anything over 20 mg glipizide per day seems to have no effect, was reliable. I expected her blood glucose to be even higher at dinner. Instead, it came in at 90, a nice, normal range number.
Three years ago when we were finding it difficult to control her blood glucose with prescribed medications and I was struggling with her to eat healthier and exercise a little, during the periods when we seemed to be having some success I devised a habit, on my own, of testing her blood glucose several times a day. This practice caused me a great deal of anxiety. On the days when it seemed as though there was every reason for her blood glucose to be normal all day long it was only normal when I took her readings before the meals she ate. Between meals it would regularly soar, sometimes as high as the 160s. At our next visit I reported this to her PCP (the same one she retains, now). Although he didn't explain the zig-zagging to me specifically he told me not to worry to stop taking her blood glucose all the time and that, if at the next blood draw her Hemoglobin A1c came in normal everything was fine. It did. Thus, I realized that the etiology of type 2 diabetes, at least in my mother's case, is that, at this time in non-alternative medical practice, it is almost impossible to bring her type 2 diabetic blood glucose under control to where it tests at or close to normal no matter when a sample is taken. When I saw the normal reading this evening I realized that her blood glucose is probably now performing exactly in this manner and has probably been doing this the entire time that we've had it under excellent control. I am thinking, now, that the glipizide at lunch did work as I was hoping it would. I might be able to control her blood glucose, now that she is eating healthily and I am occasionally able to either excite her or badger her into movement, with glipizide alone. I'm still planning on supplementing her treatment for type 2 diabetic blood glucose instability with aloe vera gel. I'm hoping the addition of this will normalize her blood glucose through most of the day instead of allowing wildly out of normal range peaks between meals (and probably at night when she sleeps). At any rate, as long as her Hemoglobin A1c (which will be tested on July 23rd) remains normal and her kidneys continue to function normally, as they have throughout these last four years (except for the times when she is severely anemic, and then, actually, her kidneys are functioning normally as they reflect her severely anemic state), I'm not going to worry too much about the peaks, although I will worry, a bit, about possible valleys and will probably, throughout the next few weeks, take a few extra readings here and there to see if she's dropping too low in order to adjust medications and supplements and bring her back up with food, if necessary.
I have a few more aspects I want to mention, but I think I'll wait until morning. We have some business to which we need to attend and I need to regress Mom's awake time to 0900, so I'll be setting my alarm for an early rising and need to get to bed, now.
Later.
Tuesday, July 13, 2004
In case anyone is interested...
...in following up some of my research: It would be silly, and pretty close to impossible, for me to list all the sites I've hit in the past couple of weeks, but I thought I'd mention two.
No, I'm not ignoring the fact that some extra energy direction is involved in lowering my mother's blood glucose levels on behalf of her anemia. I'm just trying to help it along. Life is about energy and effort is a good way to focus energy. It's obvious to me, so far, that something besides glipizide is necessary, at least for the time being, even though her dependence on metformin seems to be declining. So I'm focusing my energy on finding the right companion for glipizide.
- This first one is a sort of compendium that lists a wide variety of treatments and supplements, with links, to explore in regards to both diabetes types 1 and 2:
- It's always a good idea to look up a little independent discovery to see if there are reasons to question what one is learning. Bandolier is a good place to start. When I searched their site, sure enough, I found the following reason to be circumspect about aloe vera juice but it didn't discourage me from trying it. I did not, by the way, find anything there regarding alpha lipoic acid and coenzyme Q10 and their possible effects on diabetes:
No, I'm not ignoring the fact that some extra energy direction is involved in lowering my mother's blood glucose levels on behalf of her anemia. I'm just trying to help it along. Life is about energy and effort is a good way to focus energy. It's obvious to me, so far, that something besides glipizide is necessary, at least for the time being, even though her dependence on metformin seems to be declining. So I'm focusing my energy on finding the right companion for glipizide.
Although there was a significant lag...
...between the time I awoke Mom (1030) and the time she commenced breakfast (1215), it wasn't a stressful lag. She resisted sitting up for about 10 minutes, at which time, as I'd "warned" her, I set her up. From that point on we talked and cat watched for almost 45 minutes until about 1130. Good conversation. We observed and talked about: Our cats' psychology; Muggins, the cat of my mother's extreme youth, whom she always wanted to give birth to puppies; the weather, which is a bit stifling right now since the monsoons have arrived but without rainfall in this area, yet. I don't ever mind stuff being put off to accommodate conversation, even bathing, so, it was that we got what would normally be considered a "late start", but wasn't, really.
I do want to mention that I did some further research on supplemental agents that have shown, in some or all cases, to be useful in increasing cells' sensitivity to insulin, which is the problem with type 2 diabetes. I've decided on adding aloe vera juice (specifically juice with 80% aloe vera gel) to her diet and will pick up some the next time we go to Costco. Siberian Ginseng is also supposed to help but that is contraindicated for her because of the lisinopril. Alpha lipoic acid also look good but I'm going to wait to see what sort of results happen with the aloe vera gel, specifically because this supplement has been used successfully both with and without the administration of glyburide. Although my mother isn't on glyburide she is on glipizide which is of the same class as glyburide: They are both sulfonylurea drugs.
The increase in her fiber intake over the last year has probably also helped, according to the information, as has the recent increase in tuna. I think, though, I'll switch back to the oat bran bread I was previously giving her. The potato bread was a dietary compromise she and I worked out a few months ago but, after talking to her this morning about how the increase in fiber in her diet was part of the reason that her diabetes was under much better control, she agreed that I could switch her back to oat bran bread after we ran out of potato bread (probably in a week or so) and until she got sick of the oat bran bread, again. That's okay with me. If the aloe vera gel helps, considering the amount of fiber she is now getting, I don't think we'll have a problem.
Right now I'm going to take her out to do some walkering. She seems to need the energy burst that moving delivers.
I do want to mention that I did some further research on supplemental agents that have shown, in some or all cases, to be useful in increasing cells' sensitivity to insulin, which is the problem with type 2 diabetes. I've decided on adding aloe vera juice (specifically juice with 80% aloe vera gel) to her diet and will pick up some the next time we go to Costco. Siberian Ginseng is also supposed to help but that is contraindicated for her because of the lisinopril. Alpha lipoic acid also look good but I'm going to wait to see what sort of results happen with the aloe vera gel, specifically because this supplement has been used successfully both with and without the administration of glyburide. Although my mother isn't on glyburide she is on glipizide which is of the same class as glyburide: They are both sulfonylurea drugs.
The increase in her fiber intake over the last year has probably also helped, according to the information, as has the recent increase in tuna. I think, though, I'll switch back to the oat bran bread I was previously giving her. The potato bread was a dietary compromise she and I worked out a few months ago but, after talking to her this morning about how the increase in fiber in her diet was part of the reason that her diabetes was under much better control, she agreed that I could switch her back to oat bran bread after we ran out of potato bread (probably in a week or so) and until she got sick of the oat bran bread, again. That's okay with me. If the aloe vera gel helps, considering the amount of fiber she is now getting, I don't think we'll have a problem.
Right now I'm going to take her out to do some walkering. She seems to need the energy burst that moving delivers.
Thank the gods I surrendered
Yesterday, before my mother awoke, I was called to the house of a friend who I used to see a lot more than I do now...that is to say, I haven't seen her in a long, long time. She and I used to collaborate on several levels, not the least of which was a running conversation about our lives. For about a year our contact has dwindled. Within the last 6 months or so we haven't seen one another at all and have rarely talked. This has happened almost exclusively because of my involvement with my mother.
One of our avenues of contact has been her computer. Yesterday she needed to be checked out on how to access her number pad. Not remembering exactly what her keyboard looked like, I took a short trip to her house to figure out what it was she needed to know and teach it to her. It was an easy fix. Since I knew I had a few minutes before I needed to be back here, since both of us have missed the other I stayed to talk. As is usual with almost all my friends except two, a few sentences into our exchange, while I was once again explaining that my involvement with my mother was even more intense now than before, thus, I have chosen to put aside my involvement with others in order to do what I perceive to be justice to my involvement with my mother, she slipped into a refrain I often hear: Poor Gail, "you've given up your life" to take care of your mother.
I immediately took umbrage. "No I haven't," I said. "My life is a continuum. It was one way 10 years ago when I lived in Seattle. This is my life now." I added further [all of this is paraphrase from here on, but very close to what I actually said, the spirit of what I said being exactly represented]: "It's true that my life revolves around my mother's now. Thank the gods I allowed this to happen. If I hadn't I would not have been able to manage my mother's medical care the way I have. I wouldn't be able to get her through a day without her experiencing some bit of regret over that day. I wouldn't know all the seemingly insignificant details I need to know to keep her body, mind and soul running fairly close to the way she'd like them to run. The woman I was 10 years ago is nothing like the woman I am today and I'm glad."
I related my recent experience involving getting my mother out of bed in the morning, all of it, including my initial search for someone whom I could pay to do this, and my realization that I could do it myself.
"Surely you could have found some big guy who'd be able to do this for you."
As she named one of the organizations that I guessed I'd called and later, when I arrived home, noted that I had, I told her, funny, that's exactly what I'd thought. "I'm grateful that I was forced to negotiate this by myself. It changed my mother's and my relationship for the better. It added to my personal internal and external strength. In a curious way it deepened the bond between her and me, which is exactly what needed to happen at this point."
I went on to explain that surrender is how I work best. It's how I get the information I need to do what I need to do. It's how I'm able to perform at my peak. Lots of people appreciate this about me, the most appreciative of whom is probably my mother. Then, I went a step further. "You know," I declared, "I've come to realize that those people who are most likely to bemoan the life I lead now are those to whom I've become less available as I've needed to become more available to my mother."
"That's unfair," she said.
I agreed that maybe in her and my case she was right. But, I told her, I've made my choices, which I continue to make on a daily, sometimes an hourly basis. Those choices have made me who I am now. I am thrilled with the person I am and continue to become because of this journey and I'm noticing that the further these choices take me into caregiverhood, the less likely my friends and relatives are to make themselves available to me and my mother. The most important discovery I've made is that I can not only live with this but I'm not responsible for everyone else's refusal to understand and approve of my method of doing what I'm doing. If others can't figure out that what they valued in me when I was available to them is exactly what allows me to be so valuable to my mother at this point in her life, well, that's their problem, not mine.
She made a reference to "[my] writing", bemoaning the fact that I'm not doing this anymore. I countered, as I have before to her and others, "I am writing. Everyone knows where that writing is. If it isn't what others want to read, I'm not surprised." I went on to tell her about my viewing of The Maldonado Miracle and how I took offense at the portrayal of what was supposed to be the heroism of the silent, suffering caregiver. "Caregivers shouldn't be silent," I told her, "and they shouldn't be assumed to be suffering. I'm not suffering and I'm not silent, even though everyone else would like me to be because that's how caregivers are supposed to be. My feeling is, bullshit. This attitude is exactly why lots of caregivers can't find the help they need within their personal community of friends and relatives and end up dealing with the hazards involved in finding hired help. When I'm done with what I've chosen or been forced to do, I'm not going to walk away from these issues. Caregiving is about to become a completely different, much less isolated endeavor, precisely because I'm not going to be silent, and I'm not going to pretend that I'm suffering."
Her surprised response was that my attitude is "refreshing".
"You know," I told her as I left, "I'm not going to 'whistle a happy tune whenever I feel afraid'. I never learned how to whistle and, now, I'm glad I didn't."
Time to awaken Mom. Later.
One of our avenues of contact has been her computer. Yesterday she needed to be checked out on how to access her number pad. Not remembering exactly what her keyboard looked like, I took a short trip to her house to figure out what it was she needed to know and teach it to her. It was an easy fix. Since I knew I had a few minutes before I needed to be back here, since both of us have missed the other I stayed to talk. As is usual with almost all my friends except two, a few sentences into our exchange, while I was once again explaining that my involvement with my mother was even more intense now than before, thus, I have chosen to put aside my involvement with others in order to do what I perceive to be justice to my involvement with my mother, she slipped into a refrain I often hear: Poor Gail, "you've given up your life" to take care of your mother.
I immediately took umbrage. "No I haven't," I said. "My life is a continuum. It was one way 10 years ago when I lived in Seattle. This is my life now." I added further [all of this is paraphrase from here on, but very close to what I actually said, the spirit of what I said being exactly represented]: "It's true that my life revolves around my mother's now. Thank the gods I allowed this to happen. If I hadn't I would not have been able to manage my mother's medical care the way I have. I wouldn't be able to get her through a day without her experiencing some bit of regret over that day. I wouldn't know all the seemingly insignificant details I need to know to keep her body, mind and soul running fairly close to the way she'd like them to run. The woman I was 10 years ago is nothing like the woman I am today and I'm glad."
I related my recent experience involving getting my mother out of bed in the morning, all of it, including my initial search for someone whom I could pay to do this, and my realization that I could do it myself.
"Surely you could have found some big guy who'd be able to do this for you."
As she named one of the organizations that I guessed I'd called and later, when I arrived home, noted that I had, I told her, funny, that's exactly what I'd thought. "I'm grateful that I was forced to negotiate this by myself. It changed my mother's and my relationship for the better. It added to my personal internal and external strength. In a curious way it deepened the bond between her and me, which is exactly what needed to happen at this point."
I went on to explain that surrender is how I work best. It's how I get the information I need to do what I need to do. It's how I'm able to perform at my peak. Lots of people appreciate this about me, the most appreciative of whom is probably my mother. Then, I went a step further. "You know," I declared, "I've come to realize that those people who are most likely to bemoan the life I lead now are those to whom I've become less available as I've needed to become more available to my mother."
"That's unfair," she said.
I agreed that maybe in her and my case she was right. But, I told her, I've made my choices, which I continue to make on a daily, sometimes an hourly basis. Those choices have made me who I am now. I am thrilled with the person I am and continue to become because of this journey and I'm noticing that the further these choices take me into caregiverhood, the less likely my friends and relatives are to make themselves available to me and my mother. The most important discovery I've made is that I can not only live with this but I'm not responsible for everyone else's refusal to understand and approve of my method of doing what I'm doing. If others can't figure out that what they valued in me when I was available to them is exactly what allows me to be so valuable to my mother at this point in her life, well, that's their problem, not mine.
She made a reference to "[my] writing", bemoaning the fact that I'm not doing this anymore. I countered, as I have before to her and others, "I am writing. Everyone knows where that writing is. If it isn't what others want to read, I'm not surprised." I went on to tell her about my viewing of The Maldonado Miracle and how I took offense at the portrayal of what was supposed to be the heroism of the silent, suffering caregiver. "Caregivers shouldn't be silent," I told her, "and they shouldn't be assumed to be suffering. I'm not suffering and I'm not silent, even though everyone else would like me to be because that's how caregivers are supposed to be. My feeling is, bullshit. This attitude is exactly why lots of caregivers can't find the help they need within their personal community of friends and relatives and end up dealing with the hazards involved in finding hired help. When I'm done with what I've chosen or been forced to do, I'm not going to walk away from these issues. Caregiving is about to become a completely different, much less isolated endeavor, precisely because I'm not going to be silent, and I'm not going to pretend that I'm suffering."
Her surprised response was that my attitude is "refreshing".
"You know," I told her as I left, "I'm not going to 'whistle a happy tune whenever I feel afraid'. I never learned how to whistle and, now, I'm glad I didn't."
Time to awaken Mom. Later.
Monday, July 12, 2004
Just for fun, thought I'd mention...
...I tangled myself into a sort of mini-cause regarding Hidden Valley Original Ranch Salad Dressing Mix as I was reporting on Mom's dinner stats tonight. It will be continued. In the meantime, tonight's stats were very interesting. The challenge continues, taking yet another turn, explanation at the previously mentioned link.
Yes, we're still up, both of us. I'm sure we'll get a late start tomorrow, which is okay. Our plans for tomorrow fell through at the last minute and this weekend has been so intense, with Mom being livelier than usual and me needing to negotiate the less pleasant consequences of this and wanting to take advantage of the more pleasant consequences and keep her up and keep her moving that I haven't had time to look for some paperwork I need to find for the possible sale of our mobile home in Mesa. Tomorrow will be a good time to do that even though I'm going to try to get her out walkering tomorrow. I want movement to become a habit for her again.
She's delightfully confident when she's walkering. It's not unusual for her to walker away from me, attracted by the sights and sounds around her. She didn't do this when she used the wheelchair as a walker. With this real walker she knows where she is in relation to her machine and where it is in relation to her environment. I think, too, some of it has to do with her feeling of safety with me, which pleases me. She knows my world revolves around her: That where ever she goes, whatever she does, I am bound, literally, to be close by, thus, she feels safe. I hadn't thought about this until today when she wheeled away from me at the first store we visited and I had to look for her. When I spotted her I didn't rush her. I lingered a ways away, letting her be herself without any more impingement than using a walker implies. After some seconds she glanced at me and the look told me that she knew I'd be close by. Then she continued prowling the shelves along the aisle, caught up in her own interests.
I have always felt, since before I can remember, that I am, somehow, protected in a lot of situations wherein others would be so cautious as to not enter into those situations if they could help it. I have, as well, felt that in such situations anyone who is with me is protected. Today considered that it may not be that I've been protected but that I have the natural qualities of a protector, able to not only protect myself but those with me. I continued thinking that this must be what parents feel and reflected upon what I've been told by those I know well who are parents. I realized that it isn't necessarily true that people tend to feel they are natural protectors when they become parents but that they are designated protectors and must "study" the task in order to perform it. That's not how I feel. I feel as though I just do it, as though I was born with the gift of protection. Very, very nice realization, considering what I'm doing now. Maybe, I'm thinking, this is one of the reasons my mother honed in on me when she decided she no longer wanted to live alone. I'm pleased I can bring this gift, this talent, this skill, whatever it is, to bear on her life now.
Later.
Yes, we're still up, both of us. I'm sure we'll get a late start tomorrow, which is okay. Our plans for tomorrow fell through at the last minute and this weekend has been so intense, with Mom being livelier than usual and me needing to negotiate the less pleasant consequences of this and wanting to take advantage of the more pleasant consequences and keep her up and keep her moving that I haven't had time to look for some paperwork I need to find for the possible sale of our mobile home in Mesa. Tomorrow will be a good time to do that even though I'm going to try to get her out walkering tomorrow. I want movement to become a habit for her again.
She's delightfully confident when she's walkering. It's not unusual for her to walker away from me, attracted by the sights and sounds around her. She didn't do this when she used the wheelchair as a walker. With this real walker she knows where she is in relation to her machine and where it is in relation to her environment. I think, too, some of it has to do with her feeling of safety with me, which pleases me. She knows my world revolves around her: That where ever she goes, whatever she does, I am bound, literally, to be close by, thus, she feels safe. I hadn't thought about this until today when she wheeled away from me at the first store we visited and I had to look for her. When I spotted her I didn't rush her. I lingered a ways away, letting her be herself without any more impingement than using a walker implies. After some seconds she glanced at me and the look told me that she knew I'd be close by. Then she continued prowling the shelves along the aisle, caught up in her own interests.
I have always felt, since before I can remember, that I am, somehow, protected in a lot of situations wherein others would be so cautious as to not enter into those situations if they could help it. I have, as well, felt that in such situations anyone who is with me is protected. Today considered that it may not be that I've been protected but that I have the natural qualities of a protector, able to not only protect myself but those with me. I continued thinking that this must be what parents feel and reflected upon what I've been told by those I know well who are parents. I realized that it isn't necessarily true that people tend to feel they are natural protectors when they become parents but that they are designated protectors and must "study" the task in order to perform it. That's not how I feel. I feel as though I just do it, as though I was born with the gift of protection. Very, very nice realization, considering what I'm doing now. Maybe, I'm thinking, this is one of the reasons my mother honed in on me when she decided she no longer wanted to live alone. I'm pleased I can bring this gift, this talent, this skill, whatever it is, to bear on her life now.
Later.
Sunday, July 11, 2004
Oh, one more thing, while she's in the bathroom...
...I noticed, and mentioned to her after lunch when she was smoking a few cigarettes that she becomes noticeably paler when she goes off the oxygen and smokes. I just mentioned it in passing but, surprisingly, she took note of this. Some minutes later when she was close to the end of the cigarette she'd been smoking when I mentioned this, she stubbed it out, reached for the oxygen cannula, slipped it on correctly without me having to coach her (a first), began examining the OCD that delivers canistered oxygen and asked, "Now, how, exactly, do I turn this thing on?"
That's what I call amazing grace.
Later.
That's what I call amazing grace.
Later.
4. and 6. As each day reveals new data...
...my management of her meds and her health changes. Last night, after some ferocious research, I realized that it wouldn't be wise to simply stop the metformin despite what I think is going on now. Her body needs to adjust to the change so I'm lowering it little by a little more. Today if everything goes as I'm expecting, her total metformin intake will be 750 mg, significantly less than normal and less than any of the recent cutting back days. I worked breakfast to see how added sugar was going to affect her blood glucose levels and was pleased to see that her need for medical management of her diabetes appears to be lessening regardless of what she eats.
Mom is taking a nap, something she hasn't done in awhile because, well, she hasn't needed one. Walkering turned into a bit of a workout today, at her pleasure. I think she overestimated what she could do from an aerobic standpoint although her legs, including her knees, didn't give out. So it didn't surprise me when, an hour or so after she finished lunch, she decided she needed to snooze. It made me feel as though our days are returning to normal. Tomorrow is going to start early, too, so the added rest today should help.
While I have a few minutes before I awaken her for her evening iron let me explain my understanding of what's happening. Some days ago, I believe close to two weeks but it might not have been that long (I could go back and check but that would give me less time to write), I slipped back into despair over my battles with her anemia and non-alternative medicine in regards to both her anemia and her diabetes. As I've mentioned before, I'm not a "praying man". Rather, I consider that my life is a constant prayer to The Source, whatever that is (although I cannot define what I refer to as The Source, or god/God/All, or, the Essence of Everything, I have, at times, been in direct communication with "it"), there are times, especially when I am in need, that I become more formal in my communication and "pray" or, more accurately, consciously meditate on what it is I need. When I do this I am specific, often verbal, about my request. I imagine that focusing intently on my request taps into the specific kind of energy I need to have a request filled, and establishes specific direction of this energy toward the fulfillment of my request. Anyway, in the pit of despair, I "prayed" that the cause of my mother's anemia correct itself; I "prayed" additionally, that it do this without me having to negotiate the gauntlet of non-alternative medical practitioners anymore for both mine and my mother's sakes. I poured my frustration and confusion out. I didn't, I need to note, address anything else in regards to my mother's health. Not her diabetes, her back problems, her COPD (if that's what her breathing problem is) nor other items of her physical debilitation. I "prayed" this not only on behalf of my exhaustion, but on behalf of my mother's desire to no longer have to deal with doctors and tests and questionable meds and all the other detritous that's entered our lives since 2002 except for regular physical check-ups, monitoring, and judicious doctoring when an emergent situation crops up.
The very next day was the first day I recorded lower than normal blood glucose levels. It didn't hit me right away, but after a few of these passed through the monitor, I began to think that, well, my "prayer" was being "answered" (that is to say, I'd managed to marshal some very powerful, very direct energies to work on my mother's and my behalf), and, in being "answered", I was receiving the fringe benefit of having my suspicion that Mom's anemia is due to her intake of metformin confirmed.
It is typical that conscious requests I place before The Source are addressed, always in ways I am able to appreciate. It is also typical that I rarely approach needs and problems in such a direct and directed manner because the indirect "prayer" of my life usually "works". I have to say, though, that, in this case, if what I think is now happening within my mother is indeed happening I believe, as well as know, that I'm not the only one seeking focused energy applied specifically to the state of my mother's health. For this, I am heartily grateful, to all who have, as MCS (who is, spiritually similar to me) put it, "been thinking hard" about Mom and me. I'm making a lasered effort to remain aligned with all this energy coming our way. I'm trying very hard to honor it in the way I am now handling my mother's life. I hope to be able to report, as the future becomes the present and then the past, that we are in sync with an Intention that promises adequate and comfortable management of my mother's health from now to the moment she takes her last breath.
The last part of my "prayer" was that I do not, while my mother is alive, want to focus attention on non-alternative medicine so much as I want to focus attention on my mother. Because of the problems I've had negotiating the non-alternative medical establishment it's been much too easy for me to focus on the inadequacies of non-alternative healers rather than my mother's own adequacies in negotiating her Ancient body. I believe this request is being "answered", as well.
Thank you, again and again.
Time to awaken my mother and administer her evening dose of iron.
Later.
Mom is taking a nap, something she hasn't done in awhile because, well, she hasn't needed one. Walkering turned into a bit of a workout today, at her pleasure. I think she overestimated what she could do from an aerobic standpoint although her legs, including her knees, didn't give out. So it didn't surprise me when, an hour or so after she finished lunch, she decided she needed to snooze. It made me feel as though our days are returning to normal. Tomorrow is going to start early, too, so the added rest today should help.
While I have a few minutes before I awaken her for her evening iron let me explain my understanding of what's happening. Some days ago, I believe close to two weeks but it might not have been that long (I could go back and check but that would give me less time to write), I slipped back into despair over my battles with her anemia and non-alternative medicine in regards to both her anemia and her diabetes. As I've mentioned before, I'm not a "praying man". Rather, I consider that my life is a constant prayer to The Source, whatever that is (although I cannot define what I refer to as The Source, or god/God/All, or, the Essence of Everything, I have, at times, been in direct communication with "it"), there are times, especially when I am in need, that I become more formal in my communication and "pray" or, more accurately, consciously meditate on what it is I need. When I do this I am specific, often verbal, about my request. I imagine that focusing intently on my request taps into the specific kind of energy I need to have a request filled, and establishes specific direction of this energy toward the fulfillment of my request. Anyway, in the pit of despair, I "prayed" that the cause of my mother's anemia correct itself; I "prayed" additionally, that it do this without me having to negotiate the gauntlet of non-alternative medical practitioners anymore for both mine and my mother's sakes. I poured my frustration and confusion out. I didn't, I need to note, address anything else in regards to my mother's health. Not her diabetes, her back problems, her COPD (if that's what her breathing problem is) nor other items of her physical debilitation. I "prayed" this not only on behalf of my exhaustion, but on behalf of my mother's desire to no longer have to deal with doctors and tests and questionable meds and all the other detritous that's entered our lives since 2002 except for regular physical check-ups, monitoring, and judicious doctoring when an emergent situation crops up.
The very next day was the first day I recorded lower than normal blood glucose levels. It didn't hit me right away, but after a few of these passed through the monitor, I began to think that, well, my "prayer" was being "answered" (that is to say, I'd managed to marshal some very powerful, very direct energies to work on my mother's and my behalf), and, in being "answered", I was receiving the fringe benefit of having my suspicion that Mom's anemia is due to her intake of metformin confirmed.
It is typical that conscious requests I place before The Source are addressed, always in ways I am able to appreciate. It is also typical that I rarely approach needs and problems in such a direct and directed manner because the indirect "prayer" of my life usually "works". I have to say, though, that, in this case, if what I think is now happening within my mother is indeed happening I believe, as well as know, that I'm not the only one seeking focused energy applied specifically to the state of my mother's health. For this, I am heartily grateful, to all who have, as MCS (who is, spiritually similar to me) put it, "been thinking hard" about Mom and me. I'm making a lasered effort to remain aligned with all this energy coming our way. I'm trying very hard to honor it in the way I am now handling my mother's life. I hope to be able to report, as the future becomes the present and then the past, that we are in sync with an Intention that promises adequate and comfortable management of my mother's health from now to the moment she takes her last breath.
The last part of my "prayer" was that I do not, while my mother is alive, want to focus attention on non-alternative medicine so much as I want to focus attention on my mother. Because of the problems I've had negotiating the non-alternative medical establishment it's been much too easy for me to focus on the inadequacies of non-alternative healers rather than my mother's own adequacies in negotiating her Ancient body. I believe this request is being "answered", as well.
Thank you, again and again.
Time to awaken my mother and administer her evening dose of iron.
Later.
It's not nice to fool mother's nature...
...at least that's been my code of caretaker honor up to yesterday. After yet again confronting Mom's intransigence about getting up yesterday, after once again yielding to the discouragement of spending any time at all, let alone what has become the usual 1/2 to 2 hour pleading (in which I remain in her room, at her bedside, verbally coaxing her, sometimes in not very nice tones, to get her ass out of bed), suddenly I decided I'd had it. I was not going to allow Mom's misplaced show of spirit and pride to ruin my day and her health anymore. In an instant and with determined fury I pried her fingers off the edge of the mattress, rolled her on her side, bent her legs at the knee and the hip, wrapped my arms around her urine soaked body and brought her upright to the edge of the bed. She sat there, pink and blinking, like a fetal bird whose parent has just broken its shell.
I just couldn't take these beginning-of-the-day battles anymore. They weren't doing me any good and were chipping away at my ability to be a willing and fully engaged caretaker. I was startled, once she was up on end, that it was that easy. I was so thrilled I practically did a happy dance in front of her. I spent an inordinate amount of time gloating about how, at least in this particular way, she wasn't going to be able to defy me anymore. I went so far as to announce, to an improvised melody with a few of my favorite song tags (like, "I feel good" [James Brown]) that I had such a renewed sense of my own physical, emotional, intellectual and spiritual strength that there wasn't nothin' she was going to be able to put over on me anymore. I went on to inform her that from now on her getting up schedule was going to be on my well-considered terms, not on hers (I am a sore loser and a graceless winner; always have been, and cherish my right and ability to be so). This is exactly what happened this morning. She dug in almost immediately after I took her blood glucose and administered her iron and vitamin C with 8 oz of water. I gave her a few minutes of me pleading and her strengthening her defenses, then I went to work.
I was surprised I had the physical, spiritual and emotional strength to do this. After yesterday I wasn't sure I'd be able to repeat the feat from a calm center, seeing as how, yesterday, it came from desperation. Physically I knew I could assist her in getting up when she wanted to get up but was stuck. I didn't think I could actually lift her against her will. Spiritually and emotionally I was so tied into the idea of not breaking her will or her spirit that I was surprised that, suddenly, I pushed all those considerations aside in favor of just getting her the hell up to start her day.
I haven't lost sight of these considerations. Mom wasn't thrilled but her spirit wasn't broken, either. Once she realized, both yesterday and today, of what I was capable her eyes flashed with wily intent. I met her head on. I told her that I expected that, although doing what I was doing wasn't hurting her physically, it was probably wounding her dignity and I expected, after a few days of regularly having her dignity thus wounded, she'd figure out that the best way to protect her dignity was to get up herself when I told her it was time to get up. She has other ways to fight me and to preserve her spirit, I told her (and, she does), that aren't stepping stones toward her grave.
In most of those other ways, in fact, I often give in. Cigarettes, for instance. I've even devised a sort of "reward" system that allows her to feel that she's not being asked to give up the part of her identity linked to smoking. Her desire to eat without paying attention to what her body needs (and doesn't need) is a field in which we work our individual wills back and forth all the time. Movement is another area where I'll judiciously give in when I think it won't hurt her. And in the area of visitors who decide they need us to accomodate them, well, we aren't doing that anymore.
So it seems I've solved one of those problems that I can't pay someone to solve for me. I'm glad, now, I had no other way to solve it. Not only do I know that I no longer have to start her part of my day completely in thrall to her desire to fight me about getting out of bed, my sense of my strength in all areas has gotten a major boost, which it needed.
Sometimes, mother's nature doesn't know what's good for mother. That's when daughter's nature needs to step in, wrap its arms around recalcitrance and set it up on end where it can see through a more appropriate panoramic lens.
Well, off to the races.
Later.
I just couldn't take these beginning-of-the-day battles anymore. They weren't doing me any good and were chipping away at my ability to be a willing and fully engaged caretaker. I was startled, once she was up on end, that it was that easy. I was so thrilled I practically did a happy dance in front of her. I spent an inordinate amount of time gloating about how, at least in this particular way, she wasn't going to be able to defy me anymore. I went so far as to announce, to an improvised melody with a few of my favorite song tags (like, "I feel good" [James Brown]) that I had such a renewed sense of my own physical, emotional, intellectual and spiritual strength that there wasn't nothin' she was going to be able to put over on me anymore. I went on to inform her that from now on her getting up schedule was going to be on my well-considered terms, not on hers (I am a sore loser and a graceless winner; always have been, and cherish my right and ability to be so). This is exactly what happened this morning. She dug in almost immediately after I took her blood glucose and administered her iron and vitamin C with 8 oz of water. I gave her a few minutes of me pleading and her strengthening her defenses, then I went to work.
I was surprised I had the physical, spiritual and emotional strength to do this. After yesterday I wasn't sure I'd be able to repeat the feat from a calm center, seeing as how, yesterday, it came from desperation. Physically I knew I could assist her in getting up when she wanted to get up but was stuck. I didn't think I could actually lift her against her will. Spiritually and emotionally I was so tied into the idea of not breaking her will or her spirit that I was surprised that, suddenly, I pushed all those considerations aside in favor of just getting her the hell up to start her day.
I haven't lost sight of these considerations. Mom wasn't thrilled but her spirit wasn't broken, either. Once she realized, both yesterday and today, of what I was capable her eyes flashed with wily intent. I met her head on. I told her that I expected that, although doing what I was doing wasn't hurting her physically, it was probably wounding her dignity and I expected, after a few days of regularly having her dignity thus wounded, she'd figure out that the best way to protect her dignity was to get up herself when I told her it was time to get up. She has other ways to fight me and to preserve her spirit, I told her (and, she does), that aren't stepping stones toward her grave.
In most of those other ways, in fact, I often give in. Cigarettes, for instance. I've even devised a sort of "reward" system that allows her to feel that she's not being asked to give up the part of her identity linked to smoking. Her desire to eat without paying attention to what her body needs (and doesn't need) is a field in which we work our individual wills back and forth all the time. Movement is another area where I'll judiciously give in when I think it won't hurt her. And in the area of visitors who decide they need us to accomodate them, well, we aren't doing that anymore.
So it seems I've solved one of those problems that I can't pay someone to solve for me. I'm glad, now, I had no other way to solve it. Not only do I know that I no longer have to start her part of my day completely in thrall to her desire to fight me about getting out of bed, my sense of my strength in all areas has gotten a major boost, which it needed.
Sometimes, mother's nature doesn't know what's good for mother. That's when daughter's nature needs to step in, wrap its arms around recalcitrance and set it up on end where it can see through a more appropriate panoramic lens.
Well, off to the races.
Later.
