Wednesday, April 5, 2006
The Dailies for yesterday...
...detailed, are over at Mom & Me Tests & Meds, the immediately previous being a direct link to the particular post. I discuss several things, including her smoking yesterday, at that post, in case you're interested.
I am going to go away and publish this much now, and will begin the rest of what will probably be a lengthy post, or a series of posts, uno momento.
A little bit later. Back here.
...and a good time was had by all
One of the reasons these trips are good for me, however much I half dread them, now, is that her doctor and our friends remind me of Mom's strengths, allowing me to polish my appreciation of them. Because I have to be on the lookout to help her negotiate her weaknesses, I tend to elevate those; although I am not oblivious to her strengths. I simply tend to give them less credit when I'm negotiating her weaknesses. I knew that no matter how long she'd been mostly sedentary and sleeping a lot she still has it in her to mobilize for a trip, to the Valley, to anywhere, probably, although an extended "thing" would be a challenge for her.
Hold on. I think I hear her coughing. Although I doubt it, she may be ready to awaken...
...later.
That was Mom...
....who has since fallen back to sleep. Hell. It's only 1000.
I decided to administer her awakening pills, including her glipizide, which is usually given at breakfast just before her food. I'll bet, as I write, her blood glucose, if below 200, is just below 200, although I could be wrong. For all her eating, only about half was starch and some of that starch was complex carbohydrates. She ate a very good amount of meat. And, much to my surprise, vegetables. At her request. She ate everything slowly and thoroughly and, working it out, I guess she ate a little about every three hours and then a lot at around 1730-1800 at the restaurant. She also had a full 16 oz of lemonade with sugar and raspberry syrup. No desserts, though. We were gifted with a pound of a See's Candy selection and a pound can of their version of Almond Roca. She was too busy with cigarettes to be bothered, though. Depending on how her blood glucose looks, I may introduce one or both of the candy selections tonight. Since she broke herself of the chocolate habit she no longer tends to gorge.
Medically Speaking:
Her PCP was much more concerned about her low hemoglobin than me. Although she's seen the low 9's before, he was, once again, shaking his head apologetically and suggesting scoping, even noting from the file by name (impressive) Mom's colonoscopist. I had to remind him, only once though, of this very same woman's final disposition on the subject of scoping Mom, no way, not again. Imaging only.
He was provisionally taken to task. We'd already discussed the Niferex 150 Forte by prescription, which he approved. In the face of me denying scoping, he recommended a third dose of the OTC version without extra Folic Acid and B12, although he said not to worry about overdoses with those supplements. His words folks. For the time being I'm going to take it, although I will, later, look it up.
He took blood for yet another CBC, as well as a BMP (I could tell by the color of the tube top) and a round of iron-deficiency anemia tests.
He was pleased with her blood sugars and blood pressures, said specifically with enthusiastic gestures, "You're doing fine. I'm very pleased. Keep doing what you're doing." He advised me not to up her lisinopril at this time. Said that "one to two pills/day" of the glipizide, discretion being the better part of valor, was fine. We discussed, briefly, exenatide. By this time he had responded to my mention of it and had begun to shake his head when, to his mild surprise, I guess, I told him I agreed with him. Too little is known about its affect on Lightly Challenged Kidneys. It is well known, he confirmed, that glipizide has a great track record with Ancients in Early Chronic Renal Failure.
He also disavowed me of my carefully, inaccurately thought out connection between her low HA1c (although he agreed that it was probably not related to overall glucose levels) and a probable low Erythropoeitin. He said if this were happening it is caused by kidneys in much worse shape than Mom's: Her Creatinine would consistently be "around 2.0". So Mom remains at a plateau in regard to her kidneys. It's those little things, those third and fourth, etc., connections that you miss if you haven't gone to medical school. But, even with as little knowledge as I possess I realized he was right and internally scolded myself for not automatically looking for other connections to narrow the field. I, you see, didn't know enough to realize "the river is wide" with many tributaries.
He is concerned enough about her current low state of anemia to impress upon me the importance of having another CBC/BMP done at the end of the month, even though he was drawing for these tests, as well. He also suggested, depending on how the next two weeks go, that I consider scheduling her for early August for a "routine" follow-up, but stressed to wait on CBC/BMP results at the end of the month for a final decision, thus, I assume this means if she looks like she's recovering and tolerating the extra iron, schedule her for five instead of four months ahead: September. Mom and I would prefer a September trip, although MCF, whose birthday falls the day before my mother's, confirmed that she'd be ripe for celebration either of those days in August if a quarterly seems in order. We've also been invited for 4th of July at MCF's sister's and a birthday party a month later doesn't seem half bad. We tolerated this trip very well, both of us, I stress.
Speaking of which, yes, there was repetition, primarily reminding of proper breathing technique, and or reminding her that smoking was not to commence for a varying number of hours, but not nearly as much. I am pleased to say I didn't get touchy about it until late evening, at home, when, as her brain tried to accomplish a somewhat retarded quick switch of milieus and people, added to that negotiating mild smoking, and lots of moving, and lots of oxygen, when she entered The Dead Zone adamantly.
Whoa. It began when she started searching the house for "Mother", her mother.
My initial reaction? "No. No m'am. We are not going to play in The Dead Zone tonight." I caught up with her, turned her to face me, my hands on her shoulders, came with a couple of inches of her face and said, "Believe me. Just trust me on this. You'll remember it all tomorrow. You're tired. Your brain has been jogged. You know all this. It will come back to you. You're very tired. You're fogged with carbon monoxide. Give it a rest."
However, I softened while rubbing her legs down and we did, once again, have an extended personal history legend, supplemented with a short lecture on, "The State and Mechanics of Your Memory (Inclusive)", which she only partially absorbed. She tends not to think of herself as demented, even at her demented "best", and her awareness of herself and her immediate environment remains acute, although sometimes confused, in or out of her typical Dementia Daze. When at one end of the spectrum, though, (and it is a Spectrum Illness) she has no memory of The Other Spectral End.
I was not annoyed last night, though. I'm not sure why. Could just be a different part of the cycle.
So, her meds have experienced only one change, which I'll try to get around to updating today:
Impressions
Mom continues to do well. She's slowing but apparently a lot less than I perceive, especially when she is determined and on stage, so to speak, for an audience of More than Me. Good omen for a few more years.
Over the last few days prior to her appointment, in the evening two days before when she was remembering, with appreciation and amazement, her chronological age, I playfully asked Mom if she thought she had 100 in her.
"No, I don't think so. Maybe 95. Maybe." Very matter-of-fact.
The evening after, when my perception was that she felt "worse" (stiffer, slower, more apt to complain and nitpick and try to get out of moving) than the previous evening, when she was preparing for bed and as I unfastened her bra she expelled a groan of relief, I asked again: "So, I'll bet you feel like you've barely got 90 in you, tonight."
She thought about it. "Oh, much more."
"100?" I prompted.
She didn't answer, "Oh. At least," as she often does. She said, "That sounds good."
I quickly calculated that in her 100th year I'd be 65. I didn't shudder, although I had a realistic jolt of reaction to the care contingencies a decade from now. Not unpleasant, though.
Earlier in the evening, after dinner, while I was repacking our Ford mid size van, a long time friend of MCF's sister golf-carted into the driveway. We recognized each other. He had heard of me probably as much as I'd heard about him, which is a fair amount and we met some years ago before MCF's father died. He was very curious how I was doing in my role as caregiver to my mother, considering how long I've been doing it. He had specific observations regarding the nature of caregiving for the elderly. I launched into a fairly detailed explanation of the social nature and value of what I do and what this might say about me. At times during the conversation he matter-of-factly referred to me as "courageous". I noticed that I was not uncomfortable having courage ascribed to me on behalf of my journey with my mother. I did, though, insist on explicitly defining my acts of courage and, while not disavowing their courageous character, also stressed that everyday courageous acts are no longer indications of courage by dint of their frequency, however admirable they seem. In my oral apologia I stressed some specific personal rewards:
The day before, when the oxygen guy came by to check our concentrator, he took note of my carefully casual attendance on Mom and commented, as I mentioned in a recent post (Monday, April 3rd), "You take awfully good care of her. Was she a good Mom?"
I answered simply, "Oh yeah."
"How so?" he asked.
I enumerated her Animal Mom traits.
He listened. He continued to assert that she is lucky, deserving or not.
Later that day I got to thinking about care "deserved", especially in one's Ancient years. I've met up with, and can understand, the attitude that a parent was not a good parent, they can rot in State Assisted Care Hell:
What I'm doing? It is not easy and it was only vaguely planned. My mother and I share a decidedly optimistic outlook: Hers is pure, my outlook is half hers and half a caustic foreboding, sometimes depressive, from my dad. She is a good influence on me because I am also absorbent and have a mime-like tendency to subtly imitate people with whom I'm engaged, allowing my internals to be influenced by them; a form of empathy. Occasionally my somber desperation breaks through but mostly her pull on my brighter side wins out, especially when she is not too dull and I am not too environmentally challenged with duck-biting tasks.
By the Way's:
More.
Later.
I am going to go away and publish this much now, and will begin the rest of what will probably be a lengthy post, or a series of posts, uno momento.
A little bit later. Back here.
...and a good time was had by all
One of the reasons these trips are good for me, however much I half dread them, now, is that her doctor and our friends remind me of Mom's strengths, allowing me to polish my appreciation of them. Because I have to be on the lookout to help her negotiate her weaknesses, I tend to elevate those; although I am not oblivious to her strengths. I simply tend to give them less credit when I'm negotiating her weaknesses. I knew that no matter how long she'd been mostly sedentary and sleeping a lot she still has it in her to mobilize for a trip, to the Valley, to anywhere, probably, although an extended "thing" would be a challenge for her.
Hold on. I think I hear her coughing. Although I doubt it, she may be ready to awaken...
...later.
That was Mom...
....who has since fallen back to sleep. Hell. It's only 1000.
I decided to administer her awakening pills, including her glipizide, which is usually given at breakfast just before her food. I'll bet, as I write, her blood glucose, if below 200, is just below 200, although I could be wrong. For all her eating, only about half was starch and some of that starch was complex carbohydrates. She ate a very good amount of meat. And, much to my surprise, vegetables. At her request. She ate everything slowly and thoroughly and, working it out, I guess she ate a little about every three hours and then a lot at around 1730-1800 at the restaurant. She also had a full 16 oz of lemonade with sugar and raspberry syrup. No desserts, though. We were gifted with a pound of a See's Candy selection and a pound can of their version of Almond Roca. She was too busy with cigarettes to be bothered, though. Depending on how her blood glucose looks, I may introduce one or both of the candy selections tonight. Since she broke herself of the chocolate habit she no longer tends to gorge.
Medically Speaking:
Her PCP was much more concerned about her low hemoglobin than me. Although she's seen the low 9's before, he was, once again, shaking his head apologetically and suggesting scoping, even noting from the file by name (impressive) Mom's colonoscopist. I had to remind him, only once though, of this very same woman's final disposition on the subject of scoping Mom, no way, not again. Imaging only.
He was provisionally taken to task. We'd already discussed the Niferex 150 Forte by prescription, which he approved. In the face of me denying scoping, he recommended a third dose of the OTC version without extra Folic Acid and B12, although he said not to worry about overdoses with those supplements. His words folks. For the time being I'm going to take it, although I will, later, look it up.
He took blood for yet another CBC, as well as a BMP (I could tell by the color of the tube top) and a round of iron-deficiency anemia tests.
He was pleased with her blood sugars and blood pressures, said specifically with enthusiastic gestures, "You're doing fine. I'm very pleased. Keep doing what you're doing." He advised me not to up her lisinopril at this time. Said that "one to two pills/day" of the glipizide, discretion being the better part of valor, was fine. We discussed, briefly, exenatide. By this time he had responded to my mention of it and had begun to shake his head when, to his mild surprise, I guess, I told him I agreed with him. Too little is known about its affect on Lightly Challenged Kidneys. It is well known, he confirmed, that glipizide has a great track record with Ancients in Early Chronic Renal Failure.
He also disavowed me of my carefully, inaccurately thought out connection between her low HA1c (although he agreed that it was probably not related to overall glucose levels) and a probable low Erythropoeitin. He said if this were happening it is caused by kidneys in much worse shape than Mom's: Her Creatinine would consistently be "around 2.0". So Mom remains at a plateau in regard to her kidneys. It's those little things, those third and fourth, etc., connections that you miss if you haven't gone to medical school. But, even with as little knowledge as I possess I realized he was right and internally scolded myself for not automatically looking for other connections to narrow the field. I, you see, didn't know enough to realize "the river is wide" with many tributaries.
He is concerned enough about her current low state of anemia to impress upon me the importance of having another CBC/BMP done at the end of the month, even though he was drawing for these tests, as well. He also suggested, depending on how the next two weeks go, that I consider scheduling her for early August for a "routine" follow-up, but stressed to wait on CBC/BMP results at the end of the month for a final decision, thus, I assume this means if she looks like she's recovering and tolerating the extra iron, schedule her for five instead of four months ahead: September. Mom and I would prefer a September trip, although MCF, whose birthday falls the day before my mother's, confirmed that she'd be ripe for celebration either of those days in August if a quarterly seems in order. We've also been invited for 4th of July at MCF's sister's and a birthday party a month later doesn't seem half bad. We tolerated this trip very well, both of us, I stress.
Speaking of which, yes, there was repetition, primarily reminding of proper breathing technique, and or reminding her that smoking was not to commence for a varying number of hours, but not nearly as much. I am pleased to say I didn't get touchy about it until late evening, at home, when, as her brain tried to accomplish a somewhat retarded quick switch of milieus and people, added to that negotiating mild smoking, and lots of moving, and lots of oxygen, when she entered The Dead Zone adamantly.
Whoa. It began when she started searching the house for "Mother", her mother.
My initial reaction? "No. No m'am. We are not going to play in The Dead Zone tonight." I caught up with her, turned her to face me, my hands on her shoulders, came with a couple of inches of her face and said, "Believe me. Just trust me on this. You'll remember it all tomorrow. You're tired. Your brain has been jogged. You know all this. It will come back to you. You're very tired. You're fogged with carbon monoxide. Give it a rest."
However, I softened while rubbing her legs down and we did, once again, have an extended personal history legend, supplemented with a short lecture on, "The State and Mechanics of Your Memory (Inclusive)", which she only partially absorbed. She tends not to think of herself as demented, even at her demented "best", and her awareness of herself and her immediate environment remains acute, although sometimes confused, in or out of her typical Dementia Daze. When at one end of the spectrum, though, (and it is a Spectrum Illness) she has no memory of The Other Spectral End.
I was not annoyed last night, though. I'm not sure why. Could just be a different part of the cycle.
So, her meds have experienced only one change, which I'll try to get around to updating today:
- Two Niferex-150 Forte and one OTC Niferex-150 per day, for awhile, anyway, at least two weeks.
- I must make a note to myself to compare my mentions of more active times with her hemoglobin counts, see if there's a correlation.
Impressions
Mom continues to do well. She's slowing but apparently a lot less than I perceive, especially when she is determined and on stage, so to speak, for an audience of More than Me. Good omen for a few more years.
Over the last few days prior to her appointment, in the evening two days before when she was remembering, with appreciation and amazement, her chronological age, I playfully asked Mom if she thought she had 100 in her.
"No, I don't think so. Maybe 95. Maybe." Very matter-of-fact.
The evening after, when my perception was that she felt "worse" (stiffer, slower, more apt to complain and nitpick and try to get out of moving) than the previous evening, when she was preparing for bed and as I unfastened her bra she expelled a groan of relief, I asked again: "So, I'll bet you feel like you've barely got 90 in you, tonight."
She thought about it. "Oh, much more."
"100?" I prompted.
She didn't answer, "Oh. At least," as she often does. She said, "That sounds good."
I quickly calculated that in her 100th year I'd be 65. I didn't shudder, although I had a realistic jolt of reaction to the care contingencies a decade from now. Not unpleasant, though.
Earlier in the evening, after dinner, while I was repacking our Ford mid size van, a long time friend of MCF's sister golf-carted into the driveway. We recognized each other. He had heard of me probably as much as I'd heard about him, which is a fair amount and we met some years ago before MCF's father died. He was very curious how I was doing in my role as caregiver to my mother, considering how long I've been doing it. He had specific observations regarding the nature of caregiving for the elderly. I launched into a fairly detailed explanation of the social nature and value of what I do and what this might say about me. At times during the conversation he matter-of-factly referred to me as "courageous". I noticed that I was not uncomfortable having courage ascribed to me on behalf of my journey with my mother. I did, though, insist on explicitly defining my acts of courage and, while not disavowing their courageous character, also stressed that everyday courageous acts are no longer indications of courage by dint of their frequency, however admirable they seem. In my oral apologia I stressed some specific personal rewards:
- A realistic view of age and a chance to contemplate it;
- The Ultimate Academy of Patience, Sympathy and Empathy that is the nature of caregiving;
The day before, when the oxygen guy came by to check our concentrator, he took note of my carefully casual attendance on Mom and commented, as I mentioned in a recent post (Monday, April 3rd), "You take awfully good care of her. Was she a good Mom?"
I answered simply, "Oh yeah."
"How so?" he asked.
I enumerated her Animal Mom traits.
He listened. He continued to assert that she is lucky, deserving or not.
Later that day I got to thinking about care "deserved", especially in one's Ancient years. I've met up with, and can understand, the attitude that a parent was not a good parent, they can rot in State Assisted Care Hell:
- The first time, the son of a sister-in-law cousin of my mother's, who resented his parents from way back for two large, thoughtless errors in raising and supporting him, responded to his mother's death as though he'd have preferred not to have flown out. He did, finally, with his older teenage son, consent to scattering her ashes off Wind Caves. He gladly left all the death detail to Mom, who was the executor of her sister-in-law's will and about the only person besides paramedics to have contact with her in the last months of her life. He disdained any kind of social memorium. He turned his mother's shed contents over to us without interest or inventory; a pity because her shed contained a box of letters from him during one of the horrifically difficult occurrences between him and his parent. I retain these letters.
- The second time I became acquainted with the care recipient who had been left: A woman in her early seventies who had fallen, broken her hip, and, although still sharp, lamented that she would need to go into Assisted Living because she knew her children would not care for her. She admitted to being a problem mother. She did not seem of that type to me, but I was not one of her children. She was never specific, but spoke with a pronounced sadness and regret.
What I'm doing? It is not easy and it was only vaguely planned. My mother and I share a decidedly optimistic outlook: Hers is pure, my outlook is half hers and half a caustic foreboding, sometimes depressive, from my dad. She is a good influence on me because I am also absorbent and have a mime-like tendency to subtly imitate people with whom I'm engaged, allowing my internals to be influenced by them; a form of empathy. Occasionally my somber desperation breaks through but mostly her pull on my brighter side wins out, especially when she is not too dull and I am not too environmentally challenged with duck-biting tasks.
By the Way's:
- The appointment happened so quickly Mom commented on it...to be continued;
- a glitch accidentally discovered and not believed, until I followed up with what I knew, in her insurance information.
- Got a substantial discount from the motel, La Quinta Inn which does them credit. We'll stick with them.
- Very quiet, steady, satisfied drive up.
- Mom phased into a short, "I want to move back down there," after an equally short, intense phase, much earlier in the day, of, "Am I glad we no longer live here." My short response to her first seizure was, "Hey. This is it. This is the house out of which you will die."
That set her back a bit. She did not ask for an explanation this time. Good thing.
I also stressed the positive aspects of living here and visiting there, including in the summer. She likes that dead heat season. It lubricates her joints. - Possible MCF April visit to deliver buffalo meat, steaks and ground.
More.
Later.
