Thursday, June 23, 2005

 

Remind me never to buy a Monte Carlo!

    What a day! Everything went without a hitch but each thing blossomed into something else. On our way home Mom said 'anew' several times in almost exactly the same way every time: "You know, I think it's always the days that start without a plan that turn out to be the most satisfying." We did have a sketch of a plan, at least I did, and assumptions about how each notch in the plan would contribute to the play of our day. But Mom's bridle can't be notched anymore so everything was unplanned, for her. And she loved every minute of it! So did I, actually, though much of it was unexpected, which changed the character of what I thought was going to be wholey expected and correctly anticipated, our visit with MCF and her family. All of them, including, "...that girl who came later, who was she again? She seems like family...oh, then she is family..." Mom, of course, including her as a member of MCF's family, of which she considers herself a member in permanent-no-renewal-necessary-you've-paid-your-dues standing.
    Yes, she smoked. Maybe five cigarettes. I was very strict, citing her difficulty breathing in the Health Advisory Alert Quality Air blanketing the Phoenix metroplex today. I insisted, on behalf of our friends, myself, her laboring lungs and the dignity of our food, no smoking at dinner.
    At one point during the evening, not in defense but in an overwhelming need to express her deep appreciation for the smoking salon, she said, directing her robust delivery using her cigarette, held delicately between the index and middle finger of her left hand, "I don't care what they say. I've always enjoyed a cigarette, from the time I started smoking. Always will. And I think I should have a cigarette or two every once in awhile."
    The occupants of the room expressed a hushed assent. Yes. Of course. Everything in moderation. One of these days someone will discover, in one of those danged studies, that occasional smoking is a dare because of the risk involved but it has been discovered and loved for a variety of reasons, throughout many cultures and many eras. In some countries, right now, this is an era of smoking.
    So, long story short, she enjoyed her cigarettes, today. That family doesn't smoke all that much, anyway, so, considering that she once before, instantaneously, in the presence of available cigarettes, became a chain smoking fiend, again, I was surprised she was so mellow about her smoking today.
    The car we rented was non-smoking, so was the room, so, of course, was the doctor's office, and she took all that with gracious forgetfulness. But, interestingly, much like my father in the latter stages of his alcoholism who became drunk when he decided he wanted to be drunk long before ever touching his lips to a glass, when she understood that we were finally on our way to MCF's she began worrying the upholstery, her pockets, the glove compartment and although she couldn't quite remember what she was trying to locate, I knew. I prompted her by asking and it took seconds for her to answer, "Cigarettes."
    "This is a non-smoking car, Mom. Not until we get to MCF's."
    She clicked her teeth together in mock agitation, but she did good.
    At home, she asked for a cigarette. I was going to allow her two, with the stipulation that if her attention wandered enough from her awareness of holding a lit object that ashes and she dropped the ashes or cigarette, that was it. This happened about two thirds of the way through her 'first' cigarette, which became her last.
    I think, after a few days, she'll forget, again, that she considers smoking a natural activity.
    The rest of the day? The appointment with the new physician/PCP? Suffice it to say, I think I'll be writing an open, and sent, of course, letter to him. It was a turning point visit for me, that's for sure. It could be for him, too, and we could both benefit through our association with and about my mother if we step back and check with each other in stereo to understand what really happened today.
    What it a bad visit? Well, I don't know. I think it contained latent possibilities, both negative and positive, and it depends on whether The Good Shiny New Doctor and I can come to a mutually beneficial understanding.
    To be less abstract, at one point I spontaneously told him, with no bluster but with definition, nonetheless, not that I 'considered' myself my mother's PCP but that I was her PCP. My exclamation surprised us both. I hope we both recognized that this admission, and other, hmmm, well, spontaneous, strong reactions of mine were not contrived and a surprise to both of us and were not fundamentally antagonistic.
    Got you wondering. I'll cover it, from at least two angles...
    ...later.

Wednesday, June 22, 2005

 

Any Port in a Storm

    Well, what a wake-up session we had today! You can read the report in the previous link at the Tests & Meds site. It involved yet another Mother of All Bowel Movements and a few other interesting developments.
    Anyway, after I'd cleaned the bathroom then put away the clean-up stuff, the phone rang. From the Caller ID I, which indicated it was "Phx Newspapers" (a.k.a. The Arizona Republic), I knew it was the circulation department calling to solicit a subscription. We haven't subscribed to any newspapers for over a year, now, although this paper used to be one of the three to which we subscribed. Normally I'd let the call bounce into Voice Mail but I decided I needed to talk off some steam and this solicitor would be my audience. I picked up the phone.
    I was right. Poor soul. As soon as he'd finished his spiel, which involved telling me that he'd "noticed" that we used to subscribe and perhaps he could convince me to re-up, I started in. I explained that I love newspapers. I used to be a journalist. I used to work in circulation and layout, as well. I used to subscribe to all kinds of papers. I used to keep a huge clipping file going back years. I even created a database for it on my computer. But, I continued, here's the problem: I take care of my 87 year old mother, now. I've been doing this for a long time. Some time over a year ago when her care became intense, I continued, I realized I was no longer reading the newspapers and stopped the subscriptions because, as it turned out, I was paying to recycle fresh newsprint. I'd love, I said, to read newspapers again but I have a feeling that isn't going to happen until my mother "passes on" [why disturb his day anymore than necessary with the word "dies"]. If I'm lucky, that won't be for a long time, but, you see, that means that I won't be subscribing to newspapers, either, for a long time.
    Ever the savvy salesman, he suggested that perhaps I might be interested in their "Sunday Only Special". If nothing else, he said, I could use the coupons.
    I laughed. "You know," I said, "my addiction to newspapers means that every once in awhile, if I happen to be at the grocery on a Sunday, I can't resist picking up the Sunday edition. But a week goes by, then two, and the paper is still sitting on the table unread, the coupons unclipped, and I finally stopped doing that. I'm sorry," I said, "I'd love to subscribe but it just isn't practical, right now."
    The fellow sat quietly so long I thought he might have hung up on me.
    "Hello," I said, testing the silence.
    "I'm here," he said. "Wow. You have your hands full. I see what you mean. Well, good luck to you, and your mother. It sounds like you're taking good care of her. I'm sorry you can't subscribe to newspapers, anymore, but I understand."
    I suddenly felt volumes better, thanked him for his understanding, and we disconnected from one another.
    Cheap sympathy, I know, but, sometimes, the cheap stuff works.

 

I forgot to mention...

...her bowel movements timed themselves perfectly for ease of travel yesterday. This was the only disappointment in our trip cancellation. I decided to encourage the production of one today by feeding her, as often as possible yesterday, the artichoke salad I'd purchased for the trip which is rich in green olives. With a little luck her bowels will clean themselves out today and tomorrow will be an easy, pleasant journey, full of new doctors and old friends.
    Item for today's To Do list: Get more artichoke salad for the trip...enough so that we'l have plenty to share with friends. And, don't forget the ice! I also plan to stop by the rental agency and do all the paperwork ahead of time so all we'll have to do tomorrow is pick up keys, transfer traveling goods and hit the accelerator.

 

Yesterday's Game Called on Account of Brushfire on I-17

    I kept my ear to the phone all morning, following all the promises of opening and then their abortions until, at 0730, it was finally announced that I-17 would be closed most of the day while crews beat back the fire between Bloody Basin and Black Canyon City. I had no problem moving all our plans to Thursday, tomorrow. Most of yesterday I recuperated from the very short sleep (maybe 4 hours, and that's optimistic) the night before. If I know I have to run on empty I can do it with panache, but once I realize I don't need to I collapse. We both had a very lazy day.
    We could have taken the Wickenburg road but I was sure everyone and their dog (in separate vehicles) would be on that road. It involves a 20 mile stretch of hairpins that is posted at 25-35 mph and can't be negotiated much faster than this, especially considering that there are always big rigs traipsing up and down that route and, yesterday, all of them would be heading that way. When I called the auto rental company at 0800 to push our reservation to Thursday and mentioned this, the rep said she'd heard that the Wickenburg road was "a mess". No guarantee that we would have made Mesa in time for our appointment.
    As of last night the fire was 50% contained well away from the freeway and it was open, once again, with signs posted to slow and watch for fire crews. I'm sure by tomorrow it will be clear and running at its usual pace.
    Bless my mother and her adventurous spirit: When I informed her of our change in plans she accepted the situation with equanimity, then added, "Wouldn't it be fun, though, to drive through the area and watch the fire and the crews at work?!?"
    What a woman!

Monday, June 20, 2005

 

I decided we'd rent a car for the trip...

...since one of ours has a dead battery as of today and the other has an iffy a/c fan. Thus, I'm feeling much better about the trip.
    So much better, in fact, that I talked to my friend, begged her forgiveness for being an ass and we're going to spend the late afternoon and evening at her house before heading back up the mountain.
    Mom's side is significantly better today. I'm anticipating that there will be no need for x-rays; what good would they do now? Her knee is "giving her fits", but that's easily handled.
    No more stats today. I'll take a Blood Glucose in the morning to see how she's doing but I don't anticipate any surprises.
    Later, probably late tomorrow night or the next day.

 

I am, by the way...

...feeling unusually good, today. Can't imagine why. I had a restless night...probably only got about 5 hours sleep in all. I was up once, in the dark, drinking tea and mulling. But I feel great, now, very optimistic about tomorrow.

 

In case you're interested...

...there's a detailed description of Mom's Rising this morning over at the Daily Tests & Meds site. If I manage to post much information about our day today it'll probably be scattered. I'll try to keep a running tally here.
    Later.

 

I just entered Mom's lab results...

...from draw date 6/17/05. They can be accessed at the links below:
CBC/BMP
Urinalysis
    Her BUN is back up and there was an indication of "moderate" red blood cells in her urine, to which I've appended a note on the test posting. Even though her anemia indicators appear to have dropped a bit here and there they are within her normal range. As far as I'm concerned, she's holding loose. My concern would only heighten if she drops any more and significantly next month. I happened to notice that there is a CBC posted for exactly a year ago. I couldn't help comparing. This CBC was taken after her transfusion. She appears to be doing better this year on most of her anemia indicators and holding steady on all others. Good. I'm satisfied.
    We're spending today getting ready for the trip tomorrow.
    I only took one set of BP and BG stats, yesterday. We did perform a much modified and aborted exercise session yesterday because her side seemed to be giving her so little distress. You can check out the results at the previous link. I gave her only one tablet of extra strength acetaminophen once yesterday after the exercise session with some yoghurt and she took a looong nap. Once back up, though, she stayed up until around midnight. She seemed in a good mood but subdued. I questioned her a lot about her side all evening and she seemed to be experiencing no pain under any conditions. She was ravenous at dinner, which didn't surprise me as her "lunch" was more like a snack for the purposes of taking the acetaminophen. I asked her what she wanted for dinner, she said "a hamburger" and that's what she got.
    I'll be awakening her shortly. I've checked up on her a couple of times and she's snoozing deeply and peacefully. Noon will be her twelve hour point, good time to rouse her.
    Looks like it's going to be a moderately warm day tomorrow both here and in The Valley. I expect we'll leave about 0900 and be back sometime late in the evening if all goes as planned.
    There was an article in the New York Times yesterday about Steve Case's new venture, Revolution. The website doesn't give much more than blurbs about the project but the article, which appears to be accessible only if you are registered with NYT (it's free) and, thus, will only be available for seven days, has a bit more about about his goals for the medical end of this project. The part that interests me specifically is his idea for developing companies to provide what he calls "Health 'concierges' or 'coaches' who help patients navigate the medical system." If you've been a regular reader here for awhile, you know that I talked about this, briefly a while back. I plan to comment on the article later but probably not today. Hmmm, I can't seem to get the target to work although it's coming up on the right page. Mom's up, though, so I'll work on it...
    ...later.

 

Blood Draw Review: 6/17/05

Faxed to Office 6/18/05 in preparation for appt. at 1300 on 6/23/05:

TO:  Wondrous FNP (to whose attention I was instructed to direct it, even though I'd already been informed that we'd be seeing Dr. New [vs. Dr. Neo]) - Name of Medical Clinic
FAX:  #
FROM:  Me
RE:  Mom - SS# - Review of Health since 5/21/05: Last review should be on file in your records.

Blood Pressure:
No change since last review - I’ll bring new chart with us to appointment.

Blood Sugar:
No change since last review - I’ll bring new chart with us to appointment.

Urinary Issues:
No change since last review - AND NO UTIs!!!!

Hydration:
No change since last review.

Energy Level:
Continues slow improvement. Doing more walkering outside and regular therapy exercises for strength and flexibility.

Skin Condition & Circulation:
No change since last review.

Appetite & Diet:
No change since last review - continues to get one 8 oz. serving of non-fat, artificially sweetened yoghurt per day in order to help counteract UTIs. Seems to be working.

Dementia:
No change since last review.

Will & Spirit:
Remain strong and high, respectively.

Medication:
See Medication & Supplement Review faxed 6/16/05.

Bowel Movements:
No change since last review.

Blood Draw & Urinalysis:
6/17/05 was draw day. Results should be completely faxed to you from lab by the end of business day 6/20/05. I should have my results in hand when we arrive for our appointment on 6/21/05. I expect no significant changes from last blood draw.

AS AN ADDED NOTE: All the information above and more is detailed in the following web logs which I keep on my mother (don’t worry, they’re not required reading; just thought this should be in her file in case someone wants to look something up):
The Mom & Me Journals dot Net: General day to day stuff and personal commentary on all aspects of my mother’s life and taking care of her. Thousands of words. Searchable.
Mom & Me Daily Tests & Meds: Daily record of blood pressures, blood glucose readings, changes in meds. Earlier archives also include detail of daily meals. Searchable.
Mom's Test Results: All test results recorded back through 8/1/00 which I’ve been able to procure (I think I’m missing only one x-ray report from a doctor here in Prescott who dismissed us after only a few appointments, and a few urinalyses taken last summer through the Urgent Care Clinic up here). Searchable.
=>Moving =>Mom: Started last fall, went through a hiatus this winter when it was impossible to get her to move much. Recording of all ‘formal’ exercise sessions, including descriptions of exercises, reps and sets and performance. Recently started reporting on her walkering sessions, as well. Not Searchable.

ALSO:
    Thank you for the holdover RX for lisinopril.
    I think she may have bruised her right side internally above the waist and below the rib cage during a walkering incident on Wednesday, July 15th. She reported it as a “side cramp” on Thursday and refused medication for it, although I’ve cancelled all walkering and exercise sessions for the time being. She is continuing to get around normally, though, without pain and no other health indicators seem to be affected. It just bothers her when she leans over. As of Friday, July 17th, I started her an 100 mg acetaminophen 3 times per day, which seems to alleviate it, and she reports that it is “getting better”.
    Sorry this is a day late. I was worried about her yesterday, although she seemed to do just fine, and didn’t want to leave her alone even when napping, just in case.

All material copyright at time of posting by Gail Rae Hudson

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