Mom & Me Three Archive

    There is a pall that hangs over a "professional medical day" in this household. I think I noticed it this time because it's been awhile since my mother has gone so long without seeing a doctor, to a lab for a blood and/or urine draw or being in a medical facility for any length of time.
    Normally our lab visits up here are quick; there are very few people (sometimes none) waiting to have fluids drawn. Yesterday I wheeled my mother into an almost full waiting room. Despite the number of people it was quiet. Everyone, including my mother, appeared to be steeling themselves against the moment when medicine would be making physical contact with them. My mother, as she always does at this lab, noticed that the aquarium was a "habitat for algae, not for fish". We've been visiting this lab regularly since June of last year and although the aquarium filter burbles ceaselessly, the tank, which stretches the length of one of a diagonal wall that appears to have been installed for this purpose, has never contained fish. When she made her observation a few people in the waiting area chuckled ominously.
    One by one the waiting area residents' names were called, each shuffled to the cubicles following someone with a plastic tray containing needles, brightly capped syringes and cups, and, as my mother observed, "...you don't see them again...". A few more chuckles burped from the hunkered, waiting clients. People exit the same way they enter, through the waiting area, but I think everyone is so focused on their individual fates which are about to be determined by their impending harvest that it seems as though a person disappears after a draw.
    As usual, the tech, who was lively and talkative, had trouble finding a cooperative vein (my mother's veins, while quite visible, roll with the punches, which is, to me, an optimistic sign...it's the way she does her life) and a second, more experienced tech was solicited. My mother winced several times and her wit turned dry and a touch snide.
    I mentioned that it had been awhile since we'd come in. After all the medical attention she received in the fall from hospitals and the skilled nursing facility, I explained, she protested being stuck monthly through the holiday season and I'd agreed. The second tech, an RN, immediately reacted to my mention of the skilled nursing facility. "Don't ever put your mother in one of those places permanently," she said. "I've worked in a couple and the reason I'm no longer working in them is that I couldn't stand participating in the lack of care the residents received."
    "Funny you should mention that," I said. "We did our homework, found one of the best in Chandler for her therapy and, still, I was commuting from Prescott every other day just to make sure that she maintained a half-way decent level of hydration, cleanliness and skin care. And don't even talk to me about medication management!"
    The RN tech nodded vigorously. "It's upsetting to work in one of those places and it pays almost nothing. That's why the turnover is so high. Most decent people can't take it very long. Understaffing. Lack of attention to the basics. The doctors and administrators treat residents like they're on a factory belt heading toward discharge. The ones who are successfully processed shoot back to their relatives. The ones who aren't shoot into pine boxes. The staff acts like they have nothing to do with the final outcome. Very discouraging. I would never put my mother-in-law into one of those places. That's no way to honor her. My husband and I've decided we'll do what you're doing." Then, she added a curious insight: "I'd put my mother in one. She's a troublemaker and didn't raise me, my aunt did. As far as I'm concerned, she deserves exactly the care she gave: Zero." She stopped palpating my mother's veins for a moment to illustrate a zero with the thumb and forefinger of her right hand. "My mother-in-law, though, raised such a good son, and is the best mother-in-law. When she needs care, she's coming to live with us."
    Wow, I thought. I wonder how many people 'end up' in nursing homes as a kind of punishment for past sins against those with whose care they were entrusted. I wonder, in long range, how inevitable it is that, given our society's lack of attention to those ensconced in the tasks of caregiving, making it even harder to give care, our society sets up some ill-prepared, surly citizens to be "bad caregivers" and to earn the neglect of their charges. I know that it is common to believe that intense needs caregiving, particularly of the elderly and infirm, often reaches the point where care within the family is considered too demanding to be avocationally possible. Now I wonder how many people would automatically be better caregivers of all types, able to go the distance, if our society didn't silently agree that giving care is a personal, not a societal, matter.
    After our long haul at the lab my mother's spirits were droopy. She slept off the drudgery for almost four hours, during which she shed water as though she'd slept through a night. When she awoke she thought it was early morning of the next day. It may as well have been. We performed a second bath and laundry load. She had to be reminded that the upcoming meal was lunch. Once she reoriented herself she was fine but unusually quiet. "We don't have to go back to the doctor today, do we?" she asked.
    "No, not until Monday. Today's Friday."
    She sighed. "Well," she said, "let's make it a short visit."
    "We will, Mom," I promised. And, I can't see why this won't be possible. Unless I'm completely off base, Monday's appointment should be no more than routine, preceded by a trip to the Valley, which she always finds diverting, and followed by a visit and dinner with friends and dogs. At any rate, if "something" is discovered which appears to be in need of immediate, intensive treatment, as usual, I'm going to approach such treatment with great circumspection. A little bit of medicine is handy; a lot of medicine tends to become an added circumstance from which my mother must recover. Somehow, that just doesn't seem right.

...actually, that's an inside joke...I don't expect hell to break loose, but that's the phrase my mother used last night when I reminded her that she's having her blood drawn today.
    I just called her clinic in Mesa and she'll also be getting her flu shot. I don't think she'll need a pneumonia shot. She had her last one in 2000 and I think those are considered to last for "5 - 7 years", as I recall, so we're still on the inside track on that one.
    I'm not stressing over her blood work, so, instead of picking it up on my own I'll have them mail my copy, which I probably won't get before our clinic appointment on Monday. Results won't be available here until sometime next week.
    I'm considering putting her back on Detrol since she seems to be able to control, for the most part, her urination during the day. Maybe giving her Detrol at night will help her control the watershedding she does at night. At any rate, I figure it's worth another try considering that she's not one of the over medicated elderly.
    Time to awaken the Mom and get her clean and moving.
    Damn, I feel unusually good today!
    Later.

...to get her blood drawn this morning. She was not in the mood and I wasn't in the mood to push her, anyway. Although I got to bed early (for me), I had a series of strange dreams that continually awoke me throughout the night. I was up at 0700 to get her up but when she resisted I decided, nah, if I push her we'll both be in surly moods most of the day.
    If you're wondering why we can't do this later in the day, for this CBC I want a fasting reading, not for her blood sugar, I know she's always within normal range in the morning, but for her sodium level. I want to see if it's doing things or is steady, and in normal range.
    At any rate, getting in there in the morning will allow the results to be available and faxed to Mesa in the afternoon tomorrow in plenty of time for her Monday appointment.

...last night she shed water like she hasn't in a long time and no longer looks bloated. I think the water retention could have resulted from one of two possibilities:

1. I retained water over the last few days, as well, uncomfortably so, and spent a good part of this morning shedding it. It may have been something we ate.
2. Her body was confused, with the change in medication, and spent a couple of days going, "Hmmm, what is this stuff this woman is dumping into me? I think I'll hold onto everything and analyze it until I figure it out."

    Anyway, only 3 more days of antibiotics and she'll be done. Thank the gods.

    Routine doctor's appointment in Mesa on Monday at 1500. We leave Prescott around 1000, arrive there around noon and check into a motel close to the doctor's office; pick up some lunch someplace, probably fast food, which will delight my mother. She'll have time to take a short nap at the motel and refresh herself for the rest of the day. We'll check out of the motel around 1400 and head over to her doctor's office. After the appointment we'll head down to MCF's house and enjoy an evening of good friends, good conversation, good dogs, good food, etc. Sometime in the evening, well after rush hour, we'll pack ourselves back in the car and return to Prescott. We're both looking forward to the trip. MCF suggested that we forget about the motel altogether, that Mom could nap at her house. I told her there's an excellent chance that Mom'll leak through while she naps and I'd rather she do that at a motel than at a friend's house. I'm taking along a plastic sheet to slip under the bed sheet just in case but, you know, motel laundries are set up to handle stuff like this. A house full of friends, all of whom are continent adults, is not.
    The weather has been beautiful up here, in the low 60's during the day, plenty of unadulterated sun, but Mom still thinks it's too cool and will only stick her nose out the door long enough to say, "I'm not going out there!" I'm hoping that an afternoon in a sunny Chandler back yard with treasured friends while the temperature is in the 70's will warm her up a little, get her moving, perk her interest in moving about outside the house up here.
    Funniest thing: Today we watched a couple of episodes of the first season of Northern Exposure, which I finally ordered. One of the episodes was "Soapy Sanderson". In this episode an elderly man commits suicide. It is mentioned during the episode that his age at his death was 82. When Mom heard this she said, "82?!? That's so young to die!" That's my Mom! One of the aspects of the episode that heartened me is that Soapy Sanderson, at 82, with a broken hip which happened when he fell from a tree he was climbing, is scolded by Dr. Fleischman because he isn't doing what the doctor told him to do and, if he doesn't he can't expect to "improve". This is one of my fairly frequent litanies to my mother, and from her doctors. And, yet, she continues. It put me in mind of the episode we watched yesterday, Brains, Know How and Native Intelligence, during which Dr. Fleischman and Uncle Anku, a tribal medicine man, agree on several aspects of medicine, including that the body is, in many cases, an amazing self-righting machine. Of course, in the case of Uncle Anku's urinary bleeding, it isn't, and his pride must be addressed in order to convince him to seek western medical treatment. In my mother's case I don't think pride is the problem. I think, for the most part, she simply doesn't want to be fooled with as much as doctors would like to fool with her and, frankly, I don't blame her. In most cases I support her. I think, at 87, considering her entire life profile, that, as with Soapy Sanderson, she has the right to decide when to listen to medicine and when to say, "Hey, go practice on someone else and leave me the fuck alone! It's okay with me if I don't qualify as AARP's Amazing Ancient of the Year!"

    Mom and I watched Gallipoli tonight. Although I love Peter Weir movies, even the "bad" ones. Despite the user review featured at the link I provided, Gallipoli is very far from one of his "bad" ones. Mosquito Coast comes to mind, for my money, and I stay out of discussions of another Weir film that's often considered "bad", The Last Wave, which I saw when it first came out, have seen several times since and by which I continue to be haunted. There are some of his movies I have yet to see, and this was, until tonight, one of them. I started watching it while Mom was napping late this afternoon. I was maybe fifteen minutes into it when she awoke. I thought I put it on pause but apparently put it on slow rewind, so that when she entered the living room the movie was inching backwards through the opening credits. She asked about it, I told her it was "a war movie" (although I consider this description inaccurate; it is a movie about the urge to war but not a classic war movie) by one of my favorite directors but if she didn't want to see it I'd put off watching it until she was asleep. She was game and became immediately engrossed. I was surprised and pleased since the first 15 minutes had sold me on the movie and I was disappointed that her nap had lasted only a half hour. There were a couple of things about the movie that were particularly startling:

1. Weir back-sounded some of the running segments with bits of Jean Michel Jarre's Oxygene, one of my favorite synthesized thematic collections of music;
2. During one of the scenes before the final slaughter at the hands of the Turkish military, Frank Dunne (Mel Gibson) rifles through a care package from home full of stuff he can't use, comments snidely about the contents, one of his mates berates him, "It's the thought that counts, Frank," and Frank responds, "It would count a bit more if they could bloody well think." I paused the movie, pointed excitedly at the screen and exclaimed, "See, Mom, I'm not the only one who thinks that, and not the first!" She doesn't agree with my feeling that, if all you can say about a gift is that it's the thought that counts the giver wasn't thinking. She's thinks it's rude of me to assert this.
       I realized this bit of specific wisdom when my mother and I began conjoined housekeeping. Although she is often a spectacular gift choose/giver (I've gotten some of my best, most surprising gifts from her) she also has a marked tendency, if she doesn't know a person, to think that anything will do and not "waste the mental energy" figuring out something appropriate. The year I thought of this little gem of wisdom was a year when we were both well aware that MPBIL's parents were trying hard to stick to a healthy diet and my mother wanted to get them a Hickory Farms box for Christmas. "It'll be a nice change," she insisted.
       "Mom," I corrected, "it won't if they aren't going to eat it and I can guarantee you they won't."
       "It's the thought that counts."
       That's when I came up with, "If all you can say about a gift is that it's the thought that counts, the giver wasn't thinking." I continued, "Mom, no one likes to get a gift that they're going to end up giving or throwing away."
       "I suppose you're right," Mom responded, still unconvinced.
       That year we got them a dried fruit plate augmented with low fat cheeses and water crackers.

    Anyway, my mother remained glued to the movie until it became apparent to her that several of the soldiers were smoking. She began hunting cigarettes and once again reacted with shock when I told her she hasn't smoked since August. She insisted she'd had a cigarette "earlier today". From that point on she could not keep her mind on the movie. Upon later reflection I realized why these particular smoking sequences triggered her desire for cigarettes when some others don't: She took up smoking during a war. If she hadn't been in the Navy and hadn't been in the Navy during WWI, it's entirely possible that, like many of her cousins, she would not have ever taken up smoking.
    I persevered, though, paused the movie once to tell her that I intended to see the movie through, I was too caught up in it to stop and reminded her, when she tried to go to bed, that she had to stay up until 2130 in order to take her 3rd dose of iron. he made it to the end. The final scene was a horrific take on the first scene. When the action stopped as Archy Hamilton, one of two featured runners, was shot by the Turkish military, her interest was renewed and she asked me to backtrack the movie so she could view the final moments and appreciate the connection.

    Earlier today a local friend of mine called for a catching up conversation. She mentioned this journal, which she occasionally accesses "to see if I'm still alive", which she always says with a chuckle. She writes, some, not a lot and only privately and mentioned that she feels this journal is "too repetitive. You only need to mention things once," she said. "The repetition dulls a lot of what you write in there."
    "It's a journal," I told her, "not a commercial effort. The repetition is important to me. I can go back and see how many times or under what circumstances certain behaviors occur, in both Mom and me."
    "But it's boring," she said. "It'll never be published."
    "Well," I said, "it is published, as I write it. And, anyway, it's not meant for a publishing company, it would have no value to me if it was. It's meant to be a blow by blow description of what I'm doing and what I'm thinking and feeling while I'm doing it."
    As this subject dropped by the wayside and we continued talking I realized that, aside from this journal's therapeutic value to me, the striking amount of repetition is an extraordinarily accurate portrayal of the life of a caregiver to An Ancient One. So much of what I do is repetitive, sometimes absurdly so. Curiously, I have a taste for repetitive tasks: Needlepoint, for instance. One of my (on hold at this time) passions is creating art needlepoint. The canvasses I create require intense repetition of stitches for weeks at a time. One of the pleasures I derive from creating and stitching these canvasses is the one-stitch-at-a-time focus...making sure each stitch glows with its individuality within its hundreds of thousands of siblings. I now wonder if this is part of what makes me suited to taking care of my mother. I have occasional moments, it's true, when I think I cannot bear to repeat another, "drink water, Mom", or "scrub, scrub, scrub," but for the most part each repetition is like an individual stitch in the overall canvas of her life and mine. Each occurs at a different time, each exacts unique attention, each begs to be done well. As I apply the mental technique I use when I needlepoint to the creation of my mother's and my life together I often have the same excited anticipation of the finished work that comes over me when I'm involved in the creation of a canvas. When I finish a canvas it is common for me to stare at it in awe and think, "Wow, I did this? This came out of me? I had no idea I was capable of this!" At the "end" of any particular "episode" of caregiving I often have the same reaction. I wonder what my reaction will be when I am at a point where the entire canvas of my mother's Ancient years is completed, when she has offered up the final skein and I have used it to stitch over last bare grid.

    Yesterday wasn't terribly busy but it was involved. While my mother slept I sorted through paperwork. While she was up I spent a lot of time at her side, her faithful dog, keeping her company. She was neither in the best nor worst of moods yesterday. I was copacetic. I decided to move her Friday doctor's appointment in Mesa to Monday since she finishes the course of antibiotics on Saturday. She tends toward motion sickness as a passenger in a car and the one eventuality I don't want to confront is that the Augmentin, on top of the trip, will cause vomiting episodes since on the day of her appointment we'll be in the car a lot. I'm going to secure a hotel room although I'm not expecting that we'll spend the night. It'll be a place for her to rest between the appointment and the possibility of seeing friends and/or family.
    I had a minor epiphany yesterday. A local friend, one I haven't visited in awhile and who instituted the book club to which I belong (and in which I haven't participated in some months) emailed me in response to my assurance that we wouldn't be attending the upcoming book club meeting. I had mentioned that I thought I'd be putting both the book club and reading, in general, on the list of "things to do when my mother dies". I've gotten so used to mentioning this list to people when they ask me if I participate in activities in which they know I'm interested that I didn't realize I'd never mentioned it to her. Her response included concern that I sounded "depressed".
    No, I assured her, I'm not depressed (and I'm not), just realistic. I went on to tell her, "...don't worry. I'm fine. My mother's fine...Somehow, underneath it all, I have this feeling that if I don't do this [caring for my mother] the way I am geared to doing everything, with intense focus and concentration, that it won't be 'me' doing it and I'll lose out all the way around on the amazing gifts this experience has to offer. It's kind of like being a dedicated monk in a strict monastery. You know that, even as you sometimes grate against the discipline, it is, spiritually, the most effective thing you can do, for yourself and everyone else."
    I wrote this "off the top of my head", without much conscious thought. After sending it I realized how appropriate it is to me that I described my caregiving of my mother as analogous to the experience of a monk. While there are times when I yearn for a break, the fundament of this experience is that it suits me precisely because I am geared toward periodic, intense isolation and concentrated focus on what I'm doing. I remember many times when my life has seemed much too busy for me, not enough time to think, not enough time to focus; times when I've fantasized about being a life-long scholar or living in a monastery-like situation for awhile in order to soak myself in isolation and focus. When I'm bothered, as I was yesterday, that my mother isn't "getting out enough" or has days when she really doesn't want to do much of anything, it doesn't bother me on my behalf, it bothers me on hers. As well, being suited as I am for isolation, I am more often likely to see the focus required of intense needs caregiving as an opportunity rather than a burden.
    At any rate, after realizing this, I petitioned my mother about how she felt about our extremely calm, peaceful life; the lack of obvious social activity, etc.
    "Oh," she said, "I like it. I don't like it when people are at me to do this or that. You used to do that, too. I'm glad you've settled down."
    Yeow! "Don't you miss getting out, people watching?"
    "I get out enough," she said. "It's too cold, right now. Everyone's wrapped up in coats and hurrying to get back home. We'll get out again."
    I've worried, too, that her recent episodes of deciding that she needs to determine where she'll be teaching next year are happening because she's restless for movement. I've suggested several times that we consider surveying the local "Grandparents in the Classroom" program, wherein older people are recruited to do things like read to kids, listen to them read, etc. She has turned down this suggestion every time for a variety of reasons, all of which make sense considering where she is, now, in her life (when I think about it from her perspective and not from mine). It's not fear that keeps her from wanting to do this, of that I'm sure.
    So, anyway, I feel a bit better. I expect I'll still worry that it's 'too easy' for my mother to settle into habits that suit me, but, you know, maybe she's been this way all along and I'm only now discovering from where I inherited my love of solitude. I thought this trait of mine was a family fluke, but maybe I got it from her. She likes someone besides her in the home but, overall, she prefers to be "on her own".
    Time to peek in on her again and see where she is in her progidious sleep cycle.

...that, even though she awoke on her own close to 1030 this morning in a great mood, she's back to her normal watershed at night. I guess it was a fluke.
    Later.