Saturday, August 28, 2004
We're not going to Mesa today.
My paltry explanation is that, despite me getting up in plenty of time to prepare for the trip and completing preparation, I've had this feeling all morning that today is not the right day, tomorrow would be best. I'm not sure whether this means that today is not best for her, or me, or both of us, but I'm not concerned about this. I probably will not find out why today is not the right day to go...I rarely do in these circumstances, but that doesn't concern me, either. It's enough for me to know that "the universe", as it were, is telling me, "not today, tomorrow". I know it will make no difference to Mom, especially since the change is allowing her to sleep in, not so much by hours, as, considering her bedtime, last night, even if I let her go until 1000, which may happen, she'll still "only" have gotten 11.5 hours of sleep. That's a short night for the original "Sleepy Time Gal". Going tomorrow makes no difference, as well, to what we are planning on doing, there.
So I think today we'll either walker in the square (which may be difficult, since the three day Jazz festival is taking place in Prescott this weekend and it may be impossible to find parking downtown that allows the square to be handy to us without tiring her out before we get there) or maybe walker around the outside of the mall, snoop around the shops we've never visited, have lunch at one of the many restaurants, etc.
It's not unusual for me to change plans based on, "good day/bad day feelings". It also isn't unusual for me to ignore such feelings and continue with plans, then wish I hadn't. My track record satisfies me that we will not be sorry putting the trip off a day.
I finally did something this morning that I should have done a long time ago; I called to get Mom started on receiving her diabetic testing supplies through a mail-order service who will negotiate the paperwork that pharmacies don't handle and that I never seem to find the time to do. Medicare/Tricare for Life should be covering 100% of her supplies but the process isn't automatic, as it is with everything else medical in her life. Going through pharmacies and having to negotiate the ridiculous paperwork that they refuse to do (which I put off until it is no longer applicable) has been ensuring, over the last 5 years, that we have been paying out of pocket for most, and sometimes all, of her diabetic supplies, the price of which is formidable. This service should nip that problem in full flower.
I'm curious about how her knee is doing today. I offered her acetaminophen last night but she refused it, telling me her knee wasn't bothering her "that bad". Aside from her high pain tolerance, she continues to prefer not to take pills even for pain or discomfort unless absolutely necessary. I know when she finally assents to a pill for pain for most people it would be long overdue so I trust her on this score. I'm actually pleased she is not a pill taker by nature. This trait of hers is my inspiration for continually trying to cut back, cut back, and then cut back some more on medications and handle conditions that would normally throw a physician into medication hyperdrive through other means. Except for supplements. She's always been an enthusiastic supplement taker. I just manage them now with a great deal more information than she ever did. She still regularly, sometimes daily, questions the need for one or another of the pills she notices me shaking out of an obvious prescription bottle. "Now what's that?" she'll ask, while sitting at the table before a meal, sitting on the toilet during her bath, laying in bed before arising while I administer her first dose of iron. If I don't provide all the information she considers important she'll ask, "Why am I taking it?" and "Is it necessary?"
I always answer her in full and honestly. I also keep her informed as to what medications I'm working on cutting back, with which ones I'm having little success with cut backs and why, in my opinion, this is happening. I do this even though I tend to have to daily repeat all of it.
I'm not the only medicine dispenser who gets this third degree. When she's in a medical facility she does the same, to her credit, I believe. The problem with medical facilities is that they usually don't answer her fully or honestly, thus creating the secondary problem of having to connive against her to get her to take medication she doesn't think she needs. I've given up telling them that they are better off respecting her questions and giving full, honest answers rather than placating her and/or trying to get her to take prescribed meds with veiled threats to her health.
I have just as much trouble as does she managing medications being dispensed on-the-spot by medical facilities. The difference between her attempts at management and mine is that I'm not bedridden when I'm tending to her in-facility and always follow up on my investigations and medical management decisions with vigor until someone listens to me (usually with a series of annoyed sighs), takes my input into consideration and puts it into practice.
I think I'll stop here and check in on Mom, maybe start working her toward the edge of the bed. I have no idea how the day will unfold today but I'm satisfied that it will be a good one.
Later.
So I think today we'll either walker in the square (which may be difficult, since the three day Jazz festival is taking place in Prescott this weekend and it may be impossible to find parking downtown that allows the square to be handy to us without tiring her out before we get there) or maybe walker around the outside of the mall, snoop around the shops we've never visited, have lunch at one of the many restaurants, etc.
It's not unusual for me to change plans based on, "good day/bad day feelings". It also isn't unusual for me to ignore such feelings and continue with plans, then wish I hadn't. My track record satisfies me that we will not be sorry putting the trip off a day.
I finally did something this morning that I should have done a long time ago; I called to get Mom started on receiving her diabetic testing supplies through a mail-order service who will negotiate the paperwork that pharmacies don't handle and that I never seem to find the time to do. Medicare/Tricare for Life should be covering 100% of her supplies but the process isn't automatic, as it is with everything else medical in her life. Going through pharmacies and having to negotiate the ridiculous paperwork that they refuse to do (which I put off until it is no longer applicable) has been ensuring, over the last 5 years, that we have been paying out of pocket for most, and sometimes all, of her diabetic supplies, the price of which is formidable. This service should nip that problem in full flower.
I'm curious about how her knee is doing today. I offered her acetaminophen last night but she refused it, telling me her knee wasn't bothering her "that bad". Aside from her high pain tolerance, she continues to prefer not to take pills even for pain or discomfort unless absolutely necessary. I know when she finally assents to a pill for pain for most people it would be long overdue so I trust her on this score. I'm actually pleased she is not a pill taker by nature. This trait of hers is my inspiration for continually trying to cut back, cut back, and then cut back some more on medications and handle conditions that would normally throw a physician into medication hyperdrive through other means. Except for supplements. She's always been an enthusiastic supplement taker. I just manage them now with a great deal more information than she ever did. She still regularly, sometimes daily, questions the need for one or another of the pills she notices me shaking out of an obvious prescription bottle. "Now what's that?" she'll ask, while sitting at the table before a meal, sitting on the toilet during her bath, laying in bed before arising while I administer her first dose of iron. If I don't provide all the information she considers important she'll ask, "Why am I taking it?" and "Is it necessary?"
I always answer her in full and honestly. I also keep her informed as to what medications I'm working on cutting back, with which ones I'm having little success with cut backs and why, in my opinion, this is happening. I do this even though I tend to have to daily repeat all of it.
I'm not the only medicine dispenser who gets this third degree. When she's in a medical facility she does the same, to her credit, I believe. The problem with medical facilities is that they usually don't answer her fully or honestly, thus creating the secondary problem of having to connive against her to get her to take medication she doesn't think she needs. I've given up telling them that they are better off respecting her questions and giving full, honest answers rather than placating her and/or trying to get her to take prescribed meds with veiled threats to her health.
I have just as much trouble as does she managing medications being dispensed on-the-spot by medical facilities. The difference between her attempts at management and mine is that I'm not bedridden when I'm tending to her in-facility and always follow up on my investigations and medical management decisions with vigor until someone listens to me (usually with a series of annoyed sighs), takes my input into consideration and puts it into practice.
I think I'll stop here and check in on Mom, maybe start working her toward the edge of the bed. I have no idea how the day will unfold today but I'm satisfied that it will be a good one.
Later.
Friday, August 27, 2004
We enjoyed a moonlit stroll, tonight...
...up and down our driveway. Mom thought the idea was daring and was almost unwilling to try it so I bribed her with the promise of sugar-free candy afterwards. When I said, "sugar-free" I had to remind her that she likes it, but it worked.
Although it was primarily a practice session and she worked so hard her right knee began to complain, she enjoyed what she called, "the change of scenery". We had a bright 3/4 moon tonight. Our driveway is also well lit at night by a city light across the street and our porch and carport lights provide adequate illumination.
She was surprised that it was "as easy to walk at night as it is during the day."
"You know, Mom," I told her, "it won't always be daylight when we're out and about."
"Oh, really!"
"Well, for instance, the book club meetings. I'm hoping we can start going to those again in September. Those are always at night."
"Yes, that's right. I enjoy those."
"And suppose we decide to go out for dinner? In the winter, it will be dark both coming and going."
"Well, yes, you're right there."
"And, you know, they have evening concerts in the Square..."
"Really! When did those start?"
"They go on all spring, summer and fall."
"That would be interesting."
"I thought you might like the idea of going to some of those events."
"Why haven't we gone before?"
"Well, Mom, for two years we were stuck in Mesa and when we finally got back up here last September, soon after we arrived you hurt your back, then, you've been very weak and iffy this whole winter, spring and summer..."
"Oh, yes. That's right."
"But, best to forget all that now. I think Prescott is going to be seeing a lot more of us very soon."
"Well, I hope so. I'd like to see a lot more of Prescott."
Yes!
I'm still having trouble getting across the concept that one needn't work to use a walker, that the best way to use it is to relax, relax, relax. Tonight I tried several different ways of explaining it to her. When I explained that she does not need to push it with her arms she responded, "If I don't it won't move!"
So we spent some time in the carport on level ground having her "test" its mobility by "stepping up to the plate" (it has a fold down platform that can be used as either a carrier or a seat), literally walking into it, eyes forward, shoulders back, arms relaxed and feeling that it moves because the person using it is moving, not because the person using it is pushing it.
Then I demonstrated that the walker "works" even when one doesn't grip the handles but simply lays one's spread hands on top of the grips. She tried that but didn't trust the device enough to keep her hands spread.
I demonstrated that it's kind of like dancing: If you keep your eyes on your feet or on the ground you restrict your ability to move.
We practiced slow. We practiced at normal speed. Back and forth, back and forth, from one end of the carport to the other.
I reached around her and demonstrated how when one turns with the walker one pulls it close then relaxes the arm opposite the direction in which one wants to turn and pulls the walker toward one's body with the arm on the side toward which one wants to turn while pivoting in place. I think the pivoting practice is what got to her knee. She did, however, finally seem to "get" this concept at a body level.
Finally, to relax her I told her to go ahead and walk one more time down the driveway (which is on a slight incline) and back up anyway she wanted, at any speed, without my comments and without my company. That's when I noticed her limping on the right.
I think it's going to take a little time for her body to completely absorb what I'm trying to teach her. I even compared it to using a shopping cart, which probably wasn't the best idea because when she used to use shopping carts she leaned all over the handle. Although she did push it forward with the momentum of her legs, the practice of leaning on it is part of what compromised her back so badly that she was ripe for a severe lower back sprain.
We've got a ways to go. I have to say, though, she is trying so, so hard. I see the look of determination on her face as she works through her therapy and on walkering with me, I detect the underlayer of utter trust in me and what I am telling her, the deeper layer of desire to please me and do as much as she can to keep us living together without threat of being separated and, well, today, I started tearing during her workout, my heart simply melted at everything I observed in her face and her demeanor. I saw that she noticed but she didn't say anything, she just smiled and continued lifting her weights in the air as I did the same. I think she's finally beginning to appreciate that, yes, I may be "unfortunately" emotional but my emotional outbursts and leakage are not confusing to her anymore. This is a surprising development of her stay in the hospital and SNF and it's a welcome one. I think she now realizes that neither of us wants to be separated from the other and that I will do everything in my power, even when it appears as though I'm moving in the opposite direction as it surely must have seemed when I visited her only every other day at the SNF and when I despaired, out loud, just previous to the events beginning on August 1st, that I was afraid caring for her was beyond my abilities, I will do everything, and I will probably succeed, to keep us together right to the end. I think she also now knows she, too, can take steps (pun unintended but appropriate) to make sure we remain together. She has and she will.
Last night while I was rubbing down her legs and feet we had a conversation that inspired my first essay on Essaying the Situation. As we were talking I realized that her 90th year was only three years away. "Mom," I said, "you know, I'll bet that no one, not even any of our relatives, really believes that you will live into your 90s. You and I, we think of it as only three years away but I'll bet everyone else who hasn't seen us much thinks of 90 as..."
"As some far away time, someplace where almost no one goes."
"Yeah, that's exactly right. It's like, for those who haven't followed you to where you are now there's this huge ocean between where we are now and 90. When they look at where you are at 87 they can't imagine that you'll be exploring what's on the other side of the ocean. It's like 90 is beyond death even if it's only a day away."
"That's right," she said. "To you and me, it's just another three years, and then more years, after that."
"And we've already been together for ten years. Three years is nothing. It's been four years since doctors started screwing around with you trying to get us to believe that you were at death's door and wouldn't make it much further unless they could put a scope up your ass or down your throat or needles in your bones or more and more pills down your gullet."
She laughed a "we sure fooled them" laugh. "That's right! And look where we are now!"
"That's right. No more scopes, never any needles and significantly fewer pills."
"Just goes to show what's possible when you put your mind to it."
And your heart, Mom, and your soul. It just goes to show...
I'm assuming that tomorrow Mom will probably need to take a nap at some time while we're in Mesa. I'm taking my computer with me but I'm not promising anything. I might spend her nap time continuing to pack boxes. So posts tomorrow, on any of these sections, might be few to none. Just wanted to mention that.
Later.
Although it was primarily a practice session and she worked so hard her right knee began to complain, she enjoyed what she called, "the change of scenery". We had a bright 3/4 moon tonight. Our driveway is also well lit at night by a city light across the street and our porch and carport lights provide adequate illumination.
She was surprised that it was "as easy to walk at night as it is during the day."
"You know, Mom," I told her, "it won't always be daylight when we're out and about."
"Oh, really!"
"Well, for instance, the book club meetings. I'm hoping we can start going to those again in September. Those are always at night."
"Yes, that's right. I enjoy those."
"And suppose we decide to go out for dinner? In the winter, it will be dark both coming and going."
"Well, yes, you're right there."
"And, you know, they have evening concerts in the Square..."
"Really! When did those start?"
"They go on all spring, summer and fall."
"That would be interesting."
"I thought you might like the idea of going to some of those events."
"Why haven't we gone before?"
"Well, Mom, for two years we were stuck in Mesa and when we finally got back up here last September, soon after we arrived you hurt your back, then, you've been very weak and iffy this whole winter, spring and summer..."
"Oh, yes. That's right."
"But, best to forget all that now. I think Prescott is going to be seeing a lot more of us very soon."
"Well, I hope so. I'd like to see a lot more of Prescott."
Yes!
I'm still having trouble getting across the concept that one needn't work to use a walker, that the best way to use it is to relax, relax, relax. Tonight I tried several different ways of explaining it to her. When I explained that she does not need to push it with her arms she responded, "If I don't it won't move!"
So we spent some time in the carport on level ground having her "test" its mobility by "stepping up to the plate" (it has a fold down platform that can be used as either a carrier or a seat), literally walking into it, eyes forward, shoulders back, arms relaxed and feeling that it moves because the person using it is moving, not because the person using it is pushing it.
Then I demonstrated that the walker "works" even when one doesn't grip the handles but simply lays one's spread hands on top of the grips. She tried that but didn't trust the device enough to keep her hands spread.
I demonstrated that it's kind of like dancing: If you keep your eyes on your feet or on the ground you restrict your ability to move.
We practiced slow. We practiced at normal speed. Back and forth, back and forth, from one end of the carport to the other.
I reached around her and demonstrated how when one turns with the walker one pulls it close then relaxes the arm opposite the direction in which one wants to turn and pulls the walker toward one's body with the arm on the side toward which one wants to turn while pivoting in place. I think the pivoting practice is what got to her knee. She did, however, finally seem to "get" this concept at a body level.
Finally, to relax her I told her to go ahead and walk one more time down the driveway (which is on a slight incline) and back up anyway she wanted, at any speed, without my comments and without my company. That's when I noticed her limping on the right.
I think it's going to take a little time for her body to completely absorb what I'm trying to teach her. I even compared it to using a shopping cart, which probably wasn't the best idea because when she used to use shopping carts she leaned all over the handle. Although she did push it forward with the momentum of her legs, the practice of leaning on it is part of what compromised her back so badly that she was ripe for a severe lower back sprain.
We've got a ways to go. I have to say, though, she is trying so, so hard. I see the look of determination on her face as she works through her therapy and on walkering with me, I detect the underlayer of utter trust in me and what I am telling her, the deeper layer of desire to please me and do as much as she can to keep us living together without threat of being separated and, well, today, I started tearing during her workout, my heart simply melted at everything I observed in her face and her demeanor. I saw that she noticed but she didn't say anything, she just smiled and continued lifting her weights in the air as I did the same. I think she's finally beginning to appreciate that, yes, I may be "unfortunately" emotional but my emotional outbursts and leakage are not confusing to her anymore. This is a surprising development of her stay in the hospital and SNF and it's a welcome one. I think she now realizes that neither of us wants to be separated from the other and that I will do everything in my power, even when it appears as though I'm moving in the opposite direction as it surely must have seemed when I visited her only every other day at the SNF and when I despaired, out loud, just previous to the events beginning on August 1st, that I was afraid caring for her was beyond my abilities, I will do everything, and I will probably succeed, to keep us together right to the end. I think she also now knows she, too, can take steps (pun unintended but appropriate) to make sure we remain together. She has and she will.
Last night while I was rubbing down her legs and feet we had a conversation that inspired my first essay on Essaying the Situation. As we were talking I realized that her 90th year was only three years away. "Mom," I said, "you know, I'll bet that no one, not even any of our relatives, really believes that you will live into your 90s. You and I, we think of it as only three years away but I'll bet everyone else who hasn't seen us much thinks of 90 as..."
"As some far away time, someplace where almost no one goes."
"Yeah, that's exactly right. It's like, for those who haven't followed you to where you are now there's this huge ocean between where we are now and 90. When they look at where you are at 87 they can't imagine that you'll be exploring what's on the other side of the ocean. It's like 90 is beyond death even if it's only a day away."
"That's right," she said. "To you and me, it's just another three years, and then more years, after that."
"And we've already been together for ten years. Three years is nothing. It's been four years since doctors started screwing around with you trying to get us to believe that you were at death's door and wouldn't make it much further unless they could put a scope up your ass or down your throat or needles in your bones or more and more pills down your gullet."
She laughed a "we sure fooled them" laugh. "That's right! And look where we are now!"
"That's right. No more scopes, never any needles and significantly fewer pills."
"Just goes to show what's possible when you put your mind to it."
And your heart, Mom, and your soul. It just goes to show...
I'm assuming that tomorrow Mom will probably need to take a nap at some time while we're in Mesa. I'm taking my computer with me but I'm not promising anything. I might spend her nap time continuing to pack boxes. So posts tomorrow, on any of these sections, might be few to none. Just wanted to mention that.
Later.
Technical Matters, Online and Onmom
I figured out how to reduce the number of pages indexed by the Atomz search facility I'm using. Since every post, which is published as a page in itself, is duplicated in the archive, I used an exclude mask to exclude the separate pages. This means that the search facility will be able to keep up with me for a long time. It also means that when you pull a search on this site, Mom's Daily Tests and Meds and its companion material (her medical tests, etc.) and on Essaying the Situation through Mom and Me Addenda, you will pull full 7 day archives.
It appears that Google has not yet seen fit to crawl either of the sites upon which I placed the navigator bar. I'll give it a couple of weeks. If it still hasn't crawled those sites I'll delete the bar. I was thinking of putting that bar on the essays journal and the food journal once I get that started. But if Google is going to be so arbitrary as to decide not to crawl sites that specifically use "Blogger.com", which now belongs to Google, unless the navigation bar is added, which advertises Google, well, I think I'll be arbitrary as well. Atomz does good searches as long as I keep up with the indexing when I enter something important. At any rate, it automatically reindexes every week.
Today's been yet another Good Day, Sunshine day. Mom hasn't walkered yet but when she awakens from her nap we're going to practice out on our driveway. Her muscles are just beginning to get used to moving more so I gave her a choice today: Walkering around the square or practicing on our driveway. She chose the practice, which is fine. We'll do several laps in order to equal what she would have done around the square.
This morning, as you might have guessed, I bolted awake late, just before 0900. When I peeked into her room on my way to the kitchen to feed The Girls and start setting up for Mom's day she was already on her elbows looking around as though she was surprised another day had begun. I asked her if she was ready to get up. She rose further and said, "I guess so." Excellent. Once she started moving out of bed, though, she balked. After she lagged more minutes than I like, I reminded her that "movement begets energy and energy begets movement", wrapped my arms around her and started to whup her up. She pushed me away in a snit and rose to a complete sit at the edge of the bed on her own. Nothing like a little anger to get an 87 year old going.
We continued having words in the bathroom when she decided it was too cold for her. I had the floor heater way up. It had been radiating all night in a small, closed-door room and the bathroom felt like a sauna to me. After draping a plush beach towel over her, which we'd gotten just for that purpose, and having her refuse to allow me to shift it here and there so she and I could get to various parts of her body I said, "Look. I'm sorry you think it's cold. You are not in danger of freezing in this bathroom or turning blue. You have to bathe. Deal with it." And, that was the end of that.
Tomorrow we are going to Mesa to do a little packing out of the house down there. She's clearly excited. It should be interesting. I plan on taking her out for lunch and possibly dinner, too, depending on when we get out of there. Lunch will be someplace where she'll have to do some walkering but I imagine her therapy exercises will go by the wayside tomorrow. That's okay. It'll give her muscles a chance to incorporate what they're learning and rest up for Sunday.
I'll be posting some time soon on one of these Mom & Me sections a list of the exercises we're doing now (which I recreated from memory, since I can't find the handouts from the nursing home; and to which I've added a few to help strengthen her knees and recuperate her sense of balance) and keeping that updated as her physical prowess develops. I'll let you know when I complete that.
Later.
It appears that Google has not yet seen fit to crawl either of the sites upon which I placed the navigator bar. I'll give it a couple of weeks. If it still hasn't crawled those sites I'll delete the bar. I was thinking of putting that bar on the essays journal and the food journal once I get that started. But if Google is going to be so arbitrary as to decide not to crawl sites that specifically use "Blogger.com", which now belongs to Google, unless the navigation bar is added, which advertises Google, well, I think I'll be arbitrary as well. Atomz does good searches as long as I keep up with the indexing when I enter something important. At any rate, it automatically reindexes every week.
Today's been yet another Good Day, Sunshine day. Mom hasn't walkered yet but when she awakens from her nap we're going to practice out on our driveway. Her muscles are just beginning to get used to moving more so I gave her a choice today: Walkering around the square or practicing on our driveway. She chose the practice, which is fine. We'll do several laps in order to equal what she would have done around the square.
This morning, as you might have guessed, I bolted awake late, just before 0900. When I peeked into her room on my way to the kitchen to feed The Girls and start setting up for Mom's day she was already on her elbows looking around as though she was surprised another day had begun. I asked her if she was ready to get up. She rose further and said, "I guess so." Excellent. Once she started moving out of bed, though, she balked. After she lagged more minutes than I like, I reminded her that "movement begets energy and energy begets movement", wrapped my arms around her and started to whup her up. She pushed me away in a snit and rose to a complete sit at the edge of the bed on her own. Nothing like a little anger to get an 87 year old going.
We continued having words in the bathroom when she decided it was too cold for her. I had the floor heater way up. It had been radiating all night in a small, closed-door room and the bathroom felt like a sauna to me. After draping a plush beach towel over her, which we'd gotten just for that purpose, and having her refuse to allow me to shift it here and there so she and I could get to various parts of her body I said, "Look. I'm sorry you think it's cold. You are not in danger of freezing in this bathroom or turning blue. You have to bathe. Deal with it." And, that was the end of that.
Tomorrow we are going to Mesa to do a little packing out of the house down there. She's clearly excited. It should be interesting. I plan on taking her out for lunch and possibly dinner, too, depending on when we get out of there. Lunch will be someplace where she'll have to do some walkering but I imagine her therapy exercises will go by the wayside tomorrow. That's okay. It'll give her muscles a chance to incorporate what they're learning and rest up for Sunday.
I'll be posting some time soon on one of these Mom & Me sections a list of the exercises we're doing now (which I recreated from memory, since I can't find the handouts from the nursing home; and to which I've added a few to help strengthen her knees and recuperate her sense of balance) and keeping that updated as her physical prowess develops. I'll let you know when I complete that.
Later.
Oops! You know what?
Essaying the Situation already has an internal search facility; Search Mom & Me Essays as listed to the right. Of course, that search is not limited to the extemporaneous essay section, it includes the other essay section, the poetry section, and I'm not sure what else, but, what the hell, it'll include it. The search engine needs to be manually indexed; its automatic indexing schedule doesn't cycle again until early next week. I'll do that tomorrow.
"Laterlaterlater," she said, wallowing in the need for sleep.
Update 11/7/08: The search engine above no longer searches everything mentioned above. It only searched the essay section and the Information & Resources page. However, all the pages mentioned above, except for the powety page, have been transcribed into the essay section.
"Laterlaterlater," she said, wallowing in the need for sleep.
Update 11/7/08: The search engine above no longer searches everything mentioned above. It only searched the essay section and the Information & Resources page. However, all the pages mentioned above, except for the powety page, have been transcribed into the essay section.
Just to let you know...
...I've launched my extemporaneous essay journal, Essaying the Situation with my first essay. It is a truly extemporaneous essay. I hadn't thought of writing about the subject until tonight just before my mother went to bed. I will be including that journal as a link to the right and in all the link sections through the entire The Mom & Me Journals web area (when I'm not as tired as I am now). I'll also mention and link here to each new essay I'm inspired to write. The essay journal will also soon have an internal search facility.
Later.
Later.
Thursday, August 26, 2004
I'm jazzed, so I thought I should put in a few paragraphs about why.
Damn, we've had some good days lately and today is rolling out to be another. Her blood glucose is doing good [Yes!]. She's doing her therapy exercises with me and she's really paying attention and working hard [Yes!]. She's alert and interested in what's going on around her and, with very little protest, is accompanying me everywhere [Yes!]. I have to keep as focused an eye on her as before, maybe even more than before. Now that she's looking around and noticing her environment she's liable to do things like the below mentioned Depends-Instead (of sponges) incident, or a mustard incident I'll be mentioning later. We continue to be joined at the hip even more than before but it's not a drag because she's using her walker and finding out that it's pretty interesting to be out and about.
Today, instead of doing all her walkering in one place, we went on three errands together, giving her a chance to rest between spurts, thus preserving her back. At the first she said, "I'll just stay in the car while you go in."
"Nope," I said, "not an option anymore. You need to move, lady, period. When you're with me and I get out of the car, you get out of the car, even if it's a short trip. Everywhere I go, you go now. It's good for you. It's good for me. Unless you're laid out on a stretcher in traction or in a cast you're going to be up and at 'em."
She tried the "Why?" ploy on me this morning, too, when I awoke her.
"You know better than that, now, Mom," I said, giving her mind the benefit of the doubt. "I'm not even going to dignify that with an answer. It doesn't deserve it."
She gave me that, "you're treading on thin ice, there, girl" look, but she was out of bed only a bit more slowly than lately. At any rate, when she lags and the reason isn't any more legitimate than that she'd like to spend the rest of her life in bed, I simply remind her that I can "whup" her up and out any time I want. The mere "threat seems to do the trick even though she never remembers that I can do this.
She also had a bowel movement today, one that clogged the toilet, which tells me that despite my problems with controlling her hydration level (about which I will soon be preparing an extemporaneous essay on my soon to be launched companion essay site) we're back on schedule with regularity [Yes!].
A few days ago she mentioned that she'd like to spend more time outside in our yard [Yes!]. This morning I suggested we do her therapy exercises outside but she observed after poking her nose out, that it was still a bit too windy and cool for her (we've had a dry low moving through here for the last few days. I trust her to know when it's too blustery for her.
She's napping, now. Tonight is Spirit of Tomato Pie night. It's usually a good TV night, as well, from her perspective. Two of her favorites are on, CSI: Las Vegas and Without A Trace. There's also a good selection of "women's movies" on the women's channel. I can never remember which one it is but I can always tell by the names and descriptions of the movies. So, she's got her evening set. We also have one more set of leg exercises to do (she's supposed to do two sets a day). With this session I'll add the two I came up with yesterday which I hope will help strengthen her knees. We purchased some sweat pants for her yesterday. I need to hem those tonight. We also need to draft and sign the letter for change of address for her non-public stock holdings, the ones from which we get dividends. Saturday we're planning on going down to Mesa to pick up whatever mail we might be collecting there (our yard man tells me so far there's been none) and begin packing out some of the stuff there. If all goes well, even though we haven't yet sold the place and there aren't yet, any takers, we'll be doing that for the next four Saturdays until we're clear to reinstate forwarding at that address.
We haven't yet found the time to play any games since she's been home or read because, I'm pleased to report, I've been keeping her on the move [Yes!]. There are a few kinks, but even those are easily negotiated, now.
Yes! I'm jazzed!
Later.
Today, instead of doing all her walkering in one place, we went on three errands together, giving her a chance to rest between spurts, thus preserving her back. At the first she said, "I'll just stay in the car while you go in."
"Nope," I said, "not an option anymore. You need to move, lady, period. When you're with me and I get out of the car, you get out of the car, even if it's a short trip. Everywhere I go, you go now. It's good for you. It's good for me. Unless you're laid out on a stretcher in traction or in a cast you're going to be up and at 'em."
She tried the "Why?" ploy on me this morning, too, when I awoke her.
"You know better than that, now, Mom," I said, giving her mind the benefit of the doubt. "I'm not even going to dignify that with an answer. It doesn't deserve it."
She gave me that, "you're treading on thin ice, there, girl" look, but she was out of bed only a bit more slowly than lately. At any rate, when she lags and the reason isn't any more legitimate than that she'd like to spend the rest of her life in bed, I simply remind her that I can "whup" her up and out any time I want. The mere "threat seems to do the trick even though she never remembers that I can do this.
She also had a bowel movement today, one that clogged the toilet, which tells me that despite my problems with controlling her hydration level (about which I will soon be preparing an extemporaneous essay on my soon to be launched companion essay site) we're back on schedule with regularity [Yes!].
A few days ago she mentioned that she'd like to spend more time outside in our yard [Yes!]. This morning I suggested we do her therapy exercises outside but she observed after poking her nose out, that it was still a bit too windy and cool for her (we've had a dry low moving through here for the last few days. I trust her to know when it's too blustery for her.
She's napping, now. Tonight is Spirit of Tomato Pie night. It's usually a good TV night, as well, from her perspective. Two of her favorites are on, CSI: Las Vegas and Without A Trace. There's also a good selection of "women's movies" on the women's channel. I can never remember which one it is but I can always tell by the names and descriptions of the movies. So, she's got her evening set. We also have one more set of leg exercises to do (she's supposed to do two sets a day). With this session I'll add the two I came up with yesterday which I hope will help strengthen her knees. We purchased some sweat pants for her yesterday. I need to hem those tonight. We also need to draft and sign the letter for change of address for her non-public stock holdings, the ones from which we get dividends. Saturday we're planning on going down to Mesa to pick up whatever mail we might be collecting there (our yard man tells me so far there's been none) and begin packing out some of the stuff there. If all goes well, even though we haven't yet sold the place and there aren't yet, any takers, we'll be doing that for the next four Saturdays until we're clear to reinstate forwarding at that address.
We haven't yet found the time to play any games since she's been home or read because, I'm pleased to report, I've been keeping her on the move [Yes!]. There are a few kinks, but even those are easily negotiated, now.
Yes! I'm jazzed!
Later.
Wednesday, August 25, 2004
The time I seem to have trouble finding to post...
...isn't actual time (whatever that is), it's mental time. My mind is doing this furious Dance of the Review of Every Single Moment of the Past Few Weeks and doesn't seem to be close to a stop yet to allow me to organize what I'm thinking and post it. So, for those of you who are regular visitors and are wondering how Mom is doing...here's yet another excerpt from an e to MFASRF that tells that tale in a slightly cracked nutshell:
8/24/04 21:04
...I thought you might want to know...
...in short, how everything is shaking out now that my mother is home.
She was released Saturday and is doing better than fine. She's experiencing yet another spectacular revival of health and alertness. She's up and moving, once again considers the wheel chair a personal affrontery, is having a little trouble grasping the concept that, just like the idea that you don't drive the car, you correct it, you don't push the walker, you move it forward with the momentum of walking, and, of course, correct it, but she's walkering all over the place anyway. At home, she's moving very well, thank you, under her own steam. She is much less dependent on oxygen. I'm continuing all her exercises from physical therapy at the SNF every day, well, except today. Sunday she walkered all over Costco, raising her blood sugar on samples. Monday I could barely get her out of the grocery store and she had no intention of resting here and there while I gathered what we needed. Today she was tired and I gave her that. I'd planned on at least going through her exercises in the evening but she decided to go to bed at 2000, not because she was bored but because, as she said, "Ahm taard," in her worst cowboy accent. I'd be tired, too, if I was 87, fresh out of a skilled nursing facility where, although they keep you somewhat busy, it's easy to nap between therapy sessions, they get anxious every time you get out of bed without an aide nearby and "the food's just so-so and there's never enough" (she lost 3 pounds there and she's getting down to the place where she really doesn't need to lose any more) then my daughter runs me around the whole goddamn town for two days after my release and makes me do my therapy exercises, to boot.
I'm doing very well, too. My SC costume arrived on time but I've decided to turn in the com badge/beamer thing for a cape. I realized, just like with my refusal to get a cell phone, I really don't want to be THAT available to anyone but Mom and I don't have to beam or use a cell phone, to be available to her. The intensity of attention hasn't changed but it makes an enormous difference that I don't have to pick her up off the floor, don't have to keep my eye on her every time she looks like she wants to move, don't have to be her complete body support and don't have to try to wheel that damned chair all over this very small house. As well, she's no longer in a mental slump. That makes a delightful difference. I'm not worrying about her, either, again. That's very, very nice.
Well, I was thrilled when she decided to go to bed at 2000 because, I thought, great, I can write for awhile in my online journal. But, you know what, I think I only have the energy to enter dinner stats, comment on some medication changes and then I might go to bed, too, after starting the second drying cycle. We have to go to Costco again tomorrow because she thought the last bag of her Depends were disposable towels and decided to clean the sink in her bathroom with them. She'd gone through all but three in our last bag by the time I decided to check on why she was taking so long in the bathroom. I wasn't upset. It's been a good year, maybe more, since she's had the energy to even think about cleaning a sink.
And, again, I find myself more prone to thinking than writing, more prone to, well, thinking prone than sitting. Once again, as a reminder, if a day or two or even more goes by through which I don't post much, or at all, check in at Mom's Daily Tests and Meds. Chances are, in reviewing her stats, I've probably also entered personal information that will give you a taste of her day and/or her state. Certainly, that is true of the last couple-more-than-a-few days. If you've been curious about how she's doing and you haven't been going there, you've been missing out.
One thing I did record on Sunday in the small, thick notebook I call "My Life", that goes everywhere with me and in which I record everything, absolutely everything, including to-do lists, grocery lists, reminders, phone numbers, notes about things or people I encounter, appointments, information from others that I need to remember about everything under the sun, recommendations, notes to people that sometimes don't get delivered, curious thoughts...and more: "My mother continues to triumph without being aware she's in a fight." That is the gist of everything, right now.
Later. I promise. Somentaltime later.
8/24/04 21:04
...I thought you might want to know...
...in short, how everything is shaking out now that my mother is home.
She was released Saturday and is doing better than fine. She's experiencing yet another spectacular revival of health and alertness. She's up and moving, once again considers the wheel chair a personal affrontery, is having a little trouble grasping the concept that, just like the idea that you don't drive the car, you correct it, you don't push the walker, you move it forward with the momentum of walking, and, of course, correct it, but she's walkering all over the place anyway. At home, she's moving very well, thank you, under her own steam. She is much less dependent on oxygen. I'm continuing all her exercises from physical therapy at the SNF every day, well, except today. Sunday she walkered all over Costco, raising her blood sugar on samples. Monday I could barely get her out of the grocery store and she had no intention of resting here and there while I gathered what we needed. Today she was tired and I gave her that. I'd planned on at least going through her exercises in the evening but she decided to go to bed at 2000, not because she was bored but because, as she said, "Ahm taard," in her worst cowboy accent. I'd be tired, too, if I was 87, fresh out of a skilled nursing facility where, although they keep you somewhat busy, it's easy to nap between therapy sessions, they get anxious every time you get out of bed without an aide nearby and "the food's just so-so and there's never enough" (she lost 3 pounds there and she's getting down to the place where she really doesn't need to lose any more) then my daughter runs me around the whole goddamn town for two days after my release and makes me do my therapy exercises, to boot.
I'm doing very well, too. My SC costume arrived on time but I've decided to turn in the com badge/beamer thing for a cape. I realized, just like with my refusal to get a cell phone, I really don't want to be THAT available to anyone but Mom and I don't have to beam or use a cell phone, to be available to her. The intensity of attention hasn't changed but it makes an enormous difference that I don't have to pick her up off the floor, don't have to keep my eye on her every time she looks like she wants to move, don't have to be her complete body support and don't have to try to wheel that damned chair all over this very small house. As well, she's no longer in a mental slump. That makes a delightful difference. I'm not worrying about her, either, again. That's very, very nice.
Well, I was thrilled when she decided to go to bed at 2000 because, I thought, great, I can write for awhile in my online journal. But, you know what, I think I only have the energy to enter dinner stats, comment on some medication changes and then I might go to bed, too, after starting the second drying cycle. We have to go to Costco again tomorrow because she thought the last bag of her Depends were disposable towels and decided to clean the sink in her bathroom with them. She'd gone through all but three in our last bag by the time I decided to check on why she was taking so long in the bathroom. I wasn't upset. It's been a good year, maybe more, since she's had the energy to even think about cleaning a sink.
And, again, I find myself more prone to thinking than writing, more prone to, well, thinking prone than sitting. Once again, as a reminder, if a day or two or even more goes by through which I don't post much, or at all, check in at Mom's Daily Tests and Meds. Chances are, in reviewing her stats, I've probably also entered personal information that will give you a taste of her day and/or her state. Certainly, that is true of the last couple-more-than-a-few days. If you've been curious about how she's doing and you haven't been going there, you've been missing out.
One thing I did record on Sunday in the small, thick notebook I call "My Life", that goes everywhere with me and in which I record everything, absolutely everything, including to-do lists, grocery lists, reminders, phone numbers, notes about things or people I encounter, appointments, information from others that I need to remember about everything under the sun, recommendations, notes to people that sometimes don't get delivered, curious thoughts...and more: "My mother continues to triumph without being aware she's in a fight." That is the gist of everything, right now.
Later. I promise. Somentaltime later.
Tuesday, August 24, 2004
I haven't got a lot of time to post, at the moment...
...even though, for Mom, it's been a day of recuperation from two surprisingly (to both her and me) active days. Regardless of how much activity she puts in, rarely does the level of my caregiving reduce in intensity. I expect to be posting more later. For the moment, so that I don't forget, I want to mention that I launched into an extemporaneous essay about nutrition, medication and caregiving over at Mom's Daily Tests and Meds during my posting of today's lunch stats. The URL will take you directly to these observations and thoughts.
She's napping now, due to be awakened at 1700. It's been a good day, although slow for her. We'll be doing her upper body exercises later, once she's had some time to come around and I've set her hair. Maybe we'll put in a little practice on the walker in the hall. She's having a hard time grasping the concept of walking close to the walker and letting her momentum push it. Then again, maybe we'll just chill for the rest of the evening. Just depends on how she feels when she awakens.
Expect more later once Mom retires, which is about the only time I've found, recently, to muse and write without interruption. No complaints, though. I am thrilled with her progress and looking forward to many, many more active, involved days with her.
She's napping now, due to be awakened at 1700. It's been a good day, although slow for her. We'll be doing her upper body exercises later, once she's had some time to come around and I've set her hair. Maybe we'll put in a little practice on the walker in the hall. She's having a hard time grasping the concept of walking close to the walker and letting her momentum push it. Then again, maybe we'll just chill for the rest of the evening. Just depends on how she feels when she awakens.
Expect more later once Mom retires, which is about the only time I've found, recently, to muse and write without interruption. No complaints, though. I am thrilled with her progress and looking forward to many, many more active, involved days with her.
Monday, August 23, 2004
Non-Alternative Medicine Strikes [Out] Again
Interesting development regarding Home Health Care. It seems that it is specifically for the home bound. Thus, Mom is not eligible. We found this out during the evaluative appointment with the PT sent by Home Health Care here in Prescott. The appointment was going well up to the point where the PT asked if Mom takes acetaminophen. I answered, "Yes, but not often."
"When was her last dose?" he asked.
I laughed. "Well, yesterday, actually. She walked a little too much at Costco and her lower back was bothering her so I gave her 500 mg before her nap."
"She's not home bound?" the PT asked, clearly surprised.
"Goodness, no," I said. "For the last several months she's been refusing to move much, which has caused her to weaken significantly. This, added to the attacks of a few health problems made it almost impossible for me to get her moving. When she started doing what I call mini-stroking but wasn't, for a little less than a week she couldn't move without collapsing. But, generally, no, she's not home bound. In fact, she's improved so much over the last few weeks at the SNF that I'd be surprised if she ever became home bound."
"Well, then, this appointment ends here," he announced. "Home Health Care is only for the home bound."
"Why in the world, I wonder, did the SNF think she was home bound?!?" I asked of the air. "I can't imagine why anyone thought she was home bound!"
Answers to that question were not forthcoming. Before leaving, the PT was kind enough to give me the name of a PT he thought would suit my mother's profile and told me why the two I'd considered through phone interviews a little over a month ago might be too "dynamic" for my mother right now. From what he told me, I agree. I also explained that the reason why I'd selected these over the others I'd talked to was because they were the only two who didn't make assumptions about lack of ability or potential based on her age. He agreed that this can be a problem and assured me that the PT he mentioned, while gentle, was not about to do this.
Just before he left he mentioned that he could clearly see that I took very good care of my mother and he was glad that I was insisting that she get back into movement and not allow her to become home bound at this point. "When that happens," he said, "it's the beginning of the end."
Immediately after he closed the door Mom and I started a comic riff on the medical community that has surrounded her since early June (I'm including the blood transfusion team because at that time Home Health Care was also recommended but the hospital never followed up on it, leaving that to me, which I didn't do) thinking that she was somehow home bound. I can't imagine that anyone would have gotten this idea from her PCP. He knows better.
To be fair, there are some reasons why the hospital and SNF consulting physicians, who saw my mother for only short periods of time, put 2 + 2 together and came up with 22 instead of 4. They only see her when she is extremely weak. Both times this summer when she'd been admitted to the hospital and the time she'd been admitted to the SNF I mentioned that she has been refusing to move much at all since about late March, early April. Of course, now, as it turns out, besides her natural inertia, there have also been legitimate health conditions that have been lowering her energy level significantly, although, truth be told, at least one of those problems would not have been as much of a problem if she had continued to move, even a little. She is 87 and, I guess, the non-alternative medical community isn't used to seeing an 87 year old with what appears to be deteriorating health who also has dynamic recuperative powers. I do tend to refer to her as "frail" because when she's having significant health problems, she is frail, and when she's in good form she has certain conditions, such as her lack of short term memory, which make her a poor candidate for certain procedures, such as scoping. My mother is, figuratively, of the cat family, as well. If someone tells her to stay in bed she rarely argues (although she did at the SNF). I do believe that if there was a way for my mother to stay in bed without endangering any of her physical abilities and causing no one else any problems she'd grab for it as though it was the gold ring.
However, each and every medical professional involved in my mother's care since June 8th has been well informed, by me, of this website and has been told and directed on paper numerous times that her entire, reliable history resides, in several forms, on this site and that the site can be searched in order to successfully and quickly wade through all the words that might be considered insignificant. As well, I have not been shy about voicing my own determinations regarding my mother's health profile, her spirit, her will and her recuperative powers, although I've also noticed that I am usually politely tolerated then ignored. My mother, though, has surprised almost everyone involved in her care throughout the last few months with her ability to suddenly and resolutely stand and be counted, even when she's been told to stay in bed, especially at the SNF, which, this time, was the medical cooperative that recommended Home Health Care.
I don't know. Bottom line is, it's a mystery to me. Is it possible that the non-alternative medical industry, in general, isn't aware that Home Health Care is for the home bound? Or, is it simply that NO ONE IN THE NON-ALTERNATIVE MEDICAL INDUSTRY LISTENS, NO ONE REALLY OBSERVES AND NO ONE THINKS!?!?!? Yes, I shouted that. Really, really loud. Jesus fucking Christ! How in the world does anyone ever get healed through non-alternative medicine?
Nothing like a little tantrum to make one feel better.
Okay, now on to our day. It was a heavy duty moving day. Immediately after the Home Health Care PT excused himself I headed Mom out to our driveway and set her to some concentrated practice at the proper method of using her walker in order to short circuit the possibility of her compromising her back. After about 45 minutes, which also involved surveying our wild, wild yard and admiring our developing apples and one pear, I settled her inside and we went through all the upper and lower body exercises she's been doing at the facility with her new 1 lb. weights. She worked hard. I was surprised. So was she.
After some lunch and a 2.5 hour nap, which she not only deserved but through which she slept deeply, I gathered her up, jump started her and we went to the grocery to replenish some of the staples that had either spoiled during the last three weeks or through which I'd eaten. Her energy level was astounding. I gave her several chances to sit and relax, or "hang out" while I went looking for an obscure or moved item, but she kept up with me, even as I continually corrected her use of the walker. We spent a good hour in the store (in part because her speed is, well, the speed of an 87 year old who is recovering from extreme physical weakness) but she didn't tire.
I am sure that some of her recovered energy level is due to no longer smoking. We had an accidental run-in over smoking today, my fault. It is my unconscious habit, when I pet The Big Girl, who is a long-haired calico, to pick her shed off my hands and clothes afterwards and reach across the distance between Mom and me and deposit it in her ash tray. I did this without thinking, this afternoon, then, again without thinking, laughed and said, "Oh, yeah, no more cigarettes, no more ash trays! I forgot!"
Immediately I realized my mistake. An almost silent part of Mom's brain suddenly shouted. Her expression turned hard, her eyes glittered and she said, "That's right!" as though she'd located something she'd misplaced a long time ago and for which she'd subconsciously been looking. "May I please have a cigarette." It was not a request.
Oh shit, I thought. "Mom, we don't have any cigarettes."
Again, with an edge. "May I please have a cigarette."
"Mom, really, we don't have any cigarettes. You haven't smoked since about a week before you went into the hospital and all the cigarettes are gone, now."
She glared at me.
"Mom, I'm going to remind you why you're not smoking anymore. I want you to listen carefully to me." I launched into her recent history including how, since her blood transfusion, she'd been on oxygen almost 24 hours a day, had cut her cigarette consumption to no more than 7 cigarettes a day, usually 3 to 5. As the days passed, I explained, I noticed that each time she had a cigarette during this period, just one cigarette, she became significantly weaker. I reviewed how I stopped her consumption of cigarettes altogether when her right side started to collapse. I explained that because of this her hospital and her SNF stays she hasn't smoked for almost four weeks.
"Mom," I said, "you know that I've allowed you to smoke as long as I didn't think it was endangering your life. You know I've even fought the efforts of others to keep you from smoking on their behalf. I've made enemies, short and long term, over this issue. As long as it didn't appear to be a problem for you that we couldn't deal with I defended your right to smoke. But, Mom, things have changed. It is very obvious now from your spectacular recovery that smoking no longer belongs in your life. Do you remember, just before I took you down to Mesa to the hospital, how I was beside myself with anxiety knowing that I had finally reached a point where I could no longer take care of you? How your weakness had confined you to a wheelchair, how you could barely get in and out of it, how I talked to both you and MCS about realizing that it was probably time to enter you into a nursing home because your care needs had advanced beyond my abilities and how I was desolate about this? How I sat before you and apologized to you for having reached my limit and asked you to forgive me for what I was about to do?"
She had been quiet and unusually attentive through everything I said. "Yes," she said, her voice deep with obvious memory and seriousness. "I remember."
"Well, Mom, I never imagined this but, apparently, your extreme decline and weakness was due largely to smoking. As soon as you stopped smoking you revived. Look at you now, Mom. You're improving in all areas, daily by leaps and bounds. You're using significantly less oxygen than you have for months. Your breathing treatments have been cancelled. Your energy level is soaring. Everything about you has improved. Dramatically. I can't, in good conscience, anymore allow you even one more cigarette. Do you understand what I'm saying?"
"Yes. I understand."
"Mom, I don't know what the future holds. I don't know that I'll always be able to care for you. But I do know, now, that if there is something standing in the way of my being able to care for you and getting rid of it will improve our lives and keep you going, I'm obligated to get rid of it."
Then, I talked about the issue I brought up here in this journal some days ago. "Mom, believe me, I've thought a lot about this. You know how people have a tendency to say, 'Ahhh, she's old, she doesn't have much life left, let her do what she wants,'? Well, I used to think that, too, until I began to see that the combination of no movement and smoking was seriously affecting the quality and maybe even the length of your life. I realized that while thinking this may sometimes be legitimate it can often be an insult to the person about whom its being thought. I could say, 'Go ahead, let her smoke, let her stay in bed, let her have her way about refusing to move. She's old. She deserves that right.' But, Mom, you don't deserve that. Letting you do that too much longer would have landed you in a nursing home because the level of care you would require would have been beyond me. If you end up in a nursing home you certainly wouldn't be able to smoke because you would most likely be bedridden so you wouldn't be able to make it out to the smoking area. If you were in very poor health and I knew that your days were numbered in the single digits, maybe I'd let you have a cigarette. But that's not true right now. Do you agree?"
She thought for a minute or so, looking at me with concentration. I could see the gears working slowly, hitting a few rusty spots but working nonetheless. I had no idea where those gears would rest. I wasn't sure what I was going to do or say if she said, "No." While she thought, so did I, preparing myself for the possibility that I would need to accept her decision to continue the decline that we'd stopped over the last few weeks. I worked furiously to gird myself to handle this possibility resolutely without disappointment, knowing that I would be carrying out her wishes.
I cannot describe my relief and elation when she said, soberly, and deliberately, "Yes."
I burst into tears and thanked her. "Mom," I said, "I will do everything within my power to make your decision worth your while. I will do everything I can to increase my strength so that no matter what happens to you I can remain by your side through everything whatever that means."
"I know you will," she said, "you already have."
I sat before her on the floor and sobbed. When I was able to talk again I said, "You know, Mom, I can't foretell the future. Despite my resolve, there may come a time when your care is beyond me and there's no chance of reversal. These last four weeks have taught me this. I'll do everything I can to keep up with your needs, and you know I'm pretty spectacular at rising out of the ashes. But, if it ever happens that I find I can't..." I started groping. I had no idea how to finish this sentence. What would I do?
Mom stepped up to the plate. "Then I'll have a cigarette."
We both laughed. "And I'll buy it for you."
"When was her last dose?" he asked.
I laughed. "Well, yesterday, actually. She walked a little too much at Costco and her lower back was bothering her so I gave her 500 mg before her nap."
"She's not home bound?" the PT asked, clearly surprised.
"Goodness, no," I said. "For the last several months she's been refusing to move much, which has caused her to weaken significantly. This, added to the attacks of a few health problems made it almost impossible for me to get her moving. When she started doing what I call mini-stroking but wasn't, for a little less than a week she couldn't move without collapsing. But, generally, no, she's not home bound. In fact, she's improved so much over the last few weeks at the SNF that I'd be surprised if she ever became home bound."
"Well, then, this appointment ends here," he announced. "Home Health Care is only for the home bound."
"Why in the world, I wonder, did the SNF think she was home bound?!?" I asked of the air. "I can't imagine why anyone thought she was home bound!"
Answers to that question were not forthcoming. Before leaving, the PT was kind enough to give me the name of a PT he thought would suit my mother's profile and told me why the two I'd considered through phone interviews a little over a month ago might be too "dynamic" for my mother right now. From what he told me, I agree. I also explained that the reason why I'd selected these over the others I'd talked to was because they were the only two who didn't make assumptions about lack of ability or potential based on her age. He agreed that this can be a problem and assured me that the PT he mentioned, while gentle, was not about to do this.
Just before he left he mentioned that he could clearly see that I took very good care of my mother and he was glad that I was insisting that she get back into movement and not allow her to become home bound at this point. "When that happens," he said, "it's the beginning of the end."
Immediately after he closed the door Mom and I started a comic riff on the medical community that has surrounded her since early June (I'm including the blood transfusion team because at that time Home Health Care was also recommended but the hospital never followed up on it, leaving that to me, which I didn't do) thinking that she was somehow home bound. I can't imagine that anyone would have gotten this idea from her PCP. He knows better.
To be fair, there are some reasons why the hospital and SNF consulting physicians, who saw my mother for only short periods of time, put 2 + 2 together and came up with 22 instead of 4. They only see her when she is extremely weak. Both times this summer when she'd been admitted to the hospital and the time she'd been admitted to the SNF I mentioned that she has been refusing to move much at all since about late March, early April. Of course, now, as it turns out, besides her natural inertia, there have also been legitimate health conditions that have been lowering her energy level significantly, although, truth be told, at least one of those problems would not have been as much of a problem if she had continued to move, even a little. She is 87 and, I guess, the non-alternative medical community isn't used to seeing an 87 year old with what appears to be deteriorating health who also has dynamic recuperative powers. I do tend to refer to her as "frail" because when she's having significant health problems, she is frail, and when she's in good form she has certain conditions, such as her lack of short term memory, which make her a poor candidate for certain procedures, such as scoping. My mother is, figuratively, of the cat family, as well. If someone tells her to stay in bed she rarely argues (although she did at the SNF). I do believe that if there was a way for my mother to stay in bed without endangering any of her physical abilities and causing no one else any problems she'd grab for it as though it was the gold ring.
However, each and every medical professional involved in my mother's care since June 8th has been well informed, by me, of this website and has been told and directed on paper numerous times that her entire, reliable history resides, in several forms, on this site and that the site can be searched in order to successfully and quickly wade through all the words that might be considered insignificant. As well, I have not been shy about voicing my own determinations regarding my mother's health profile, her spirit, her will and her recuperative powers, although I've also noticed that I am usually politely tolerated then ignored. My mother, though, has surprised almost everyone involved in her care throughout the last few months with her ability to suddenly and resolutely stand and be counted, even when she's been told to stay in bed, especially at the SNF, which, this time, was the medical cooperative that recommended Home Health Care.
I don't know. Bottom line is, it's a mystery to me. Is it possible that the non-alternative medical industry, in general, isn't aware that Home Health Care is for the home bound? Or, is it simply that NO ONE IN THE NON-ALTERNATIVE MEDICAL INDUSTRY LISTENS, NO ONE REALLY OBSERVES AND NO ONE THINKS!?!?!? Yes, I shouted that. Really, really loud. Jesus fucking Christ! How in the world does anyone ever get healed through non-alternative medicine?
Nothing like a little tantrum to make one feel better.
Okay, now on to our day. It was a heavy duty moving day. Immediately after the Home Health Care PT excused himself I headed Mom out to our driveway and set her to some concentrated practice at the proper method of using her walker in order to short circuit the possibility of her compromising her back. After about 45 minutes, which also involved surveying our wild, wild yard and admiring our developing apples and one pear, I settled her inside and we went through all the upper and lower body exercises she's been doing at the facility with her new 1 lb. weights. She worked hard. I was surprised. So was she.
After some lunch and a 2.5 hour nap, which she not only deserved but through which she slept deeply, I gathered her up, jump started her and we went to the grocery to replenish some of the staples that had either spoiled during the last three weeks or through which I'd eaten. Her energy level was astounding. I gave her several chances to sit and relax, or "hang out" while I went looking for an obscure or moved item, but she kept up with me, even as I continually corrected her use of the walker. We spent a good hour in the store (in part because her speed is, well, the speed of an 87 year old who is recovering from extreme physical weakness) but she didn't tire.
I am sure that some of her recovered energy level is due to no longer smoking. We had an accidental run-in over smoking today, my fault. It is my unconscious habit, when I pet The Big Girl, who is a long-haired calico, to pick her shed off my hands and clothes afterwards and reach across the distance between Mom and me and deposit it in her ash tray. I did this without thinking, this afternoon, then, again without thinking, laughed and said, "Oh, yeah, no more cigarettes, no more ash trays! I forgot!"
Immediately I realized my mistake. An almost silent part of Mom's brain suddenly shouted. Her expression turned hard, her eyes glittered and she said, "That's right!" as though she'd located something she'd misplaced a long time ago and for which she'd subconsciously been looking. "May I please have a cigarette." It was not a request.
Oh shit, I thought. "Mom, we don't have any cigarettes."
Again, with an edge. "May I please have a cigarette."
"Mom, really, we don't have any cigarettes. You haven't smoked since about a week before you went into the hospital and all the cigarettes are gone, now."
She glared at me.
"Mom, I'm going to remind you why you're not smoking anymore. I want you to listen carefully to me." I launched into her recent history including how, since her blood transfusion, she'd been on oxygen almost 24 hours a day, had cut her cigarette consumption to no more than 7 cigarettes a day, usually 3 to 5. As the days passed, I explained, I noticed that each time she had a cigarette during this period, just one cigarette, she became significantly weaker. I reviewed how I stopped her consumption of cigarettes altogether when her right side started to collapse. I explained that because of this her hospital and her SNF stays she hasn't smoked for almost four weeks.
"Mom," I said, "you know that I've allowed you to smoke as long as I didn't think it was endangering your life. You know I've even fought the efforts of others to keep you from smoking on their behalf. I've made enemies, short and long term, over this issue. As long as it didn't appear to be a problem for you that we couldn't deal with I defended your right to smoke. But, Mom, things have changed. It is very obvious now from your spectacular recovery that smoking no longer belongs in your life. Do you remember, just before I took you down to Mesa to the hospital, how I was beside myself with anxiety knowing that I had finally reached a point where I could no longer take care of you? How your weakness had confined you to a wheelchair, how you could barely get in and out of it, how I talked to both you and MCS about realizing that it was probably time to enter you into a nursing home because your care needs had advanced beyond my abilities and how I was desolate about this? How I sat before you and apologized to you for having reached my limit and asked you to forgive me for what I was about to do?"
She had been quiet and unusually attentive through everything I said. "Yes," she said, her voice deep with obvious memory and seriousness. "I remember."
"Well, Mom, I never imagined this but, apparently, your extreme decline and weakness was due largely to smoking. As soon as you stopped smoking you revived. Look at you now, Mom. You're improving in all areas, daily by leaps and bounds. You're using significantly less oxygen than you have for months. Your breathing treatments have been cancelled. Your energy level is soaring. Everything about you has improved. Dramatically. I can't, in good conscience, anymore allow you even one more cigarette. Do you understand what I'm saying?"
"Yes. I understand."
"Mom, I don't know what the future holds. I don't know that I'll always be able to care for you. But I do know, now, that if there is something standing in the way of my being able to care for you and getting rid of it will improve our lives and keep you going, I'm obligated to get rid of it."
Then, I talked about the issue I brought up here in this journal some days ago. "Mom, believe me, I've thought a lot about this. You know how people have a tendency to say, 'Ahhh, she's old, she doesn't have much life left, let her do what she wants,'? Well, I used to think that, too, until I began to see that the combination of no movement and smoking was seriously affecting the quality and maybe even the length of your life. I realized that while thinking this may sometimes be legitimate it can often be an insult to the person about whom its being thought. I could say, 'Go ahead, let her smoke, let her stay in bed, let her have her way about refusing to move. She's old. She deserves that right.' But, Mom, you don't deserve that. Letting you do that too much longer would have landed you in a nursing home because the level of care you would require would have been beyond me. If you end up in a nursing home you certainly wouldn't be able to smoke because you would most likely be bedridden so you wouldn't be able to make it out to the smoking area. If you were in very poor health and I knew that your days were numbered in the single digits, maybe I'd let you have a cigarette. But that's not true right now. Do you agree?"
She thought for a minute or so, looking at me with concentration. I could see the gears working slowly, hitting a few rusty spots but working nonetheless. I had no idea where those gears would rest. I wasn't sure what I was going to do or say if she said, "No." While she thought, so did I, preparing myself for the possibility that I would need to accept her decision to continue the decline that we'd stopped over the last few weeks. I worked furiously to gird myself to handle this possibility resolutely without disappointment, knowing that I would be carrying out her wishes.
I cannot describe my relief and elation when she said, soberly, and deliberately, "Yes."
I burst into tears and thanked her. "Mom," I said, "I will do everything within my power to make your decision worth your while. I will do everything I can to increase my strength so that no matter what happens to you I can remain by your side through everything whatever that means."
"I know you will," she said, "you already have."
I sat before her on the floor and sobbed. When I was able to talk again I said, "You know, Mom, I can't foretell the future. Despite my resolve, there may come a time when your care is beyond me and there's no chance of reversal. These last four weeks have taught me this. I'll do everything I can to keep up with your needs, and you know I'm pretty spectacular at rising out of the ashes. But, if it ever happens that I find I can't..." I started groping. I had no idea how to finish this sentence. What would I do?
Mom stepped up to the plate. "Then I'll have a cigarette."
We both laughed. "And I'll buy it for you."
Sunday, August 22, 2004
Well, goodness! Home Health Care contacted me!
Today! On a Sunday! I'm impressed! The guy who called will show up tomorrow between 1045 and 1100 for an evaluation visit of an hour or so. Then, I guess, therapy will be scheduled and begin. In earnest, I hope.
He asked me to have all Mom's medications gathered together so he could record them but, you know me, I've got all that information at the tip of my webbed fingers so I've prepared a complete medication/supplement list and schedule, a recent physical history of my mother as I believe it would relate to therapy, a list of what I think are reasonable goals for therapy and a list of miscellaneous items I think he should know about my mother and me including the existence of this collection of web sites. He'll probably be shocked. I hope he's pleasantly shocked.
My mother had a good day from beginning to end. I need to hit the sack so I'll record her dinner stats tomorrow but suffice it to say, they were good, dinner was Cobb salad, one of her favorites, she's on oxygen in bed, 1/lpm, but was off it most of the day except for our outing. Her skin, which was parched from lack of daily, intense attention at the SNF, is on its way back to normal. I've been wrapping her legs and arms in warm, wet towels for a few minutes before applying lotion in order to bring it back to normal from its current scaly, flaking condition.
Ahh, the dryer just ended its first cycle. Time for me to restart it, cycle up the dishwasher and go to bed.
Later.
He asked me to have all Mom's medications gathered together so he could record them but, you know me, I've got all that information at the tip of my webbed fingers so I've prepared a complete medication/supplement list and schedule, a recent physical history of my mother as I believe it would relate to therapy, a list of what I think are reasonable goals for therapy and a list of miscellaneous items I think he should know about my mother and me including the existence of this collection of web sites. He'll probably be shocked. I hope he's pleasantly shocked.
My mother had a good day from beginning to end. I need to hit the sack so I'll record her dinner stats tomorrow but suffice it to say, they were good, dinner was Cobb salad, one of her favorites, she's on oxygen in bed, 1/lpm, but was off it most of the day except for our outing. Her skin, which was parched from lack of daily, intense attention at the SNF, is on its way back to normal. I've been wrapping her legs and arms in warm, wet towels for a few minutes before applying lotion in order to bring it back to normal from its current scaly, flaking condition.
Ahh, the dryer just ended its first cycle. Time for me to restart it, cycle up the dishwasher and go to bed.
Later.
Insulin discussed.
The one subject I haven't fully discussed is how I've decided to manage insulin administration with my mother. Today's high blood glucose reading at lunch gave me a dual opportunity to make observations regarding some off-the-cuff information handed me yesterday and finalize decisions about how I plan to use insulin with my mother, if at all. Click on the informal link above, if you're interested. If you are a caregiver for an elderly person who developed type 2 diabetes late in life you should read the discussion. You should also search this site and companion sites like the the archive and the tests and meds section.
I'm statting, again.
As of today. I caught up on today's meals and meds. I also included a rundown of her new med schedule. I did not, within the rundown, address her insulin coverage. For the time being I'm going to follow the 3 neurologists' directions and not administer insulin unless her blood glucose goes over 200. It went pretty high between breakfast and lunch today because, on her own, she settled herself at the Cheetos sampling table at Costco and downed several sample cups before I discovered her whereabouts. She only soared to 173, though. Although I picked up the insulin, today I didn't administer any even though the SNF recommended and followed insulin administration from 151 on.
We've got an issue to work on regarding her walkering. She walkered a lot today of her own accord. This wasn't a problem. The problem was that she is having trouble remembering to stay close to her walker unless I constantly remind her, half-minute by half-minute. This caused some discomfort in her lower back. I decided that tomorrow we're going to practice walkering very slowly, step by step, working on developing her the habit of staying close to the walker.
Other than this, things are going well. She's napping, now, and asked me to awaken her "between 1700 and 1730", which means 1730. I will. She's eating good, drinking well completely on her own, and continuing very good bladder control. I am anticipating that the only time she'll need to wear more than one pair of paper underwear at a time is when she's sleeping. As well, it's possible that we'll be able to go back to her wearing pads within regular underwear during the day when she's up, which will delight her no end.
I'm feeling good. She's feeling good. The Little Girl is no longer howling for her. Days are beginning at a reasonable time and, I expect, will end at a reasonable time, as well, for her, anyway. This is like a dream come true.
Later.
We've got an issue to work on regarding her walkering. She walkered a lot today of her own accord. This wasn't a problem. The problem was that she is having trouble remembering to stay close to her walker unless I constantly remind her, half-minute by half-minute. This caused some discomfort in her lower back. I decided that tomorrow we're going to practice walkering very slowly, step by step, working on developing her the habit of staying close to the walker.
Other than this, things are going well. She's napping, now, and asked me to awaken her "between 1700 and 1730", which means 1730. I will. She's eating good, drinking well completely on her own, and continuing very good bladder control. I am anticipating that the only time she'll need to wear more than one pair of paper underwear at a time is when she's sleeping. As well, it's possible that we'll be able to go back to her wearing pads within regular underwear during the day when she's up, which will delight her no end.
I'm feeling good. She's feeling good. The Little Girl is no longer howling for her. Days are beginning at a reasonable time and, I expect, will end at a reasonable time, as well, for her, anyway. This is like a dream come true.
Later.
Our home is back to normal with a twist...
This part started August 21, 2004, about 2330
...the twist being my mother's much improved physical, emotional and intellectual health. It's possible that her spiritual health and her will are improved, too, but I never noticed a drop in either of those.
It was a very good day for the wine of spirit. My trip down the mountain was uncluttered and fast. I felt very good, despite getting only about 4 hours sleep. I still feel top notch. As I drove the decline, winding through what were, centuries ago, the weave of continental drifts down to the abyss that is now The Valley of the Sun, I felt very proud about what Mom and I have accomplished over the last three weeks and realized that "the secret" to life and to a feeling of personal success in this world is to claim both life and the world as one's own then bury one's arms in it as far as one can reach, then reach further and go to it.
When I arrived at the nursing home Mom was reluctant to arise so several of the staff and her roommate joined me in joking and cajoling her out of bed. Her roommate reported to me that yesterday Mom spent very little time in a prone position after her therapy sessions, preferring to sit on the edge of the bed, gaze out the window and discuss life through the symbology of noticing and commenting on what lay beyond the window frame.
We left exactly on time. I checked my watch as we exited the breeze way of the SNF: 1100 on the dot. She had walkered herself to the car. Even though one of her favorite CNAs offered to help her into the car she refused, insisting on negotiating the low sedan seat on her own. I, however, needed help figuring out how to stow the walker in a back seat loaded with her possessions.
We had a wonderful visit at MPS's home. We ordered Filipino food, something we all love and hadn't had for ages. Mom ate heartily, including a can of V-8 juice and a dessert of German Chocolate Brownies. Left to her own sense of thirst, which seems to have returned she drank exactly enough throughout the day to keep her well but not overly hydrated. After dinner she spent almost a half hour emptying her bowels and fairly danced to the car.
Before we left MPBIL provided me with the name of a long time medical activist with whom he is very familiar in Prescott who he said would be able to answer all my questions about the veracity of the information the ER doctor up here offered me during his July 30th extemporaneous lecture on Medicare in rural communities.
Our trip up the mountain this afternoon was quiet. Both of us surveyed the scenery as if in a dream, a very good dream that promised an excellent awakening. When we arrived home and emerged from the car we were both stiff from sitting so long so I showed Mom a trick my body taught me a long time ago: Shaking stiffness out from the hips and continuing through the legs and lower back. I don't know why I'd never shown her this. When I described and demonstrated it she didn't really believe it would work for her. "I'm too old for that," she protested. Then, holding onto my arms, she wiggled and rotated her hips, looked up at me in surprise and said, "My goodness, that works! I wonder what the neighbors think we're doing out here!"
"I'm sure it looks plenty suspicious," I said.
She laughed. "Good! It'll give them something to talk about tonight."
"Yeah," I agreed. "That old woman and her strange daughter doing the hootchy kootchy together in their driveway! That'll provide everyone fodder for at least a week!"
MFS had sent a roll of Hickory Farms honey cured, sliced ham steaks to Mom for her birthday which, through a variety of company-side order errors, all of which could be considered good luck, didn't arrive until yesterday. On the way up we planned a dinner of hard-over eggs Benedict with my luscious, lemony Hollandaise sauce. During the evening she moved about the house under her own steam and went to the bathroom a couple of times with only slight suggestion from me. I noticed that she was managing to control her bladder so well that her paper underwear did not need changing until bedtime and then only as a matter of course; I refuse to send her to bed in anything but clean underwear. I'm now thinking that allowing her, under good circumstances, to determine and administer her hydration needs herself probably is the secret to bladder control for her and that I may have accidentally been not only over hydrating her but short-circuiting her bladder's ability to control itself during my months of anxious water torture.
We settled in to watch the movie Hidalgo. It reminded my mother of the "Indiana Jones" series which she followed with great enthusiasm. She refused to believe it was based on reality until noticing the printed epilogues at the end of the film.
Although I found the film engaging, I was transported into a curious reverie by the bits of Middle Eastern singing and chanting throughout the film. As I was captivated by the foreign beauty of the vocalizations I found myself considering that tending to my mother in her Ancient years has been and continues to be like listening to music created on a scale to which I am unaccustomed, sung in a language of which I have no understanding, engaged by it's mystery and beauty and learning both the music and the poetry, first phonetically, notationally and rhythmically, then technically, then emotionally and finally spiritually. I'm not sure where I am at this point in the learning process. I do know I've always had a fondness for languages not native to my tongue and brain and have sought them out. Doing what I am doing with my mother, I realized, puts me in my element.
I've decided to publish the contents of my mother's official release papers from the SNF:
INTERDISCIPLINARY DISCHARGE
RECAPITULATION OF RESIDENT'S STAY:
ADMISSION DATE: 8/5/04
REASON FOR ADMISSION: TIA, hyponatremia, NIDDM, COPD, VTI, anemia
TREATMENT PROVIDED: Physical & occupational therapy, insulin coverage for DM, fluid restriction monitoring, pain management, antibiotic therapy
PROGRESS (include any complications experienced): Improvement in strength & endurance
DISCHARGE DATE: 8/21/04
FINAL SUMMARY OF RESIDENT'S STATUS:
SOCIAL SERVICES:
SENSORY IMPAIRMENT: Ambulatory via walker
MENTAL AND PSYCHOSOCIAL STATUS: stable
ABLE TO MAKE NEEDS KNOWN: Yes
ATTITUDE ABOUT DISCHARGE (describe): Looking forward to going home
COGNITIVE STATUS: Patient is alert and oriented, daughter Gail is very supportive
DISCHARGE POTENTIAL: Good home with daughter in Prescott
NURSING SERVICES:
VITAL SIGNS AT TIME OF DISCHARGE: TEMP: 98.7 Pulse: 68 Pulse: 68 Resp: 18 BP: 110/64
PHYSICAL FUNCTIONING STATUS: Ambulatory Assistive Devices Needed: W/C & FWW
DISCHARGE TREATMENTS OR PROCEDURES: None
DENTAL CONDITION: Own teeth
DRUG THERAPY REQUIRED: See below
DIETARY SERVICES:
PHYSICAL STATS: WEIGHT: 128 HEIGHT: 5'3" WEIGHT TRENDS: None CHEWING PROBLEMS: No SWALLOWING PROBLEMS: No NEEDS ASSIST (Specify): Independent
EATING HABITS/PREFERENCES: Adhere to therapeutic diet related to diabetes. Recommend extra fluids with seasonal heat.
DIET ORDER: Diabetic - Liberal
TEXTURE: Regular
ALLERGIES: None Known
ACTIVITIES:
ACTIVITY PURSUIT: Please continue to do activities at home that you enjoy. You have the potential to pursue as tolerated.
REHAB SERVICES:
REHABILITATION POTENTIAL: Continue to walk frequently - stay close to your walker and turn with it, not without it. Continue your arm and leg exercises.
ASSISTIVE DEVICES: FWW
DRUG THERAPY:
GENERAL INSTRUCTIONS: Accuchecks before meals and at bedtime
Sliding scale regular insulin coverage:
0 - 60 = orange juice
61 - 150 = 0 units
151 - 200 = 2 units
201 - 250 = 4 units
251 - 300 = 6 units
301 - 350 = 8 units
351 - 400 = 10 units
>400 = 12 units and call MD
HOME DISCHARGE INSTRUCTIONS:
DISCHARGING FACILITY: Skilled Nursing Facility
DISCHARGED TO: Home with daughter
ALLERGIES: Sulfa, Prednisone
SKIN CONDITION: Intact
NURSING SPECIAL INSTRUCTIONS:
1) Home Health PT for safety evaluation and treatment
2) Follow-up with PCP in 1-2 weeks
MEDICATIONS (In layman's terms - no abbreviations):
1) Aspirin 162 mg daily/a.m.
2) Glipizide 10 mg twice daily/a.m & p.m.
3) Protonix 40 mg daily/a.m.
4) Lisinopril 2.5 mg twice daily/a.m. & p.m.
5) Niferex 150 mg daily/a.m.
6) Vitamin D/Calcium 200/600 twice daily/a.m. & p.m.
7) IronSorb Dosage as needed twice daily/noon & p.m.
I did not include identification information of the facility and staff, nor did I include, under "MEDICATIONS" the time of the last dose given. As a note to readers who may be unfamiliar with PT jargon, "FWW" is an abbreviation for free weights.
I didn't finish copying the chart over until this morning. It is a little after 0900. She's still sleeping. I'm giving her until 0930, in part to make sure she gets a good rest and in part to allow the hot water to complete its heating cycle so there will be plenty of hot water for her bath. She lifted her head once around 0800, groaned and asked for "a little more time", which I had no problem granting her considering the late hour at which she retired and the fact that she ran through yesterday at top speed without a nap.
Everyone is much more relaxed here. The Big Girl even reacted to Mom's return by rolling around on the floor in a kind of joy I've rarely seen her express. The Little Girl talked and talked and talked to Mom all evening. I joked with Mom that she was probably telling her that she had been afraid that I'd somehow disposed of Mom and she was afraid they'd be next. As is usual when we're all at home and fine, The Big Girl snugged in with me last night when I retired and The Little Girl snugged in with Mom when she retired, joining The Big Girl and me later when Mom began soaking the bed.
I've noticed this morning,that she hasn't shed nearly as much as usual, which is good, although the amount is significant enough to where I'll need to wash all her bed clothes this morning. I'm expecting progress in this area since her daily liquid level, following her own preferences, will be much reduced.
Although I'm not going to push a lot of activity today, we are going to practice her exercises and do some sort of outing, although I haven't yet decided where we'll go.
I slept very well last night, awoke before I expected, forgot to take ibuprofen last night and realized when I arose I hadn't needed it. I'm satisfied that my tension is quickly draining away.
I'll be calling Home Health this week to set up an evaluation for out-patient physical therapy. I'm going to wait until a week before our scheduled appointment with her PCP on September 8th to have blood drawn for her monthly CBC and the battery of tests requested by her hematologist.
Life is normal again and good. I'm looking forward to more activity in our very near future.
Later.
...the twist being my mother's much improved physical, emotional and intellectual health. It's possible that her spiritual health and her will are improved, too, but I never noticed a drop in either of those.
It was a very good day for the wine of spirit. My trip down the mountain was uncluttered and fast. I felt very good, despite getting only about 4 hours sleep. I still feel top notch. As I drove the decline, winding through what were, centuries ago, the weave of continental drifts down to the abyss that is now The Valley of the Sun, I felt very proud about what Mom and I have accomplished over the last three weeks and realized that "the secret" to life and to a feeling of personal success in this world is to claim both life and the world as one's own then bury one's arms in it as far as one can reach, then reach further and go to it.
When I arrived at the nursing home Mom was reluctant to arise so several of the staff and her roommate joined me in joking and cajoling her out of bed. Her roommate reported to me that yesterday Mom spent very little time in a prone position after her therapy sessions, preferring to sit on the edge of the bed, gaze out the window and discuss life through the symbology of noticing and commenting on what lay beyond the window frame.
We left exactly on time. I checked my watch as we exited the breeze way of the SNF: 1100 on the dot. She had walkered herself to the car. Even though one of her favorite CNAs offered to help her into the car she refused, insisting on negotiating the low sedan seat on her own. I, however, needed help figuring out how to stow the walker in a back seat loaded with her possessions.
We had a wonderful visit at MPS's home. We ordered Filipino food, something we all love and hadn't had for ages. Mom ate heartily, including a can of V-8 juice and a dessert of German Chocolate Brownies. Left to her own sense of thirst, which seems to have returned she drank exactly enough throughout the day to keep her well but not overly hydrated. After dinner she spent almost a half hour emptying her bowels and fairly danced to the car.
Before we left MPBIL provided me with the name of a long time medical activist with whom he is very familiar in Prescott who he said would be able to answer all my questions about the veracity of the information the ER doctor up here offered me during his July 30th extemporaneous lecture on Medicare in rural communities.
Our trip up the mountain this afternoon was quiet. Both of us surveyed the scenery as if in a dream, a very good dream that promised an excellent awakening. When we arrived home and emerged from the car we were both stiff from sitting so long so I showed Mom a trick my body taught me a long time ago: Shaking stiffness out from the hips and continuing through the legs and lower back. I don't know why I'd never shown her this. When I described and demonstrated it she didn't really believe it would work for her. "I'm too old for that," she protested. Then, holding onto my arms, she wiggled and rotated her hips, looked up at me in surprise and said, "My goodness, that works! I wonder what the neighbors think we're doing out here!"
"I'm sure it looks plenty suspicious," I said.
She laughed. "Good! It'll give them something to talk about tonight."
"Yeah," I agreed. "That old woman and her strange daughter doing the hootchy kootchy together in their driveway! That'll provide everyone fodder for at least a week!"
MFS had sent a roll of Hickory Farms honey cured, sliced ham steaks to Mom for her birthday which, through a variety of company-side order errors, all of which could be considered good luck, didn't arrive until yesterday. On the way up we planned a dinner of hard-over eggs Benedict with my luscious, lemony Hollandaise sauce. During the evening she moved about the house under her own steam and went to the bathroom a couple of times with only slight suggestion from me. I noticed that she was managing to control her bladder so well that her paper underwear did not need changing until bedtime and then only as a matter of course; I refuse to send her to bed in anything but clean underwear. I'm now thinking that allowing her, under good circumstances, to determine and administer her hydration needs herself probably is the secret to bladder control for her and that I may have accidentally been not only over hydrating her but short-circuiting her bladder's ability to control itself during my months of anxious water torture.
We settled in to watch the movie Hidalgo. It reminded my mother of the "Indiana Jones" series which she followed with great enthusiasm. She refused to believe it was based on reality until noticing the printed epilogues at the end of the film.
Although I found the film engaging, I was transported into a curious reverie by the bits of Middle Eastern singing and chanting throughout the film. As I was captivated by the foreign beauty of the vocalizations I found myself considering that tending to my mother in her Ancient years has been and continues to be like listening to music created on a scale to which I am unaccustomed, sung in a language of which I have no understanding, engaged by it's mystery and beauty and learning both the music and the poetry, first phonetically, notationally and rhythmically, then technically, then emotionally and finally spiritually. I'm not sure where I am at this point in the learning process. I do know I've always had a fondness for languages not native to my tongue and brain and have sought them out. Doing what I am doing with my mother, I realized, puts me in my element.
I've decided to publish the contents of my mother's official release papers from the SNF:
INTERDISCIPLINARY DISCHARGE
RECAPITULATION OF RESIDENT'S STAY:
ADMISSION DATE: 8/5/04
REASON FOR ADMISSION: TIA, hyponatremia, NIDDM, COPD, VTI, anemia
TREATMENT PROVIDED: Physical & occupational therapy, insulin coverage for DM, fluid restriction monitoring, pain management, antibiotic therapy
PROGRESS (include any complications experienced): Improvement in strength & endurance
DISCHARGE DATE: 8/21/04
FINAL SUMMARY OF RESIDENT'S STATUS:
SOCIAL SERVICES:
SENSORY IMPAIRMENT: Ambulatory via walker
MENTAL AND PSYCHOSOCIAL STATUS: stable
ABLE TO MAKE NEEDS KNOWN: Yes
ATTITUDE ABOUT DISCHARGE (describe): Looking forward to going home
COGNITIVE STATUS: Patient is alert and oriented, daughter Gail is very supportive
DISCHARGE POTENTIAL: Good home with daughter in Prescott
NURSING SERVICES:
VITAL SIGNS AT TIME OF DISCHARGE: TEMP: 98.7 Pulse: 68 Pulse: 68 Resp: 18 BP: 110/64
PHYSICAL FUNCTIONING STATUS: Ambulatory Assistive Devices Needed: W/C & FWW
DISCHARGE TREATMENTS OR PROCEDURES: None
DENTAL CONDITION: Own teeth
DRUG THERAPY REQUIRED: See below
DIETARY SERVICES:
PHYSICAL STATS: WEIGHT: 128 HEIGHT: 5'3" WEIGHT TRENDS: None CHEWING PROBLEMS: No SWALLOWING PROBLEMS: No NEEDS ASSIST (Specify): Independent
EATING HABITS/PREFERENCES: Adhere to therapeutic diet related to diabetes. Recommend extra fluids with seasonal heat.
DIET ORDER: Diabetic - Liberal
TEXTURE: Regular
ALLERGIES: None Known
ACTIVITIES:
ACTIVITY PURSUIT: Please continue to do activities at home that you enjoy. You have the potential to pursue as tolerated.
REHAB SERVICES:
REHABILITATION POTENTIAL: Continue to walk frequently - stay close to your walker and turn with it, not without it. Continue your arm and leg exercises.
ASSISTIVE DEVICES: FWW
DRUG THERAPY:
GENERAL INSTRUCTIONS: Accuchecks before meals and at bedtime
Sliding scale regular insulin coverage:
0 - 60 = orange juice
61 - 150 = 0 units
151 - 200 = 2 units
201 - 250 = 4 units
251 - 300 = 6 units
301 - 350 = 8 units
351 - 400 = 10 units
>400 = 12 units and call MD
HOME DISCHARGE INSTRUCTIONS:
DISCHARGING FACILITY: Skilled Nursing Facility
DISCHARGED TO: Home with daughter
ALLERGIES: Sulfa, Prednisone
SKIN CONDITION: Intact
NURSING SPECIAL INSTRUCTIONS:
1) Home Health PT for safety evaluation and treatment
2) Follow-up with PCP in 1-2 weeks
MEDICATIONS (In layman's terms - no abbreviations):
1) Aspirin 162 mg daily/a.m.
2) Glipizide 10 mg twice daily/a.m & p.m.
3) Protonix 40 mg daily/a.m.
4) Lisinopril 2.5 mg twice daily/a.m. & p.m.
5) Niferex 150 mg daily/a.m.
6) Vitamin D/Calcium 200/600 twice daily/a.m. & p.m.
7) IronSorb Dosage as needed twice daily/noon & p.m.
I did not include identification information of the facility and staff, nor did I include, under "MEDICATIONS" the time of the last dose given. As a note to readers who may be unfamiliar with PT jargon, "FWW" is an abbreviation for free weights.
I didn't finish copying the chart over until this morning. It is a little after 0900. She's still sleeping. I'm giving her until 0930, in part to make sure she gets a good rest and in part to allow the hot water to complete its heating cycle so there will be plenty of hot water for her bath. She lifted her head once around 0800, groaned and asked for "a little more time", which I had no problem granting her considering the late hour at which she retired and the fact that she ran through yesterday at top speed without a nap.
Everyone is much more relaxed here. The Big Girl even reacted to Mom's return by rolling around on the floor in a kind of joy I've rarely seen her express. The Little Girl talked and talked and talked to Mom all evening. I joked with Mom that she was probably telling her that she had been afraid that I'd somehow disposed of Mom and she was afraid they'd be next. As is usual when we're all at home and fine, The Big Girl snugged in with me last night when I retired and The Little Girl snugged in with Mom when she retired, joining The Big Girl and me later when Mom began soaking the bed.
I've noticed this morning,that she hasn't shed nearly as much as usual, which is good, although the amount is significant enough to where I'll need to wash all her bed clothes this morning. I'm expecting progress in this area since her daily liquid level, following her own preferences, will be much reduced.
Although I'm not going to push a lot of activity today, we are going to practice her exercises and do some sort of outing, although I haven't yet decided where we'll go.
I slept very well last night, awoke before I expected, forgot to take ibuprofen last night and realized when I arose I hadn't needed it. I'm satisfied that my tension is quickly draining away.
I'll be calling Home Health this week to set up an evaluation for out-patient physical therapy. I'm going to wait until a week before our scheduled appointment with her PCP on September 8th to have blood drawn for her monthly CBC and the battery of tests requested by her hematologist.
Life is normal again and good. I'm looking forward to more activity in our very near future.
Later.
