Thursday, July 20, 2006

 

It's the Little Things:

  1.     About a week and a half before MPS & MPNC visited, my mother noticed her several bottles of nail polish on top of the medicine cabinet in her bathroom.
        "The next time I see MPNC," she said, "I'm going to give those to her. I don't use them, anymore."
        "I've been meaning to ask you, Mom, why you don't like having your fingernails painted anymore."
        "Because all I do is peel the polish off as soon as it dries. My nails look better without polish."
        I forgot about this until the day MPS & MPNC arrived. Within minutes of greeting them, Mom scurried off into the bathroom, collected the bottles of nail polish and gave them to MPNC (who has gorgeous nails and goes through periods when she loves to wear polish).
  2.     Yesterday, when Mom arose, I greeted her (as I usual do) with the news about her blood draw. "You're almost 100 per for Prescott, Mom, and absolutely 100 per for Mesa." "100 per" is one of her typical responses when someone asks her how she's feeling or doing and she's feeling good.
        From there we started her day, and her bathing. Three quarters of the way into our routine, as she was rising from the toilet so I could wash her torso, she asked, "That 100 per...is that about my anemia?"
        I was amazed. Previously, she's remembered that she has anemia only when I've talked about it, which isn't often. "Yes. It's about your anemia," I confirmed.
        "Well," she said, "I'm glad we've got that taken care of."
        "Me too, Mom. Still feel like going for 120 (years; she often says she intends to live to 120)?"
        "How about 150?"
        That's what I like to hear.
  3. Yesterday we spent some hours watching That's Entertainment Parts I & II. The first part features a segment on the Judy Garland/Mickey Rooney series of musical movies. "I've seen all of those, you know," she suddenly told me, then proceeded to recount some of the scenes she remembered. Not only has she not done this for years, her typical response to old movies that I know she's seen, either with me or because she mentioned them in years past, has been, "I've never seen this movie," after which she'll mention whether she likes the movie in question.
  4.     At 1915, while I've been writing this post, my mother awoke from her nap.
        "Have they finished the scraping they were doing on that road this morning?" she asked.
        Earlier today several pieces of heavy machinery used our driveway to turn around while they were in the process of repaving half the road that shoots off ours immediately opposite our house. Mom's interest in what was going on was acute, which is not unusual. We discussed the various machines and what they were doing for several minutes while we were playing Sorry and she had a good view of the activity through our dinette window; also not unusual. What is unusual is that she remembered the activity after her nap and asked about it. When I reported that the road was half done she said, "Aha! Quitting time was five o'clock. I guess those machines will be in our driveway tomorrow, too."
    The four instances above aren't the only "little things" I've noticed, lately, but they're the only ones I can think of at the moment. The second prompted me, yesterday, to make a note to myself to write this post when I got back here. My best guess is that bringing her anemia under control has slightly alleviated the grip of her dementia. This doesn't change the fact that the bulk of her dementia is due to her mini-stroke in the back left lower quadrant of her brain. This doesn't mean that she is "getting better" from an overall demential standpoint. She continues to enter The Dead Zone regularly. She continues to need to be reminded of all the things of which I reminded her before the advent of the third Niferex-150. She is absolutely not capable of living independently or carrying on her life business. Within the last month we've watched a couple of movies as repeats that she continues to claim she's never seen. Her mind continues to hop skip and jump from thought to blank area to thought to blank area...but, I'll take this latest development.
    The one point I want to make: Regardless of what type of dementia an Ancient One has, other conditions can strengthen or lessen its grip. The effect may seem minimal, but, believe me, every little bit helps. This is a development I wasn't expecting, although perhaps I should've been. After all, when one is anemic, one's entire body isn't getting the proper amount of oxygen it needs to function at its optimum, including one's brain.
    I'm sure that this slight but welcome improvement is not because Mom's been playing Brain Age. In fact, I think her original interest in this device may have been partially triggered because her own brain has been working a little bit better since I upped her iron supplement in April. As well, she continues to play all the various games "wrong"; although I still haven't checked, I doubt that her brain age has improved, according to the device.
    I'm fairly sure, from all the anecdotal descriptions I've recently read and the confirmation of her mini-stroke and subsequent diagnosis of vascular dementia, that either my mother's dementia is not Alzheimer's related or, if some of it is, she's in the category of people, like some nuns in The Nun Study, who appear to be not or not as much as usually affected by the neurological changes recorded in their brain, upon autopsy, that are indicative of Alzheimer's. At this point, of course, the cause makes little difference. What is important is what I perceive her dementia to involve and how I design our lives to circumvent possible problems arising from it; and it's progression, which appears to be fallow, right now. Perhaps it will remain so. Perhaps it won't. It's very nice, though, to know that at least one of the weights, minor as it was, has been lifted, however temporarily, from her dementia.
    Despite the fact that my mother's demential trajectory doesn't seem to be mimicking what I've perceived as the Alzheimer's trajectory suggested by other anecdotal accounts which I've recently (and gratefully) discovered, Alzheimer's is always on my mind, primarily because dementia is always on my mind. The one aspect of Alzheimer's that scares me and for which I keep keen lookout, should my mother develop it, is the loss of personal identity. Last night Mom was watching a cable channel on which a credit card company had paid to broadcast several of those commercials that feature an actor whose voice is overdubbed, often hilariously, with the voice of someone who's stolen their credit identity. My mother loves these commercials and always mentions them, so, at least during these minutes, my attention was turned to them. Suddenly, during the one in which a male weight lifter speaks in the voice of a young, silly, female aspirant to American Idol, I realized: Alzheimer's is the ultimate identity thief. Perhaps if PR for the disease were cast in this mode, using this slogan, many more people would realize that this is reason enough to redouble, and then double again and again and again, all efforts to bring an end to this disease and its devastating effects.
    Any commercial enterprise who wants to buy the copyright to above slogan (and the slogan) from me for public relations/advertising use [I'm nothing if not shamelessly survival savvy when necessary; besides, in one of my previous lives I was an advertising director], contact me either through commenting on any post in any of my journals or with my email address, listed to the right. Please note, in the subject line of your email, the title to this post.

Comments:
originally posted by Mona Johnson: Fri Jul 21, 06:21:00 AM 2006

Hi Gail,

Glad to here your mom is doing well.

It's interesting to compare your mom's condition with "typical" Alzheimer's progression. Some doctors and scientists believe that "Alzheimer's" is really a vascular condition, and others think that it's a way to describe symptoms that have a variety of underlying disease processes.

I think it would probably increase our understanding to have modern imaging and the kind of info you keep on your mom for every Alzheimer's patient, but the cost and wear and tear on patient and caregiver make this tough.
 
originally posted by Gail Rae : Fri Jul 21, 01:11:00 PM 2006

Mona,
This is primarily why I stay away from using the word "Alzheimer's" in connection with my mother: On the one hand, there doesn't yet seem to be a standard medical definition for "Alzheimer's"; on the other hand, the public perception of Alzheimer's is that it has one tragic trajectory, similar to my grandmother's demential experience. "The public" has a somewhat different perception of dementia and is more willing to accept that a variety of trajectories are implicit in the word. This is the message I want to get across: If your Ancient One is demented, don't scare yourself into expecting a particular, often "the worst", outcome. In one of those aforementioned "commercial" blogs, for instance, one of the writers published a post about preparing for the eventual "wandering" of your Ancient One. My Ancient One isn't wandering and I'm not expecting this to happen, based on her demential trajectory. Even when she got up in the middle of the night and "wandered" (as it was described to me) to the nurse's station, I knew what she was doing and so did she: She was looking for middle of the night company, and she found it. She does this here at home.
 
originally posted by Deb Peterson: Fri Jul 21, 05:08:00 PM 2006

Gail--I've noticed a distinct deterioration in my mother over the past six months--it shows up in several ways that I don't recall you describing in your Mom. I think the most distressing to me is what they call "lack of affect"--she is losing, month by month, almost all animation, facial expression, spark. I can say something to her and her face registers nothing. Sometimes I just can't believe that she's even heard me, so I repeat what I've said and--nothing. This is a hallmark of Alzheimer's--if I had any doubts about the cause of her dementia a year ago, they are gone now. Oh, once in awhile she smiles a little, but that pilot light is burning down.

I don't get the impression that your mother is losing her overall sense of engagement, which is probably the result of the progressive destruction of AD on the brain. Just reading this post I see a spark in your mother that my mother no longer has--and this flatness just seems to be the most common visible denominator for AD (and possibly other progressive dementias? Mona can speak better about this than I can). Otherwise, AD sufferers seem to have different sets of difficulties. Or maybe intelligence levels mask some more than others?
 
originally posted by Deb Peterson: Fri Jul 21, 05:19:00 PM 2006

Gail--I reread your entry and my first comment sounds so fatalistic. Actually my ears perked up when I read about your Mom's improvement after her anemia lessened. Also, Patricia has an entry describing her success with chamomile tea--I haven't given up trying to improve what cognition my mother has left, as you suggest in this entry. I didn't mean to sound too gloomy!
 
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