Friday, May 27, 2005
We had one of those rip roarin' "Yes you can, goddamnit...
...yes you will, goddamnit" days today. It's days like these that cause me to question how much of my mother's short term/long term memory loss is self-selected. I don't think the majority of it is, but she has her moments...
As you know, over the last six days I've instituted formal modified therapy exercise sessions (and unusually regular doses of extra strength acetaminophen) every other day. We aren't yet walkering her during the inbetween days but we're getting there. She's taken the sessions well, done well, except that she's also increased the time she's sleeping. Because she's also been citing the Wondrous FNP's cautionary descriptions of how she will become more tired as time goes on, I've been reluctant to haul the woman out of bed and get her going. To be fair, some of these marathon sleep sessions have involved late nights, thus, on some she isn't sleeping a lot more than normal, but, well, over the last few days she's been putting it away like a sleep glutton. I find it curious and interesting in the extreme that she can remember what the FNP said about sleep (which my mother absolutely loves) without prompting.
After three days of my mother getting up, eating, peeing, turning around and heading back to bed while responding, "No, I'm not bored, I'm just tired," to my queries I finally had it today. Yes, she went to bed late last night, about 2300. Thus, I started teasing her awake at 15 minute intervals at 1100 this morning. I wasn't successful at getting her out of bed until 1300. Once we'd bathed her, she'd had breakfast and perused her latest tabloid, not two hours after arising she was taking off her glasses and positioning herself in her chair toward the bedroom.
"You're not going back to bed?!?" I exclaimed.
"Yes. I'm tired. The doctor (she considers the FNP her doctor) said this would happen."
I silently blocked her path for a good minute, gathering my, "Okay, this is it, I've had it" storm. Then, I spoke. "You know what, Mom? I remember what the FNP said, too, and I remember her entire explanation, chronic renal failure, anemia due to chronic disease, blah, blah, blah. But, Mom, you're nowhere near the end of this road. In fact, your last lab work, drawn exactly a week ago, showed that your anemia remains stable and normal for you even though it's dipped a bit and, surprise, surprise, your kidneys are absolutely fine! Your BUN wasn't even elevated, this time. You have absolutely no excuse for going back to bed except that you've made living in bed a habit and I've allowed it. Well, this is it, woman. No more. Not only are you not going back to bed, but I think this might be a good time to do your exercises."
She returned my lecture with an equally stern, equally displeased stare. "Why." It wasn't a question, it was a statement.
"Because. Just as the more you sleep the more you want to sleep, the more you move the more you'll want to move. Believe me, I'll know when sleeping until the cows come home is appropriate for you. It's not now and I know this because your lab work tells me so. Come on. We're going to do some moving, and I'm going to work you today. Prepare for Your Daughter the Drill Sergeant. You're taking advantage of my niceness, again, so I'm not going to be nice anymore."
She grumbled all the way, but she also followed my lead. I upped reps. I added a few exercises. She's not yet ready to do the standing ones but she's I suspect it won't be long until she is. She took it on the chin and came back swinging. After her post-session breather she was no longer interested in taking a nap. All her life she has sworn that when she exercises it makes her hungry so I was prepared for that. I offered her a bowl of mini dill pickles, in which she delighted. She, essentially, had two meals, breakfast and dinner, today, and two snacks, the pickles and some yoghurt. She spontaneously got in and out of her rocker more than usual to throw away her gathered Kleenexes. She didn't need to be herded to the bathroom every two hours because she discovered, on her own, at about those intervals, that she needed to go. She was thirstier than usual so not only did I not have to coax her to drink, she noticed her own thirst.
Moving is still good for her. It's not yet beyond her. She's got a few tricks left in her, and, it appears, a few more years in which to ply those tricks.
I am, of course, completely and constantly dilligent in looking for signs that I'll need to ease up here and there let her have a day of bedding her body, etc. But chronic renal failure (which I'm sure she has) is going to be a long, long path for her and she's only at the trailhead. I know this because, even after months of inactivity, her kidneys continue to rally. They're rallying now. I'm not going to make any grandiose pronouncements like, for instance, that I'll be able to convince her to travel to see relatives, etc. Maybe, but, then again, maybe not. I do know, though, that we're going to get her out again, and more, and that she will, in time and for awhile, enjoy it.
I've thought about this a lot. What it finally came down to is that I can either let her die by allowing her to take to her bed prematurely or set up circumstances so that she may die on her feet. Somehow, I think, once she regains the hang of it, she'll prefer the latter.
As you know, over the last six days I've instituted formal modified therapy exercise sessions (and unusually regular doses of extra strength acetaminophen) every other day. We aren't yet walkering her during the inbetween days but we're getting there. She's taken the sessions well, done well, except that she's also increased the time she's sleeping. Because she's also been citing the Wondrous FNP's cautionary descriptions of how she will become more tired as time goes on, I've been reluctant to haul the woman out of bed and get her going. To be fair, some of these marathon sleep sessions have involved late nights, thus, on some she isn't sleeping a lot more than normal, but, well, over the last few days she's been putting it away like a sleep glutton. I find it curious and interesting in the extreme that she can remember what the FNP said about sleep (which my mother absolutely loves) without prompting.
After three days of my mother getting up, eating, peeing, turning around and heading back to bed while responding, "No, I'm not bored, I'm just tired," to my queries I finally had it today. Yes, she went to bed late last night, about 2300. Thus, I started teasing her awake at 15 minute intervals at 1100 this morning. I wasn't successful at getting her out of bed until 1300. Once we'd bathed her, she'd had breakfast and perused her latest tabloid, not two hours after arising she was taking off her glasses and positioning herself in her chair toward the bedroom.
"You're not going back to bed?!?" I exclaimed.
"Yes. I'm tired. The doctor (she considers the FNP her doctor) said this would happen."
I silently blocked her path for a good minute, gathering my, "Okay, this is it, I've had it" storm. Then, I spoke. "You know what, Mom? I remember what the FNP said, too, and I remember her entire explanation, chronic renal failure, anemia due to chronic disease, blah, blah, blah. But, Mom, you're nowhere near the end of this road. In fact, your last lab work, drawn exactly a week ago, showed that your anemia remains stable and normal for you even though it's dipped a bit and, surprise, surprise, your kidneys are absolutely fine! Your BUN wasn't even elevated, this time. You have absolutely no excuse for going back to bed except that you've made living in bed a habit and I've allowed it. Well, this is it, woman. No more. Not only are you not going back to bed, but I think this might be a good time to do your exercises."
She returned my lecture with an equally stern, equally displeased stare. "Why." It wasn't a question, it was a statement.
"Because. Just as the more you sleep the more you want to sleep, the more you move the more you'll want to move. Believe me, I'll know when sleeping until the cows come home is appropriate for you. It's not now and I know this because your lab work tells me so. Come on. We're going to do some moving, and I'm going to work you today. Prepare for Your Daughter the Drill Sergeant. You're taking advantage of my niceness, again, so I'm not going to be nice anymore."
She grumbled all the way, but she also followed my lead. I upped reps. I added a few exercises. She's not yet ready to do the standing ones but she's I suspect it won't be long until she is. She took it on the chin and came back swinging. After her post-session breather she was no longer interested in taking a nap. All her life she has sworn that when she exercises it makes her hungry so I was prepared for that. I offered her a bowl of mini dill pickles, in which she delighted. She, essentially, had two meals, breakfast and dinner, today, and two snacks, the pickles and some yoghurt. She spontaneously got in and out of her rocker more than usual to throw away her gathered Kleenexes. She didn't need to be herded to the bathroom every two hours because she discovered, on her own, at about those intervals, that she needed to go. She was thirstier than usual so not only did I not have to coax her to drink, she noticed her own thirst.
Moving is still good for her. It's not yet beyond her. She's got a few tricks left in her, and, it appears, a few more years in which to ply those tricks.
I am, of course, completely and constantly dilligent in looking for signs that I'll need to ease up here and there let her have a day of bedding her body, etc. But chronic renal failure (which I'm sure she has) is going to be a long, long path for her and she's only at the trailhead. I know this because, even after months of inactivity, her kidneys continue to rally. They're rallying now. I'm not going to make any grandiose pronouncements like, for instance, that I'll be able to convince her to travel to see relatives, etc. Maybe, but, then again, maybe not. I do know, though, that we're going to get her out again, and more, and that she will, in time and for awhile, enjoy it.
I've thought about this a lot. What it finally came down to is that I can either let her die by allowing her to take to her bed prematurely or set up circumstances so that she may die on her feet. Somehow, I think, once she regains the hang of it, she'll prefer the latter.
