Mom & Me Two Archive

...I think I figured out "how long I can hold up". Considering how long I've held up negotiating the vagaries of medicine in a large community where the problem isn't the doctor/patient ratio but the race to make as much profit as possible from processing (badly, without thought and care) as many patients as possible, I think I can hold out until my mother's death-by-U.S.-medicine's-mismanagement or death-by-refusing-to-allow-her-to-be-mismanaged. That's been my standard. No reason to change it now. I understand that the U.S. non-alternative medical establishment believes they've got an ace in the hole by holding desperate-for-care patients hostage. I realized, while setting up the bathroom, that I pulled Mom and myself out of that hole a long time ago with a great deal of success. So, yeah, I think I can hold up and, further, I think my mother will be no worse for me taking the position, here in this community of rural medical mismanagement, that I've kept my mother alive and fairly well undamanged in the Valley by refusing or modifying questionable treatment. I'll bet I can keep my mother alive at least as long, and probably longer, by facing off with a rural medical community that thinks it's got its patients in an untenable bind.
    Rally the troops, we'll meet the bastards with all we've got.
    I'm thinking, immediately, of McNamara's advice to "empathize with the enemy" (from The Fog of War. I can see I'm not yet doing this. I'll work on it this weekend. I think, in order to clearly see that with which I need to empathize I have needed to mobilize my anger. It's mobilized. Now, I think I can afford to do a little enemy dance, see what it's like, then we're on our way. Not that I think my approach will be much different than previously but maybe I need to tailor it with some detail attractive to the enemy.
    I'll work on this.
    Time, over time, I guess, to tantalize my mother out of her reverie. Ahh, reconnaisance coughing. Yes, it's time.

...I need a drying out period after this week, culminated by yesterday, so this weekend is going to be very low key. I am keeping my expectations regarding my mother's ability to mobilize on her own to a minimum and wait and see what happens. Last night she seemed to be recovering some of her strength. Her blood pressure, as well, slipped back to normal throughout the afternoon and evening, the 120s over the 50s.
    I have decided that, the next time she collapses (although I'm going to try to keep this to a minimum) I'm taking her into the ER. I'm prepared, now, for the ridiculous medical situation in this community. In fact, as I was telling my mother last night, although I hope she doesn't collapse, I kind of hope she does because "I'm itching for a fight". I'm ready to deal with these doctors and hospitals who are holding patients hostage, here, in an attempt to manuever insurance institutions into fairly lining their pockets. I don't have a problem with physicians and health care institutions getting their due. I have a problem with the way they're going about it.
    It's funny, one of the sub-rants of the ER doctor's monologue, yesterday, was that he's been trying to encourage patients to write their representatives in congress and the senate, etc. In my sleep deprived state this sounded good to me, and then, later, after a few hours sleep, I realized, hey, you guys, your insurance buddies, and your congress/senate buddies got us into this mess, and you expect your patients to get you out?!? Up yours! I'm going to push you, all of you, by using anger and shame, back to what should be your true calling, the calling of the healer, and I'm going to force you, one way or another, whether it takes you negotiating with the veteran's hospital up here to take her over their congress/senate approved denial (which I'm sure you somehow managed to finagle in order to increase your power in the wildly out of kilter doctor/patient ratio here), you recoding her paperwork to get paid in an amount you think is fair, you arranging med-evac transport for her down to the valley, to get your hands dirty on your own behalf and stop relying on your victims for help.
    Fuck this country's medical crisis. Fuck the professionals that got us here and are now crying, "Foul!" Fuck all of you who stand in my way. One way or another, I'm going to attempt get my mother taken care of adequately and compassionately and I'm going to get you to do it, because you're the ones who are supposed to do this and you're the ones who created this situation, in the first place.
    Well, that felt good. I wonder how long I'll be able to hold up.

    I haven't had any time to update here, although some of you who read this should know what has taken place over my journal absence. I did, however, cover all the events of yesterday in e's to a friend with whom I keep up a correspondence that may as well be considered journaling. I'm appending the pertinent sections of those e's below.

7/30/04 - 0301
    Oh, MFASRF...what a week it's been. When did I write that last e? Let me check...the 25th and today is, damn, let's see, Sunday was...ahhh...okay, I wrote it late Sunday night. Well, since then I've figured out that my mother probably had another mini-stroke although I'm not sure when. It's hard to calculate with mini-strokes because nothing happens for awhile then little things start to happen. Anyway, although none of the stuff I said in my previous e is untrue or misperceived. I've finally figured out by observation and questioning that the pronounced weakness is affecting her right side, which was already challenged by the previous mini-stroke. Everything else still applies. She managed to recover before, as much as possible, because she was more active when she had the last one: Active enough that I never realized she'd had one, nor did her Mesa PCP until he medicated her into a blood pressure crash in the fall of 2002, she ended up in the hospital, a routine brain scan was done and the doctor who ordered the brain scan discovered its tracks. I'm not sure why she had this recent one. Could be because her PCP took her off her daily aspirin in order to combat the possibility that her anemia was being caused by internal bleeding. I put her back on a couple of natural anti-coagulants in higher doses than she'd previously been taking: Vitamin E and garlic (which I'd removed because they are anti-coagulants) maybe 3 weeks ago. Soon after I doubled her usual supplemental doses because her blood rouleauxed in her last blood draw (that means that her red blood cells splayed out like a bunch of lined up, knocked over dominoes, which indicates sticky blood). Her rouleaux factor was very low, so low that MCS said it could have been caused by a dry slide, but I didn't want to take any chances. I think she mini-stroked, anyway. However, that doesn't really change anything.
    This one wouldn't be affecting her as badly as it is if she hadn't refused to move. She's lucky if she can stand from a sitting position and walk up and down the two stairs leading into/outof (should be a conjoined preposition) our sunken living room. There's nothing that can be done medically except therapy. Mini-strokes are almost never discovered until it's too late to apply those wonder drugs to them. So, yesterday I realized we'll have to use the wheelchair in the house for awhile. Today, our first day using it all day, I figured, well, she's my captive now so she goes with me where ever I go and she'll probably enjoy it, since she'll be sitting on her ass. She did. Except that, once again, all the standing up and moving an aided step or two from bed to wheelchair to toilet to wheelchair to table to wheelchair to steps to wheelchair to rocker to wheelchair to steps to wheelchair to car to wheelchair...well, you get the idea, exhausted her legs. Unfortunately, she felt so good that it also gave her a false sense of confidence. She decided, after we returned and I told her I was going to confine her to level ground for the rest of the day, while I was in the bathroom, that she could damn well walk from the dinette down the steps to the rocker if she felt like it. She almost made it, collapsing maybe a foot from her rocker. When I returned from the bathroom I saw her, surveyed her for damage and picked her up again. But this time my muscles were so tired and overworked from the last several days (they haven't yet incorporated all the new things they're doing) that I'm now fucking sore all over.
    So, you know, leave it to me, I cried out of exhaustion, then I got angry. Not really bad. My mother thought I was joking. I decided she needs a skilled nursing facility for a short period of time. I spent the evening researching that possibility through her Medicare/TriCare for Life insurance. That one requires a three day stay in a hospital to qualify. Like I'm going do that to her again. I'm having trouble researching her commercial policy. I called and they observe ET business hours so I've got to call tomorrow. I'm not expecting good news. Call me a cynic, but I've learned too many fucked-health-care system lessons in the last several years to be anything but.
    I am pleased, oddly, to hear from you that there is such a thing as working out to the point of vomiting. I was assuming a few other possibilities besides the ones I mentioned, including her anemia, which I know scored a temporary low during her urinary tract infection...unfortunately, her infection was not cured by the three day course of Cipro XR and we were back at the urgent care clinic day before yesterday because she was once again bleeding from the urinary tract. She's now on a milder, longer course of Levaquin which is working well, I think. However, her weakness and her challenged immune system have convinced me that I should probably start looking, once again, for a doctor up here. I just haven't had the time. Most of the time now I'm focused on what my mother is doing or aiding her in doing something. It's so weird. I have now achieved a peculiar state of "I care/I don't care" which, come to think of it, may very well be a type of Buddhist detachment. Odd that this is happening to me. I'm not exactly the best candidate for detachment.
    Well, I'd better get back to bed. I'm sleeping in my mother's room in case she forgets she can't stand on her own and tries, in the depths of sleep, to go to the bathroom. I was "too tired to sleep" tonight, which, now, I'm glad I was. When I happened upon your e, much earlier I figured I wouldn't get around to answering it for awhile, measured in days. But, lucky me, I just fucking couldn't get to sleep!

7/30/04 - 1205
    This morning, at 0515 I sat bolt upright on my futon. My mother was sitting on the floor staring at me. I asked her what had happened. First she said she'd rolled out of bed. Then she wasn't sure, but that's not the point. Once again I checked her and everything seemed fine I arranged her, picked her up off the floor with great difficulty considering that my body has had an unaccustomed beating in the last few days. As usual, she was not working with me but I got her into bed, her legs collapsing underneath her as we went.
    I'd had it. I said, "Mom, I'm calling the paramedics. Something's seriously wrong and you're going into the ER." She protested like the devil but the paramedics arrived within minutes. I explained what happened, etc., and while three of them (one of them was one of the guy's sons who had on a T shirt, just like his dad's in every respect except it said, "My Dad is a Paramedic", it was very cool and I said so; the father grinned, the son continued very seriously into the house, carrying a piece of equipment...it was an unexpected highlight, but, that's not the point) gathered in her room to pick her up out of bed one of the men took me into the master bedroom to take a short history, med rundown and my version of what happened. He correctly guessed that my mother is senile.
    So he finished the history taking and I turned to see my mother sitting up in the cot. One of the into-the-cot guys said, "What's wrong with your mother?"
    I told him she had fallen out of bed and couldn't get up and that even when I lifted her her legs collapsed underneath her.
    "She walked from her bed to the cot," he said.
    I was stunned. "Unaided?" I asked.
    "No, he said, "I held her right hand for support but she did real well."
    So, here I sit, head shaking, eyes closed, literally beside myself, very, very tired, (so I'm going to take a nap, in her room, of course), understanding something very important and very troubling about my mother's relationship with me, pretty much understanding what needs to be done, she needs to be living with another one of my sisters now, I think, pretty much aware that this probably won't happen because they have reasons why it can't, all involving her extremely high maintenance, all of which are legitimate, and, well, fuck, I guess I'll take a nap and think about it later.
    I did tell her, and have been telling her ever since we left the hospital, that every time she collapses now I'm calling the paramedics and she's going to the ER. I don't know whether that will make a difference. I also told her that she needs to perform for me just like she performed for the paramedics. That seemed to make an impression but I have no idea if the impression will last.
    Sometimes, MFASRF, sometimes...I don't know how to finish, I'm not sure how to put into words what I'm thinking. Just sometimes...

7/30/04 - 1710
So, I realized, in my bleary-eyed update this morning...
...I forgot to let you know how my mother is. No different than when she left for the hospital. They didn't do much looking because she statted out fine. Even my mention of the possible mini-stroke didn't bring out the machines. We went home with some references for physical therapists (some of which I already know) and a number for a local physicians' referral service. I also talked to her attending physician about the problems of finding a physician in Prescott, including my problems with the physician we previously retained. I asked him point blank if the problem was, as it seemed to me, that there were too many patients and too few doctors.
    "Yes," he said. "It's a seller's market."
    I also asked him if he was taking new patients.
    "Yes," he said, but not anyone on Medicare (he laughed nervously), then he launched into a long but interesting monologue about the problems with Medicare and commercial insurance companies in a rural area from a doctor's point of view. I also mentioned to him that I am a very assertive caregiver when it comes to my mother's medical care and at least one local doctor, whom I mentioned by name, has a problem with this and sent us a registered letter dismissing us from her service because of my assertiveness.
    "She isn't the only one," he said, not naming names. "I've heard that complaint about other physicians in the area."
    I'm still not completely recovered. I think this day is going to be a wash for me. I slept for about 2 hours. The Little Girl awoke me then took my position on the futon. I decided, well, I've got bills to pay, may as well do that. I'm letting Mom nap as long as she wants. As is usual in the hospital, regardless of my warnings, they put her on her back, kept returning her to her back whenever she or I repositioned her and she got sick and vomited...something to do with the way the curvature of her spine works or doesn't work.
    So, it's weird, because maybe a week ago I ruminated in my online journal about taking care of my mother that one of the things that gets me through is a strange little fantasy about being alone on an island with her. If you're curious about the fantasy, here's a direct link to it (with target): I have an often indulged fantasy....
    Anyway, whether or not you read it, in my sleep deprived, wondering-if-I'm-mother-toxic way, I'm thinking, it isn't just a fantasy. It's my reality, now. The reason I fantasize about it, I figure, is to try to create some of that "distance with clarity" that might help me handle what I'm doing and what I have to negotiate to do it. That's the theory, anyway. It's not working today, of course, because I'm not fantasizing about it, I'm believing I'm there.
    Didn't mean to bother you again, and it's not that I'm feeling any recrimination about my self-involved e of earlier. But I thought you'd want to know how my mother is and what happened at the ER since I know you have an interest in her.
    Well, back to dinner. I'm making something that should stay down and taste wonderful, a chicken with rice soup using my own homemade broth as a base, with sweet basil, lemon, celery and onion. I wasn't going to awaken her, but she went down at noon and it's five so I think I'll gently bring her to. I think it will be relatively easy. After a cup of very strong coffee I think I can handle anything again, for at least a couple of hours. Anyway, Driving Miss Daisy is on tonight and my mother can't get enough of that movie, so that should keep her up for awhile. --Gail

1. Last night when I told Mom of my plan to combine our sleeping quarters in the master bedroom (which is where I sleep; she doesn't like "my" room because it is the warmest room in the summer so I keep the windows open all the time, and coldest in the winter, so I keep my windows open all the time) she said, "I don't think it's time to consider that, yet." Wondering if she'd prefer that I not sleep in her room "for the time being", I asked her directly (even though I will still do this as long as I'm concerned that she may attempt to get out of bed without realizing her right knee won't support her). She is comfortable with the current arrangement but isn't interested in "making it permanent".
       In sidebar to this, last night we retired at the same time, 11:30, settling in bed by midnight. She sat on the edge of her bed, watched me make up mine on the floor, we went through our usual "good night" routine, I switched off her bed lamp and settled onto my futon. Before she reclined she called through the darkness, "Where are you?" Her tone wasn't worried, just curious. I reached out my hand, put it on her knee and said, "I'm right here, at your feet, your faithful dog." She patted my hand and said, "Good," and promptly slid herself onto her bed, covered herself and was gently snoring before I drifted off.
2. When I explained to my mother yesterday how we were going to be using the wheelchair and, since I can't take it up and down the steps easily without the possibility of dumping her out or getting her and the chair stuck she objected. Strenuously. "I think I can manage the steps all right," she told me. "Maybe we'll try that tomorrow, Mom, when my back hasn't had such a workout, is refreshed, and I know I can pick you up if you collapse." "I won't collapse," she insisted, "let's just try it." So we did. And, she's right, as long as she isn't hobbling all over the house she's fine (for her) on the two steps, both up and down. So, the entire house is at her disposal, even in the wheelchair. Good. I wasn't sure how we were going to negotiate the fact that she can't see the TV from the dinette and I can't move it closer.
3. As I was outlining our impending day for her last night, I mentioned both the blood draw and my intention to begin calling around for a local doctor.
       "Why don't we wait another day on the blood draw," she requested.
       I asked her why.
       She said, "I'm feeling better. I think it'll look better if we wait a day or so."
       Wow. I didn't think she was aware of her blood draws, their results and the connection between how she feels and what the results are.
       In regards to finding a local doctor she said, "I know we should, but I don't want to see any doctors right now. You're doing fine. I don't think they can do anything else right now. Let's wait and see how things go."
       I protested mildly, telling her that we should probably at least begin the search now.
       "If anything happens to me," she said, "we can go to the emergency room. Right now, let's wait." I was surprised by this one, too, but I still believe she is in the best position to know how her insides feel so I'm going to go along with this, cautiously, of course.

    This morning, instead of allowing a just-below-conscious eye survey to direct me to something interesting in the horoscope area of my ISP's home page, I purposely looked. Amazingly, it contained the following sentence: "Don't be too quick to settle on anything now. There's a good chance you can get more for your effort. Be patient for a day or two longer." Considering that my mother is asking me to "wait" on a couple of health issues, I think we will.
    We have a movie date tonight. A couple of days ago, when she was doing what I now realize may have been sleeping off a mini-stroke, I caught a viewing of the movie My House in Umbria. Aside from me enjoying the movie, I realized, scene by scene, that my mother would love it. The main character is a people watcher who is optimistic to what seems to be a fault until reality reveals her to actually be powerfully and intentionally realistic. The set up is quirky. The end is magically uplifting. It won't reappear until later tonight but I'll be gearing our day for it.
    As I was settling into sleep last night I realized something about the leg exercises I've been trying to get her to do from her chair for some days and with which she has been distinctly uncooperative. They aren't, at this point, addressing her legs needs. So I attempted to settle into her body and realized what she actually needs at this point: To practice standing up and sitting down with control; maybe in a week or two, practicing walking up and down the steps into the living room. Last night we discussed the possibility of a cane in addition to the walker. She wasn't happy with this until I reminded her that her main problem is her right side, not both sides. She isn't walker capable right now, hasn't been since what I think was another mini-stroke. She is, though, capable of standing up and sitting down, and, as I found yesterday, negotiating two stairs. Both activities are hard for her but her spirit is hardy. I won't overtax her and, of course, how much of either of these exercises we do today will depend on how well she does when she has to get up and down. I noticed yesterday that after about 15 or 20 minutes' rest in a chair her right knee revives enough for her to do both of these so we'll try practicing these activities as therapy.
    Every day "everything old is new again". This has become my motto in dealing with my mother.
    Time to bring her into the day. I'm sure I'll report more...
    ...later.

...on days like today. I imagine that someone is here visiting; one of my sisters, with or without family, MCF, with or without daughter and daughter's friend, maybe a curious relative maybe even the oxygen guy, and something happens. I plug in the electric teapot, am electrocuted and, oops!, I die. I go out to get the mail and am accidentally run over by the garbage truck and, oops!, I die. It's a holiday and we're in the back partying, someone in the adjoining area decides to fire a gun into the air in the type of celebration typical (although now illegal) in this state, the bullet falls back to earth in the exact spot where I am standing and, oops!, I die. But someone's here to take up the slack, gather Mom and her affairs into their arms, homes or a nursing home, if that's what has to happen, straighten out those of her affairs I've had to let go because I simply don't have the time or energy to attend to them, take on the responsibility for her care from there on out, no one feels guilty because, oops!, it was a tragic accident and, anyway, we all know the dead are better off than the living. From there on out everything proceeds well. For me, for my mother and for everyone else connected to us. This fantasy actually relieves a certain amount of frenzy and frustration.
    I don't think the doctor was right yesterday about my fears about another mini-stroke. I think it happened, I'm not sure when, and I now think this may have something to do with Mom's weakness onset. I noticed today that it seems as though it was her right knee that gives out. For confirmation, I asked her if both of her knees go or if it is just one and she confirmed that it was one, her right, without me coaching. There isn't anything else, except her right eye swimming in white, that is cluing me into this. At any rate, if she is suffering from the after effects mini-stroke there is nothing medical that can now be done except therapy. I hope I feel confident enough about her anemia, after her blood draw, tomorrow, which is absolutely going to take place, to trigger the prescription for strength and ambulation therapy.
    Today I realized that I can't be her walker from place to place in the house anymore because she refuses to cooperate with me, lean into me and keep her arms around my neck. So, this afternoon, I decided to ban her from the living room. When she awakens from her nap I'll be using the wheelchair to get her around. I've discussed it with her and this is okay with her. It's going to be a little dicey getting her in and out of the bathroom. I tried both and hers is easier but that doesn't mean much. There's a good chance, too, that I will probably need to sleep in Mom's vicinity from now on. If that happens I will actually move stuff around and make the master bedroom the shared bedroom.
    A couple of days ago at Costco I noticed a woman, probably 10 years younger than me, with a man who is obviously her husband and a woman who is probably his or her mother. I've seen the three there before, as well as the younger woman alone with the older woman. What I previously noticed was that the younger woman was pushing both a shopping cart and the mother's wheelchair. My reaction was funny, I've wondered if I could do that. It was a relief to observe that it's possible. It takes strong forearms but I'm pretty sure my forearms are strong enough for this by now. It will also take some practice to get the hang of controlling both without one of the vehicles wandering, which is why I tend to forget to try this when both Mom and I go to Costco. The day before yesterday, though, as the three took off down an aisle adjoining ours suddenly I realized, the man isn't doing anything but walking along beside the two women. Why, I wondered, isn't he pushing either the cart or the wheelchair? Hmmm...I thought, maybe he's the one who gets items and fills the cart. I kept my eye on them throughout the store and, nope, the woman pushing the cart and the wheelchair was also the one filling the cart. The man was hanging out looking and pointing at things while the younger woman veered, with the cart and the wheelchair, in the pointed direction to retrieve whatever the man indicated should be added to their purchasing inventory.
    How often, I wonder, does this kind of thing happen when a family, rather than an individual, takes care of an Ancient One? Wow. What an eye-opener.
    Later.

...as the hospital allowed her to become on a saline drip while they were "observing" her after her blood transfusion from 6/9/04 - 6/10/04. Her color was surprisingly good, though, even prone. Once she was up her arms and legs turned positively ruddy and her face blossomed. I'm pushing fluids more than usual this morning, of course, and once I explained how dehydrated she is and how this is sapping her strength, she settled down and hasn't protested.
    I ruminated on something interesting, though, that I noticed pre-breakfast during her nebulized breathing treatment. My usual focus during her breathing treatments is on reminding her several times throughout the 10 minutes to keep the mouthpiece in her mouth and keep her lips around it so the medication goes into her lungs. When these treatments began over two years ago it took a long time for me to "train" her to breathe both in and out through her mouth instead of her nose. That's something I figured we'd taken care of, though. This morning, just by chance, I happened to notice that the air valve on the top of the mouthpiece, which should respond both during a breath in and a breath out, was only responding during breaths out. So I figured I need to reteach her to breathe in. Occasionally I have to remind her of this by telling her that the reason the mist backs up in her mouth and she feels the need to release it by taking the mouthpiece out is because she's not breathing in with her mouth. Anyway, we went through the skill again.
    Once she seemed to be concentrating on breathing in through her mouth as well as out I settled back and watched her and thought about why it is that she has trouble remembering this. In the process of reviewing her tricks and my instructions I realized that one of the things I often say to her when she's not paying attention to her breathing as she takes the treatment is, "Mom, I can't breathe the treatment for you, you have to do it yourself." I often make similar statements to her, some of them recorded in this journal, such as, "I can't be your body, Mom, you have to be your body," etc. I wondered, is this the crux of it: That she decided some time ago, probably subconsciously, that she'd done enough for everyone else throughout the years, her children, her husband, her students, other teachers, etc., now it's time for everyone to do everything for her? The more I think about this the more likely it sounds its its application to all women (and, maybe, I'll grant, a few men) who've found their lives absconded by the role of primary and often, only, caregiver while being surrounded by people, children and adults, who are perfectly capable of taking care of themselves. In addition, the woman who finds herself in this role, when she's overwhelmed, is scolded to "take care of yourself". I know, I wrote a whole essay on this some time ago which you can find in the here. It hadn't, though, occurred to me until now that as women age and are finally divested of all these people demanding care and attention, when it comes time that women need care their subconscious attitude is, "Okay, fine, take care of me, and, while you're at it, take complete care of me...walk for me, talk for me, breathe for me, beat for me, eat for me, shit for me...it feels as though I did all those things for you. At the very least I coached you into doing these things. Now it's your turn. And if you don't, well, hell, everyone dies anyway. If I die because you won't do these things for me, just goes to show you, people will never, never appreciate their caregivers, will they!?! They'll let them die before they appreciate them, then they'll call it "natural causes!" It's amazing to me, now that I think about it, that, despite this underlying hostility that grows in women who have been subtly harassed into taking care of everyone all their lives, they still live longer than men even considering the rising rates of cancer and heart disease in women. Pretty strong stuff from which women are made, I'd say. How much longer do you suppose we'd live if we weren't responsible for the behind the scenes maintenance of the entire world? How much healthier would my mother be right now if she weren't convinced that it's time for her to slack the rest of her life away and let someone else do everything for her, including breathing for her?
    I know this would be a subconscious attitude that develops over time. My mother, for instance, even in her earlier retirement years, was adamant about walking and mowing lawns and gardening to keep herself fit. She continued these activities even when my father's health and life were failing and she was called, once again, into intense caregiving. After my dad died she approached handling the personal business of her own household with gusto and did an amazing job, enjoying every moment. She continued this for some years after she asked me to live with her. Even when her short term memory began to lurch she worked hard at maintaining herself despite her mistrust of doctors and was usually successful. All the living tasks I took over from her were not released to me without struggles, both overt and covert. But somewhere along the way over the last 5 years or so, I'm beginning to think, she's decided that the bill for all the caretaking, both of others and of herself, has come due and she's entitled...look at her record. Look at the record of all women in this society (and others) including those who become consciously hostile early and take it out on those around them.
    Damn, when are we going to get it? We'd all, young and old, be better off if we all pitched in. Caregiving needs to undergo a revolution from inside out, from bottom to top, with everyone involved. This can't just be a women's campaign. It has to be a people's campaign.

...The Little Girl (one of our cats) was sleeping with Mom this morning when I awoke a little less than an hour ago. This is a good sign. The cats have been avoiding her bed in the morning because it smells like urine, I'm sure, probably "sick" urine. Although I noticed she'd leaked as usual this didn't seem to bother The Little Girl.
    At 0445 this morning I awoke on the floor of Mom's bedroom. She was staring at me. She asked me indignantly why I was sleeping on her floor. I explained. She said, "Don't you sleep better in your own room?"
    I knew where she was heading. "Yes," I said.
    "Well, why don't you go back there?"
    "I think I will," I said. "The sun will be pouring in your window soon, and you know I'm not a sun person."
    "I know," she said. "I'll be fine. Go sleep in your own bed."
    I did.
    It occurred to me that maybe I should get her up then since maybe her awakening was a sign that, having gone to bed so early, she was ready to arise. I wasn't looking forward to doing this as this would have meant I would have gotten about four hours' sleep. But I put my figurative shoulder to the literal Mom and said before I left her alone, "You've slept for a good eight and a half hours, Mom. Maybe we should get you up."
    "Maybe we shouldn't," she said.
    I left here there to sleep. I'm still not sure I did "the right thing" by her. The more she sleeps the harder it is for her to move in the morning. I am very little good to her, though, when I'm running on empty so I headed into my room.
    Time, now, to get her up. I'm both expecting and hoping for a good day. I still haven't decided whether we're going for the blood draw or to the ER or if we're just going to hang out here today. I'll figure that out soon enough.
    One comment. This morning when I brought up the ISP home page through which I click into this profile my eye was caught by one word in the daily horoscope that my ISP offers, among other things, on their home page. I never read it, never even notice it but this morning I noticed the word "wait" and stopped to read it. It said something about not making decisions today about a "pressing family matter", to "wait", the "matter" will be "close to resolving itself tomorrow". Hmmm...I wondered, this must be for yesterday as it reminded me of my frantic indecision last night. I checked the date. It was for today. I used to read horoscopes a lot some time ago but haven't for more than a few years, having stopped when I realized they made little sense to my role as my mother's caregiver. This one, though, made some sense. I don't think it was "the stars" so much as maybe an intelligent universe saying to me, "We took note of your frenzy last night, heard what you had to say. Calm down. Everything will be all right."
    I'm calm. One way or another, everything is always all right, a least this is what my mother assures me.
    Time to awaken an all right Mom.
    Later.

instead of the lab for a blood draw. This morning I again noticed that pinkish tinge in Mom's urine, less than before but clearly there. I wondered last night if her urinary tract infection might not have been completely eradicated because she complained, in the bathroom on her way to bed, that she felt as though she was having some difficulty urinating, although her paper underwear was soaked. I've been hyper-vigilant anyway, since she threw up the last dose of Cipro XR, wondering if maybe the E. Coli might still be crawling around inside her and whether this was the reason that I was continuing to have trouble controlling her blood sugar and her blood pressure. Her temperature, though, has been normal and was this morning but the pink urine told me all I needed to know.
    This time we did not, thankfully, spend all day at the clinic. I was able to get through to Mom's attending physician's nurse at the clinic by phone and within minutes of arriving, after a good breakfast and having Mom down her normal (for this period of unusual medication and UTI problems) 48 ounces of morning fluids (the last 16 of which she drank in the car), we were called in and she gave a sample which was not quite yet the color of cranberry juice but on its way. Within 15 minutes the nurse met with us, assured us that the physician would call in a prescription to our pharmacy and we were on our way home, arriving back by 1520 (we'd left the house at 1310). This time the physician prescribed a milder 10 day course of 250 mg Levaquin, one a day. Truthfully, I've been leery of hitting her with mega doses of antibiotics, especially since she's had so many lately, so I am relieved that she's on a lighter, longer dose.
    I'm sure that she's anemic. My mind has been racing all day and evening trying decide what to do tomorrow: Take her into the ER here and inform them that I think she needs a blood transfusion; take her in to the lab to have her blood drawn since I'm curious but I know, pretty much, what everything is going to show and that I'm going to get a call from her Mesa PCP saying "bring her down", which I don't want to do, she seems too weak to travel right now; or...I don't know. I've been sorting, like a NORAD computer, through my options and upsetting myself terribly. Finally I decided, well, I'll just wait until morning as Mom suggested (she retired at 2015, exhausted and weak kneed) and see what comes to me then.
    She is not in pain. She's confused by her continued weakness. I've become her human walker. She hasn't sunk to the floor anymore since yesterday, though, and is finally getting the hang of allowing me to lend her all my strength. As always, she continues to say she feels good. She even told me after dinner, after I'd practically carried her into the bathroom to change out her underwear and check the condition of her urine (which has already begun to clear) that she feels "100%". A few minutes later she decided to go to bed.
    I still don't feel bad about scolding her about her lack of movement in the last few months. Obviously, the major cause of her weakness, right now, is the infection that's running riot throughout her urinary tract combined with her obvious anemia, which, the doctor told me, can be expected since she's probably been bleeding fairly steadily from the urinary tract but at such a low rate that it would have been impossible for me to detect unless I "had a laboratory at home". I'd been worried, as well, that she may be mini-stroking, mentioning to the doctor that her right eye looked a bit more blasted than usual and she seemed foggier. He said, though, he didn't think this was happening, that both could be attributed to her weakness as a result of the fight her body is continuing with her urinary tract infection. He did mention that there is a catch 22 situation with the anemia, as the infection is probably screwing up her kidney functions, which doesn't help her body as it tries to make hemoglobin out of the mega-doses of iron I'm giving her. As well, of course, there has been a good week of days (not sequential) when she has not received her evening dose of iron, either because she was on the Cipro XR or because she wasn't up long enough on a particular day to justify giving her the extra 36 mg so close to the 150 mg. In regard to her refusal to move around for the last few months, though, he was also stern with her, in a strangely grandfatherly way, so, I felt not only vindicated but supported on this score.
    I certainly don't want a hospital to get ahold of her again anytime soon, although, if this is necessary I'd rather we be up here. If she needs a transfusion I want to be able to take her home immediately after rather than having doctors crawl all over her trying to scope, needle or radiate her. I'm not interested in discovering any more ways that a hospital can sicken and damage a patient while that patient is "under observation".
    I made myself a cup of hot chocolate to settle me down It seems to be working. I've also completely opened myself up to the "prayer" level of healing on my mother's behalf and my own. When I was thoroughly beside myself a few hours ago, unable to settle my mind, I was "saying" that, if this is it, if this is her last illness before the end, let her die tonight and spare her and me the fight if she's on the way out anyway. Since settling down, though, I can recall more than a few times in the last few years when I thought she had only a few more days or weeks, and, well, here we are, continuing the journey.
    I asked my mother a couple of times tonight if she was scared, to which she replied, "No," surprised that I'd asked. Then, realizing that the possibility of her imminent death may not scare her (which I understand, the possibility of my death doesn't scare me) I asked her point blank if she felt she might die soon. There I was, practically carrying her down the hall, hoping her knees wouldn't give out before I got her to bed, she was concentrating so hard on moving her feet that she was practically bent double: She looked up at me like I was clearly insane and said, "Of course not, child!"
    I'm sleeping in her room tonight. I suggested it carefully, knowing that she normally she resents me even considering this. Tonight, though, because her legs are so shaky, she said, "Maybe that would be a good idea." So, I'm signing off, making my bed on her floor, and closing down the day.
    I'm sure there will be more, much more...
    ...later.

...for the day. I couldn't be happier. As Loren Eisley, one of my very favorite essayists, wrote, If there is magic on the planet, it is contained in water. Check out the link, by the way. It's interesting.
    Again, later.

...I had the impression that Mom would die sometime in the night. I wasn't upset by the impression, just, well, surprised. I never expect, although I'm always prepared for, what I know will be the final outcome of this life of ours. I guess the impression was really a personal accumulation of all the events that have transpired in her life, thus in mine, over the last two days. As I always do, I checked in on her this morning as soon as I arose, even before going to the bathroom. She was sprawled on her bed, face to the sun, our Girls (the cats) warming themselves, too, in the direct rays streaming through her bedroom window.
    As I petted each of The Girls and scrutinized Mom to pick up reconnaissance on how her day might go from her perspective, I recalled a story related to me by a close friend here in Prescott about some close friends of hers, two sisters who'd emigrated here from Russia and now live together in a community close to me, both, at the time of the story, in their very late 80's. The oldest sister had a serious heart attack, the damage so extensive that the physicians decided operating on her to repair vessels and muscles was beside the point and would probably hasten death. She was in the hospital for weeks then was moved to a skilled nursing facility under the expectation that, since she was not recovering, she would die there. Her sister tended to her every day without fail, prayed copiously over her, harassed physicians to apply treatments that offered even a tiny speck of hope but as the weeks passed and her sister declined, she accepted "the inevitable" and prepared to confront her sister's passage. She bought a new dress for herself for the expected funeral, one she knew her sister would've loved to have worn. Within a week of purchasing the funereal attire, her sister began to perk up. Slowly but surely the elder sister healed. At a certain point her doctors felt she might be strong enough to endure some reparative surgery but she refused, saying that she'd already been "through the Valley of the shadow of death" without reservations and wasn't interested purchasing a ticket. The doctors, of course, offered only dire predictions of her outcome without surgery but she persisted and finally returned home. The sisters are now in their early 90's, once again living together. The one who'd been at death's door, peaked through and decided, nah, not right now, still staunchly refusing to join her younger sister on her daily afternoon walk, saying that if she'd been doing this regularly she'd have "perished of heart failure" long ago. She also, by the way, inherited the funeral dress, which her sister didn't like, anyway.
    I'm prepared for anything. I have been for awhile. In the depths of my concern and despair, though, yesterday, when I was at Costco, I purchased a couple of new blouses for my mother that I knew she'd love. I was right. Luckily, we aren't the same size so, if they are to be worn, my mother is going to have to do the honors.
    Considering that she retired at a few minutes after 0200 this morning, I'm waiting until she has eight hours and some minutes under her belt before awakening her. We are going to the lab, today, regardless, for her blood draws. I have no idea what to expect. Some hours she looks robust. At others she looks anemic. Every time I look at her I remember an article to which I created a link somewhere in this journal over a year ago, the best medical article I've read so far about anemia in the elderly. Although this bit of information from it didn't make a conscious impression on me at the time, I've never forgotten it. The physician who wrote it speculated that perhaps it is "normal" for certain of the elderly to run anemic throughout their Ancient One years.
    Impressions, impressions, impressions. In some way, impressions carry molecules of truth, I think. Perhaps, last night, my mother was considering that the last few days of weak knees and having to depend on her daughter to pick her up off the floor had been enough, maybe she's still considering this. This morning, though, unfolding in the sun, her eyes slit to register the light on her cranial lobes, she looks as though she might be ready for another round.
    We'll see.
    By the way, at Mom's Daily Tests and Meds I've caught up with all the stats over the last few days that have languished on their computerized devices since July 24th.
    Later.

    I had to pick her up off the floor, again, earlier this evening, or, I guess it would be yesterday evening. She went in for a nap around 1700. Normally around this time I make myself a cup of coffee knowing that when she awakens she'll be up for awhile and drinking coffee will keep me alert. Yesterday evening, instead of doing this I decided, no coffee, even though I was exhausted. I decided I needed to get out of that habit and maybe nap when Mom's napping. I laid down at 1800, set my alarm for 1900 knowing how exhausted I was. I guess I was so exhausted I turned off my alarm in my sleep. A few minutes before 2000 I bolted awake. I headed down the hall, noticed a light in the dinette and Mom's oxygen cord strung down the hall, which was a surprise since she usually takes the cord off first thing when she awakens from a nap. I figured she must have arisen on her own and made her way out to the dinette, which seemed promising. I also guessed that the distance from her bedroom to the dinette is less than 40 feet, the length of the cord. As I entered the kitchen I saw her sitting on the floor between the kitchen and the dinette. Her oxygen cord hadn't reached into the dinette had, apparently, pulled her back, she'd lost her balance and ended up sitting on the floor.
    I lowered myself to the floor with her, asked her what happened. She wasn't sure, although I was. She also wasn't sure how long she'd been there. I asked her if she was hurt. She responded that she was not. I checked her out everywhere, asking specifically about her knees, her legs, her back, her neck, and moved my hands over her body looking for places that might register pain on touch. Everything seemed fine, thank the gods. So, I manuevered her into position and picked her up off the floor while talking her through the procedure. As she did yesterday, despite my clear instructions before I began to pick her up and during the procedure, she unlocked her arms from around my neck and tried to "help" me by bracing herself against the refrigerator and the counter. I had to yell at her, while I was halfway up, to get her to stop "trying to help" me and lock her arms around my neck, again. She did. Luckily, there was no danger to my back, as my legs, I've discovered, are strong enough to remain sturdily in a semi-squat while waiting for my mother to believe that she does not have to help the whole goddamned world at a time like this, she needs to allow the world to help her.
    I take full responsibility for this collapsing-to-the-floor incident. I shouldn't have napped. I am, first of all, not much of a napper but, second, I've pretty much given up even those naps that seem impossible to resist in order to make sure that this sort of thing doesn't happen when my mother arises from hers. I learned my lesson, today, and, luckily, it seems as though there is no damage to my mother.
    She's been very weak in the legs again today, partly, I think, a hold over from yesterday. I think some of the weakness, too, is because I insisted on giving her metoclopramide before breakfast and lunch to make sure she kept at least two of her meals down, since all the food she really ingested, yesterday, was breakfast. I hope the vomiting wasn't from lowering hemoglobin but I guess we'll find out Wednesday, since it is imperative, I think, to get her to the lab today. We didn't make it to the lab yesterday because the metoclopramide made her so woozy that I was afraid she'd collapse; yet, I also felt that, to be on the safe side, I needed to give it to her. I didn't give it to her at dinner.
    Being ancient is a tough row to hoe. Being the caretaker of an Ancient One is a tough row to hoe. I've just about decided I'm not going to allow myself to get old. Period. I admire my mother for hanging in there and I know she has her reasons, but, well, my life doesn't have the same reasons as hers and none of the reasons for my life have anything to do with becoming ancient.
    I'm unclear, now, how much of her developing weakness these past few months is due to her dedication to immobility and how much of it might be due to something else. Her blood pressure is still going crazy. I wonder if something "new" is going on inside her. I wonder if I was too hard on her yesterday. I wonder, I wonder, I wonder...and, you know, I know that I probably won't find much out from the doctors, I never do, but, well, it looks like we're due for another round of visits.
    She seems to think she is having trouble urinating, again, although she actually isn't. Her right eye is swimming a bit more obviously in the white area. I wonder if she's having a series of mini-strokes although nothing else seems to point to this. Her obvious weakness isn't sudden, really, nor has it gotten suddenly worse. I know, that sounds pretty strange to be saying, considering the last few days, but there are so many other variables involved that its hard to say these incidents are "sudden".
    I'm on the island, again, with my mother, the island with no other people, only resources. It's the only place, now, from where I've been able to draw the strength to continue from moment to moment these last few days, making plans and then having to change them, then having to change the changes, then having to pick her up off the floor, again.
    The end of my mother's life is seeming imminent, again. This happens on occasion. When it does I'm reminded of her Will, which specifies no funeral; rather, a memorial service, as I believe she put it, "have a party on me." This is her style. Over the last few years I've made and confirmed, many times over, a decision of my own of which I am presently reminded as I observe, at the moment, how her hold on life seems tenuous. At previous times like this I've meant to mention it but am usually too busy to get back here. Tonight, though, having made myself drink a cup of coffee at 2030 so I could keep up with her this evening, I find myself having the time to put this down. When my mother dies I am planning not to be involved in her memorial service, neither the execution of it nor in attendance. I am soaked to the bone with my mother. Not only do I have no need for a memorial service, I have no desire to attend and be at the mercy of people whose memories of my mother, of their own accord, are fragmented, personal and no longer related to mine. I consider that I'm not going to want to be around people mourning her loss. I will have no desire to set myself up as a grief stricken resource for others. This journal is the resource of who my mother has been and continues to become while I've been with her through this period to the end of her life. I began this journal so there would be a resource that didn't involve me being asked, over and over, to tell stories on my mother. All my stories, all my memories, everything about her that I can relate is here. When she dies I expect to be grief stricken but I have no desire to be the resource on my mother at her memorial service. I won't need to be. I won't want to be. Everything everyone will want to know will be here. This is my memorial. This is my service. When she is done, my memorial and my service will be done.
    By the way, the party interested in our mobile home, which I have been wanting to sell for a buck, has decided not to purchase it. I'm not sure why, although I believe it was being considered as a quick turnover investment and the possibility of turning it over really quickly fell through due to the park management's priorities. Perhaps someone else will be interested it buying it for a buck but I'm pretty overwhelmed by my mother's personal and health issues, right now, so her business issues, as usual, will have to wait, or go on, in their way, without my help.
    I wonder what "tomorrow", the sunrise after my imminent sleep, will bring.
    Later.

[From an e written this evening to MFASRF]:
...but, I had to tell you about something that happened today, even though you won't get the message yet. I wanted to tell you before I tell anyone else and write about it on the web.
    The short version is: I lifted my mother off the floor today when her knees gave out in the bathroom. I was startled but it wasn't one of those "oh my god, there's a baby underneath that mac truck and the gas tank just exploded and I have to save the baby" moments where superhuman strength intervenes, whether from within or without. It was a "shit, my mother's knees just collapsed and she can't get up and I think I'll try to do it before I pay a paramedic $1000 to do it for us," moment. What was so startling was that I didn't realize I had the skills, the upper body strength or the leg strength to do it. I have told my mother many times in the last several months since her back injury, "Mom, you need to move because you need to stay as strong as you can because I may be able to sit you upright in your bed and get you out of a chair but I'm sure I can't get you off the floor." Well, as it turns out, I can get her off the floor. I can even get her off the floor when she's fighting me under the assumption that I can't get her off the floor.
    Once I got her through the hall, down the two steps into the living room and into her rocking chair, I was so startled I said, "Wow, I can lift you off the floor!" and sat down on the couch and cried. I must have cried for about 10 minutes, continuing to repeat, "I can pick you up off the floor, Mom, I didn't realize I was that strong."
    Her two responses (bless my mother's practical heart) were, "Why are you crying!?! It's good that you can do it!" and "I didn't know you were that strong, either, but I'm glad you are."
    I manuevered her into the position where her knees gave out in the first place. Last night, after spending the day trying to get her to move, trying to get her to hydrate herself in a timely manner, trying to get her to eat, and having her defy every try, I decided last night, I'd had it. I lay in bed on my back shaking my head and repeating in a manner designed to etch the words directly into my soul, "I can't do this anymore. I can't make her move when she doesn't want to. I can't make her drink fluids when she doesn't want to. I can't make her eat when she doesn't want to. I don't have the heart, or lack of it, whatever it takes, to abandon her to a nursing home. I'll just do the best I can, look out for my own sanity, and let the chips fall where they may, whatever that means for my mother."
    When I awoke this morning I was stoked with new determination. Today, I decided, I'm going to become her will (not her spirit, which is a different thing, I think). I awoke her using my "Gail is determined" voice at 1000, earlier than I've been able to (or wanted to face the assured battle to) get her up for awhile. I pulled her soaked covers off, cleaned out the litter box (the cat's litter box, that is, I haven't resorted to one for her, yet), gave her iron and vitamin C and got 8 ounces of water down her to help metabolize the pills. I answered her every-morning-question, "Why do I have to get up?" with, "Because, if you're alive and you're not comatose you wake up in the morning." I talked her into putting an arm over the edge of the bed, took her blood glucose, gave her a few more minutes to raise herself on the bed telling her that I'd "whup" her up if she didn't arise on her own in a timely manner, which, miracle of miracles, she did, herded her into the bathroom for her bath and told her, "Today, Mom, we're going to do it my way. You are going to begin hydrating yourself in the morning and you're going to continue throughout the day so that I don't have to force 3 glasses of liquid on you just before you go to bed like I did last night. You are going to eat everything on your plate at every meal. You are going to start moving a little bit, today. You're going to the grocery with me to pick up a few items. You got out of it yesterday because of the storm but you're not getting out of it today. We'll take both the walker and the wheelchair in case your knees give out but you're going to start moving. You've got some time, we'll do your hair, the whole meal deal. But you're getting out you're moving, even if it's hard."
    It was hard for her. We have a handicapped parking placard now. I got the closest spot to the store. She walkered maybe 20 feet and her knees started to shake so I sat her down on a bench and we waited until she regained confidence in her knees. She walkered maybe 20 more feet to the first perpendicular aisle in the store and her knees began to shake so I sat her down on her walker (which converts to a stool) and we waited. She walkered maybe 20 more feet down the frozen food aisle and her knees wobbled so I sat her down again and we waited. Once more, she walkered to the end of the aisle where there are usually benches but, for some reason, the store had gotten rid of them. I sat her down once again on her walker and told her I'd pick up the items we needed and she could wait there. It took me about 15 minutes. When I returned she felt confident about walkering back to the front of the store in shifts, she said, so we began again. After the first 20 feet I could see that she was really struggling (not that this isn't good, but I figured she'd had enough for the day). I sat her down and told her I was going to get the wheelchair, which I did. I wheeled her through the auto checkout, walker slung over one handle, oxygen slung over the other and we left. She was able to get into and out of the car quite well. I immediately took her to the bathroom when we arrived home, knowing that she'd probably soaked her doubled paper underwear by that time. No problem. She was pretty shaky, though, when she tried to get off the toilet. Once she'd used my arms to steady and pull herself up she insisted (with a touch of left over anger from my morning announcement) that she could get out of the bathroom herself (which she usually does) so I backed off. Well, her knees and the backs of her legs had other plans. While she was guiding herself out of the bathroom, clutching the vanity on one side and the towel rack on the other, she suddenly looked at me, said, "Oh, dear", and down she went. Her muscles just weren't strong enough to take as much movement as she and I had thought.
    Coda: second paragraph.
    Her knees didn't "go out". Nothing like that. She's just refused movement to the point where her muscles are severely atrophied. After all this happened and she was comfortably in her rocker, fed, hydrated, etc., I swung her around to meet my eyes and told her I wanted to talk to her. This is, in paraphrase (as is most of everything in quotes above) what I said:
    "Mom, listen. I may have pushed you a little further than was wise today, but I'm not going to apologize. The only excuse you have for your legs buckling is that you have refused to move for the last few months. It's been such hell to try to get you up in the morning and get you moving that morning after morning, day after day, I give up. You cannot continue to sleep 12-14 hours a day and expect your legs to work. You cannot continue to spend day after day sitting, only moving when you go from table to rocker, bathroom to table or bathroom to bed, and expect your legs to work. I've been way too easy on you. I'm sorry about that but, you know, I'm not apologizing for it either. MFS and MPS know how impossible it was to get you out of bed and moving around a couple of years ago, and it's a hundred times worse, now."
    This time, she was startled. I responded to this, too. "Look, I know," I began, "everyone's supposed to be nice to you and let you do, or, for that matter, not do, what you want because you're old. Well I'm done with that. I've been unsuccessfully battling that attitude in you for more than a few years now and look where it got you. You can't depend on your legs. There is absolutely no reason why you can't walk except that you've been refusing to walk for way too long. It's not your back. You were bedridden for two months and in January you were up and around like a champ. It's not your anemia. You've walked through most of that. It's not your urinary tract infection. It's that for the last few months you've decided you don't have to move any more because you're old, and, I think, because you need more oxygen than you used to and that means fewer cigarettes and you're angry about that. So, you're taking your anger out on yourself by refusing anything else that life has to offer. How long did you think you could get away with not moving and retain the use of your legs?
    "This stops here, now. I've babied you for way too long and you've fought me for way to long. I'm not apologizing for giving in to you. You're hell's child when you've got your mind set. It's been torture for me to try to convince you that you need to move, you need to keep yourself hydrated all day long, you need to eat better, you need more oxygen, I've felt like shit when I've given in to you, I've felt like shit the very few times you've given in to me, and now, after having gotten your way too many times, your legs don't work.
    "The bottom line is, you don't want to be in a nursing home, I don't want to put you in a nursing home, but if you don't start taking your body seriously and putting some effort into doing some of the things that will keep you up on end, neither of us is going to have a choice. You're going to get to the place where I simply don't have the skills and the tools necessary to take care of you. You can't just sit back and let me take care of you anymore while you mourn the loss of a few cigarettes. You need to put some effort into this, too, not effort into fighting me but effort into fighting for yourself. Do you understand?"
    Her eyes had been glued to me, flashing surprise and anger the whole time I talked. Now, they turned dark. "Yes," she said, very somberly (not apologetically).
    "Do you get that I can't be your body? You have to be your body?"
    "Yes."
    "Do you get that if you don't use it you will lose it, and if you lose it, you may lose me as your caregiver because I won't have the ability to take care of you?"
    "Yes."
    "Do you get that mourning the loss of some of your cigarettes is a stupid reason to become an invalid, especially since I haven't asked you to quit and I don't intend to?"
    Whoa. This took awhile but, finally, she said, "Yes."
    We sat there staring at each other for a moment of silence.
    Suddenly I understood something. "No one's ever talked to you this way, not in your whole life, have they?"
    "No," she said.
    "Well, I'm talking to you this way now, and you need to listen. Are you listening?"
    "Yes," she said.
    "Good. I want you to know, Mom, I gave up on you last night. I gave up on this ridiculous situation of fighting you tooth and nail, then caving in and letting you have your way, then cleaning up after you. I decided, to hell with this, I don't have the spiritual strength to try anymore, she can do whatever she wants and I'll just move the fallout aside and plan on calling the gravedigger earlier than I'd figured. This morning I woke up with new determination because I love you and I can't just let you continue to think that you can live to be 120 without eating properly, drinking properly, moving some and abandoning your mourning for the loss of a few cigarettes a day. It's possible that my determination to get you moving and as healthy as possible might kill you but I can guarantee you that if I let you do it your way one second longer that'll kill you even faster. I once told you that when you were ready to die I'd protect you and let you go however you wanted. Are you ready for that?"
    "No."
    "Well, then, I'm going to take that as an affirmation that you're ready for this."
    "O.K."
    Whereupon, after about 15 minutes she decided to take a nap, which I allowed. Her muscles, I figured, needed a chance to rest and incorporate what she and I had been having them do today. Her subconscious also needed a chance to process everything I'd said. She went to the bathroom, aided by me, went to bed, aided by me, settled in and promptly began vomiting up her lunch. She continued, both in the bedroom and the bathroom, until all of it was up.
    You know, MFASRF, I think it was a combination of physical shock and emotional shock, combined with some acetaminophen I gave her at lunch to negotiate any stiffness she might develop in her legs. The Mucinex I gave her this morning to help expel some minor lung congestion may have contributed, too, as I recall the second to the last time she vomited unexpectedly I had given her some in the morning (the last time she vomited, it was her final dose of Cipro XR that did it). I quizzed her continually about whether her back hurt (from me lifting her off the floor) or her legs (from the unusual amount of exercise they got today) and she responded in the negative. She's resting now and may sleep for awhile. I've been checking in on her and she is in what looks like a very defensive position, backed up against the wall, her eyes slit. I think it may take her a day or two to digest the fact that the proud, headstrong, beautiful WWII gunnery instructor who could out shoot anyone, who had her pick of any man and refused all but one, finally met her match in the daughter who, except for being a woman, is the spitting image of that one man.
    Tomorrow probably isn't going to be the best of days because we've got to show up for a blood draw. If necessary, and it probably will be, we'll use the wheelchair for that. I've been putting off activating the prescription for ambulation and strength training physical therapy because we've had several arguments about it which I've allowed her to win. This week we set up her first appointment. I decided tonight that if the therapists tell me I need to practice her exercises with her, I'm going to tell them that they need to extend the prescription to cover them practicing her exercises with her, even if this means several visits a week. She performs for an audience and she doesn't consider me an audience. For awhile, too, I expect her to continue to ply her habit of fighting me and expecting to win and I'm not interested in that, anymore.
    You know, MFASRF, I know that many people who are intense caregivers, as I am, would probably flinch at knowing what I did today. At sometime in their experience, though, they've probably done the same thing and will appreciate knowing that they are not the only ones who have, finally, taken their Ancient One firmly by the shoulders and said, "Look, this has to stop and that has to start or you're going to die for no good reason and you're going to end up doing it someplace where you wish you weren't." I also know that lots of people who aren't caregivers to Ancient Ones but think they know what it's all about would not only flinch but consider reporting me to the Elder Abuse hot line. I know that at least one of my relatives will probably be horrified at what took place today, especially since it led to Mom losing control of her legs and, later, losing her lunch. Frankly, if some Cassandra had prophesied this to me a few months ago I would have been horrified and refused to believe that I could be capable of what seems like the ultimate in uncompassionate behavior. But, today happened, I made it happen, and I'm not backing down. I've put up with vomiting, and shitting accidents, and loss of leg control because I've been weak and given in to her too many times. I may as well put up with them occurring as a result of me defying her and see if after all the spew is cleaned off the field there is some benefit to her which wasn't possible when I gave in to her.
    So, you know, MFASRF, the heavy rains finally began yesterday afternoon. It's glorious. I'm in my element. Hmmm...maybe that's the cause of everything that happened today and everything that is about to happen. Then, again, maybe sometimes caregivers and their charges are better off when the caregiver loses her patience. I guess I'm about to find out.
    So, where ever you are, however your vacation is going, I hope you are feeling properly vacated of whatever it is vacations are supposed to vacate and I hope you're having a delightful time being vacated. --Gail

P.S. I just spell-checked and read this over and, you know what, MFASRF, this is exactly what I wanted to say on the web. Not that hardly anyone will read it but I hope you won't be offended if I simply copy this, take it over to motherandmetoo and publish it. You'll probably still be the first one to read it. Anyway, you'll know that it was written to you. I'll use your favored acronym instead of your name, of course. And, I'll correct any mistakes I notice during the second reading before publishing it. MFASRF, thank you for being where you are in relation to me. That's all I ever really mean to say, through all the words and words and words.

...Bad Day Hangover Day had it's ups and downs, the ups including a magnificent rain storm that disallowed me from taking Mom out on my errands but beckoned me into it and the downs including a very low point for both of us at the end of the day. I'll probably write about some of it later. I have daily stats to catch up on and, of course, there will be more stats today beginning in a few minutes.
    Mom, yet again, is developing a little lung congestion which I'll try to expel today with Mucinex. So far it's sunny. I'm hoping, with this relatively early start, I can get her out and moving a little bit. It'll depend on her internal time clock and the weather. We're supposed to be developing thunderstorms again today. For my own appreciation, I hope we do. For my mother's need to move, I hope we don't, as, since I'm going in immediately to awaken her, I expect that our morning routine will be drawn out and will include "whupping" her up, which she rarely considers a felicitous start to the day.
    As a footnote to last night, it was so stressful for both of us that, as I fell into bed, I threw up my spiritual hands and said, out loud, "I give up. Hit me with whatever you like, I'll do my best and,when I can't do anything, anymore, well, I'll let the chips fall where they may." I still feel this way this morning. Oddly, I'm finding optimism in it.
    As a second footnote, the very low point in the evening began over Mom not wanting to eat everything I put in front of her, even though she needed it. An added irritant was her dehydration versus her preference not to drink anything. I won this time but I don't know how much more fight I have left in me to negotiate these problems. It would be easier, I think sometimes, if she were off in Senility Land to the point of having lost her identity and her will. Not that I wish this for her, or for me as her caregiver, but, well, at this point sometimes I wonder which is better in Ancient Ones, fight or no fight. It seems that her fight is often misdirected even as she thinks my fight is often misdirected.
    I've tried being nice. This works much less well than being, well, not exactly mean but certainly not nice. Drill sergeant not nice. This still works with her. I wonder how long it's going to work with her.