Mom & Me Three Archive

...and, already, I'll be glad when it's over," I told my mother as I tucked her into bed tonight.
    She laughed. "Aren't you glad I don't want to travel anymore," she responded.
    Yes. I am. We'll be back home probably about 36 hours after we leave. I'm shaving the amount of stuff we have to take by deciding I'm not going to take any stats, thus we don't have to take her monitors. We'll be eating one meal, possibly two, out, thus I don't have to take food for those meals; since we will be in Phoenix I'm taking decidedly less oxygen than we might otherwise; we'll take her walker but not the wheelchair. Still, there is an amazing amount of stuff I've been collecting and packing today:

• extra sets of clothes, in case she leaks through;
• a plastic sheet for her bed and pads to put on top of her sheets, just in case (she's very concerned about wetting her sheets at a motel);
• a carefully figured number of paper underwear which still fills, with the folded bed pads, one entire Depends box;
• pills (both meds and supplements) for 36 hours for her and me, plus Tums for her in case her stomach gets upset, acetaminophen in case her knee or back bothers her and metoclopramide, just in case
• extra towels and washcloths, as I know the hotel won't have as many as I use on her;
• all her bathing and grooming stuff;
• all mine, too, which is nothing compared to hers
• all her regular food for Saturday, plus food for MPS;
• her magazines and a crossword puzzle book
• baby wipes and paper towels, just in case;
• napkins, plastic eating utensils and durable cups and glasses;
• sunglasses, sunblock, tissues.

    It is amazing, how many things I do for her everyday without thinking that, when broken down into units of activity, concern and stuff, become close to overwhelming for just a short trip. I can't even imagine traveling with her any distance for any length of time. She can't, either. It exhausted her today watching me prepare. She took an extra long nap this afternoon, which was fine with me. It gave me more uninterrupted prep time.
    Although I considered this trip a practice for other possible trips, I'm convinced, now, I don't want to do this very often. Mom was right some months ago when she said, "Let them come to us." Absolutely.
    To bed.
    Later, probably sometime Sunday.

...and cautioned me that she only wanted to sleep an hour, which I'll honor, it's been a pretty lazy day. She asked at breakfast if there were anymore Mary Tyler Moore episodes left on "that tape". We still had a litle over half the episodes to go so, at her request, we spent the day finishing off the second season. After each episode she said, "That was a good one. I'd forgotten about that one." Good gift, I think. I knew when I got it I'd probably have to endure a couple of days of nothing but MTM, but it was worth it. Much of the comedy, of course, is timeless, and the outfits are amazing. I'd forgotten about all that stuff.
    Today is the first day we haven't turned on fans. I turned them off this morning soon after I awoke at 0630 and turned on the fan at the Arcadia door in my bedroom that draws air from our back yard into and through the house just a few minutes ago. It's been cloudy and there have been some periods that my mother would call dreary. The pressure has been up and down as storms have passed close by, but no rain today.
    Over the last few days I've noticed something: Since she's been taking the daily Macrodantin her day leaking is down to almost nothing. She still leaks at night, although for the last few nights she's awakened in the middle of the night to go to the bathroom, so her shedding overnight isn't as bad as it was just a week and a half ago. I guess the antibiotic is doing good work. Now, if I can get her moving a little more we might have a couple of eliminatory problems fairly licked and her energy level might improve. As well, over the last week beginning with last Thursday when her empty oxygen tanks were replaced, she's used very little oxygen when she's up and sitting. I only give it to her when she's mouth breathing and looks a little pale. Since last Thursday her mouth breathing has been confined to when she's walking around the house going to the bathroom, throwing away her Kleenex collections, etc. Maybe she needed the antibiotic for some other reasons, as well. If I can get her moving enough to edge up her aerobic capacity it's possible that we're in for a period of renewal before the inevitable. The woman amazes me.

...full of sleep, the second season of Mary Tyler Moore (her birthday present from me) and my mother's savory eating requests. We got in only two meals; a breakfast with buckwheat blueberry pancakes covered with maple syrup and a dinner of tomato bisquit pie, in which Mom suggested we include green peppers, which I did and which was successful despite the green peppers competing for nose time with the basil in the crust, with Costco chocolate cake. Normally if dessert is being served we have a Just Desserts dinner or she waits for a couple of hours after dinner to have dessert. Last night, though, she surprised me by deciding, after a healthy slab of the dinner pie, that dessert was immediately in order. I allowed her to name her size on the cake. After jokingly asking how much I was going to have (a very thin slice postponed for a few hours...I'm not much into chocolate; even less than I ever was; maybe because closely watching my mother gorge on chocolate for some years caused me to lose my interest in it), she announced she'd take the rest of the cake, then marked out an inch and a half slice; a reasonable decision.
    The only stats I took were two blood pressures, morning and night, both neatly in her normal zone. The power went out for about 15 minutes during an evening rain storm, which was fun, truly; after I scrounged candles (birthday candles, I guess; the best kind of birthday candles one can have: Power-out candles) Mom talked about her grandfather, who loved storms [from whom I guess I inherited this love]: He would stand outside in the middle of storms in "rain clothes".
    MCS sent an arrangement of lilies that filled the house with fragrance. We chatted (again, excitedly) about the upcoming Saturday during which my mother will be spending the day with MPS. Mom received a birthday phone call from MCF and promise flowers later in the week. When I reminded Mom (again; she's asked me for this reminder a couple of times in the last week) how old she is she looked at me as though I was teasing and remarked, "I couldn't be that old!" She was alert and clear. We talked about Mechanicsville, the people she'd known there, relatives alive and dead (all of whose dispositions she remembered without prompting) and gently mourned those who "should still be alive" (such as her sister and brother, my father and, surprisingly, The Big Girl) but weren't. We talked, too, about the eventuality of her 90s, upon which Mom, once again, cautioned me, "Don't get old, Gail," but continued, "Of course I'll make it to my 90s; why wouldn't I?"
    All in all, a successful day. Mom and I remarked, simultaneously, that it seemed like a Sunday.
    Her light went off last night at 2330 so in 15 minutes I'll be bringing her into The Day After Her Birthday.
    Later.

...and the official anniversary of one year without medical emergencies. No hefty celebration is planned although I've promised her buckwheat pancakes with blueberries for breakfast. I'm going to make that tomato bisquit pie for her birthday dinner, which I'd planned for tonight but which she trumped with another suggestion. I asked her if she wanted anything special in the way of dessert.
    "No, not really," she said, "I usually don't have room for dessert anyway, after dinner," which is true.
    I let it go. Then, maybe 20 minutes later, funny woman, she said, "Do we still have some of that chocolate cake in the freezer? That would be good, tomorrow." It wouldn't, after all, be a proper birthday without sugar and chocolate.
    We don't, but I'll go to Costco and pick one up for her tomorrow before she awakens. I have no idea if we'll have it for lunch or dinner. We'll have it whenever she likes. What I do know is that I won't be taking her blood glucose readings tomorrow, although I will be taking her blood pressure readings. I think, though, once she moves her bowels, and I have reason to believe she'll be experiencing a move 'em up, head 'em out elimination tomorrow (see posting for today at Mom's Daily Tests and Meds for explanation), probably early, her blood pressure will settle back down within 24 hours.
    Happy, happy birthday, Mom. Oh, I'm so glad you're still here. Let's target 90 and see how far we can go beyond that, just for fun.
    Her light went out at 2315.
    Later.

    These were the first words out of my mother's mouth this morning. She's felt this way before; maybe once every two years. It always surprises me, but I know how to handle it.
    "Well," I began, "that's pretty much not possible, but why do you want to stop taking your pills?"
    "I'm constipated and I think the pills are doing it."
    Mind you, she had a bowel movement yesterday and a clean-out movement two days before that. However, considering the only fair volume she eliminated yesterday and the fact that I had to "help" that clean-out movement along with a laxative, I was willing to consider that she is, indeed, regularly building up shit that doesn't get eliminated on schedule, even when some of it does. "Are you feeling constipated right now."
    "Yes," she said, her brow wrinkling.
    "Okay, well, you may be right that the pills are contributing to this." I explained about the recent 'only fair' elimination volume, reminded her of the stool softener induced clean-out movement and reviewed which medications might be causing this. "Your antibiotic mentions constipation as a side effect."
    "And," she added, much to my surprise, "the iron."
    "Well, yes and no. Iron salts do indeed contribute to constipation. The type you're taking isn't supposed to do that nearly as often and all the fiber and olives you're eating have mitigated any possibility of constipation up to a couple of weeks ago. The furosemide you've been taking lately, even though it hasn't been much, doesn't help your colon, either, because it pulls fluid off you. So, I, too, think that your colon isn't eliminating quite as well as it should. I think you're right. I have some suggestions. First, I'll give you a stool softener (ducosate sodium [Colace], 1 tablet) this morning. You have to drink liquids today, more than you usually do, to get it to work, though, and I'll be reminding you. Second, Mom, I'm telling you, exercise of any kind and moving around, even simple moving around, promote regular bowel movements. It doesn't matter which muscles you exercise, almost everything helps to keep those muscles involved in elimination up to snuff. Third, although you're already eating a good amount of fiber we'll up it. How about adding an apple a day? You like apples, right?"
    "Oh, yes! That sounds good."
    "And," I continued, "I'll work on getting more fiber in your diet. Maybe wheat germ in your yoghurt, for instance. You've been refusing it but I'll remind you, now, that you need it."
    "Good. Do that."
    "But, Mom, we've got to get you moving a little more. When you start to fight me on exercising and walking around, before it escalates to the point where I give up, I'm going to remind you that you're constipating yourself."
    "I understand. I think you should do that."
    "Good. The only other thing I could do is get some of that soluble fiber to mix with liquids. When we tried those back in 2002 when you were on iron salts, even low doses caused you to have diarrhea, which is why I've not used those again on you. But, if the other strategies don't work, we'll try that. I'll pick some up the next time I'm at Costco. One other thing we'll try, I'll pick up a bottle of caffeinated instant coffee. Caffeine often promotes regularity. I'll just give you one cup a day, when necessary, in the middle of the day, but that might help, too."
    "Okay."
    This afternoon, although she hasn't had a bowel movement, I've asked her a couple of times if she feels constipated. Each time I ask she looks at me as though I picked the question out of thin air and denies feeling constipated. She hasn't had a bowel movement yet, even with the stool softener underneath her belt. According to her regular schedule, tomorrow is her target day. But I would like to see her eliminatory volume upped, a bit. I've been concerned that over the last month or so she's been having only fair volume movements, followed, after three or four of those, with a clean-out movement which usually causes her some minor discomfort. I'd like us to get back to where we were. This may take some experimenting, especially since the antibiotic will be a daily affair from now on, probably, and it looks as though our use of furosemide, although very light, once or twice a week, will probably continue for the rest of her life.
    Time to make some adjustments.
    I like discussing her care with her in detail. So does she. I know that she won't remember much, if anything, although sometimes her memory kicks in when I least expect it. But just taking her seriously when she wants information or suggests changes in her care and discussing in detail the possibility of making the changes she suggests keeps her feeling as though her life is under her control. Today, for instance, I carefully explained what each medication and supplement was for, what might or would happen if she discontinued its use and gave her choices where choices were appropriate: With her supplements, for instance. Since her supplements are mostly substances that she's chosen on her own and taken for years (even though I've found personally specific reasons for all these supplements), she decided, supplement by supplement, to continue taking everything. She wavered on the iron until I explained to her that the alternate to taking iron was for her hemoglobin to drop month by month, as well as her energy level and sense of well-being, and enduring transfusions when it dropped low enough. She doesn't want to do that. Once she understood, again, what the lisinopril, glipizide, Protonix and Macrodantin do she decided to continue taking those, too. I assured her, more than once, that, all things told, she's actually on very little medication and I continue to work to look for ways to keep her medications from being increased or for ways to reduce them. She knows this and trusts me to make sure she isn't over medicated or dangerously cross-medicated.

    Test results came through today. I've posted them here. I was wrong about a draw for TIBC and Ferritin, which is fine. A reading for iron was taken as a part of the CMP chemistry section. She reads in the normal range. The only out of range reading that concerned me was her unusually low Anion Gap, which can be noted in the CMP section. I talked to MCS about this and we both looked it up in our medical texts. Anion Gap is a measurement of "all other electrolytes" beyond Potassium, Sodium, Chloride and CO₂. We both discovered that a low Anion Gap reading often occurs as a result of taking, among other substances, diuretics, some antibiotics and, get this, licorice. Interestingly, although one wouldn't think her low intake of furosemide would qualify, both her Detox teas, of which she ingests one cup daily (usually strong, since she prefers to keep the bag in the cup as she drinks her tea) contain licorice root. The aroma of the teas, in fact, are strong with licorice. So this not only explains her low reading (she's been minorly low before) but also explains, in part, why the doctor was not concerned about this. As well, MCS's text mentioned that this reading should be considered in conjunction with the other four electrolyte readings. Her other readings are fine.
    All's well that tests well.
    Later.

...my mother asked me what time MPS "gets home".
    At first I thought my mother was thinking that MPS lives here and we were awaiting one of her regular arrivals. So, I told her it was Sunday, a day on which MPS doesn't work, and asked, "You mean home at her house in [the Phoenix metroplex]?" just to make sure to clear any confusion about where MPS lives.
    Mom looked at me as though I was the one in the house experiencing dementia. "Well, of course," she said, and continued, "I want to call her."
    Earlier in the day we had called MCS to thank her for her Best in the Universe homemade bread & butter pickles. I couldn't think of any reason why Mom would think to call MPS today and thought she might be confusing the two, so I reminded her of the earlier call.
    Again I got that, "you aren't listening to me, are you crazy" look. "I know," she stated. I want to call MPS."
    "Okay, I'll get the phone." Out of curiosity, though, I asked her the purpose of the call, even though it doesn't really matter. I just wanted to know where my mother was mentally.
    "About Saturday, of course. I want to firm up the plans."
    This was a complete surprise; she was obviously talking about next Saturday, when she and MPS will be spending the day together at the Traffic School hotel. "You know, Mom, I set all that up with MPS yesterday. Do you want me to go over the plans for you?"
    "No, I want to firm them up with MPS." Very stern.
    Oops. I was stepping on her toes. I dialed the number, handed the phone to her. She confirmed her date with MPS and, at least from what I could gather from her side of the conversation, made further plans regarding what the two would be doing on Her Day Without Me.
    I wasn't going to horn in on the conversation, I even told her before I dialed that this conversation belonged to her, "don't hand me the phone unless MPS specifically asks to talk to me," but just as Mom was obviously getting ready to sign off I motioned that I wanted to speak to MPS.
    In case it wasn't obvious, I remarked that Mom was very excited about their day together, so excited that she's talked about little else since Saturday morning when I told her about the plans. So excited that she has a clear memory of these plans and is anticipating the visit at least as much, if not more, than she's anticipated any visit. MPS was thrilled.
    So am I. I'm sure part of the reason Mom is so excited is that she knows she'll be spending time with one of her "other" daughters without me around. It pleases me that she's looking forward to this for a couple of reasons. First, the only times she feels confident about being alone with others are when she's feeling very good physically. Second, she and I both need occasional breaks from each other but those breaks only work well when Mom is confident about being around other people without me. Third, I can completely relax while I'm doing what I have to do, knowing that MPS and Mom will be reveling in their time together alone.
    This bodes well, I'm thinking, not only for the visit, but for the possibility that Mom might be amenable to trying out the Senior Day Care, again, as long as she's feeling good (and confident).
    It's tricky. Sometimes when we have visitors or are visiting, when I leave the room she worries and asks repeatedly where I am. I don't think that's going to happen next Saturday. I think, in fact, that when I return to the hotel room after class Mom will tell me that if I want to leave again it's perfectly okay with her. When we take MPS's family out to dinner Saturday night she's going to have one of her "I don't need Gail" episodes and I'll become the delighted (this time) butt of a few of her humorously snide remarks designed to show that she's just fine on her own, thank you. Moments likes these help to make life more than bearable for both of us and serve to remind Mom and me that, above all, when it is possible in the context of An Ancient One's life to allow that Ancient One a feeling of independent mobility in the world, these moments should be seized and savored, as they will cast a redeeming glow over all other moments.
    Time to awaken The Mom.
    Later.

...that I promised to set up a type of introductory page, divided into sections such as, for instance, Dementia, Medical Misadventures, Bowel Issues, Caregiver Help and Lack of It, etc. I started by searching specific keywords but that wasn't working very well; I was missing a lot since, as you know if you're a regular reader, I often use a variety of phrases to refer to the same item or issue. So I've begun reading everything I've written from the beginning in order to catalogue and table it correctly. It will take awhile. When I get a fair amount of material worked into areas of subject I'll begin the index. Don't look for it for awhile. Reading and writing don't necessarily mix, so many of you will be pleased to hear that posts will probably be shorter and more to the point.
    Today started very well but as the storms moved close this afternoon Mom began to feel a bit run down. She's napping now, but stayed up longer than usual after breakfast.