Mom & Me Three Archive

...over at Mom's Daily Tests & Meds.
    Over the next week (I imagine it will take at least that long) I'll be setting up some introductory pages to this group of sites about my mother and me. I'll be setting up the link to the initial page immediately below the site description on this page. From that page there will be at least one other: A page that has ready made, significant links to a variety of subjects involved in taking care of an Ancient One such as: dementia, dealing with the medical industrial complex, hydration in the elderly, well, you get the gist of it. I figure, with all the words and words and words here, it might help people negotiate the site.
    Time to awaken Mom from her nap. Looks like it might rain! Cool!
    Later.

    Last night, "as I laid me down to sleep", I noticed something curious about my mind, or, perhaps it would be more accurate to say, my heart, maybe my soul. It was at peace. I rummaged back through my recent past and noticed that the seed of peace that appears to have settled into the foundation of my internal life seems to have been sending up shoots to entwirl everything I've felt, thought, said and done in the last few weeks. I drifted into sleep smiling.
    Considering my expressed displeasure with my mother's latest physician, my resulting (and expressed) increased skepticism of the medical industrial complex, the repercussions of that expression, my negotiation of those backlashes, and everything else that's happened lately, remarkable or not, I might have been inclined to assume that I am internally unsettled. This doesn't seem to be the case, though.
    This morning, while considering my most recent tranquil night and the unbroken string of immediately previous similar nights, I realized something: Peace does not mean lack of activity or lack of thought at odds with reality; the kind of thought that causes one to attempt to manipulate reality. It doesn't mean acceptance beyond reaction nor the inability to be moved into exultation or anger. It means, I think, lack of attachment to possibility. I remember freaking the last time I managed to get my mother dismissed from the active patient roles of a physician. This time, not only did I not freak, I smiled after reading the dismissal letter, which I wasn't expecting. I don't remember suddenly and agitatedly activating in a direction I hadn't anticipated, I remember continued smooth engagement as I noticed an upcoming curve and readjusted my muscles for negotiation.
    It's possible that this undercurrent of peace is primarily generated in my physiology, a result of my body settling into post-menopausal calm. Perhaps its psychological/emotional/spiritual, a result of knowing that I'm where I'm "supposed" to be, doing what I'm "supposed" to do. After considering the possibilities for a short while I realized I don't care about its genesis. It's just wonderful to be having this time. "Wish you were here."
    Later.

...maybe I'll update stats...
    ...later...

...the doctor responded and we've been dismissed, once again, from a doctor's care. Not to worry. Within two hours we were back with our former PCP who originally treated us through the same clinic from which we were bounced. I've published both my addressing of the problem, the physician's response and my thoughts about the entire episode in the following two essays:
Medicine in the Hot Seat
Physician in the Hot Seat
    You can also access them through the links to the right. They are the two latest essays added to my essay site.
    I know it's hard to tell, when I don't write in here for awhile, whether that means our days have been going well or badly. They've been going well. Here are a few updates, in the order in which I think of them:

• Not too long ago I called MCS and said, "I thought we might have another summer or two when Mom heated up nicely and was more active than in winter, but I guess the summer of 2004 was the last." Despite what I do or say, Mom has hit a plateau of inactivity that, I guess, is going to remain summer and winter.
• We have an appointment for the initial reunion with our former PCP next Thursday, July 21st, at 1400. I'm looking forward to it. My mother, of course, who is never interested in going to the doctor, is looking forward to the trip but not the appointment.
• No more UTI's since the last, which occurred immediately after our last doctor's appointment. Thank the gods.
• We're now using the window a/c in the living room regularly in the afternoon. I also purchased a room evaporative cooler for the back of the house. I intended it for Mom's room but the older she gets the more she wants heat. We tried it in her room the day I bought it during her nap. She complained about the cold. I swear, her room is a hot box, but that's the way she seems to like it. When she's up, though, in the living room, she prefers our home somewhat protected from the heat. The house probably remains, during the day, around 85°F. Comfortable for both of us. I keep a good breeze going through with several fans even when the windows are closed when the a/c is on during the day. The evaporative cooler seems to help her breathing during the day, as well.
• As of yesterday I've been negotiating a slight CHF incident. Although her fluid retention isn't extraordinary, when she awoke this morning, again, second day in a row, with slightly pudgy feet I gave her 20 mg furosemide at breakfast. Lately I've instituted a policy of no naps if I can't get her up (I can always awaken her...I just can't always get her up and moving, anymore) after twelve hours of sleep. Today, though, the furosemide went to work and the watershed seemed to tire her. I wasn't planning on allowing her a nap today but I gave in when I realized that I wasn't going to be able to seduce her into her normal wakeful alertness. I told her, though, two hours only, that's it. I expect that by tomorrow she'll be fine, although not necessarily willing to spend more time awake.
• I'm doing well, thank you. I wasn't even phased by the second doctor's dismissal. I did, by the way, for those of you who are interested, check once again with the Veteran's Hospital to see if the policy on a freeze on accepting new veteran patients has changed. It has not. It is still based on whether the veteran was seen at a veteran's facility since 1997 and income. My mother makes more than the cut-off. This time, though, the eligibilityy person advised me to contact our congressman and express her displeasure over the current policy. She also gave me the number for our congressman's liaison. I will be contacting him, although I doubt that anything will be done soon. She also mentioned that there is a bill being considered by Congress that would allow any veteran eligibility if that veteran paid a one time fee for future service. She had no information about how the fee would be determined. I will be looking into this legislation. If I remember I will report back here. In the meantime, if we have an emergency, my inclination is to transport her, myself, down to whatever hospital our PCP is practicing through, regardless of the emergency. I'm not happy about the possibility of having her inadequately treated at the emergency room here again. I have another idea, as well, but, before I activate that idea I need to do a little more thinking about it.

    I'm looking forward to the coming monsoon. So is my mother, surprisingly. This is the first time I think I've ever heard her say, "I wish it would rain." I don't think it's the relief from the heat to which she's looking forward; I think it's the regreening of our property. Despite all the rain we got last year, Prescott citizens are now on voluntary water restriction. Just last week the city began considering making the restrictions mandatory. It's beginning to look a little brown around the edges, here.
    Well, she just arose, taking a shorter nap than I'd expected. Her body is continuing to hold onto fluid, although it's releasing some. I just gave her the other 20 mg (a half tablet) of furosemide with her lunch.
    Time to be with my mother again in more than spirit. I hope to update her stats later this evening.
    Later.

    It appears as though I discovered the answer to that question tonight [see Tonight's Dinner Stats; this link will take you directly to the specific post]. Perhaps you will recall that at lunch today I administered no type 2 diabetic medications to my mother, only supplements, including 1/4 tsp cinnamon and 2 oz aloe vera gel juice. As well, she had exactly the same lunch today as yesterday and a breakfast with less sugar in it than yesterday. A half hour before dinner tonight, her blood glucose tested at 158; actually, somewhat lower than I was expecting but definitely higher than I'd hoped. Considering what I learned yesterday regarding adding another 10 mg of glipizide at lunch to her medication regimen, I think I am very close to hitting on the correct way to medicate her for her type 2 diabetes without using metformin.
    Keeping in mind that she received 1 dose of 225 mg of metformin at breakfast yesterday, I've decided that tomorrow I will administer 10 mg glipizide 1/2 hour previous to all three of her meals and use the aloe vera supplement at both breakfast and dinner, to be administered with her glipizide. I'm hoping this will work. I'm going to start with 1 oz at breakfast and 1 oz at dinner; this is the recommended dose. However, since I don't know whether I'm giving her 80% aloe vera gel juice and I can't tell from today's experiment whether the aloe vera gel juice worked (it may have...she may have been quite a bit higher if I hadn't given it to her) tomorrow should fill in some of my knowledge gaps.
    Although she has been dragging most of the day today and was very reluctant to arise from her nap this afternoon, she's quite lively tonight, except for a congested cough. She ate a good dinner, has been drinking fluids pretty well and is leafing through The Joy of Cooking marking recipes that pique her interest with playing cards, such as (she's so funny and so predictable) waffles, pancakes and French toast; a page with a variety of chocolate shortbreads; a page on the decorative art of powdered sugar dusting...you can take the sugar out of the woman but you can't take the woman out of the sugar, I guess.
    Earlier this evening we had what is a continuing discussion addressing her fear of developing Alzheimer's. Forgive me if I've written on this before. It seems as though I may have recently but I performed several searches and couldn't seem to find anything. When we discuss this it is because Mom brings it up and uses the following sentence toward the beginning of these discussions, "Mother [her mother] had Alzheimer's, you know."
    Actually, since the family did not ask for an autopsy this is not known, although because of her mother's behavior in her last years (I'm thinking between 5 and 10 years, but I may be off on the long side) the chances are fair to good that her senility was Alzheimer's. Whether or not it was, she traveled into advanced dementia and probably died of this. Many of her senile behaviors were specific to Alzheimer's also not exclusive to it. In the beginning she hid things and she wandered. As her senility advanced she hallucinated and had an urgent need to "go" somewhere, a where she could never define. She not only lost touch with her friends and loved ones but with herself. During her final days, which she spent in a nursing home, she curled into a fetal position. By the time she was my mother's age, she had begun to exhibit the first of these behaviors with abandon.
    My mother's sister also traveled into moderately advanced senility. The family referred to her senility as Alzheimer's but I don't think it was. Her senility developed very quickly and at the beginning was pronounced by at least one of her physicians as stemming from malnutrition due to advanced alcoholism. She did, at times, exhibit a need to "go" somewhere, but the most significant characteristics of her senility were constant, severe fogginess and a lack of ability to do anything for herself. There were certain aspects of her character that she did not lose and which she exhibited often. As well, she paused at a certain point and never went further.
    Tonight, when my mother, once again, voiced her fear, we talked about all these aspects of senility in her family. I also reminded her that she takes after her father's side of the family.
    "That's true," she agreed.
    "Grandpa certainly became forgetful, and he lost interest in life close to his death, but he did not lose himself, nor did he lose the ability to remember those who were significant in his life and who he'd encountered many times throughout his life."
    "I know," she said.
    "Grandpa also never stopped telling stories about the past."
    She glanced at me sardonically. "Are you suggesting something?"
    We both laughed. I reminded her that she doesn't tell nearly as many stories as Grandpa did, nor does she repeat them nearly as often, but she has her moments.
    So she'd know that I wasn't trying to josh her into a false sense of security, I reminded her that she's occasionally mistaken me for her mother, students of hers from scores of years ago or treasured friends.
    "I have!?!" she said. "Does it bother you?"
    "Not at all! You always mistake me for someone you love a lot, and that pleases me."
    She grinned. "Well, good!"
    "I'll start to worry when you mistake me for someone you hate."
    "I don't think that'll happen," she said thoughtfully. "I can only remember one person I've hated, and that was a man. Have I ever mistaken you for a man?"
    "No," I assured her. "You haven't."
    "Well, it bothers me that there is so much I can't remember."
    "That's why I'm here," I told her, something I say to her often when she needs reassurance. "I remember the things you need to remember, and, if I don't remember it it's probably not important."
    Once again, she displayed that wily grin. "Probably, eh? How many things have you forgotten that you shouldn't've?"
    "It's probably a good thing that neither of us knows the answer to that question," I said.
    She cast a wizened glance my way. "I'm sure you're right about that."
    She went to bed about 45 minutes ago. We had a very good evening. I told her this as I settled her into bed. "I was worried earlier today but you seem to be feeling much better than you were before you took your nap."
    "You don't need to worry," she said. "We're just fine."
    Through it all, through every step of the way, whether I'm feeling optimistic or pessimistic about what's going on, underneath it all, I agree with her.
    Now it's my turn. The second drying cycle just ended. Time for me to go to bed.
    Later.